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Biomedical subjects

M Kajiyama

Publications and source records attributed to M Kajiyama.

At least 37 records · Page 2Linked to original sources

[Evaluation of neo-adjuvant chemotherapy for oral squamous cell carcinoma].

In the present study, we investigated the clinical and histopathological effects of CP therapy consisting of cisplatin (CDDP 50 mg/m2) or carboplatin (CBDCA 300 mg/m2) and peplomycin (PEP 5 mg/day) for 25 patients with oral squamous cell carcinoma. The effects of treatment and associated complications were as follows: 1) Complete response (CR) was achieved in 8 and partial response (PR) in 14 of the 25 cases. The overall clinical response rate was 88%. The histological response rate was 64%. 2) The clinical effects were not always consistent with the histopathological effects. There were discrepancies between the clinical and histopathological effects, especially in PR determined by clinical findings. 3) The principal adverse reaction was gastro-intestinal disturbances, but symptoms were able to be controlled. Signs of hematologic toxicity and renal disturbance were mild and did not preclude the continuance of therapy. The results of this study indicated that neo-adjuvant chemotherapy with CDDP and PEP was highly effective for the local control of oral squamous cell carcinoma.

Adult↗

Quantitative analyses of correlations of signal intensity on T1-weighted images and T1 relaxation time with copper concentration in the rat liver.

RATIONALE AND OBJECTIVES: To evaluate the effects of intrahepatic copper on magnetic resonance (MR) images, we studied the signal intensity (SI) of T1-weighted images and the T1 relaxation time of Long-Evans Cinnamon (LEC) rats, which have abnormal copper metabolism, and compared them with those of Sprague-Dawley (SD) rats. METHODS: We imaged the livers of four LEC rats before they developed hepatitis and four SD rats. The SI ratio of the liver to a phantom of polyvinyl alcohol gel was measured on T1-weighted images, and the T1 relaxation time was obtained from calculated T1 images. Copper concentration was measured by atomic absorption spectrophotometry. RESULTS: The mean copper concentrations in the liver of LEC rats were approximately 20-fold and statistically higher than in SD rats. There was no significant difference in the SI ratio and the T1 relaxation time between the LEC and SD rats. CONCLUSION: Intrahepatic copper does not significantly influence either the SI of T1-weighted MR images or the T1 relaxation time of the rat liver.

Animals↗

Blood pressure response during dental surgery.

To investigate blood pressure and pulse rate responses to dental surgery, 21 patients 18 to 73 years of age (mean age, 42 +/- 4 years) who visited our hospital for tooth extraction were studied. Before dental treatment, the patients underwent a mental arithmetic stress test, electrocardiography, and an anxiety evaluation with the State-Trait Anxiety Inventory. Baseline blood pressure and pulse rate were 118 +/- 4/70 +/- 3 mmHg and 69 +/- 2 beats/min, respectively. Blood pressure rose by 24 +/- 3/17 +/- 2 mmHg during the mental stress test, and the magnitude of the rise in systolic blood pressure was significantly correlated with age (r = 0.81, p < 0.001) and baseline blood pressure (r = 0.56, p < 0.01). After the topical injection of local anesthetic containing 1: 80,000 epinephrine, a transient increase in systolic blood pressure was observed. The maximum blood pressure and pulse rate increases during dental surgery were 24 +/- 4/13 +/- 2 mmHg and 17 +/- 3 beats/min, respectively. Similarly, the rate pressure product increased from 8,196 +/- 486 to 11,802 +/- 682. The magnitude of the blood pressure increase during dental surgery was not correlated with age, sex, family history of hypertension, baseline blood pressure, anxiety score, or response to mental stress. On the other hand, when the subjects were divided into two subgroups according to the blood pressure response during dental surgery, the larger response group (increase in mean blood pressure greater than 15 mmHg, n = 9) required a significantly larger dose of local anesthetic than did the smaller response group. The number of cases of pericoronitis of the third molar tended to be greater in the larger response group. These results indicate that an increase in blood pressure during dental surgery cannot be predicted on the basis of baseline blood pressure or the response to mental stress, but is related to the cause of tooth extraction and the volume of local anesthetics required to control the pain.

Adolescent↗

[Quadricuspid aortic valve: report of a case associated with severe aortic regurgitation].

A case of quadricuspid aortic valve is reported. A 53-year-old man was admitted to our hospital for exertional dyspnea. He had a grade 3/6 to & fro murmur along the left sternal border. Aortogram showed grade 3 aortic regurgitation. The aortic valve consisted of two equal larger cusps and two equal smaller cusps, and a supernumerary cusp located between the right and noncoronary cusps. Aortic valve replacement was performed successfully and his post operative course was uneventful. On histological examination, the resected cusps showed fibrotic thickening and no sign of previous inflammatory disease. Quadricuspid aortic valve has been extremely rare. 27 Japanese cases of quadricuspid aortic valve which were corrected surgically are reviewed.

Aortic Valve↗

[A case report of right-sided cardiac and pulmonary thromboembolism treated by emergent operation].

A forty-four-year-old man with a clinical diagnosis of diabetes melitus and severe obesity (height 170 cm, weight 108 kg) was admitted to the hospital on 12th January 1995 because of acute myocardial infarction, and on 21st January, he was referred to our hospital with sudden onset of shock, bradycardia, loss of consciousness in spite of having recovered well from myocardial infarction. The echocardiography and pulmonary arteriography revealed a pulmonary embolism and a tumor in the right atrium. Administration of tissue plasminogen activator (TPA) was not sufficiently effective. An emergency operation (pulmonary arteriotomy, right atriotomy, milking of bilateral lungs) with cardiopulmonary bypass revealed a massive consecutive thrombus, which occupied the right atrium, right ventricle and bilateral pulmonary artery. The postoperative course was uneventful.

Adult↗

Magnetic resonance imaging of Long-Evans cinnamon rats as a new model of hepatocellular carcinoma.

RATIONALE AND OBJECTIVES: Following hereditary hepatitis, Long-Evans Cinnamon (LEC) rats spontaneously develop hepatocellular carcinomas (HCC) histopathologically similar to human well-differentiated HCC. We demonstrated that LEC rats are an appropriate model of evaluating magnetic resonance (MR) imaging of well-differentiated liver tumors. METHODS: Six 23-25-month-old LEC rats were studied using liver MR imaging and histologic observation. RESULTS: Signal intensity of HCCs without cystic areas was normal or slightly high on T1-weighted images and slightly high on T2-weighted images. Histopathologically, most tumors resembled human highly or well-differentiated HCCs. CONCLUSION: The LEC rat is a good model of investigating MR imaging of well-differentiated HCC.

Animals↗

[A case report of primary pulmonary artery sarcoma].

A 49-year-old man was admitted because of dyspnea and generalized edema. CT scan pulmonary scintigram and cardiac catheter examination revealed pulmonary arterial obstruction due to a tumor associated with right heart failure. The tumor was extirpated as much as possible by a pulmonary arteriotomy under cardiopulmonary bypass. Postoperatively, right ventricular pressure decreased to about 40 mmHg while PO2 increased to the normal level. Histological examination of the tumor revealed rhabdomyosarcoma arising from the pulmonary artery. Chemotherapy consisting of a single course of CDDP and adriamycin was administered.

Humans↗

[A case report of traumatic diaphragmatic hernia treated by thoracoscopic surgery].

A 56-year-old man who had been accidentally hit on the right side of the chest about 20 days previously was admitted because of intractable cough. Chest X-ray and CT scan revealed a right-sided diaphragmatic hernia and slight pneumothorax. No other hemorrhagic or perforative complications were detected. On the third hospital day, the patient underwent therapeutic thoracoscopy. Herniated transverse colon and liver were repaired through the abdominal cavity and the lacerated diaphragm was sutured through four thoracoports with video system assistance. The postoperative course was uneventful, and the patient was discharged 28 days later.

Endoscopy↗

A simple surgical atrial septectomy for complex congenital heart disease.

A simple method of surgical atrial septectomy using a rongeur (Kerrison bone-cutting forceps), which is used in neurosurgery, is described. The closed rongeur is inserted into the left atrium through the right atrial appendage and the atrial septum. Then it is opened and the edge of the atrial septal defect and/or patent foramen ovale can be hooked by pulling slowly. The rongeur is then tightly closed again and pulled out together with the resected atrial specimen. This technique is safer and simpler than the Blalock-Hanlon technique or atrial septectomy with extra-corporeal circulation for older infants in whom balloon atrial septostomy is difficult.

Heart Defects, Congenital↗

[A case underwent separate operation for AAE, AR and TAA using elephant trunk method].

A 20-year-old man with Marfan syndrome was recommended emergency operation for impending rupture of TAA. Because he was in the state of acute heart failure due to coexisting AAE and AR, so the simultaneous operations for AAE, AR and TAA were needed. He underwent Bentall, arch replacement and elephant trunk operation utilizing separate extracorporeal circulation and circulatory arrest. Chest CT, taken after 5 months postoperatively, revealed only a small amount of thrombus in TAA. Anticoagulation therapy stood in the way of aneurysmal thrombo-exclusion. The second operation, grafting of descending thoracic aorta, was performed 6 months later and elephant trunk made the second operation easier. Now 12 months passed after the second operation, he is in good health.

Adult↗

Evaluation of tumor markers in patients with squamous cell carcinoma in the oral cavity.

Serum levels of six tumor markers (carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), immunosuppressive acidic protein (IAP), alpha-fetoprotein (AFP), ferritin (FER), and carbohydrate antigen 19-9 (CA 19-9)) were simultaneously measured in 29 patients with primary squamous cell carcinoma (SCC) of the oral cavity to determine their significance. The positive rates were 34.5% for CEA, 41.4% for SCCA, 51.7% for IAP, 0% for AFP, 10.3% for FER, and 6.9% for CA 19-9 in patients with oral SCC. Therefore, CEA, SCCA, and IAP levels, of which the positive rates were significantly different (P < 0.01) from those of control patients without oral cancer, were considered to be of diagnostic value. The sensitivity (69.0%) and accuracy (90.3%) of the combination assay with these three tumor markers proved to be higher than those obtained with individual markers. A combination assay with CEA, SCCA, and IAP could be useful for the screening of patients with oral cancer.

Adult↗

Treatment of isolated growth hormone deficiency type IA due to GH-I gene deletion with recombinant human insulin-like growth factor I.

Biosynthetic insulin-like growth factor I (IGF-I) was administered subcutaneously twice a day for one year to a patient with isolated growth hormone deficiency (IGHD) type IA with high titres of anti-GH antibody (up to 1:1,000,000). During IGF-I therapy he showed good linear growth without any side effects, such as hypoglycemia and anti-IGF-I antibody formation. Administration of IGF-I to IGHD type IA with poor response to GH therapy appears to have a beneficial effect on growth.

Antibodies↗

Growth hormone therapy in achondroplasia.

The status of growth hormone (GH) secretion together with the effect of GH therapy was studied in six children with achondroplasia. One patient had impaired GH secretion, which may, in part, be due to obesity. The pre-GH-treatment height velocity was 3.8 +/- 0.7 cm/year, but this increased to 6.0 +/- 1.0 cm/year in the first year of treatment and to 4.4 +/- 0.6 cm/year in the second year. One patient who underwent GH therapy for 4 years showed good response in height velocity. A considerable variation was observed in response to GH therapy within the treated cases.

Achondroplasia↗

[Safe and easy surgical atrial septectomy for congenital heart diseases].

Surgical atrial septectomy using a Kerrison clamp, which is used in neurosurgery, was done in four elder infants without extra-corporeal circulation. Two (6 and 4 months old) had an atresia of left atrio-ventricular valve with small atrial septal defect, one (8 months) had a transposition of great arteries with closing multiple ventricular septal defects, and one had a pure pulmonary atresia. A purse string suture was put on the right atrial appendage and the clamp in a closing position was inserted into the left atrium through the appendage and the atrial septum. The edge of the atrial septal defect and/or patent foramen ovale was hooked by pulling it slowly. It was closed strictly and pulled out together with a resected atrial specimen. This technique is safer and easier than the Blalock-Hanlon technique and atrial septectomy under extra-corporeal circulation for elder infants for whom balloon atrial septostomy is difficult to be done.

Cardiac Surgical Procedures↗

Effect of long-term calcitonin therapy by injection and nasal spray on the incidence of fractures in osteogenesis imperfecta.

The effect of calcitonin therapy by injection or nasal spray on the incidence of bone fractures was studied in patients with osteogenesis imperfecta. In contrast to injection of calcitonin, intranasal administration of calcitonin twice a week for 2 weeks, followed by 2 weeks of no therapy, was simple and seemed beneficial for decreasing bone fractures in patients with osteogenesis imperfecta.

Administration, Intranasal↗