Biomedical subjects

M Sasagawa

Publications and source records attributed to M Sasagawa.

At least 37 records · Page 2Linked to original sources

PubMed1993

[Evaluation of helical scan CT in the detection of lung nodules of pulmonary metastasis].

The purpose of this study was to evaluate the diagnostic capability of helical scan CT (HS-CT). We investigated the ability of HS-CT to detect lesions by scanning 129 small nodular lesions in the lung field in six cases of pulmonary metastasis. HS-CT was then employed to scan the same regions at table slide speeds of 20 mm/sec and 25 mm/sec. The acquired images were recorded on film and a video tape recorder (VTR), using axial multiplanar reconstruction. We then compared the various images to evaluate the effectiveness of conventional CT (slice thickness: 10 mm, table slide pitch: 10 mm) and HS-CT in visualizing the lesions. HS-CT images acquired at 20 mm/sec and at 25 mm/sec were equally effective in visualizing the lesions. Diagnostic capability was significantly lower in the apical area than in the middle and subdiaphragmatic areas. VTR images were better than film images in terms of diagnostic capability. The disadvantage of VTR images was that VTR processing required much time and labor, and thus is not practical at present. In conclusion, HS-CT is useful in detecting small nodular lesions in the lung field. However, the scanning conditions of HS-CT and interpretation of images, especially in the apical area, require further improvement.

Humans↗

PubMed1993

Continuous 5-fluorouracil infusion causing acute gastric mucosal lesions.

A 59-year-old woman with advanced gastric cancer was treated with continuous 5-fluorouracil infusion for thirty-five days. Endoscopy of the upper gastrointestinal tract was performed due to continuing nausea seven days after the cessation of 5-fluorouracil infusion and revealed multiple erosions in the antrum which were absent before chemotherapy. Continuous 5-fluorouracil infusion was probably the cause of acute gastric mucosal lesions and should be included in the differential diagnosis of dyspepsia in 5-FU-treated patients.

Adenocarcinoma↗

PubMed1993

A follow-up study of resected stomach cancer patients with special emphasis on the incidence of second primary cancers.

The causes of death in long-term survivors of stomach cancer after a gastrectomy have been investigated in a follow-up study of 320 such patients, with special focus on the postoperative development of a second primary cancer. The five- and 10-year overall survival rates of early stomach cancer patients were 87.5 and 75.8%, respectively, and of advanced stomach cancer patients, 44.2 and 37.5%, respectively. A multivariate analysis identified the patient's age and stage of cancer at the time of diagnosis as separate prognostic factors for overall survival. During the observation period, 15 (4.7%) patients developed a second primary cancer, so that no significantly elevated risk of developing a second primary cancer was demonstrated. During the same observation period, however, 48 (15%) of the patients died of a non-cancerous disease, 12 succumbing to an acute myocardial infarction and/or heart failure. Given these results, it is felt that continued follow-up of long-term stomach cancer survivors should be pursued to prevent or impede the development of a non-cancerous disease and/or a second primary cancer, so that the life of such former patients can be prolonged.

Adult↗

PubMed1993

[A study of the clinical factors which have the greatest effect on bronchial hyperresponsiveness in atopic asthma by multiple regression analysis].

We studied the clinical factors which have the greatest effect on bronchial hyperresponsiveness, with 37 atopic asthma patients (23 males and 14 females). They were from 13 to 59 years old. We measured the control value of the respiratory conductance (Grs.cont), the minimum dose of methacholine (bronchial sensitivity, Dmin), the linear slope of the Grs (= 1/Rrs) decreased (bronchial reactivity, SGrs) and SGrs/Grs.cont by the "Astograph" method (Chest 80, 600, 1981). Statistical analysis was performed by multiple regression analysis. Grs.cont, log Dmin, SGrs and SGrs/Grs.cont were regarded as objective variables. Age, onset age of asthma, period of disease, smoking history, family history of atopy, serum IgE, blood eosinophil counts, positive skin test counts, FEV1.0% and type of asthma attack (perennial or seasonal) were regarded as explanatory variables. The results were as follows: 1) The explanatory variable which showed the highest partial correlation coefficients, was the type of asthma attack in multiple regression analysis of Grs.cont and log Dmin (p < 0.05, p < 0.05). 2) Grs.cont of perennial asthma attack (0.247 +/- 0.064) was significantly lower than that of seasonal attack (0.318 +/- 0.097) (p < 0.02). Log Dmin of perennial asthma attack (-0.837 +/- 0.457) was significantly lower than that of seasonal attack (-0.254 +/- 0.429) (p < 0.005). Therefore in mild atopic asthma, the clinical factor which has the greatest effect on bronchial hyperresponsiveness is the type of asthma attack. We conclude that the existence of perennial asthma attacks is mostly related to increased bronchial hypersensitivity.

Adolescent↗

PubMed1992

[Respiratory control in diffuse interstitial lung disease].

Whether the change of lung volume affect ventilatory responsiveness to chemical stimuli has not been studied in patients with interstitial lung disease (ILD). We measured the responses of minute ventilation (VE), tidal volume (VT), and occlusion pressure (P0.1) to hypercapnia (HCVR) and hypoxia (HVR) in these patients. Breathing efficiency (delta VE/delta P0.1) and effective compliance (delta VT/delta P0.1) were also measured under the same stimuli. 1) HCVR and HVR were measured in one female patient with hypersensitivity pneumonitis. VE responses during low VC phase (VC; 71% of predicted value) were similar to that during increased VC phase (VC; normal level) in both HCVR and HVR. However, VT responses of low VC phase were lower than those of increased phase, and P0.1 responses of low VC phase were higher than those of increased VC phase. Both breathing efficiency and effective compliance of low VC phase were lower than those of increased VC phase. 2) Thirty one patients with ILD were divided into two groups: low VC group; VC < 80% of predicted value, and normal VC group; VC > 80% of predicted value. HCVR and HVR were compared between two groups. Mean values of VE response to hypercapnia and hypoxia in low VC group were lower than those of in normal group, although they were not significantly different. VT response to hypercapnia and hypoxia were significantly lower of low VC group than those of normal VC group. Mean values of P0.1 responses to hypercapnia and hypoxia of low VC group were higher than those of normal VC group, although they were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[Sputum leukotrienes in chronic airway diseases and bronchial asthma attacks].

To determine the pathogenetic role of leukotrienes in chronic airway diseases, sputum samples from patients with bronchial asthma (BA), diffuse panbronchiolitis (DPB), sinobronchial syndrome (SBS), and bronchiectasis (BE) were examined for the presence of leukotrienes (LT) C4, D4, E4, B4, all apparently derived from airway inflammatory cells. Sputum samples from 21 patients, including 10 with BA attack (5 atopic type, 5 non-atopic type) and 11 with chronic obstructive airway diseases (3 DPB, 6 SBS, and BE), were studied. Patients expectorated sputum directly into test-tubes containing 80% ethanol. Following ethanol extraction and partial purification by a C18 SEP-PAK column, LTs were further purified by high performance liquid chromatography (HPLC). Fractions from HPLC with elution times corresponding to synthetic LTC4, D4, E4, and B4 were used to quantify LTs by radioimmunoassay. Eosinophils and neutrophils in the sputum (0.5 ml) were counted following Papanicolaou staining. Percentages of eosinophils in sputum were higher in BA, while those of neutrophils were higher in DPB. Sputum levels of LTC4 were 1.2 +/- 1.6 in BA, 0.12 +/- 0.11 in SBS, and 0.42 +/- 0.14 ng/ml in DPB. Those of LTD4 were 0.21 +/- 0.27 in BA, 0.9 +/- 0.13 in DPB, and 0.10 +/- 0.07 in SBS. LTE4 levels were 5.06 +/- 3.83 in DPB and 2.66 +/- 4.32 in BA. Levels of LTB4 were 1.36 +/- 1.19 in DPB, 0.28 +/- 0.27 in BA, 0.12 +/- 0.07 in SBS, and 0.04 +/- 0.04 in BE. In asthmatics, peptide leukotriene content in sputum was higher than that in chronic airway disease patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Three-dimensional computed tomography image of small pulmonary lesions.

To evaluate diagnostic imaging of small lesions in the peripheral lung, three-dimensional (3D) reconstruction CT images were used to study 36 cases (including which had been 19 resected) of pulmonary nodules less than 3 cm in diameter. Rapid scanning was employed in 17 cases and helical scanning (in which the X-ray tube rotates continuously with simultaneous table sliding) in 19 cases. The rapid scanning could not be evaluated in two cases because respiratory motion resulted in discontinuous image data. We were able to evaluate 34 cases. The addition of 3D images to the conventional images made it possible for us to obtain useful information on visualizing relations between nodules and vascular structures in 32% (11/34) of the cases. The 3D images enabled us to visualize the lesions and pulmonary vessels three-dimensionally. It was, however, difficult to evaluate lesion shape since we were able to obtain useful information in only 3% (1/34) of the cases. In helical scanning, data are acquired from an extensive area within a short time, providing consecutive axial-slice images remain free of any respiratory artifacts. In this regard, helical scanning is suitable for generating 3D images. A diagnostic procedure based on 3D lesion analysis should be developed and standardized.

Aged↗

PubMed1992

[A case of chronic persistent cough (CPC) caused by gastroesophageal reflux (GER) (including a study of CPC caused by suspected GER)].

A patient, an 80-year-old female, had complained of a cough for 20 weeks, and was not cured by cough medicine. Gastroesophageal reflux was considered as the cause of the cough because of her symptoms and gastrointestinal fiberscopy (GIF) and barium meal studies. She made favorable progress on a histamine H2 blocker and cysapurid for 4 weeks. Therefore we diagnosed her cough as caused by gastroesophageal reflux. We also studied the incidence of chronic persistent cough in patients suspected of gastroesophageal reflux because of symptoms and GIF results. Among 676 cases examined by GIF at Niigata-kenritsu Myoko Hospital, we detected 7 cases who complained of heartburn and in whom we observed hiatal hernia and reflux esophagitis by GIF. Only one of them, the present case, complained of a cough. CPC caused by gastroesophageal reflux is not seen frequently, but the possibility of GER as the cause of CPC should be considered.

Aged↗

PubMed1991

A case-control study of stomach cancer and its genesis in relation to alcohol consumption, smoking, and familial cancer history.

A case-control study of stomach cancer and its genesis has been conducted in relation to alcohol consumption, cigarette smoking, and familial cancer history. Two hundred and ninety-four cancer cases, discovered by mass screening and histologically verified after endoscopic examination, have been compared with 588 randomly selected controls, who received the same early detection program and were verified as being free of the disease. No statistically significant association was observed between the development of stomach cancer and alcohol consumption or familial cancer history. However, the development of stomach cancer was found to have a positive correlation with smoking (relative risk for those who smoke less than 19 cigarettes/day, 3.56: 95% confidence interval, 2.39 to 5.31; relative risk for those who smoke more than 20 cigarettes/day, 2.58: 95% confidence interval, 1.60 to 4.17). The results of this study suggest that cigarette smoking appears to have a more harmful effect on the development of stomach cancer than either alcohol consumption or a familial history of cancer. The high relative risk of smoking revealed by this study implies that further research on the effects of smoking in the development of stomach cancer would be desirable.

Aged↗

PubMed1991

Tumor invasion of the chest wall and mediastinum in lung cancer: evaluation with pneumothorax CT.

For preoperative evaluation of chest wall and mediastinal invasion by lung cancer, computed tomography (CT), combined with artificial pneumothorax (pneumothorax CT), was performed in 43 patients with lung cancer in whom conventional CT scans showed that the mass was contiguous to the chest wall (n = 30) and/or mediastinum (n = 25) but without evidence of definite tumor invasion. Invasion was diagnosed on the basis of whether an air space existed between the mass and the adjacent structures. In three patients pneumothorax was not produced. After the procedure, four patients developed symptomatic pneumothorax, and one, subcutaneous emphysema. Comparison of diagnoses based on findings at pneumothorax CT, surgery, and pathologic examination showed that pneumothorax CT is 100% accurate for chest wall invasion and 76% accurate for mediastinal invasion. The authors conclude that this procedure is helpful in accurate evaluation of the T criterion in lung cancer, especially for patients in whom findings at conventional CT suggest tumor invasion of the chest wall and mediastinum.

Adenocarcinoma↗

PubMed1991

[A case of isocyanate-induced hypersensitivity pneumonitis and a compression-air mask thought to be effective in its prevention].

A 41-year-old paint sprayer, who had worked with polyurethane paint since the spring of 1989, developed exertional dyspnea and dry cough and entered hospital on December 4, 1989. Plain chest X-ray film and a computed tomogram of the lung revealed diffuse micronodular shadows in both lower lung fields. DLco was shown to be significantly decreased in a pulmonary function test. A sample of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD4/8 ratio. A lung biopsy specimen revealed alveolitis, but neither Masson body nor granulomas were seen. Serum antibody specific to TDI-HSA was detected, and an environmental provocation test was positive. From these results, the patient was diagnosed as having isocyanate-induced hypersensitivity pneumonitis. We advised him to wear a compression-air mask when he worked, because he did not want to quit his job. Respiratory symptoms have not been seen since then, but careful observation was thought to be necessary. The involvement of type III humoral and type IV cellular immunity was suspected in this case.

Adult↗

PubMed1991

[Clinical evaluation in 69 cases with neurogenic bladder].

Clinical evaluation was made in 69 cases of neurogenic bladder experienced during the past 3 years. Thirty seven of the patients were male and 32 female, and they ranged in age from 4 to 88 years with an average of 63.2 years, The basic diseases of neurogenic bladder were brain lesions in 27 cases, spinal cord lesions in 18 cases, and peripheral nerve lesions in 13 cases. Three cases were of the mixed type and the basic disease was unknown in 8 cases. Cerebrovascular diseases were the most frequent, followed by spinal cord injuries and intrapelvic operations. Duration from the onset of urological symptoms to the first visit to our clinic was less than 1 month in half of the patients. The chief complaints at the first visit were pollakisuria in 25 cases (25.8%), incontinence in 18 cases (18.6%), urinary difficulty in 25 cases (25.8%) and urinary retention in 13 cases (13.4%). Urological conditions at the first visit were spontaneous urination in 53 cases (76.8%), indwelling catheterization in 12 cases (17.4%) and clean intermittent catheterization in 4 cases (5.8%). Urological complications seen at the first examination were urinary tract infections (UTI) in 27 cases (39.1%) and chronic renal failure in 2 cases (2.9%). The patients were classified by cystometrography into 3 patterns: 42 cases (60.9%) with underactive detrusor, 21 cases (30.4%) with overactive detrusor and 6 cases (8.7%) with normal detrusor. Detrusor sphincter dyssynergia was observed in 29 cases (42.0%), 40.7% had brain lesions, 44.4% spinal cord lesions, and 46.2% peripheral nerve lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

[Evaluation of axial multiplanar reconstruction CT for the diagnosis of small nodular lesions in the peripheral lung].

Our study investigated the relationships between tumors and surrounding structures, particularly vessels and bronchi within lesions in the periphery of the lung. We performed axial multiplanar reconstruction CT (AMPR-CT) with a Toshiba TCT-900S scanner, as well as conventional CT (Conv. CT) and CR tomography (CR tomo.). We examined 19 patients with pulmonary lesions who later underwent surgical resection (12 with lung cancer, 1 with metastatic tumor, 1 with hamartoma, 2 with tuberculoma, and 3 with pulmonary granuloma) of a total of 43 patients with small nodular lesions less than 3 cm in diameter. AMPR-CT, Conv. CT, and CR tomo. were compared against resected specimens. The accuracy of each modality to detect involvement of bronchus, the pulmonary artery, and vein was AMPR-CT 50%:93%:91%, Conv. CT 47%:76%:55% and CR tomo. 37%:55%:42%, respectively. AMPR-CT was judged superior to both Conv. CT and CR tomo. In conclusions: 1) That AMPR-CT permits easier visualization of vessels and bronchi, and 2) That AMPR-CT is more effective than Conv. CT examinations in the morphological assessment of small nodular lesions. Thus, AMPR-CT is a useful new approach to the diagnosis of lesions in the lung.

Evaluation Studies as Topic↗

PubMed1990

Small nodular lesions in the lung periphery: new approach to diagnosis with CT.

To evaluate relationships between lesions in the lung periphery and surrounding structures, particularly vessels and bronchi, axial multiplanar reconstruction (AMPR) computed tomography (CT) was used to study 26 patients who underwent surgical resection of pulmonary nodules less than 3 cm in diameter. Findings at AMPR CT, conventional CT, and digital radiographic tomography were compared with findings obtained at evaluation of the resected specimen with regard to the ability to display the relationships between vessels, bronchi, and lesions. AMPR CT was significantly superior to conventional CT and digital radiographic tomography in detecting involvement of pulmonary vessels (P less than .001). Involvement of pulmonary veins was seen in all lung cancers, whereas such involvement was seen in only one of eight nonneoplastic lesions. Thus, involvement of pulmonary veins is strongly suggestive of malignancy. AMPR CT permits three-dimensional visualization and morphologic assessment of pulmonary nodules.

Adenocarcinoma↗

PubMed1990

An electron microscopic study of ectomesenchymal contacts in rat incisors.

In order to clarify connections between epithelium and mesenchymal tissue in the early stage of odontogenesis, the formation of ectomesenchymal contacts and the presence of coarse-textured material at the interface between ameloblasts (AMs) and odontoblasts (ODs) on growing rat incisors were studied by electron microscopy. The presecretory zone was classified into five regions according to the ultrastructure of each preameloblast (PA). The region where collagen fibrils could be observed was designated PZ-2, the region where predentin existed PZ-3, the region where the basal lamina began to disappear PZ-4, and the region where the basal lamina had disappeared PZ-5. In PZ-2, the cytoplasmic processes of PAs penetrated the basal lamina and reached the dental papilla cells. In some locations, ectomesenchymal contacts were also observed, in which the cytoplasmic processes of the PAs were in contact with those of the preodontoblasts (POs). In PZ-3, the distal cytoplasm contained large amounts of type-1 vesicles, and secretory granules. In the distal membrane of the PA, membrane invaginations containing fibrillar structures were visible. Also in some areas, the cytoplasmic processes at the distal ends of the PAs invaded the predentin. In the predentin, a large amount of coarse-textured material, considered to be the precursor of the enamel matrix, was observed. In PZ-3, a large number of cytoplasmic processes extended into the predentin, while in PZ-4, microvillus-like processes extended from the distal ends of the PAs, showing a high frequency of ectomesenchymal contact. It was suggested that secretory activity of the PAs was induced after ectomesenchymal contact had been accomplished, but that the PAs did not undergo morphological change into secretory ameloblasts.

Ameloblasts↗

PubMed1990

[Release of leukotrienes (LTC4, D4, E4, B4) from peripheral leukocytes in patients with bronchial asthma].

To evaluate the pathogenetic role of leukotrienes in bronchial asthma, the levels of leukotrienes released from leukocytes stimulated by calcium ionophore A23187 were measured by the HPLC-RIA method in 32 asthmatic patients (12 infectious type, 12 non-hyposensitized atopic type, and 8 hyposensitized atopic type). The following results were obtained: 1) The level of leukotrienes released from the leukocytes of asthmatic patients were higher than those of healthy subjects, but there was no significant difference in the levels of leukotrienes between mild and moderate asthmatic patients. 2) The levels of leukotriene B4 released from the leukocytes of the infectious-type asthmatic patients were higher than those of the atopic asthmatic patients (non-hyposensitized group). There was a tendency for levels of leukotriene C4 released from the leukocytes of the infectious-type asthmatic patients to be higher than those of the atopic-type asthmatic patients. 3) The levels of peptide leukotriene released from the leukocytes of the atopic hyposensitized patients were lower than those of the patients in the atopic non-hyposensitized group, but there were no significant differences in leukotriene B4 between the groups. In addition, the levels of leukotriene C4 released spontaneously from the leukocytes of the hyposensitized group of patients were lower than those in the non-hyposensitized group. 4) Though the mechanism of the efficacy of hyposensitization has not been completely clarified, the reduction of leukocyte ability to release peptide leukotrienes through immunotherapy seems to be part of this mechanism. These results suggest that leukotrienes may play some role in the pathogenesis of both atopic- and infectious-type bronchial asthma.

Adult↗

PubMed1990

[Clinical evaluation and problem of intra-arterial infusion chemotherapy of liver metastasis from digestive organ cancer].

Intra-arterial infusion chemotherapy using an implantable reservoir was used for 22 patients with liver metastasis from September 1986 to March 1990. The material consisted of 8 subjects with gastric cancer and 14 with colorectal cancer. One had metastasis in one lobe (H1), 10 had a few scattered metastases in both lobes (H2) and 11 had numerous metastases in both lobes (H3). In 5 cases, a reservoir was implanted to prevent the recurrence after hepatectomy. Infusion catheter was placed in the proper hepatic artery in 5 cases via the gastroduodenal artery at laparotomy and it was carried out subcutaneously via the femoral artery in 17 cases. In all cases intra-arterial infusion of 5-FU was continuously administered followed by intermittent one shot injection of ADM. The clinical effectiveness of the therapy was well evaluated. One-year cumulative survival rate of all cases by Kaplan-Meier method was 55% and that of H2 cases was 78%. No recurrence was noted in post hepatectomy cases. Eight cases (36.3%) showed remarkable complications, which made it impossible to continue intra-arterial infusion chemotherapy: hepatic artery occlusion (3 cases), infection (2 cases), abdominal pain (1 case), hematoma in the implanted site (1 case) and dislocation of the infusion catheter (1 case). From the present study, it is considered that intra-arterial infusion chemotherapy is a useful procedure for the control of liver metastasis. Regimens for improved chemotherapy and the maintenance of more useful and safer catheters should therefore be investigated for further development of the therapeutical estimation.

Colorectal Neoplasms↗

PubMed1990

[MHC class I antigen expression by molar trophoblast].

It is an issue for debate why molar tissues are not rejected by an immunologically potent host, since all genes in complete moles and 2/3 genes in partial moles are considered to be paternally derived. Molar trophoblasts are in direct contact with host cells, and therefore HLA expression by these cells may hold the key to the elucidation of the immunological reaction between molar tissues and the host. It has been reported that villous trophoblasts are negative and extravillous trophoblasts are positive for HLA-A, B,C, but the expressed HLA-A,B,C molecule has been noted to lack their polymorphic determinants. We analyzed the reactivity of two monoclonal antibodies to a monomorphic determinant of HLA-A,B,C (W6/32 and Cappel anti-HLA-A,B,C) with molar trophoblasts, using three uteri containing complete moles and two containing partial moles. The reactivity was examined by an indirect immunoperoxidase method. The staining patterns were almost identical in complete moles and partial moles. Villous trophoblasts showed a negative reaction with both antibodies. On the other hand, extravillous trophoblasts exhibited intense staining for W6/32 and negative staining for Cappel anti-HLA-A,B,C, which may suggest that the expression of a constant region as well as a variant region of HLA-A,B,C molecule is incomplete.

Antibodies, Monoclonal↗