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Biomedical subjects

M Tamakawa

Publications and source records attributed to M Tamakawa.

17 recordsLinked to original sources
PubMed2000

Accelerated radiotherapy for T1, 2 glottic carcinoma: analysis of results with KI-67 index.

PURPOSE: Hyperfractionated and accelerated radiotherapy without a split was performed to improve the local control probability of early glottic carcinomas. We analyzed the results of this regimen by using the Ki-67 index. METHODS AND MATERIALS: Over a 12-year period, 85 T1N0M0 glottic cancers and 50 T2N0M0 glottic cancers were treated with conventional fractionation (CF) from 1984 to 1989 and with accelerated fractionation (AF) since 1990. The CF program consisted of five daily fractions of 2 Gy per week, for a total of 64 Gy. The AF program consisted of 1.72 Gy per fraction, two fractions per day, 5 days a week, for a total of 55 or 58 Gy. The specimens, taken before radiotherapy, were immunohistochemically stained with anti-Ki-67 antibody. RESULTS: The 5-year local control probability for T1 tumors was 79.6 +/- 6.9% with CF treatment, whereas with AF it was 86.9 +/- 5.6%. For T2 tumors it was 62.7 +/- 12.2% with CF, whereas it was 74.7 +/- 7.8% with AF. The difference between CF and AF did not reach the point of statistical significance. However, when T1 tumors had a Ki-67 index lower than 50%, the local control rate achieved with AF was significantly better than that with CF (p = 0.018). When the tumors had a Ki-67 index that was 50% or more, there was no difference in the local control rate between CF and AF, whether they were T1 or T2. The peak mucosal reactions at the larynx and/or hypopharynx were much more severe and appeared at smaller doses and earlier in AF than in CF. The patients with AF showed no severe late complications. CONCLUSIONS: AF could not obtain statistically significant improvement in local control probability of T1 or T2 glottic carcinomas.

Adult↗
PubMed2000

Osteosarcomatosis involving craniofacial bones presenting with cranial nerve palsies.

Osteosarcomatosis (also known as multifocal osteosarcoma or multiple sclerotic osteosarcoma) is a rare condition, characterized by multiple skeletal lesions at initial presentation. We describe a case of osteosarcomatosis involving craniofacial bones presenting with cranial nerve palsies. In addition, a brief review of the literature is given, with a discussion of this highly aggressive form of osteosarcoma.

Abducens Nerve Diseases↗
PubMed2000

Acquired anomalous intrapulmonary venous connection secondary to pulmonary venous stenosis.

An unusual case of acquired development of anomalous intrapulmonary venous connection with pulmonary venous stenosis is presented. Appearances on a chest radiograph resembled the "scimitar" sign in a patient with previous surgery for partial anomalous pulmonary venous return. Spiral CT and pulmonary arteriography showed stenosis of the right upper pulmonary vein and an anomalous intrapulmonary venous connection between the right upper pulmonary vein and the right lower pulmonary vein. We consider the slow progression of pulmonary vein stenosis led to anomalous intrapulmonary venous connection as an intrapulmonary collateral.

Adult↗
PubMed1999

Prognostic factors of nasopharynx tumors investigated by MR imaging and the value of MR imaging in the newly published TNM staging.

PURPOSE: To examine the usefulness of MR imaging for predicting local control of nasopharyngeal carcinoma (NPC) and the value of MR imaging in the newly published fifth edition of the TNM classification. METHODS AND MATERIALS: We studied 29 patients with NPC with MR imaging and CT before and after treatment. Staging was done according to the fourth and newly published fifth editions of the International Union Against Cancer (UICC) staging system. The radiotherapy protocol was designed to deliver 66 to 68 Gy to the primary tumor and clinically involved nodes. RESULTS: MR proved better than CT at identifying obliteration of the pharyngobasilar fascia, invasion of the sinus of Morgagni, through which the cartilaginous portion of the eustachian tube and the levator veli palatini muscle pass, invasion of the skull base, and metastases to lymph nodes in the carotid and retropharyngeal spaces. All seven patients without invasion of the pharyngobasilar fascia had local control. The local control rates of patients with invasion of the skull base were not good (60 to 73%). There was no apparent relationship between tumor volume determined by T1-weighted MR images and local control when the tumor volume was more than 20 cc. The newly published N staging system appears to successfully identify the high-risk group for distant metastasis as N3. In our series, four of five patients with N3 disease developed distant metastases. CONCLUSION: Deep infiltration of the tumor is a more important prognostic factor in NPC than tumor volume. Since the newly published T staging system requires a search for tumor invasion into soft tissue such as parapharyngeal space and bony structures, MR imaging may be indispensable for the newly published NPC staging system.

Adolescent↗
PubMed1999

Elastofibroma dorsi: CT, MRI, and pathologic findings.

We report two cases of elastofibroma dorsi and discuss the CT and MR findings and histopathology of these tumors. Increased awareness of the characteristic MR patterns should lead to reduced misdiagnosis of such lesions as malignant and prevent unnecessary wide excision.

Female↗
PubMed1998

Radiotherapy for Kimura's disease: the optimum dosage.

PURPOSE: To evaluate retrospectively the optimum dosage of irradiation for Kimura's disease. METHODS AND MATERIALS: Twenty patients with Kimura's disease were treated with radiotherapy. The sex ratio was 19 males to 1 female. The mean ages at onset, initial treatment, and radiotherapy were 26.2, 29.5, and 32.2 years, respectively. Radiotherapy was mainly applied for residual or recurrent tumors. The eosinophil count increased by more than 10% in 18 of the 20 patients. In most instances, irradiation was given through a single field with dosages ranging from 20 to 44 Gy. RESULTS: At the completion of radiotherapy, a marked response in tumor size was noted in all cases. The minimum follow-up was 48 months. Local control was obtained in 23 of 31 lesions (74.1%). At dosages of < or =25 Gy, 26-30 Gy, and > 30 Gy, local control was obtained in 2 of 8 (25.0%), 9 of 10 (90.0%), and 12 of 13 sites (92.3%), respectively. CONCLUSIONS: Radiotherapy is an effective treatment for Kimura's disease. This strongly suggests that no surgical procedure other than a biopsy should be carried out. The radiation field should be limited to the lesion and swelling of the adjacent lymph nodes as much as possible, with a optimum dosage of 26-30 Gy regardless of tumor size.

Adolescent↗
PubMed1998

Retroperitoneal extrarenal angiomyolipoma with early gastric carcinoma.

We present a very rare case of a retroperitoneal extrarenal angiomyolipoma accompanied by early gastric cancer. A 41-year-old Japanese man, who had undergone surgery for a type IIc early gastric cancer 2 years earlier, was admitted to hospital presenting with back pain and abdominal fullness. Computed tomographic scanning and magnetic resonance imaging of the abdomen disclosed a massive fatty tumor extending from the hepatic hilus to the retroperitoneum. A large retroperitoneal tumor mass with no sign of involvement in the kidney was totally resected by radical surgery. Histologically, the tumor was classified as an angiomyolipoma.

Adenocarcinoma↗
PubMed1998

Diagnosis and treatment of malignant lymphoma of the parotid gland.

BACKGROUND: To correlate the imaging and pathological features and to discuss therapeutic modalities and the prognosis of malignant lymphoma originating in the parotid gland, which is relatively rare. METHODS: The subjects were five patients with malignant lymphoma originating in the parotid gland. Three and two patients were stage I and stage II, respectively. CT examination was applied to all, whereas only one case was examined by MRI. All were treated with radiotherapy following surgery or chemotherapy. Three patients underwent combination chemotherapy, such as with MACOP-P or VEPA, following surgery. RESULTS: Although malignant lymphoma originating in the parotid gland is histologically described as low-grade non-Hodgkin's lymphoma, two and one of the cases were classified as intermediate and high grade in the present series, respectively. These three exhibited a tendency for infiltration into the adjacent tissue and tumor inhomogeneity in the imaging findings, suggesting a correlation with histologically intermediate or high-grade non-Hodgkin's lymphoma. It was successfully controlled by radiotherapy, with dosages ranging from 40 to 44 Gy. The patients were followed for 2-8 years. No relapse was found in the three patients with stage I. However, both stage II patients had relapses and were subjected to additional radiotherapy combined with chemotherapy. Since then, no tumor relapse has been noted at either this or other sites. CONCLUSIONS: Malignant lymphoma including intermediate or high grade originating in the parotid gland indicated satisfactory prognosis following radiotherapy and chemotherapy.

Aged↗
PubMed1997

Radiotherapy of vertebral hemangiomas.

Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films. CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy.

Adult↗
PubMed1996

Retropharyngeal abscess after radiation therapy and cis-platinum, 5-fluorouracil treatment for nasopharyngeal carcinoma with collagen disease: report of two patients and a review of the literature.

Collagen disease are frequently associated with malignant tumors. Recently, radiotherapy combined with chemotherapy has been recommended for improving the efficacy of treatment for nasopharyngeal carcinoma. Two patients with nasopharyngeal carcinoma complicated by collagen diseases (dermatomyositis in one, and Sjögren's syndrome with mixed connective tissue disease in the other) were given radiotherapy combined with chemotherapy consisting of cis-platinum and 5-fluorouracil. Following this combination therapy, both patients developed retropharyngeal abscess and ulceration of the mucosal membrane on the posterior wall of the oropharynx; there was no tumor cell involvement. Because these injuries were more severe than would have been expected from radiotherapy alone, it is recommended that special attention be paid to combination therapy in patients with nasopharyngeal carcinoma complicated by collagen disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Radiation tolerance of normal lung-pulmonary radiation syndrome].

Radiation pneumonitis and radiation fibrosis are two distinct syndromes with probably different target cells. The ultrastructural changes occur rapidly and current evidence suggests that damage to the type II pneumocyte and the endothelial cell is linked to the pneumonia process than the fibrotic. The fibrosis process may be related to the basement membrane of both endothelial cells and alveolar type I cells. Dose time and volume data for tolerance dose are well documented in animals. Many antineoplastic agents enhances radiation lung damage. The pneumonitis and fibrosis will be discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Three dimensional CT reconstruction image using a personal computer].

Three dimensional (3D) images were reconstructed from axial CT slices using the personal computer. Some devices of the program made it possible to decrease the image processing time and to produce the realistic images with cubic effect. The thresholding in the conventional 3 D imaging was not practical especially in the display of the soft tissues. The employment of the volume rendering technique and MRI data will give a clue to the solution of these problems.

Humans↗
PubMedDate not supplied

Spontaneously reduced midgut malrotation: CT diagnosis.

Midgut malrotation is a relatively rare congenital malformation that arises from an error of rotation and fixation of the midgut. We report a case of spontaneously reduced duodenal malrotation diagnosed by computed tomography and roentgenography after the ingestion of barium.

Adult↗
PubMedDate not supplied

Pseudoaneurysm of the superficial femoral artery in Behçet's disease with spontaneous thrombosis followed by CT angiography.

A 25-year-old man developed sudden pain and a pulsating mass in the left thigh. A diagnosis of Behçet's disease was made because of four major symptoms. Laboratory data indicated active inflammation. Emergency spiral computed tomographic angiography (CTA) showed an aneurysm of the left superficial femoral artery (SFA). Under steroid therapy, follow-up spiral CTA showed spontaneous occlusion of the aneurysm. In the active phase of arteritis, spiral CTA is useful for the diagnosis of arterial lesions to avoid the arterial puncture of conventional arteriography.

Adult↗
PubMedDate not supplied

Magnetic resonance evaluation of brainstem dysfunction in eclampsia and the HELLP syndrome.

An unusual case of a 40-year-old woman with eclampsia and the HELLP syndrome associated with brainstem dysfunction is presented. The patient made a progressive neurological recovery. A follow-up magnetic resonance image (MRI) demonstrated complete resolution of the multiple foci. The MRI of the brainstem was found to correlate far more closely with neurological findings than with computed tomography (CT scan).

Abruptio Placentae↗
PubMedDate not supplied

A case report of Paget's disease of the breast treated with radiotherapy alone.

Paget's disease of the breast is a rare form of breast cancer. Patients with nipple-areolar disease alone and no palpable mass have an excellent prognosis. Although there is some argument about the treatment of this type of Paget's disease, only two reports have been published on the role of conservative treatment. This report discusses a case of limited Paget's disease of the nipple and areola of the breast which was treated by radiation alone without limited surgery.

Breast Neoplasms↗