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Biomedical subjects

N Hirata

Publications and source records attributed to N Hirata.

At least 127 records · Page 7Linked to original sources
PubMed1991

[A case of leiomyoma of the trachea].

An asymptomatic 59-year-old male in whom an abnormal shadow was detected on indirect chest X-ray film, was referred to our hospital for further examination. Further examinations revealed no problem at the previously checked site. However, bronchoscopy revealed a protruding hemispheric lesion on the membranous portion of the trachea 2 cm above the carina. The biopsy specimens revealed that the lesion was leiomyoma of the trachea. Transbronchoscopic biopsy was performed three times and the lesion disappeared. A few small fibrous nodules remained. The incidence of this primary tracheal tumor is rare, and benign lesions are much less common than malignant lesions. Furthermore, leiomyoma of the trachea is extremely rare. Only 20 cases have been reported in Japanese and English literature. The average age of the reported cases, including our case, was 49.3 years old. Among the male patients, most cases were around 50 years old but among female patients, there was no standard age for this disease. Clinical symptoms included coughing, dyspnea, wheezing and bloody sputum. There were several patients with severe dyspnea, two of which died. Ten patients (50%) had been misdiagnosed as having bronchial asthma. If a case is suspected to be bronchial asthma in which and where bronchodilators have little effect, we must always consider the possibility of this type of lesion, and perform further examinations and treatment.

Bronchoscopy↗
PubMed1991

[A case report of right ventricular myxoma which was found by cardiac systolic murmur at a medical examination].

Right ventricular myxoma is very rare with the only 19 cases in the Japanese literature. We report on a 26-year-old woman with a right ventricular myxoma which was found by cardiac systolic murmur at a medical examination and successfully excised. Echocardiography and coronary angiography is very useful in deciding the location of insertion on the right ventricle. Right atriotomy prior to right ventriculotomy was important for right ventriculotomy and necessary for complete excision. Clinical characteristics, and diagnostic and therapeutic aspects are discussed.

Adult↗
PubMed1991

[The long-term results of patients over 70 years old after coronary artery bypass surgery].

We have assessed the long-term results of heptagenerians after isolated coronary artery bypass surgery from 1979 to 1989 in 32 patients over 70 (mean 72) years old using actuarial techniques. In these patients, the long-term results could not be properly assessed because many other factors other than cardiac events influenced their survival. Accordingly, we compared our subjects with the general population matching the operative age and sex characteristics from life tables (= matched population). There was no operative mortality. The 5 year and 9 year survival rates were 93% and 31%. In the matched population, the 5 year and 9 year survival rates were 81% and 59%. The survival rate between the two groups was not significantly different. We concluded that the long-term results of coronary artery bypass surgery in patients over 70 years were similar to those of the matched population. Therefore, coronary artery bypass surgery should be offered to older patients for usual indications.

Aged↗
PubMed1991

[A case of squamous cell carcinoma of the urinary bladder associated with bladder calculi].

A case of squamous cell carcinoma of the urinary bladder associated with a bladder stone in a 43-year-old man is reported. Because a 1 cm x 1 cm sized mass was found in the right lateral side of the dome at the time of vesicolithotomy, partial cystectomy was performed. The weight of the stone was 285 g and the tumor was histologically diagnosed as squamous cell carcinoma, grade 2, pT2. Radical cystectomy with ileal conduit was sandwiched by a total of 6 cycles of chemotherapy with PVB. Twelve cases of squamous cell carcinoma of the urinary bladder associated with a bladder stone(s) from the Japanese literature are reviewed, and the relationship between bladder stone, leukoplakia and squamous cell carcinoma discussed.

Adult↗
PubMed1990

[Studies on porphyrin related compounds and tumor tissue affinities. I. Synthesis of a carrier for tumor imaging agent, bifunctional chelating agent coupled porphyrin (ATN-2)].

A carrier for a new tumor imaging agent, a bifunctional chelating agent (BCA)-coupled porphyrin (ATN-2), has been synthesized from protoporphyrin dimethyl ester in 4 steps. At first, the hydrobromination of protoporphyrin dimethyl ester is carried out to obtain a monobromo derivative. The derivative is treated with ethylene glycol. The resulting porphyrin has an ether group at the either 7- or 12-position of the ring. Metallation with GaCl3 of the porphyrin having a ethylene glycol residue affords Ga-metalloporphyrin. Final condensation of the metalloporphyrin with diethylenetriaminepentaacetic acid (DT-PA) gave BCA-coupled porphyrin (ATN-2). The chelation of ATN-2 with 111InCl3 easily afforded [111In]ATN-2. This agent was used for imaging transplantable pancreatic carcinoma in Syrian golden hamster at 72 h after postinjection. The efficacy of the new agent was compared with that of [67Ga]citrate. The images with [111In]ATN-2 were found to be clearer than those with [67Ga]citrate. Therefore, ATN-2, a carrier for 111InCl3, seems to be more useful for tumor imaging agents.

Animals↗
PubMed1990

[Combination chemotherapy of human renal cell carcinoma in athymic nude mice with human lymphoblastoid interferon (HLBI) and UFT, 5-Fu].

The effectiveness of interferon alpha (HLBI) for nude mouse transplantable human renal cell carcinoma 72nd general meeting, in combination with UFT and 5-Fu, was examined using, 1 x 10(7) IU/kg, 2 x 10(7) IU/kg HLBI; 25 mg/kg 5-Fu; and 10 mg/kg, 20 mg/kg UFT, administered for 10 consecutive days. The ratio of relative mean tumor weight of treated group to control group was under 42% for the combination of 25 mg/kg (I.P.) 5-Fu, 20 mg/kg UFT, and HLBI and the effect was particularly clear for the combination with 2 x 10(7) IU/kg which indicated a grade IIA histologic classification. In comparison with the control groups only UFT (20 mg/kg) and HLBI (2 x 10(7) IU/kg) showed significant inhibition when administered alone. Although none of the drugs had an inhibitory effect when administered alone, in combined use they showed a strong antitumor effect which was more than synergistic. Orally administered 5-Fu showed a statistically significant difference only in the combination with 2 x 10(7) IU/kg HLBI. Furthermore, the concentration of 5-Fu in the tumor tissue was not affected by the route of administration or drug combination, whereas that in the serum was below the limit of detection in the intraperitoneally administered cases, 0.0096 +/- 0.0079 microgram/ml, lower than the value for orally administered cases. The 5-Fu concentration was 0.026 +/- 0.012 microgram/ml for orally administered UFT which was significantly higher than the value obtained for orally administered 5-Fu. Thus, combination therapy of HLBI and UFT for renal cell carcinoma is expected to be clinically useful.

Animals↗
PubMed1990

[An experience with simultaneous carotid endarterectomy and myocardial revascularization in a patient with calcified ascending aorta].

We reported a 65-year-old male with the history of both cerebral and myocardial infarctions. Simultaneous carotid endarterectomy and myocardial revascularization (coronary artery bypass grafting = CABG) were performed. Ascending aorta was severely calcified. CABG was performed without aortic cross clamp under systemic moderate hypothermia and elective ventricular fibrillation. The wean off from extracorporeal circulation was successful. The postoperative course was uneventful. We recommend the simultaneous revascularization for the carotid and coronary artery obstructive diseases. CABG under ventricular fibrillation without aortic cross clamp was useful and unhazardous in patients presenting calcified ascending aorta.

Aged↗
PubMed1990

A clinical study of total cystectomy for transitional cell carcinoma of the urinary bladder.

Fifty six patients with transitional cell carcinoma of the urinary bladder were treated by total cystectomy from January, 1979 through December, 1988. A retrospective study was conducted on 52 patients on whom prognosis could be followed up. There were 40 men and 12 women (male to female ratio: 3.3: 1), between 32 and 79 years old (mean age, 64.1 years old). The overall 1-, 3- and 5-year survival rates were 65.8%, 54.1% and 43.0%, respectively. The 5-year survival rates for patients with low grade (G, I, II) and high grade (G. III) were 41.9% and 42.7%, respectively: with no significant difference in the survival curves between the two groups. The 5-year survival rates according to histopathological stage were 78.9% for patients in low stage, 24.7% in high stage, and the difference in the survival curves between the two groups was statistically significant (P less than 0.001). The mortality in the 21 cases of the 33 high stage cases in which cisplatin was used was 42.9%, with 3- and 5-year survival rates were 53.1% and 36.8%, respectively. In the remaining 12 cases in which cisplatin was not used for post-operative chemotherapy, the mortality in the 12 cases was 83.3%, with 3- and 5-year survival rates of 25.1% and 12.3%, respectively. Thus, the patients who received post-operative chemotherapy showed a better survival rate than those who did not with a significant difference (P less than 0.05). The results of the present study suggest the usefulness of post-operative adjuvant chemotherapy in the high stage case.

Adult↗
PubMed1990

[An aged case of coronary-aorta bypass grafting surgery (CABG) with severe chronic obstructive pulmonary disease].

This paper reports CABG which was successfully performed on a male patient of 70-year-old with severe chronic obstructive pulmonary disease (FEV1.0% 43%) and diabetes mellitus. The patient necessitated reintubation because of hypercapnea on 18 POD in spite of bronchodilator and physical therapies. Long respiratory care was continued after tracheotomy, and finally he could wean from the mechanical respiratory care utilizing acetazolamide (carbonic anhydrase inhibitor) on 59 POD.

Acetazolamide↗
PubMed1990

[Late results of CABG for postinfarction angina--relation to preoperative myocardial infarct size].

We evaluated the late results of coronary bypass grafting (CABG) in 85 patients. The patients were divided into two groups according to preoperative MI size estimated by the Selvester QRS score; 24 with MI size of larger than 20% of LV muscle (group A; average 28 +/- 11%), and 61 with MI size smaller than 20% (group B; average 10 +/- 9%). New York Heart Association classes of both groups following CABG improved significantly (from 2.8 +/- 0.7 to 1.3 +/- 0.4 in group A; p less than 0.01, from 2.5 +/- 0.6 to 1.2 +/- 0.5 in group B; p less than 0.01). There was higher incidence of serious ventricular arrhythmias in group A than in group B (83% vs. 21%, p less than 0.01). In Group A, LVEF and LVESVI did not improve following CABG (from 17 +/- 9 to 16 +/- 8 mmHg, from 39 +/- 15 to 40 +/- 15%, from 66 +/- 28 to 69 +/- 40 ml/M2), while in Group B, those improved significantly (from 13 +/- 6 to 11 +/- 5 mmHg; p less than 0.01, from 53 +/- 14 to 58 +/- 10%; p less than 0.01, from 39 +/- 23 to 32 +/- 14 ml/M2; p less than 0.05). The exercise-to-rest LVSWI ratios increased significantly following CABG in both groups (from 86 +/- 25 to 160 +/- 56% in group A; p less than 0.05, from 92 +/- 31 to 140 +/- 37% in group B; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Studies of serum bone Al-P isoenzyme and serum osteocalcin in patients on maintenance hemodialysis.

This report describes an investigation of 128 patients on maintenance hemodialysis. Their serum bone Al-P isoenzyme (Al-P III) values were measured by the Rosalki method, and simultaneous estimations were made of their serum osteocalcin levels as a diagnostic indicator of renal osteodystrophy (ROD). ROD was evaluated clinically from Jensen's criteria, based on a four-stage classification of the radiographic evidence for subperiosteal resorption: no change (stage 0), minor change (stage I), and definite change (stages IIa and IIb). The serum Al-P III levels in the stage IIa and IIb patients showed significantly elevated values (p less than 0.01), i.e., 4.98 +/- 6.23 and 20.51 +/- 13.46 KAU, respectively. In contrast, their serum osteocalcin levels were not appreciably different. Patients with elevated N-PTH values of 0.30 ng/ml or more were found to have serum Al-P III levels of 20 KAU or more, and all of these patients were categorized under the stage IIb classification. It is concluded therefore that in chronic renal failure patients on hemodialysis, measurements of the serum Al-P III are highly useful for diagnosing ROD, and may also be considered as a critical parameter for assessing the indication for parathyroidectomy (PTX).

Alkaline Phosphatase↗
PubMed1989

Peroral cholecystoscopy.

Three cases of peroral cholecystoscopy was reported. Dilatation of the cystic duct ranged from 8.5 mm to 10.0 mm in diameter, permitting passage of a 4.5 mm diameter baby 'scope. Endoscopic lithotripsy was performed without difficulty.

Cystic Duct↗
PubMed1989

[Reliability and validity of the Japanese version of the GBS scale].

The Japanese version of the GBS Scale (GBSS-J) was administered to 246 elderly patients with dementia in a geriatric hospital to test the inter-rater reliability and validity of the items and the subscales of the GBSS-J. The inter-rater reliability of the 26 items was tested by rating 20 patients. After the raters conferred with each other how to rate the items of the scale, the items were rated independently. Pearson's correlation coefficients indicating the agreement between the rates were as good as more than. 660 except for the items of impaired wakefulness and confusion. The validity of the 28 items was examined by comparing them with the stages of Functional Assessment Staging (FAST). Hasegawa's dementia scale (HDS) was employed as an external standard to test the items of the subscale of intellectual functions. Physical disability was checked by using the Rapid Disability Rating Scale (RDRS). Mean scores of the 20 items except for the 6 items included in the subscale of different symptoms common in dementia significantly increased as the FAST stage advanced. These results indicated that the 20 items of the GBSS-J measured the severity of dementia with sufficient validity. In addition, according to the results of analysis of variance and covariance, the items of motor insufficiency in taking food, impaired physical activity, impaired wakefulness and irritability were related to the severity of physical disability rather than that of dementia. Also, the 10 items of the subscale of intellectual functions showed significant correlations with the scores of HDS, while the item of impaired wakefulness showed a significant, although fairly low correlation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Measurement of blood flow of saphenous vein graft with Doppler catheter].

We investigated the measurement of blood flow of saphenous vein graft by Doppler Catheter. Under operation of femoro-popliteal bypass graftings (3 cases with 5 grafts of arteriosclerosis obliterans) with reversed saphenous vein grafts, blood flow of saphenous vein graft was measured. At the same time, blood flow of saphenous vein graft was measured by electromagnetic flowmeter. And the values obtained by Doppler Catheter (y) and those obtained by electromagnetic flowmeter (x) were compared. As a result, a good corelationship (y = 0.752 x -14.9, r = 0.836, p = 0, n = 20) was obtained. In conclusion, we suggest that the values of saphenous vein graft can be measured by Doppler Catheter. We actually measured the blood flow of saphenous vein graft with CABG. The measurement was thought to be possible.

Arteriosclerosis Obliterans↗
PubMed1989

[Three cases of successful early operations of post-infarction ventricular septal perforation].

We reviewed three cases who underwent early operations for post-infarction ventricular septal perforation. Three patients were 56-year-old male, 66-year-old female, and 62-year-old female. These three cases had sustained antero-septal infarction with perforation. The periods to operations were 11 days, 86 hours, and 76 hours from the onsets of myocardial infarction. And 70 hours, 51 hours, and 42 hours from the onset of postinfarction ventricular septal perforation. Operations were performed after cardiac standstill using cold potassium cardioplegia and topical cooling. At first ventricular infarctectomy was performed and a large Teflon patch was used to create the septum after resection of the necrotic septum, and then resulting defect in the right and left ventricles was closed with Teflon strips and interrupted mattress sutures, incorporating the patch in the repair. Postoperative clinical courses were not smooth, but all the cases were going well. So we believed to get good results for early operations of post-infarction ventricular septal perforation, unless operative chances were lost.

Aged↗