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Biomedical subjects

N Honda

Publications and source records attributed to N Honda.

At least 73 records · Page 4Linked to original sources

[Evaluation of the retrosternal space and the retrocardiac space on normal left lateral radiographs of the chest].

Left lateral chest radiographs with normal studies were evaluated in 100 Japanese (50 females and 50 males) to compare the radiolucency of the retrosternal space (RSS) with that of the retrocardiac space (RCS) and to measure the RSS. In 56 (56%) cases, the RSS was equally radiolucent to the RCS. In 40 (40%) cases, the RSS was less radiolucent than the RCS (33 of 50 females and 7 of 50 males). The difference between the sexes was statistically significant (p = 0.0001). The RSS was more radiolucent than the RCS in only 4 (4%) males. Frontal chest radiographs of 50 females were classified into one of three groups (Small, Medium, or Large) depending on the size of soft tissue opacity of the breast. The differences between the radiolucency of the RSS and RCS were statistically significant between the Small and Medium and the Small and Large groups (both p < 0.0001). The strength of the relationship between the radiolucency and body-to-fat ratio was statistically significant (p = 0.0028). Results of data comparison between females and males remained significant when adjusted for differences in body-to-fat ratio (p < 0.0001). The distance on the chest radiograph from the sternum to the most anterior aortic border (the distance of RSS) could be measured on only 37 (37%) lateral chest radiographs, and the averages and standard deviations were as follows: 2.2 +/- 0.5 in all cases, 2.0 +/- 0.5 in females, and 2.4 +/- 0.5 in males. The difference between the sexes was statistically significant (p < 0.05). In conclusion, an RSS that is more opaque (less radiolucent) than the RCS is a frequent normal finding because of the opacity of the breast and fat tissue, especially in females, and the length of the RSS is shorter in females than in males.

Adult↗

[Clinical evaluation of power Doppler sonography for the diagnosis of hepatocellular carcinoma].

We compared power Doppler sonography (PDS) with conventional color Doppler sonography (CDS) in the visualization of intratumoral blood flow of hepatocellular carcinoma (HCC) and evaluated the usefulness of PDS for assessing of the effects of TAE with Lipiodol and anticancer agents (Lp-TAE) and for the diagnosis of recurrence of HCC after Lp-TAE. The ability of PDS and CDS to visualize intratumoral blood flow was compared in 36 patients with HCC, and the usefulness of PDS for the diagnosis of HCC was evaluated. Also, in 17 patients with HCC who underwent Lp-TAE, the usefulness of PDS for evaluating the therapeutic effects of Lp-TAE and the diagnosis of recurrence after Lp-TAE was examined. The ability of PDS to visualize intratumoral blood flow and delineate tortuous and meandering intratumoral vasculature was superior to that of CDS. The effects of Lp-TAE could be evaluated and recurrence detected accurately and easily by PDS on the basis of residual intratumoral blood flow and the appearance of new blood flow. PDS is expected to achieve widespread acceptance as a useful imaging modality for the diagnosis of HCC, assessment of therapeutic effects of TAE, and detection of recurrence of HCC after TAE.

Carcinoma, Hepatocellular↗

[Stress hormone response during midazolam/fentanyl anesthesia combined with epidural anesthesia for abdominal total hysterectomy].

Stress hormone response was investigated during midazolam/fentanyl/oxygen/air anesthesia combined with epidural anesthesia in six patients undergoing abdominal total hysterectomy (group MF). A control group of six patients received nitrous oxide/oxygen/sevoflurane anesthesia combined with epidural anesthesia (group C). We evaluated plasma concentrations of ACTH, cortisol, aldosterone and beta-endorphin during the control period, 10 min, 60 min after incision, and in the recovery room. In group C, plasma concentrations of ACTH, cortisol, aldosterone and beta-endorphin increased significantly 60 min after incision compared with control concentrations. But in group MF, they did not increase significantly during anesthesia. In the recovery room there were significant differences compared with preinduction concentrations in both groups. It is concluded that midazolam/fentanyl anesthesia combined with epidural anesthesia is more effective than nitrous oxide/oxygen/sevoflurane anesthesia combined with epidural anesthesia to control the stress response to surgery.

Adrenocorticotropic Hormone↗

[Anesthetic and postoperative care of a patient with Crigler-Najjar syndrome type II].

Crigler-Najjar syndrome is a rare inherited deficiency of bilirubin uridine diphosphate glucuronyl transferase, characterised by lifelong unconjugated hyperbilirubinemia. We report anesthetic and postoperative management of a patient with this syndrome. A 64-yr-old man with Crigler-Najjar syndrome type II underwent cholecystectomy. Preoperative laboratory values included total bilirubin 8.4 mg.dl-1 and direct-bilirubin 1.8 mg.dl-1. He received epidural anesthesia combined with general anesthesia with nitorous oxide and isoflurane. He had no remarkable perioperative complications.

Anesthesia, Epidural↗

Renal oncocytoma treated by surgical enucleation: a case report.

We experienced a case of renal oncocytoma, in a 46-year-old woman. At a health examination, ultrasonography revealed a right renal tumor, and she was admitted to our hospital for evaluation. From the ultrasonogram, computerized tomography (CT) and angiography, we suspected a renal oncocytoma, but renal cell carcinoma was not completely ruled out. Since the location of the tumor seemed suitable for a local resection, we scheduled a surgical enucleation, but we intended to switch to a radical nephrectomy if examination of a frozen-section suggested renal cancer. Because the frozen findings were suggestive of an oncocytoma without malignancy, the surgical enucleation procedure was completed as scheduled. Pathological findings of the resected specimens were characterized by granular eosinophilic cytoplasm, and rounded nuclei without nuclear pleomorphism or mitotic figures. Electron microscopic studies revealed an increased number of mitochondria. The patient was accordingly diagnosed as having renal oncocytoma. We also reviewed the literature to elaborate procedures for a preoperative diagnosis and therapy for renal oncocytoma.

Adenoma, Oxyphilic↗

[Anesthetic management of a patient with erythroderma].

We gave anesthesia to a patient with erythroderma for distal partial gastrectomy. Erythroderma is an inflammatory disorder in which generalized erythema and scaling occur, either as a specific phase of processes such as T cell lymphoma, as a manifestation of underlying malignancy or in the absence of preexisting diseases. Severe cases of erythroderma may involve disturbances in the cardiovascular, thermoregulatory and metabolic systems which make the management of general anesthesia difficult. Systemic scale also causes a difficulty in placing ECG monitor electrodes and endotracheal tube. In the present case, dyspnea and asthmatic bronchitis occurred postoperatively. Therefore, in a patient with erythroderma, we recommend careful systemic management throughout the perioperative period.

Adenocarcinoma↗

[Diagnostic accuracy of 201T1 SPECT.MRI in brain diseases and inter-reader variance of diagnostic performance].

Fifteen-four studies of 201T1 brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SEP), and sensitivity and specificity for malignancy of 201T1 SPECT were 84, and 53 and 55%, which were changed to 94, and 74 and 55% after referring to the MR images. The SFP was significantly improved (p < 0.05), but sensitivity and specificity for malignancy, assessed by areas under the ROC curves, were not significantly improved. Inter-observer variation of the SFP was significantly reduced with addition of the referring MR images. Cerebral lobar localization of lesions by SPECT showed great inter-observer variations (true localization ranged from 30 to 68.4%). It is concluded that 201T1 brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations.

Adolescent↗

[The effect of iontophoresis with several Ca channel blockers for PHN patients].

We performed iontophoresis with Ca channel blockers for healthy adult volunteers. In this clinical study, we used iontophoresis with Ca channel blockers. Ten out patients with PHN treated at our pain clinic were treated with iontophoresis. They were randomly assigned to one of the following four treatments: (1) 5 ml of 4% lidocaine HCl, (2) 2 mg of nicardipine HCl + 5 ml of distilled water, (3) 2 mg of verapamil HCl + 5 ml of distilled water, and (4) 2 mg of diltiazem HCl + 5 ml distilled water. Iontophoresis was performed using the above four drugs on the positive pole. Using a VAS, each patient was evaluated concerning the analgesic effect. The pain before treatment (10 points) was used as the base line. Compared with the scores before treatment, VAS scores decreased significantly after iontophoresis in all four groups. In the lidocaine group, a significant decrease in VAS scores occurred immediately after iontophoresis and lasted up to 24 hours, reaching the nadir at 2 hours. In the nicardipine group, the decrease occurred immediately after iontophoresis and lasted up to one day, reaching the nadir at four hours. In the verapamil group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 8 hours. In diltiazem group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 4 hours. Iontophoresis with Ca channel blockers produced a prolonged analgesic effect in PHN patients. Previously we had observed the same effect in adult volunteers. Therefore, we believe that this therapy will be clinically useful.

Aged↗

An approach to cerebral vasodilatory capacity in unilateral and bilateral cerebrovascular diseases using radiolabeled human serum albumin.

The acute cerebrovascular response to acetazolamide was assessed using a blood pool agent and planar dynamic imaging to evaluate cerebral vasodilatory capacity. Ten normal subjects and 12 patients with unilateral or bilateral cerebrovascular disease were studied. After the injection of radiolabeled human serum albumin, dynamic imaging of the anterior view of the head was started. Ten minutes later, 1000 mg of acetazolamide was infused. The dilatation index (the percent increase in activity at the peak response) was obtained for each cerebral hemisphere. The mean dilatation index in normal subjects was 17.1 +/- 3.2% (N = 20). The value was significantly lower in patients with multiple infarcts (7.7 +/- 1.1%, N = 8, P < 0.001), and below the normal range in two involved hemispheres of five patients with unilateral occlusive carotid artery disease and in three hemispheres of three patients with moyamoya disease. It was suggested that this simple method may be useful in assessing cerebral vasodilatory capacity in both unilateral and bilateral diseases.

Acetazolamide↗

[Clinical study on stage PT1 and grade 3 transitional cell carcinoma of the urinary bladder].

Thirty-three patients who had transitional cell carcinoma of the bladder with stage PT1 and grade 3 components were treated between January 1980 and December 1992. Clinical study was done for these 33 patients on treatment modalities and it's problem, intravesical recurrence, disease progression and prognosis. Twenty-five of 33 patients underwent bladder-sparing surgeries and total cystectomy was performed for another 8 patients as initial treatment. Intravesical recurrence was observed in 18 (72%) of 25 patients who underwent initial bladder-sparing surgeries. Recurrence-free rate was 44% for 1 year and mean period to recurrence from initial therapy was 13.1 months. Although some adjuvant therapy after initial treatment was performed for 20 patients, it's efficacy in preventing intravesical recurrence could not be confirmed. Disease progression was recognized in 10 (40%) of 25 patients initially treated by bladder-sparing surgeries after median latent period of 33.7 months, whereas only one (12.5%) of another 8 patients who underwent total cystectomy showed progression, and 5-year progression-free rate after initial bladder-sparing surgeries was 55.6%. Three and five-year actural survival rate in all cases were 81.5% and 65.1%, respectively. According to initial treatment, 5-year survival rate was 62.2% for the patients treated by bladder-sparing surgeries, whereas it was 83.3% for the cases who underwent total cystectomy. However statistical significant difference was not recognized. In view of disease progression after initial bladder-sparing surgeries, patients with progression yealed a 45.7% 5-year survival rate compared to 81.5% for the patients without progression, and significant difference was demonstrated between them.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Usefulness of color Doppler flow imaging in differential diagnosis of multilocular cystic lesions of the kidney.

Color Doppler flow imaging was carried out in 10 multilocular cystic lesions of the kidney. These consisted of three renal cell carcinomas, three hemorrhagic renal cysts, one benign multilocular cystic nephroma, two infected renal cysts, and one benign multilocular renal cyst secondary to von Hippel-Lindau disease. In the patients with renal cell carcinoma, color signals were obtained at the septum and in the solid component within the lesions. A pulsatile wave with a large maximum flow velocity and a high PI value was obtained in two of them. In one of the patients with hemorrhagic renal cysts, color signals were obtained at the region of the septum. In the other benign lesions, however, color signals were obtained only at the peripheral margin, and the flow waveform in these cases was identical to the waveforms found in the interlobar arteries. This study suggested that color display in the lesion well reflects its vascularity in patients with multilocular cystic renal diseases and that measurement of the systolic maximum flow velocity by fast Fourier transform analysis is useful for the differential diagnosis of malignant versus benign lesions.

Adolescent↗

[The analgesic effect of iontophoresis with magnesium sulfate].

The analgesic effect of iontophoresis with magnesium sulfate was studied in fourteen healthy adult volunteers. Magnesium sulfate 0.5 mg.5 ml-1 was locally administered by the iontophoresis with 1.0 mA electric current for 10 min. The pain recognition time was measured by the pain thermometer before and after 5, 15, 30, 60 and 120 min of iontophoresis. The pain recognition time was significantly extended and lasted for 60 min. These results support the view that the iontophoresis with magnesium sulfate has analgesic effect and produces a good pain relief clinically.

Adult↗

Scintigraphic detection of xenografted renal tumor by anti-renal cancer monoclonal antibody radiolabeled with technetium-99m.

Accumulation in the tumor of the RCS-1 monoclonal antibody, which recognizes the cell surface antigen of renal cancer cells was examined. The antibody purified by affinity chromatography (protein-A column) and gel fractionation was labeled with technetium-99m (99mTc) by a direct method. High labeling efficiency (> 98%) could be routinely obtained. However, the 99mTc labeling of the antibody did not reduce the reactivity of the RCS-1 antibody. The labeled antibody was injected into nude mice transplanted with human renal and gastric tumors, and the accumulation of the antibody in each tumor and various tissues was compared at 48 hours after injection. The highest accumulation of radiolabeled RCS-1 antibody was observed in the AM-RC-3 renal tumors; at 8.0% of the injected dose per gram and a tumor-to-blood ratio of 1.05, respectively. However, the radiolabeled RCS-1, did not show specific accumulation in the gastric tumor nor in any tissues tested. The xenografted tumor, AM-RC-3 was successfully visualized with the radiolabeled RCS-1 antibody by scintigraphy.

Animals↗

[MR diagnosis for metastasis or non-metastasis of mediastinal and hilar lymph nodes in cases of primary lung cancer: detectability, signal intensity, and MR-pathologic correlation].

The detectability and signal intensity on MR imaging of mediastinal and hilar lymph nodes were studied in cases of lung cancer. Additionally, short inversion time inversion recovery (STIR) images and pathologic findings were compared. In the detection of resected metastatic mediastinal and hilar lymph nodes (n = 146), the STIR image (82%) was superior to the T1-weighted image (71%) and the T2-weighted image (60%). On STIR imaging, 212 (60%) of 412 resected non-metastatic mediastinal nodes and 38 (33%) of 116 resected non-metastatic hilar lymph nodes were detected. Characteristics of signal intensities of metastatic nodes were mainly low on T1-weighted images, high on T2-weighted images, and very high on STIR images. The rate of these characteristics of signal intensity of metastatic nodes was 59%. However, the rate of very high signal intensity of metastatic nodes on STIR imaging was 81%. Pathologically, lymph nodes with high or very high signal intensities on STIR images were metastatic, reactive and hyperplastic, or non-metastatic. Lymph nodes with slightly high signal intensity or high intensity with a low focus on STIR images were anthracotic, anthrasilicotic, caseous necrotic, calcified, or fibrotic. Thus, when the signal intensity of a lymph node was decreased on the STIR image, there was no definite evidence of metastasis excluding micro-metastasis or coagulation necrosis of a metastatic tumor. We conclude that the signal characteristics on STIR imaging are useful for distinguishing between macro-metastatic and non-metastatic lymph nodes when enlarged nodes are detected by various other types of medical imaging.

Adenocarcinoma↗

[The efficacy of midazolam-famotidine suppository for premedication in children].

We evaluated the efficacy of midazolam-famotidine suppository (M-F suppository) for premedication in children. After obtaining informed parental consent, we studied children aged 5m-7y, ASA I status, scheduled for minor elective surgery. The suppository group (n = 26) was given suppository of both midazolam 0.5 mg.kg-1 and famotidine 2 mg.kg-1, and the intramuscular injection group (n = 19) was given hydroxyzine 1 mg.kg-1. In the suppository group, gastric pH (3.90 +/- 0.34) was significantly higher, and gastric volume (1.88 +/- 0.54 ml) was significantly less than in the intramuscular injection group (1.82 +/- 0.15, 8.42 +/- 1.76 ml). The M-F suppository may offer similar sedative effect as an intramuscular injection of hydroxyzine. We concluded that the M-F suppository is an effective premedicant for pediatric patients.

Administration, Rectal↗

[The comparison of hypnotic potency of nitrous oxide with that of sevoflurane: evaluation by the middle latency auditory evoked response].

In 10 consented patients (ASA I-II) we quantitated the hypnotic potencies of 0.7 MAC nitrous oxide and 0.7 MAC sevoflurane by measuring auditory evoked response (AER), and compared the hypnotic potency of nitrous oxide with that of sevoflurane at the same MAC. In each patient, measurements of AER waves were performed in the following three stages, 0.7 MAC nitrous oxide, 0.7 MAC sevoflurane and 0.7 MAC nitrous oxide after induction of anesthesia. Analysis of variance was used to compare the hypnotic potencies between two inhaled anesthetics. Pa and Nb latencies with sevoflurane were longer than those with nitrous oxide, and Pa and Nb amplitudes with sevoflurane were greater than those with nitrous oxide. However, we found that there were no statistical significances in our results. In conclusion, nitrous oxide exerts as much hypnotic effect as sevoflurane.

Analysis of Variance↗

[Two cases of priapism cured by transcatheter embolization of internal pudendal arteries].

We report here two cases of priapism. One of these cases was suspected to be drug induced and high and low flow mixed type. The patient had taken the drugs, alpha-blocker for hypertension and dysuria by BPH for a long time. He was treated by a caveno-glandular shunt. After surgery, detumescence was obtained for some time, but erection appeared again soon. Transcatheter embolization of the internal pudendal arteries was then performed, and detumescence became permanent. The other case was an idiopathic and high flow type. Detumescence was achieved soon by transcatheter embolization of the internal pudendal arteries only, then he experienced morning erection imperfectly on the 9th day after this treatment. The management of priapism as reported to date is also reviewed.

Aged↗

Semiquantitative analysis by scanning electron microscopy of cochlear hair cell damage by ototoxic drugs.

The ototoxicity of cisplatin and carboplatin in the organ of Corti of the guinea pig was evaluated semiquantitatively. Damage of the stereocilia of outer hair cells (OHCs) observed by scanning electron microscopy (SEM) was classified into normal, grade 1 (10-50% loss of stereocilia), grade 2 (less than 50% remaining stereocilia), or grade 3 (missing stereocilia). The OHCs observed by light microscopy (LM) were classified as remaining or missing cells. Fifty OHCs of each row in the middle part of each turn of the cochlea were counted (a total of 150 cells per turn). Guinea pigs were administered 5 mg/kg of cisplatin or 50 mg/kg of carboplatin intraperitoneally for three consecutive days. In groups 1 and 2, in which both cochlea were fixed in 2.5% glutaraldehyde and 1% osmium tetroxide (OsO4) and observed by SEM, the percentages of damage of the OHC stereocilia were similar in each cochlear turn bilaterally. In group 3, the right cochleae were fixed in OsO4 and observed by phase contrast microscopy as surface preparations. Left cochleae were submitted for SEM observation. Missing and grade 3 cells were observed at similar percentages in each row of each turn. In group 4, succinate dehydrogenase staining was performed in the right cochleae and observed by LM. The degree of damage in the right cochleae was compared with that of the left cochleae which was observed by SEM. On average, the mean numbers of missing cells and cells showing grade 3 damage were similar in each row of each turn. From these similarities of evaluation of ototoxicity at LM and SEM levels, it was concluded that semiquantitative analysis by SEM only is appropriate for the assessment of ototoxicity.

Animals↗