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Biomedical subjects

S Hasebe

Publications and source records attributed to S Hasebe.

At least 55 records · Page 3Linked to original sources
PubMed1997

Combined therapy with external beam irradiation and hepatic arterial epirubicin infusion through an implanted port for advanced hepatocellular carcinoma.

Nineteen patients with advanced stage IV hepatocellular carcinoma for which transcatheter arterial embolization and percutaneous ethanol injection were not indicated have been treated by combined therapy with external beam irradiation and repeated hepatic arterial epirubicin infusion through an implanted port. The response rate was 47%, and the median survival was 11.6 months (range, 4.0 to 27.1 months). Eighteen of the 19 patients were able to undergo the infusion therapy on an outpatient basis 3 to 7 weeks after initiation of therapy. This combined therapy was effective in improving tumor-bearing survival and less stressful for the patients because of the minimal therapy-related toxicity and brief hospitalization.

Antibiotics, Antineoplastic↗
PubMed1997

Prediction of postoperative decompensated liver function by technetium-99m galactosyl-human serum albumin liver scintigraphy in patients with hepatocellular carcinoma complicating chronic liver disease.

BACKGROUND: Preoperative technetium-99m galactosyl-human serum albumin (Tc-GSA) liver scintigraphy may predict postoperative decompensated liver function and its value has been investigated in patients having resection of hepatocellular carcinoma (HCC). METHODS: Hepatic uptake ratio of Tc-GSA (LHL15) was measured before operation in 30 patients. Postoperative complications were analysed retrospectively and compared with LHL15 values and other indicators evaluating hepatic function. RESULTS: The LHL15 of 22 patients without complications was 0.91 or more, compared with 0.90 or less in the eight patients who had complications. Multifactorial analyses showed that LHL15 and Child-Pugh grade significantly predicted postoperative complications (P < 0.0001 and P = 0.0111 respectively). LHL15 was a significant predictor of complications in patients with Child-Pugh grade B disease (n = 15, P = 0.0011). CONCLUSION: LHL15 was a reliable preoperative indicator of the risk of major postoperative complications in patients who had resection for HCC.

Aged↗
PubMed1997

[Arterial infusion chemotherapy with SMAN CS-Lipiodol for hepatocellular carcinoma evaluation of infusion method].

Forty-four patients with hepatocellular carcinoma were treated with oily anticancer agent SMANCS dissolved in Lipiodol (SMANCS-LPD). The local response rate after the first arterial infusion in all patients was 39%, against 63% in 27 patients with Lipiodol accumulation occupying more than two third of tumor areas. Repeated arterial infusion of SMANCS-LPD did not enhance the therapeutic effect. An infusion of 4mg of SMANCS was ineffective for patients with tumors distributing in bilateral lobes of liver, and 6 mg was recommended for such cases.

Aged↗
PubMed1997

[Preoperative evaluation of the limitation of hepatic resection using 99mTc-GSA (galactosyl human serum albumin) scintigraphy].

UNLABELLED: Preoperative evaluation of the operative indication of hepatic resection using the parameters obtained by 99mTc-GSA scintigraphy has been done. In particular, the accurate evaluation of the postoperative hepatic functional reserve essentially depends on these parameters. In the present study, a preoperative evaluation of postoperative hepatic functional reserve using 99mTc-GSA scintigraphy was performed in our operated cases retrospectively. PATIENTS AND METHODS: Thirty-eight patients who underwent hepatic resection were studied on 99mTc-GSA scintigraphy before and after operation. These patients were divided into two groups. Group A; had no postoperative complications (n = 31). Group B; had some postoperative complications (n = 7). Preoperative parameters of 99mTc-GSA liver scintigraphy (HH15, LU15) were calculated from the activities of liver and cardiac ROIs at 5 and 15 minutes after injection. The resection ratio (RR) was obtained by comparing the liver volumes which were calculated from the pre- and postoperative SPECT studies. The resectability indices (Res) were as follows: Res (LU15) = LU15 x (100-RR(%)/100, Res (HH15) = (1/HH15) x (100-RR (%)/100. RESULTS: There were statistically significant differences in the distribution of Res between A and B groups (p = 0.002, Mann-Whitney test). The values of Res, of which half of patients have complication, were 1.10 (Res (HH15)) and 16.4 (Res (LU15)). CONCLUSION: The resectability indices using 99mTc-GSA liver scintigraphy are useful for the preoperative evaluation of the limitation of hepatic resection.

Adult↗
PubMed1996

Strabismus surgery in ocular myasthenia gravis.

We evaluated the efficacy of eye muscle surgery in 4 patients with ocular myasthenia gravis with troublesome diplopia. All patients were in remission and had shown a consistently stable angle of deviation for at least 6 months preoperatively. The extent of eye muscle surgery was based on the degree of deviation in the primary position, and conventional recession and resection procedures were performed in 3 patients and hang-loose recession with an adjustable recession in 1. Single binocular vision was obtained in 3 patients in the primary position without prism correction or compensatory head posture. Electron-microscopic studies on the eye muscle specimens obtained at strabismus surgery revealed non-specific degenerative findings for the muscle fibers and sarcomeric disorganization compared to that in a control extraocular muscle.

Adolescent↗
PubMed1996

[Fast two-compartment model analysis with 99mTc-GSA liver scintigraphy].

The use of numerical integration method (N. INT) was evaluated in determining parameters by two-compartment model analysis from liver scintigraphy. Among the 15 subjects, 14 had liver cirrhosis or chronic hepatitis, and one was normal. When using N.INT, the sum of two exponential functions on heart regression curve following intravenous injection of 99mTc-galactosyl human serum albumin (99mTc-GSA) was promptly calculated. The parameters obtained from N.INT, including transfer rate of 99mTc-GSA from extrahepatic blood to liver (k1), dissociation rate from liver to extrahepatic blood (k2), and excretion rate from liver to gallblader (k3), were significantly correlated with those obtained by the nonlinear least square method (NLS). k1/k2 was related with the maximum removal rate of 99mTc-GSA obtained from nonlinear five compartment model analysis (r2 = 0.705, n = 15) and also with the severity score of liver disease as classified by the First Department of Surgery, Mie University Medical School (r2 = 0.686, n = 13). In terms of the time required to obtain these parameters, including the blood retention rate of 99mTc-GSA at 15 min after injection (%ID15), N.INT was faster than the traditional method (NLS).

Aged↗
PubMed1996

[Quantitative analysis of 99mTc-GSA liver scintigraphy with graphical plot method].

99mTc-galactosyl human serum albumin (99mTc-GSA) is a newly developed receptor-binding agent, specific for the asialoglycoprotein receptor, which resides exclusively on the plasma membrane of mammalian hepatocytes. Liver scintigraphy using 99mTc-GSA was performed on 65 patients with liver diseases. Dynamic data were obtained by gamma camera during 20 minutes after the intravenous injection of 3 mg (185 MBq) of 99mTc-GSA. The maximum removal rate of 99mTc-GSA (denoted as P(2)) was measured by two methods: nonlinear five-compartment model analysis adopting the Michaelis-Menten constant for the transfer of 99mTc-GSA from hepatic blood to receptor, and a graphical plot using compartmental dose curves. The graphical plot could estimate easily the maximum removal rate in terms of two data points of 0 and 1 minutes without nonlinear least squares and numerical integration. The results indicated that the maximum removal rate was decided immediately after the intravenous injection of 99mTc-GSA. Although 99mTc-GSA is recognized to accumulate nonlinearly on the liver, the rate constant P(2)*(1/min) of transfer from hepatic blood to the receptor was estimated by graphical plot, assuming a linear five-compartment model. P(2)*Km, which was given by the product of the rate constant P(2)* and the Michaelis constant Km, was well correlated with P(2). Next, for 99mTc-GSA liver scintigraphy, we applied a Patlak plot that was applicable to the linear system, and the rate constant Ku of transfer from extrahepatic blood to the liver was estimated. From the results of graphical plot, it was theoretically shown that Ku represented P(2). This was confirmed by clinical data.

Adult↗
PubMed1996

Clinical studies of ocular motility disturbances. Part 1. Ocular motility disturbances: causes and incidence.

Between January 1985 and December 1994, 500 cases of ocular motility disturbances were encountered in our department; we analyzed these statistically. There were 48 cases of supranuclear palsy (10%), 281 of ocular motor nerve palsies (56%), 19 with myasthenia gravis (4%), 29 with myogenic palsy (6%), 57 with abnormal innervation (11%), and 63 instances of mechanical disturbances (13%). There were more men than women in all groups except myasthenia gravis. Eighty-four ocular motor nerve palsy and 15 blowout fracture patients recovered spontaneously. Spontaneous recovery occurred within 6 months in 80 (93%) patients with ocular motor nerve palsy. The abnormality detection rate, using diagnostic imaging, was high for supranuclear and myogenic palsy and the mechanical disturbance groups, but very low for the ocular motor nerve palsy groups. In 3 supranuclear palsy patients, small infarctions of the brainstem were discovered by magnetic resonance imaging (MRI) but were not found with computed tomography (CT). MRI thus proved useful in detecting abnormalities of brainstem lesions.

Adult↗
PubMed1995

Using Ga-67 scintigraphy in prostatic abscess.

The use of Ga-67 scintigraphy (Ga) in prostate inflammatory diseases may be restricted by the difficulty in distinguishing between the accumulation of Ga-67-citrate (Ga-citrate) in the lesion and feces. The diagnosis of prostatic abscess has been mainly made by other radiologic methods without scintigraphic studies and no finding of Ga has been reported. This patient demonstrated that coordinating the findings of Ga-citrate accumulation can be helpful in making a prompt diagnosis of a possibly fatal prostatic abscess, especially in those patients with poorly defined clinical symptoms and high risk factors.

Abscess↗
PubMed1995

The reliability of a video-enhanced Hirschberg test under clinical conditions.

PURPOSE: To examine the reliability and usefulness of a video-based Hirschberg test under clinical conditions. METHODS: The authors estimated ocular deviation in 87 patients with strabismus through automated analysis of corneal reflex displacement using a video refractor. The reproducibility of measurement, the comparison with the prism and alternate cover test (PACT), and the distribution of the Hirschberg ratio were investigated. RESULTS: The 95% limits of agreement of the video-based Hirschberg test evaluated by repeated measurements were +/- 0.18 mm (equivalent to +/- 2.2 degrees or +/- 3.8 prism diopters [PD] of calculated strabismic deviation) for the horizontal deviation and +/- 0.28 mm (equivalent to +/- 3.4 degrees or +/- 5.9 PD) for the vertical deviation. The 95% limits of agreement between the Hirschberg measures and the PACT were within +/- 7.8 degrees or +/- 13.7 PD. The average (+/- SD) Hirschberg ratio was 12.3 +/- 1.2 degrees/mm or 21.8 +/- 2.1 PD/mm. CONCLUSIONS: The video-enhanced Hirschberg measurement shows good reproducibility and ease of application, even in the testing of infants. In quantitative analysis, however, systematic measurement error resulting from intersubject variance of the Hirschberg ratio should be taken into consideration.

Adolescent↗
PubMed1995

[A study of acquisition time using compartment analysis with 99mTc-GSA liver scintigraphy].

99mTc-galactosyl human serum albumin (99mTc-GSA) is a newly developed receptor-binding agent specific for the asialoglycoprotein receptor, which resides exclusively on the plasma membrane of mammalian hepatocytes. Liver scintigraphy using 99mTc-GSA was performed on 13 patients with liver disease. Dynamic data were obtained by gamma camera during 40 min after the intravenous injection of 3 mg (185 MBq) of 99mTc-GSA. Heart and liver time activity curves with acquisition times of 40,30 and 20 min were created, and two different compartment analyses were examined. One was a nonlinear five-compartment model adopting the Michaelis-Menten type for the transfer of 99mTc-GSA from hepatic blood to receptor, and the other was a linear five-compartment model assuming a linear rate constant (P(2)*) for the transfer of 99mTc-GSA. The maximum removal rate obtained by the nonlinear model, P(2), was found to be independent of the change in acquisition time, while the maximum removal rate obtained by the linear model, P(2)*.Km, which was given by the product of P(2)* and the Michaelis constant Km, increased with shortening acquisition times from 40 to 20 min. For both models, the liver blood flow rate decreased with shortening acquisition time. The maximum removal rate and liver blood flow rate obtained by the linear model were significantly correlated with those obtained by the nonlinear model. It was concluded that linear model with an acquisition time of 20 min was applicable to liver scintigraphy with 99mTc-GSA.

Adolescent↗
PubMed1994

Critical period for restoration of normal stereoacuity in acute-onset comitant esotropia.

We conducted a retrospective study of 25 patients with acute-onset comitant esotropia to evaluate whether the timing of the start of treatment is a critical factor in the development of normal stereopsis. The mean age at onset was 12 years 4 months, and mean age at the start of treatment was 17 years 9 months. Bifixation was defined as a stereoacuity threshold score that was numerically lower than 60 seconds of arc on stereotesting. An operation was performed on the nonfixating eye for the prism-adapted angle. At the final examination, bifixation was observed in four patients (16%) with the Randot test and in 15 patients (60%) with the Titmus test. No relationship was found between the time of the start of treatment and the postoperative development of stereopsis, nor was there a significant (P > .10) difference between the two groups with early and delayed start of treatment in the proportion of patients with bifixation.

Acute Disease↗
PubMed1994

Extraocular muscle surgery in a rabbit model: site of reattachment following hang-back and conventional recession.

To determine the precise site of reattachment of recessed muscles, 4-mm conventional and hang-back recessions of the inferior rectus muscle were performed in 18 albino rabbits. Six weeks later, the distance from the anterior border of the reattached muscle to the insertion was measured both grossly and microscopically. In all cases the operated muscles had advanced minimally from the site of surgical placement. Gross observation showed that the mean forward creep was significantly greater for those rabbits which underwent hang-back recession (1.81 +/- 0.67 mm) than for those that were submitted to the conventional technique (0.83 +/- 0.38 mm). Measurements done on histological sections revealed that the mean distance of the anterior border of the muscle fiber from the reference suture was larger for conventional recession (2.73 +/- 0.75 mm) than for hang-back recession (1.91 +/- 0.72 mm).

Animals↗
PubMed1994

Intraoperative adjustable suture surgery for bilateral superior oblique palsy.

BACKGROUND: The modified Harada-Ito procedure has been reported to be an effective treatment for correction of cyclotorsion in bilateral superior oblique palsy. However, there are no reports regarding its use in intraoperative adjustable suture surgery. METHODS: The authors performed a retrospective study of 12 patients with traumatic bilateral superior oblique palsy who were classified as having either symmetric or asymmetric palsy according to the symmetry of the alternate hyperdeviation on side gazes. Cyclotorsion and vertical and horizontal deviation in the nine diagnostic positions were measured preoperatively and postoperatively. RESULTS: Of the 12 patients, 6 were determined to have symmetric palsy and 6 asymmetric palsy. Intraoperative adjustable suture surgery with the modified Harada-Ito procedure was performed bilaterally in the six patients with symmetric palsy and unilaterally in those with asymmetric palsy. The median measured value of extorsion in the primary position was reduced from 14.5 degrees to 2.5 degrees in patients with symmetric palsy and from 9.5 degrees to 2.0 degrees in those with asymmetric palsy. In downgaze, some degree of residual extorsion remained, and there was no significant change in esodeviation after surgery. In five patients with symmetric palsy and in all of those with asymmetric palsy, normal single binocular vision in the primary position but did not that in downgaze was restored after surgery. CONCLUSION: Intraoperative adjustable suture surgery is an effective treatment in correcting torsion, but may not be as effective for esodeviation in downgaze.

Adult↗
PubMed1993

[CT finding of right diaphragmatic rupture due to blunt trauma--subhepatic hemothorax].

Owing to the poor detectability of the anatomic location of diaphragm on the parallel plane of computed tomography (CT), capability of CT to predict traumatic ruptured diaphragm has been debated in several reports. A specific hematoma (subhepatic hemothorax) adjacent to the posterior attachment of the right diaphragm was identified on CT. The finding originated from herniated liver that migrated to the posterior thoracic wall as a result of gravity, to separate the hemothorax in the supine position. This was surgically proven in two patients after blunt traumatic accident. The finding is useful in predicting right diaphragmatic rupture on CT study. The formation of subhepatic hemothorax, its differential diagnosis and a brief review of diaphragmatic rupture are discussed.

Adult↗
PubMed1993

Preoperative prism correction in patients with acquired esotropia.

We performed a prospective study of preoperative prism adaptation in 77 patients with acquired esotropia. Sixty-three of them increased their angle of squint when wearing Fresnel press-on prisms for 5-7 days. After the angle had stabilized to a point that did not exceed the press-on prisms by more than 10 prism D, they were randomly divided into two groups. Thirty-two patients underwent surgery based on the prism-adapted angle. The other 31 patients underwent surgery based on their initially measured angle. Fourteen patients who did not respond to prism correction underwent surgery based on the angle before prism correction. Success rates with deviations between 0 and 10 prism diopters measured 1 year after surgery were highest in those in whom surgery was based on the prism-determined angle and were lowest in the nonresponders, who had no fusion response to the prisms.

Adaptation, Ocular↗