Biomedical subjects
Publications and source records attributed to S Koga.
Esophageal diverticula in infants and children are rarely seen, even by the pediatric radiologist. This is a case report of an infant girl presenting with an esophageal diverticulum arising from the right anterior lateral aspect of the proximal third of the esophagus. The diverticulum included a metallic foreign body.
Forty percent of patients with gastric cancer with direct infiltration to adjacent organs survived for more than 5 years after curative resection. Favorable results were obtained in cases in which combined resection of the body of the pancreas or the liver was performed due to cancer infiltration. However, patients who had undergone gastrectomy with combined colectomy or pancreatoduodenectomy showed a poor survival rate. The postoperative 5-year survival rate was 29% for patients who had presented with group 3 lymph node metastasis and undergone potentially curative surgery. Particularly, favorable results were obtained in cases with metastases confined to lymph nodes in the hepatoduodenal ligament. In dissection of the deepest nodes, lymph nodes in the hepatoduodenal ligament is the most important to remove in surgery for stage IV gastric cancer. We have performed gastrectomy combined with dissection of group 1 and 2 lymph nodes in the treatment of patients with gastric cancer with peritoneal metastasis. Results obtained so far revealed that only patients with a lesser extent of serosal invasion survived longer after operation. We are presently conducting a trial of hyperthermia combined with anticancer chemotherapy as a possible method for prolongation of survival of patients with peritoneal metastasis of gastric cancer.
Nuclear DNA content was microspectrophotometrically measured in 120 gastric cancer patients to assess the predominance of a particular DNA distribution pattern in gastric cancer with biologically high malignancy, such as the marked tendency for severe vessel invasion and remote metastasis, and for early recurrence after curative surgery. DNA distribution patterns were grouped into low and high ploidies, and the correlation between the DNA ploidy pattern and histopathologic, biologic findings was evaluated. The incidence of high DNA ploidy tended to be increased as the histological stage and level of infiltration progressed. On the other hand, the incidence of high DNA ploidy was higher in dead cases of early recurrence among cases of the same histological stage, or where vessel invasion and remote metastasis were severe among cases of the same depth of invasion. Therefore, we consider that the DNA distribution pattern well reflects the malignancy of gastric cancer.
This paper describes levels for discharge from hospital and return to general ward of patients treated with 131I. The level was determined by comparing the possible exposure dose to those individuals whom the patients are in daily contact with the annual dose limit for the public. The external exposure dose was calculated by using the data on the distance between the patient and individuals, length of the time spent at each distance, and each individual's age. The following levels were obtained: (1) For the patient to be discharged from the hospital, the maximum residual radioactivity should be less than 0.51 GBq if the distance from the patient in bedroom is 50 cm or more and the ages of her children are all over one year. No restriction is needed for the patient with residual radioactivity of 0.20 GBq. (2) For the patient to be returned to the general ward, the maximum residual radioactivities should be 28 MBq and 41 MBq, corresponding to the distance from the patient of 2.0 m and 2.5 m respectively. We established a method to analyze the factors affecting the level.
To elucidate the role of protein C (PC) in the release of plasminogen activator inhibitor (PAI) from endothelial cells, the effect of PC and activated protein C (APC) on plasma levels of PAI in endotoxin (ET)-treated rats was examined. When activated by snake venom, human PC significantly prolonged the activated partial thromboplastin time (APTT) of both human and rat plasma samples. Addition of APC also prolonged the APTT of both human and rat plasma samples. PAI activity in plasma from septicemic patients and ET-treated rats was neutralized by APC. A small dose of ET (0.1 microgram/kg) gradually increased plasma PAI activity, which became maximum 3h after ET-treatment. APC administered prior to ET-treatment, PC decreased PAI activity, however, no such inhibition was seen when administered after ET-treatment. A significant negative correlation between PC concentrations and PAI activities was observed in plasma from septicemic patients. These findings indicated that activation of PC on endothelial surface plays a regulatory role in releasing PAI and that endotoxin might inhibit the surface activation of PC.
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We compared the cost to store X-ray films among storing them by themselves, utilizing rental stock, converting to microfilm and entering images into optical file system. We used microcomputer and spread sheet system on it for this comparison. Storing X-ray films by themselves is the most inexpensive, but the cost is depend on the price of land. Rental stock is the second. If the price of land is high, microfilm is most inexpensive. Optical file system is much expensive. It is not suit to store X-ray images which are already being stored as X-ray films. Beside of the cost, we should also estimate the factors as accessibility to image, easiness of use the systems etc.
To evaluate cerebral hemodynamics by N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) preoperative and postoperative (after 1 day, and after 7-10 days) regional cerebral blood flow scan, 6 arteriovenous malformations (AVMs) which performed total removal operations were studied by using a ring type SPECT "HEADTOME". We performed the dynamic scan just after the intravenous injection of 222 MBq (6 mCi) of 123I-IMP, then the static scan 20 minutes after the intravenous injection. In preoperative dynamic scans of all cases, only the first frame image showed the increased activity on the nidus probably because of the blood pool. Preoperative static scans of all cases showed the remarkable decreased activity on the nidus, and decreased activity surrounding the nidus probably because of the peripheral steal phenomenon. In postoperative scan of the next day, 4 out of 6 cases showed the transient decreased peripheral steal, particularly 2 out of those 4 cases showed the transient hyperperfusion probably because of the normal perfusion pressure breakthrough (NPPB). And, 2 out of 6 cases showed transient peripheral low perfusion on much larger area than those of the preoperative scans probably because of the focal brain damages and edemas. We conclude that 123I-IMP SPECT on AVM is very useful to decide the indication of the removal operation, and to estimate the postoperative risk, and to evaluate the preoperative and postoperative cerebral hemodynamic changes in the peripheral area of AVM.
To evaluate the cerebral hemodynamics and the pathogenesis by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV), 42 transient ischemic attack (TIA) patients and 9 normal volunteers were studied using SPECT. We classified these patients into Group A (n = 23: no occlusion or stenosis of the internal carotid or middle cerebral artery; non large vessel disease) and Group B (n = 19: chronic occlusion or severe stenosis of the internal carotid or middle cerebral artery; large vessel disease). We obtained rCBF with 133Xe inhalation and rCBV with 99mTc-red blood cells. Of 9 normal volunteers aged 43-70 yr (mean age 59.8 +/- 8.3 yr), the mean rCBF was 45.8 +/- 5.1 (ml/100 g brain/min), the mean rCBV was 4.0 +/- 0.4 (ml/100 g brain). The examination was done by comparing the values of the affected hemispheres of Group A and Group B patients with the mean rCBF and the mean rCBV of normal volunteers. Eleven out of Group A patients and 15 out of Group B patients showed decreased rCBF. But of those patients, no patients of Group A showed increased rCBV and 6 out of 19 Group B patients showed increased rCBV. Thromboembolic mechanism which is of Group A patients and Group B patients without increased rCBV, and hemodynamic mechanism which is of Group B patients with increased rCBV were considered as the main cause of TIA. Decreased rCBF and increased rCBV in Group B patients can be assumed as the misery perfusion as reported in PET studies.(ABSTRACT TRUNCATED AT 250 WORDS)
A case of iatrogenic right subclavian artery pseudoaneurysm which had disappeared spontaneously without surgical procedure, was presented. Among several diagnostic imaging modalities, ultrasonic color doppler method was considered most useful to visualize the anatomy and hemodynamics of the artery and the aneurysm.
The effects of bunazosin and propranolol administration on hypertension and serum levels of lipids, lipoproteins and apolipoproteins were studied in a controlled, randomized multicenter study. After a 4-week washout period, 48 patients with mild to moderate essential hypertension were randomly assigned to either the bunazosin or the propranolol group. Twenty-four were treated with bunazosin (1 to 3 mg t.i.d.) and 24 with propranolol (10 to 40 mg t.i.d.) for 12 weeks. Systolic and diastolic blood pressures decreased significantly in both groups. After 12 weeks of bunazosin treatment, significantly lowered apolipoprotein (apo) B and apo B/apo A-I ratio (p less than 0.05, in both cases) were observed, in contrast to no changes in the propranolol group. Although the changes were not significant, bunazosin tended to decrease the ratio of total cholesterol minus HDL cholesterol to HDL cholesterol. There were no significant changes in total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, apo A-I, apo A-II, apo C-II, apo C-III and apo E for either bunazosin or propranolol. The difference between the two drugs was significant for the apo B/apo A-I ratio (p less than 0.05). Bunazosin monotherapy was shown to be as effective in reducing blood pressure as propranolol. In addition, its favorable effects on lipoprotein metabolism seem to offer an additional advantage in mitigating coronary risk.
Dynamic Respiratory Scanning (DRS) was developed in order to get a series of respiring chest image during the period from maximum inspiration to maximum expiration by using fast CT. The image of different respiratory phase was selected and displayed successively under the control of a track ball. We could recognize the relation of the visceral and parietal pleura as the relative position of the ribs and peripheral pulmonary vessels. The DRS was useful for the diagnosis of pleural adhesion.
In treating cancerous metastases to the liver, we combined hyperthermic treatment with chemotherapy via the intra-hepato-arterial injection (IHAI) of cis-diamminedichloroplatinum (II) plus 5-fluorouracil. The subjects were 14 patients having metastases to the liver: 3 from gastric cancer and 11 from colorectal cancer. In metastases of colorectal origin, the response rate (partial response) was 55%; the 1-year survival rate was 80%; the 50%-survival period was 23 months. The response rate and the 50%-survival period in metastases of gastric origin were 67% and 11 months, respectively. When IHAI chemotherapy was combined with hyperthermic treatment, antitumor effects were generated in 3 of 6 metastatic patients from colorectal cancer, who had received no benefit from the IHAI chemotherapy alone. Better results were produced by thermochemotherapy than by IHAI chemotherapy alone. Hepatic blood flow, which influences the antitumor effect of hyperthermic treatment or chemotherapy, was measured using the 133Xe clearance method. Over the long term, the hepatic blood flow, especially that of the portal-venous route, showed a decreasing tendency after repeated sessions of the present regimen. This fact suggests the increased retainability of arterial-injected carcinostatics in cancerous tissues.
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Natural cell-mediated cytotoxicity against NK-resistant target tumor cells was found in the peripheral blood of tumor-bearing patients approximately 1 mo after combined chemotherapy. The recognition specificity of these effector cells was broad and had no restriction. From the experiments of negative selection with mAbs and complements, these newly developed killer cells after chemotherapy were thought to be LAK-like cells. Contribution of these LAK-like cells to the mechanism of action of anticancer drugs remains to be clarified.
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