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Biomedical subjects

S Takai

Publications and source records attributed to S Takai.

At least 361 records · Page 20Linked to original sources

[Chronology of medullary carcinoma of the thyroid].

In order to study the chronological progress of medullary carcinoma of the thyroid, clinical records and histological findings of 62 patients with the tumor were reviewed. Postoperative plasma calcitonin levels were examined in 54 patients. Among the patients with the disease of the hereditary type, those of 30 years of age younger with no lymph node involvement and a tumor weight less than 5 g were most likely to have normal plasma calcitonin levels postoperatively, provided total thyroidectomy were performed. The peak of age distribution of patients of the hereditary type without lymph node involvement was 15 years less than that of those with nodal involvement. In the sporadic type, there was no correlation between teh age and the nodal nodal involvement. Plasma calcitonin levels in the patients with residual tumor showed exponential increase according to the time course. The regression lines, log y = log a + bx (y: plasma calcitonin level, x: years after operation), were calculated in 23 patients followed 6 months or longer. The doubling time of the plasma calcitonin level (T2), given as 1/b log 2, correlated well with the tumor progression rate. T2 for patients of the hereditary type were 0.8 years or longer except for one. Four patients of the sporadic type with T2 of 0.1-0.3 year within 3 years after operation.

Adolescent↗

Skeletal maturity of Japanese children in Western Kyushu.

This paper describes the skeletal maturity status of Japanese children in Western Kyushu and its variation within Japanese populations. Hand-wrist skeletal maturity was assessed by the Tanner-Whitehouse (1975) (TW2) method from radiographs of 500 boys and 485 girls aged from 4 to 15 years. Western Kyushu children showed retarded skeletal maturity scores (RUS, carpals, and 20-bone) under the age of 12 years for boys and 10 years for girls, and thereafter they were advanced in relation to the British standard. Within Japanese populations the present sample showed delayed maturity compared to Tokyo children, but was close to that of Sapporo children throughout the age range studied. However, the expected effect of secular trend suggested skeletal maturity more advanced for Tokyo children and somewhat advanced one for Sapporo children compared to that of Western Kyushu children.

Adolescent↗

[Fine needle aspiration of neck tumor. Application of cytological, bacteriological and hormonal examinations].

Aspiration of neck tumors with a fine needle combined with cytological, bacteriological and hormonal examinations greatly improved the accuracy of the differential diagnosis of the neck tumors. Fine needle aspiration cytology in 45 patients with thyroid tumor gave only 4% (1/25) false negative diagnosis and 0% (0/20) false positive diagnosis for carcinoma, whereas false negative and false positive diagnosis by palpation were 34% and 4%, respectively and those by soft tissue roentgenogram were 55% and 0%, respectively. Differential diagnosis of histological types of thyroid carcinoma was possible by cytology. Fine needle aspiration of cervical lymph nodes gave the diagnosis of malignant lymphoma, metastatic squamous cell carcinoma, adenocarcinoma or inflammatory changes. Bacterial culture from the aspirate yielded causative microorganism in 5 patients including 4 with tuberculosis. The specimens aspirated from thyroglossal duct cysts or branchial cysts showed specific appearance and cytological feature. The aspirate from a parathyroid cyst was watery clear and contained high amount of parathyroid hormone. Dark brown serous aspirate from extrathyroidal mass suggested metastatic lesion from occult papillary carcinoma of the thyroid in 2 patients. Demonstration of very high content of thyroglobulin of the aspirate determined by radioimmunoassay supported the diagnosis, which was confirmed later at surgery. This method has become a routine work in our out-patient clinic.

Adenocarcinoma↗

[Urinary epinephrine and norepinephrine excretion in patients with medullary thyroid carcinoma and their relatives].

Medullary thyroid carcinoma can arise as a component of multiple endocrine neoplasia (MEN) syndrome which includes adrenal pheochromocytoma. Familial medullary thyroid carcinoma with no association of other components of MEN syndrome is also reported. Epinephrine and norepinephrine excreted in 24 hour urine and/or randomly voided urine were measured for screening of pheochromocytoma in patients with medullary thyroid carcinoma of either the hereditary or sporadic type and in their relatives. Six patients with clinical symptoms and signs suggesting pheochromocytoma had a markedly increased epinephrine and epinephrine/norepinephrine (E/N) ratio and a less dominant increase of norepinephrine in 24 hour urine. The diagnosis of pheochromocytoma was proved later at surgery. Among 10 patients with hereditary medullary thyroid carcinoma without any clinical symptoms and signs for pheochromocytoma, 6 patients had increased epinephrine and E/N ratio and normal norepinephrine, and the remaining 4 had normal epinephrine, norepinephrine and E/N ratio in 24 hour urine. The six patients with increased epinephrine and E/N ratios were regarded as having latent adrenal medullary hyperfunction. The mean ages of the 6 patients with proved pheochromocytoma, the 6 with latent adrenal medullary hyperfunction and the 4 with normal urinary catecholamine fractions were 51.3, 42.5 and 28.5 years, respectively. At least one patient in each family with hereditary medullary thyroid carcinoma had proved pheochromocytoma or latent adrenal medullary hyperfunction, leaving no family with hereditary medullary thyroid carcinoma only. Urinary epinephrine, norepinephrine and E/N ratios in patients with sporadic medullary thyroid carcinoma and relatives of patients with medullary thyroid carcinoma were not higher than those in normal subjects. Measurements of epinephrine and norepinephrine in randomly voided urine are also a valuable and convenient method for the screening of pheochromocytoma in patients with medullary thyroid carcinoma and their relatives, because they gave results similar to those in 24 hour urine.

Adolescent↗

Postoperative prophylactic use of progesterone in renal cell carcinoma.

Medroxyprogesterone acetate has been used prophylactically in 35 patients with stages I and IIIA renal cell carcinoma who had undergone radical nephrectomy. Metastasis was noted in 26 per cent (9 of 35) of the patients who had received the drug and in 44 per cent (20 of 45) of those who had not (controls). The incidence of metastasis in patients who had undergone nephrectomy more than 3 years previously was 10 per cent (3 of 31) for patients who received medroxyprogesterone acetate and 35 per cent (15 of 43) for the control group, the difference being statistically significant. Prognosis tended to be better in patients who had received medroxyprogesterone acetate than in the controls, and relative 3 and 5-year survival rates being 99.3 and 87.2 per cent, respectively, in the former group, and 86.8 and 75.0 per cent, respectively, in the latter group. There was no significant difference between these 2 groups. However, it may be concluded that prophylactic medroxyprogesterone acetate seems to be beneficial in the prevention of postoperative metastasis of renal cell carcinoma.

Adenocarcinoma↗