[Epithelial tumors of the lower respiratory tract].
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Adenocarcinoma↗
Biomedical subjects
S Tamai
Publications and source records attributed to S Tamai.
[Papilloma of the respiratory tract].
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Diagnosis, Differential↗
[Anatomical study on the atrophy of supraspinatus muscle belly with cuff tear].
We dissected the 76 shoulders in 38 cadavers to investigate changes in the supraspinatus muscle with a cuff tear and correlated these with age. We made a transverse section in the supraspinatus muscle and stained the section by the van Gieson method. Then we analyzed the changes in the supraspinatus muscle belly with the cuff tear, and by age, measuring the short and long diameter of a slice of the muscle belly and the area of tendon fiber. In the group with a normal cuff, there was a negative correlation between age and the short diameter of the slice of the supraspinatus muscle but no significant correlation between the age and the long diameter of the slice. In the group with a cuff tear, not only the short diameter but also the long diameter of the slice of the supraspinatus muscle decreased with increase in the length of the cuff defect. We concluded that measuring the long diameter of the slice of the supraspinatus muscle was more efficient than measuring the short diameter to evaluate muscle atrophy with a cuff tear. The area of the tendon in the slice increased with the length of cuff defect. The increased area of the tendon may have been responsible for reducing the elasticity in the supraspinatus muscle with a cuff tear.
Adult↗
Twin-barrelled vascularized fibular grafting to the pelvis and lower extremity.
From 1988 to 1992, 17 patients were treated for a large bone defect or established nonunion of the pelvis or lower extremities with twin-barrelled vascularized fibular grafts. There were 13 men and four women whose average age at operation was 39 years (range, 13-73 years). The reconstructed site was the pelvis in two patients, the femur in 12, the tibia in two, and the ankle in one. The mean length of the bone defect was 8.5 cm, and the mean length of the harvested fibula was 22 cm. Free grafts were transferred in 14 patients and pedicle grafts in three patients. The mean duration of the operation was six hours 46 minutes (range, 3.5-10.6 hours). Average blood loss was 1949 ml (range, 268-5308 ml). In one patient, the vascularized transfer failed, and recurrence of local infection was encountered in another. In the remaining 15 patients, the postoperative course was uneventful; the mean period to bony union was 5.1 months (range, two to 12 months). The mean time to full weight bearing was four months in pelvic reconstruction, 10.6 months in femoral reconstruction, and 6.3 months in leg reconstruction. Only one patient had a fracture of the fibular graft. This method is well suited for patients with a bone defect up to 13 cm in length of the pelvis or lower extremities.
Adolescent↗
[A case of hepatocellular carcinoma with portal invasion and right adrenal gland metastasis showing marked contraction of primary tumor and metastasis with treated by UFT alone].
A 79-year-old female with hepatocellular carcinoma with portal invasion and right adrenal gland metastasis was treated by low dose UFT (200 mg/day). Two months after the initiation of UFT administration, CT scan revealed marked contraction of the primary liver tumor and right adrenal metastasis. Serum AFP and PIVKA-II were also reduced, and right flank pain disappeared. Six months later, CT scan and MRI study were performed. The findings of liver and metastatic lesion were the same as in the earlier study, and the liver function and the patient condition were well controlled. This case is probably rare, but suggestive in the choice of treatment for advanced hepatocellular carcinoma.
Adrenal Gland Neoplasms↗
Increased expression of nucleoside diphosphate kinase/nm23 and c-Ha-ras mRNA is associated with spontaneous lung metastasis in rat-transplantable osteosarcomas.
The relationship between expression of nucleoside diphosphate kinase (NDP kinase)/nm23, c-Ha-ras, and c-myc genes and metastatic potential was assessed in rat-transplantable osteosarcoma lines, derived from spontaneous and chemical carcinogen (4-hydroxyamino quinoline 1-oxide)-induced osteosarcomas in Fischer 344/NS1c rats. These osteosarcomas possess metastatic potential and highly metastatic lines spontaneous osteosarcoma-selected lung metastatic lesions and 4-hydroxyamino-quinoline 1-oxide-induced osteosarcoma-selected lung metastatic lesions were respectively established by selectively transplanting lung metastatic lesions. Northern blot analysis revealed that the levels of NDP kinase/nm23 and c-Ha-ras gene expression were increased in line with metastatic ability; thus transcript levels were remarkably greater in both spontaneous osteosarcoma-selected lung metastatic lesions and 4-hydroxyamino-quinoline 1-oxide-induced osteosarcoma-selected lung metastatic lesions highly metastatic lines than in their respective low metastatic spontaneous and chemical carcinogen (4-hydroxyamino quinoline 1-oxide)-induced osteosarcoma counterparts. c-myc mRNA expression was observed in all tumor lines, without any correlation with metastatic ability. Southern blot analysis did not show evidence of gross rearrangement or amplification of NDP kinase/nm23, c-Ha-ras, or c-myc genes suggesting regulation of their gene expression at the transcriptional and/or posttranscriptional level. These results indicate that NDP kinase/nm23 and c-Ha-ras might be cooperatively involved in a positive manner in signal transduction processes, especially involving G-protein reactions, responsible for metastasis of rat-transplantable osteosarcomas.
Animals↗
The male preponderance in incidence of hepatocellular carcinoma in cirrhotic patients may depend on the higher DNA synthetic activity of cirrhotic tissue in men.
BACKGROUND: The relationship between the DNA synthetic activity of hepatocytes from cirrhotic liver tissue and the incidence of hepatocellular carcinoma (HCC) during a 3-year follow-up period was studied in male and female patients with posthepatitic cirrhosis. METHODS: The bromodeoxyuridine labeling index (BrdU LI) of hepatocytes was estimated in 38 cirrhotic patients (Child A stage, 23 men and 15 women) using a BrdU/anti-BrdU in vitro method. The incidence of HCC was compared between male and female cirrhotic patients during a 3-year follow-up period. RESULTS: Sixteen of 23 (69.6%) male patients belonged to the high-DNA synthesis group (BrdU LI > or = 1.5%), and only 7 (30.4%) were in the low-DNA synthesis group (BrdU LI < 1.5%). Among female patients, only 5 of 15 (33.3%) were in the high-DNA synthesis group, and 10 of 15 (66.7%) were in the low-DNA synthesis group (P < 0.05). Eleven of 23 (47.8%) male patients and 3 of 15 (20.0%) female patients had HCC develop. In the high-DNA synthesis group, 10 of 16 (62.5%) of the men and 3 of 5 (60.0%) of the women had HCC develop during the follow-up period. In contrast, only one of seven (14.3%) male patients and none of ten (0%) female patients in the low-DNA synthesis group had HCC develop. CONCLUSIONS: It was concluded that HCC developed frequently (about 60% of the time within 3 years) in patients of both sexes who were in a high-DNA synthesis group. Thus, the larger proportion of men in the high-DNA synthesis group compared with the number of women in the group (69.6% versus 33.3%) might be one possible reason for the male predominance in the development of HCC in cirrhotic patients.
Adult↗
DNA synthesis activities of hepatocytes from noncancerous cirrhotic tissue and of hepatocellular carcinoma (HCC) cells from cancerous tissue can predict the survival of hepatectomized patients with HCC.
BACKGROUND: There is a concept that a cancer often maintains some of the traits of the background tissue cells. Thus, the possibility exists that the DNA synthetic activity of the hepatocytes in cirrhotic tissue affects that of hepatocellular carcinoma (HCC) cells. METHODS: DNA synthesis activity of hepatocytes from background cirrhotic tissue and HCC cells from cancerous tissue was studied in 30 patients with liver cirrhosis (LC) and HCC who had undergone hepatectomy; the study was done using the bromodeoxyuridine (BrdU)-anti-BrdU in vitro method. The correlation between the BrdU labeling index (LI) of hepatocytes from noncancerous cirrhotic tissue and that of HCC cells was studied. The relationship between both BrdU LI values and the survival after hepatectomy also was studied. RESULTS: A significant correlation (r = 0.572; P < 0.001) was identified between the BrdU LI for HCC and that for noncancerous cirrhotic tissue. A significant correlation (r = -0.572; P < 0.05) was found between the BrdU LI of HCC cells and the survival after hepatectomy. A significant correlation (r = -0.678; P < 0.01) was observed between the BrdU LI of the noncancerous cirrhotic tissue and the survival. CONCLUSIONS: It was concluded that a significant correlation existed between DNA synthesis of hepatocytes from the background cirrhotic tissue and that of HCC cells and that DNA synthesis activity of hepatocytes from noncancerous cirrhotic tissue and that of HCC cells from cancerous tissue could predict the survival of patients with HCC who had undergone hepatectomy.
Adult↗
Handling characteristics of braided suture materials for tight tying.
To establish criteria for characterizing synthetic sutures, the handling characteristics of silk suture were analyzed. The characteristics that distinguish silk suture from other braided suture materials are its good "knot security" and relatively low "tiedown resistance." Analytic consideration of knot security suggests that not only superficial friction but also resistance force produced by cross-sectional deformity of braided threads plays an important role in silk's superior performance. Results of a "pullout friction test," developed to quantitatively evaluate resistance produced by surface friction and cross-sectional deformity suggest that the superiority of silk thread can be explained in terms of high static withdrawal resistance under low loads and relatively low dynamic withdrawal resistance under high loads.
Elasticity↗
Osteogenic differentiation of marrow stromal stem cells in porous hydroxyapatite ceramics.
Bioactive materials such as hydroxyapatite ceramics (HA) are known to show a stable interfacial bond with tissues (the bone bonding property has been especially well documented). However, the biological phenomenon on the material surface that evoke bone bonding is not well documented. To address this issue, composites of porous HA and rat marrow cells were implanted into ectopic (subcutaneous) sites. At 3 weeks after implantation, active osteoblasts lining the HA surface initiated bone formation, primarily as mature bone (lamellar type). Gene expression study using Northern blot analysis of the composites showed that alkaline phosphatase (ALP) and bone Gla protein (BGP) mRNAs began to appear at 2 weeks and the level of BGP mRNA at 4 weeks was comparable to that of cancerous bone. However, HA implantation without marrow cells did not show bone formation and neither BGP nor ALP mRNA were detected. These results indicate that the HA surface is able to support cell differentiation (osteoblastic phenotype expression of marrow stromal stem cells), as well as cell coordination resulting in mature bone formation that bonds to the HA.
Alkaline Phosphatase↗
History of microsurgery--from the beginning until the end of the 1970s.
Fine surgeries were started by vascular surgeons in the mid 1500s and included vascular ligature or suture of vascular wounds incurred in battle. Between 1800 and 1900, vascular end-to-end or end-to-side anastomoses and autogenous vein grafts became possible due to the efforts of Eck, Carrel and Guthrie. Thereafter, several experiments were performed for the transplantation of organs and limbs. Since the first use of the monocular microscope for ear surgery by Nylén in 1921 and the use of the binocular microscope by Holmgren in 1923, true microsurgery has developed and has gradually been specialized for every clinical discipline including otorhinolaryngology, ophthalmology, brain-neurosurgery, orthopedic surgery, plastic surgery, transplantation surgery, oncology, gynecology and urology. This could not have been accomplished without the development of the Zeiss operating microscope (OpMi system), fine microinstruments, and fine suture materials. The author describes the history of microsurgery from its beginning through the end of the 1970s, covering as many surgical disciplines as possible.
Animals↗
"Plasmatic imbibition" in the rat musculocutaneous pedicled venous flap: enzymatic proof using horseradish peroxidase.
To determine the reason for survival of a pedicled venous flap in which only a draining vein is preserved, it is important to clarify what kind of blood flow is present in the preserved draining vein. Pedicled venous flaps were prepared on the dorsum of the rat and histologically evaluated using horseradish peroxidase (HRP). HRP was applied between the flap and recipient bed in one group. In the other group, HRP was injected into the femoral vein after the flap was turned over (to prevent contact with the recipient bed). The flaps in these HRP-treated groups were compared with untreated control groups. HRP applied between the flap and recipient bed was imbibed into the flap and subsequently transferred into the preserved draining vein. HRP that was injected into the femoral vein was also found in the draining vein of the flap. These results suggest that (1) plasmatic imbibition occurs in pedicled venous flaps; and (2) antegrade and retrograde blood flow are present in the draining vein.
Administration, Topical↗
Vascular complications of vascularized composite tissue transfer: outcome and salvage techniques.
Two hundred fifty-two vascularized composite tissue transfers were performed from 1985 to 1992 at Nara Medical University Hospital. Free tissue transfers were performed in 185 patients and island tissue transfers in 67 patients. Of these, 39 flaps were reexplored because of vascular complications. On initial reexploration, vascular obstruction was found at the site of anastomosis or in the main vascular pedicle in 36 patients and in the perforating vessels to the monitor flap in three patients. Arterial thrombus occurred in 11 patients, venous thrombosis in 12, and both in nine. Twenty-five reexplored flaps were salvaged. Initially, heparin was administered systemically when vascular compromise was suspected intraoperatively or postoperatively. Recently, we have used a "continuous local heparinization" technique to minimize blood loss. This method has been used in 12 patients who underwent reexploration and in nine patients in whom vascular compromise was suspected. Nineteen flaps survived completely, and two flaps failed.
Adolescent↗
Synovial chondromatosis of the acromioclavicular joint. A case report.
Synovial chondromatosis involving the acromioclavicular joint is very rare. We report a case of synovial chondromatosis of the acromioclavicular joint associated with synovial cyst formation. Arthrography of the acromioclavicular joint revealed that the loose bodies lay within a synovial cyst which was in communication with the acromioclavicular joint. Synovectomy including removal of the synovial cyst and the loose bodies relieved symptoms completely. The patient was still pain- and recurrence-free at 4 years' follow-up.
Acromioclavicular Joint↗
Primary ovarian lymphoma. A case report.
A 44-year-old woman with stage IV non-Hodgkin's lymphoma (NHL) of the left ovary is described. She had an extended hysterectomy and bilateral salpingo-ophorectomy and thereafter received six courses of combination chemotherapy (cyclophosphamide, adriamycin, vincristine and predonisolone; CHOP). The patient is well with no evidence of recurrence at 12 months after surgery. The literature on primary ovarian lymphoma is reviewed.
Adult↗
The arterialised venous flap: experimental studies and a clinical case.
It is accepted that small arterialised venous flaps (AVF) can survive on a recipient bed with poor blood supply but survival of larger flaps is not always satisfactory. Possible reasons for this include the flap anatomy, particularly the pattern of the venous network, or factors at the recipient site. To investigate the possible factors in the flap design and the recipient site of an arterialised venous flap, we studied the relationship between (1) size of the artery used to arterialise the flap at the recipient site and the survival rate and (2) the number of draining veins and the survival rate, using rabbit ear skin flap models. Our results suggest that AVFs may become necrotic in the presence of a relative excess of arterial blood inflow, and that two exit veins are more effective than one. We also report a case where a 10 x 15 cm sized free AVF harvested from the lower extremity survived on the forearm.
Adult↗
The pedicled venous flap. Clinical applications.
Experimental findings of survival of pedicled venous flaps were clinically applied in seven cases for traumatic skin defects on digits. Five flaps which were transferred to or on digits other than the thumb survived, but two flaps from the index to the thumb developed partial necrosis. In order to prevent flap necrosis, the draining vein should be short.
Adult↗