Biomedical subjects

S Yoshida

Publications and source records attributed to S Yoshida.

At least 973 records · Page 54Linked to original sources

PubMed1995

[Non-traumatic cerebrospinal fluid rhinorrhea associated with hydrocephalus: a case report].

We report an unusual case of non-traumatic cerebrospinal fluid rhinorrhea associated with aqueductal stenosis and hydrocephalus. The patient was a 10-year-old girl who suddenly developed massive CSF rhinorrhea following severe edema of the left side of her face. CT scan showed marked dilatation of the lateral and third ventricles and enlarged sphenoid sinus of water density, extending to the lateral wall of the left orbit and to the left pterygoid fossa. Immediately after the onset of CSF rhinorrhea, ventricular drainage was performed, but the rhinorrhea persisted. Ventriculography revealed predominant flow of the contrast medium into the left temporal horn and abnormal collection in the sphenoid sinus. Coronal CT scan did not show any focal bony defect, but a thin layer was seen in the base of the left middle fossa. Exploration of the skull base in the left middle fossa was performed through a left frontotemporal craniotomy. An irregular bony defect measuring 7 x 12mm was then found in the anterolateral floor of the middle fossa and the dura was also perforated there. Brain tissue including the temporal horn protruded through the bony defect into the sphenoid sinus. After excision of the herniated brain tissue, repair was accomplished by packing muscle into the bony defect and covering the dural defect with fat reinforced by coating with fibrin glue. Postoperatively, the CSF rhinorrhea has stopped and the edema of her face has disappeared. We discuss the etiology of this unusual spontaneous CSF leakage through the middle fossa and the abnormally enlarged sphenoid sinus.

Cerebrospinal Fluid Rhinorrhea↗

PubMed1995

[Effects of estrogen and thyroid hormone on EGF receptor expression, proliferative activity and SCC production in the CaSki cervical carcinoma cells].

This study was undertaken to see if estrogen and thyroid hormone affected EGF-receptor (EGF-R) expression, proliferative activity and intracellular SCC levels in uterine cervical squamous carcinoma cells. The uterine cervical cancer cell line (CaSki) was cultured in vitro in the absence or presence of 17 beta-estradiol (E2) or L-triiodothyronine (T3) in a serum free condition. Effects of E2 or T3 on the characteristics of EGF-R were assessed by the Scatchard analysis of the binding assay with 125I-EGF. Cellular levels of EGF-R expression were examined by the immunoperoxidase method with a monoclonal antibody to EGF-R. Proliferative activity of the cells was determined by proliferating cell nuclear antigen (PCNA) immunostaining, 3H-thymidine uptake and the number of cells. The effects of E2 or T3 on intracellular SCC levels were also examined by determining the intracellular SCC concentration with an SCC-RIA Kit. The scatchard analysis of 125I-EGF binding to CaSki cells showed that the addition of E2 or T3 had little effect on the affinity of EGF-R for CaSki cells but increased the capacity of EGF-R for the cells. Immunocytochemical staining with anti EGF-R antibody demonstrated that EGF-R expression in the CaSki cells was augmented by the addition of E2 or T3. The addition of E2 or T3 also resulted in an increase in 3H-thymidine uptake by the CaSki cells, the PCNA positive rate and the number of cells. Furthermore the addition of E2 or T3 increased intracellular SCC in the CaSki cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗

PubMed1995

[Correlation between acute rejection and the role of donor specific cytotoxic T lymphocyte in canine lung allotransplantation].

We investigated the correlation between the donor specific CTL activities and pathological findings of the grafted lungs by using mononuclear cells obtained from BAL fluids (BAL), peripheral blood (PBL), spleen (SpL) and grafted lungs (GIL) in canine lung allotransplantation. Twenty eight mongrel dogs underwent left lung allotransplantation. Fifteen dogs were not given immunosuppressive drugs. Thirteen dogs were given cyclosporine a 20 mg/kg/day per os for ten days postoperatively. Dogs were monitored by chest roentgenograms and cytotoxic activity tests of which targets were donor's fibroblasts. Pathological findings were classified by Prop's classification. The results were as follows. In latent and vascular phases no elevations of cytotoxic activities were demonstrated in PBL, BAL and GIL. But in early alveolar phase the cytotoxic activity was elevated to 19.83 +/- 14.54% in BAL. In late alveolar phase the highest cytotoxicities of 30.83 +/- 15.28% in PBL, 72.63 +/- 7.36% in BAL and 70.07 +/- 6.34% in GIL at E:T = 100:1 were demonstrated. In pneumonia cytotoxicity did not elevate at all in any effectors. As a result of them, it clearly shows that BAL is a good tool for the diagnosis of lung rejection.

Animals↗

PubMed1995

[Clinical characteristics and poor outcomes in patients with de novo AML with trilineage myelodysplasia].

De novo AML with trilineage myelodysplasia (AML/TMDS) is reported to account for 10-15% of de novo AML and respond poorly to conventional intensive chemotherapy, In our series, 12 (25%) of 48 patients with de novo AML were diagnosed as AML/TMDS. We found that the platelet count was significantly higher (p < 0.05), and the blast percentage of the bone marrow was significantly lower (p < 0.05) in the AML/TMDS group than in the AML/non-TMDS group. Sex ratio, age, WBC and RBC count did not significantly differ between the two groups. The immunological markers and the myeloperoxidase positivity of the blasts of AML/TMDS varied widely. The CR rate was 66.7% in the AML/TMDS group and 83.3% in the AML/non-TMDS group. Dysplastic changes were still detected in the bone marrow smears in 7 of 8 AML/TMDS cases who achieved complete remission. The AML/TMDS group showed significantly shorter CR duration (median; 169 days) and survival (median; 511 days, p < 0.05). However, in two cases which underwent allogeneic bone marrow transplantation (allo-BMT) during early relapse phase the disease-free survival has extended over 4 years and 2 years 8 months, respectively. Thus, we would like to propose that allo-BMT should be performed as early as possible to overcome poor outcome of AML/TMDS.

Adolescent↗

PubMed1995

Clinical trial of continuous infusion of 5-fluorouracil using an ambulatory pump for metastatic colorectal cancer.

A clinical trial was conducted in order to evaluate the anti-tumor effect and toxicity of a continuous infusion of 5-fluorouracil (5-FU) for metastatic colorectal cancer. Two-hundred and fifty mg/m2/day 5-FU was administered as a continuous infusion through an indwelling central venous catheter with ambulatory pump. Twenty patients with metastatic colorectal cancer which could be measured or evaluated were enrolled in the trial. The objective response rate was 35% (95% confidence interval, 14-56%). The response rates by site were 33% in liver, 17% in lung, 60% in lymph nodes, 50% in adrenal gland and 50% in primary lesion. The major toxicity was stomatitis (50%; grades 2 and 3 on Eastern Cooperative Oncology Group (ECOG) criteria) and hand-foot syndrome (40%; grades 2 and 3 on ECOG criteria). The sequence of toxicity was stomatitis first, followed by hand-foot syndrome. The median cumulative dose of 5-FU from the initiation of therapy to the onset of toxicity was 7125 mg in stomatitis and 17,875 mg in hand-foot syndrome. These toxicities were mild and reversible after a short interruption to the 5-FU infusion. Neither hematological toxicity nor serious catheter-related complications were observed. We concluded that continuous infusion of 5-FU was a feasible treatment for the patient with metastatic colorectal cancer, and manageable on an out-patient basis.

Adult↗

PubMed1995

[Relationship between left atrial spontaneous contrast echo and coagulofibrinolytic findings].

Transesophageal echocardiography (TEE) has been used to identify patients with left atrial thrombi (LAT) and spontaneous contrast echo (SCE). Patients with LAT or SCE are at high risk for cerebral embolism. The aim of this study was to examine the relationship between SCE detected with TEE [5MHz] and coagulation and fibrinolysis factors. We took blood samples from 83 patients to measure plasma levels of TAT, PIC, D-dimer, fibrinogen and thrombomodulin (TM) just before TEE examination. The patients were classified into four groups according to SCE grade based on echo density and area of the left atrium occupied by SCE. Plasma TAT and D-dimer were higher in the high grade SCE group than in the lower SCE group. Plasma TM was lower in the high grade SCE group. From these results, high grade SCE detected by TEE correlates with activation of coagulation and fibrinolysis.

Adult↗

PubMed1995

Infection of Mycobacterium bovis bacillus Calmette-Guérin in antibody-mediated gamma delta T-cell-depleted mice.

To evaluate the hypothesis that gamma delta T cells participate in protective immunity against mycobacterial infection, we depleted gamma delta T cells from mice by administration of anti-T-cell receptor (TCR)gamma delta monoclonal antibody (mAb) and analysed protection against Mycobacterium bovis bacillus Calmette-Guérin (BCG). The gamma delta T-cell-depleted mice did not show any exaggerated bacterial multiplication compared with control mice. In contrast, alpha beta T-cell-depleted mice, which were administrated anti-TCR alpha beta mAb before BCG infection, showed a depressed protective immunity. These results suggest that gamma delta T cells are not essential for coping with a primary BCG infection.

Animals↗

PubMed1995

[Anesthesia for a patient with Creutzfeldt-Jakob disease].

We reported anesthetic as well as perioperative management for a patient with Creutzfeldt-Jakob disease, a very rare transmissible neuropathy. A 51 year-old woman was scheduled for extirpation of recurrence of acoustic neurinoma. Three months before the operation, she had complained vertigo. After admission to our hospital, she had become progressively dementiated and developed disturbed consciousness. Anesthesia was induced with thiamylal and maintained with 0.7-1.5% isoflurane, nitrous oxide and oxygen. The anesthetic course was uneventful and the recovery from anesthesia was smooth. Postoperatively dementia progressed and myoclonus of extremeties appeared sixth weeks after the operation. Two months after the operation, a diagnosis of Creutzfeldt-Jakob disease was established by characteristic EEG and clinical course. Anesthesia for a patient with dementia was discussed.

Adult↗

PubMed1995

[A case of deep sylvian meningioma presenting temporal lobe epilepsy].

A rare case of deep sylvian meningioma is presented. A 62-year-old woman was admitted to our hospital because of one year history of temporal lobe epilepsy. She had no neurological deficit except for EEG abnormality. CT scans showed a small calcified mass in the left temporal lobe adjacent to the sylvian fissure with no enhancement by contrast medium. The mass was low-intense in both T1- and T2-weighted MR images. The T1-weighted image after the infusion of gadolinium revealed enhancement of the middle cerebral artery adjacent to the mass, similar to dural tail sign. Left external carotid angiography did not show any tumor stain nor the dilatation of the middle meningeal artery. Left internal carotid angiography disclosed enlarged middle cerebral artery without tumor stain. A left frontotemporal craniotomy was performed and the mass was totally removed. The tumor was located deep in sylvian fissure without any connection to the dura or ventricular system, which was firmly adherent to the middle cerebral artery. The histological examination of the surgical specimen revealed a psammomatous meningioma. Meningiomas are believed to originate from the arachnoid cap cells and can arise from various intracranial locations where arachnoid cap cells exist. The majority of them are attached to the dura, choroid plexus, or the tela choroidea. Only eleven cases of deep sylvian meningiomas have been presented in the literature. We have reviewed the clinical and radiological findings in such meningiomas. MR findings in deep sylvian meningioma have not been described.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Aqueduct↗

PubMed1995

[Criteria of limited operation for bronchial carcinoid].

The purpose of this study is to establish criteria of limited operation for bronchial carcinoid. Ten cases surgically treated in our hospital and 47 cases reported in Japan from 1981 to 1992 were examined. Thirty-nine cases had typical carcinoid tumor and 18 had atypical. Limited operation, such as pulmonary segmentectomy, wedge resection or partial resection, was performed in 12 cases. In these, all patients of typical type were alive except for a case died of other disease. However, two patients of atypical type died of distant metastasis of the tumor. No lymph node metastasis was revealed in all cases of typical type. On the contrary, in cases of atypical type, six had n1 and two had n2 disease. Moreover, two cases with n1 disease had pulmonary metastasis. Therefore, patients with typical bronchial carcinoid can be cured by limited operation, but radical operation should be indicated for atypical bronchial carcinoid.

Adult↗

PubMed1995

[Recent advances in chemotherapy for advanced gastric cancer: from the standpoint of survival advantages].

Recently, there have been many reports indicating higher response rates in combination chemotherapies for advanced gastric cancer. Since 1990, several randomized controlled trials (RCT) have been reported, which showed evidences of survival impacts in such cases. Patients treated with chemotherapy obtained significant survival advantages over those with best supportive care in three RCTs. The RCT from EORTC also resulted in more significant survival prolongation in FAMTX than in FAM, and FAMTX should be a reference arm for new regimens. Some RCTs are now under way to establish a standard therapy for advanced gastric cancer. From the analysis of long-term results of Japanese studies, 3% of entry cases survived longer than 5 years with no evidence of disease by chemotherapy. Chemotherapy for gastric cancer should be evaluated with survival advantages or rate of long-term survivors in future studies.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1995

[Changes in blood flow and skin reaction following radiation therapy].

Skin blood flow (SBF) during radiation therapy was measured and compared with skin reaction to examine the relationship between skin reaction and blood flow. The SBF of 50 patients including 16 with head and neck (H&N) cancer, 13 with breast cancer and eight with lung cancer were analyzed. In the H&N patients, SBF was increased according to the treated dose, while in the breast cancer patients SBF was slightly increased at 10 Gy, and did not change up to 40 Gy. In the lung cancer patients SBF was not increased until 20 Gy, and thereafter increased moderately at 30 Gy. Among H&N, breast and lung cancer patients, the most severe skin reaction was observed at the earliest time in breast cancer patients, while blood flow was only slightly increased. This must have resulted in a relatively higher skin dose than the reference point dose in breast cancer patients. Therefore, differences in the relationship between SBF and skin reaction were observed among different types of cancer patients. However, in H&N cancer patients, SBF was increased as skin dose increased. Skin blood flow could be a good indicator by which to estimate skin reaction quantitatively when the daily skin dose is around 1.6 Gy.

Aged↗

PubMed1995

[Three-dimensional longitudinal dissection view of hollow viscus].

To visualize the pathologies of hollow viscus and their extension three-dimensionally, volume data of the larynx, trachea, stomach, rectum, and urinary bladder were obtained using helical CT with moderately thin slices. Longitudinal cut sections were made as in a simulated surgical cut, and the interior morphology was displayed along with the pathology. A cylindrical projection profile was made by making a longitudinal incision on one wall and pulling apart the flaps to reveal the interior, providing better visual perception. The detailed outline from the 3D profile and the cylindrical projection views constituted an added advantage over the existing procedures.

Humans↗

PubMed1995

Concurrent chemotherapy and radiation therapy for locally advanced carcinoma of the esophagus.

A pilot study was undertaken to clarify the efficacy of concurrent chemoradiotherapy against locally advanced esophageal carcinoma. The 20 patients in this study had previously untreated esophageal carcinoma with evidence of T4 disease and/or distant node metastases. Chemotherapy consisted of protracted infusion of 5-fluorouracil at a dose of 400 mg/m2/day on days 1-5 and 8-12, combined with a 2-h infusion of cisplatinum at 40 mg/m2 on days 1 and 8. Radiation treatment for the mediastinum was administered 5 days per week for 3 wk at 2 Gy/day, along with chemotherapy. These schedules were repeated twice to give a total radiation dose of 60 Gy. For patients who responded, two additional courses of chemotherapy were administered. Five of the 20 patients had UICC stage III disease and 15 had stage IV. Seventeen (85%) of the 20 patients exhibited an objective response, including 6 (30%) complete responses. Local control was excellent with 10 (50%) complete responses. Toxic effects were severe. Major toxicities were leukocytopenia of grade 3 or more in 45% of the patients and esophagitis, including four perforations. There were two treatment-related deaths. The median survival time was 9 mo (range: 2 to 34+). Concurrent chemotherapy and radiotherapy was effective even for locally advanced esophageal carcinoma, but was associated with significant toxicity.

Aged↗

PubMed1995

[The measurement of blood lactate concentration and its age change in days on healthy infant].

We measured the lactate concentration in whole blood of healthy infant with use of the recently developed assay system consisting of an enzyme-coated electrode and a small meter. The mean values of blood lactate concentration at each age in days were not showed the significant difference between male and female infants. The trace of lactate concentration change in days showed the peak at the age in 1 days and then, gradually decreased to the almost constant level at the age in 6 days after. At the age in 6-7 days, the concentration mean values of infants, born in 38-40 gestational weeks were lower than that of 37 and 41 weeks one. It was assumed by mathematically that these equilibrium constant level of the lactate concentration in early neonatal period was arrived at 6.20 days and the equilibrium level was estimated to 1.29 mmol/l. As the results, the normal ranges were calculated to the value of 0.49-3.95 mmol/l as initial (age in 0-3 days) and that of 0.29-2.92 mmol/l as final (age in 6-7 days) period, by the truncation method, respectively.

Aging↗

PubMed1995

[Uterine cervical cancer: usefulness of MR imaging after the initial radiation therapy].

To evaluate the usefulness of magnetic resonance imaging (MRI) in diagnosing residual or recurrent tumors of cervical cancer after radiation therapy, we investigated the time difference between MRI and gynecologic findings in the diagnosis of residual or recurrent tumor in 12 patients with invasive cervical cancer. We defined a positive finding for residual or recurrent tumor as an uterine cervical mass isointense to muscle on T1-weighted images and hyperintense on T2-weighted images, and when a positive biopsy specimen was obtained. Two patients were diagnosed as having a residual or recurrent tumor by MRI. Positivity was demonstrated four and seven months later, respectively. MRI was more useful in the earlier diagnosis of residual or recurrent tumor of cervical cancer after radiation therapy than uterine biopsy. There was one patient whose differentiation from residual tumor or radiation-induced necrosis or inflammation on MRI was difficult. MRI and gynecologic check-up at a regular interval after radiation therapy was needed to distinguish them. One patient was diagnosed as having a recurrent tumor by gynecologic finding three month earlier than by MRI. Follow-up MRI examinations at a regular interval in addition to gynecologic examination is necessary for the early detection of recurrent cervical cancer after radiation therapy.

Adult↗

PubMed1995

[Influence of warm ischemia and reperfusion on no-derived cyclic GMP release in the perfused rabbit lung].

To elucidate the vascular endothelial function at pulmonary ischemia and reperfusion, cyclic GMP (cGMP) release in lung perfusate at reperfusion after ischemia was examined as a marker of nitric oxide (NO) release from the endothelium in an in situ perfused rabbit lung. The lung was perfused from the pulmonary artery with Krebs-Henselite buffer and cGMP in the lung effluent from the left ventricle was assayed in a time-dependent manner. The inhibition of cGMP release by NG-nitro-L-arginine methyl ester and the reversal of the effect by L-arginine indicated that cGMP released into the perfusate was elicited by NO from the endothelium. There was a significant decrease in cGMP release during reperfusion after warm ischemia (30 min and 60 min) compared with the immediately perfusion without intervening ischemia. These data suggest that NO release is impaired by the endothelial dysfunction at reperfusion after warm ischemia in the perfused rabbit lung and the biochemical studies of the perfusate is useful in assessing the vascular endothelial function.

Animals↗

PubMed1995

[Reverse-tolerance phenomenon in methamphetamine-induced behavioral stereotypy and impairment of cliff avoidance reaction after subchronic methamphetamine administration in rats].

Clinical evidence of methamphetamine (MAP)-induced reverse-tolerance phenomenon is available in studies of methamphetamine psychosis. To examine the clinical relevance of the reverse-tolerance phenomenon as a model of this psychosis, two experiments were conducted using rats. In the first experiment, we examined the relationship of MAP (4 mg/kg/day)-induced reverse tolerance in behavioral stereotypy to impairment of the cliff avoidance reaction (CAR). The stereotypy scores by the method of Creese and Iversen reached a maximum at day 14, and were unchanged thereafter. Impairment of CAR appeared in 3 of 6 rats at day 21 or 28 without motor ataxia, as rated by the scoring system of Hiramatsu et al. This suggested that cognitive dysfunction reflected by CAR impairment may develop after MAP-induced reverse-tolerance phenomenon, as evaluated by the behavioral stereotyping rating scale. In the second experiment, the effect of PCP (1 mg/kg) on CAR was examined in rats pretreated with MAP (4 mg/kg/day) for 30 days. No behavioral stereotypy or CAR impairment was found in these rats for 1 hour after PCP challenge. This showed that MAP-induced reverse-tolerance did not alter sensitivity to PCP in producing behavioral stereotypy or CAR impairment.

Animals↗