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Biomedical subjects

T Aoki

Publications and source records attributed to T Aoki.

At least 235 records · Page 13Linked to original sources
PubMed2000

[Diagnosis--radiologic imaging].

One of the most important recent advances in imaging technology for the diagnosis of lung cancer is CT consisting of high-resolution and helical volumetric techniques. CT has made a detailed morphological analysis correlated with histopathology as well as the detection of small peripheral lung cancers possible. MRI still remains as a complementary role to CT, but MR angiography using fast gradient-echo technique has achieved a great progress. FDG-PET is the most encouraging development in nuclear medicine and is vigorously evaluated for its cost-effective clinical value in differentiating benign and malignant nodules as well as in staging of lung cancer. In chest radiography, the development of computer-aided diagnosis is underway and seems promising.

Humans↗
PubMed2000

[Two cases of malignancy-associated hypercalcemia from bone metastases of breast cancer successfully treated with combination therapy using pamidronate and calcitonin].

Two patients with malignancy-associated hypercalcemia from bone metastases of breast cancer, accompanied by consciousness disturbance, were treated by a combination therapy of pamidronate and salmon calcitonin. The cause of the hypercalcemia in both cases was thought to be expanded bone metastases, which induced a local osteolytic hypercalcemia (LOH). In the end, this regimen could not control the growth of the metastatic tumor, but it produced a more rapid and prolonged decrease in serum calcium level than a single agent, and resulted in lessened consciousness disturbance without adverse effects. Hypercalcemia is a life-threatening paraneoplastic syndrome which requires urgent medical treatment, since malignant hypercalcemia progresses very rapidly and induces several severe complications. In conclusion, this combination therapy was extremely effective for consciousness disturbance accompanying hypercalcemia due to widespread bone metastases of cancer.

Antineoplastic Agents↗
PubMed2000

[Diagnosis using esophageal manometry and various loading tests].

Two approaches of infusion and microtransducer manipulation are available for esophageal manometry. If esophageal peristalsis and relaxation of the lower esophageal sphincter (LES) are diminished, the diagnosis of achalasia can be made. As compared with the infusion method, the microtransducer method requires no perfusion of water and has no limit on posture, allowing successful measurement in an empty esophagus. Thus this method, which allows measurement after feeding and continuous monitoring for 24 hours, seems to be more physiological than the infusion method. With this method, however, peristasis-like contractile waves and relaxation of the LES may be observed in addition to simultaneous contractile waves, even in cases of achalasia. Although methods to observe excessive reactions of the LES often involve a loading test with gastrin or mecolyl in some institutions, a loading test with cerulein is routinely used in our department. In healthy controls, administration of cerulein usually leads to decreased LES pressure, while increased LES pressure is observed in patients with achalasia (paradoxical response).

Ceruletide↗
PubMed2000

A rare case of lung cancer associated with renal cell cancer and benign histiocytoma of bone.

Lung cancer often metastasizes to organs outside the thorax, and consequently radiological evaluation of distant metastasis has become standard procedure prior to surgery. Although positive radiological findings generally suggest distant metastasis, the possibility of the co-existence of a benign tumor and primary malignancies must be considered. Herein we report a case of surgical resection of histologically confirmed lung cancer associated with renal cell cancer and benign histiocytoma of the humerus.

Adenocarcinoma↗
PubMed2000

[Cardiac function estimated by Doppler echocardiography in patients with hypertensive intracerebral hemorrhage].

We carried out transthoracic Doppler echocardiography on 38 patients with hypertensive intracerebral hemorrhage(ICH) to examine cardiac functions. The ratio of myocardial hypertrophy and the prevalence of valvular regurgitation were investigated. The E/A ratio which reflects left ventricular diastolic function and the ejection fraction(EF) of each patient were also studied to demonstrate cardiac functions in patients with hypertensive ICH. Myocardial hypertrophy was found in 39.5% of patients with hypertensive ICH. The aortic regurgitation showed a trend to have a higher prevalence in patients with hypertensive ICH when compared to normal volunteer group. Although there was no significant differences in the ejection fraction between groups, the E/A ratio in patients with hypertensive ICH showed a significantly lower value than in normal volunteer group. Therefore, transthoracic Doppler echocardiography demonstrated that patients with intracerebral ICH showed a trend to have a myocardial hypertrophy, aortic valvular regurgitation, and the lower ventricular diastolic function. Thus, transthoracic Doppler echocardiography is useful to evaluate cardiac functions in patients with hypertensive ICH.

Adult↗
PubMed2000

[Anesthetic management for reconstruction of the superior vena cava by monitoring of peripheral venous pressure in a patient with a mediastinum tumor].

A 26-years-old man with a giant mediastinum tumor was scheduled for reconstruction of the superior vena cave and tumor resection. Anesthetic management for reconstruction of the superior vena cava was performed by monitoring of peripheral venous pressure. A bypass between the inominate vein and right auricula was made by using an artificial vessel before clamping the superior vena cava. When the superior vena cava was clamped, peripheral venous pressure increased suddenly to 42 mmHg. Immediately after the venesection from the peripheral vessel, it was possible to control peripheral venous pressure at about 20 mmHg. Blood was re-transfused from the femoral vein to the patient. Cerebral neurological symptom due to the increasing venous pressure was not detected. In conclusion, monitoring peripheral venous pressure during reconstruction of the superior vena cava in a patient with a mediastinum tumor may be a useful technique.

Adult↗
PubMed2000

[Significance of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) activity in breast cancer tissue].

TS, DPD, uridine phosphorylase and thymidine phosphorylase are enzymes involved in the metabolism of the anticancer drug pyrimidine fluoride. In this study, levels of these enzymes were measured in 47 women with primary breast cancer. These enzyme levels were then compared to levels determined from breast cancer patients who received either preoperative chemotherapy or nothing, in order to determine whether they might predict clinical outcome. The TS inhibition rate was significantly higher (p < 0.05) in patients receiving preoperative chemotherapy (20.4 +/- 13.3%) than in the untreated group (11.4 +/- 9.8%). No other significant differences in activity were noted between the treated and untreated groups for any of the other enzymes studied. The activity of each enzyme at the tumor site and the tumor/normal (T/N) ratio were also compared between patients with and without recurrence. The TS inhibition rate at the tumor site was lower in recurring cases than in non-recurring cases, and the T/N ratio tended to be higher for DPD in patients with recurrences. These findings indicate that the TS inhibition rate and DPD activity may be useful predictors for early recurrence of breast cancer following surgery.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

[Optimal conditions for establishment of experimental tuberculosis model using an automated inhalation exposure apparatus and its application].

Animal (mouse and guinea pig) pulmonary tuberculosis models were established, using an automated inhalation exposure apparatus (Glas-Col Corp., USA, Model 099CA-4212). This apparatus includes four steps--preheating, nebulization, cloud decay and decontamination. The optimal conditions for M. tuberculosis H37Rv strain infection experiments were as follows: 10(5-6) colony forming unit (cfu) tubercle bacilli; preheating for 15 min.; nebulization for 90 min.; cloud decay for 15 min. and decontamination for 5 min. When 10(4) cfu M. tuberculosis H37Rv strain were introduced into the lungs of interferon (IFN)-gamma knockout mice, using the inhalation exposure apparatus and were followed up for 9 months, the primitive cavitary lesions were observed. This apparatus was also useful for inhalation exposure experiments of guinea pigs. This apparatus can also be utilized for animal inhalation experiments of allergens.

Animals↗
PubMed2000

[A family with heat-sensitive myotonia alternating with hypokalemic periodic paralysis].

We report a 34-year-old man with evident family history of paralysis and myotonia. He has noticed episodic morning paralysis alternating with muscle myotonia since the age of 10 years. When an episode of paralysis occurred, his serum potassium level decreased to 2.3 mEq/L and tended to increase to about 4.0 mEq/L when he complained myotonia. This case is obviously different from several already-known diseases, as it is perhaps the first case thermo-sensitive disorder of muscle activity in that the myotonia is induced by warm environment but paralysis occurs in the setting of cold ambient temperature and hypokalemia. Therefore, we are underway to perform molecular genetic analysis of ion channels since paramyotonia/hyperkalemic periodic paralysis is known to be associated with Na(+)-channel missense mutations, while hypokalemic periodic paralysis is with Ca(++)-channel. Addendum: After submission of the manuscript, we identified a novel mutation in Na+ channel alpha subunit. The detail of molecular aspect will be reported elsewhere.

Adult↗
PubMed2000

[A case of postoperative lung and pleural recurrence after 20 years in a breast cancer patient with marked response to orally administered UFT and cyclophosphamide].

A 62-year-old woman who underwent standard radical mastectomy for left breast cancer developed pleural and pulmonary metastases 16 years later. She complained of slight dyspnea, and computed tomography of the chest revealed a tumor with marked pleural effusion. Her serum level of carcinoembryonic antigen was also increased (49 ng/ml). Systemic chemotherapy with cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) was performed, but she did not show a marked response to CAF therapy. Therefore, she was orally administered UFT and CPA for 5 consecutive days followed by 2 drug-free days. Pleural disseminated foci and a lung tumor were reduced in size on chest CT and the CEA level was decreased within the normal limit. Recently, it was reported that UFT demonstrated significant antiangiogenic activity. This effect may play an important role in the efficacy seen in this patient.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Effectiveness of prostaglandin E1 on pulmonary hypertension and right cardiac function induced by single-lung ventilation and hypoventilation.

It is known that prostaglandin E1 (PGE1) is a potent vasodilator and improves red cell deformability. Single lung-ventilation sometimes occurs under lung transplantation, lung cancer surgery and traumatic pneumonectomy, and may result in increased pulmonary resistance, right heart failure and severe hypoxemia. The present experimental study was undertaken to examine the effects of PGE1 on these states induced by single-lung ventilation and hypoventilation. Fourteen pigs weighing 32-33 kg were anesthetized, intubated and ventilated using a respirator and then randomly assigned to two groups, the control group and the PGE1 treated group, 7 pigs each. After median sternotomy to induce severe hypoxemia hypoventilation was induced and then the right hilus pulmonis was cross clamped. Mean blood pressure, mean pulmonary arterial pressure (PAP), pulmonary vessel resistance (PVR), right ventricular stroke work (RVSW) and arterial blood gases (PaO2 and SatO2) were measured at baseline, in the hypoventilation state, and 15 min, 1 hour, and 2 hours after the right hilus pulmonis clamping with hypoventilation. PGE1 (250 microg/20 ml saline) was administered via the central vein starting 15 min after right hilus cross clamping for 1 hour and 45 min in the PGE1 group. PGE1 significantly reduced PAP and PVR, normalized RVSW, and improved PaO2. PGE1 may be useful for the condition of increased pulmonary hypertension during single-lung ventilation and hypoventilation.

Alprostadil↗
PubMed2000

[Failure of operating room oxygen delivery due to a structural defect in the ceiling column].

Two operating rooms were newly constructed to facilitate the increasing need of surgical services in our university hospital. After a half year of use, the oxygen delivery was suddenly blocked in one of them. Fortunately, the serious incident did not occur because an anesthesiologist identified the blockage of oxygen flow when he checked the anesthesia machine prior to the patient arriving in the operating room. Upon investigation we found the structural defects in ceiling column of that operating room. The pipe containing nitrous oxide and its structural support touched the valve of oxygen supply. It appears that the valve was gradually turned off by this contact while the ceiling column was moved up and down. Once this structural defect had been repaired, there was no longer any incident of the accidental blockage of oxygen to the operating room.

Anesthesiology↗
PubMed2000

[A case of breast cancer with multiple metastases successfully treated by medroxyprogesterone acetate with intermittent intra-arterial infusion low-dose chemotherapy to hepatic metastasis].

A 48-year-old woman who underwent breast-conserving therapy for left breast cancer developed bone, pleural, and liver metastases with local recurrence. The result was an improvement in each image with a marked improvement as seen by elevated tumor marker levels, with treatment by MPA (800 mg/day p.o.) and intermittent low-dose chemotherapy with hepatic arterial infusion. The side effects were acceptable. Normalization of imagings and an improvement in tumor markers continued for two years. Thus, in spite of being a palliative treatment, hepatic arterial infusion chemotherapy for liver metastasis from breast cancer might lead to prolongation of survival because of the improvement of other metastases due to the increased passage effect with MPA.

Antineoplastic Agents, Hormonal↗
PubMed2000

[Surgical treatment of middle cranial fossa arachnoid cyst in children with atypical symptoms--report of three cases].

We report three cases of symptomatic arachnoid cyst in the middle cranial fossa who presented with atypical symptoms including speech delay, vomiting and personality changes. They were improved by a cyst-peritoneal shunt operation. In many patients with a small or middle sized arachnoid cyst in the middle cranial fossa, their symptom tends to be so trivial that surgery is not the choice of treatment. The present cases suggest that peculiar symptoms caused by a limbic system lesion may be improved by treating the arachnoid cyst in the middle cranial fossa.

Arachnoid Cysts↗