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Biomedical subjects

T Aruga

Publications and source records attributed to T Aruga.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Two cases in which the presence of ciliospinal response led to indecisiveness in the evaluation of brain death].

The ciliospinal reflex was first described by Budge in 1852. This reflex is used as an indicator of brain stem and autonomic nervous system functioning. In the Japanese guideline for determining brain death, the absence of this reflex is considered essential. We reported two cases in which the ciliospinal responses judged to be present resulted in the authors' indecision in determining brain death. They were the cases of a 74-year-old woman who suffered a right putaminal hemorrhage and that of a 28 year-old male with severe head and cervical cord injury. Although brain death was suspected in both cases from its clinical courses, the fact that the ciliospinal reflex was present in each case kept us from declaring that these patients were in the state of brain death. The center of the ciliospinal reflex lies in the first three segments of the thoracic spinal segments and two pathways are involved in this reflex. A noxious stimulation to the face will be registered through the brain stem, but if stimulation is in the neck or upper trunk, it may go directly to the spinal center. Because of the latter pathway to the spinal center, this reflex might remain in patients in whom the brain stem is completely nonfunctioning. Therefore, the presence of this reflex dose not always preclude a state of brain death.

Adult↗
PubMed1998

[Bleomycin, adriamycin, cyclophosphamide, vincristine, deacadron, etoposide (BACOD-E) chemotherapy for the treatment of non-Hodgkin's lymphoma: long-term survival rate and complications].

This study was performed to analyze the effect of Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, Deacadron, Etoposide (BACOD-E) chemotherapy for patients with non-Hodgkin's lymphoma. Seventy patients with non-Hodgkin's lymphoma (stage I: 15, stage II: 23, stage III: 20, and stage IV: 12) were treated at the Department of Radiology, Chiba University Hospital, between 1987 and 1995. The response rates for treatment were CR: 63%, PR: 35%, and PD: 2%. The overall disease-free 5-year survival rate was 54%, and those for each stage were as follows: stage I: 78%, stage II: 55%, stage III: 51%, and stage IV: 28%. There were no significant differences between patients with and without B symptoms, or those with and without elevated LDH levels. Treatment associated deaths occurred in six patients. Two patients died due to side effects of chemotherapy during treatment, and one patient due to leukemia 2 years and 5 months after treatment. One patient died due to radiation pneumonitis, one patient due to heart failure, and one patient due to an unknown reason one month after treatment. This chemotherapy may be useful for patients with advanced disease or unfavorable prognostic factors such as B symptoms or elevated LDH. Moreover, the addition of radiation therapy may prolong survival.

Adolescent↗
PubMed1997

Radiotherapy for centrally recurrent cervical cancer of the vaginal stump following hysterectomy.

PURPOSE: This study was performed to establish the classification and the treatment modality for recurrent cervical cancer of the vaginal stump after hysterectomy. PATIENTS AND METHODS: Ninety patients with centrally recurrent cervical cancer of the vaginal stump following hysterectomy were treated with high-dose-rate intracavitary brachytherapy with or without external irradiation. The intervals between primary surgery and vaginal recurrences varied from 3 months to 36 years. Tumor size of the vaginal stump was determined by bimanual rectovaginal examination at the time of recurrence and was classified into three groups, i.e., small (no palpable tumor), medium (less than 3 cm), and large (3 cm or more). RESULTS: The 10-year survival rates for all patients were 52%. Survival was greatly influenced by the tumor sizes of the vaginal stump. The 10-year survival rates of patients with small, medium, and large size tumors were 72, 48, and 0%, respectively. All patients with large size tumors died within 5 years. Of 90 patients, 75 (83%) were determined by physical examination to be free of tumor on at least one visit within 2 months of the completion of treatment (CR). The remaining 15 patients (17%) had physical findings suggestive of residual tumor (Residual). The overall 10-year survival rate for all patients with CR was 63%, compared with 10% for the patients with Residual (P < 0.0001). The incidences of distant metastases of the patients with or without local failure were 55 and 13%, respectively (P < 0.0001). The patients with local failure had significantly higher incidence of metastases. Most patients with small size tumor were treated with brachytherapy alone, and the survival rates of these patients were not improved by combination with external irradiation. CONCLUSION: These results suggest that tumor size was a significant prognostic factor for recurrent cervical cancer of the vaginal stump. Patients with small size tumors were recommended to be treated with brachytherapy alone.

Adult↗
PubMed1997

Facial nerve enhancement on gadolinium-DTPA in a case with neurosarcoidosis.

In a case of neurosarcoidosis with bilateral facial nerve palsy and hydrocephalus, contrast-enhanced magnetic resonance imaging (MRI) study and angiotensin converting enzyme (ACE) activities in cerebrospinal fluid (CSF) were valuable for the diagnosis and the follow up. Facial nerve lesions were demonstrated on gadolinium-DTPA enhanced MRI. The disappearance of enhancement was concomitant with the amelioration of facial nerve palsy after corticosteroid therapy.

Adult↗
PubMed1997

Effects of reoxygenation on repair of potentially lethal radiation damage in cultured MG-63 osteosarcoma cells.

The effects of reoxygenation on repair of potentially lethal radiation damage were investigated using MG-63 human osteosarcoma cells in vitro. When exponentially growing MG-63 cells were cultured under hypoxic conditions for 24 h, cells stopped growing and remained at a low density. The hypoxic cells were then reoxygenated by exposure to air and irradiated with a single dose of 3 Gy X rays. The fraction of the reoxygenated cells surviving after 3 Gy increased by a factor of 20.6 when the colony assay was delayed for 24 h. In control cells which were cultured under aerobic conditions before receiving a single dose of 3 Gy, the surviving fraction increased by a factor of 2.5 when the assay was delayed for 24 h. The difference in the magnitude of the repair observed between reoxygenated and aerobic cells was less prominent in confluent cells plated at high density. The enhanced repair after reoxygenation was due mainly to a decrease in the alpha coefficient when the dose-survival curve was fitted to the linear-quadratic model, whereas the most significant change in the fit of the dose-survival curve for the aerobic cells was a decrease in the beta coefficient. The control aerobic cells accumulated at G2/M phase after irradiation, whereas the reoxygenated cells did not show such an accumulation. When the hypoxic cells were irradiated and then reoxygenated, repair of these cells irradiated under hypoxic conditions was also enhanced. This is the first report to show that reoxygenation could increase cell survival after tumor irradiation.

Aerobiosis↗
PubMed1996

[The significance of neurological manifestations from the aspect of aggressology].

The pathophysiological processes of the nervous system observed in the reactions to aggressive external stresses like severe trauma, systemic infection and so on have been reviewed. As is generally understood, such stresses as tissue destruction lead to the metabolic changes via proprioceptive impulses to central nervous system and neuroendocrinological courses. Cytokines are well known to work to induce systemic inflammatory responses and also to be important components of sepsis syndrome, for example. In the early phase of septic encephalopathy without overt infection of the brain or the meninges, it is possible that cytokines cause capillary leakage with brain edema, interference with microcirculation and direct effects on tissue metabolism resulting in brain dysfunction. And besides, Interleukins are prove to be produced in a few hours post-injury in experimental model. In clinical settings, severe head injury patients, who are often complicated with respiratory or urinary infection and with bacterial translocation, can suffer not only from systemic inflammatory responses originated from the brain but also from septic encephalopathy mentioned above. Therefore multiply traumatized patients with damaged brain for instance might well have to be considered as the aggregation, or integration of the systemic insult from the aspect of aggressology.

Brain Diseases↗
PubMed1995

Radiosensitivity and cell cycle redistribution of cultured human tumour cells during fractionated daily 2-Gy irradiations.

Exponentially growing SQ-5 human lung squamous cell carcinoma cells were irradiated in vitro at 2-Gy per fraction per day continuously for 14 days. The number of total cells continued to increase exponentially till day 5, and reached a plateau level thereafter. The cell cycle distribution changed marginally for the first 5 days, and showed a prominent G2/M accumulation at day 7. Plating efficiencies decreased exponentially with increasing fractionation while the total clonogenic cell number remained constant until day 4. Radiosensitivity at each fraction was stable until day 9, but significantly increased at day 11. A comparison of plating efficiencies between the immediate and 24-h delayed assays revealed that the capacity of cells to spare 2-Gy damage increased with the number of 2-Gy fractions. These results suggest that sublethal damage could accumulate during multifraction daily irradiations, while repair of potentially lethal damage and/or proliferation could rather increase.

Carcinoma, Squamous Cell↗
PubMed1995

Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms.

The clinical characteristics of vertebrobasilar dissecting aneurysms occurring with subarachnoid hemorrhage (SAH) were reviewed in 42 patients, with particular focus on the time, incidence, and outcome in association with subsequent rupture. Twenty-nine patients underwent 31 surgical procedures, and the remaining 13 patients were managed without surgery. Surgical details included 19 proximal vertebral artery obliterations (including 1 case of endovascular surgery using balloon occlusion), 9 trappings, 1 wrapping, 1 bleb clipping, and 1 bleb clipping combined with wrapping. Surprisingly, subsequent rupture occurred in 30 (71.4%) of the 42 patients. Excluding one patient with postoperative rupture, 29 patients suffered a subsequent rupture in the unsecured stage. Of these 29 patients, 19 were operated on after the subsequent rupture and 10 were not operated on because of deteriorated clinical condition (9 patients) or anatomic considerations (1 patient). Of the 30 patients that suffered a subsequent rupture, 14 died. Twelve of the deaths were directly related to the second episode of rupture. Of the 12 patients who did not suffer a subsequent rupture, 10 underwent operations and there were no operative deaths. Only one patient died as the result of the initial critical SAH. The mortality (46.7%) of the patients with subsequent rupture was significantly higher (P < 0.05) than that (8.3%) of the patients without subsequent rupture. Seventeen (56.7%) of the 30 subsequent ruptures occurred within 24 hours after the first SAH, and 24 (80%) occurred within the first week. Six (66.7%) of the 9 patients operated on within 24 hours after the first SAH and 11 (68.8%) of the 16 patients operated on within a week suffered preoperative subsequent ruptures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Total recanalization of a spontaneously thrombosed arteriovenous malformation. Case report.

The authors describe what they believe to be the first case of an asymptomatic, totally recanalized arteriovenous malformation (AVM) demonstrated by angiography 31 months after complete spontaneous thrombosis. The AVM, which initially became symptomatic with bleeding, had a 2-cm diameter nidus that was located within the inferior aspect of the left frontal lobe and was fed by branches from the left anterior cerebral and anterior ethmoid arteries. A single draining vessel flowed from the nidus into the anterior superior sagittal sinus. The AVM was surgically extirpated after recanalization. The authors stress the necessity for follow-up care for angiographically "cured" AVMs.

Cerebral Angiography↗
PubMed1995

[Whole mediastinal irradiation with or without entire hemithoracic irradiation for invasive thymoma].

We retrospectively reviewed the case histories of 45 patients with invasive thymoma who underwent postoperative or definitive radiotherapy. Patients in stage II or stage III were classified according to the treatment volume as follows: a) those who received irradiation confined to the primary tumor site with a generous margin (involved field group, n = 17) and b)those who received prophylactic whole mediastinal irradiation with or without entire hemithoracic irradiation (prophylactic group, n = 21). Seven recurrences were observed among the involved field group, while all patients in the prophylactic group were relapse-free and alive after a median follow-up interval of 50 months. Major side effects were observed in two patients who received entire hemithoracic irradiation. One developed severe pneumonitis resulting in lung fibrosis that required hospitalization, while the other developed nephrotic syndrome of unknown cause. We conclude that whole mediastinal irradiation with or without entire hemithoracic irradiation can be used as a treatment of choice for postoperative invasive thymoma.

Adult↗
PubMed1994

Primitive trigeminal artery variant associated with intracranial ruptured aneurysm and cerebral arteriovenous malformation--case report.

A 48-year-old female presented with a unique combination of ruptured aneurysm of the right middle cerebral artery (MCA) manifesting as sudden loss of consciousness associated with arteriovenous malformation (AVM) in the right parietal lobe and left primitive trigeminal artery (PTA) variant. Angiography revealed the right MCA aneurysm, AVM fed by the right anterior cerebral artery and MCA, and contralateral PTA variant. The PTA variant was an anomalous posterior cerebral artery originating from the ipsilateral cavernous internal carotid artery. The neck of the aneurysm was successfully clipped and the AVM was totally removed.

Aneurysm, Ruptured↗
PubMed1994

[Two cases of trochlear nerve neurinoma].

Two cases of trochlear nerve neurinoma without Recklinghausen's disease are described. A 60-year-old male had a left-side sensory disturbance and a hemiparesis. Computed tomography (CT) scan and magnetic resonance image (MRI) showed a cystic enhancing mass in the right tentorial incisura. A 57-year-old male had a gait disturbance and a left-side facial numbness. CT scan and MRI showed a solitary enhancing mass in the right tentorial incisura. These tumors were subtotally removed, and the intraoperative diagnosis of two patients was trochlear nerve neurinoma. Unique clinical manifestations of trochlear nerve neurinoma are discussed with a brief review of 11 cases reported in the literature.

Aged↗
PubMed1993

Prepubescent pituitary null cell macroadenoma with silent macroscopic apoplexy: case report.

Secreting pituitary adenomas have marked prevalence in pediatric adenomas. We described a case of an 11-year-old boy with pituitary null cell macroadenoma with silent macroscopic pituitary apoplexy. The patient was admitted with bitemporal hemianopsia and a gradual deterioration of visual acuity. An endocrinological study revealed a low concentration of testosterone and in the plasma a decreased response of luteinizing hormone and follicle-stimulating hormone to luteinizing hormone-releasing hormone. This patient may be the first case of prepubescent null cell macroadenoma confirmed with immunohistochemical study in addition to the findings of classical histopathology.

Adenoma, Chromophobe↗
PubMed1992

[Results of radiation therapy of extrahepatic bile duct carcinoma].

From January 1975 to August 1988, 40 patients with extrahepatic bile duct carcinoma were treated by external irradiation at Chiba University Hospital and the National Medical Center Hospital. Thirty-four patients (male: 20, female: 14) were evaluable. Eighteen patients were postoperative cases because the surgical margin was positive for tumor cells in the postoperative pathological examination; the other 16 were inoperable cases. Survival in postoperative and inoperable cases was not significantly different, with median survival times of 13.8 and 8.1 months, respectively. Survival in the recanalization-positive and negative-groups was significantly different (p less than 0.05) after irradiation, with median survival times of 13.5 and 6.0 months, respectively. Complications of therapy were recognized in 68% of all cases. They were mainly gastrointestinal symptoms such as nausea, vomiting, erosive gastritis and loss of appetite, but they were not severe. Distant metastasis was recognized in only 4 patients (10%): three had bony metastasis and one had supraclavicular and pulmonary hilar lymph node metastasis. Ninety percent of all cases died from hepatic failure or peritonitis carcinomatosa due to failure to obtain local control by external irradiation. A more effective modality of treatment is necessary to cure these patients.

Aged↗
PubMed1992

Multiple arteriovenous malformations located in the cerebellum, posterior fossa, spinal cord, dura, and scalp with associated port-wine stain and supratentorial venous anomaly.

Multiple arteriovenous malformations involving the left cerebellum and extra-axial posterior fossa with associated calcified cyst, spinal cord, dura, and scalp were present in a 7-year-old girl, who became symptomatic after a cerebellar hemorrhage. A large port-wine stain was noted on the right temporoparietal scalp, consistent with the scalp arteriovenous malformation area, as demonstrated by angiogram. In addition to the multiple arteriovenous malformations, nonfilling of the superior sagittal sinus and tortuous, irregular cortical veins were recognized.

Carotid Artery, Internal↗