Search PubMedSearch

Biomedical subjects

T Hashimoto

Publications and source records attributed to T Hashimoto.

At least 235 records · Page 13Linked to original sources

The state of recurrence and the role of hepatectomy in hepatocellular carcinoma.

The subjects involved in the present study were 113 patients with hepatocellular carcinomas who had undergone hepatectomy in our hospital during the past 10 years. During the surveillance, 79 of the 113 patients (69.9%) had recurrence in the residual liver. The cumulative non-recurrence rate at 2 and 5 years was 48.4% and 18.1%, respectively and the cumulative survival rate at 2 and 5 years was 83.8% and 47.5%, respectively. The recurrence in the residual liver tended to occur in the group with the larger tumor size, in the single nodular surrounding proliferative types and in the aneuploid types. There were no differences in the recurrence rate and state relating to the operative procedure. To improve the prognosis of hepatocellular carcinoma, it is necessary to consider the hepatic functional reserve after hepatectomy, and to make plans for multidisciplinary therapy, including such further treatment as transcatheter arterial embolization, infusion chemotherapy and preoperative percutaneous ethanol injection.

Adult

[Quantitative analysis of EEG background activity in drug-naive schizophrenic patients].

In this study we performed quantitative EEG analyses in 12 drug-naive patients who fulfilled DSM-IIIR criteria for schizophrenia and in a group of 12 healthy subjects. The schizophrenic patients were found to have slower activity (delta and theta) than the controls. These differences were most marked in the frontal region for delta band and in the occipital region for theta band. The schizophrenic patients also had more beta 1 activity, particularly in the occipital leads. Conversely, they had less alpha 2 activity over all regions examined. Our findings indicate cerebral dysfunction in schizophrenia and are in line with the hypothesis of hypofrontality in this disorder.

Adult

[Neurophysiologic studies on patients with migration disorder].

Neurophysiologic studies on six patients (five lissencephaly and one schizencephaly) with migration disorder were performed in order to evaluate the CNS function by multimodality evoked potentials. All cases revealed abnormalities in SSEP, four cases lost components below P 3 or had low voltage of P 3 indicating brainstem dysfunction in the somatosensory pathway. Two cases lost component below N 1 indicating sensory cortical dysfunction. Three cases revealed ABR abnormalities including a low amplitude of wave V, and one case revealed a prolonged peak latency of wave I and a low amplitude of all components. Two cases revealed abnormalities of poor cortical components in SEP, two cases in VEP, and three cases in MLR. Five cases had normal findings in P-SEP and three cases in VEP. The result of this study demonstrates that patients with migration disorder are frequently associated with cortical, brainstem and peripheral dysfunctions and has heterogeneity in pathophysiology.

Brain

[Innate resistance to thymidylate synthase inhibition after 5-fluorouracil treatment--a rationale of combined use of cisplatin and its optimal administration dose].

We examined the changes of the number of FdU MP binding sites of thymidylate thynthase (TS-BS) in Yoshida sarcoma after administration of 5-FU to the tumor bearing rats. We also investigated the optimal dose of CDDP for the increase of intracellular folate level. In the group received consecutive 7-days administration of UFT (U-7 group), total TS-BS was significantly increased compared with non-treatment group and the group received only UFT (U-1 group). For free TS-BS, however, there was no difference despite of UFT administration. Thymidylate synthase inhibition rate (TSIR) was, therefore, significantly high in U-7 group compared with U-1 group. It seemed necessary to take some counter measure for the induction of TS in the tumor tissue when 5-FU chemotherapy was performed. The optimal dose of CDDP as a modulator of 5-FU was 1 mg/kg in rat when it was estimated from the changes of intracellular folate levels after administration, which was less than the dose to reveal its own anticancer effect.

Animals

[A case of Mycobacterium avium complex pulmonary disease in the early phase].

A 51-year-old female was admitted to our hospital due to hemoptysis. Chest radiography revealed infiltrations in the middle lobe. Computed tomography (CT) of the thorax showed clusters of small nodules associated with a small cavity in the middle lobe, ligula and lower lobe of the right lung. Bronchiectasis was not detected. Transbronchial lung biopsy specimen (B4a) showed epithelioid cell granulomas with giant cells, and Mycobacterium avium was isolated in 4-week cultures of bronchial washings. This could be a case of early phase of pulmonary Mycobacterium avium complex infection in a patient without a so-called underlying condition. CT findings were characteristic and useful for the early diagnosis of MAC infection.

Biopsy

[Portal-transfer of an orally administered anti-cancer agent analysis of the time course of portal blood and systemic blood levels of preoperatively administered UFT].

The transfer of an orally administered anti-cancer agent, UFT, into the portal vein was examined in 21 patients with hepatic metastasis of colorectal cancer (synchronous metastasis in 9 and metachronous metastasis in 12 cases) encountered at our department. The time course of tegafur, 5-FU and uracil levels in portal blood was traced for maximum 6 hrs, starting 2 hrs after the final oral dose of UFT. The portal blood tegafur level was 11.89 +/- 4.31 micrograms/ml at 2 hrs after the final dose and decreased gradually thereafter, reaching to 8.48 +/- 8.42 micrograms/ml at 6 hrs after the final dose. Unlike the portal blood tegafur level, the portal blood 5-FU level did not show any similar tendency; it remained almost unchanged at 0.018 +/- 0.006 microgram/ml and approximately equal to the serum 5-FU level throughout the observation period.

Administration, Oral

[Pharmacokinetics and changes of reduced folate levels in tumor after administration of cisplatin].

Cisplatin acts as a biochemical modulator of 5-FU to increase the intracellular concentration of reduced folates. To determine the optimum schedule for administering cisplatin as a 5-FU modulator, we analyzed pharmacokinetics of platinum and changes of reduced folate levels in the tumor following administration of cisplatin in Yoshida sarcoma-bearing rats. Clinical kinetics of cisplatin was also investigated. The reduced folate level in the tumor was temporarily increased 2-1.6 fold of the control level 1-2 hours after the rapid injection of cisplatin (4 mg/kg). The folate level 2 hours after the rapid injection of cisplatin increased dose-dependently within the dose of 1mg/kg and reached to the plateau with the doses of 1, 2, 4, 8 mg/kg, although the platinum concentration in plasma and tumor increased linearly correlated with the dose of cisplatin. These findings suggest the modulatory effect through rapid injection of cisplatin is transiently exerted only in the early phase, and not dose-dependently but limitatively with the dose of 1 mg/kg or more. Therefore, repeated administration with low dose or continuous infusion of cisplatin simultaneous with 5-FU derivatives is desirable for combination chemotherapy. Clinically, the minimum effective dose of cisplatin as a modulator was thought to be 10-20 mg/body judging from experimental as well as clinical kinetic study of cisplatin.

Animals

[Infantile spasms with localized cerebral lesion detected by 99mTcHMPAO-SPECT].

We experienced a 6-month-old girl with infantile spasms who had localized cerebral lesion detected by 99mTcHMPAO-SPECT. She was born vaginally after a full term uncomplicated delivery with a birth weight of 3,100 g. She developed emprosthotonic spasms with series formation and EEG showed asymmetric periodic hypsarrhythmia which was predominant in the right hemisphere. While MRI could not detected any focal lesion, 99mTcHMPAO-SPECT disclosed hypoperfusion at the right anterior temporal and frontal areas. Although vitamin B6, clonazepam and sodium valproate were administered with no remarkable benefit, the treatment with ACTH-Z or carbamazepine resulted in cessation of spasms and improvement of the EEG findings. Consequently, the study with 99mTcHMPAO-SPECT was useful to clarify the pathology of infantile spasms, and we concluded that a patient with localized cerebral lesions should be given carbamazepine.

Brain

MR appearance of Virchow-Robin spaces along lenticulostriate arteries: spin-echo and two-dimensional fast low-angle shot imaging.

PURPOSE: To delineate the appearance of normal Virchow-Robin spaces on routine spin-echo images and demonstrate the lenticulostriate arteries within them with a flow-sensitive fast low-angle shot (FLASH) pulse sequence. METHODS: Seventy subjects, free of cerebrovascular diseases and other neurologic disorders, ranging in age from 1 to 75 years, were examined. On a 1.5-T MR system, axial spin-echo images of 5 mm thickness were obtained in all subjects. In 45 of 70 subjects axial two-dimensional FLASH images of 3 mm thickness were continuously imaged. RESULTS: On T1- and spin density-weighted images Virchow-Robin spaces were detected as small foci of cerebrospinal fluid intensity around the anterior commissure in all subjects (100%), and in the basal ganglia at the level of the foramen of Monro in 40 (57%). T2-weighted images equally showed Virchow-Robin spaces around the anterior commissure but were less sensitive than T1- and spin-density weighted images at the level of the foramen of Monro (14%). Virchow-Robin spaces identified on T2-weighted images should be isointense with cerebrospinal fluid. However, one or two spaces in 11 younger subjects were hypointense relative to adjacent brain tissue. On FLASH images most Virchow-Robin spaces identified on spin-echo images were delineated as high-intensity foci, corresponding to lenticulostriate arteries. CONCLUSIONS: Normal Virchow-Robin spaces along the lenticulostriate arteries are frequently detected on spin-echo images. Their appearance, affected by the flow of associated lenticulostriate arteries, varies from hyper- to hypointensity to brain tissue on T2-weighted images. The two-dimensional FLASH sequence can demonstrate the flow of the arteries, thereby helping confirm that these are truly Virchow-Robin spaces.

Adolescent

MR imaging of middle cerebral artery stenosis and occlusion: value of MR angiography.

PURPOSE: To investigate the effectiveness of MR angiography in conjunction with spin-echo imaging for evaluating vascular patency in patients with middle cerebral artery (MCA) stenosis or occlusion. METHODS: Seven patients with MCA stenosis or occlusion, verified with contrast angiography in five and correlated with transcranial Doppler sonography in two, were examined using two-dimensional and/or three-dimensional time-of-flight MR angiographic techniques as well as conventional spin-echo imaging. RESULTS: Of the seven patients, six demonstrated basal ganglionic and/or cortical infarct in the MCA territory. Except one case with minimal stenosis immediately distal to the MCA origin, all six cases with either severe stenosis or occlusion of the main trunk of the MCA showed the absence of normal flow voids using spin-echo imaging in the sylvian fissure on the affected side. However, it was not possible to discriminate between stenosis and occlusion. Although different mechanisms (ie, flow-induced spin dephasing for the 2-D technique and progressive spin saturation for the 3-D technique) were predominantly responsible for the loss of signal through the area of stenosis, both the 2-D and 3-D MR angiograms clearly depicted the compromised flow of the MCA: a focal discontinuity with decreased vessel caliber corresponded to stenosis, and nonvisualization of distal MCA branches represented occlusion. CONCLUSION: Either 2-D or 3-D time-of-flight MR angiography is a useful adjunct to conventional parenchymal spin-echo imaging for evaluating vascular patency in patients with MCA stenosis or occlusion, although it is important to recognize that each technique has a different basis for the loss of signal through the area of stenosis.

Adult

An INTERSALT study investigation: relationship between body mass index and blood pressure in the combined populations of three local centres in Japan.

Body mass index was positively and strongly correlated with BP in the INTERSALT study. Because the average body mass index in Japan, although low relative to other developed countries, has been increasing recently it would be useful, particularly from the public health viewpoint, to investigate the impact of body mass index on BP in Japanese populations. In this study, the relationship between body mass index and BP was investigated taking into account age, alcohol intake and sodium and potassium excretion in 24h urine. Data were obtained from 274 men and 284 women, aged 20-59 years, who were not taking antihypertensive medication. Random selection of participants took place at three local centres as outlined in the 1985 INTERSALT study in Japan. It was found that body mass index was positively and significantly correlated with BP in men and women, respectively, but was independent of age, alcohol intake and urinary sodium/potassium ratio. Both SBP and DBP were significantly higher by > or = 5 mmHg in participants whose body mass index (kg/m2) was in the highest quartile compared with participants in the lowest or the next lowest quartile category in men and women. In this study, it was suggested that the body mass index in Japanese men and women was directly correlated with BP independent of other confounding factors. Accordingly, the maintenance of a moderate body mass index may be important in achieving and maintaining a desirable BP level.

Adult

Novel subtype of peroxisomal acyl-CoA oxidase deficiency and bifunctional enzyme deficiency with detectable enzyme protein: identification by means of complementation analysis.

We describe four infants with a novel subtype of an isolated deficiency of one of the peroxisomal beta-oxidation enzymes with detectable enzyme protein. The patients showed characteristic clinical and biochemical abnormalities, including hypotonia, psychomotor retardation, hepatomegaly, typical facial appearance, accumulation of very-long-chain fatty acids, and decreased lignoceric acid oxidation. However, beta-oxidation enzyme proteins were detected by immunoblot analyses, and large peroxisomes were identified by immunofluorescence staining. In order to identify the underlying defect in these patients, complementation analysis was introduced using fibroblasts from these patients and patients with an established deficiency of either acyl-CoA oxidase or bifunctional enzyme, as identified by immunoblotting. In the complementing combinations, fused cells showed increased lignoceric acid oxidation, resistance against 1-pyrene dodecanoic acid/UV selection, and normalization of the size and the distribution of peroxisomes. The results indicate that two patients with a more severe clinical course were suffering from bifunctional enzyme deficiency and that the other two infants, who were siblings and had a less severe clinical presentation, were the first patients with acyl-CoA oxidase deficiency with detectable enzyme protein.

3-Hydroxyacyl CoA Dehydrogenases

[Developmental changes in proton MR spectroscopy of the brain].

Volume-selective proton MR spectroscopy (1H-MRS) of the brain was performed on a 1.5 T magnet in 31 healthy children aged from 1 month to 15 years and one healthy adult. Peaks of N-acetylaspartate (NAA), choline (Cho) and creatine (Cr) were observed in all cases on 1H-MRS, but not lactate. On 1H-MRS of the right parietal region, with advancing age, 1H-MRS revealed an increase in the ratios of NAA to Cho and NAA to Cr and a decrease in Cho to Cr. The most rapid change was noted during the first one to three years of life. 1H-MRS of the right frontal region was also performed in eleven cases. The ratio of NAA/Cho was smaller in the right frontal region than in the right parietal region. From this result, it may be suggested that the neuronal maturation in the frontal region delays as compared with the parietal region.

Adolescent