Biomedical subjects

T Hirai

Publications and source records attributed to T Hirai.

At least 181 records · Page 10Linked to original sources

PubMed1998

The role of radical gastrectomy with systematic lymphadenectomy for the diagnosis and treatment of primary gastric lymphoma.

OBJECTIVE: We evaluated the therapeutic efficacy of radical gastrectomy for primary B-cell lymphoma of the stomach and attempted to identify patients who could be adequately treated with surgery alone. SUMMARY BACKGROUND DATA: Several recent gastric lymphoma reports have discussed the therapeutic benefits of various treatment strategies for stage IE and IIE lymphoma. However, few studies have been based on patients accurately staged by systematic lymphadenectomy with subsequent pathologic examination. METHODS: A retrospective study was performed to evaluate the survival and biologic behavior of lesions in 60 patients with gastric lymphoma who were treated by radical gastrectomy alone. Tumors were classified according to the histopathologic concept of mucosa-associated lymphoid tissue (MALT)-derived lymphoma. RESULTS: A low histopathologic grade was associated with a significantly lower incidence of nodal metastasis (p = 0.07) and less extensive infiltration of the gastric wall (p < 0.005) despite larger tumor size. A 5-year survival rate of >95% was attained with surgery alone for MALT lymphoma and for true stage IE lymphoma diagnosed by pathologic examination of up to N2 lymph nodes routinely performed after radical gastrectomy. CONCLUSIONS: Surgery alone is adequate treatment for stage IE or pure MALT lymphoma, provided that the staging is performed after radical gastrectomy.

Adult↗

PubMed1998

Childhood parental loss and alcohol dependence among Japanese men: a case-control study. Group for Longitudinal Affective Disorders Study (GLADS).

There have been many studies in the literature examining childhood parental loss as a risk factor for adult psychiatric disorders such as depression, schizophrenia or anxiety disorders. However, with regard to alcohol dependence, only a limited number of such studies exists, and these have reported inconsistent findings. The present paper aims to examine the relationship between early parental loss and subsequent development of alcohol dependence among Japanese men. We directly interviewed 75 men with alcohol dependence (according to DSM-III-R), who were visiting 23 psychiatric hospitals and clinics all over Japan, and 52 healthy controls without any lifetime psychiatric diagnosis, drawn from a general population. When stratified for sex and age, there was no statistically significant difference between the patients and the controls in the rates of maternal or paternal death or separation before the age of 16 years. These findings and the review of the literature suggest that the relationship between childhood parental loss and alcohol dependence is not a straightforward one.

Adult↗

PubMed1998

Modified Bagolini striated glass test: clinical applications of starlight test in binocular visual field screening.

AIM: To introduce the "starlight" test which was devised to check binocular vision in normal conditions of seeing in a rapid, easy, and cost effective manner and to estimate the possibility of its clinical use in screening the binocular visual field of patients. METHOD: The Bagolini striated glass test consists of optically plano lenses with imperceptible parallel scratches that barely blur the environment but produce two perpendicular luminous stripes (right eye stripe of 45 degrees and left eye stripe of 135 degrees) when subjects with normal binocular vision view one light source. Unlike the original Bagolini test, the starlight test uses three light sources in horizontal or vertical lines according to the testing purposes and the subject is asked to fixate upon the centre light. Through Bagolini glasses, the subject observes the resulting grid-like pattern and the state of binocular visual field of the subject can be roughly estimated. RESULTS: Normal subjects and patients with strabismus, visual field loss from intracranial diseases, glaucoma, retinitis pigmentosa, and functional visual loss were examined using the starlight test and findings from each case were discussed. CONCLUSIONS: The starlight test, which was made by hand at a low cost, is a simple test that can be used clinically. It provides information about the state of binocular vision of patients in normal conditions of seeing. It is also useful because it enables the examiner to share similar experiences with the examinee. The results suggest it can be effective in visual field screening.

Adult↗

PubMed1998

Dural carotid cavernous fistulas: role of conventional radiation therapy--long-term results with irradiation, embolization, or both.

PURPOSE: To evaluate the long-term results of irradiation alone or of embolization with or without irradiation in patients with dural carotid cavernous fistulas (DCCFs). MATERIALS AND METHODS: Between 1984 and 1996, symptomatic DCCFs in 26 patients were treated by using irradiation alone (protocol 1, n = 12) before April 1988 and by using embolization as an initial treatment (protocol 2, n = 14) during and after April 1988. When angiography showed no improvement after embolization, irradiation was added (n = 6). On the basis of drainage flow speed, DCCFs were classified as fast, medium, or slow. RESULTS: With irradiation alone, all six patients with slow- to medium-type DCCFs had cure with a mean follow-up of 62 months. Four of six patients with fast-type DCCFs had cure or improvement, but the remaining two had no change. In the embolization group, irradiation was added in six patients with fast-type DCCFs. With a mean follow-up of 24 months, four of the six patients had cures, one had improvement, and one had no clinical change. Those who underwent protocol 2 had cures significantly earlier than those who underwent protocol 1 (P < .05). CONCLUSION: Conventional radiation therapy resulted in cure of DCCFs in nine (75%) of the 12 patients and in improvement of signs and symptoms in one (8%). Fast-type DCCFs may not always be improved. Radiation therapy may be useful in DCCFs after embolization.

Adult↗

PubMed1998

CT angiography in vascular intervention for steno-occlusive diseases: role of multiplanar reconstruction and source images.

The aim of this study was to assess the efficacy of CT angiography for steno-occlusive diseases before and after interventional procedures, focusing on the role of multiplanar reconstruction (MPR) and source images. 17 patients with 20 steno-occlusive lesions underwent CT angiography before and after interventional procedures. For each lesion, the percentage stenosis obtained on CT angiography was compared with that on conventional angiography. In addition, MPR and source images were evaluated for the presence of wall thickening and calcification before interventional procedures, and the presence of dissection and luminal shape after interventional procedures. These findings were compared with those of conventional angiography. Although the percentage stenosis depicted on CT angiography correlated well with that on conventional angiography, MPR and source images clearly demonstrated the effect of intervention and the residual stenosis. MPR and source images clearly depicted wall thickening, wall calcification, the presence of dissection and the luminal shape. CT angiography provides useful information before intervention, while MPR and source images are of value in evaluating arterial wall abnormalities and morphological changes associated with interventional procedures.

Adult↗

PubMed1998

[Mercury sensitization induced by environmental exposure].

We investigated mercury sensitization in relation to urinary and hair mercury concentrations. Patch tests were performed on 215 medical students and these tests demonstrated that 28 students were mercury-sensitized (13.0%). Life-styles were studied by questionnaire in 26 of the mercury sensitized students and 46 of the non-sensitized subjects. Urinary mercury concentrations were measured in 25 sensitized and 46 non-sensitized and hair mercury concentrations were measured in 19 sensitized and 22 non-sensitized subjects. The eating of fish was not significantly associated with mercury sensitization (one-tailed t-test). The number of teeth treated with metals in the sensitized group was significantly higher than in the control group (6.8 +/- 4.3 in sensitized vs. 4.8 +/- 4.1 in non-sensitized, one-tailed t-test. p < 0.05). The usage of mercurochrome was not significantly associated with mercury sensitization (chi-squared test). Urinary mercury concentrations were not significantly higher in sensitized subjects. Hair mercury concentrations were significantly higher in sensitized subjects (1.98 +/- 0.91 micrograms/g in sensitized vs. 1.23 +/- 0.53 in non-sensitized, one-tailed t-test p < 0.05). These results suggest that mercury sensitization is associated with increased hair mercury concentrations but not with urinary mercury concentrations. In this study it is confirmed that dental amalgam for treating teeth may be an important factor relating to mercury sensitization.

Adult↗

PubMed1998

Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas.

OBJECTIVE: Our purpose was to evaluate the relationships between the ratio of maximum relative cerebral blood volume (rCBV) (rCBV ratio = rCBV[tumor]/rCBV[contralateral white matter]) and histologic and angiographic vascularities of gliomas using the gradient-echo echoplanar MR imaging technique. We also evaluated the usefulness of rCBV maps for grading gliomas. SUBJECTS AND METHODS: We examined 30 patients with histologically verified gliomas. Gliomas were classified as glioblastoma, anaplastic glioma with enhancement, anaplastic glioma without enhancement, and low-grade glioma. The maximum rCBV ratio of each glioma was compared with both histologic and angiographic vascularities, and the relationship between the maximum rCBV ratios and each type of glioma was established. RESULTS: The maximum rCBV ratios of the gliomas significantly correlated with both histologic and angiographic vascularities (p < .001). Mean values and SDs of maximum rCBV ratios of each type of tumor were 7.32+/-4.39 for glioblastomas, 5.84+/-1.82 for anaplastic gliomas with enhancement, 1.53+/-0.75 for anaplastic gliomas without enhancement, and 1.26+/-0.55 for low-grade gliomas. The maximum rCBV ratios of the glioblastomas were significantly higher than those of the anaplastic gliomas without enhancement (p = .002) and the low-grade gliomas (p < .001). The maximum rCBV ratios of the anaplastic gliomas with enhancement were higher than those of the anaplastic gliomas without enhancement and the low-grade gliomas, but the differences were not statistically significant (p = .08 and p = .03, respectively). CONCLUSION: The results of perfusion-sensitive MR imaging with gradient-echo echoplanar technique correlated with both histologic and angiographic vascularities.

Adolescent↗

PubMed1998

Three-dimensional power Doppler sonography of tumor vascularity.

The purpose of this study was to assess the value of routine clinical examination using three-dimensional power Doppler sonography of intratumoral blood flow. Twenty-two hepatocellular carcinomas, seven cases of hepatic metastasis, four hepatic hemangiomas, six renal cell carcinomas, two cases of hepatic focal nodular hyperplasia, and one case of splenic metastasis were included in the study. Three-dimensional images were reconstructed by maximum intensity projection method using cine-loop data on a built-in computer in a LOGIQ 500 and a LOGIQ 700 from GE Yokogawa Medical Systems. The three-dimensional images obtained were viewed multidirectionally on a monitor screen. Three-dimensional representations of intratumoral blood flow became available for all tumors approximately 5 s to 30 s after scanning. In every case, the entire vasculature of the tumor was appreciated more easily from three-dimensional images than from cross-sectional two-dimensional images. These three-dimensional images of intratumoral blood flows corresponded to the tumor vessels that could be visualized by angiography at the early arterial phase. Differential diagnosis of hepatic tumors based on distinct difference in their intratumoral vascular structures was performed. Our results suggest that three-dimensional power Doppler sonography can be used for routine clinical examination of tumor vascularity and may provide improved diagnostic information.

Carcinoma, Hepatocellular↗

PubMed1998

Intrarenal varices: demonstration by color Doppler sonography.

Idiopathic intrarenal varices are a rare disease, and only a few cases have been reported. We encountered a patient with intrarenal varices in whom color Doppler sonography was useful for diagnosing and demonstrating this disease, especially with 3D reconstruction of blood flow, which we began using recently.

Female↗

PubMed1998

[Analyses on the long-term prognosis of surgical treatment for primary lung cancer in the elderly patients of 75 or over years old: how should be treated the non-recurrent death?].

We analyzed the long-term prognosis in 68 elderly (75 years old or over) patients with primary lung cancer. The 5- and 10-year survival rates were 56.5% and 10.2%, respectively. There were 33 deaths due to 16 recurrences (REC) and 17 non-recurrences (NREC). Thirty-three dead patients were divided into two groups; patients with less than 5-year follow-up period (group A) and patients with 5-year or over follow-up period (group B). In group A, the REC/NREC ratio was 15/6, and in group B, the REC/NREC ratio was 1/11. The mortality due to non-recurrence was significantly (p < 0.05) higher in group B. In conclusion, we recommend to include non-recurrent death in the survival rates, because it is impossible to clear the cause of death, strictly.

Aged↗

PubMed1998

Three-dimensional FISP imaging in the evaluation of carotid cavernous fistula: comparison with contrast-enhanced CT and spin-echo MR.

PURPOSE: The purpose of this study was to assess the value of three-dimensional fast imaging with steady-state precession (FISP) MR sequences relative to contrast-enhanced CT and spin-echo MR imaging in the diagnosis of carotid cavernous fistula (CCF). METHODS: Seventeen patients with 19 angiographically proved CCFs had contrast-enhanced CT, spin-echo MR imaging, and 3-D FISP imaging. Three observers assessed these imaging studies as well as those of 43 control sides in a blinded manner for the presence or absence of CCF. Receiver operating characteristic analysis was used to assess the diagnostic utility of each imaging technique. In a nonblinded study, contrast-enhanced 3-D FISP images were also evaluated. RESULTS: Higher diagnostic accuracy was obtained with 3-D FISP sequences, as the shunt flow within the cavernous sinus was well seen. Sensitivity of 3-D FISP images was 83% and specificity was 100% in the blinded study. In the receiver operating characteristic analysis, the diagnostic performance of observers was found to be better with the 3-D FISP images than with the spin-echo MR images. Although there were no significant difference between 3-D FISP and contrast-enhanced CT, higher diagnostic performance was obtained with 3-D FISP images. In three CCFs without anterior drainage, a diagnosis was made only from the 3-D FISP images. The contrast-enhanced 3-D FISP images were not helpful, since the cavernous sinuses enhanced. CONCLUSION: Three-dimensional FISP imaging is superior to spin-echo MR imaging and contrast-enhanced CT in the diagnosis of CCF. Contrast-enhanced 3-D FISP images are not helpful for the evaluation of CCF.

Adolescent↗

PubMed1998

[Primary large cell carcinoma of the lung in the patients undergoing pulmonary resection: a comparison between pre- and post-operative diagnosis].

Between 1981 and 1995, 591 patients with primary lung cancer underwent operations. Of these, 19 patients (3.2%) was diagnosed as a large cell carcinoma pathologically. Clinicopathologically, we analyzed a discrepancy between pre- and post-operative diagnosis of these patients. This study showed as follows: 1) Accuracy of preoperative diagnosis was 73.7%; 2) No patients with primary site in right upper lobe had a correct diagnosis; 3) Accuracy of preoperation was not depending on tumor size; 4) In retrospective findings of the biopsied specimens, 'incomplete glandular differentation' caused preoperative diagnosis to adenocarcinoma, and modification of the specimens by pneumonia caused it to squamous cell carcinoma; 5) Inadequatespecimens originated from the right upper lobe or pneumonia lobe; 6) The five-survival rate was 27.3%.

Adult↗

PubMed1998

Effect of metabolic substrate on BMIPP metabolism in canine myocardium.

UNLABELLED: The lipid tracer 1 5-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) is clinically useful, and its basic metabolism is being analyzed. Because the pharmacokinetics of this lipid tracer may be affected by blood concentrations of fatty acid or glucose, this study evaluated the effects of excess levels of lipid or glucose on BMIPP uptake and metabolism. METHODS: A technique using an open-chest dog model was used. Blood sampling was performed from the left anterior descending coronary artery and great cardiac vein after an injection of 123I-BMIPP either with a glucose infusion (n = 6) or a lipid infusion (n = 5). High performance liquid chromatography and double-tracer kinetic analyses clarified the extraction, retention, backdiffusion and further metabolism of BMIPP. These results were compared with data from control dogs (n = 6). RESULTS: In this experiment, a 10-fold increase over the normal lipid blood concentration and twofold increase over the normal blood glucose concentration were evaluated with either intralipid or glucose infusion, respectively. In the lipid infusion studies, the extraction significantly decreased compared with the control values (74% +/- 12% to 58% +/- 8%; p < 0.05), and the washout increased from 50% +/- 13% to 68% +/- 16% (p < 0.05). The BMIPP backdiffusion increased (p < 0.05), and the levels of the further metabolites decreased (p < 0.05), while the retention level remained constant (normal, 89% +/- 9%; lipid infusion, 91% +/- 3%; ns). In the glucose infusion studies, the BMIPP extraction, retention and washout showed no statistical differences compared to controls; however, these parameters showed the same tendencies as those in the lipid infusion group. In addition, the BMIPP backdiffusion increased significantly (control, 25.1% +/- 8%; glucose infusion, 48.7% +/- 25.6%; p < 0.05) as it did after the lipid infusion. CONCLUSION: BMIPP metabolism and uptake are affected by excess concentrations of lipid and glucose in the blood. However, the retention of BMIPP was not affected by either type of infusion. The BMIPP backdiffusion and the further metabolite comprising 10% of the tracer extracted were affected both by the lipid and glucose infusions. These results indicate that an excess fat concentration and glucose affect BMIPP uptake, especially the extraction of BMIPP and BMIPP backdiffusion.

Animals↗

PubMed1998

Significance of vessel count and vascular endothelial growth factor in human esophageal carcinomas.

The purpose of this study was to determine the angiogenic profile of human esophageal carcinomas. The expression of vascular endothelial growth factor (VEGF) was examined in 6 esophageal carcinoma cell lines and 119 human esophageal carcinoma tissues by Northern blot analysis and immunohistochemistry, respectively. Immunohistochemistry using antibodies against CD34 (endothelial cell specific) was carried out on archival specimens, and microvessels were quantitated by counting vessels in a x200 field in the most vascular area of the tumor. All of the cell lines constitutively expressed VEGF mRNA at various levels. A total of 71 of 119 (59.7%) tumors showed intense VEGF immunoreactivity in the cytoplasm of cancer cells. Vessel count was significantly higher in the VEGF-positive tumors than it was in the VEGF-negative tumors. VEGF expression correlated with the depth of tumor invasion, tumor stage, venous invasion, and lymphatic invasion. The survival rate of patients with high vessel density in the tumor was significantly worse than that of patients with low vessel density in the tumor. There was a tendency for poorer prognosis in the group with VEGF-positive tumors compared with that of the group with VEGF-negative tumors. Overall, these results suggest that VEGF is associated with tumor progression by stimulating angiogenesis in human esophageal carcinoma.

Blotting, Northern↗

PubMed1998

[Enchondroma protuberance with destroying the rib: report of a case].

A 18-year-old female was admitted to our hospital because of a mass shadow in the left upper lung field on chest roentgenogram of a medical check. Computed tomography and magnet resonance imaging of the chest revealed a tumor which located in the left 5th rib, and was unclearly demarcated to the rib. Under the diagnosis of a rib tumor, the patient was treated by radical en bloc excision. The pathologic diagnosis was enchondroma protuberance of the rib. This tumor may be indistinguishable from osteochondroma or chondrosarcoma. Therefore, total resection is recommended for accurate diagnosis and absolute cure.

Adolescent↗

PubMed1998

[The electrocardiogram in the diagnosis of acute coronary syndrome].

The 12-lead ECG remains a simple and noninvasive technique to diagnose myocardial ischemia in patients with acute coronary syndrome. Although the diagnostic accuracy of the ECG depends upon the extent of myocardial ischemia and its severity, the initial ECG is the most rapid and readily available tool for the evaluation of patients presenting with suspected acute myocardial infarction. This paper discussed classic ECG changes which can be seen in acute myocardial infarction and unstable angina. A brief review is also made of the prognostic significance of the various patterns of the ECG in the era of thrombolytic therapy and invasive revascularization.

Acute Disease↗

PubMed1998

[Recent management of metastatic colorectal cancer].

The most common metastatic sites in colorectal cancer are the lung, liver, and the pelvis in rectal cancer. Systemic chemotherapy for these metastases is not effective. Our principle of treatment for metastatic colorectal cancer is as follows. Radical resection is the first choice of treatment if the metastases are localized. Radiation therapy and intra-arterial infusion of 5-FU is adopted if radical resection is impossible. Five-year survival rates of curative resection at our hospital for pulmonary metastases, hepatic metastases and local recurrences of rectal cancer are 35.3% (n = 44), 28.4% (n = 72) and 34.1% (n = 32), respectively. Intra-arterial hepatic continuous infusion of 5-FU and weekly high-dose infusion of 5-FU (WHF) are effective chemotherapy for inoperable hepatic metastases. For inoperable pelvic recurrence of rectal cancer, intraoperative radiation therapy, 192 Ir brachytherapy, interstitial hyperthermia and intra-arterial chemotherapy have seemed to be effective treatment methods.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1998

Contrast-enhanced T1-weighted three-dimensional gradient-echo MR imaging of the whole spine for intradural tumor dissemination.

BACKGROUND AND PURPOSE: When evaluating intradural tumor dissemination in the spine, contrast-enhanced T1-weighted 2D spin-echo (2D-SE) images are frequently problematic because most of the lesions are very small. Our purpose was to compare 2D-SE images with 3D gradient-echo (3D-GE) postcontrast images to determine which technique is better for depicting intradural tumor dissemination. METHODS: Ten patients with and 10 without intradural tumor dissemination were examined prospectively with MR imaging. After contrast administration, all patients underwent sagittal imaging with 2D-SE and 3D-GE sequences. Subsequently, the 2D-SE, 3D-GE, and multiplanar reconstruction (MPR) images of the 3D-GE sequence were evaluated for image quality, lesion detectability, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the disseminated lesions. RESULTS: Although delineation of spinal cord from CSF was slightly poorer on the 3D-GE sequences than on the 2D-SE sequences, the difference was not significant. In the evaluation of image artifacts and contrast between spinal cord and CSF, there was no significant difference. In seven patients with nodular enhancement, the 3D-GE sequence detected 46 lesions and the 2D-SE sequence detected 36. With MPR, the greatest number of lesions (n = 51) was detected, and vascular enhancement was clearly distinguished. There was no difference in SNR and CNR of lesions between the 3D-GE and 2D-SE sequences. CONCLUSION: The contrast-enhanced 3D-GE technique offers advantages over 2D-SE imaging in detecting intradural tumor dissemination, especially when the MPR technique is applied. This technique should be used for detecting intradural tumor dissemination.

Adolescent↗