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Biomedical subjects

T Hirata

Publications and source records attributed to T Hirata.

At least 379 records · Page 21Linked to original sources
PubMed1989

[Intraoperative radiation therapy for malignant glioma].

Intraoperative radiation therapy (IOR) is an ideal means of exterminating residual tumor after surgical resection. In this study, the clinical results of IOR using a Scanditronix Microtron MM-22 were evaluated in 14 patients with malignant glioma, five of whom had recurrent tumors. Between July, 1985 and October, 1986, 11 patients with glioblastoma multiforme (GB) were irradiated 18 times (mean, 1.6 times/case), and three with astrocytoma (Kernohan grade III) underwent IOR once each. The target-absorbed dose at 1 to 2 cm deeper than the tumor resection surface was 15 to 50 Gy. During irradiation, a cotton bolus was placed in the dead space after over 91% of the tumor had been resected. As a rule, external irradiation therapy was also given postoperatively at a dose of 30 to 52 Gy. One patient died of pneumonia and disseminated intravascular coagulation syndrome 1 month postoperatively. The 1- and 2-year survival rates of the remaining 13 patients were 84.6% and 61.5%, respectively; among the 10 with GB, they were 80% and 50%. Generally, the smaller the tumor size, the better the results. There were no adverse effects, despite the dose 15 to 50 Gy applied temporally to the tumor bed. IOR was especially effective against small, localized tumors, but was not always beneficial in cases of large tumors, particularly those with a contralateral focus. The improved survival rate in this series demonstrates that IOR is significantly effective in the "induction of remission" following surgical excision of malignant gliomas.

Adult↗
PubMed1989

Serovirological study of vestibular neuronitis.

A serovirological study to clarify the pathogenesis of vestibular neuronitis was made on 44 patients. The diagnosis of vestibular neuronitis was made under the diagnostic criteria. Sera from all 44 cases were collected twice or more at defined intervals. Of these, 36 cases were treated as paired sera. Seventeen out of 36 paired cases showed significant change in serum viral antibody titer (HSV, 2 cases; CMV, 1 case; EBV, 7 cases; rubella, 2 cases; adeno., 2 cases; influ. A, 1 case; influ. B, 2 cases). It was assumed that infection caused by these detected viruses played an important role in the onset of vertigo in each case.

Adolescent↗
PubMed1989

[Peculiarity of pulsed dye laser lithotriptor and its clinical application].

Ultrasound lithotriptors (USL) and electrohydraulic lithotriptors (EHL) are representative lithotriptors for endoscopic elimination of upper urinary tract stones. However, they have some disadvantages. For example, USL can not be used with flexible scopes and EHL can cause unexpected tissue injury. To overcome these problems, the pulsed dye laser lithotriptor (MDL-1, Candera Co.) was developed. The characteristics of this laser lithotriptor and its direct effects on tissue was investigated. This pulsed dye laser lithotriptor generates a 504 nm wavelength green light beam by using a combination of a xenon flash lamp and the greenish dye composed of coumarin solution. The maximum output energy is 60 mJ/pulse and the pulse duration is 1.5 microsecond. The pulse rate can be varied from 1 to 20 Hz. First, the intensity of the shock wave was measured by using a combination of a piezoelectric element and an oscilloscope, and then, the results were compaired with those obtained by a similar experiment with an EHL. The average intensity of the shock wave was 54.4 mW under the conditions of 40 mJ/pulse of output energy and 10 Hz of pulse duration. On the other hand, the EHL generated an average of 54.7 W under the conditions of 400 mJ/pulse output energy. Then, fragmentation of various kinds of urinary stones in saline solution was performed. The results showed that this lithotriptor could fragment almost all kinds of stones except cystine stones. Then, hen's eggs were used to observe the effect if laser bean influenced on the organism immediately behind the photoradiated object. Only the egg shell was demolished but the egg membrane below the eggshell did not undergo any change. After these experiments, skin, liver, kidney and urinary bladder of nude mice and human prostatic urethral mucosa in case of TUR-P were irradiated by this laser. The results showed that laser energy caused slight penetration and localized hemorrhage from the surface of epithelium to subcutaneous tissue. It was confirmed that these effects were generated when the tip of the quartz fiber was in direct contact with the object.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

In vitro and in vivo antibacterial activity of KT3777, a new orally active carbacephem.

KT3777 is a novel carbacephem antibiotic structurally identical to cefaclor (CCL), except that the sulfur atom of position 1 of the cephem nucleus has been replaced by carbon. KT3777 was investigated for in vitro and in vivo antibacterial activities in comparison with CCL, cephalexin (CEX) and amoxicillin. The MIC50 of KT3777 ranged from 0.2 to 3.13 micrograms/ml for clinical isolates of Staphylococcus aureus, Streptococci, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae. KT3777 possessed an antibacterial spectrum and potency similar to that of CCL. However, against E. coli and K. pneumoniae, KT3777 was about twice as active as CCL. KT3777 was more active than CEX against all strains tested. Killing-curve studies demonstrated bactericidal activity of KT3777 at concentrations above the MIC. KT3777 showed good affinity for penicillin-binding proteins 1A, 1Bs, 3 and 4 of E. coli NIHJ JC-2. The protective effect of KT3777 against systemic infections in mice was comparable to that of CCL with a few exceptions and about 3 to 7 times greater than that of CEX. KT3777 also proved effective against localized infections such as acute pneumonia and ascending urinary tract infections in mice.

Administration, Oral↗
PubMed1989

Synthesis and antibacterial activity of novel 3-substituted carbacephems.

A series of novel 3-heterocyclothio substituted carbacephems having phenylglycyl side chain have been prepared starting from 3-H carbacephem. The compounds exhibit better chemical stability than the corresponding cephalosporin and strong activity against Gram-negative and Gram-positive organisms including Enterococcus faecalis.

Cephalosporins↗
PubMed1989

[An immunoradiometric assay of the serum TPA from patients with primary lung cancer and a comparison with the conventional double antibody method].

The serum level of tissue polypeptide antigen (TPA) has been measured by a new immunoradiometric assay (IRMA) method that has been recently developed using a specific antibody, and compared with the results obtained by the conventional double antibody method, using a polyclonal antibody. Both methods gave essentially the same results, i.e. the serum TPA level in patients with primary lung cancer was higher when compared with non-malignant pulmonary diseases and healthy individuals (p less than 0.01). However the positive rate and average values of TPA with patients of non-malignant diseases were found to be lower by the new IRMA method than by the conventional method. This may be due to the improvement in specificity and accuracy of this newer method of assay, as they also statistically decrease within the cut off level (110 U/L) estimated in non-malignant diseases and healthy individuals. Therefore, it has been concluded that the IRMA method is more suitable than the conventional method for diagnosis of primary lung cancer.

Adenocarcinoma↗
PubMed1989

[Effect of sequential MTX/5-FU therapy for a case of disseminated intravascular coagulation syndrome associated with recurrence of gastric cancer--a case report].

Although a 39-year-old male received the curative operation of total gastrectomy for advanced scirrhous carcinoma of the stomach, recurrence of cancer was occurred soon after the surgery, accompanied by hemorrhagic diathesis from DIC. The abdominal CT scan examination revealed the rapid enlargement in the size of the several lymphnodes around the abdominal aorta, and the blood chemistry tests showed marked increase of the serum CEA value. The sequential chemotherapy with intermediate dose of MTX and 5-FU in conjunction with OK-432 was started to treat the case. This chemotherapy was carried out once a week for 5 times and consequently DIC was led to the perfect remission. Furthermore, CEA level decreased within normal range, and the size of the enlarged lymphnodes at paraaortic area diminished remarkably. Although he complained of nausea and loss of appetite during the treatment, no severe adverse effects such as granulocytopenia, diarrhea, or loss of hair were observed. The successful result in this patient suggests that sequential therapy of intermediate dose of MTX and 5-FU with administration of OK-432 may be effective in the treatment of advanced scirrhous carcinoma of the stomach.

Adenocarcinoma, Scirrhous↗
PubMed1989

[The management of chest injuries].

The mortality from chest injuries is so high due to severe physiologic imbalance that an immediate and accurate diagnosis of the injured organ and prompt treatment can salvage the patient from the strategy. This study comprises 1329 injured cases including 145 patients with crushed chests. The cause of injury was traffic accident in 537 cases (40.5%), fall or degradation in 332 cases (25%). There was a correlation between the cause of injury and age, as that traffic accident was a major one in young aged and fall in elders. Treatment against crushed patients included 150 surgical operations, 206 plaster bandages, 56 drainage of thoracic, peritoneal and cranial cavities. Thoracotomies performed in patients with flail chest (2), lung contusion (4), rupture of the bronchi and diaphragm (each 1) and for evacuation of clotted hemothorax in 3 patients. The prognosis of all these patients was good. Lastly we conclude that since the prognosis of injured patients depends on how fast the patient can be carried to the hospital and how quickly the physician or surgeon can evaluate the trauma and institute a prompt treatment, the education of the primary staff is the most important.

Accidents, Traffic↗
PubMed1989

[The effect of epidural injection with morphine on the post-thoracotomy respiratory function].

Patients undergoing thoracotomy experience severe post-operative pain and marked respiratory impairment, which causes pulmonary atelectasis and pneumonia. The effects of epidural injection on postoperative pain and respiratory function were examined in this study. The group undergoing epidural injection of 3 mg morphine (at the end of operation, 09oo and 21oo for the next 3 days) included 37 patients, while the control group involved 16. The number of required analgesics on the operating day and next three days were compared between the two groups. And postoperative vital capacity (VC), forced expiratory volume in the first second (FEV1), maximum mean flow (MMF) were compared with preoperative value. Patients receiving epidural morphine required significantly less analgesics throughout the postoperative periods (p less than 0.01). The morphine injected group had significantly better value in VC and FEV1 in the first two postoperative day (p less than 0.01), while significance were seen only in the first postoperative day in MMF (p less than 0.01). It seems that epidural morphine is highly effective in alleviating pain and improving respiratory function in post-thoracotomy patients. These effects help the expectoration of sputum especially in senile patients. As the side-effects of epidural morphine, urinary retention, nausea, vomiting and itching were seen in few patients. No serious side effect such as hypotension or ventilatory depression were seen.

Humans↗
PubMed1989

[Thallium-201 imaging of brain tumors using single photon emission CT].

Single photon emission CT using thallium-201 chloride, injected intravenously, was performed on 28 cases of cerebral lesions, among which were 16 gliomas, 2 meningiomas, 5 other brain tumors, 3 metastatic brain tumors and 2 cerebral radiation necroses. The degree of thallium-201 accumulation was evaluated by a new method called the thallium index (TLI); that is, TLI was expressed as (T-C)/C (T and C indicate relative counts in a pixel of a lesion and in non-affected normal brain tissue, respectively). Thallium-201 accumulation occurred in 86% (24) of the evaluated cases. In general, there was a tendency in high-grade or recurrent gliomas, as well as in metastatic brain tumors for the TLI values to be high. Moreover, high TLI values were noticed in cases of meningioma, radiation necrosis of cerebellum and in cases involving subacute stages of cerebral infarction. It is particularly noteworthy that the meningioma TLI values were about two times higher than those of the glioblastomas. The CT contrast-enhancement of lesions was clearly correlated with the TLI values, and the relationship between the TLI values and the number of vessels observed microscopically in the specimen was statistically significant. From the above results, it was concluded that thallium-201 accumulation in lesions might be strongly influenced by the development of vascularity in lesions, and/or the interference with the blood brain barrier due to the tumor itself. However, this malignancy diagnostic method is probably limited to the diagnosis of glioma.

Adult↗
PubMed1989

Characterization of lymphocytes in a patient with Wiskott-Aldrich syndrome: studies by fluorescence polarization.

Lymphocytes from a patient with Wiskott-Aldrich syndrome (WAS) were employed for a study of the intracellular viscosity and fluorescein permeability through the cell membrane by a fluorescence polarization spectrofluorometer, which was designed to calculate polarization value and permeable fluorescein intensity automatically. Fluorescein diacetate (FDA) was used as the indicator probe. The fluorogenic substrate is taken up by viable cells and converted to a fluorescent molecule, fluorescein, by intracellular esterase, where upon the fluorescein easily effluxes through the cell membrane. The response to stimulation with phytohemagglutinin (PHA) for 45 min led to a decreased polarization value (p-value) as compared to lymphocytes of healthy donors, and the fluorescein efflux through the cell membrane was greater than that of healthy donors. Fluorescein efflux from lymphocytes in the patient during 48 and 72 h incubation with or without PHA was markedly increased. In healthy donors, the degree of fluorescein permeability was not increased during the culture. These results indicate that intracellular viscosity of lymphocytes is altered in initial mitogenic stimulation, but that there was some abnormality in the fluorescein permeability properties through the cell membrane of lymphocytes in a patient with WAS.

Adolescent↗
PubMed1989

[Two cases of testicular rupture].

Two cases of testicular rupture are presented and 119 cases in Japanese literature are reviewed. A 29-year-old man and a 32-year-old man were admitted to our hospital with the complaint of gradually increasing pains and swelling on the right testicle. Four days and three days before admission they experienced trauma during athletic activities. The diagnosis was established preoperatively by means of ultrasonography in the first one, but not in the other. The necrotic tissue of 1/3-1/2 of testis was removed and tunica albuginea was repaired in both cases. Of 119 cases of testicular rupture in Japanese literature a peak occurs in the 2nd decade and during contact sports. The ultrasonography is an effective diagnostic modality. The rate of orchiectomy has been decreasing. The function of the affected testis is hard to evaluate.

Adult↗
PubMed1989

[Clinical study on intracranial arachnoid cyst: with reference to the middle cranial fossa].

Thirty-two cases of congenital arachnoid cyst (AC), 26 cases of supratentorial, and 6 cases of infratentorial cyst are reported. They were encountered over a period of 9 years. The 26 supratentorial cysts consisted of 21 cases located in the middle fossa, 2 in the frontal, and 3 in the suprasellar. Patients' ages ranged from 7 months to 67 years (mean: 19.3 years), with a male to female ratio of 23:9. The most common symptoms were headache, epileptic seizure, and cranial enlargement. Based on observations between neuroradiological examinations including analysis of the cyst content, and operation, typical AC might be defined as "duplicated arachnoid and its splitting", and it may be said that "there is continuous existence of cerebral structure such as cortex and white matter lying adjacent to AC on MRI". Out of 32 cases, 15 received surgical treatment because of mass effect of AC itself, abnormal dynamics of the AC fluid, and/or increasing sign of ICP. 13 cases had resection of AC outer membrane with craniotomy, and the remaining two had cystoperitoneal shunt. One of the shunting cases complicated subdural hematoma. Surgical treatment was discussed and radical craniotomy rather than a shunt procedure was preferred. Prognosis of all cases was favorable and uneventful.

Adolescent↗
PubMed1989

[Effect of immune response during cardiopulmonary bypass on post-operative infections].

To study the effects of extracorporeal circulation on the post operative infections, the relationship between the influences of the immunologic change during cardiopulmonary bypass (CPB) and post operative change of neutrophilia was evaluated in 52 patients. These patients were divided into two groups: group A (non-infected), 19 patients whose neutrophil count increased within 15,000/microliters in peripheral blood after operation. Group B (infected), 33 patients whose neutrophil count increased 15,000/microliters or more within one week after operation. Immunoglobulins (IgG, IgA, IgM) and complement fraction (C3, C4, CH50) levels decreased significantly during CPB, but there was no significant difference between the two groups. The amount of lymphocyte subsets of helper/inducer T cell and suppressor/cytotoxic T cell showed similar change in both groups. On the contrary the amount of lymphocyte subset of Natural Killer cell showed significant increase in A group during CPB when compared with B group, suggesting immunological activation, however, in the group which showed less than 40% increase of NK cell during CPB, there was significant increase of neutrophils after operation compared with the other group which showed high increase of NK cell. These findings suggested the increased activation of the Natural Killer cell during CPB is a favorable response, especially for preventing infections after operation.

Adult↗
PubMed1989

[The remote effects of brain tumors on cerebral blood flow as measured by single photon emission CT].

In order to assess the remote effects of supratentorial brain tumors, the cerebellar blood flow and cerebral blood flow of the symmetrical regions in the contralateral cerebral hemispheres were measured by single photon emission CT. Forty four patients with supratentorial brain tumors, such as gliomas, meningiomas and germ cell tumors etc., were included in this study. Contralateral cerebellar hypoperfusion (CCH) was exhibited in 51%, 18 of 35 unilateral brain tumors. Regarding tumor location, CCH was more correlated with frontoparietal lesions. The mean values of contralateral delta Cerebellar blood flows (delta CBFs) were lower than those of ipsilateral delta CeBFs, and also statistically, bilateral delta CeBFs significantly decreased. The greater the volume of lesions including peritumoral edemas, the lower the delta CeBF became. Among the 9 cases with obstructive hydrocephalus, the preoperative delta CeBFs which had decreased significantly, returned to normal postoperatively. Statistically, it seemed that there was no transcallosal suppression caused by unilateral brain tumors. However the delta rCBF of the mirror foci in postoperative patients decreased significantly. In conclusion, the remote effects on the cerebral blood flow, which are common in strokes cases, were demonstrated in many cases of supratentorial brain tumors and the occurrence of CCH was closely related to the frontoparietal lesion including the tumor and peritumoral edema. Also the mechanism of CCH was discussed with preference for a transneural suppression.

Adolescent↗
PubMed1989

[Evaluation of the contractile state of the left ventricle before and after aortic valve replacement from end-systolic stress-volume relations in patients with chronic aortic regurgitation].

Before and one month after aortic valve replacement, the contractile state of the left ventricles in 10 patients with chronic aortic regurgitation were studied. The slope and intercept of the end-systolic stress-volume relationship (ESSVR) determined by M-mode echocardiography during intravenous infusion of Nitroprusside were used as an index of myocardial contractility. We found that the end-systolic wall stress-volume relationship from more than four points of pressure and dimension data have shown the linear relation for each subject with linear coefficients ranging from 0.848-0.997. There was no significant change in the slope of ESSVR between the pre- and early postoperative studies (1.66 +/- 0.37 to 1.92 +/- 1.02; p greater than 0.05), however, the intercept decreased significantly (44.7 +/- 32.4 to 29.4 +/- 28.0; p less than 0.01), which meant the leftward shift of the line of ESSVR and may imply the improvement of myocardial contractility. On the contrary, the fractional shortening decreased significantly (25.6 +/- 8.5 to 18.9 +/- 8.8%; p less than 0.01), reflecting marked reduction in preload or left ventricular end-diastolic volume (7.52 +/- 1.07 to 6.04 +/- 1.38; p less than 0.01). The change in the slope of the liner of ESSVR demonstrated that myocardial contractility might not be depressed at this time but rather improving.

Adult↗
PubMed1989

[A case of squamous cell carcinoma of the thymus].

A case of squamous cell carcinoma of the thymus was reported. A 60-year-old female was admitted because of swelling of left cervical and left axillary lymph nodes. Chest X-ray revealed left anterior mediastinal mass shadow. The histological examination on the excised left axillary lymph nodes revealed well differentiated squamous cell carcinoma. After radiotherapy, the operation was performed with median sternotomy and then the mediastinal tumor was diagnosed squamous cell carcinoma originated from the thymus. The postoperative course of the patient was unfavorable, though adjacent postoperative radiotherapy and chemotherapy. Compared with ordinary thymoma, squamous cell carcinoma of the thymus commonly metastasizes outside the thorax and has poor prognosis. In view of these differences, it should be separated histologically from ordinary thymoma.

Carcinoma, Squamous Cell↗