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Biomedical subjects

T Ishida

Publications and source records attributed to T Ishida.

At least 847 records · Page 47Linked to original sources
PubMed1991

CT findings of endobronchial metastasis.

One hundred and sixty-one patients with pulmonary metastases were studied with CT. Six of them proved to have endobronchial (intraluminal) metastatic lesions by bronchoscopy. Retrospective analysis of the CT studies showed obstruction and/or narrowing of the bronchi in 5 cases while no lesion was observed in one patient. Although CT can not always demonstrate intraluminal lesions, it should be performed when an endobronchial metastasis from extrathoracic malignancy is seen by bronchoscopy because it will show hilar or mediastinal lymphadenopathy, or single or multiple pulmonary metastases other than the endobronchial lesion.

Adult↗
PubMed1991

[A case of a calcifying odontogenic cyst associated with odontoma inducing impaction of a deciduous tooth].

A 4-year-old boy was examined with a chief complaint of "Delayed eruption of maxillary right deciduous central incisor". Oral examination revealed a firm swelling on the labial gingiva at the right deciduous incisor of maxilla. Radiographic examination revealed that odontoma-like substances disturbed the eruption of the central deciduous maxillary incisor. The odontoma-like substances were removed surgically and examined histopathologically. The thin sections showed findings typical of a Calcifying Odontogenic Cyst with Odontoma.

Child, Preschool↗
PubMed1991

[A clinical survey of advanced bladder cancer: treatment of advanced and non-resectable bladder cancer].

Sixty-three patients with advanced cancer of more than T3b and/or non-resectable bladder cancer who were treated at Kanazawa University Hospital from January 1982 to June 1990 were analyzed with regard to treatment and prognosis. Thirty-one of the 63 patients had non-resectable bladder cancer; T3b in 9, T4b in 15, M1 in 6 and N4 in 4. Twenty-four of the 31 patients received anticancer therapy consisting of systemic chemotherapy, 8 MHz-RF hyperthermia, radiation or a combination of these modalities. With this treatment 9 patients achieved partial response, 4 minor response, 7 no change and 2 progressive disease. In 2 patients evaluation was not performed. Seven of the 31 patients received no treatment. One-year and 2-year survival rates with the above types of treatment were 27.7% and 16.7%, respectively, and 33.4% and 16.7%, respectively, without anti-cancer treatment. There was no significant difference between the survival rates of the two groups. Thirty-two of the 63 patients underwent operation. In 17 patients, total cystectomy was carried out, 9 and 8 of whom received and did not received respectively various adjuvant therapies before operation. One-year and 2-year survivals in the group undergoing adjuvant therapy were 33.3% and 11.1%, respectively, and 66.7% and 66.7% respectively in the group without adjuvant therapy. Survival of the 2 groups did not differ significantly. These data indicate that anticancer treatment including chemotherapy, hyperthermia and radiation dose not enhance long-term survival.

Adult↗
PubMed1991

[A case of multiple pulmonary arteriovenous fistulae associated with splenic abscess].

A 51-year-old female was admitted with high grade fever, cyanosis and hypoxemia. The chest X-ray showed nodular shadows on bilateral lung fields. Beta-streptococci were found on culture from the blood, and the fever fell after administration of both antibiotics and corticosteroid. Pulmonary angiography revealed four arteriovenous fistulae on bilateral lung fields. On abdominal ultrasonography and CT scan, a hypoechoic lesion with an irregular wall and varying internal echogenicity was detected within the spleen. This lesion changed in size and shape during the clinical course and diminished with improvement in the patient's condition. These findings were compatible with splenic abscess. Splenic abscess with pulmonary arteriovenous fistulae is rare.

Abscess↗
PubMed1991

[A case of pulmonary alveolar microlithiasis showing respiratory failure after 33 years and revealing microliths in bronchoalveolar lavage].

A 43-year-old woman was admitted to our hospital because of dyspnea and anorexia. She had hypoxia and cyanosis. The chest roentgenogram revealed dense reticular, partly nodular shadow and emphysematous bullae in both lung fields. An abnormal chest X-ray had been pointed out and pulmonary alveolar microlithiasis had been diagnosed 33 years previously. Bronchoscopy and bronchoalveolar lavage were performed and calcium microliths were seen in the bronchoalveolar lavage fluid smear. Bronchoalveolar lavage appears useful in the diagnosis of pulmonary alveolar microlithiasis. A series of X-ray findings showed development of emphysematous bullae, niveau formation and disappearance of bullae. These changes seem to reveal the progress of her disease from the established stage to the advanced stage. Such a case of pulmonary alveolar microlithiasis over the course of a long period is rare.

Adult↗
PubMed1991

[A case of apyretic miliary tuberculosis which was discovered accidentally].

A 78 year-old female was referred to our hospital, because diffuse miliary shadows in bilateral lung fields were discovered during upper G.I. series. She did not complain of fever or display any chest symptoms. Her laboratory data on admission revealed mild hypoxemia and high serum CA 19-9. The transbronchial lung biopsy specimen proved epithelioid cell granulomas. M. tuberculosis was observed on culture from the sputa, urine and bronchoalveolar lavage fluid. She was diagnosed to have miliary tuberculosis, and antituberculous drugs were administered. After the antituberculous therapy, the diffuse miliary shadows on the chest X-ray diminished gradually, and the laboratory data improved. No elevation in the body temperature was seen during the entire clinical course. Though it is known that miliary tuberculosis in elderly patients is often atypical and has mild symptoms, miliary tuberculosis without fever is very rare.

Age Factors↗
PubMed1991

[Bilateral renal cell carcinoma in a patient receiving long-term dialysis].

Bilateral renal cell carcinoma developing in a 55-year-old male receiving long-term dialysis is reported. The patient, who had undergone maintenance hemodialysis for 12 years, was admitted in July, 1986 for the purpose of extensive examination of a right renal mass. CT scan and ultrasonography demonstrated an enlarged bilateral kidney associated with multiple cysts, containing a solid mass in the right upper pole. The patients underwent right nephrectomy under the diagnosis of right renal tumor. The solid tumor 4 x 3 cm in size revealed a grade 1 to 2 renal cell carcinoma pathologically. Two small tumors were recognized in other portions of the kidney. Multiple cysts of varying sizes, the largest 2 cm in diameter, replaced the renal parenchyma. The cyst walls frequently contained hyperplastic changes. The patient has been subsequently followed up for 2 years and 9 months and underwent left nephrectomy for suspected left renal tumor. The surface of the left kidney was covered by numerous cysts. The result of pathological examination was renal cell carcinoma, which was recognized in a total of 7 regions of the left kidney. The patient remains well on hemodialysis, with no evidence of recurrence or metastasis.

Adenocarcinoma↗
PubMed1991

[The CT diagnosis of emphysema and correlation with pathologic findings].

It is difficult to diagnose clinically silent or mild emphysema. The efficacy of CT scans for the diagnosis of emphysema has attracted attention and comparisons have been made between CT images and the pathological grade of emphysema in resected lungs. With a view to determine to what extent high resolution CT images are accurate concerning the diagnosis of mild emphysema, we conducted an extensive comparative study on CT scores of emphysema, based on high resolution CT, the pathology score derived from the cut surface of the lung identical in its plane with that of the CT and destructive index (DI) which is said to be instrumental in representing the degree of deterioration of alveolar walls in the same regions of the lungs. In this study, 42 patients who underwent thoracotomy and their lung specimens including a solitary nodule of considerable size have been employed. The CT scores and pathology scores depend on the picture grading system developed by Thurlbeck and coworkers for the basis of counting. The findings were such that with 1 mm collimation, the CT scores ranged between 12 and 57 with a mean +/- SD of 22.1 +/- 9.6 (n = 35) while with 5 mm collimation, the CT scores ranged between 7 and 46 with a mean +/- SD of 16.5 +/- 8.3 (n = 33). The pathology scores stood at 10 to 57 with a mean +/- SD of 23.2 +/- 9.8 (n = 42).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Immunohistochemical evidences of prognostic parameters associated with tumor development of pulmonary adenocarcinoma].

We immunohistochemically examined 186 lung adenocarcinomas for the presence of prognostic indicators of local growth of tumor, invasiveness and metastasis. Of the examined tumors, 67% showed a high expression of transforming growth factor alpha (TGF alpha); 50% for epidermal growth factor (EGF), 45% for EGF receptor (EGFR), and 30% for urokinase type plasminogen activator (uPA). In the EGFR-high cases, the 5-year survival rates of patients with high TGF alpha and low TGF alpha were 36% and 85%, respectively. In the EGFR-low cases, there was no statistical difference between the two groups. These findings suggested the presence of autocrine growth mechanisms. On the other hand, the high expression of uPA was modulated by TGF alpha and/or EGF. The 5-year survival rates of patients with high uPA and low uPA were 20% and 51%, respectively. The tumors with high expression of uPA showed degradation of the matrix components, including laminin and fibronectin. These findings suggested that uPA played a role to break through the surrounding basement membrane of blood and lymphatic vessels, and connective tissue for their growth and metastasis. We wish to emphasize the usefulness of the immunohistochemical evidences, such as autocrine growth mechanism and breakdown of extracellular matrix, as a possible parameters of tumor development, invasiveness and metastasis.

Adenocarcinoma↗
PubMed1991

Lung adenocarcinoma is more sensitive than gastric adenocarcinoma to anticancer drugs in vitro.

The chemosensitivities of 26 lung adenocarcinoma tissues were compared to those of 110 gastric adenocarcinoma tissues, using the in vitro succinate dehydrogenase inhibition (SDI) test. Tumour tissues obtained at surgery were exposed to five different anticancer drugs: carboquone (CQ), adriamycin (ADM), mitomycin C (MMC), cisplatin (DDP) and 5-fluorouracil (5-FU). The lung adenocarcinomas showed a statistically significant reduction in succinate dehydrogenase (SD) activity, compared to the gastric adenocarcinomas, after exposure to each drug. The chemosensitivity was defined as a reduction in SD activity to 50% of control or less. Lesser degrees of reduction in SD activity were defined as drug resistance. The sensitivity rates to ADM, MMC and DDP, respectively, were significantly higher in the lung than in the gastric adenocarcinomas. Tumour cells from 22 (84.6%) of the 26 lung adenocarcinoma tissues showed a sensitivity to more than three drugs, whereas the rate was only 46.4% (51/110) for the gastric adenocarcinomas. The rate of resistance to all the drugs tested was 3.8% (1/26) for the lung adenocarcinomas, in contrast to the 20.9% (23/110) seen with the gastric adenocarcinomas. Thus, while adenocarcinomas of the lung and stomach both show clinical resistance to anticancer agents, the chemosensitivity of the lung tissues is greater. In the light of these observations, attention must be directed to improving specific drug delivery systems.

Adenocarcinoma↗
PubMed1991

[Bone infarction and fat island appearing as local defects in radionuclide bone marrow imaging].

Parallel studies of radionuclide bone marrow imaging and bone scanning are helpful in the early diagnosis of skeletal metastasis. In bone marrow imaging, most lesions are observed as a local defect. We had two cases of nonmetastatic lesions which appeared as local defects in bone marrow imaging. The first case was a male Hodgkin's disease patient, aged 48, who had been treated with frequent chemotherapy, including the administration of a large quantities of steroids. He complained of slight pain in the left shoulder. Without increased uptake in bone scanning, abnormal accumulation of 67Ga-citrate and a local defect in bone marrow imaging appeared, corresponding to localization of the pain. Suspecting bone marrow metastasis, we performed magnetic resonance imaging (MRI). An area of slightly decreased intensity in T1-weighted spin-echo images and lower intensity than fat tissue in T2-weighted images were observed, although it was slightly enhanced by Gd-DTPA. This lesion was diagnosed by biopsy as a bone infarction. The second case was that of a 69-year-old male lung cancer patient. Though no abnormality was revealed by bone scanning or 67Ga-citrate scintigraphy, an apparent defect at the 10th thoracic vertebra was observed in bone marrow imaging. It was not accompanied by pain. MRI was also performed in this case. This was depicted as a clearly defined high intensity area. This was diagnosed as a fat island, and no change has been seen in the seven months of follow up. In conclusion, it is necessary to consider the possibility of nonmetastatic lesions, when local defects appear in bone marrow imaging performed on cancer patients.

Adipose Tissue↗
PubMed1991

[Clinical evaluation of renal cell carcinoma and acquired cystic disease of the kidney in long-term dialysis patients].

Long-term dialysis patients frequently develop acquired cystic disease of the kidneys (ACDK). One hundred and sixty-seven dialysis patients were classified into two groups according to the presence or absence of ACDK, and the two groups were compared with regard to the dialysis period, laboratory findings, and so forth. Among the 167 dialysis patients, 37.7% showed ACDK and had an average dialysis duration of 10.3 years, which was significantly longer than the 5.0 years for patients without ACDK. The proportion of patients with ACDK rose with increasing duration of dialysis; 64.6% of the patients on dialysis for more than 10 years had ACDK. The values of hemoglobin and hematocrit of patients with ACDK were significantly higher than those without ACDK. Of 12 dialysis patients who were operated upon because of suspected renal tumor, pathological examination confirmed renal cell carcinoma in 8 and adenoma in one. One of these patients had been treated with chronic ambulatory peritoneal dialysis, and another had bilateral renal tumor. Among the 8 patients with renal cell carcinoma, ACDK was detected in 5 by means of CT and ultrasound tomography, and cystic changes were observed in two on light microscopic examination of the resected kidneys. Pathological examination of the non-tumorous renal tissues revealed hyperplastic or adenomatous changes in the cyst epithelium in 5 patients undergoing dialysis for more than 7.5 years. These changes were thought to be pre-neoplastic. The high incidence of ACDK and the development of renal tumors in long-term dialysis patients indicates the necessity of intensive monitoring.

Adenoma↗
PubMed1991

[Non-functioning adrenal cortical carcinoma: a case report--MRI findings].

A 42-year-old woman was admitted to our hospital complaining of dull left flank pain. Excretory urogram showed a downward compression above the left nephrogram. Computed tomographic scan and magnetic resonance imaging (MRI) revealed a left adrenal tumor with a non-homogenous inner density. The mass was hyperintense as compared to the liver on T2-weighted images of MRI. No endocrinological abnormalities were detected by laboratory examinations. We performed transperitoneal left adrenalectomy and nephrectomy under the diagnosis of non-functioning left adrenal tumor. The histological examination revealed adrenal cortical carcinoma without lymph node metastasis. The patient has been receiving 4.5g o,p'-DDD per day after the operation. There has been no evidence of recurrence or metastasis during the 7-month follow-up period.

Adrenal Cortex Neoplasms↗
PubMed1990

Molecular conformation of achatin-I, an endogenous neuropeptide containing D-amino acid residue. X-ray crystal structure of its neutral form.

The molecular conformation of achatin-I neutral form (H-Gly-D-Phe-Ala-Asp-OH), an endogenous neuropeptide, was elucidated by X-ray crystal analysis. The molecule has a type II' beta-turn structure with the D-Phe-Ala residues at the corner of the bend, which is further stabilized by two NH(Gly)...C gamma = O sigma(Asp) and NH(Asp)...C gamma = O sigma(Asp) intramolecular hydrogen bonds. This turn conformation may be an important feature of achatin-I related to its neuroexcitatory activity.

Amino Acid Sequence↗
PubMed1990

[Post radiation changes in the rectum: assessment by MR imaging].

MRI findings of pelvic radiation changes in 42 patients were correlated with the tumor and critical tissue dose, time post treatment, and clinical symptoms. The severity of tissue changes was graded. The ability of MRI to differentiate post radiation tissue changes from residual or recurrent tumor was also correlated. Radiation tissue toxicity increased significantly when the dose exceeded 4,500 cGy, with the incidence of marked rectal changes rising from 8% to 44% with a dose greater than 4,500 cGy. All grades of tissue change were seen in the rectum of time from start of therapy. All patients who exhibited clinical grade 2 or 3 rectal changes showed moderate or severe changes on MRI. Grade 1 MRI changes indicative of mucosal edema were present in 33% of patients with no clinical symptoms. In conclusion, the gradation and sequence of MRI changes following radiation therapy to the pelvis have been documented and correlated with clinical findings. With its potential for distinguishing radiation change from recurrent tumor. MRI should prove to be of value in the assessment of the post-radiation pelvis.

Adult↗