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Biomedical subjects

T Kajiwara

Publications and source records attributed to T Kajiwara.

At least 127 records · Page 7Linked to original sources
PubMed1992

[Chemical composition of gallstones in Santa Cruz--Bolivia].

The knowledge of the gallstones chemical composition is very important from view point of lithogenesis and possible medical therapy of dissolution. The composition (chemical) of gallstones in 30 consecutive cholecystectomized patients were studied in the 2nd. Department of Surgery of Hospital San Juan de Dios, Santa Cruz, Bolivia (altitude 1900 m). All gallbladder stones were washed, counted, measured and dried before sending them to Japan to be processed. The composition of gallstones was analyzed by infrared absorption spectroscopy. Cholesterolemia, age, sex and number of stones were analyzed in cases of pure cholesterol stones. The incidence of pure cholesterol stones was 56.6%, statistically similar to be reported by other authors, but very low if compared with the valley area of Bolivia (Cochabamba altitude 2300 m) where hypothyroidism is frequent. Hypercholesterolemia had little relation with the pure cholesterol gallstones. There was no difference in the chemical composition and the size of the stones, but while their number was small, cholesterol stones were more frequent. The low incidence of pure cholesterol stones may show a bad nutritional condition of our population (poor fat and protein content) and this result is important in order in using the new advance: lithodissolvent drugs.

Adolescent↗
PubMed1992

["Left unilateral agraphia with right hemiparesis" after occlusion of the left middle cerebral artery].

This paper presented a case of a right-handed male who showed a right hemiplegia without aphasia and apraxia. He lost the ability to write with the left hand. A 56-year-old right-handed man, who had a daughter of left-handedness, was sent to our hospital with a homonymous hemianopsia, facial weakness, spastic hemiparesis and sensory disturbance in the right side. CT scan revealed an infarction in the territory of the left middle cerebral artery. On a month after the onset, he was alert and oriented. His speech was normal and verbal comprehension was intact. Although he neglected the right side of the page, he could read and comprehend it correctly. In contrast with his normal abilities to speak, comprehend, and read, difficulties in writing were prominent. Spontaneous writing with the left hand was extremely poor, and he even had difficulty writing his own name. His dictation was also poor, but his writing improved with copying letters. Agraphia had seen even after USN was recovered. Analysis of this case suggested the presence of the dominance for speech, comprehension, and praxis in the intact right hemisphere, and writing center in the damaged left hemisphere.

Agraphia↗
PubMed1992

[Application and technique of breast conservative treatment of breast cancer].

In patients with breast cancer who had undergone breast conservative treatment involving lumpectomy, axillary lymph node dissection and irradiation, the surgical results and risk factors for remaining cancer foci in the conserved breast were investigated. This form of surgery was performed in 25 patients with T1,N0,-Ia,M0 breast cancer. The cut end of the resected specimen was histopathologically positive for cancer cells in 48% of the patients, but there has been no local or distant recurrence in any patient to date with a mean follow-up period of 17.2 months after surgery. In most breasts resected after lumpectomy, slight cancer foci remained in mammary glands at the sites within 1.0cm distant from the cut end. Extensive remaining cancer lesions were found among cases with advanced intraductal spread or central necrosis in the intraductal foci. The above findings indicate that breast conservative treatment by lumpectomy may result in histopathologically remaining cancer foci, although these can be controlled by irradiation therapy. However, application for this treatment requires much caution when severe intraductal spread or central necrosis is present in the intraductal foci, because extensive cancer foci may remain postoperatively in such cases.

Adult↗
PubMed1992

[Conservative surgery and radiotherapy of early breast cancer].

Radiation dose-effect relationship is reviewed. In conservative treatment of early breast cancer, necessity of radiation is discussed and surgery with radiotherapy technique in our hospital is presented. Our procedures consist of lumpectomy which is removal of 1 cm of normal tissue containing primary breast cancer and complete axillary dissection and postoperative radiotherapy of 46 Gy with 9 Gy of electron boost. Since November 1987, 51 patients treated by this procedure have shown a good local control and a satisfactory cosmetic results. We can conclude that the positive aspects of radiotherapy in the management of conservative therapy for early breast cancer are overwhelming.

Breast Neoplasms↗
PubMed1991

The clinical value of tissue carcinoembryonic antigen in breast cancer.

The relationship of tissue carcinoembryonic antigen (CEA) to clinicopathological factors and prognosis was investigated in 168 patients with invasive ductal carcinoma of the breast. Tissue CEA was determined by radioimmunoassay and a level of 5.1 ng/ml or more considered to be positive. Tissue CEA was positive in 31.5 per cent of the patients overall and, of the clinicopathological factors, tumor size and the presence or absence of lymph node involvement were not found to be correlated with tissue CEA. However, the tissue CEA positivity rate was significantly higher in patients who had four or more metastatic lymph nodes (p less than 0.01). Tissue CEA-positive patients showed earlier recurrence than CEA-negative patients (p less than 0.01) and had a poorer outcome (p less than 0.05). Thus, tissue CEA is considered useful as a prognostic index for primary breast cancer patients.

Adult↗
PubMed1991

[A case of Plasmodium vivax malaria with findings of DIC].

We reported a rare case of Plasmodium vivax malaria who showed findings of disseminated intravascular coagulation (DIC). A 50-year-old Japanese male was sent to our hospital with the diagnosis of Plasmodium vivax malaria on the 26th of April, 1990. He had stayed in the Solomon Islands from Oct. 1987 to Dec. 1989, and had febrile episodes during his stay in the island. On April 18, 1990, he complained of a high fever with chills, and showed the same episodes on the 20th, 22th and was diagnosed as malaria. He was treated successfully with the sulfadoxine 500 mg and pyrimethamine 25mg (Fansidar), following the normal temperature on the 4th day and disappearance of malarial parasites in the peripheral blood smear on the 6th day. Interestingly, he had thrombocytopenia and a high titer serum level of fibrin degradation product (FDP) supporting the questionable diagnosis of DIC. Even on the 12th day after improved thrombocytopenia by treatment with Gabexate (FOY), the serum level of FDP, D-dimer and thrombin-nati-thrombin (TAT)III complex still remained at high titer levels. One month later he was readmitted for a relapse of Plasmodium vivax malaria, when he showed thrombocytopenia but the serum level of FDP, D-dimer, TAT III complex and PM.alpha 2 PI complex were normal levels. We concluded that the thrombocytopenia and the high titer of FDP at his first admission was a manifestation of DIC.

Animals↗
PubMed1990

[Two case reports of maxillary prognathism. Some considerations of treatment for different facial type cases].

Generally, prognathism has been just identified as a large overjet. However, for the purposes of treatment, it should be noticed that different facial types are included in this malocclution. Facial pattern is classified into 2 groups; dolico and brachio facial types. The dolico facial type is generally a high angle case. It has a weaker natural anchorage than the brachio facial type. Consequently, it has a downward component in its mandibular growth. The classification of the two different facial types of maxillary prognathism would influence orthodontic treatment. When deciding on the treatment, the differences between the two facial types--in type of anchorage, growth direction, and control of toothaxis--should be taken into account.

Cephalometry↗
PubMed1990

[Evaluation of correlation between the disappearance rate of indocyanine green and the maximum removal rate].

The disappearance rate of indocyanine green (K.ICG) and the maximum removal rate (Rmax) usually correlate with each other. However, in some cases it was shown there was a dissociation between them. We investigated the relationship between the two rates in 146 subjects. K.ICG and Rmax correlated strongly with a correlation coefficient of 0.749 (p less than 0.001). Sixty-six cases were included in the limits of 95% confidence, and the other 80 cases outside the limits were defined as dissociated cases. Among them a lower Rmax rate as compared to the K.ICG rate was found in many cases of obstructive jaundice. Particularly a lower K.ICG rate compared to the Rmax rate was found in many cases of liver cirrhosis accompanied by esophageal varices and idiopathic portal hypertension. On the other hands, we performed multiple regression analysis on 12 other liver function tests. K.ICG was strongly related to platelet count, circulatory blood volume, and albumin, all factors relating to portal hypertension. Rmax largely depended on LCAT, A/G ratio, and cholinesterase, which are Therefore, the dissociation between K.ICG and Rmax was caused by differences in the characteristic of each disease.

Cholestasis↗
PubMed1990

[Study of conservative treatment of breast cancer in view of the spread of primary lesion].

Two hundred and six patients with breast cancer t1 or t2 were subclassified histologically into the following 8 types; comedo type, papillary type, mucous type, papillotubular or cribriform type, small solid alveolar type, large solid alveolar type, sclerotic type and pure scirrhous type. The risk of remaining cancer with lumpectomy was investigated clinicopathologically in relation to intraductal spread and lymphatic invasion of cancer cells. The tumor invasion was classified into intraductal type, localized type or extraductal spreading type, and lymphatic invasion was divided into 2 grades, i.e., vicinity of the tumor and 5mm or more distant. 1. In cases of intraductal spread, the comedo type was the most frequent, followed by the papillary type and mucous type. 2. The small solid alveolar type accounted for the highest proportion, 22.7%, in the group with distant lymphatic invasion. 3. The incidence of lymph node metastasis was as high as 63.6% and 61.7% for the small solid alveolar type and pure scirrhous type. 4. In cases of intraductal spread, t1 accounted for 32.6% and t2 for 47.0%. 5. The incidence of positive lymph node metastasis was 28.9% for t1 and 52.0% for t2. Tumors associated with a higher risk of remaining cancer are those of the comedo type and papillary type in terms of intraductal spread, those of the small solid alveolar type and pure scirrhous type in terms of lymphatic invasion, and those measuring 2cm or more.

Breast↗
PubMed1989

[Case report of long-term treatment of a cleft lip and palate patient].

Cleft lip and palate patients have narrow maxillary arches and mesio-distal disharmony between the jaws caused by cicatricial contracture from cleft lip and palate surgeries. In such cases, early orthodontic treatment is required including improvement of the mesio-distal disharmony of the jaws. Following orthodontic treatment, prosthodontic treatment is required to improve the masticatory function and esthetic appearance in the cleft area. Thus, improving the occlusion of cleft lip and palate patients takes a long time. This case report concerns such a longterm handling of over 17 years from the initial treatment at 5 years 3 months till the final prosthodontic treatment for an under-developed maxilla with partial closure of the fistula to which ilium was later grafted following orthodontic treatment. Considerations are discussed about timing of the initiation of orthodontic treatment, closure of the oronasal fistula and the final prosthodontic restoration.

Child↗
PubMed1989

Glanzmann's thrombasthenia associated with a transient deficiency of factor XIII.

A three-year-old girl suffering from ecchymoses developed severe epistaxis. The diagnosis of thrombasthenia was made on the basis of platelet aggregation studies, flow cytometric analysis with monoclonal antibodies and gel electrophoretic analysis. In addition, coagulation studies at the time of epistaxis repeatedly showed a transient deficiency of factor XIII activity and antigen.

Blood Platelet Disorders↗
PubMed1989

[Diagnosis of colon cancer (depth of invasion) by barium enema examination; present condition].

Accuracy of the barium enema examinations in diagnosis of the depth of invasion of the small carcinomas of the colon was reviewed. The materials included 101 sessile carcinomas and 12 small advanced carcinomas that were 20 mm or less in diameter. The carcinomas with stalks and the depressed type early carcinomas (Type IIc) were excluded from the study, because the former were impossible to the nature by X-ray examinations and the latter were extremely rare. Presence of the depressed portions on the surface of the elevated lesions observed in the frontal views and the degree of the deformity observed in the profile views of the lesions were correlated with the pathological specimen and the accuracy of the radiological diagnosis of the depth of invasion was estimated. The cases with gross malignant cell invasion into the submucosal or the deeper layers were diagnosed correctly with present radiological diagnostic criteria. But, those with a small amount of malignant cell invasion into the submucosal layer or the cases with malignant cell invasion limited to the mucosal layer (intramural cancer) were not always correctly diagnosed and there was a variety in diagnosis of the depth of invasion in this group. With the current radiological techniques, proper profile views of the lesions were not obtained in quite a few cases, nor the surface characteristics of the small elevated lesions were well documented. It would probably be possible to improve these techniques and to improve diagnostic accuracy to some extent, but with certain limitations.

Barium Sulfate↗
PubMed1989

[Histopathological study on the safety of conservative breast surgery in terms of the degree of axillary dissection for breast cancer].

The subjects were 15 patients with primary mammary cancer who underwent radical mastectomy. Axillary dissection (level I, II and III) with an incision 7 cm below the axilla was performed. After radical mastectomy, the presence/absence of remaining lymph nodes and fatty tissue was determined. All operations were performed by the same surgeon. The number of lymph nodes dissected by means of subaxillary incision ranged from 10 to 32 (mean 20.4). The proportion of remaining lymph nodes found after radical mastectomy was 0/142 (0%) for level I, 0/113 (0%) for level II and 3/54 (5.6%) for level III. In the subclavian Halsted area, fatty tissue partially remained in 60.0% of the patients and more than half in 13.3%. It was shown that complete dissection of level III lymph nodes is difficult when this surgical technique is employed. Although fatty tissue did remain in some cases after level II dissecting, this technique presented hardly any problems in the case of level I and II dissection. Therefore, from the viewpoint of axillary dissection alone, the present technique can achieve results similar to those obtained by radical mastectomy, suggesting its applicability to mammary cancer at a relatively early stage.

Adipose Tissue↗