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Biomedical subjects

T Motohara

Publications and source records attributed to T Motohara.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Examination of portal hemodynamics of patients with gastric varices and clinical investigation of the significance of distal splenorenal shunt].

The portal hemodynamics of patients with gastric varices has not yet been clarified adequately and no treatment has been established. Distal splenorenal shunt was placed in thirty-two patients with gastric varices and by comparing with those with esophageal varices, several investigations were conducted. The results are presented below. 1) There were no specific factors influencing the basic illness, liver dysfunction and portal venous pressure of patients with gastric varices. 2) The portal hemodynamics of early or late stages after the distal splenorenal shunt of patients with gastric varices showed no specific change compared with those with esophageal varices. 3) The direction of portal blood flow of post operative gastric varix patients showed less uniformity than those with esophageal varices. 4) In the latter stages of post operative gastric varix patients, 80% of varices disappeared and showed progress in their daily lives. 5) It has been proven that distal splenorenal shunt is effective for patients with gastric varices.

Adult↗
PubMed1994

[Clinical application of expandable metallic stent for intractable benign biliary strictures].

Four patients with benign biliary stricture were treated with expandable metallic stent (EMS). In these patients, conventional dilating methods such as balloon dilatation and/or insertion of a tube stent had been attempted before the application of EMS placement without sufficient effects. Successful insertion of EMS was attained in each case, and led to the removal of the external drainage catheter. During the observation period, no recurrent jaundice was seen. No serious complications related to the placement of EMS occurred. In our experience of only four patients with limited follow-up periods, EMS was expected, but not yet established, to be a useful method for the long-term treatment of benign biliary strictures. We emphasize for the present that EMS should be so positioned as not to interfere with any possible successive treatment including surgical intervention.

Aged↗
PubMed1994

[Intra-arterial chemotherapy for the treatment of advanced hepatocellular carcinoma through implantable port (reservoir)].

In this study, we evaluated the effectiveness of the arterial infusion chemotherapy through an implantable port for the treatment of advanced hepatocellular carcinoma. The chemotherapy comprised weekly or biweekly administrations of epi-ADM combined with 5-FU and MMC. The patients were divided into 4 groups as follows: 1) 37 patients treated mainly by repeat transcatheter arterial embolization (TAE) (TAE group); 2) 16 patients treated by arterial infusion chemotherapy through implantable port after TAE (TAE-RV group); 3) 9 patients with no indication for TAE treated by one-shot arterial infusion chemotherapy (one-shot group); and 4) 13 patients with no indication for TAE treated by arterial infusion chemotherapy through an implantable port (RV group). The median survival after the complete courses of TAE was 23 weeks in the TAE group, and 59 weeks in the TAE-RV group. There was a statistically significant difference in median survival time between the TAE group and the TAE-RV group (p < 0.01). On the other hand, the median survival time after the initial administration of an anticancer agent was 9 weeks in the one-shot group and 24 weeks in the RV group. There was also a statistically significant difference in median survival between the one-shot group and the RV group (p < 0.01). In the RV group, the 30-day mortality after the initial arterial infusion chemotherapy was 23.1% (3 patients). Two of these 3 patients showed a poor clinical status with uncontrollable ascites at the beginning of this study. In conclusion, arterial infusion chemotherapy through implantable port was evaluated as effective for the treatment of advanced hepatocellular carcinoma in patients with no indication for TAE, but the indication of this therapy remained subject for further evaluation.

Adult↗
PubMed1993

[Radiation therapy for carcinoma of vagina].

Thirty-four patients with carcinoma of the vagina were treated by radiotherapy at the Hyogo Medical Center for Adults between April 1965 and May 1990. All patients were treated with a combination of external and intracavitary or intestinal irradiation. Twenty-three patients had squamous cell carcinoma, five had adenocarcinoma and two had malignant melanoma. The five-year survival of patients with squamous cell carcinoma was 70% in Stage I (10 patients), 40% in Stage II (seven patients), 50% in Stage III (three patients) and 0% in Stage IV (three patients). Local control was achieved in 72.7% of the patients with squamous cell carcinoma and 60% of those with adenocarcinoma. However, neither of the malignant melanomas was controlled. Five patients had severe complications that required surgical treatment: severe proctitis and small-bowel perforation, ileus, rectal stenosis, vesicovaginal fistula and small-bowel perforation. Local and pelvic failure was noted in three patients. Patients with previous hysterectomy were more likely to develop serious treatment-related complications.

Adenocarcinoma↗
PubMed1993

[Radiotherapy for vulvar cancer].

Fifteen patients who had primary vulvar cancer treated with radiotherapy as an initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from January 1971 to December 1990 are presented. Two patients were stage 0, one stage I, three stage II and nine stage III. Nine patients received electron irradiation with or without interstitial irradiation and intracavitary vaginal irradiation. Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed fields including the pelvic nodes and perineum followed by boost irradiation of electrons, interstitial irradiation and intracavitary vaginal irradiation. The total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on average). The actuarial 5-year survival rate of the patients was 43.6%. Complete regression (CR) was achieved in 60% of the patients. However, CR was not achieved in any of five patients with palpable inguinal nodes. In contrast, all the patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine CR cases relapsed. First sites of failure were vagina, groin and vulvar region. Recurrence occurred more than four years after treatment in three cases. Necrosis occurred in five of nine CR cases.

Adult↗
PubMed1993

Demonstration of primary tracheobronchial amyloidosis by 99mTc-HMDP bone SPECT.

A case of primary tracheobronchial amyloidosis is reported. A 61-year-old man presented with a 2-year history of intermittent hemoptysis. Chest X-ray and CT scanning showed tracheobronchial thickening. Bronchoscopic examination revealed diffuse tracheobronchial narrowing, and tracheobronchial biopsy detected amyloid deposits. Both 99mTc-HMDP planar and SPECT images were obtained in this patient. Coronal SPECT images revealed more precisely that the activity was not in the thoracic cage but in the bilateral hilar region. Localization of the amyloid deposits could be better determined on SPECT images than on planar images.

Amyloidosis↗
PubMed1993

[Weekly hepatic arterial infusion of high-dose 5-FU for liver metastases from colorectal cancer].

A study was conducted on weekly infusion of high-dose 5-FU by way of the hepatic artery for liver metastases from colorectal cancer. In the evaluation of 13 cases, no CR and 6 PR were observed. The response rate was 46.2%, 1-year survival was 73% and 1.5-year survival was 42%. No patients suffered from major side effects. Two patients had ileus, which was controllable by supportive care with intravenous hyperalimentation, and was caused by peritoneal dissemination of cancer. In conclusion, this regimen was relatively safe, effective, and useful for improving the quality of life of patients, compared with other regimens. How to control extrahepatic metastases in addition to this regimen is a subject for forthcoming study.

Adenocarcinoma↗
PubMed1992

[Hormone therapy using tamoxifen in unresectable carcinoma of the pancreas--preliminary study].

In 1981 Greenway and co-authors reported the existence of estrogen receptor in tumor tissue of the pancreas. We have tried hormone therapy using tamoxifen in 4 of 11 patients with unresectable carcinoma of the pancreas in whom expandable metallic stents were inserted for the palliation of obstructive jaundice. The mean survival period in these 4 patients was 235 days, and 2 of them had a remarkably long survival of 321 and 463 days respectively. On the other hand, the mean survival was 128 days in 7 control patients. We therefore evaluated this new therapy with tamoxifen as effective in patients with unresectable carcinoma of the pancreas.

Estrogens↗
PubMed1992

SPECT demonstration of splenosis.

Splenosis is defined as the heterotopic autotransplantation of splenic tissue. The main cause of splenosis is splenic rupture following abdominal trauma, in which fragments of splenic tissue are seeded throughout the peritoneal cavity. Demonstration of splenosis by scintigraphy or CT imaging has been reported, but there is no previous report of simultaneous demonstration by SPECT and CT imaging. Autotransplantation of splenic tissue in the abdominal cavity forms a solid tumor-like image on CT and is difficult to differentiate from other abdominal masses. In such cases, SPECT demonstration of splenosis is very important for identification of its exact site. A case report of splenosis is presented, in which simultaneous demonstration by SPECT and CT was performed. This was confirmed at laparotomy for gastrectomy.

Abdominal Neoplasms↗
PubMed1992

[Diffusely increased uptake in the skull in normal bone scans].

Diffusely increased skull uptake (a hot skull) is often seen in patients with bone metastases and metabolic diseases. This finding is also, however, noticed in normal bone scans of aged women. To determine whether the hot skull could be considered a normal variant in elderly women and is associated to menopause, we studied 282 normal bone scans (166 women and 116 men without metabolic and hormonal disease; age range 11 to 84 yr). We divided the patients into eight age groups--ages 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 yrs. Measurements of skull uptake were obtained from anterior total body views using contrast-to-noise ratio (CNR). CNR for the skull was calculated using the following equation: (counts skull - counts femur)/square root of counts skull+counts femur, where the denominator signifies a measure of the noise and the numerator represents the contrast between the skull and the midfemur. Counts skull and femur are the number of average counts per one pixel recorded over the skull and midfemur, respectively. The sex dependent difference in skull uptake began to develop in the age group 30-39 yrs (p less than 0.05). The skull showed greater activity in women than in men for age groups from 30-39 to 80-89 yrs. In the age groups 50-59 and 60-69, the difference was particularly large (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Enhanced MRI of breast cancer smaller than 3 cm].

Twenty-two patients with breast cancers were studied using magnetic resonance (MR) imaging with a cylindrical surface coil at 1.5 Tesla. All were examined with the FE sequence and Gd-DTPA as a contrast medium. These images were compared with micrographs of the specimens. All cancers were enhanced clearly, and demarcated margins or spiculations of the tumors were seen as clearly on MR images as on micrographs of the specimens. In 12 patients (9 carcinomas, 2 fibroadenomas and 1 benign phyllodes tumor), dynamic studies were performed after the intravenous injection of Gd-DTPA. All nine carcinomas showed enhancement characterized by a sudden increase in signal intensity on the order of 100% or more within the first 2 minutes after injection. Two fibroadenomas were enhanced slowly. Thirteen patients with breast cancers were examined with several sequences (FE, T1-weighed SE, T2-weighed SE and STIR) with or without Gd-DTPA. The most clearly delineated images of the tumors were those of FE images with Gd-DTPA enhancement. A phantom constituted of various concentrations of Gd-DTPA in 20% albumin solution was measured by signal intensities with T1-weighted SE sequence and FE sequence. The ratio of enhancement of the 20% albumin solution relative to the Gd-DTPA concentration was higher with the FE sequence than with the SE sequence. The sensitivity of the FE sequence to Gd-DTPA enhancement was 1.5 times that of the SE sequence under the usual concentration of Gd-DTPA.

Adenocarcinoma↗
PubMed1991

[Lymphoscintigraphy with 99mTc-DTPA-HSA: detection of metastases to iliopelvic lymph nodes].

The purpose of this study was to evaluate 99mTc-DTPA-HSA as an iliopelvic lymphoscintigraphic agent in 5 normal volunteers and 10 patients with metastases of malignant tumors (cancer, 9; and malignant lymphoma, 1) to the iliopelvic lymph nodes. The subjects underwent intradermal injection of 185 MBq of 99mTc-DTPA-HSA into digital web spaces of the feet. Massage was applied at the injection sites for 30 sec; the subjects then walked around for 2 min. Whole-body scintigrams were obtained 5 min after injection. The whole-body scanning speed was 20 cm/min. The tracer transport was prompt. Within 15 min after injection, the tracer reached the termination of the thoracic duct in all normal volunteers. Normal whole-body images of excellent quality delineated the lymph nodes and channels almost without background radioactivity. The images of 9 patients with metastases of cancer showed clearly the following abnormal patterns: a) obstruction of lymphatic system (5/9, 55.6%); b) absence of visualization of the thoracic duct (44.4%); c) decreased uptake in lymph nodes (88.9%); d) visualization of collateral circulation (44.4%); e) tracer extravasation into more proximal soft tissue (22.2%). The image in the patient with malignant lymphoma showed increased uptake in the enlarged lymph nodes in addition to the all abnormal findings mentioned above. We concluded that 99mTc-DTPA-HSA is an excellent radiopharmaceutical for iliopelvic lymphoscintigraphy.

Adult↗
PubMed1988

Pure squamous cell carcinoma of the thyroid gland--report of an autopsy case and review of the literature.

A rare autopsy case of primary squamous cell carcinoma of the thyroid gland is reported herein. A 61-year-old Japanese woman with a swelling of the left neck underwent surgery and the resulting tumor was histopathologically diagnosed as pure squamous cell carcinoma of the thyroid gland. She had had the nodule for 20 years, and it was histologically diagnosed as having been a well-encapsulated, follicular adenoma. Histopathological observation of the resected glands also revealed the coexistence of pure squamous cell carcinoma, which presumably originated from the adenoma. Postoperatively, an esophagotracheal fistula formed due to local invasion of the tumor cells. The patient's state gradually deteriorated and she died of severe bronchopneumonia and renal dysfunction, 4 months after the operation. Autopsy revealed no distant metastases, but severe septicemia caused by bacterial infection affecting the systemic organs was found, which presumably resulted in multiple organ failure.

Carcinoma, Squamous Cell↗