Biomedical subjects
Publications and source records attributed to T Nakada.
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Sixty-six patients with thymoma have undergone surgical treatment since 1965 and have been assessed from the viewpoint of clinical manifestations and prognosis. Thirty-one patients with encapsulated thymoma were treated with total surgical resection alone, and they had no postoperative tumor recurrence. With the exception of one patient who died of respiratory insufficiency on the fourth day after the operation, 34 patients with invasive thymoma were evaluated on the basis of their postoperative prognosis. Fifteen patients with invasive thymoma died from 1 1/2 months to 10 years, 1 month postoperatively; 9 died of local or metastatic tumor and 6 died of other diseases. Associated autoimmune diseases, as well as the invasive tendency of the tumors, apparently affected the prognosis. Ten-year survival rates of the patients who underwent surgical treatment were as follows: 61.6% for the total group, 74.3% for those with encapsulated thymoma, and 49.4% for those with invasive thymoma. In the surgical treatment for invasive thymomas, one should aim to resect the tumor totally, even though adjacent tissues are resected simultaneously. Even for the patient with total resection of invasive tumor, postoperative radiation should be required. Finally, if residual tumor must be left during the operation, postoperative radiation as well as anticancer chemotherapy should be aggressively scheduled, because postoperative distant metastasis may appear in these patients with residual thymoma.
A 19 year-old female, complaining of gigantic tumor on each breast and hemorrhagic diathesis, was admitted to our hospital. Laboratory data and clinical findings suggested the presence of DIC. Bilateral mastectomies reduced the bleeding tendency within a week. In conclusion, removal of the tumors was effective to avoid fatal hemorrhage.
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A clinical study was made on 26 patients with renal cell carcinoma, who visited our department between October, 1979 and April, 1984. There were 21 men and 5 women. As the major initial symptoms, hematuria and flank pain were observed in 14 cases (53.8%), followed by symptoms of metastatic tumors in 7 cases (26.9%). Four cases of malignant renal masses which showed no abnormality on the excretory urogram were diagnosed by chance at the time of examination of the abdominal computed tomography (CT). CT was especially useful in diagnosing the renal cell carcinomas.
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The effectiveness of cold crystalloid potassium cardioplegia was evaluated in 26 infants (age 27 days to 17 months, 7.5 +/- 5.2 months, mean +/- SD) who underwent intracardiac repair for various cardiac lesions. A myocardial biopsy sample was obtained before aortic cross-clamping (AXC) and 20 min after release of AXC (AXC time 22 to 161 min, mean 68 +/- 37 min), and semiquantitative assessment of the mitochondrial structure was made by scoring. The post-AXC score was significantly higher than the pre-AXC score (1.1 +/- 0.6 vs 0.4 +/- 0.4, p less than .001) for the whole group. Patients receiving preoperative catecholamine support had higher pre- and post-AXC scores than those who did not (pre-AXC score 0.7 +/- 0.4 vs 0.2 +/- 0.3, p less than .01; post-AXC score 1.4 +/- 0.5 vs 1.0 +/- 0.5, p less than .05). Infants less than 3 months old (n = 7) and those 3 to 12 months old (n = 11) had higher pre AXC scores than infants over 12 months old (n = 8). With respect to post-AXC score, only those less than 3 months old had significantly higher values than the other infants. These results indicate that the myocardial injury was not fully prevented by crystalloid potassium cardioplegia in infants, and that infants with preoperative heart failure and less than 3 months old appear to have increased myocardial susceptibility to ischemic injury under cardioplegia.
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Almost all cases with metastatic lung tumor have no symptoms and their metastatic lesions of the lung are detected on X-ray films. The shapes of the shadows are so different that many kinds of examination are made. Among them, the radiographic examination is the most common and useful. It is important to make a diagnosis of metastatic lung tumor in the early stage in order to select effective treatment. In forty patients in whom metastatic lung tumors were removed in our institute hospital, the 5-year survival rate is as good as that of primary lung cancer. Ten of these patients survived for over 5 years after surgical treatment for metastatic lesions. The number of lesions and the type of lung resection did not relate to the prognosis. The thoracotomy is an effective therapeutic method for operable patients with metastatic lung tumor.
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Contents of catecholamines were determined in 46 adrenal specimens removed from subjects without adrenal disease. These subjects were allocated in a retrospective conformation to two points: one for renal function and another for blood pressure. Based on the findings, elevated adrenal catecholamines associated with hypertension appear to impair renal function in man.
This study was done to ascertain whether hyperbaric oxygenation really affects testicular activity in rats. We evaluated serum testosterone concentration, testicular content of connective tissue protein and histological analysis of testes in each rat treated with 2 or 3 atmospheric pressures associated with oxygen saturation, together or singly for 90 minutes daily for 58 days. There were no significant differences in serum testosterone concentrations between the examined groups. The amounts of collagen, non-collagenous protein or elastin in testis were similar in all groups except one set of determinations. In addition, no prominent histological differences were noted in the testes of the animals. Thus, the pressure environment of this study, which can be regarded as almost the same as that of the hyperbaric oxygenation chamber in clinical use, appears to be nontoxic to rat testes.
Two series of experiments were conducted to ascertain whether the central catecholamines would participate in the elevation of blood pressure in two-kidney, one clip (2K-1C) Goldblatt hypertensive rats. The effect of 6-hydroxydopamine (6-OHDA) injected intraventricularly (250 micrograms/kg.) before the induction of hypertension (acute phase) or after the establishment of hypertension (chronic phase) was examined in 2K-1C rats and sham rats. The evidence has been presented: 1) that the hypothalamic norepinephrine content of 2K-1C rats in acute phase is 50 per cent lower (p less than 0.001) than that of sham rats, but norepinephrine content in the pons is similar in these animals, 2) that the content of dopamine in hypothalamus or pons is similar in 2K-1C rats and normotensive age-matched sham rats in acute phase, 3) that the content of these monoamines either in hypothalamus or pons in 2K-1C rats in chronic phase is almost identical with that in sham rats, 4) that administration of 6-OHDA markedly reduced the development of hypertension in 2K-1C rats in the acute phase, but did not affect their sustained hypertension in the chronic phase. These findings suggest that hypothalamic norepinephrine participates in the development of hypertension in 2K-1C rats in the acute phase but is not connected with the maintenance of their established hypertension in the chronic phase.