Hypergraphia in temporal lobe epilepsy--compared with stroke of the right cerebral hemisphere.
Explore the source record for details and available documents.
Aphasia↗
Biomedical subjects
T Okamura
Publications and source records attributed to T Okamura.
[A case of complete rupture of the righ TMJ disc].
A case of complete rupture of the right TMJ disc was described. A 43 year old woman visited our hospital with the chief complaint of a mild pain in the right TMJ. Initially, a conservative treatment using the occlusal splint (condylar repositioning appliance) was carried out. This was because she had reciprocal clicking of the right TMJ which had occurred not long before and it seemed that the symptoms were due to the trouble with the disc. In spite of this treatment, for 6 months no improvement was obtained and the reciprocal clicking changed into crepitation. Moreover the double contrast arthrotomographic image indicated a perforation or a wide rupture of the disc, and deformities of the articular bone. Then a right TMJ osteoarthrosis with wide (complete) disc rupture was diagnosed, and a discectomy was performed. The symptoms were greatly reduced by this treatment. It was conceivable that the steroid which she had used for a long time to treat bronchial asthma caused a remarkable inhibition of the tissue repairing, and an internal derangement of the TMJ rapidly progressed to osteoarthrosis.
Adrenal Cortex Hormones↗
Laser arterial disobstructive procedures in 148 lower extremities.
Preoperative arteriographic findings in immediate postoperative results as well as follow-up studies of treatment with argon and YAG lasers have been evaluated in 148 lesion found in 137 patients. Preoperative arteriography revealed a solitary lesion in 42 of 148 legs (28%) examined, and a combined lesion was found in the remaining 106 legs (72%). Incapacitating intermittent claudication, rest pain, tissue loss, or a combination of these was an indication for laser arterial reconstruction. None of the argon laser-treated lesions was treated with balloon dilatation, but since March 1988 all appropriate YAG laser-treated lesions were immediately followed by laser-assisted balloon angioplasty. The lesions in 64 of 89 legs (72%) treated by argon and 42 of 59 (71%) treated by YAG were successfully recanalized. However, successful angioplasty was performed in 44 of 89 (49%) and 34 of 59 (58%) lesions, respectively. The recanalization depended on the type of lesion (tight stenosis vs occlusion) and the length of lesion (localized vs total-length occlusion). However, the success rate of recanalization was almost the same as the success rate when both laser systems were used. Argon laser treatment proved successful in 19 of 20 (95%) segmental occlusions in popliteal arteries, whereas YAG laser treatment proved successful in four of five (80%) short segmental (less than 15 cm) occlusions of superficial femoral arteries and in 16 of 23 (70%) long segmental (greater than or equal to 15 cm) occlusions of superficial femoral arteries. In 26 of 36 (72%) total-length occlusions of superficial femoral and popliteal arteries, recanalization was not possible (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Laser recanalization, laser assisted balloon angioplasty and laser angioplasty.
The efficacy of laser recanalization (LR), laser assisted balloon angioplasty (LABA) and laser angioplasty (LA) was evaluated. These procedures were performed a total of 55 times upon 49 patients who had occlusive arterial disease of a lower extremity with a history of incapacitating, intermittent claudication, rest pain or loss of tissue, or all three. Patients with lesions through which a guide wire could be passed were eliminated from this study. Two lesions in the common iliac artery, 44 in the superficial femoral artery, seven in the popliteal artery and two in the infrapopliteal artery were studied. Thirty-nine of 55 lesions (71 per cent), including 12 of 12 stenoses and 27 of 43 occlusions (63 per cent), were successfully recanalized. None of the seven total length occlusions were successfully recanalized (p less than 0.001); perforation occurred in four. Bypass procedures were required in six of 13 and two of 25 lesions treated by LR and LABA, respectively (p less than 0.05). All patients with lesions successfully recanalized using LR, LABA and LA were observed for a period of 15 days to six months, with an 82 per cent patency rate (32 of 39). Total length occlusions are not a good indication for treatment with currently available laser techniques. The addition of balloon dilation in LR decreased the requirement for bypass procedures in a significant number of patients.
Angioplasty, Balloon↗
Laser-assisted reconstructive vascular surgery.
To clarify the efficacy of laser-assisted reconstructive vascular surgery (LARVS) for patients with severe symptoms of peripheral arterial occlusive disease, 118 ischemic legs of 104 patients were retrospectively analyzed (argon:89 and YAG:29 lasers). Of those 118 legs, 26 (22%) had tissue loss, 60 (51%) had rest pain, and 32 (27%) had incapacitating intermittent claudication. The LARVS was adequate in 60 of 118 (51%) and inadequate in 58 of 118 (49%). With argon:89 and Nd:YAG:29 lasers, respectively, 41 of 89 (46%) and 19 of 29 (66%) were adequate. In the superficial femoral artery (SFA) and popliteal artery (PA), the LARVS was adequate in 31 of 43 (72%) in segmental occlusion and in one of 31 (3%) in total-length occlusion (p less than 0.001). In segmental occlusion of the SFA, however, argon:89 and Nd:YAG:29 lasers were adequate in four of 12 (33%) and in 10 of 12 (83%), respectively (p less than 0.05). The legs in which laser was used in more than one artery (eight of eight) or in occluded grafts (proximal SFA to distal PA; three of 18) required amputation within 30 days. A follow-up study demonstrated patency in 31 of 34 (91%) 1-24 months later with the argon:89 laser and in 15 of 16 (94%) 1-6 months later with the Nd:YAG:29 laser. This study indicates that LARVS was adequate in segmental occlusions, particularly in SFA and PA lesions; however, total-length occlusions and combination arterial lesions were not appropriate for the currently available laser systems. Laser application should not be performed if a guidewire passes through the lesion, since these lesions may be more appropriately treated with balloon angioplasty.
Aged↗
YAG laser angioplasty in lower extremity: sole therapy as well as adjunct to balloon dilatation.
To evaluate efficacy of the YAG laser in severe occlusive arterial lesions of lower extremity, 64 lesions were considered for either laser recanalisation (LR) or laser assisted balloon angioplasty (LABA). Indications for the procedure were incapacitating intermittent claudication (28), rest pain (17) and tissue loss (19). Of those 64, 46 (72%) were recanalised whereas 38 (59%) recanalised to adequate diameter. In stenoses, segmental occlusions and total length occlusions, successful recanalisation resulted in 12/12 (100%), 28/35 (80%) and 6/17 (35%) cases respectively. As compared to stenoses and segmental occlusions, successful recanalisation rate was significantly low in total length occlusions (p less than 0.001). Addition of balloon dilatation to LR decreased the requirement of additional by-pass surgery from 6/16 (60%) to 2/30 (7%) (p less than 0.05). Addition of balloon dilatation to LR had improved the results.
Angioplasty, Balloon↗
Herpes simplex virus in oral mucosal ulcers in patients with hematological malignancy.
Developments of oral mucosal ulcers induced by herpes simplex virus (HSV) were studied in patients with hematologic malignancy. Herpes simplex virus type-1 (HSV-1) was identified by immunological staining using virus-specific monoclonal antibodies in the epithelial cells of such ulcers from two patients with malignant lymphoma (ML), three with acute myeloblastic leukemia (AML), one with refractomy anemia with excess blasts, two with chronic myelocytic leukemia (CML), one with acute lymphoblastic leukemia (ALL) and one with aplastic anemia (AA). Herpes simplex virus type-2 (HSV-2) was also identified in an ulcer from a patient with AML. Isolation of HSV-1 was successful in the two patients with ML, one with CML, one with AML, the one with ALL and the one with AA. The ulcers developed on the tongue (four cases), buccal membrane (five cases), hard palate (one case), soft palate (one case), soft palate (one case) and gingiva (two cases). Only one patient with CML and one with AML had accompanying labial vesicular lesions. All patients except the one with AA had previously been given combination chemotherapy with anti-neoplastic agents. The results indicate that HSV may have an important role to play in the development of chemotherapy-related oral mucosal ulcers in patients with hematological malignancy.
Adult↗
Fatal graft-versus-host disease following transfusion during open heart surgery.
We report fatal transfusion-associated graft-versus-host disease (GVHD) in a patient who was not severely immunosuppressed. A 58-year-old man received 800 ml of fresh whole blood from his son and an unrelated volunteer donor during open heart surgery. On the 10th day after the operation, he suddenly had a high fever, followed by generalized skin rash and liver dysfunction. Pancytopenia due to bone marrow aplasia developed a week later. A skin biopsy revealed a cutaneous lesion highly compatible with acute GVHD. The patient did not respond to high-dose methylprednisolone therapy, and died of multiple organ failure on the 18th day after the operation.
Graft vs Host Disease↗
[Significance of right precordial ST elevation in experimental right ventricular infarction].
We produced experimental isolated right ventricular infarction (RVI) with closed chest method, and examined ECG changes of right precordial leads and changes of cardiac output (C. O) in 19 dogs. As a result, ECG showed ST depressions in leads, II, III, aVF and V2-V6 and ST elevations in a VR lead in all 15 cases of the proximal occlusion of right coronary artery (RCA). In 10 of 15 dogs ST elevations in some right precordial leads occurred, and the sensitivity of ST elevation in single right precordial lead was 60% (V5R), 53% (V4R) and 47% (V3R and V1), respectively for the detection of RVI. When left circumflex artery (LCX) was occluded, ST elevation in V4R lead after RCA occlusion was blocked. Therefore, it is thought that the sensitivity of ST elevation in right precordial lead may be lower than expectation in identifying RVI. Concerning anterior chest leads, none of 15 dogs with RVI showed ST elevations in leads V2-V6 in this study. If ST elevations in right precordial leads did not appear, variation of C.O was small and C.O reduced in proportion to the extension of ST elevations in right precordial leads.
Animals↗
[The practice of home oxygen therapy using liquid oxygen].
Explore the source record for details and available documents.
Home Care Services↗
[Phase II clinical study of LC9018 on carcinomatous peritonitis of gastric cancer. Subgroup for Carcinomatous Peritonitis, Cooperative, Study Group of LC9018].
Using patients with carcinomatous peritonitis caused by gastric cancer, we conducted a Phase II clinical study of LC 9018 by administering the agent alone or in combination with mitomycin C (MMC). Out of 29 patients enrolled, 12 were treated with LC 9018 alone and 17 others with LC 9018 + MMC. Of these, 15 cases were found completely evaluable. The response rate for 15 complete cases against carcinomatous peritonitis was 60.0% (3/5) for the group treated with LC9018 alone and 70.0% (7/10) with LC9018 + MMC. Of the 27 eligible patients, the ascites could be controlled in 58.3% (7/12) for those treated with LC9018 alone and 60.0% (9/15) for those with LC9018 + MMC, with tumor cells being eliminated in 50.0% (6/12) and 60.0% (9/15), respectively. Major adverse reactions included fever, nausea/vomiting, abdominal pain and increases in GOT and GPT. These findings suggest that LC9018 might be a useful therapeutic agent against carcinomatous peritonitis of gastric cancer whether used alone or in combination with MMC.
Adjuvants, Immunologic↗
Eighteen-year survival of unresected leiomyoblastoma of the stomach with liver and lymph node metastases.
A case of gastric leiomyoblastoma with liver and lymph node metastases occurring in a 31-year-old man, who has been alive with the tumor but without symptoms for more than 18 years after only an exploratory laparotomy without resection, is reported. On laparotomy, the liver metastasis and paragastric and para-aortic lymphadenopathies made it impossible to resect the stomach with the tumor. A diagnosis of malignant leiomyoblastoma was confirmed by incision of the liver and paragastric lymph nodes. Postoperative chemotherapy with mitomycin C and cyclophosphamide was performed for 6 months. As demonstrated by roentgenography, echography and computed tomography, the size of the tumor has remained almost identical for an 18-year period. Histologically, the low mitotic rate of the tumor in this case is considered primarily responsible for the long survival of the patient. A review of the records has revealed that our patient is the longest survivor to have unresectable gastric leiomyoblastoma with liver and lymph nodes metastases.
Adult↗
Thoracoabdominal approach for cure of patients with an adenocarcinoma in the upper third of the stomach.
In 134 patients with an adenocarcinoma in the upper third of the stomach and involving the lower esophagus, the authors retrospectively assessed the significance of a thoracoabdominal approach (TAA). Nineteen (48.7%) of 39 with TAA had major postoperative complications, while 25 (26.3%) of 95 with the abdominal approach (AA) had similar complications (P less than 0.02). The most frequent complication was anastomotic leakage. In the case of TAA, seven (18.0%) experienced this, and nine (9.5%) did so after AA. However, deaths resulting from complications were few for both TAA (five, or 12.8% and AA nine, or 9.5%). There was one (2.6%) patient with histologically positive cancer cells at the proximal stump of the resected specimen in patients with TAA, while there were seven (7.7%) such patients with AA. In the histologically curative cases without palliative factors, patients with TAA had a significantly better prognosis than did those with AA (P less than 0.05). In the histologically noncurative cases and in cases with palliative factors, the prognosis was poor for both TAA and AA patients. These results suggest that the surgeon should perform the TAA in order to obtain tumor-free margins at the proximal stump and a better prognosis in patients without palliative factors, while the surgeon need not consider doing the TAA in patients with palliative factors.
Adenocarcinoma↗
[Factor analysis of bone mineral dynamics in patients with renal osteodystrophy].
Remarkably high accumulation of Tc-99m-MDP is seen in the skull on bone scintigraphy of patients with renal osteodystrophy (ROD), especially with secondary hyperparathyroidism. For the quantitative evaluation, the Factor Analysis (FA) was used for the early phase of bone scan. Tc-99m-MDP (14.8 MBq/body weight kg) was injected as a bolus through the medial antecubital vein. Dynamic acquisition of 40 x 30 sec frames were performed in a 64 x 64 matrix. For pre-processing, nine points smoothing was carried out, and then the region of interest was set on the frontal image of the head for the FA. The FA was performed with an 8 x 8 sampling corresponding to 64 dixels from 4,096 dixels. Bone factor was clearly extracted by the FA. Then, two original parameters were calculated. One is the bone radionuclide uptake counts (Bu) which is the product of the total radionuclide counts of skull and the contribution ratio, the other is the uptake ratio (Br) derived by the time activity curve (physiological component) of the FA. These parameters of ROD were significantly different compared to those of controls. The FA seems to be useful in quantitative evaluation of bone mineral dynamics.
Adult↗
Comparison between microspectrophotometry and cytofluorometry in measurements of nuclear DNA in human hepatocellular carcinomas.
A cell nuclear deoxyribonucleic acid (DNA) content analysis of paraffin-embedded materials of hepatocellular carcinoma in 18 patients was performed by two different methods, two-wavelength microspectrophotometry (paraffin section) and cytofluorometry (cell isolation). The DNA pattern was grouped into two types, low ploidy or high ploidy, and results achieved by each method were compared. The coincidence rate was 88.9% (16 in 18). Among the 14 with no or slight pleomorphism the coincidence rate was 100%, while it was only 50% (two in four) in those with moderate or marked nuclear pleomorphism. Therefore, when measuring the nuclear DNA content of cancer cells, the possibility of considerable differences between results of absorption and fluorescence cytophotometry in cases of a moderate or marked pleomorphism has to be considered.
Adult↗
DNA ploidy is closely linked to tumor invasion, lymph node metastasis, and prognosis in clinical gastric cancer.
DNA ploidy microspectrophotometrically determined in 254 patients with gastric carcinoma was investigated from the standpoint of tumor invasion, lymph node metastasis, and prognosis. DNA distribution patterns were grouped into low and high ploidies. The 24.0% frequency in the high ploidy group, at the mucosal stage, increased in proportion to invasion into the deeper layers. There was a high incidence of lymph node metastasis in the high ploidy group, compared with the low ploidy group, in case of invasion beyond the mucosa. Widespread nodal involvement was frequent in the high ploidy group. The 5-year survival rate was 73.7% in patients of high ploidy, with a statistical difference compared to the 90.6% in those of low ploidy (P less than 0.01). In the multivariate analysis of 226 patients undergoing curative surgery, the DNA ploidy proved to be a major independent prognostic factor. These findings indicate a close correlation among DNA ploidy, tumor invasion and nodal involvement, and the significant clinical value of DNA analysis for predicting the prognosis in patients with gastric carcinoma.
Aged↗
Endoscopic intratumoral injection of OK-432 and Langerhans' cells in patients with gastric carcinoma.
OK-432, a compound composed of penicillin-G-treated, attenuated Streptococcus pyogenes of human origin, was administered by intratumoral injection (IT) to 15 of 49 patients with Stage III gastric carcinoma, at the time of preoperative endoscopic examination. The 5-year survival rate of patients given IT was 73.3%, whereas the rate was only 36.5% in those not given IT (P less than 0.05). A study of recurrent cases revealed a significantly low incidence of peritoneal recurrence in the group on OK-432 IT (P less than 0.01). In previous work, the authors noted a favorable prognosis of patients with Stage III gastric carcinoma and with a marked infiltration of Langerhans' cells (LC) in the tumor tissues. All of the 49 in the current study were thus examined immunohistochemically, using anti-S-100 protein antibody, the objective being to clarify the relationship between OK-432 IT and the density of LC. The density of LC among those given IT was significantly increased as compared with those not given IT (P less than 0.05). The results of this study suggest that OK-432 IT may lead to augmentation of the density of LC in tumor tissues and hence prevent peritoneal recurrences in patients with Stage III gastric carcinoma.
Adenocarcinoma↗
DNA analysis of hepatocellular carcinoma and clinicopathologic implications.
Cell nuclear DNA content was microspectrophotometrically measured in 60 specimens of clinical hepatocellular carcinoma (HCC). The DNA distribution pattern was classified into two types, diploid and nondiploid, according to the degree of dispersion on the DNA histogram. Among these 60 specimens, 26 had an HCC of less than 5 cm in diameter. In these 26, 17 (65%) had the diploid pattern and 9 (35%) had the nondiploid pattern. In the remaining 34 specimens with a large HCC exceeding 5 cm in diameter, the diploid pattern was seen in only six (18%), and the nondiploid pattern was seen in 28 (82%). Following increase in tumor size, the number of cases of nondiploid increased. The DNA pattern closely correlated with the morphologic grading and age of patients, yet there was no correlation among DNA pattern and presence of hepatitis B surface antigen (HBsAg) or presence of liver cirrhosis. Regarding the prognosis of patients with HCC, there was no statistic difference between DNA pattern and prognosis. The present study suggests that the DNA pattern relates to the biologic characteristics of the growth pattern of HCC. However, the DNA pattern showed no significant correlation with survival rates of patients with HCC who underwent hepatic resection.
Adult↗