Biomedical subjects

T Tono

Publications and source records attributed to T Tono.

At least 55 records · Page 3Linked to original sources

PubMed1996

Determination of the presence of interleukin-6 in bile after orthotopic liver transplantation. Its role in the diagnosis of acute rejection.

OBJECTIVE: The authors evaluated the significance of interleukin-6 (IL-6) in bile in the diagnosis of acute rejection after liver transplantation. SUMMARY BACKGROUND DATA: Interleukin-6 in blood has not been shown to be useful as a marker of acute rejection in clinical liver transplantation. In a rat liver transplantation model, the authors have found that bile IL-6 levels correlated well with the severity of rejection as determined histologically, whereas kinetics of serum IL-6 differed among rats without any definite feature related to graft rejection. METHODS: Fifty-one patients who underwent orthotopic liver transplantation between May 1990 and February 1991 at the University of California, Los Angeles, were included in the study. After liver transplantation, bile and blood were collected daily, and IL-6 levels were measured by the enzyme-linked immunosorbent assay. RESULTS: Bile IL-6 increased to 1228 +/- 317 pg/mL on the day of transplantation and decreased to 50 pg/mL or less within 48 hours. Patients who had uneventful postoperative courses had low levels of bile IL-6 throughout their hospitalization. In patients with acute rejection, bile IL-6 significantly increased (1090 +/- 990 pg/mL; p<0.05), but decreased in response to antirejection therapy. In patients who had liver dysfunction due to ischemic change or sepsis, bile IL-6 did not increase. Patients with cholangitis had significantly increased levels of bile IL-6 (146 +/- 47; p<0.05). Interleukin-6 in blood increased with many kinds of complications other than rejection and seemed to be less specific than that in bile. CONCLUSIONS: Measurement of IL-6 in bile may be a useful, noninvasive tool for diagnosing acute rejection.

Acute Disease↗

PubMed1996

[Tympanic electrocochleography with disposable electrode].

Extratympanic recording of electrocochleography (ECochG) has played an important role in the differential diagnosis of inner ear diseases. We used a special electrode, which was wrapped in a cotton ball at the tip and covered with a silicon sheath over the entire length, and recorded ECochG from the tympanic membrane (tympanic ECochG). Our method was found to be more convenient and less traumatic than recording with an ear canal electrode. Tympanic ECochG records from 10 normal volunteers showed no influence of iontophoretic anesthesia on the tympanic membrane. The effects on the conductive hearing mechanism were negligible. The input-output curve of the action potential (AP) by click stimuli was fairly stable and comparable to that obtained with transtympanic recording. We performed tympanic ECochG in patients with Meniere's disease or other sensory hearing loss, and compared the amplitude ratios of the summating potential (SP) and AP (SP/AP ratio) with those in normal hearing subjects. The SP/AP ratios in patients with Meniere's disease were significantly increased, an observation consistent with the results of other studies. The SP/AP ratio was also elevated in patients with autoimmune sensory hearing loss or perilymphatic fistula. Based on the results of the present study, we speculate that it is possible to diagnose an inner ear disorder by comparing the tympanic ECochG findings with not only records from normal subjects, but also the contralateral record of tympanic ECochG from the same subject. We conclude that tympanic ECochG using disposable electrodes can provide useful information on inner ear function, because of its convenience, non invasiveness and safety in clinical use. We found tympanic ECochG to be useful in the glycerol dehydration test and for monitoring inner ear function during acoustic neurinoma surgery.

Acoustic Stimulation↗

PubMed1996

[Middle ear cholesteatoma caused by cannonball foreign bodies impacted in the bony eustachian tube: a case report].

We present a 76-year-old male patient with adhesive-type cholesteatoma and with metal foreign bodies which were shown to be located in the bony eustachian tube by computed tomography. He sustained a burn injury of the left tympanic membrane when he was struck by a bomb 52 years ago, during World War II. The cannonball fragments that entered the tympanic cavity were apparently transported to and stuck in the eustachian tube isthmus by mucociliary action after spontaneous closure of the tympanic membrane perforation. Persistent tubal obstruction due to the impacted foreign bodies and surrounding granulation tissue seems to have caused chronic adhesive otitis, leading to cholesteatoma which developed in the attic and mastoid antrum. No foreign bodies became visible after cholesteatoma removal by an intact canal wall technique in conjunction with anterior tympanotomy for wide exposure of the supratubal recess and the tympanic osteum of the eustachian tube. Therefore, anterior tympanotomy was further extended anteriorly to open the enlarged bony eustachian tube, allowing visualization and safe removal of two cannonball-fragments firmly impacted within it. We call this surgical approach to the bony eustachian tube "extended anterior tympanotomy". The transmastoidal accessibility of the bony eustachian tube produced by this technique should be assessed by preoperative computed tomography.

Aged↗

PubMed1996

[Combination of intra-hepatic arterial infusion of low-dose cisplatin and oral administration of high-dose doxyfluridine for patients with liver metastases of gastric cancer].

Three cases of gastric cancer with multiple liver metastases were treated with low-dose CDDP and high-dose 5'-DFUR after surgery. The regimen was 20 mg CDDP intra-hepatic arterial infusion per week and 1,200 mg 5'-DFUR oral treatment per day. The liver metastases of two cases responded to this chemotherapy with a reduction of more than 90%, and two cases lived more than 2 years. All of them lived more than one year. This therapy had few side effects and was performed ambulatorily once per week, so patients were able to maintain their quality of life. This combination therapy may well assure a better prognosis for patients with liver metastases of gastric cancer.

Administration, Oral↗

PubMed1996

Developmental anatomy of the supratubal recess in temporal bones from fetuses and children.

The supratubal recess (STR), located superior to the bony eustachian tube and anterior to the attic and often the site of disease, is clearly separated from the attic by the presence of a bony partition. Its anatomic development in childhood, however, remains nuclear. We reviewed serial horizontal sections of fetal and children's temporal bones from the collection of the Otopathology Laboratory, University of Minnesota. Apparently, upward expansion of the bony eustachian tube begins at a late fetal stage and continues throughout childhood, thus forming the STR. Our finding that the STR had already developed in temporal bones without pneumatization of petrous bone suggests that its formation is independent of the air-cell system. Absorption of mesenchymal tissue in the STR tends to be slower than elsewhere in the temporal bone. Surrounded solely by petrous bone, the STR seems, both developmentally and anatomically, a distinctive compartment of the middle ear.

Child↗

PubMed1996

Strategy for breast conserving treatment--analysis of recurrence and prognosis after breast cosnserving treatment.

Two hundred and four patients with small breast cancer (T < or = 3.0 cm. N0 or N1a) were given breast conserving treatment (radiation group: 101, non-radiation group: 103) during the period from Feb. 1988 to Jan. 1995. Survival analysis of breast conserving treatment radiation group versus non-radiation group revealed the following: 1) Breast conserving treatment had a good prognosis, and a 5-year overall survival rate of 96.2%. 2) There was no significant difference of 5-year overall, disease-free and ipsilateral breast disease-free survival rate between the radiation group and non-radiation group. 3) Surgical margin involvement was the most significant risk factor in local recurrence after breast conserving treatment, and non-radiation was a possible risk factor. 4) Local recurrence was a significant risk factor for distant metastases after breast conserving treatment the same as node positive. These results suggested as follows: 1) Lumpectomy with a clear margin and radiation is the best choice for small breast cancer (T < or = 3.0 cm, N0 or N1a). 2) Adjuvant therapy after surgical treatment is necessary for local recurrence.

Axilla↗

PubMed1995

Measurement of intracellular free Ca2+ concentration in guinea pig spiral ganglion cells.

Intracellular free Ca2+ concentration ([Ca2+]i) in spiral ganglion cells (SGC) of guinea pig was measured using the fura-2 fluorescence method. Application of high-K+ external solution increased [Ca2+]i. [Ca2+]i elevation was suppressed by either depletion of external Ca2+ or application of the dihydropyridine Ca2+ channel antagonist, nicardipine. One of the putative hair cell afferent nerve neurotransmitters, L-glutamate (Glu), induced [Ca2+]i elevation in SGC. Pharmacological studies suggested that the Glu receptor may be a non-NMDA subtype. Glu-induced response was suppressed by either depletion of external Ca2+ or application of nicardipine, indicating that Glu-induced [Ca2+]i elevation is mainly carried out by the voltage-dependent Ca2+ channel in SGC.

Animals↗

PubMed1995

Effects of experimental round window membrane laceration on the free amino acid profile of perilymph.

To evaluate biochemical changes of inner ear fluid following perilymphatic fistula (PLF), free amino acid (FAA) profiles of perilymph in experimental PLF were determined using high performance liquid chromatography (HPLC). Thirty-five guinea pigs were anesthetized and prepared as PLF models by perforating the round window membrane (RWM) of the left ear. Right ears served as controls. Samples (2 microliters) were aspirated from scala tympani through a RWM perforation. Animals were divided into two groups according to time of sampling following PLF induction: 2-week group (n = 17) and 4-week group (n = 18). Compound action potential (CAP) evoked by 1, 2, 4 and 8 kHz tone bursts were measured using a round window electrode from the left ear before PLF induction and from both ears before final sampling. RWM perforations were completely closed at the time of the final sampling in 8 of 17 animals from the 2-week group, and 15 of 18 animals from the 4-week group. In comparison with that in control ears, concentrations of FAA throughout all profiles was dramatically elevated in the PLF ears with a healed RWM perforation. Most PLF ears with persistent RWM perforation showed minimal differences between 2-week and 4-week groups. No remarkable CAP threshold changes were found at any frequencies tested following PLF induction in both the 2-week and 4-week groups. The unchanged 8 kHz threshold suggests that FAA concentration increases only at the basal end of the cochlea. FAAs accumulate within the basal end of scala tympani in ears with a healed RWM.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗

PubMed1995

[Postoperative MRI findings after cholesteatoma surgery].

This study was designed to show MRI findings of postoperative middle ear pathologies and to discuss the usefulness of Gadolinium-enhanced MRI in evaluating the postoperative state of cholesteatoma. Thirty-eight ears which underwent intact canal wall tympanoplasty for cholesteatoma were examined. Recurrent cholesteatoma was detected as an iso-intensity area on T1-weighted images with negative enhancement. Notably, residual cholesteatoma were generally depicted as a round iso-intensity area with negative enhancement. Residual cholesteatoma less than 5mm in diameter were, however, not generally detectable with our MRI scanner. Granulation tissue can be separated from cholesteatoma as an area with positive enhancement. Cholesterol granuloma shows a characteristic high signal pattern on both T1 and T2-weighted images. Hypovascular fibrous tissue and fluid collection may be depicted as a pattern similar to that of cholesteatoma. However, the signal is usually more homogeneous than that of cholesteatoma. We conclude that Gadolinium-enhanced MRI is useful for detecting postoperative cholesteatoma and avoiding unnecessary second-look operations after cholesteatoma surgery, by the canal-up procedure.

Adolescent↗

PubMed1995

[Hearing results after anterior tympanotomy in cholesteatoma surgery].

Between 1987 and 1993, 71 ears of attic type cholesteatoma and 20 ears of adhesive type were operated on using the intact canal wall technique combined with anterior tympanotomy. Pre- and postoperative pure tone hearing after the surgery were analyzed, especially to determine whether anterior tympanotomy is harmful to the inner ear. Mean values of 500, 1000 and 2000Hz of air conduction threshold immediately, before and about 1 year after the operation were compared. In attic cholesteatoma, type 1, type 3, and type 4 of ossiculoplasty revealed significant improvement of 8.4dB, 9.3dB, and 8.0dB respectively. In adhesive cholesteatoma, results obtained were 8.4dB, 0.8dB, and -3.0dB. Differences between pre- and postoperative bone conduction threshold at 4000Hz were 1.5dB in type 1, 1.3dB in type 3, and 5.0dB in type 4 in attic cholesteatoma. Those in adhesive cholesteatoma were -2.5dB, -0.2dB, and -10.0dB respectively. From the results obtained, we concluded that (1) our results were satisfactory with regards to hearing ability following all types of ossiculoplasty in attic cholesteatoma and in type 1 in adhesive cholesteatoma, (2) anterior tympanotomy itself is not a harmful procedure to the inner ear in both types of cholesteatoma, (3) an increase in bone threshold in adhesive cholesteatoma is due to the surgical procedure at the stapes and/or the oval window.

Adolescent↗

PubMed1995

[Evaluation of prophylactic hepatic arterial infusion chemotherapy after hepatectomy for metastases from colorectal cancer].

The significance of continuous hepatic arterial infusion (HAI) chemotherapy of 5-FU to prevent recurrence in the remnant liver following curative hepatectomy for colorectal metastases was analyzed in the prospective randomized study. Patients of HAI chemotherapy group received 6 weeks of 5-FU 500 mg/day. The one- and two-year overall survival rates of nine patients with HAI therapy were 87.5% and 87.5%, respectively, while the rates of ten cases without the regional chemotherapy were 100% and 66.7%, respectively, indicating no obvious difference. On the other hand, the disease-free survival rates of HAI Group were higher than those of control group. The disease-free survival rates of the former were 75.0% at one-year and 75.0% at two-year, and the rates of the latter were 47.6% and 47.6%, respectively. No serious complications such as severe liver dysfunction, sclerotic cholangitis or hepatic necrosis were observed. Although the follow-up period was not enough long to accurately evaluate the efficacy, local prophylactic chemotherapy by continuous infusion of 5-FU could be a promising method as an adjuvant chemotherapy after hepatic resection for colorectal metastases.

Aged↗

PubMed1995

[Neoadjuvant intraarterial chemotherapy with dose intensification in locally advanced breast cancer].

Sixteen patients with advanced breast cancer were treated with neoadjuvant intraarterial chemotherapy with high dose epirubicin. The following results were obtained: 1) Excellent down-staging effects were confirmed. Response rate of the primary tumor was 81.3%. 2) Leukopenia was the dose-limiting factor, and 81.3% of patients had WHO grade 2 or more leucopenia. However, the regimen was completed with supportive therapies. 3) At a median follow-up of 17 months, improved survival rates were noted. The present study showed the efficacy of neoadjuvant intraarterial chemotherapy with high dose epirubicin in the treatment of locally advanced breast cancer.

Alopecia↗

PubMed1995

Improvement of the surgical technique of anterior tympanoplasty in cholesteatoma.

Technical improvements in anterior tympanotomy with a transmastoid approach in cholesteatoma surgery are reported. Mastoidectomy must be extended to the root of the zygoma and the space anterior to the malleus head must be opened. For this purpose, the visual axis must coincide with the external meatal axis. In this head position, complete removal of the anterior attic bony plate becomes possible only through the transmastoid approach, without touching the ossicular chain. In the case of the pyramidal type bony plate with a normal ossicular chain, the incudo-malleal joint is temporary subluxated, as this is more convenient for access and removal of pathology than incudostapedial joint subluxation. Our clinical results on postoperative hearing showed no damage to the inner ear by the improved technique.

Cholesteatoma, Middle Ear↗

PubMed1994

Magnetic resonance imaging in patients with sudden deafness.

Although many theories on the etiology of sudden deafness have been proposed, the main pathological focus remains uncertain. In this study, MR examinations were performed on patients with unilateral sudden deafness to study the relationship between MRI findings and response to treatments, i.e. amidotrizoate, steroid, or both. In 7 out of 30 cases, the cochlea and/or the vestibule showed higher signal intensity on proton density and T2-weighted images on the diseased side (MRI positive cases). These findings suggest changes in the chemical composition of the perilymph and/or the endolymph, since proton density and T2-weighted images reflect water content. It appears that MRI positive sudden deafness is more difficult to cure even with the use of amidotrizoate or steroid than MRI negative sudden deafness. Amidotrizoate seems to be more effective in MRI negative sudden deafness. MRI would help us to further classify the etiology of sudden deafness.

Adolescent↗

PubMed1994

[Combination with intra-hepatic arterial infusion of low-dose cisplatin and oral administration of high-dose doxyfluridine in patients with liver metastases of gastric cancer].

Two cases of gastric cancer with multiple liver metastases were treated with 5'-DFUR and CDDP after the surgery. The first case, a 79-year-old male, was administered 1,200 mg/day of 5'-DFUR orally, 6 mg/day of CDDP continuously for 2 weeks, then 20 mg once a week for 5 months by intra-hepatic arterial infusion. This case showed 95% tumor reduction by CT. The other case, a 78-year-old female, was administered 1,200 mg/day of 5'-DFUR orally and 20 mg of CDDP once a week through the hepatic artery. Following several intra-hepatic arterial infusions, it was changed to intra-venous infusion of 20 mg of CDDP twice a week because of trouble with the vascular access system. Two months after, CT showed a 46% tumor reduction in her liver. Neither complained of diarrhea nor nausea, but there was a mild degree of appetite loss. Combination with high-dose 5'-DFUR and low-dose intra-hepatic arterial infusion of CDDP is considered a very effective chemotherapy which can be performed ambulatorily while maintaining the quality of life of patients with liver metastases of gastric cancer.

Administration, Oral↗

PubMed1994

[Evaluation of prophylactic intra-hepatic-arterial infusion chemotherapy after resection of hepatic metastases from colorectal primaries].

To prevent recurrence in the residual liver after surgical treatment for colorectal metastases, the efficacy of intermittent or continuous intra-hepatic-arterial chemotherapy was analyzed. The three- and five-year survival rate of patients with intermittent infusion of ADM or MMC (n = 11) was 36.4% and 36.4%, respectively, while the survival rate of the patients without the regional chemotherapy (n = 32) was 41.9% and 23.3%, respectively, indicating no statistical significance. On the other hand, one patient out of 8 with continuous infusion of 5-FU and 2 patients out of 6 without local chemotherapy developed recurrent disease during the median follow-up time of 12 months. No serious complication such as sclerotic cholangitis or hepatic necrosis was observed. Although the follow-up was not long enough to accurately evaluate the efficacy, local chemotherapy with continuous infusion of 5-FU could be a promising method as an adjuvant chemotherapy after hepatic resection for colorectal metastases.

Administration, Oral↗

PubMed1994

[Intra-arterial infusion chemotherapy for recurrent breast cancer via an implantable system--the second report].

Intra-arterial infusion chemotherapy via an implantable port catheter has been applied in 16 patients with locally recurrent breast cancer. The regimen consisted of induction and subsequent maintenance: intra-arterial infusion of epirubicin (EPI). Non-responders were entered into the second-line regimen consisting of Methotrexate and 5-FU (MF). The results were as follows: 1) The response rate (CR+PR) of EPI to locoregional lesions was 50%, and the median duration of response was 5.7 months. 2) The response rate and the duration of response of MF were 25% and 3 months, respectively. 3) Patients with ER-rith, no previous therapy and a long disease-free interval tended to have a high rate of response to intra-arterial infusion therapy. 4) Improvements of QOL, such as intractable pain, infection and severe lymphedema were recognized in 68.6% of the cases. In more than half of the cases, these treatments were carried out in an outpatient clinic. 5) Leucopenia and catheter or portal problems were encountered in 68.6% and 25.0%, respectively. We conclude that intra-arterial infusion chemotherapy via implantable system is a promising modality with regard to therapeutic effect and improvement of quality of life.

Adult↗

PubMed1994

[Neoadjuvant intra-arterial infusion chemotherapy for the treatment of locally advanced breast cancer with remote metastases].

Intra-arterial infusion chemotherapy (I.A.) before the operation was performed in 7 advanced breast cancers with remote metastases. The locations of remote metastases were bone (6 cases), lung (one case), and brain (one case). The response rate of primary lesions to I.A. was 71% and the responders of remote metastases were two cases, of which one was CR (lung). After the chemotherapy, all cases underwent standard radical mastectomy, and five of seven cases are alive at this writing without local recurrence. We have performed I.A. for locally advanced breast cancer with remote metastases on the grounds that the effect of this treatment is "semi-local and semisystemic," I.A. bring down-staging to the primary lesions and can control local recurrence. The effect of the drug which leaks from I.A. is expected to the metastatic lesions. I.A. was considered to be useful too for the treatment of locally advanced breast cancer with remote metastases in terms of the excellent control effect of the local lesions and the effect on the metastatic lesions.

Aged↗