Search PubMed⌕ Search

Biomedical subjects

T Tsunoda

Publications and source records attributed to T Tsunoda.

At least 127 records · Page 7Linked to original sources

Intracranial hypoglossal neurinoma without preoperative hypoglossal nerve paresis--case report.

A 46-year-old female presented with an intracranial hypoglossal neurinoma manifesting only as spasticity in the lower extremities without hypoglossal nerve paresis. Magnetic resonance imaging greatly aided in the early detection of the tumor with this atypical presentation. Unilateral suboccipital craniotomy with resection of the occipital condyle allowed us to approach the tumor in front of the medulla from an inferolateral direction and to remove it successfully. We emphasize the need to pack dead space with fatty tissue to prevent cerebrospinal fluid leakage.

Cranial Nerve Neoplasms↗

Herniation of the third ventricle into empty sella caused by surgery for pituitary apoplexy--case report.

A 46-year-old male presented with acute visual loss in the right eye, high fever, nausea, and vomiting. This was caused by herniation of the third ventricle into empty sella at 15 months of surgery for pituitary apoplexy. The sellar-suprasellar tumor was totally removed via a transcranial approach. Histological examination showed chromophobe adenoma with necrotic tissue, indicating pituitary apoplexy. His visual field defect worsened 15 months after the operation, and magnetic resonance imaging revealed moderate hydrocephalus and protrusion of the dilated anterior inferior portion of the third ventricle into the sella. The optic nerve, optic chiasm, and pituitary gland were compressed onto the sellar floor. Ventriculoperitoneal shunt relieved the visual impairment. A decompressive procedure such as ventriculoperitoneal shunts is a reasonable treatment for such a marked herniation of the third ventricle.

Cerebral Ventricles↗

[Severe surgical infection with no information in terms of bacteria].

The incidence of bacteria caused postoperative infections was performed at the timing when bacteria or fungi is not yet detected. This period is important for management of postoperative infections. MRSA, E. faecalis, P. aeruginosa and fungi were detected with high frequency irrespective of the surgical area. After the operation of esophageal cancer, the most frequent infection was postoperative pneumonia, and the isolated bacteria was P. aeruginosa frequently. In the cases of gastric cancer, hepato-biliary-pancreas cancer and colorectal cancer, intraabdominal sepsis was the highest incidence, and the isolated bacteria was E. faecalis. In terms of intravenous catheter infection, fungus was common. Thus, it may suggest that we can identify the bacteria caused, and the management for postoperative infections was performed appropriately by using the antibiotics which have the sensitive against the expected pathogen.

Bacterial Infections↗

Clinical significance of quantitative analysis of carcinoembryonic antigen assessed by flow cytometry in fresh human gastric cancer cells.

The expression of carcinoembryonic antigen(CEA) on tumor cells freshly excised from 51 patients with gastric cancer was studied using flow cytometry. The expression of CEA by flow cytometry was more quantitative than that by immunohistochemical staining. There was no relationship between the fluorescence intensity assessed by flow cytometry and serum CEA levels, except for patients with a high titer of serum CEA. The patients with high grade CEA expression on tumor cells by flow cytometry had poor prognoses, compared to patients with low CEA expression in undifferentiated gastric cancer. Thus, it is suggested that the quantitative CEA expression on tumor cells by flow cytometry could be a useful prognostic marker in postoperative gastric cancer patients.

Adenocarcinoma↗

Generation of CD4+ cytotoxic T lymphocytes stimulated by immobilized anti-CD3 monoclonal antibody and interleukin-2 in cancer patients.

The proliferation of autologous tumor-reactive cytotoxic T lymphocytes (CTL), induced by autologous mixed lymphocyte tumor-cell culture, was remarkably enhanced by activation with immobilized anti-CD3 monoclonal antibody (MAb) and interleukin-2 (IL-2), as compared with IL-2 alone. The activated CTL exhibited high cytotoxicity against autologous tumor cells. Cytotoxicity against autologous tumor cells was inhibited by anti-HLA-DR MAb. In negative selection with immunomagnetic beads, cytotoxicity against autologous tumor cells was inhibited by the elimination of CD4+ cells. The major cell-surface antigens of the activated CTL were CD3+, CD4+, CD25+, CD45RO+ and CD45RA-, suggesting helper T cells, and the activated CTL produced IL-2. It is concluded that the CTL activated by immobilized anti-CD3 MAb and IL-2 were CD4 cells that had both killer and helper functions. Our findings indicate that adoptive immunotherapy using these activated CTL would be effective in cancer patients.

Antibodies, Monoclonal↗

Effect of celiac and superior mesenteric ganglionectomy on fasted canine colonic motor activity.

The role played by extrinsic nerves in colonic motor activity and motor coordination between the small intestine and the colon in the fasting state was investigated in a canine model. To evaluate motor activity before and after celiac and superior mesenteric ganglionectomy (CSMG), seven strain gauge force transducers were implanted in the small and large bowels of five dogs. No significant differences were observed in the frequency, duration, cycle, or migration time of bursts of contractions from the colon (BCC), or in the duration of the quiescent state before and after CSMG. When small intestinal phase III activity reached the ileocecal junction before and after CSMG, a characteristic contractile pattern, namely, small intestinal phase III activity followed by BCC, was observed at the ileocecal junction. Before and after CSMG, 84% and 83% of the small intestinal phase III activity, respectively, was transmitted to the colon as BCC after reaching the ileocecal junction. However, only 19% and 18% of BCC before and after CSMG, respectively, followed small intestinal phase III activity. These results led us to conclude that the extrinsic nerves exert little effect on fasting colonic motor activity and motor transmission from the small intestine to the colon.

Animals↗

Pleomorphic nonfunctioning islet cell tumor of the pancreas.

A nonfunctioning islet cell tumor of the pancreas in a 68-yr-old female is reported. All of the laboratory data, including serum hormones, glucose, and tumor markers, were within normal limits. A pancreatoduodenectomy was performed. Cut sections of the specimen revealed a cystic mass measuring 6.0 x 4.5 x 3.5 cm. Histologically, the tumor consisted of large acidophilic cells with bizarre giant nuclei. The tumor cells were positive for chromogranin-A, synaptophysin, neuron-specific enolase, and S-100 protein. Multifocal proliferation of endocrine cells, centroacinar cells and changes in acinar cells were found in the adjacent uninvolved pancreatic tissue. Ultrastructural studies of the tumor revealed clear nuclei with no zymogen, but immature neurosecretory granules in the cytoplasm of the tumor cells. These findings were consistent with those of nonfunctioning islet cell tumors, especially of the pleomorphic type. To the best of our knowledge, this is the first report on pleomorphic nonfunctioning pancreatic islet cell tumors.

Adenoma, Islet Cell↗

[clinical study of balofloxacin on infectious enteritis and assessment of the fecal drug concentration and intestinal microbial flora in patients with inpatients with infectious enteritis. Research group of balofloxacin on infectious enteritis].

The efficacy, safety and usefulness of balofloxacin (BLFX) for patients with acute infectious enteritis and the carriers mainly shigellosis, were investigated. The drug was administered at a daily dose of 200 mg twice a day for 3 days to patients with cholera, 7 days to patients with Salmonella enteritis and 5 days to patients with other conditions of infectious enteritis including shigellosis; 1. The efficacy was analyzed in 89 of the 135 patients who received the administration (43 patients with shigellosis, 14 with Salmonella enteritis, 8 with enteropathogenic/ enterotoxigenic Escherichia coli enteritis, 3 with cholera, 7 with enteritis with other pathogenic bacteria, 6 with polymicrobial infectious enteritis and 8 with acute enteritis that was pathogen-negative). 2. In patients bearing symptoms and who thus could be analyzed for drug efficacy, the drug was markedly effective or effective 50/52 (96.2%). 3. Bacteriologically, the drug was effective for Shigella spp. in 41 (100%) of 41, Salmonella spp. in 12 (85.7%) of 14, and enteropathogenic/enterotoxigenic Escherichia coli in 8 of 8 cases. 4. Adverse effects were seen in 5/133 patients (3.8%) receiving the drug, including two cases of skin eruption, one of the numbness of the hands, one of oral aphtha, and one of nausea. In patients for whom laboratory findings were available, 20/115 (17.4%) showed abnormalities, mainly elevations of GOT and/or GPT, but these were slight. 5. In terms of subjective reports of usefulness, 51/82 (62.2%) were markedly satisfied, and 73/82 (89.0%) were either satisfied or markedly satisfied. 6. The influence of administration of BLFX on fecal concentration and intestinal microbial flora was investigated in 2 patients with acute infectious enteritis. Results approximately equivalent to such flora levels in healthy subjects were obtained. These results suggest that BLFX is highly useful for infectious enteritis such as that caused by shigellosis.

Adolescent↗

Hereditary hemorrhagic telangiectasia showing severe anemia which was successfully treated with estrogen.

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is a bleeding disorder attributed to a vascular developmental abnormality. It is transmitted as an autosomal dominant trait. A 63-year-old female was admitted because of repeated episodes of severe anemia which resulted from bleeding of telangiectases in the gastric mucosa. Conventional therapies including endoscopical microwave coagulation and ethanol injection were not effective. The persistent anemia necessitated frequent blood transfusion. Estrogen was orally administrated and blood transfusion became unnecessary. Thus, estrogen therapy should be considered as one of the effective treatments for recurrent severe anemia due to hereditary hemorrhagic telangiectasia.

Administration, Oral↗

Effect of lymphokine-activated killer cells with or without radiation therapy against malignant brain tumors.

The use of autologous lymphokine-activated killer (LAK) cells to treat malignant brain tumors was evaluated in 10 patients, one with metastatic malignant melanoma and nine with malignant glioma. LAK cells were obtained by culturing autologous peripheral blood lymphocytes with human recombinant interleukin-2 (rIL-2) for 7-28 days. All patients underwent surgery to remove as much tumor as possible and an Ommaya reservoir was implaced in the tumor cavity. Two of the 10 patients had received radiotherapy elsewhere, so were treated with LAK cells alone. Eight patients were treated with a combination of LAK cells and radiotherapy, using 1.8-2.0 Gy fractions given five times a week with a total dosage between 54 and 65 Gy. LAK cells and rIL-2 were injected to the tumor cavity via the Ommaya reservoir once a week for inpatients and once a month for outpatients. The duration of the LAK therapy ranged from 3 to 23 months (mean 13.7 mos). Neuroimaging evaluation revealed two complete responses, three partial responses, four no changes, and one progressive disease. In one patient with pontine glioma, the Karnofsky performance score was raised from 20 to 60. There were no side effects after the injection of LAK cells and rIL-2. The results suggest low-dose LAK therapy is a useful and safe treatment modality for malignant brain tumors.

Adult↗

Characterization of an established transplantable adenocarcinoma of the gallbladder in Syrian golden hamster.

A carcinoma of the gallbladder was transplantable in Syrian golden hamsters. The tumor was induced by subcutaneous injection of N-nitrosobis (2-oxopropyl) amine (BOP) following dissection of the common duct and preparation of a cholecysto-duodenostomy. The histology revealed a poorly differentiated adenocarcinoma. The tumor was inoculated into the cavity of the gallbladder and subcutaneous tissue of the hamster and was transplantable (uptake rate was 100%). This tumor expressed blood group-related antigens, including A, H, and P-glycoproteins. To our knowledge, this is the first report of carcinoma of the gallbladder transplantable in a laboratory animal.

Adenocarcinoma↗

Gastrocolic fistula originating from transverse colon cancer: report of a case and review of the Japanese literature.

A 72-year-old woman was admitted to our hospital complaining of loss of weight, general fatigue, and upper abdominal pain. Barium studies suggested that a fistula was present between the proximal transverse colon and the stomach which originated from a carcinoma of the colon. A plain computed tomography (CT) scan confirmed the presence of a gastrocolic fistula. A two-thirds distal gastrectomy and right hemicolectomy with a resection of a bulky tumor in the mesocolon were performed en bloc. Histological examination revealed a well-differentiated adenocarcinoma of the transverse colon which was involved with the wall of the stomach. We were able to obtain information on 14 previous cases of gastrocolic fistula originating from transverse colon cancer in the Japanese literature, including the present case. The most common symptom was abdominal pain (64%). A preoperative diagnosis of fistula was confirmed in 10 of the 11 cases examined by barium studies. A plain CT and a CT scan after the barium studies may also be helpful in detecting fistula formation. A fistula between the carcinoma of the middle or distal transverse colon and the stomach was found in 13 of 14 cases, but not in our case. Only one case lived longer than 9 years, even though a surgical resection was possible in 9 of 11 cases.

Adenocarcinoma↗

Successful preoperative preparation for thyroidectomy in Graves' disease using lithium alone: report of two cases.

To elucidate the effect of lithium carbonate in the preoperative preparation of patients with Graves' disease, it was given without any other antithyroid medication to two patients as an alternative to thionamide, which had caused adverse effects. The initial dose of lithium carbonate was 600 mg/day, and the final doses were 1200 and 900 mg/day, while the periods of administration were 67 and 27 days, respectively. The highest serum concentrations of lithium during the administration period were 0.83 and 0.43 mEq/l, respectively. This preoperative preparation lowered serum thyroid hormone levels and clinical improvement. A subtotal thyroidectomy was performed uneventfully in both patients, after which the serum lithium levels decreased rapidly and the thyroid hormone levels increased only slightly for a few days. No adverse effects of lithium carbonate were observed. Thus, we conclude that the administration of lithium carbonate alone is an effective and safe method for the preoperative management of Graves' disease when conventional antithyroid drugs show adverse effects.

Adult↗