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Biomedical subjects

Y Monden

Publications and source records attributed to Y Monden.

At least 217 records · Page 12Linked to original sources
PubMed1985

[Distribution of cefotiam dihydrochloride to the bloodless lung].

The concentration of cefotiam (CTM) in the serum and the bloodless lung with time is discussed. Five patients who were undergone pneumonectomy or lobectomy, were given 1 g of CTM intravenously during the operation. Blood samples and lung samples were collected 15, 30, 60, 90, 120, and 300 minutes after the administration. The CTM levels in the blood and the lung samples were measured by the agar well bioassay. The CTM levels in the lung samples were modified as the CTM levels in the bloodless lung by calculating the contained blood volume, as lung samples were proven to have a mean value of 34.2% of blood in weight. The serum CTM level was 73.3 micrograms/ml at 15 minutes after injection and then decreased gradually. The CTM level in bloodless lung was elevated during the first 60 minutes, became equal to that of the blood during next 30 minutes and then exceeded the serum levels thereafter. These results indicate that the distribution of CTM to the bloodless lung was excellent and a satisfactory preventative effect against postsurgical infection could be expected.

Aged↗
PubMed1985

Anti-acetylcholine receptor antibody titer with extended thymectomy in myasthenia gravis.

Twenty-four patients with myasthenia gravis of Osserman's generalized type underwent extended thymectomy through a sternal-splitting approach. Their clinical responses to thymectomy and postoperative changes in anti-acetylcholine receptor antibody titers were evaluated. The follow-up time ranged from 1 month to 7 years and 7 months (average, 36 months). Six patients (25%) had remissions and 17 patients (71%) were improved after operation. The preoperative anti-acetylcholine receptor antibody titers dropped significantly after operation (p less than 0.001). The postoperative reduction in these titers correlated with the time course after operation (p less than 0.05). Their postoperative reduction was significantly greater in the six patients having remissions than in the 15 having marked (p less than 0.02) and the six having moderate improvement (p less than 0.005). This study has revealed that anti-acetylcholine receptor antibody titer in plasma declines progressively after thymectomy, and the postoperative reduction of this titer correlates with the clinical effect of thymectomy.

Adolescent↗
PubMed1985

[Diagnosis and therapy of thymoma].

In the postoperative diagnosis of thymoma, the most important problem over the last 30 years has been whether the condition is benign or malignant. In this paper, we discussed the diagnosis of thymoma malignancy and its therapy based on our own experiences. All thymomas have the potential to be malignant. Some thymomas have low malignancy and others high malignancy. As the malignancy is therefore not uniform, it is impossible to divide thymomas into either benign or malignant categories. Masaoka, one of the present authors, introduced the concept of clinical stage to thymoma. We think that the difference between invasive and noninvasive thymomas is due to differences in the clinical stage. We also proposed a new classification of thymomas based on the degree of epithelial differentiation. This new classification reflects the malignancy of the thymoma. Both the clinical stage classification and the classification based on epithelial differentiation showed good correlations with the prognosis of thymoma can be surmised by an exact diagnosis based on these two new classifications. The most important point concerning the therapy of thymoma is radical resection of the tumor. However, reduction surgery can be the method of second choice, especially in myasthenic thymoma, because of its slow growth. We carried out irradiation in all patients with thymoma postoperatively, resulting in a low rate of recurrence of the thymoma. This indicates the effectiveness of radiation therapy for this condition.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Surgical treatment of chronic empyema. A new one-stage operation.

The operative results in a series of 92 patients with chronic empyema were reviewed. Of these, 46 had empyema with an underlying fistula, and 46 had empyema without fistulization. Twenty-one underwent decortication, 65 were treated by our technique, and six were treated by a modification of the Eloesser technique. These techniques were employed with priority given in the order just cited. Our technique involves decortication of the visceral peel and obliteration of the dead space by collapsing of the parietal wall without rib resection. Cure was obtained with decortication alone in 20 of 21 patients. Sixty of 65 patients treated by our technique were cured without deformation of the thoracic cage. In all patients treated by the modified Eloesser technique, obliteration of the empyema cavity was achieved secondarily by thoracoplasty combined with a pedicled muscle flap. Postoperative pulmonary function studies demonstrated a significant improvement in vital capacity and forced expiratory volume in 1 second in patients treated by decortication or by our technique. With the modified Eloesser technique, in contract, pulmonary function tended to decline.

Adult↗
PubMed1985

[Effect of preoperative intra-arterial infusion of adriamycin on locally advanced breast cancer].

The effect of adriamycin (ADM) infused intraarterially as a preoperative procedure was analyzed retrospectively in 15 patients with primary advanced breast cancer. A high clinical response rate (CR+ PR) of 73% (11/15) was obtained by the treatment, and also remarkable degenerative changes of tumor cells were histologically noted in 10 out of 15 surgical specimens (67%). A correlation between the dose of ADM infused and the rate of tumor regression was observed. A significantly higher concentration of ADM was detected in metastatic lymph nodes and tumors obtained 3-4 weeks after intra-arterial infusion of ADM than that in normal mammary gland. As for side effects, alopecia, leukocytopenia, anorexia, nausea and vomiting occurred at high frequencies. The side effects due to this treatment were considered to be tolerable. Prognostically, a good survival rate was not observed using preoperative treatment with intra-arterial ADM infusion.

Adult↗
PubMed1984

Invasive thymoma with myasthenia gravis.

In 261 surgically treated patients with myasthenia gravis (MG), 26 had an invasive thymoma and 49 had a noninvasive thymoma. Invasive thymoma was seen in 41% of thymomatous MG patients older than 40 years of age, and 28% in patients younger than 40 years of age. Of 19 patients who underwent total or subtotal thymothymomectomy accompanied by irradiation (4000 rad), 17 were still alive on an average 6.5 years after surgery. The deterioration of MG by the irradiation was observed in 7 of 20 irradiated cases. Thus, postoperative irradiation is effective but should be done with attention to the deterioration of MG. The prognosis of MG in patients with an invasive thymoma was poorer than that in patients with a noninvasive thymoma.

Adult↗
PubMed1984

Radical operation for thyroid carcinoma invading the trachea.

We report 12 cases of well-differentiated thyroid carcinoma that invaded the trachea. In all of these cases, we performed a hemithyroidectomy, including the isthmus, with an accompanying neck dissection and resection of the trachea. Six of 12 patients experienced hemoptysis, and a diagnosis of tracheal invasion was made preoperatively in nine patients by tracheal endoscopy and computed tomography. Histologic diagnosis was confirmed by a preoperative biopsy in one case only. An end-to-end anastomosis of the trachea was performed in five patients, an anastomosis between the cricoid cartilage and the trachea was performed in five patients, and an anastomosis between the thyroid cartilage and the trachea was performed in two patients. One patient with a recurrence of tumor died of tracheal bleeding 11/2 years later. One patient died of massive gastrointestinal bleeding postoperatively. The remaining ten patients have been doing well from three months to five years two months postoperatively.

Adenocarcinoma↗
PubMed1984

Myasthenia gravis with thymoma: analysis of and postoperative prognosis for 65 patients with thymomatous myasthenia gravis.

Sixty-five patients with thymomatous myasthenia gravis were investigated. Thymomas were present in 44% of the male patients and 19% of the female patients with myasthenia gravis. The incidence of thymomatous disease in male patients was higher than in female patients in all age groups. Eighty percent of men more than 50 years old and women more than 60 years old had myasthenia gravis with thymoma. Germinal center formation in the thymus of patients with thymomatous myasthenia gravis was positive in 91% and was high grade. The prognosis for patients undergoing extended thymectomy of thymomatous myasthenia gravis was significantly better than in those having transsternal simple thymectomy, but it was worse than the prognosis for patients with nonthymomatous myasthenia gravis. No increase in the rate of remission or palliation was seen one year after thymectomy. It is concluded that early thymectomy is effective in control of myasthenia gravis in thymomatous myasthenia gravis.

Adult↗
PubMed1984

Effects of preoperative duration of symptoms on patients with myasthenia gravis.

In 80 patients with type II nonthymomatous myasthenia gravis who underwent extended thymectomy, we investigated preoperative duration of symptoms, prognosis after thymectomy, immunological findings, and germinal center formation in the thymus. Our findings included the following. First, the palliation rate after thymectomy ranged from 73 to 100% and was independent of the preoperative duration of symptoms. The remission rate was high in patients with a short preoperative duration. Second, the lymphocyte count of peripheral blood decreased as preoperative duration increased. Third, the percentage of positive reactions to purified protein derivative of tuberculin decreased as preoperative duration increased: 100% in the one-year group, 78% in the two-year group, 75% in the three-year group, and 56% in the four-year group. Fourth, the degree of germinal center formation in the thymus was higher in patients with a longer preoperative duration. The correlation between germinal center formation and preoperative duration was significant. Finally, the T-cell population in peripheral blood and immunoglobulin, and antibody to acetylcholine receptor in serum, had no significant relationship with the preoperative duration of myasthenia gravis.

Adolescent↗
PubMed1984

Trans-FBS-channel ventilation during the flexible bronchoscope (FBS) examination in infant.

The most important problem during FBS examination in infants is respiratory care. A new ventilation method using the channel of the FBS is proposed for respiratory care during FBS examination in infants. An FBS with a channel of more than 1.2 mm in diameter was directly inserted into the trachea under general anaesthesia without an orotracheal tube. The first step of this ventilation is the flushing of pure O2 into the lung as inspiration through the channel of the FBS. The second step is the aspiration of expiratory gas through the channel by a vacuum pump. Ventilation during the FBS examination is maintained by the repetition of these two steps by the operation of a stop-cock. Experiments in dogs, and clinical use showed that this method of respiratory care is effective and safe with certain limitations. Clinically, inspection with the FBS could be performed continuously for five minutes in most cases.

Animals↗
PubMed1984

Antibody to acetylcholine receptor in myasthenia gravis: production by lymphocytes from thymus or thymoma.

In 13 of 17 myasthenic patients without thymoma and all 7 patients with thymoma, thymic lymphocytes produced antibody to acetylcholine receptor (AChR). Lymphocytes from the thymoma itself did not produce AChR antibody except in one patient. The rate of antibody production was higher in patients without thymoma than in patients with thymoma (32.5 and 3.9 fmol/10(6) cells/week, respectively). The rate of antibody production was related to the serum titer of AChR antibody (r = 0.7, p less than 0.001). Enrichment of B cells using a nylon wool column increased the rate of antibody production by thymic lymphocytes 1.3- to 8.0-fold.

Adult↗