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Biomedical subjects

Y Shoji

Publications and source records attributed to Y Shoji.

At least 127 records · Page 7Linked to original sources
PubMed1994

Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging.

BACKGROUND: We evaluated the ability of magnetic resonance imaging (MRI) to define local extension of rectal carcinoma. STUDY DESIGN: Thirty-three patients with rectal carcinoma were preoperatively assessed by MRI. RESULTS: When sagittal or coronal images, or both, were added to transverse images as needed, the sensitivity rate was 84.2 percent and the specificity rate was 92.9 percent. False-positive results when using only transverse images were mainly related to slight extramural spread, to an anterior location in the lower rectum (partial volume effect), and to massive extramural spread of the middle rectal tumors. CONCLUSION: Preoperative MRI was helpful to define tumor extension three-dimensionally.

Aged↗
PubMed1994

Clinicopathological study of anorectal mucosa in total colectomy with mucosal proctectomy and ileoanal anastomosis.

OBJECTIVE: To find out whether the extent of inflammation of the anorectal mucosa affects the quality of the mucosectomy and postoperative function in patients undergoing total colectomy with mucosal proctectomy and ileoanal anastomosis. DESIGN: Prospective study. SETTING: University hospital. SUBJECTS: 33 patients with ulcerative colitis and 17 with familial adenomatous polyposis. INTERVENTIONS: With the patient in the prone jackknife position, the anorectal columnar mucosa above the dentate line was removed transanally by the forceps coagulation technique. MAIN OUTCOME MEASURES: Score of histological appearance on light microscopy. RESULTS: All the patients with ulcerative colitis had moderate (n = 17, 52%) or severe (n = 16, 48%) inflammation, and their mean histological score was 12 (range 7-16). The patients with polyposis had little or no inflammation, and a mean histological score of 0.4 (range 0-2). The mucosectomy became more difficult as the severity of the inflammation increased, but there were no significant differences between the two groups in operating time, blood loss, or bowel function postoperatively. CONCLUSION: Though mucosectomy is technically more difficult in the presence of severe inflammation, there were no adverse effects on bowel function postoperatively.

Adenomatous Polyposis Coli↗
PubMed1994

[Autologous vs bovine pericardial valved patch for widening of the right ventricular outflow tract of tetralogy of Fallot].

Autologous or glutaraldehyde treated bovine pericardial valved patch was utilized for widening of the right ventricular outflow tract in 20 patients with tetralogy of Fallot (autologous pericardium group in 10 patients and bovine pericardium group in 10). Pericardial valve function of the both materials was evaluated by postoperative cardiac catheterization performed 1 year after the operation. There were no significant differences in pulmonary arterial and right ventricular pressures, and right ventricular ejection fraction and end-diastolic volume between the 2 groups. Pulmonary angiogram in the autologous pericardium group patients demonstrated the pulmonary regurgitation (PR) of grade 1 in 5 patients, grade 2 in 4 and grade 3 in 1. On the other hand, 1, 3 and 6 patients in the bovine pericardium group demonstrated no-PR, grade 1 PR and grade 2 PR, respectively. It was concluded that there were no significant differences between autologous and glutaraldehyde treated bovine pericardium as a material of valved patch for widening of the right ventricular outflow tract of tetralogy of Fallot.

Bioprosthesis↗
PubMed1993

Anorectal function after preoperative intraluminal brachytherapy and colonic J pouch-anal anastomosis for rectal carcinoma.

The effects of preoperative intraluminal brachytherapy on bowel function after anoabdominal rectal resection and colonic J pouch-anal anastomosis were studied. The patients included eight not receiving irradiation (group 1), eight who received 30 Gy (group 2) and eight who received 80 Gy (group 3). Stool frequency and the incidence of soiling were significantly greater in group 3 than in the other groups. Anal resting pressure was lower in group 3 during the study period but J pouch distensibility was not reduced. The maximum tolerated volume, threshold volume and squeeze pressure were significantly lower in group 3 than in the other groups in the early postoperative period. These results suggest that high-dose brachytherapy affects the anal sphincters and colonic J pouch. A moderate dose of 30 Gy may be more suitable before restorative anorectal surgery.

Adult↗
PubMed1993

Tissue distribution of mutant mitochondrial DNA in mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS).

We analysed the distribution of mutant mitochondrial DNA (mtDNA) with A-to-G substitution mutation of tRNA(Leu)(UUR) in various autopsied tissues from a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). There was no significant difference in the proportion (76-86%) of mutant mtDNA in many tissues, except in the lung and spleen. Unequal partitioning of mtDNA in somatic cells appears less prominent than that in germ cells.

Adult↗
PubMed1993

Replacement of the transverse aortic arch for type A acute aortic dissection.

Surgical treatment of acute aortic dissection involving the segment of transverse aortic arch is difficult and often associated with a high mortality and morbidity. The high mortality and morbidity are primarily related to anatomic features and techniques of cerebral protection employed during the period of aortic branch occlusion needed for reconstruction. This study reports our experience of 20 consecutive cases of acute type A aortic dissection treated by repair or replacement of the transverse aortic arch during emergency operation. Ages of the patients ranged from 56 to 76 years. All patients were referred to us within 2 weeks of onset (mean time, 58 hours). Selective cerebral perfusion or deep hypothermia with complete circulatory arrest was employed during the period of aortic branch occlusion. Duration of cerebral perfusion, circulatory arrest, myocardial ischemia, and cardiopulmonary bypass averaged 106 minutes, 32 minutes, 127 minutes, and 248 minutes, respectively. There were three operative deaths. All three dissections were ruptured ones, and the patients died of hemorrhage, deep coma, or multiple organ failure. One patient died of infection 3 months after operation. The remaining patients are alive and well without any detectable neurological deficit 1 month to 4 years postoperatively. This experience emphasizes that repair or replacement of acute type A aortic dissection involving the aortic arch can be performed safely by adequate selection of patients, supportive measures, and operative methods.

Acute Disease↗
PubMed1993

[Antisense DNA].

Antisense DNA has been given a big attention as future therapeutic reagents. However, there are several shortcomings including biological instability and low membrane permeability. In order to overcome these shortcomings, the first generation of oligonucleotides has been synthesized. The efficacy of these analogues in vitro or in vivo seems to be promising. In this reviewing article, we mainly describe the intracellular delivery of oligonucleotides from the pharmaceutical point of view.

Animals↗
PubMed1993

[Solitary fibrous tumor (SFT) of the thymic area--a case report].

A 52-year-old man was referred to our hospital with a large anterior mediastinal tumor on chest X-ray. A preoperative CT scan revealed the large tumor in front of the ascending aorta. We failed aspiration biopsies for several times because of scant tumor cells. This tumor was totally removed with a small part of the pericardium through median sternotomy after preoperative radiation therapy consisting of a total dose of 25 Gy. There was no metastasis to regional lymph nodes nor dissemination in the anterior mediastinum. The tumor was encapsulated, 9 x 12 cm in size, 270 g in weight with necrotic region induced by preoperative radiation therapy. We made the diagnosis of solitary fibrous tumor of the thymic area by pathological examination and immunohistochemical study. SFT most frequently arises in the pleura and is less frequently observed in the pericardium and peritoneum. But SFT of the mediastinum has been rarely reported in the world and this is the second case in Japan.

Humans↗
PubMed1993

[Preoperative intra-arterial injection of mitoxantrone for locally advanced breast cancer].

Mitoxantrone (MIT) is a new anthraquinone anti-cancer agent. We successfully treated 3 patients with locally advanced breast cancer, including two inflammatory breast cancers, by pre-operative arterial injection of MIT. The treatment protocol was MIT 12 mg/m2 injected into both the internal mammary and the subclavian artery with oral administration of 5' DFUR 1,200 mg/day. In two cases of inflammatory breast cancer, the redness of skin was immediately reduced after the first course. After 2 courses, all tumors were decreased over 50% in size. Standard radical mastectomy could be carried out on all patients. Preoperative arterial injection of MIT might be the treatment of choice for locally advanced breast cancer. This preliminary result encourages further study.

Administration, Oral↗
PubMed1993

[Surgical treatment in the patients with ocular type myasthenia gravis associated with thymoma].

During past 16 years, 192 patients underwent surgery for myasthenia gravis including 40 patients with pure ocular symptoms in our institute. In these 40 patients, 8 were associated with thymoma. The clinical stages of the thymomas were registered into Stage I (n = 5), Stage II (n = 1), Stage III (n = 1), Stage IV (n = 1) according to the classification of Masaoka and colleagues. All patients underwent extended thymothymectomy. The patient in stage III had been well until generalized myasthenic symptoms appeared 4 years after the surgery. Since the chest X-ray film revealed the tumor shadow on the right diaphragm, removal of the tumor was performed. Although he developed myasthenic crisis postoperatively, he is well controlled medically. Other 7 patients have been doing well. We concluded that a close postoperative follow up should be performed for the patients with ocular type myasthenia gravis associated with thymoma.

Adult↗
PubMed1993

[Management of myasthenia gravis (MG) associated with thymoma].

From June 1975 to June 1992, we experienced 203 patients with MG. Sixty patients had associated thymoma, registering stages I (n = 31), II (n = 18), III (n = 9), and IV a (n = 2), according to the classification of Masaoka and colleagues. Fifty patients had generalized MG and 10 had ocular MG. Histopathological findings indicated round-oval, polygonal cell type in 46 patients and mixture of round-oval and spindle cell type in 11 patients and invasive thymomas had a tendency to have a predominantly epithelial type with and increased epithelial element as compared with non-invasive thymomas. An extended thymectomy including thymoma was performed in all patients. Three patients in stage II, 7 patients in stage III, and 2 patients in IV a received postoperative radiation therapy. Twenty-one patients needed prolonged respiratory care for respiratory crisis. Fifty-three patients have been doing well with the alternate-day corticosteroid therapy, however, 4 patients had an excavation of myasthenic symptoms associated with recurrence of thymoma on the pleura. In conclusion, early extended thymectomy including thymoma is markedly effective therapy for MG with thymoma and a careful attention should be paid for recurrence in the patients with invasive thymoma.

Adult↗
PubMed1993

Effects of sodium valproate on various intestinal motor functions after ileal J pouch-anal anastomosis.

BACKGROUND: We investigate the effects of sodium valproate, a gamma-aminobutyric acid transaminase inhibitor, on the clinico-physiologic state after ileoanal anastomosis. METHODS: Twelve patients (five with ulcerative colitis and seven with familial adenomatous polyposis coli) were studied in a placebo-controlled trial. RESULTS: Placebo had no effect, but valproate increased the resting anal pressure by 22.4% and the maximum tolerable pouch volume by 20.7%. It also prolonged pouch emptying by 47.3%, with an associated improvement in stool frequency and incontinence. These results suggested that valproate improved both reservoir continence and sphincter continence. CONCLUSIONS: Only minimal side effects were noted, so the administration of sodium valproate appears to be a safe and useful adjunct for patients with ileoanal anastomosis in the early postoperative period.

4-Aminobutyrate Transaminase↗
PubMed1992

The application of a thread holding ring for ileoanal and coloanal anastomosis.

A thread holding ring, originally developed for valve replacement surgery and now commercially available, was successfully employed when performing ileoanal or coloanal anastomosis in 34 patients. The use of this instrument for ileoanal or coloanal anastomosis shortened the operation time and resulted in a decreased rate of complications related to the anastomosis.

Anastomosis, Surgical↗
PubMed1992

Transitory elevation of serum amylase levels after restorative proctocolectomy.

The incidence of postoperative hyperamylasaemia was evaluated in 70 patients who underwent staged restorative proctocolectomy. On the 14th postoperative day, 27 of 70 patients after total colectomy showed hyperamylasaemia, and the serum amylase returned to normal on the 30th postoperative day. Three out of 37 after ileoanal anastomosis and 8 out of 70 after stoma closure showed elevation of serum amylase postoperatively. Total colectomy might have a possible role in the postoperative increase of serum amylase. None of these patients had any obvious clinical evidence of postoperative pancreatitis. In 7 patients showing significant elevation of serum amylase levels (over 1000 IU), this was due predominantly to the pancreatic isoenzyme. This transitory elevation of serum amylase did not seem to be altered by the administration of therapeutic agents for pancreatitis. These observations suggest that postoperative hyperamylasaemia without clinical evidence of pancreatitis is very common after total colectomy, and that postoperative hyperamylasaemia itself does not necessarily require treatment.

Adenomatous Polyposis Coli↗