A case of pelvic arteriovenous fistula.
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Biomedical subjects
Publications and source records attributed to Y Torii.
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Lung cancer and chronic interstitial pneumonia associated with systemic sarcoidosis was detected in a 66-year-old woman at autopsy. Histologically, hyalinized sarcoid lesions were scattered in cervical lymph nodes, thoracic lymph nodes, abdominal lymph nodes, and spleen. Scattered non-caseating epithelioid cell granulomas with giant cells were observed in both lungs demoting cancer and chronic interstitial pneumonia. A tumor mass occupying right hilar portion was well-differentiated squamous cell carcinoma involving right upper lobe and right hilar lymph nodes. In the lower lobe of the left lung, a small nodule of poorly differentiated squamous cell carcinoma was detected. Alveolar septa, especially in both lower lobes of the lungs were thickened diffusely with fibrosis, edema, and inflammatory cell infiltration. Alveolar cavities contained hyaline membrane and large mononuclear cells. Atypical bronchiolar epithelial proliferation and squamous metaplasia associated with squamous cell carcinoma were detected. The clinical and pathological characteristics among eight reported cases of lung cancer associated with sarcoidosis and three reported cases of interstitial pneumonia associated with sarcoidosis were reviewed separately. There is no report describing both lung cancer and chronic interstitial pneumonia associated with sarcoidosis.
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Aztreonam (AZT), a monobactam antibiotic, is known to have a high activity against Gram-negative bacteria. Fundamental and clinical studies were carried out on AZT with the following results. Following 1 g of bolus intravenous injection, the transfer of AZT to uterine artery and internal genital organs was found to be satisfactory. The levels of the drug in uterine artery showed 34.28, 4.50 micrograms/ml at approximately 2, 6 hours, and those in internal genital organs showed 3-34 micrograms/g at 2 hours. Clinical efficacy was; excellent in 4 cases, good in 13 cases and poor in 1 case, with the very high overall efficacy rate of 94.4%. Abnormal laboratory findings and side effects due to the drug were not noted.
Ceftizoxime (CZX) was used for 33 patients with respiratory tract infections; 22 patients with pneumonia, 3 patients with pulmonary abscess, 4 patients with diffuse panbronchiolitis and 4 patients with acute exacerbation of bronchiectasia. Clinical effects of CZX were evaluated in 33 patients; excellent in 16 and good in 14 patients. The efficacy rate was 91%. Bacteriological effects of CZX were prominent in 7 patients infected with S. pneumoniae, H. influenzae, K. pneumoniae and Citrobacter, but not in a patient infected with P. aeruginosa. The elimination rate was 92% (12/13). As the side effects, exanthema in 1 patient and gastrointestinal symptoms (nausea and vomiting) in 1 patient were observed. However, they improved without any treatment by cessation of CZX use. Abnormal laboratory findings were observed in 2 patients with elevated GOT and/or GPT. They normalized after cessation of drug. The usefulness of CZX was 82% (27/33). Therefore, CZX is a very useful drug and its effects are promising in clinical management of respiratory tract infections.
The clinical effect and utility of sfericase was compared with an inactive placebo by a double-blind method in three groups of a total 109 patients suffering from chronic respiratory diseases who had complained of difficult expectoration of sputum. A significantly greater improvement of expectoration was obtained in Group A-1 (6 tablets/day). Also in group A-1, more cases showed subjective and objective improvement, i.e., improvement in expectoration, reduction in coughs, decrease in the amount of sputum, and disappearance of râles. However, the sputum and its degree of purulency remained unchanged in most cases in all three groups. Side effects were few. The clinical efficacy of sfericase in the group with 2 tablets, 3X/day (total daily dose of 6 tablets) was shown to be significantly superior to the other two groups. This dosage was established as the optimal dose for treating difficulty in expectoration.
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Serum levels of complement components(cc), whole complement activity (CH 50), and circulating immune complexes (IC) were measured in 41 patients with neoplastic diseases. The level of cc was higher than in healthy controls; the levels of C1q, C1INA, C4, C3c, C3ACT, C5, and C9 were statistically higher. In patients with lung cancer, the levels of cc were correlated with the clinical stage as well as the performance status. Both the IC serum level and the incidence of high serum IC levels in lung cancer were higher in stage III and IV than in stage I and II. Serum CH 50 was higher than in healthy controls, but not correlated with the clinical stage.
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One hundred and eight patients with suspected ischemic heart disease were evaluated by exercise thallium-201 myocardial imaging (T1-IM), coronary arteriography and graded treadmill exercise test (GTX). They were divided into four groups; Group I consisted of 21 patients without significant coronary artery disease (less than 75% diameter stenosis), Group II of 47 patients with significant coronary artery disease (greater than or equal to 75% diameter stenosis) but without previous myocardial infarction, Group III of 24 patients who had previous myocardial infarction with additional coronary artery disease, and Group IV of 16 patients who had previous myocardial infarction without additional coronary artery disease. In Group I, T1-IM showed positive findings in only two patients (9.5%), whereas GTX showed positive findings in seven (33.3%) and borderline findings in four (19.0%). In Group II, T1-IM showed positive findings in 34 patients (74.5%), while GTX showed positive findings in 31 (66.0%) and borderline findings in 12 (25.5%). In Group II, the sensitivity of T1-IM and GTX for identifying severe stenosis (more than 99%) were 95.0% (19 of 20 patients) and 75.0% (15 of 20), respectively, but only 50.0% (four of eight) and 50.0% (four of eight), respectively, for identifying less severe stenosis (about 75%). In Group III, the sensitivity for detecting infarcted lesion by T1-IM was 95.8% (23 of 24 patients), but the sensitivity for detecting ischemic area in the non-infarcted lesion was 41.7% (10 of 24). In Group IV, a significant defect was detected by TI-IM, corresponding to the infarcted site in 14 of 16 patients (87.5%), and periinfarcted ischemia was shown in seven of the 14 patients (50.0%). In both Group III and IV, GTX was positive in only 50% and 31.3%, respectively. We conclude that T1-IM is a useful technique in the diagnosis of myocardial ischemia, especially severe coronary stenosis, and is more specific than GTX. However, we must be careful for evaluating ischemic, but not infarcted lesion by T1-IM in patients with myocardial infarction.