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PubMed1990

[The characters of AFP-producing early gastric cancer].

During the last decade, we have experienced 525 cases of gastric cancer. Within these, 195 were early gastric cancer (37.1%). Five and eight year survival rates were 86.9 and 77.2%. There were seven cases of recurrence, all of which were liver metastasis of submucosal cancers. Two combined with pulmonary metastasis. Three of the recurrent cases had serum AFP raised (greater than 20ng/ml) before or after partial gastrectomy. When these gastric specimens were reviewed, AFP positive cells were stained by PAP method. Compared with the AFP negative group of 168 early gastric cancers, invasion of lymphatic and venous vessels of the stomach and incidence of the liver metastasis were significantly higher in the stained group. 1.3 and 4.5 year survival rates of the cases (including ours) of AFP producing early gastric cancer, which had been reported in Japanese literatures, were 76.1, 45.7 and 22.9%, respectively. Liver metastasis was found in 7 of 12 cases (58.3%). It is clear that AFP producing early gastric cancer has the same tendency for liver metastasis as the AFP producing advance gastric cancer does. To prevent its recurrence, early diagnosis by PAP method for specimens with hepatic picture and aggressive adjuvant chemotherapy are mandatory.

Aged↗
PubMed1987

Endolymphatic sac surgery for Menière's disease: eighteen years' experience with the Kitahara sac operation.

From 1968 to 1983, 162 cases of Meniere's disease were treated surgically with our intramastoid drainage technique. One hundred forty of these cases could be followed up for two years or more. Treatment results were calculated according to the 1972 AAOO criteria and the 1985 AAO-HNS criteria. Using our technique, definitive vertigo spells could be controlled completely in 78% of cases and substantially controlled in 94%. Hearing worsened in only 15% of all cases. Therefore, prevention of worsening of hearing, especially in bilateral cases, and control of vertigo spells in patients with frequent attacks were considered absolute indications for our technique. In this study critical observations were made based on the number of cases hitherto reported by surgeons (the average number of patients undergoing surgery in our clinic was fourteen per year). The need for careful selection of patients for surgery is emphasized.

Adult↗
PubMed1994

Expression, functional analysis, and in situ hybridization of a cloned rat kidney collecting duct water channel.

The cloning and expression of an apical membrane water channel from rat kidney collecting duct (WCH-CD) homologous to a 28-kDa integral membrane protein (CHIP28) was reported recently (K. Fushimi, S. Uchida, Y. Hara, Y. Hirata, F. Marumo, and S. Sasaki. Nature Lond. 361: 549-552, 1993). We obtained an approximately 1.8-kilobase clone from a rat kidney lambda gt10 cDNA library by a polymerase chain reaction cloning method; whereas the coding sequence (814 base pairs, predicted protein size 29 kDa) was identical to that reported, we identified an in-frame ATG codon at base pair -123 predicting a protein size of 33 kDa. On Northern blots probed by cDNAs corresponding to the WCH-CD coding sequence (base pairs +1 to +814) or 5'-untranslated sequence (-403 to -16), a single band at 1.9 kilobases was observed in kidney medulla greater than in cortex but not in other tissues; mRNA expression was increased strongly by dehydration. Translation and oocyte expression studies were performed to identify the translation start site. The short (base pairs +1 to +814) and long (base pairs -123 to +814) cDNAs were subcloned in vector pSP64 containing the 5'-untranslated Xenopus globin sequence upstream to the ATGs; a 30-base pair c-myc sequence was engineered at the COOH- terminal for antibody recognition.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2005

Usefulness of the 3-dimensionally reconstructed computed tomography imaging for diagnosis of the site of tracheal injury (3D-tracheography).

Computed tomography (CT) has not been considered useful for early diagnosis of traumatized patients who could hardly hold their breath, particularly patients with tracheal injuries. However, the recent development of spiral CT has made it possible to acquire contiguous patient data, which eliminates the respiratory misregistration. Air is easily differentiated from surrounding tissues by striking contrast, and the trachea can therefore be well displayed by three-dimensional (3D)-CT. We consider that it is possible to show tracheal injury by 3D-CT. The aim of this study is to clarify the usefulness of 3D-CT for detecting the injury site of blunt tracheal injuries. The study was carried out in hemodynamically stable patients who were suspected of having tracheal injury based on clinical manifestations such as hemoptysis, or cervical subcutaneous, deep cervical, or mediastinal emphysema. Repeated bronchoscopy confirmed tracheal injury. The virtual images of the 3D-CT (3D-tracheography) were compared with the direct images of bronchoscopic findings. Five cases were examined. In patients with tracheal injury, bronchoscopy revealed laceration of the tracheal lumen or disruption and dislocation of the tracheal cartilage, partially coated by mucus and clot, findings that confirmed the diagnosis of tracheal injury. The virtual images of the 3D-tracheography clearly showed the injury as a defect in the tracheal wall or a depression in the wall. The site and size of injury shown in the 3D-tracheography were comparable with those detected by bronchoscopy. We succeeded in detecting tracheal injuries by 3D-CT imaging, the virtual images of which were comparable with the bronchoscopic findings. 3D-tracheography is a useful method for diagnosing the site and form of tracheal injury in hemodynamically stable patients.

Adult↗
PubMed1995

Angiogenic therapy of acute myocardial infarction by intrapericardial injection of basic fibroblast growth factor and heparin sulfate: an experimental study.

To examine whether angiogenesis and myocardial salvage occur, 30 micrograms basic fibroblast growth factor (bFGF) and 3 mg heparin sulfate (HS) were injected through the right atrium into the pericardial cavity by a thin needle-tipped catheter in a canine model of acute myocardial infarction. One month later infarcted weight/left ventricle weight was 24% +/- 5.2%, 25% +/- 4.0%, 18% +/- 2.4%, and 10% +/- 1.8% (mean + SE) in saline solution, HS, bFGF alone, and bFGF plus HS groups, respectively. Vascular number in the infarcted area of the outer layer was 13 +/- 3.3, 20 +/- 2.2, 47 +/- 8.3, and 136 +/- 26.3/200 x 200 microns2 in saline solution, HS, bFGF alone, and bFGF plus HS groups, respectively. Thus the vascular number was the largest in the bFGF plus HS group. The vascular number was larger in the subepicardial than in the subendocardial infarcted areas. Vessels directed from the epicardium toward the subepicardial infarcted area were also observed. The transcatheter intrapericardial injection of bFGF plus HS caused angiogenesis and myocardial salvage. This method might bring about a selective therapeutic and preventive modality of myocardial infarction irrespective of coronary anatomy and contraindications for coronary interventions and surgery.

Animals↗
PubMedDate not supplied

Clinical and experimental observation of glistening in acrylic intraocular lenses.

PURPOSE: To determine whether or not glistening particles in implanted acrylic intraocular lenses (IOL) increase with the passage of time. METHODS: Prospective clinical study: Glistenings were evaluated in 31 patients (49 eyes) with implanted acrylic IOL, the emphasis being on when glistening first became evident and subsequent changes in the number of glistening particles. EXPERIMENT: IOLs were monitored for any changes that occurred with the passage of time as they were immersed first in a 50 degrees C saline solution and then in another saline solution with a temperature of 35 degrees C. RESULTS: Prospective clinical study: Glistening phenomenon was observed in 28 IOLs (57%) 2 to 16 months after implantation (mean = 6.6 months). Glistenings reached their peak in number within a few months of formation in all cases, showing no further increase thereafter. EXPERIMENT: Glistening particles first appeared on the 10th day of the experiment in sizes ranging from 3 to 10 microm in diameter. They remained at the same level for the next 60 days without showing any increase. CONCLUSIONS: Glistening formation in acrylic IOLs was found to stabilize within a few months after appearance. The method of our experiment proved reliable in producing, in a relatively short period of time, glistening similar to that found in patients.

Acrylic Resins↗
PubMed2000

Telomerase activity of needle-biopsied liver samples: its usefulness for diagnosis and judgement of efficacy of treatment of small hepatocellular carcinoma.

BACKGROUND/AIMS: High values for telomerase activity in malignant tumors have been reported. The clinical usefulness of measurements of telomerase activity as a diagnostic tool and to evaluate treatment efficacy in small hepatocellular carcinoma was investigated. METHODS: We investigated 22 patients (26 nodules) with intrahepatic abnormal nodules < or =20 mm in size determined by abdominal ultrasound. All underwent needle biopsies of tumorous nodules and extranodular regions of the liver by ultrasound guidance for histopathological diagnosis and measurement of telomerase activity by the fluorescence-based telomeric repeat amplification protocol. Re-biopsy of the same nodule was performed 1 week after percutaneous ethanol injection therapy to measure telomerase activity in 10 patients (10 nodules) found to have hepatocellular carcinoma. Liver-biopsied samples from 30 patients with chronic hepatitis C were used as a control. RESULTS: Telomerase activity increased with statistical significance stepwise: chronic hepatitis (n=30, mean: 0.00 U) extranodular regions (pre-cirrhosis or cirrhosis, n=22, mean: 1.80 U), atypical hyperplasia (borderline or premalignant lesions, n= 15, mean: 7.02 U) and low-grade malignant hepatocellular carcinoma (n=11, mean: 31.96 U) (p<0.0001 by the Kruskal-Wallis test). Percutaneous ethanol injection therapy resulted in loss (0.00 U) of telomerase activity in 9 nodules and persistence in 1 nodule. CONCLUSIONS: Measurement of telomerase activity appeared useful for diagnosis of intrahepatic abnormal nodules and assessment of the efficacy of percutaneous ethanol injection therapy and may be used as an alternative diagnostic method, especially when pathohistological discrimination between atypical hyperplasia and well-differentiated hepatocellular carcinoma is difficult.

Aged↗
PubMed1992

Usefulness of the hypo-osmotic swelling test for evaluation of human sperm fertilization.

We examined spermatozoa from 135 male patients consulting for infertility to evaluate the usefulness of the hypo-osmotic swelling (HOS) test of sperm fertility for the swim-up washing method. HOS test values significantly improved following the treatment of spermatozoa using the swim-up washing method. There were no differences in the rate of sperm motility between the normal group and the oligozoospermic group following treatment, but the HOS test identified significant differences in swelling rates in both groups before and after treatment. The results of the HOS test following swim-up washing were higher during fertilization attempts for 11 cases of successful intra-uterine insemination (IUI) than during unsuccessful IUI attempts; there were no significant differences between the control group and the successful IUI cases. Moreover, using the lower-normal limits for overall sperm swelling (52%) and g-type sperm swelling (30%) obtained from a normal control group, we found that swelling rates were higher when IUI was successful. These findings indicate that the HOS test is an effective measure of sperm fertilizing function when the swim-up washing method is used for sperm treatment. The score of g-type sperm swelling can be used as a substitute for overall sperm swelling.

Humans↗
PubMedDate not supplied

Clinical application of vascular closure staple clips for blood access surgery.

We investigated the usefulness of nonpenetrating titanium vascular closure staple (VCS) clips developed for anastomosis of peripheral blood vessels. VCS clip applier systems (Autosuture; United States Surgical Corporation, Norwalk, CT) were used for 10 patients on hemodialysis who needed peripheral vascular anastomoses for blood access. Two arteriovenous (AV) fistulas, one closure of a fistula with reconstruction of the radial artery, six vascular graft implantations, and one vascular graft closure were performed. Medium clips were used for AV fistulas and large clips for vascular graft implantation. It took 12 min, on average, for vascular access graft anastomoses and 8.5 min, on average, for the AV fistulas. In two patients, bleeding from the anastomosed site occurred after declamping and additional sutures were required; however, neither hematoma nor wound infection occurred at 9 to 12 months after surgery. In one patient, stenosis of the graft-venous junction was found and was successfully treated by percutaneous transluminal angioplasty. The VCS clip applier is easy to manipulate, is as safe as hand-suture methods, and has time saving potential. We conclude that these VCS clips are useful for vascular anastomoses of blood access.

Anastomosis, Surgical↗
PubMed1995

[The squash technique for silver staining of argyrophilic nucleolar organizer regions on bladder tumors: comparison with paraffin embedded sections].

We examined nucleolar organizer region (NOR) indices on 13 bladder tumors on both squash-prepared specimens and paraffin embedded specimens stained by silver-colloid method. It was noted that; 1. The nuclear size was enlarged by squashing, 2. Aggregated NOR dots were dispersed, 3. Uniformity of microscopic phase of the dots was obtained, 4. Squash specimens had more precise countabilities than the paraffin embedded sections for avoidance of nuclear resection. NOR indices (mean +/- S.D.) of those bladder tumors on squash-preparation and paraffin section were 8.64 +/- 4.32 and 6.13 +/- 1.58, respectively, and the former showed good correlation with the tumor stage. When we prepare the squashed specimen from the surgically resected bladder tumor tissue, embedding and sectioning processes which are inevitable for preparation of paraffin embedded section, could be eliminated. Thus, squash-smear technique was considered to be better than the method using paraffin embedded section on the point of shorter duration of examination and accurate countability of the NOR dots.

Aged↗
PubMed1999

Intraoperative extracorporeal autogenous irradiated bone grafts in tumor surgery.

There are several procedures for reconstruction of bony defects after resection of malignant musculoskeletal tumors. The clinical results of intraoperative extracorporeal autogenous irradiated bone grafts in 20 patients with musculoskeletal tumors are discussed. The authors' method of treatment consists of: (1) wide en bloc resection of the tumor with involved bone; (2) curettage of the tumor from the resected bone; (3) extracorporeal irradiation with 50 Gy as a bolus single dose to the isolated bone; and (4) reimplantation of the irradiated bone into the host with fixation devices. Twelve bone sarcomas and eight soft tissue sarcomas with bone involvement were treated surgically with this reconstruction method after wide resection of the tumors. The irradiated bone was used as an intercalary graft in seven cases, as an osteoarticular graft in 11 cases, and as a hemicortical graft in two cases. The theoretical advantages of this method are certain sterilization of tumor cells with radiation, easy availability and good adaptation of size and shape, no risk of disease transmission, preservation of bone stock and ligamentous tissue, and no immunologic reaction. Radiologically, bony union occurred in 23 of 29 (79%) osteotomy sites. The overall radiographic evaluation rating was 74% and the functional rating was 73% according to the International Society of Limb Salvage rating system. Nonunion (20%) and infection (15%) were the two major complications. Preservation of the tendon insertions and ligamentous structures of the irradiated bone seemed to restore excellent joint function. No local recurrence was detected from the irradiated bones during the mean followup of 45 months. These results indicate intraoperative extracorporeal irradiated bone graft can be a widely applicable method for reconstruction in tumor surgery.

Adolescent↗
PubMed1995

[Endoscopic lithotomy using sublingual nitroglycerin].

After medical sphincter dilation using sud-lingual nitroglycerin, endoscopic removal of common bile duct stones in 15 patients was carried out. Complete stone removal was obtained in 14 of 15 patients. Only 0.3 mg to 0.6 mg nitroglycerin was needed to give an enough dilation of the orifice for cannulating the basket catheter into the bile duct. Mechanical lithotriptor was smoothly cannulated in one patient because of possible impaction. Blood pressure was dropped transiently in one patient by nitroglycerin, however, the general condition of the patient was stable. This procedure is safe, easy and effective in preserving sphincter function. Acute cholecystitis, a common complication of persistent gallbladder stone after endoscopic sphincterotomy, may be avoided by employing this method. More clinical studies, on long term and in a large scale of patients, are necessary to reduce complications that usually occur after sphincterotomy.

Female↗
PubMed1978

Synthesis and antitumor activity of preactivated isophosphamide analogues bearing modified alkylating functionalities.

In search of cancer chemotherapeutic agents with greater efficacy than cyclophosphamide, 4-hydroperoxyisophosphamide analogues bearing modified alkylating functionalities such as 2-bromoethyl, 2-iodoethyl, 2-methyl-sulfonyloxyethyl, and 2-ethylsulfonyloxyethyl groups were prepared by ozonolytic cyclization reaction of N,N'-substituted 3-butenyl phosphorodiamidates. Comparative cytotoxicity against L1210 cells and antileukemic life-span activity against L1210 implanted BDF1 mice of the newly synthesized compounds were tabulated. The 4-hydroperoxyisophosphamide analogues which have different alkylating groups in a molecule showed slightly greater cytoxicity in vitro than those with the same alkylating groups. Most of the compounds having different alkylating groups also showed high antileukemic activity in vivo. Among them, the highest efficacy was found for 2-[N-methyl-n-(2-chlorethyl)]amino-3-(2-methylsulfonyloxyethyl)-4-hydroperoxy-1,3,2-oxazaphosphorinane 2-xoide (NSC 280122D) whos life-span activity was also greater than that of 4-hydroperoxyisophosphamide, cyclophosphamide, and isoposphamide. The superiority of this compound was especially apparent by oral administration.

Alkylating Agents↗
PubMed1981

Seroepidemiologic studies of acute hemorrhagic conjunctivitis virus (enterovirus type 70) in West Africa. II. Studies with human sera collected in West African countries other than Ghana.

Human sera were collected in Senegal, Nigeria, Ivory Coast, Dahomey, Liberia, Gabon and Togo during the pre-epidemic period of acute hemorrhagic conjunctivitis (AHC) from 1965 to 1969, and tested for virus neutralizing (VN) antibody to enterovirus type 70 (EV70). Of these, 1109 (91%) were antibody negative (less than equal to 1:4), 116 (9%) neutralized at a dilution of 1:8 or over, and 45 (4%) at dilutions of at least 1:16. The distribution pattern is not significantly different from that of sera collected from Kenya in 1967 or from army recruits in the United States, Argentina, Brazil and Colombia in the 1960s. Sera collected during the post-epidemic period (1970 to 1977) in Senegal, Sierra Leone, Mali, Upper Volta, Chad, Niger and Gabon were also examined; 1573 (68%) were VN antibody negative (less than or equal to 1:4), while 733 (32%) and 433 (19%) had titers of 1:8 or greater and 1:16 or over, respectively. There is a significant difference in distribution between pre- and post-epidemic antibody titers (p less than 0.001), although the incidence of AHC was lower in these countries than in Ghana and Southeast Asia. The prevalence of VN antibodies tends to be lower in the dry, hot inland areas and thus humid coastal monsoonal climates and dense populations seem to favor the spread of AHC.

Adolescent↗
PubMed1984

Subtotal versus total parathyroidectomy with forearm autograft for secondary hyperparathyroidism in chronic renal failure.

Forty-three patients with chronic renal failure and secondary hyperparathyroidism underwent parathyroidectomy; 20 of the 43 underwent subtotal parathyroidectomy (Group A) and 23 patients underwent total parathyroidectomy and parathyroid autotransplant in the forearm (Group B). Postoperative clinical improvement was similar in both groups. In the immediate postoperative period eight patients in Group A who had severe bone changes and 21 patients in Group B needed supplemental calcium administration. The grafted tissues in all cases functioned well; reimplantation of the cryopreserved parathyroid tissues was unnecessary. One case in each group showed a recurrence. One patient in Group A was submitted to reexploration of the neck with a lateral approach. The other patient in Group B underwent excisions of the transplanted parathyroid tissues on three separate occasions under local anesthesia. The second operation was definitely easier and safer to manage after a total parathyroidectomy with autotransplantation to the forearm.

Adult↗