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Biomedical subjects

K Fujiyoshi

Publications and source records attributed to K Fujiyoshi.

17 recordsLinked to original sources
PubMed1998

Neoadjuvant intraarterial chemotherapy followed by radical hysterectomy and/or radiotherapy for locally advanced cervical cancer.

OBJECTIVES: We assessed neoadjuvant intraarterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. METHODS: Over 5 years, 48 consecutive women with International Federation of Gynecology and Obstetrics stage IIb-IVa cervical cancer were enrolled. Treatment consisted of bilateral internal iliac artery infusion of cisplatin (100 mg/m2, day 1) or carboplatin (400 mg/m2, day 1) and peplomycin (20 mg/m2, day 1) for two courses separated by 3 weeks. Doxorubicin (30 mg/m2, day 1) was added for patients with adenocarcinoma. Stage III patients who responded to NAC and Stage IIb patients underwent radical hysterectomy with pelvic lymphadenectomy. Stage III patients not responding to NAC and all stage IVa patients were treated with pelvic radiotherapy. RESULTS: Complete response was achieved in 5 (10.4%) of 48 patients, while a partial response was noted in 32 (66. 7%) and stable disease in 11 (22.9%). Of 25 patients with stage IIIb disease, 16 (64.0%) were able to undergo surgery. The 4-year disease-free survival (DFS) was 80.0% in patients with stage IIb and 62.3% in patients with stage III. In stage IIIb, the 4-year DFS in patients receiving surgery (75.2%) was higher than the DFS for those receiving radiotherapy (44.4%) (P < 0.05). Grade 3 or 4 leukopenia developed in 17 (35.4%) patients. Nausea and vomiting of grade 2 or higher occurred in 34 (70.8%). Creatinine clearance transiently decreased (>/= grade 2) in 16.6%. Patients negative for serum squamous cell carcinoma-associated antigen (SCC) responded better to NAC than to SCC-positive cases, and SCC-negative survival was significantly better than SCC-positive survival (P < 0.05). CONCLUSIONS: Neoadjuvant intraarterial chemotherapy with platinum was safely performed, and a survival benefit followed radical surgery with or without radiotherapy after response to NAC.

Adult↗
PubMed1997

Working pressure for full balloon inflation during intraaortic balloon pumping.

With changes in heart rate and mean aortic pressure, an intraaortic balloon (IAB) works with incomplete inflation. The effects of initial peak positive pressure and plateau holding positive pressure on IAB volume were investigated and minimum pressures necessary to inflate an IAB to a desired volume were established with a standard IAB catheter (Datascope type, 9.5 Fr, 40 ml). Initial peak pressure greater than 200 mm Hg was adequate to attain the desired volume of the IAB. Plateau positive pressure should be altered in accordance with hemodynamic changes.

Analysis of Variance↗
PubMed1997

Adenoma malignum: MR imaging and pathologic study.

PURPOSE: To evaluate the clinical, pathologic, and magnetic resonance (MR) imaging findings in adenoma malignum, a rare variant of uterine cervical adenocarcinoma. MATERIALS AND METHODS: Medical records of all patients (n = 7) with adenoma malignum of the uterine cervix diagnosed pathologically between 1988 and 1996 were retrospectively reviewed. Unenhanced T1-weighted and T2-weighted images and gadolinium-enhanced T1-weighted MR images were evaluated, and findings were correlated with gross pathologic and microscopic features. RESULTS: In five of seven patients, enlargement of the cervix was seen. All lesions were detected as multiple cystic lesions that extended from the endocervical gland to the deep stroma of the cervix. They appeared isointense (n = 5) or slightly hyperintense (n = 2) relative to the uterus on T1-weighted images and markedly hyperintense relative to the uterus on T2-weighted images. Solid portions of variable size were seen between cystic lesions, and both the multiple cystic component and the solid portion were most apparent on the gadolinium-enhanced T1-weighted images. Microscopic parametrial invasion was seen in two patients but was not detected at MR imaging. CONCLUSION: Adenoma malignum was depicted on MR images as a multicystic mass with solid portions located in the deep cervical stroma. Gadolinium enhancement helped identify the solid portion of the tumor.

Adenocarcinoma↗
PubMed1996

Changes of intraaortic balloon volume during pumping in a mock circulation system.

The effects of hemodynamic changes on intraaortic balloon (IAB) volumes were studied experimentally using a helium tachometer in a mock circulatory system. The IAB volume decreased with increases in the heart rate and mean aortic pressure, but the degree of reduction in the IAB volume was different among 4 commercially available IAB drivers. Improvements in IAB consoles are needed to compliment the progress made in percutaneous techniques for IAB insertion resulting in smaller balloons.

Arrhythmias, Cardiac↗
PubMed1996

Optimal control algorithm for pneumatic ventricular assist devices: its application to automatic control and monitoring of ventricular assist devices.

We developed a control and monitoring unit for pneumatic ventricular assist devices (VADs), which provides optimal fill and empty control and real-time evaluation of pump performance. The flow signal of the inflow cannula is integrated every beat to yield pump filling volume per pump diastole. The ejection signal is triggered when pump filling reaches a preset level. The instantaneous mean flow of each beat (stroke volume/cycle length) is compared with the previous beat, and the threshold level is readjusted to optimize flow. This feedback loop is repeated every beat, and pump filling is immediately adjusted to yield maximum pump flow. Simultaneously the mean flow of every 10 beats is compared with that of the previous 10 beats; then, the ejection time is readjusted to optimize flow. Initial clinical application of this unit supports its effectiveness and reliability.

Aged↗
PubMed1996

[A case of aortic dissection associated with congenital bicuspid aortic valve].

It is known that bicuspid aortic valve with dilatation of the ascending aorta is one of risk factors of the aortic dissection. A case of acute aortic dissection (DeBakey type-II) associated with bicuspid aortic valve who underwent successfully operation 8 hours after onset is reported. This patient went into cardiogenic shock because of cardiac tamponade and aortic valve regurgitation immediately after onset. Aortic valve and the ascending aorta were replaced using composite graft (#23 SJM prosthetic aortic valve and 26 mm woven Dacron vascular graft) combined with coronary artery reconstruction by Cabrol's technique. Aortic valve showed bicuspid and histological examination revealed cystic medionecrosis and loss of elastic fiber. Postoperative course was uneventful and this patients is doing well 3 years after the operation.

Acute Disease↗
PubMed1995

Detection of lymph node metastasis in ovarian carcinoma and uterine corpus carcinoma by preoperative computerized tomography or magnetic resonance imaging.

OBJECTIVE: Preoperative CT or MRI findings were compared with the results of staging the laparotomy to evaluate the accuracy of CT or MRI for detecting pelvic and para-aortic lymph-node metastases. METHODS: In evaluating CTs in 95 ovarian carcinomas, we examined plain and contrast images made in 1- to 1.5-cm-thick slices from the pubis to the xiphoid process. Lymph nodes 1.5 cm or larger were considered to be positive. MRIs of 60 uterine corpus carcinomas utilized T1-weighted contrast, T2-weighted, and short-inversion time inversion-recovery (STIR) images. RESULTS: CT had a sensitivity of 60.9% and a specificity of 93.1%. The positive and negative predictive values were 73.7% and 88.2%, respectively. The diagnostic accuracy of CT for detecting para-aortic lymph-node metastases exceeded that for pelvic node metastases. The results of MRI indicated that the T1-weighted image and STIR image were the most accurate in identifying metastatic nodes. CONCLUSIONS: These results indicate that the most practical approach might be to search for enlarged lymph nodes by CT, and to follow-up with MRI when CT scans are questionable.

Carcinoma↗
PubMed1993

[Angiotropic lymphoma presenting with subacute dementia: treatment with combination chemotherapy (CHOP) based on antemortem diagnosis--a case report].

We report a 64-year-old male with angiotropic lymphoma. He developed subacute dementia with right hemiparesis. Laboratory abnormalities included elevated serum lactic dehydrogenase (LDH) (715 U/l) erythrocyte sedimentation rate (38 mm/hr) and CSF protein (90 mg/dl). Precontrast MR imaging of the brain demonstrated lesions involving the left internal capsule, subcortical white matter in the right frontal lobe and splenium within the atrophic corpus callosum. A brain biopsy revealed intravascular lymphoid cells, strongly suggestive of angiotropic lymphoma. By combination chemotherapy (CHOP), serum LDH and CSF protein normalized through the patient remained demented. He died of bronchopneumonia about 2 years and 5 months after the onset. Coronal sections of the brain showed infarct in the left internal capsule as well as markedly thin corpus callosum with necrotic lesions involving both the genu and splenium. Microscopic examination showed many small vessels occluded by lymphoma cells (B-lymphocyte) predominantly in the corpus callosum, cerebral white matter, thalamus, midbrain, medulla oblongata, thoracic and lumbar segments of the spinal cord. By combination chemotherapy, our patient survived longer than most of previous patients with angiotropic lymphoma. An early diagnosis and subsequent combination chemotherapy may improve neurological manifestations, and make possible longer survival in angiotropic lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Periventricular spread of malignant lymphoma: report of two cases.

Two cases of intracranial malignant lymphoma with an atypical feature on CT scan are reported. Both patients presented subacute progressive dementia. CT scan showed high density lesion extending all the way along the ventricular wall, which was homogeneously enhanced and resembled severe ventriculitis. Differential diagnosis on CT scan is discussed.

Aged↗
PubMed1987

Reduction of arginine-vasopressin in the cerebral cortex in Alzheimer type senile dementia.

Arginine-vasopressin (AVP) concentrations in five cortical areas were measured post mortem in nine patients with senile dementia of Alzheimer's type (SDAT), and compared with the control group of comparable ages. In SDAT patients, AVP was significantly reduced in Brodmann areas 4, 7 and 10 (p less than 0.05). In areas 17 and 22, the detectability and the mean concentrations of AVP were also lower than those of control patients, although not significantly.

Aged↗
PubMed1984

Neurotransmitters in dementia.

Changes in the activity of neurotransmitters in dementia were studied by measuring the activities of each of choline acetyltransferase (CAT), dopamine-beta-hydroxylase (DBH) and hydroxylase cofactor (tetrahydrobiopterine; BPH4), and the concentrations of homovanillic acid (HVA) and vasopressin. CAT activity was low in the cerebral cortex of patients with senile dementia of Alzheimer's type (SDAT). The CAT activity was high in the nucleus basalis, which correlated well with the CAT activity in the cerebral cortex, Brodmann areas 22 and 17. DBH activity was lower in the cerebrospinal fluid (CSF) of SDAT and multi-infarct dementia (MID) patients than in that of control subjects. No age-related change was observed in control subjects. Serum DBH activity was decreased in patients with SDAT but not in patients with MID. DBH activity was especially low in the serum of SDAT patients with a low dementia rating score and/or severe brain atrophy shown on computed tomography (CT) scan. Serum DBH activity was also decreased in older normal subjects (greater than or equal to 80 years). The concentration of HVA in the CSF of control subjects decreased with the advance of age, but the decrease in HVA concentration was more pronounced in the CSF of SDAT patients, which would reflect the lowered dopaminergic activity in SDAT. BPH4 activity was also decreased in the CSF of SDAT patients. Arginine-vasopressin was widely demonstrated in the cerebral cortex of control subjects but could not be detected in many areas of the cerebral cortices of demented patients. These results suggest that a deficit of dopamine, noradrenaline or vasopressin as well as acetylcholine may occur in the brain of SDAT patients. The evidence presented points toward areas for consideration in the search for methods of therapy or prevention of SDAT.

Adult↗