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Biomedical subjects

K Hidai

Publications and source records attributed to K Hidai.

7 recordsLinked to original sources
PubMed1990

Aggressive fibromatosis in the neck. A case treated effectively by testolactone with a long follow-up study.

Extra-abdominal fibromatosis in the neck may occasionally cause serious sequelae when aggressive invasion of the vital structures occurs. However, the principle of wide excision is difficult to apply in some patients because of the important organs surrounding the tumor. We report herein, a woman followed up for 22 years, in whom testolactone showed a definite effect during the course of observation. She first presented, at the age of 52, with a painful tumor in the neck, located behind the right thyroid lobe and fixed to the adjacent structures. Incomplete excision of the tumor was followed by a local recurrence accompanied with recurrent laryngeal nerve palsy and Horner's syndrome on the right side. Prednisolone was administered for 2 1/2 months and external irradiation of 8,000 RAD was given. Enlargement of the recurrent tumor stopped but 2 months later an emergency tracheostomy was required for an airway obstruction. Over the next 3 years, the local findings remained unchanged, but then a painful tumor growth reappeared cephalad which gradually attained a size of 5 cm in diameter, and was fixed to the base. Testolactone 150 to 200 mg was given to the patient daily for 2 months, resulting in marked regression of the tumor. During the last 13 years the patient has been well with the tumor still decreasing in size.

Combined Modality Therapy↗
PubMed1987

Serum bile acid profile in thyroid dysfunction and effect of medical treatment.

1. Serum non-esterified bile acid profile was examined in patients with thyroid dysfunction. Sixteen hyperthyroid patients, six hypothyroid patients, nine patients taking thyroid or antithyroid drugs and 26 healthy controls were studied. The medicated patients were euthyroid when serum samples were collected. Bile acid concentration was determined by the simplified microassay method involving mass fragmentation spectrometry. 2. The sum of the concentrations of the individual bile acids was not significantly different among the four groups. However, the composition of bile acid reflected the thyroid function. The most prominent bile acid was deoxycholic acid in the hypothyroid patients and chenodeoxycholic acid in the hyperthyroid patients. The serum bile acid profile of medically treated patients was similar to that of normal controls. The ratio of the sum of deoxycholic and cholic acid to that of lithocholic and chenodeoxycholic acid was found to be a good indicator of thyroid function, while the ratio of cholic acid to chenodeoxycholic acid correlated poorly with it. 3. The characteristic effect of thyroid hormone on the serum bile acid composition in man was the shift from the 'family' of cholic acid to that of chenodeoxycholic acid. This is in agreement with experimental results in the rat, and suggests a specific action of thyroid hormone on the hydroxylating enzymes involved in the conversion of cholesterol into bile acids.

Adolescent↗
PubMed1986

Justification of conservative surgical treatment of childhood thyroid cancer: report of eleven cases and analysis of Japanese literature.

Eleven thyroid carcinoma patients of 15 years old and under are reported. They represent only 1.3% of our personal series of 861 thyroid carcinoma cases. One case died from undifferentiated carcinoma of the thyroid. However, the other 10 cases of papillary or follicular carcinoma are all alive, in spite of the apparently advanced stage of the disease at the time of operation in most of the cases. From our experience and analysis of 127 cases of childhood thyroid cancer reported in the Japanese literature, it is suggested that childhood thyroid cancer constitutes an extreme case of thyroid cancer occurring in the adolescent and young adult periods, and that rather conservative surgical treatment, avoiding total laryngectomy, and preserving the recurrent laryngeal nerve and the parathyroid glands as far as possible, usually suffices for treatment. In these Japanese cases, radiation did not appear to have been an important causative factor of childhood thyroid cancer.

Adenocarcinoma↗
PubMed1980

Effects of splenectomy on blood coagulation and fibrinolysis in patients with liver cirrhosis: possible role of the spleen in haemostasis.

Blood coagulation and fibrinolysis before and after splenectomy was studied in 74 cases of liver cirrhosis. A hypocoagulable state was found before splenectomy, but the platelet count, and the levels of fibrinogen, plasminogen, alpha 2-macroglobulin and antithrombin III increased significantly after splenectomy (p less than 0.05 to p less than 0.001). A marked improvement was observed on the values of r (reaction time), k (clot formation time) and ma (maximal amplitude) of thrombelastograms (p less than 0.05 to p less than 0.001). The prothrombin time was reduced after the surgery, but not significantly (p less than 0.1, greater than 0.05). The levels of alpha 1-antitrypsin remained almost unchanged, while serum fibrinogen-fibrin degradation products (FDP) showed a slight decrease postoperatively. The immunohistologic study of the spleen excised from 7 cases with liver cirrhosis, with the use of the direct immunofluorescence technique, demonstrated the deposits of fibrin in the splenic cords in all cases. It was not recognized in the spleens of 4 cases without cirrhosis used as the control. A further study of the spleen weight and plasma fibrinogen level showed that a significant inverse correlation exists between these two parameters (p less than 0.01). These findings suggest that localized intravascular coagulation (LIC) occurs in the enlarged spleen associated with liver cirrhosis.

Adult↗
PubMed1980

Parathyroid adenoma found by vertebral vein sampling.

We report on a 33-year-old man with hypercalcemia and recurrent nephrolithiasis, who underwent the first neck exploration for primary hyperparathyroidism on September 27, 1973. No tumor was found and bilateral upper normal parathyroid glands were removed. However, hypercalcemia persisted postoperatively. Selective venous sampling for radioimmunoassay of parathyroid hormone 5 years later revealed a sharp unilateral gradient in the right vertebral vein. On November 2, 1978 the second neck exploration was performed and a right lower parathyroid adenoma was removed from the right lateral wall of the esophagus. Postoperatively, the serum calcium level decreased to 8.8 to 9.3 mg./dl. and convalescence was uneventful. In this case the pathway of parathyroid venous effluent might have been changed by the previous neck exploration and probably drained anomalously through the vertrbral vein. Selective venous sampling for radioimmunoassay of parathyroid hormone should include samplings from the vertebral veins as well as the thyroid veins, especially in cases with 1 or more previous neck explorations.

Adenoma↗