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Biomedical subjects

K Tokiwa

Publications and source records attributed to K Tokiwa.

At least 73 records · Page 4Linked to original sources
PubMed1989

Nuclear magnetic resonance computerised tomography (NMR-CT) in early diagnosis of dumbbell neuroblastoma.

This is a report on a dumbbell neuroblastoma with intraspinal extension first noted by 99mTc-HMDP imaging and CT, and confirmed by NMR-CT before the symptoms of spinal cord compression become clear. Paravertebral neuroblastoma and its intraspinal involvement were successfully excised following laminectomy and abdominal surgery without any residual neurologic complications. We report this case to emphasise that NMR-CT was particularly useful to diagnose the extent of intraspinal portion of the tumour, and should be performed in any patient who presents with neuroblastoma adjacent to the vertebral body.

Humans↗
PubMed1989

[Treatment of lymphangiomas arising around cervico-facial region: surgery, bleomycin therapy and OK-432 therapy].

To determine a favorable treatment for lymphangiomas arising around cervico-facial region, a 10-year (1979, 1-1988, 9) experience with 58 these lesions were reviewed. Therapeutic records were divided into 3 groups according to the treatment: surgical Excision (n = 16), intralesional Bleomycin (BLM) therapy (n = 11), and intralesional OK-432 Picibanil therapy (n = 31). Complete disappearance of the lesions without serious complications was noted in 3 of 16 patients treated by surgery, in 3 of 11 patients treated by BLM therapy, and in 21 of 31 patients treated by OK-432 therapy. Serious complications such as facial nerve palsy (3), ugly scars due to repeated excision (5) and short of tongue (1) were noted in surgically treated group. In BLM and OK-432 therapy groups, only a fever of 2 to 3 days' duration and local inflammatory reaction of 3 to 5 days were noted. The results suggest that OK-432 therapy is effective for these lesions.

Biological Products↗
PubMed1989

[Clinical significance of intracranial hemorrhage caused by cerebral arteriovenous malformations: with special reference to intraventricular hemorrhage].

Forty-two cases with intracranial hemorrhage caused by cerebral arteriovenous malformation (AVM), which was diagnosed by CT scan, were reviewed with regard to the clinical significance of intracranial hemorrhage, especially intraventricular hemorrhage (IVH). Twenty-one patients were defined as poor risk cases whose level of consciousness at admission was 100 to 300 according to the Japan Coma Scale, whereas the remaining 21 patients were defined as good risk cases. Surgical excision of AVM was undertaken in 35 out of the 42 cases. Urgent surgical removal of intracerebral hematoma and AVM within 24 hours following onset was undertaken in 11 cases. In 14 patients, urgent continuous ventricular drainage was carried out. The effects of the following factors on the level of consciousness at admission, and on the result of AVM treatment were investigated to clarify the clinical significance of intracranial hemorrhage; 1) cast formation of 3rd and/or 4th ventricle, 2) volume of intraventricular hematoma, 3) accompanying intracerebral hematoma and 4) acute hydrocephalus. It was confirmed that all these factors significantly contributed to the development of serious disturbance of consciousness in the acute stage following intracranial hemorrhage. For good risk cases, the rate of patients who showed a good recovery or only moderate disability according to the Glasgow Outcome Scale reached 91%, whereas for poor risk cases, it was only 43%. The presence of large intracerebral hematomas of more than 4 cm in diameter accompanied with IVH was significantly correlated with the result of AVM treatment. The presence or absence of cast formation of 3rd and/or 4th ventricle, volume of intraventricular hematoma and acute hydrocephalus were not significantly related to the result of AVM treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1988

Comparative studies between counterimmunoelectrophoresis and microprecipitation method of identification of human minute bloodstains.

A minute bloodstain on a thread 2 mm in length was tested to identify human origin by counterimmunoelectrophoresis (CIE), modified CIE, and microprecipitation method (MPM), using anti-human HbA serum. The detection limits expressed as the highest dilution of human blood on the thread in positive reaction were 1:160, 1:320, and 1:320 in CIE, modified CIE, and MPM, respectively. About 1 h was required to obtain the results. In CIE and modified CIE, the detection limits diminished according to the reduction of the samples from one half to one-eighth of the thread, but not in MPM.

Adult↗
PubMed1988

Congenital cervical neuroblastoma associated with Horner syndrome.

A rare case of congenital neuroblastoma of the neck associated with complete Horner syndrome and respiratory distress is described. The case was successfully treated by total excision secondary to chemotherapy. Horner syndrome was of value for early diagnosis of this lesion.

Female↗
PubMed1988

Voluntary anal continence after surgery for anorectal malformations.

Electromyography (EMG) and measurement of voluntary contraction pressure of the external sphincter muscle were performed in 28 patients, aged 5 to 14 years, to assess the function of the external sphincter after surgical correction of anorectal malformations. Ten normal children, aged 5 to 15 years, served as controls. External sphincter function in patients with high-type anomalies was disturbed in the areas of tonic activity, inflation reflex, and activity during further rectal filling. In patients with low-type or intermediate-type anomalies, function was preserved and was equal to that in normal controls. Phasic activity was observed in patients with all types of anomalies and in normal subjects. Among those with high-type anomalies, the three patients with Kelly's score of less than 2 had voluntary contractions of 20 cmH2O or less. However, the mean voluntary contraction pressures were not significantly different among the three types of anomalies. Therefore, patients with high-type anomalies may acquire compensatory voluntary continence through bowel training.

Adolescent↗
PubMed1988

Reliability of anorectal manometry in the diagnosis of Hirschsprung's disease.

Anorectal manometry was performed in 79 patients, aged 2 days to 19 years, who were referred to us because of constipation or symptoms of intestinal obstruction. A definitive diagnosis was obtained in 75 of the 79 patients (95%). Thus, anorectal manometry is a reliable tool in the diagnosis of Hirschsprung's disease. In the neonatal period, however, a definite diagnosis was possible in only 17 of the 21 neonates (81%). The age at the time of the first examination was 14 +/- 2 days in those with a definite diagnosis and 5 +/- 1 days in those with an indefinite diagnosis (p less than 0.001). If intestinal obstruction can be managed by conservative therapy, examination should be repeated after two weeks of age if the diagnosis before one week of age is not definite. These results indicate that anorectal manometry is non-invasive and reliable in the diagnosis of Hirschprung's disease. However, further examinations such as barium enema or rectal biopsy should be done, even in the neonatal period.

Anal Canal↗
PubMed1988

Giant cavernous haemangioma: treatment with intralesional injection of OK-432.

Giant cavernous haemangioma was treated successfully with a new therapy consisting of intralesional injection of OK-432 (group A Streptococcus pyogenes of human origin). Complete regression was observed within 3 months without serious side effects except for fever of 2-3 days' duration and local inflammatory reaction lasting for 3-4 days. Local inflammatory reaction did not cause any damage to the overlaying skin and did not lead to scar formation.

Biological Products↗
PubMed1988

Results of surgical correction of anorectal malformations. A 10-30 year follow-up.

Of 119 patients with surgical correction of anorectal malformations, 47 who were 10-30 years of age were interviewed personally and had manometric studies to evaluate postoperative continence. This clinical study included not only long-term anorectal function but also sexual function. Patients with low type anomalies or with intermediate type anomalies were more likely to be continent, whereas patients with high type lesions had some problems with continence. However, only two of the 16 patients (12%) with high type anomalies were classified as having poor results. This rate is perhaps lower than might be expected. Thus, incontinent patients may become continent even if they were classified as having fecal incontinence before 6 years of age. Most patients who were 15-30 years of age had normal sexual function except for two females with irregular menstruation. These results indicate that achievement of fecal continence and sexual function in patients with high type anomalies treated by abdominoperineal rectoplasty depends on careful dissection as close as possible to the rectal wall and bringing the terminal bowel down exactly within the sling of the puborectal muscle.

Adolescent↗
PubMed1988

Adjuvant chemotherapy for murine neuroblastoma with special reference to cell kinetics of residual tumor after primary tumor removal.

We examined the effect of adjuvant chemotherapy for neuroblastoma (C-1300NB) after surgery, especially on the increase in cells in the DNA synthetic phase in the remaining neuroblastoma from the 6th to 24th postoperative h caused by the reduction of the tumor cell in the tumor-bearing A/J mice. The mice were inoculated with C-1300NB cells in the chest and leg simultaneously, and administered adriamycin (ADM), as a cell cycle phase-specific agent, or cyclophosphamide (CPM), as a cell cycle phase nonspecific agent. The growth rate of chest tumors (residual tumors) in the mice treated with ADM just after amputation of the tumor-bearing leg was significantly lower than that of the other groups (p less than 0.05). 3H-TdR labeling indices of chest tumors in this group decreased more effectively than in the other groups. These results indicate that it is important to administer a cell cycle phase-specific agent rather than a cell cycle phase nonspecific agent during the period of rapid growth of residual tumors after surgery.

Animals↗
PubMed1988

Neuroblastoma: incomplete differentiation on the way to maturation or morphological alteration resembling maturity?

The following study was performed to investigate whether antitumor agents can induce maturation of advanced neuroblastoma (NB). Of 56 NB patients (1970-1987), 13 in stage III or IV underwent resection of the primary tumor (11 abdominal, 2 mediastinal) following complete or partial response to preoperative chemotherapy (11 conventional cytotoxic chemotherapy, 2 conventional cytotoxic chemotherapy combined with intraarterial infusion of prostaglandin E1 and oral papaverine). Histological examinations, performed on these 13 NB patients before and after chemotherapy, showed (1) differentiation of the NB to ganglioneuroblastoma (GNB) with predominance of mature atypical ganglion cells, development of stromal components and a few immature malignant cells in 10 of 13 and (2) differentiation of the NB to a more mature form than was seen histologically before treatment in the remaining 3. Our results indicate that the morphological differentiation of immature NB in advanced stage to more mature GNB can be induced by conventional cytotoxic chemotherapy with or without so-called 'maturation-inducing' agents. However, the chemotherapy-induced morphological differentiation did not correlate with the prognosis of the patients.

Alprostadil↗
PubMed1987

Intraarterial chemotherapy with lipid contrast medium for hepatic malignancies in infants.

Antitumor drugs dispersed in a lipid lymphographic medium (Lipiodol, Laboratorie Guerbert, Rue Jean-Chaptal, France) were intraarterially administered in two infants with unresectable hepatoblastoma. The Lipiodol and antitumor drug complex was found to selectively accumulate in the tumor and was associated with a marked reduction in the tumor size and a 50% decrease in the alpha-fetoprotein (AFP) level after 4 days in one patient and 16 days in the other. The tumor was successfully resected by right trisegmentectomy in one patient, but surgery was not performed on the other because of evidence of pulmonary metastasis. The patients had moderate fever for 2 to 3 days after the intraarterial chemotherapy. It is believed that intraarterial chemotherapy with Lipiodol may be a useful preoperative chemotherapy for initially unresectable hepatoblastoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children.

Nine patients with cystic hygroma were treated with a new sclerosing therapy consisting of intracystic injection of OK-432 (group A Streptococcus pyogenes of human origin). Favourable results including complete regression in eight patients and marked regression in one were observed within 2-3 months without serious side-effects except for fever of 2-3 days' duration and local inflammatory reaction lasting for 3-4 days. Local inflammatory reaction did not cause any damage to the overlying skin and did not lead to scar formation.

Abdominal Neoplasms↗
PubMed1987

Combination chemotherapy for unresectable hepatoblastoma in children.

Combination chemotherapy (adriamycin, vincristine, cyclophosphamide, etc.) was prescribed for two patients with initially unresectable hepatoblastoma. A significant reduction in tumor size occurred, and subsequent successful resection was feasible in one, although in the other the regressed tumor remained inoperable due to the link to the hepatic veins. The survival time for these patients was 9 months after operation and 41 months from diagnosis, respectively. Preoperative combination chemotherapy for initially unresectable hepatoblastoma facilitates surgical removal under more favorable conditions of a decreased tumor size.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Intraarterial injection of anti-tumor drugs dispersed in lipid contrast medium: a choice for initially unresectable hepatoblastoma in infants.

Intraarterial injection of anti-tumor drugs (THP-ADR, CDDP, 5-FU) dispersed in lipid contrast medium (Lipiodol, Laboratorie Guerbert, France) was used in an infant with initially unresectable hepatoblastoma. Lipiodol complex selectively accumulated in the tumor tissue and may keep the chemotherapeutic agents in the tumor tissue for a longer period of time, and a significant reduction of the tumor with a four-day half-life of alpha-fetoprotein (AFP) was followed immediately after the institution of chemotherapy. Successful resection of decreased tumor by extended right hepatectomy under more favorable conditions was performed 2 months after diagnosis. Intraarterial chemotherapy with Lipiodol was particularly useful in potentiating the cytoreduction of anti-tumor drugs and was also useful in reducing the toxicities of anti-tumor drugs to the host.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Clinical and manometric assessment of anorectal function after Martin's operation.

Anorectal function after Martin's operation for total colonic aganglionosis was assessed in five patients by clinical and manometric studies. One year after operation the frequency of bowel movements decreased to three times a day, and the stools became semi-formed. Anorectal manometry showed decreasing anal resting pressure and anorectal pressure difference one month after the operation. However, these values became gradually normal. Rectal compliance increased as bowel function improved clinically. These results show that increasing rectal compliance and normalisation of stools by adequate absorption of intestinal fluid are important factors in the improvement of faecal continence after Martin's operation.

Child, Preschool↗
PubMed1987

Treatment of cystic hygroma in children with special reference to OK-432 therapy.

During a five-year period, 18 patients with cystic hygroma were treated as follows: 8 patients were treated surgically, 3 patients were treated by sclerosing therapy with Bleomycin (BLM) and 9 patients including 2 secondary to incomplete surgical therapy were treated by sclerosing therapy with OK-432 (Picibanil; Chugai Pharmaceutical Co. Ltd., Tokyo). OK-432 therapy for cystic hygroma showed excellent results; cure was noted in 8 patients, and marked regression with the expectation of subsequent cure was noted in the other patient. Complete excision of the cystic hygromas was possible in 4 patients and resulted in cure; but only partial excisions could be performed in the other 4 patients because of the surrounding tissue and the results were unfavorable. BLM therapy gave insufficient results and was not considered a favorable treatment.

Adolescent↗