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Biomedical subjects

T Goya

Publications and source records attributed to T Goya.

At least 127 records · Page 7Linked to original sources

Prognosis and survival in resected lung carcinoma based on the new international staging system.

A new TNM staging system was proposed and the previous system has been revised recently. To evaluate the new TNM staging system for lung cancer, we analyzed records of 1737 patients who underwent pulmonary resection at the National Cancer Center Hospital, Tokyo. With regard to clinical stages, three patients had occult carcinoma; 821 patients had stage I disease; 248 patients, stage II; 465 patients, stage IIIA; 82 patients, stage IIIB; and 118 patients, stage IV. The 5-year survival rates for the respective stages were 50.1% for stage I, 31.2% for stage II, 20.2% for stage IIIA, 5.1% for stage IIIB, and 7.9% for stage IV. In terms of postoperative stages, four patients were classified in stage 0, 536 in stage I, 221 in stage II, 559 in stage IIIA, 159 in stage IIIB, and 258 in stage IV. The 5-year survival rates were as follows: stage I, 65.0%; stage II, 42.9%; stage IIIA, 22.2%; stage IIIB, 5.6%; and stage IV, 7.5%. In both the clinical stage and the postoperative stage, there were significant prognostic differences between stage I and stage II, stage II and stage IIIA, and stage IIIA and stage IIIB, but there was no significant difference in 5-year survival rates between stage IIIB and stage IV.

Adenocarcinoma↗

[AUFRAP therapy: combined modality treatment of malignant gliomas with intraarterial infusion of ACNU].

A method of combination therapy was proposed for the treatment of malignant gliomas, and the clinical results were reported. This combination consisted of ACNU (nimustine), UFT (tegafur + uracil), Radiation, vitamin A and PSK (krestin), and was named AUFRAP therapy. Intracarotid infusion of ACNU (100 or 150 mg/body) was done after the administration of vitamin A (100,000 units), in the first and last week of radiation therapy with a total dose of 60-70 Gy. UFT (400-600 mg/day) and PSK (3g/day) were also given orally. After the induction of remission, patients were treated in the outpatient clinic under a similar maintaining protocol. Two patients who received 150 mg of ACNU and daily 600 mg of UFT in combination with radiation therapy showed severe myelosuppression in the early stage of treatment, and the combination therapy was aborted. Two of four patients who received 100mg of ACNU and daily 400mg of UFT did not show such severe side effects and two showed transient, moderate myelosuppression and vomiting. The serum phenitoin concentration doubled and was thought to be a side effect of tegafur. All four patients completed the induction protocol and follow-up CT scans disclosed shrinkage of the remained tumors, decreased contrast enhancement or no evidence of recurrence. Interactions of these drugs and radiation were discussed and the literature was reviewed.

Adult↗

[Prognostic factors in lung cancer].

For 1,886 cases, out of total 1,982 lung cancer cases, which had been admitted to and undergone resection at National Cancer Center Hospital during the period between May, 1962 and December, 1987, excluding cases of multiple primaries and low grade malignancies, prognostic factors have been reviewed and examined. Prognosis does not depend on only one factor, but many complicated factors, however, 5 year survival rate was very good for stage I and stage II cases, for which curative resection could have been performed. There have been difference histologically in prognoses between cases of squamous cell carcinoma, adenocarcinoma, large cell carcinoma and small cell carcinoma, but prognoses of stage I and II cases were good in the group, for which curative resection was possible. Prognostic factors of lung cancer cases can be epitomized by staging of the disease and histological type and it is evident from the review on these cases that early detection, early treatment and indication of curative resection should be pursued as much as possible.

Adult↗

Carpal tunnel syndrome in chronic renal dialysis patients: clinical evaluation of 62 hands and results of operative treatment.

A prospective study was performed on 62 hands in 45 consecutive patients on chrome dialysis carpal tunnel syndrome developed within an average of 116 months after formation of the arterio-venous fistula. We measured the intra-carpal canal pressure by the wick catheter technique and performed neurography. At operation, a markedly thickened transverse carpal ligament was usually found. A pneumatic tourniquet was applied in all except three cases, whose functioning fistulae were made of implants, but no complications such as obturation of the fistulae occurred. Thirty-three (76.7%) of 43 cases had good results. Full recovery of sensibility was obtained in all hands in which symptoms had been present for less than two years. There was no benefit from operation in two patients (4.7%), both of whom had symptoms for more than two years.

Adolescent↗

Plasmacytoma of the lung associated with nodular deposits of immunoglobulin.

A case of extramedullary plasmacytoma of the lung associated with nodular immunoglobulin deposits is presented. The main tumor was located in the posterior basal segment of the lower lobe of the left lung and showed intrabronchial polypoid growth. Multiple metastatic tumors were observed in regional lymph nodes and the visceral and parietal pleura. Histologically, the tumor was composed of sheets of plasma cells with mild atypia. A large amount of amorphous material resembling amyloid was observed in the tumors, and was more marked in the metastatic lesions. Immunohistochemically, the tumor cells were shown to contain monoclonal IgG-kappa immunoglobulin. The amorphous deposits were not identical to amyloid since congo red stain was negative and amyloid fibrils were not observed ultrastructurally. By Western blotting, immunoglobulin (IgG, kappa) was identified as the major component in an extract from the nodular deposits. In the preoperative serum from the patient, M-protein (IgG-kappa) was detected by immunoelectrophoresis. Bone marrow examination revealed no abnormality.

Female↗

[Glomus jugulare tumor with intra- and extracranial extension: a case report with MRI study].

A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C2. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension.

Female↗

[Clinical and basic studies on the treatment of cancer metastasis].

Lung resection for metastatic lung tumors from cancers of other organs has shown a significant curative success rate among affected patients. Hepatectomy also shows promise as a good curative approach for patients with liver metastasis from cancers of various abdominal organs. Descriptive data and their analysis of metastases by Bross and Viadana indicate a cascade spreading process. The fact that key-sites such as the lung and/or liver which, for some time, have proved a stumbling block to the generalization of cancers by metastases, has led to the success of therapy for metastasis in the clinical field. Chemotherapy as an adjuvant therapy to surgery for key-site metastatic foci is anticipated to raise future cure rates.

Humans↗

Noninvasive measurement of central sensory and motor conduction.

Potentials evoked by median and peroneal nerve stimulation were digitally filtered between 300 and 2,500 Hz to measure early latency components and assess sensory cord conduction velocity. Short (R1) and long (R2) latency reflex responses were recorded from contracting thenar and tibialis anterior muscles. R1 is considered a spinal reflex akin to the H-reflex. Clinical evidence suggests that R2 involves a reflex arc with turnaround at the motor cortex. Sensory-motor cord velocity was derived from the latencies of R1 and R2. The method can be used to compare peripheral and central sensory conduction or conduction in central sensory and motor pathways.

Adolescent↗

[Multiple anomalies of cerebral vessels. A case of multiple aneurysms associated with fenestration of the middle cerebral artery and persistent primitive trigeminal artery].

A case of multiple intracranial anomalies was reported. They consisted of fenestration of the middle cerebral artery (MCA), persistent primitive trigeminal artery and four intracranial aneurysms. The patient, 45-year-old male, had an attack of subarachnoid hemorrhage on July 15, 1982. He was transferred and admitted to our Dept. of Neurosurgery on July 27. On admission neurological examinations revealed retinal hemorrhage, bilateral papilledema and abducens nerve paresis on the left. Cerebral angiography demonstrated multiple aneurysms, one in the left vertebral artery, one in the left MCA, one in the right IC-PC junction and one in the fenestrated right MCA and persistent primitive trigeminal artery. Computed tomography (CT) demonstrated high density areas in the basal cistern and bilateral sylvian fissures, and cavum septi pellucidi and cavum Vergae as well. Surgical intervention was done and all aneurysms were clipped or coated successfully. The aneurysm in the fenestrated right MCA had originated from the proximal end of the fenestration of the MCA. The cavum septi pellucidi and cavum Vergae were asymptomatic. The postoperative course was uneventful. The authors discussed the pathogenesis and clinical meanings of fenestration of the MCA and persistent primitive trigeminal artery, and inferred that the genetic abnormality at the stage of development of cerebral vessels could play one part of the formation of intracranial aneurysms, because of the fact that the cerebrovascular anomalies showed high incidence of coexistence of intracranial aneurysms.

Cerebral Angiography↗