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Biomedical subjects

Y Hada

Publications and source records attributed to Y Hada.

At least 19 recordsLinked to original sources
PubMed1996

[Concurrent high-dose thoracic irradiation plus daily low-dose cisplatin and vindesine in locally advanced unresectable stage III non-small cell lung cancer].

Patients with unresectable non small-cell lung cancer were treated to evaluate the toxicity and efficacy of high-dose thoracic irradiation (RT) combined with concurrent daily cisplatin plus vindesine. Fourteen evaluable patients with unresectable stage III non small-cell lung cancer treated with continuous-course RT (70 Gy in 35 fractions of 2 Gy once daily) and concurrent daily intravenous cisplatin (6 mg/m2) plus vindesine (3 mg/m2 on day 1 and day 8). The objective response rate was 86%, and two patients achieved a radiographic complete response. Leukocytopenia was the severe toxicity, but there were no episodes of discontinuation of treatment. Only one patient had grade 3 acute radiation esophagitis. Ten patients experienced late radiation pneumonitis and nine of those had grade 1 or grade 2. There was only one life-threatening case of toxicity (grade 5 pneumonitis). We concluded that the regimen of high-dose thoracic RT combined with concurrent daily cisplatin plus vindesine obtained a high response rate. Further testing on late toxicities and survival time is required.

Aged↗
PubMed1995

Choroid plexus carcinoma in the lateral ventricle--case report.

A 68-year-old male presented with choroid plexus carcinoma in the left lateral ventricle manifesting as dysarthria and gait disturbance. Magnetic resonance imaging showed a homogeneously enhanced mass in the trigone of the left lateral ventricle. Selective left posterior cerebral arteriography showed the tumor was fed by the left medial posterior choroidal artery. Detailed examinations found no evidence of an extraneural primary focus. He underwent partial removal of the tumor followed by local Lineac irradiation (50 Gy). After irradiation, the serum level of carcinoembryonic antigen decreased and the size of the residual tumor was reduced.

Adenocarcinoma↗
PubMed1995

[Cardiothoracic ratio].

Cardiothoracic ratio has been a useful index of cardiac dilatation, and a value of 50% is generally considered to indicate the upper limit of normal cardiac size. However, this value is not always correct and increases the number of false-positive results, especially in obese or older subjects who may have a misdiagnosis of cardiac enlargement. The maximal transverse diameter of the cardiac shadow of chest X-ray film consists mainly of the diameters of the left ventricle and the right atrium as shown by X-ray computed tomography, but this ratio is influenced by many factors; not only left ventricular dilatation or hypertrophy, but also dilatation of the other cardiac chambers and the aorta, rotation and shift of the heart, respiratory phase, body posture, and measurement errors. In contrast, echocardiography is an accurate method for the diagnosis of cardiac dilatation. This study correlated left ventricular dimension with cardiothoracic ratio in 80 consecutive subjects with normal physical, ECG and Doppler echocardiography examinations. There was no relationship between left ventricular end-diastolic dimension and the cardiothoracic ratio. Chest X-ray is mandatory for initial cardiac examination. However, we must be careful about roentgenographic diagnosis of cardiac dilatation. Cardiac enlargement should be diagnosed by echocardiography, but follow-up and management can be based on chest X-ray films.

Cardiomyopathy, Dilated↗
PubMed1993

[MR tractography--visualization of structure of nerve fiber system from diffusion weighted images with maximum intensity projection method].

We developed a new noninvasive technique to visualize the anatomical structure of the nerve fiber system in vivo, and named this technique magnetic resonance (MR) tractography and the acquired image an MR tractogram. MR tractography has two steps. One is to obtain diffusion-weighted images sensitized along axes appropriate for depicting the intended nerve fibers with anisotropic water diffusion MR imaging. The other is to extract the anatomical structure of the nerve fiber system from a series of diffusion-weighted images by the maximum intensity projection method. To examine the clinical usefulness of the proposed technique, many contiguous, thin (3 mm) coronal two-dimensional sections of the brain were acquired sequentially in normal volunteers and selected patients with paralyses, on a 1.5 Tesla MR system (Signa, GE) with an ECG-gated Stejskal-Tanner pulse sequence. The structure of the nerve fiber system of normal volunteers was almost the same as the anatomy. The tractograms of patients with paralyses clearly showed the degeneration of nerve fibers and were correlated with clinical symptoms. MR tractography showed great promise for the study of neuroanatomy and neuroradiology.

Aged↗
PubMed1993

[Embolization of the internal maxillary artery for severe epistaxis--including an experience of the approach from the superficial temporal artery].

Six cases of severe epistaxis were treated with the super-selective intraarterial embolization of the internal maxillary artery. Tens of fragments of Gelfoam were delivered into the distal internal maxillary artery and, additionally, embolized by several pieces of the coils. In a case with cerebral infraction, catheter was inserted via the superficial temporal artery. There were no complications due to these procedures in all cases of this study. It is considered that therapeutic intraarterial embolization of the internal maxillary artery is an effective therapy for severe epistaxis and the superficial temporal artery approach is useful for selected cases.

Aged↗
PubMed1992

Detection of coronary artery calcification by X-ray computed tomography and its significance: a new CT scoring technique.

In order to study the utility of X-ray computed tomography (CT) for the evaluation of coronary stenosis, the authors developed a scoring system for calcification seen through CT and compared the results with coronary angiographic (CAG) findings (Friesinger's scoring system). Their study included 143 patients (angina pectoris 53, myocardial infarction 44, control 46) who received both CT and CAG. Judkins method was selected for CAG, and stenosis greater than or equal to 75% was defined as significant. Horizontal slices of CT from ascending aorta to cardiac apex at 1 cm intervals were imaged without contrast enhancement. CT scoring system was as follows: no calcification = 0, the length of calcification less than 1 cm = 1, 1-2 cm = 2, more than 2 cm = 3 points. They then totaled the separate scores of all the slices for each coronary artery. Sensitivity, specificity, and predictive value of CT against coronary stenosis were good (79%, 80%, 69%, respectively). The correlation between CT and CAG scores was significant (r = 0.644, p less than 0.01). For all coronary arteries, no correlation was found between the CAG and CT findings for patients less than forty-five years of age. However, from 45 years of age upward, the results were significant. Until now, to the best of their knowledge, no satisfactory system to define the severity of coronary calcification has existed. Density cannot be used, because values are dependent on the area of the region of interest used. They demonstrated the considerable potential usefulness of CT in predicting the presence of coronary stenosis and analyzing its severity.

Calcinosis↗
PubMed1992

[Assessment of coronary artery bypass grafts by X-ray computed tomography with and without contrast enhancement].

To assess the patency of coronary artery bypass grafts, we tested the capability of X-ray computed tomography (CT) with and without contrast enhancement. This procedure was used on 63 grafts (30 in the LAD; 20 in the LCX; 13 in the RCA) in 32 patients with a mean age of 56 +/- 8 years, all of whom were referred to our department for postoperative management or evaluation. The CT scanner used was Toshiba TCT-60A with a scan time of 3 sec, 5 mm thick slices, and 512 x 512 pixels. CT scans without contrast enhancement were obtained from the level of the aortic arch to the left ventricle. Eight sec after 30 ml of contrast media was injected at a rate of 3 ml/sec into an antecubital vein, 5 scans were made at the same level of the pulmonary artery truncus. After positioning the regions of interests on the ascending aorta and grafts, we obtained time-density curves (TDCs) and compared the data with those recorded from an intraoperative electromagnetic flow meter (EMF). Fifty grafts were angiographically patent. The appearance time, build-up time, peak time, disappearance time and peak densities obtained from TDCs of grafts did not correlate with the flow volumes measured by EMF. Patent grafts were easily identified visually, without contrast enhancement (sensitivity; 88%, specificity; 100%, accuracy; 91%). Occluded grafts were not imaged on CT, either with or without contrast enhancement. We concluded that the TDCs of grafts obtained by CT are of no value for predicting the graft flow, and that plain CT without contrast enhancement is sufficiently useful for assessing the patency of such grafts.

Aged↗
PubMed1992

[Doppler and echocardiographic study of normal systolic murmurs].

To elucidate the genesis of normal ejection systolic murmurs, we performed phono and Doppler echocardiography in 42 normal subjects. Individuals with hypertension, ST.T changes on ECG, anemia or other cases with definite cardiovascular findings were excluded from the study. Their ages ranged from 22 to 61 years with an average of 48.1 years. They were classified in 2 groups; 9 with Levine 2/6 systolic murmur and 33 without murmur or with 1/6 murmur. Fifteen patients with pure aortic regurgitation or with aortic prosthesis but without significant stenosis, and 7 patients with pulmonic valvular stenosis were served as control. We correlated the intensity and timing of murmur with maximal flow velocity, acceleration time and other parameters. All systolic murmurs were early systolic. Mid-systolic murmur was not noted. Peak of flow velocity increased at the aortic orifice than at the left ventricular outflow tract or pulmonary orifice. Left-sided peak flow velocity occurred earlier than the right-sided peak flow velocity. Early systolic maximal flow velocity of the aorta significantly increased in 9 subjects with murmur than in the remaining 33 without significant murmur. Ejection fraction, hematocrit and body surface area did not differ between the groups with and without significant murmur. Systolic blood pressure and age, however, were higher in subjects with murmur. In aortic valvular disease, systolic murmurs and peak flow signals were early systolic, but in pulmonary stenosis these were mid-systolic in timing. In conclusion, normal ejection systolic murmurs were early systolic and originated at the aortic orifice. Mid-systolic murmurs were unlikely as left-sided murmur in origin. Flow velocity was the most important determinant of the intensity of ejection murmur.

Adult↗
PubMed1992

[Intraperitoneal chemotherapy using CBDCA for malignant gynecological tumors].

At our clinic for peritoneal dissemination cases of gynecological malignant tumors, we have been using intraperitoneal administration (ip) of anticancer agents such as CDDP with favorable results. However, since CDDP cannot be used for patients with renal dysfunction, we have administered CBDCA ip, and along with determining drug concentration, we also studied therapeutic effects. At the time of laparotomy in 5 cases of malignant tumors (ovarian cancer 4 cases, oviduct cancer 1 case), we subcutaneously implanted a reservoir port for the peritoneum in the upper inguinal region. Through this completely open port we administered by natural dripping 200-450 mg/body of CBDCA dissolved abdominal fluid and peripheral venous blood, and we determined the concentrations of total and free platinum. The ip concentration of platinum reached a peak of 142-19.8 micrograms/ml immediately after administration, and then gradually declined; at 8 hours it became 20.1-2.23 micrograms/ml, and was still detectable at 48 hours. In the peripheral venous blood peaked at 2 hours at 4.78-1.2 micrograms/ml, and was still observed at 48 hours. One 84-year-old patient with stage III oviduct cancer and renal dysfunction showed a marked reduction in ascites and improvement in PS from 4 to 1, so she is being treated on an outpatient basis. The efficacy rate was 60.0% with 2 CR and 1PR. Repeated ip administration of CBDCA was possible even in cases with renal damage rather than CDDP, but the side effects on the blood were severe. CBDCA ip achieves an effective level of free platinum in both the peritoneum administration methods for treating peritoneal disseminated cases.

Administration, Oral↗
PubMed1991

[Clinical features of main and peripheral pulmonary artery stenosis: significance of auscultation and phonocardiography].

Twenty-five patients with main and peripheral pulmonary artery stenosis were studied to determine the most frequently observed diagnostic sign of this abnormality regardless of the underlying etiologies, such as intrinsic or extrinsic narrowing of the pulmonary artery due to tumor, fibromuscular dysplasia, thromboembolism, angitis including the aortitis syndrome (Takayasu arteritis) and a variety of other disease entities. Among a variety of signs and symptoms, we emphasized the importance of cardiac auscultation and phonocardiography, which were often the initial diagnostic clues. The diagnostic features included a systolic murmur of pulmonary arterial origin and the behavior of the splitting of the second heart sound. The systolic murmur was often trans-systolic or continuous. In cases with left-sided cardiac murmurs (Takayasu arteritis, etc), the pulmonary systolic murmurs were not identified by auscultation alone and required phonocardiographic confirmation. In many cases the second heart sound was split and this was sometimes the first clue to the diagnosis. The split intervals varied, but were more marked in cases with pulmonary hypertension, and were accompanied by the accentuated pulmonic component (IIP). Phonocardiographic analysis disclosed that wide splitting was caused by the delayed appearance of IIP as well as the concomitant early appearance of the aortic component (IIA). It was concluded that, although the final etiological diagnosis is not identified, auscultation and phonocardiography provide important clues for further diagnostic and etiological studies of pulmonary artery stenosis.

Adolescent↗
PubMed1991

[Chemotherapy in malignant gynecologic tumors using intraperitoneal catheter with a subcutaneous reservoir].

Malignant gynecologic tumors are liable to encourage intraperitoneal dissemination and liver metastasis. Using an implantable reservoir (R), we undertook intraperitoneal (ip) administration of CDDP (P) and etoposide (E). After the ip injection of 150 mg of P, 300 mg of E was diluted with 1,500 ml of saline solution through the R. P and E of the intraperitoneal fluid and blood were measured after the administration, and the therapeutic results were evaluated. The blood concentration of P and E reached peaks at 30-60 minutes and at about 4 hours, respectively, after administration. Detectable levels of both P and E were observed at up to 48 hours after administration. In the first treatment of patients who showed severe peritonitis carcinomatosa and high intraperitoneal levels of proteins, the transfer to blood of P from the peritoneal cavity was slow, but as the treatment progressed (second and third administrations) protein binding P decreased and peritoneal permeability improved. Both maximum blood P concentrations and the concentrations of free P were also increased 48 hours after administrations. The area under the curves (AUC) of the blood free P and E concentrations were 8.0 and 274.0 (microgram/ml x h), respectively, which were higher than those following intravenous administration. The results showed 3 CR and 6 PR. This ip regimen obtained a 64.3% response rate for measurable lesions. A patient in stage IV of ovarian cancer showed marked remission of a liver metastatic focus. Repeated ip administration through R proved to be effective by means of systemic therapy.

Adult↗
PubMed1991

[Prediction of coronary artery bypass graft flow--analysis of time density curve obtained from digital subtraction angiography].

UNLABELLED: To predict the coronary artery bypass graft(CABG) flow based on the time density curve(TDC) obtained from the digital subtraction aortograms(DSA), we developed a pulsatile CABG model (perfusion pressure 60, 130 mmHg, pulse rate 53, 126/min, cardiac output 3-7 l/min, diameter of the graft 2.1-6.0 mm). After positioning the regions of interest (ROI), we injected contrast medium (5-40 ml/sec, 5-40 ml) into the outlet conduit. Concerning the TDCs, we calculated appearance time(Ta), peak densities(Dp), peak time(Tp), disappearance time(Td), integral of TDC, delta Tp (difference of Tp between two ROI) and delta Ta (difference of Ta between two ROI). RESULTS: Perfusion pressure, graft flow and output curve were similar to those of patients with CABG. Ta, Tp, Td and delta Tp were affected by both the injection rate and the volume of the contrast medium; while Dp and the TDC integral were only affected by the latter parameter. Under the same conditions of contrast medium injection, the TDC depended strongly on graft flow, diameter of the graft, output and pulse rate. 21.6 + 0.92 pi.d2/4.delta 1/delta Tp.60 provided the most accurate estimation of CABG flow (r = 0.865, p less than 0.01). We conclude that densitometric analysis of DSA may be useful in the prediction of CABG flow.

Absorptiometry, Photon↗
PubMed1990

[A clinicopathological study of pulmonary metastases in carcinoma of the uterine cervix].

Carcinoma of the uterine cervix was evaluated in 1,121 patients at Kure National Hospital, Hiroshima, between 1969 and 1987. The patients were retrospectively evaluated for the presence of pulmonary metastases. On chest radiography, 35 patients were found to have metastases. Pulmonary metastases were seen in 3.1% of patients with carcinoma of the cervix. Thirty-two patients out of 35 could be evaluated about their clinical stage, histology, and disease course: 3 patients were classified into stage Ib, 10 were stage II, 15 were stage III, and 4 were stage IV. Histologically, 27 patients were squamous cell carcinoma, 2 were adenocarcinoma, and 3 were others. Mean interval from initial disease staging to detection of lung metastases was 17.1 months. Once pulmonary spread was discovered, half of them expired within 4 months. Twenty-two patients had other focus of metastasis besides lung.

Adenocarcinoma↗
PubMed1990

Follow-up in mitral valve prolapse by phonocardiography, M-mode and two-dimensional echocardiography and Doppler echocardiography.

To assess the serial phonocardiographic and echocardiographic change in patients with mitral valve prolapse (MVP), phonocardiograms and echocardiograms were reviewed retrospectively in 116 patients (48 men and 68 women, mean age 27 years) who had been determined to have MVP and were reexamined 4.3 years (range 1 to 14) later by phonocardiography and echocardiography between 1971 and 1988. Follow-up phonocardiograms showed periods when 5 of 18 patients with silent MVP developed mid- or late systolic clicks. Of 57 patients with mid- or late systolic clicks, 15 had silent MVP, 6 developed a late systolic murmur with or without systolic clicks and 1 developed a pansystolic murmur. Two of 9 patients with an isolated late systolic murmur developed a pansystolic murmur. M-mode echocardiograms showed that left atrial and left ventricular dimensions at end-diastole and end-systole increased in patients with systolic murmur (33 +/- 10 vs 35 +/- 11, 46 +/- 6 vs 50 +/- 7 and 29 +/- 4 vs 31 +/- 5 mm, respectively, all p less than 0.001) and no statistically significant changes in any of these dimensions were found in patients without a systolic murmur. The degree of MVP evaluated by the anteroposterior mitral leaflet angle on the 2-dimensional echocardiogram was more severe in patients with a systolic murmur than in patients without systolic murmur (157 +/- 12 vs 131 +/- 16 degrees, p less than 0.001). The degree of prolapse did not change during the follow-up periods. The number of patients with mitral regurgitation detected by pulsed Doppler echocardiography increased from 21 of 72 (29%) to 31 of 72 (43%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗