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Biomedical subjects

A Koike

Publications and source records attributed to A Koike.

At least 127 records · Page 7Linked to original sources
PubMed1988

[Evaluation of coronary blood flow using digital subtraction technique and cine coronary angiography: a preliminary report].

To evaluate coronary circulation in ischemic heart disease, digital image processing with cine coronary angiography was performed. Using time-density curves obtained from individual pixels, images showing the distribution of contrast density and transit time were obtained. To record angiograms, contrast medium was injected into the coronary artery in a steady manner during right atrial pacing. Frames in the end-diastolic phase immediately before the P wave were selected, and digitized into a 512 x 512 x 8 bit matrix using a system composed of a video camera, an analog-to-digital converter, and a computer. These digitized images were then stored in a disk memory. A mask image was prepared before the injection of contrast medium. Subtraction was performed using the mask image and a series of images following contrast injection. The subtracted images were of sufficient quality to permit clear observation of the individual coronary arterial branches. Time-density curves were then determined from these subtracted images. From these curves, time from the onset of contrast injection to its peak density (Tp), time from the peak density to the half peak density (T 1/2) and the attenuation factor of the curves (tau) were derived. Their distributions were expressed as color images. Examples of a normal control and a case of inferior infarction were demonstrated. Blood flow function images with good spatial resolution were thus obtained. This method is useful for evaluating coronary blood flow.

Angioplasty, Balloon↗
PubMed1988

[A randomized controlled trial comparing short-term MF chemotherapy with MF plus long-term HCFU chemotherapy as an adjuvant to a curative resection of stomach cancer: Mifurol Study Group for Stomach Cancer].

In order to clarify the clinical response of long-term adjuvant chemotherapy using Carmofur (HCFU), a comparative multicenter trial has been performed by a randomized controlled method. Curative resected patients suffering from stomach cancer were randomly allocated into two arms. Arm A consisted of short-term MF chemotherapy (mitomycin C 0.04 mg/kg plus 5-fluorouracil 5.0 mg/kg x 6 bolus i.v.) and arm B consisted of arm A plus long-term HCFU chemotherapy (HCFU 6-12 mg/kg/day over 12 weeks, p.o.). The difference of overall survival probability between the two studied arms significantly supported arm B therapy (generalized Wilcoxon test: p = 0.0405) up to 5 years after surgery. The difference of the survival curves was clearer in the case of patients with cancers in the advanced stage, such as a positive serosal inversion and a lymph node metastases [ps(+).n(+)]. The side effects of HCFU, most patients experiencing subjective symptoms such as gastrointestinal toxicities, polyuria, and hot sensation, were reversible. Our results suggest that HCFU maintenance therapy has effect on preventing the postsurgical recurrences of stomach cancer and elongating the patient's survival.

Antineoplastic Agents↗
PubMed1988

[The minimization method in a medium size clinical trial. Study of immunochemotherapy with PSK in gastric cancer].

One of the objectives of randomization is to balance the number of patients in each level and combination of levels of prognostic factors. However, as the number of possible prognostic factors increases, some imbalance may occur and make the results of the analysis less interpretable. In order to balance the marginal distribution of each factor and to facilitate more interpretable trial results, the "minimization method" reported by Pocock was applied in our multi-center immunochemotherapy clinical trial. Balancing in every institution was achieved by using Zelen's prespecified value d = 3 for replacing provisional assignment in the individual institution. Nonmetric principal component analysis in S, N factors which were used in minimization process showed good equilibration between groups. Also, in uncontrolled background factors, such as cancer pathology or Borrmann types, acceptable balance was obtained spontaneously at the end of the trial.

Clinical Trials as Topic↗
PubMed1987

Local recurrence of breast cancer: treatment of nine patients with a recurrence in the skin flap of the chest wall.

From 1975 through 1985, nine patients with a local recurrent lesion (LRL) of breast cancer to the skin flap of the chest wall were treated. Four had undergone primary mastectomies in our clinic and the other five were referred from other surgeons, following signs of recurrence. Aggressive topical therapy, such as resection or irradiation, proved effective in eradicating the LRL in all cases, thereby indicating that topical therapy is useful for improving quality of life. Adjuvant systemic chemo-immuno-endocrine therapy is also required for patients with LRL, to increase longevity. Seven of the patients died of a distant metastasis within 66 months after the onset of LRL.

Adult↗
PubMed1986

[A randomized controlled trial comparing short-term MF chemotherapy with MF and long-term carmofur chemotherapy as an adjuvant to curative resection of stomach cancer].

In order to clarify the clinical response to long-term adjuvant chemotherapy with carmofur (HCFU), a comparative multicenter trial has been performed by a randomized controlled method. Curatively resected patients suffering from stomach cancer were randomly allocated into two arms. Arm A consisted of those receiving short-term MF chemotherapy (mitomycin C, 0.04 mg/kg + 5-fluorouracil, 5.0 mg/kg X 6, IVr) and arm B consisted of arm A plus long-term carmofur chemotherapy (Mifurol, 6-12 mg/kg/day over 12 weeks, PO). The difference of overall survival probability between the two study arms was significant in fabior of arm B (P less than 0.05) up to three years after surgery. The difference of survival curves was more distinct (P less than 0.01) in the case of the advanced stage of the cancer such as serosal inversion [ps (+)] and lymph node metastasis [n (+)]. The side effects of carmofur, mostly subjective symptoms such as gastrointestinal toxicities, pollakisuria, and sensation of hotness, were reversible. From the results, it is suggested that carmofur maintenance therapy is effective for the prevention of postsurgical recurrence of stomach cancer by means of the prolongation of patient survival.

Antineoplastic Agents↗
PubMed1985

Study of the cell proliferation kinetics in ulcerative colitis, adenomatous polyps, and cancer.

Cell proliferation kinetics, using autoradiography, was investigated in 4 specimens of normal colonic mucosa, 11 cases of ulcerative colitis, 15 adenomas, and 17 advanced cancers of the large intestine. In the normal mucosa, the labeled cells were located only in the lower three fifths of the crypts, the so-called proliferation zone, and their labeling index was 11.7 +/- 4.0%. In the ulcerative colitis, the proliferation zones were remarkably extended toward the upper part of the crypts, and the mean labeling index was 20.5 +/- 9.4%. In the adenomatous polyps, labeling was seen in any part of the crypts, and abnormal proliferation patterns such as denseness, stratification, expansion, and budding of the labeled cells tended to increase in accordance with the degree of the histologic atypism. Their mean labeling index was 22.2 +/- 8.6%. However each labeling index of the polyps increased proportionally to their histologic atypism, from 15.2 +/- 8.1% in grade II to 30.1 +/- 9.9% in grade V. The mean labeling index of the cancers was 23.3 +/- 9.6%, and there was little difference in the labeling patterns of the malignant polyps and cancers. The proliferation patterns of the polyp and cancer were qualitatively different from those of the normal mucosa and the ulcerative colitis.

Autoradiography↗
PubMed1984

Pheochromocytoma without specific symptoms.

A 72-year-old Japanese woman with pheochromocytoma, who had had no characteristic symptoms was treated. A large retroperitoneal tumor was discovered incidentally by sonographic examination for mild upper abdominal pain and, with CT-scan and abdominal angiography confirmed that the tumor originated in the right adrenal gland. The tumor was suspected of being a pheochromocytoma because preoperative laboratory examinations revealed only a mild elevation of daily urinary excretions of adrenaline and noradrenaline. Provocation tests for pheochromocytoma and even angiographic examination revealed no diagnostic change in serum levels of catecholamines and distinctive clinical signs were nil. Thus, surgery was performed without preoperative prescription of any catecholamine blockade. During the surgery, the blood pressure and pulse rate fluctuated considerably. A non-functioning pheochromocytoma detected incidentally must be preoperatively managed as a functioning one, even in the absence of specific symptoms of pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1984

Minimal thyroid carcinoma: a report of nine cases discovered by cervical lymph node metastases.

From 1962 to 1983, nine patients with minimal carcinoma of the thyroid were referred to Aichi Cancer Center Hospital and to Aichi Medical University Hospital for evaluation of enlarged lymph nodes in the neck. The radiographic study and scintigraphy of the thyroid were useful in detection of small thyroid lesions. In two cases, a lymph node biopsy was required for confirmation of the diagnosis. The thyroid lesions were histologically papillary carcinoma, in all the cases. A modified neck dissection with total thyroidectomy was carried out in five patients and modified neck dissection with thyroid lobectomy was done in four cases. Nine patients were followed for 6 months to 20 years and all the patients except one are alive.

Adult↗
PubMed1984

Pulmonary veno-occlusive disease in an elderly man: case report and review of the literature.

A 75-year-old man complaining of dyspnea and having sings of postcapillary pulmonary hypertension was diagnosed as pulmonary veno-occlusive disease and confirmed at autopsy. This is the oldest case ever reported. Almost all the small veins 2 mm or less in external diameter were partially or nearly completely occluded by intimal fibrous tissue, and the obstructive changes in the pulmonary arteries were much more limited. Pulmonary veno-occlusive disease is a rare, almost inevitably fatal disease of unknown etiology which has only recently been separated clearly from primary pulmonary hypertension as a distinct entity. Chest roentgenogram finding suggesting postcapillary pulmonary hypertension is a clue to a diagnosis and differentiates this from two other causes of clinical primary pulmonary hypertension, that is, recurrent pulmonary embolism and plexogenic pulmonary arteriopathy.

Aged↗
PubMed1984

Adrenocortical carcinoma responded to treatment with o,p'-DDD--a case report.

A case of a huge inoperable adrenocortical carcinoma which secreted testosterone without characteristic symptoms was treated with o,p'-DDD (2,2-bis(2-chlorophenyl-4 cholorophenyl) 1,1-dichloroethane). With this therapy, the tumor decreased in size which was confirmed by the computed tomography (CT). Eighteen months later, however, lethargy and logopathy appeared and the tumor grew again rapidly with the withdrawal of o,p'-DDD performed for the evaluation of these mental disturbances. The tumor then diminished gradually in size soon after the treatment was resumed and the above unfavorable symptoms were not developed again with the combined administration of a central nervous stimulant. During o,p'-DDD treatment, plasma testosterone and estrogen decreased, and plasma aldosterone also decreased but within the normal range. Plasma cortisol also tended to decrease despite hydrocortisone was administered. Plasma adrenocorticotropic hormone (ACTH) was maintained within the normal range for the first six months but then increased gradually. It decreased and became normal with the additional administration of hydrocortisone. The patient's normal menstruation at the preadministrative stage changed to oligomenorrhea, then amenorrhea after the treatment, but no endocrinological sign except for the menses was observed during the treatment.

Adrenal Cortex Neoplasms↗