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Biomedical subjects

H Koie

Publications and source records attributed to H Koie.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Immune response in cancer patients treated with adjuvant immunochemotherapy].

In order to evaluate the immune response in cancer patients treated with adjuvant immunochemotherapy, a committee was organized in Japanese research Society for Surgical Cancer Immunology. Skin reactions, subsets of PBL, HLA, immunosuppressor (IAP), Immunoactivity (NK activity and lymphoblastogenesis with PHA), general nutritional condition and performance status were picked up and discussed as to how these reactions influence the prognosis of patients. For example, 395 cases of gastric cancer (excluded stage I, non-chemotherapy and absolute non-curative resection) collected from the committee's hospital were divided into two groups, according to a statistical "cut off point", i.e., more than 5.9g/dl of TP, 4.0g/dl of Alb, and 1500/mm3 of PBL, and values less than these. The five-year survival rate was significantly high in the former group. In the group that kept high counts of these parameters after operation, the 5-year survival rate was significantly high in cases which received immunotherapy. In conclusion, immunoparameters paralleled to the stage of disease and prognosis. When the parameters remained at high levels after operation, the immunotherapy group showed good survival compared to the non-immunotherapy group. Immunotherapy is not valuable in patients with high IAP levels and poor nutritional condition.

Humans↗
PubMed1991

[Two cases of idiopathic pneumopericardium].

Idiopathic pneumopericardium (I.P.) is a rare disease which occurs in a manner etiologically different from pneumopericardium. Recently, we encountered two apparent cases of I.P. at the Department of Surgery, Aomori Rhosai Hospital. Results of observation indicated that, in case 1, diving practice in a pool was the cause of the sickness, and in case 2, the cause was severe morning sickness during pregnancy. Unlike pneumopericardium that comes from traumatism, lesions of the surrounding organs, infection iatrogenicity and the like, the present cases were diagnosed as idiopathic pneumopericardium resulting from rupture of a number of alveoli due to transitory abnormal increase in Valsalva maneuver at expiration.

Adolescent↗
PubMed1990

[Two treated cases of infectious endocarditis with subsequent rupture of cerebral aneurysm].

Infectious cerebral aneurysm secondary to infectious endocarditis is susceptible to rupture and its prognosis is unfavorable with high mortality. Recently, we encountered two cases (a 20-year-old man and a 21-year-old woman) with intracranial bleeding due to this disease at the Department of Surgery, Aomori Rosai Hospital, and succeeded in replacing the mitral valve. Based on the present case and related reports in Japan and abroad, the importance of immediate appropriate brain surgical treatment and subsequent radical treatment such as replacement of the mitral valve for infectious endocarditis is shown for improvement in the lifesaving rate for intracranial bleeding due to the present disease.

Adult↗
PubMed1989

The influence of liver dysfunction on cyclosporine pharmacokinetics--a comparison between 70 per cent hepatectomy and complete bile duct ligation in dogs.

The influence of experimentally induced hepatic dysfunction on the pharmacokinetics of Cyclosporine A (CsA) was determined in dogs. The pharmacokinetics of oral (PO) and intravenous (IV) CsA were studied before and after 70 per cent hepatectomy or complete bile duct ligation (CBDL). Changes in liver function were monitored by serial measurements of serum bilirubin, and by the maximum removal rate (Rmax) and plasma disappearance rate (ICG-K) of indocyanine green (ICG). Concentrations of CsA in whole blood were measured by HPLC. Seventy per cent hepatectomy caused significant liver dysfunction: the ICG-Rmax decreased by 47.7 +/- 7.1 per cent (mean +/- SD) and the ICG-K decreased by 61.3 +/- 9.7 per cent during the first week after hepatectomy. At the same time, the systemic clearance (CLs) of IV-CsA decreased by 43.9 +/- 8.2 per cent, the area under the concentration curve (AUC) of IV-CsA increased by 35.4 +/- 20.8 per cent and the bioavailability of CsA decreased by 26.4 +/- 14.8 per cent. CBDL also induced significant liver dysfunction: the ICG-Rmax decreased by 39.1 +/- 12.8 per cent and the ICG-K decreased by 65.6 +/- 3.6 per cent in the second week after the operation. During the same period, the AUC of PO-CsA decreased by 69.9 +/- 10.7 per cent and the bioavailability of CsA also decreased markedly by 73.9 +/- 15.6 per cent. These data indicate that hepatic impairment significantly influences the pharmacokinetics of CsA, not only by the changes in intestinal absorption, but also by those in hepatic metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[Adoptive immunotherapy of advanced cancer patients with immune RNA-sensitized lymphocytes].

Tumor cell suspension was prepared from resected tumor tissue of various cancer patients. I-RNA was extracted from lymphoid tissues of rabbits immunized with each tumor cell and CFA. Autologous (in some cases, allogeneic) lymphocytes were prepared with blood cell separator and incubated with I-RNA, then, returned to himself. Twenty five cases of non-curatively resected gastric cancer (group A), 27 cases of stage II-IV of esophageal carcinoma (group B), 21 of lung cancer (group C), 14 of colorectal cancer (group D) and 37 cases with metastatic lesions (group E) were treated with this schedule. Five year cumulative survival rate was 21% in group A, 23% in group B, 46% in group C and 61% in group D, respectively. One case of CR and 5 of PR were recognized in group E. In many cases of the responder, lymphocyte count, ratio of Leu 4+, 3a+ subset in the peripheral bloods increased and skin reaction to autologous tumor cell extract, LAI and LMI became to positive. Interferon activity was also increased in the responder. It was reported on the preliminary study of combination treatment with I-RNA sensitized lymphocytes and IL-2.

Animals↗
PubMed1989

[A case of ruptured left subclavian artery associated with von recklinghausen's disease].

Emergency operation was performed on a 38-year-old woman of von Recklinghausen's disease, who fell in shock due to massive hemorrhage in the left thoracic cavity following rupture of the left subclavian artery. The vascular wall was so fragile that hemostasis was difficult. She survived the operation. Vascular complications in von Recklinghausen disease were discussed.

Adult↗
PubMed1989

[Coronary hemodynamics in a patient developing chest pain in the middle age in congenital coronary-pulmonary fistula].

Recently reports of congenital coronary-pulmonary fistula have been increasing with the wide-spread use of coronary angiography. However, the cause of the angina sometimes seen as a chief complaint in coronary fistula has not been well demonstrated although it has been suggested that coronary steal phenomenon accounts for it. This report documented coronary hemodynamics in a patient who came to develop anterior chest pain in the middle age owing to congenital coronary-pulmonary fistula, measuring coronary flow before and after the fistula-closure operation. A 35-year-old woman suffered from a sudden onset of severe anterior chest pain in April, 1986. She was referred to our hospital on suspicion of ruptured aneurysm of Valsalva. Auscultation disclosed continuous murmur at 3 LSB, but no evidence of ruptured aneurysm of Valsalva was detected by echocardiography nor aortography. Coronary angiography showed both left and right coronary fistula into the stem of pulmonary artery and otherwise normal angiogram. Great cardiac vein flow (GCVF) measured with regional thermodilution method was 25 ml/min at rest (70 bpm) and 30 ml/min during rapid atrial pacing (150 bpm) before the operation, and 30 ml/min (78 bpm) and 58 ml/min (150 bpm) after the operation, respectively. Before the surgery, anterior coronary resistance (CRant) was higher than that in normal subjects at rest and remained almost steady during atrial pacing. After the surgery, CRant was still higher at rest but remarkably reduced during pacing of 150 bpm. These findings suggest that the gradual increase in peripheral coronary resistance for a long time may lead to the inducement of coronary steal in the middle-later age in patients with coronary fistula.

Adult↗
PubMed1989

[A case of myocardial infarction due to the left main trunk lesion, in which percutaneous coronary recanalization and emergency coronary-aorto bypass graft, and subsequent percutaneous coronary angioplasty were effective not only from a viewpoint of survival but from comeback to social life].

A case of acute myocardial infarction due to the lesion in the left main coronary artery was reported. A 50-year male was referred to our department for suspected acute myocardial infarction. Physical examination on admission revealed slight cyanosis with cold sweating due to severe chest pain. Pulse was irregular and heart rate was 78 beats/min. Blood pressure was 100/80 mmHg. A series of electrocardiograms (ECG) and laboratory data provided the diagnosis of wide-ranged anterolateral infarction in the left ventricle. Emergency coronary angiograms taken without delay showed a subtotal occlusion (99% stenosis) of the left main coronary trunk (LMT) before the initiation of intracoronary thrombolysis (PTCR). Following the intracoronary infusion of urokinase of 1,200,000 units, symptoms and ECG changes transiently improved but worsened later, and LMT stenotic lesion and delayed filling of myocardium were similar with before PTCR. Emergency coronary-aorto bypass graft (CABG) was undertaken without a significant delay to both the left anterior descending artery (LAD) and left circumflex coronary artery (LCX). With these treatments, the patient could survive despite the wide area of infarction due to LMT lesion. Coronary angiograms performed 37 days after the CABG showed that the graft to LAD was completely occluded and the LCX graft was patent with partial stenosis. Treadmill test at this time induced an anginal episode with ischemic ECG changes on moderate exercise, indicating the presence of significant area of ischemic myocardium. For salvage of the ischemic myocardium, percutaneous transluminal coronary angioplasty (PTCA) was successfully performed for the LMT stenosis, resulting in no episode of angina nor ischemic ECG changes during exercise loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1989

[Bypass operation adaptable to stature increase in child with atypical coarctation of the aorta].

A 9-year-old girl was admitted with hypertension and severe congestive heart failure. Upon physical examination, a discrepancy of blood pressure between arm and leg was noted. Aortography revealed narrowing about 5 cm in length at the midportion of the descending thoracic aorta. Bypass operation of the narrow segment was performed under mild hypothermia with the diagnosis of atypical coarctation of the aorta. It was supposed that the patient might outgrow the graft and the graft would become too small for grown-up patient in diameter and length, then the haemodynamics would become less satisfactory and too much tension on the suture line would occur. A woven Dacron graft, 10 mm in diameter, 15 cm in length, was anastomosed proximally and distally to the coarcted segment at a distance of about 6 cm. So, the graft was disposed in a C-shaped configuration. It was expected that the arch of the graft would open more widely with increase of her stature, even if the graft does not increase in length. She has been followed for twelve years. Hypertension of upper extremity and arm-to-leg gradients of the systolic blood pressure were recognized from two years after the operation, particularly with exercise. However, cardiomegaly and left ventricular hypertrophy in ECG were improved. She appears to have been developing normally with no cardiac symptoms. Estimating from angiography, the distance between proximal and distal anastomoses stretched about 2 cm during the period of rapid growth, though calcification of the graft had been seen from four years after the operation, perhaps due to increased calcium turnover in childhood.

Aorta, Thoracic↗
PubMed1988

[Cooperative research on post-operative adjuvant therapy of breast cancer. Tohoku Society of Adjuvant Chemo-endocrine Therapy of Breast Cancer].

A randomized trial was carried out in 55 institutes in the Tohoku district to examine the significance of breast cancer post-operative adjuvant chemo-endocrine therapy in stage II and IIIa patients for possible radical mastectomy. A total of 619 patients were entered from November 1982 to November 1984, of whom 554 were eligible. Patients were administered MMC 13 mg/m2 after surgery, and randomized using the envelope method into either group A, treated with Tegafur 400 mg/m2 alone (275 patients), or group B, treated with Tegafur 400 mg/m2 and Tamoxifen 20 mg/daily (279 patients), for a year from the 7th day after operation. There was no significant difference between the two groups in the background factors of age, menopausal status, operation methods, stage or number of positive lymph nodes, but there were more patients of ER(+) in group B. A Kaplan-Meier method comparison showed no significant difference between the two groups in 3-year disease-free survival rates. There was no significant difference between the two groups compared by ER or menopausal status. However, patients with 4 or more positive lymph nodes showed a significant benefit in group B. Group B also marked a higher disease-free survival rate for ER(+) patients with 4 or more positive lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Long-term results of aortic valvuloplasty for aortic regurgitation associated with ventricular septal defect.

Long-term results in 64 patients who underwent aortic valvuloplasty for aortic regurgitation associated with ventricular septal defect are presented. The average age of the patients was 10.2 years and the average cardiothoracic ratio was 0.57 at the time of operation. The average degree of aortic regurgitation, as classified by Sellers, was 2.7. The type of ventricular septal defect was subpulmonic in 31 patients, perimembranous in 20, and was a total conal defect in five patients. Valvuloplasty was performed at one end of an aortic cusp in 23 patients, at two ends in 33, at three ends in six, and at four ends in two patients. There was one operative death (1.6%). The follow-up period was 447.7 patient-years, and there were no late deaths. The actuarial survival rate was 98.3% at 5, 10, and 15 years. Postoperative cardiac catheterization was performed in 40 patients. Valvuloplasty failure was defined as the presence of a cardiothoracic ratio greater than 0.6, a loud regurgitant murmur (Levine grade 3/6 or greater), moderate or severe aortic regurgitation (Sellers grade 3 or 4), or the necessity of reoperation. There were 17 patients whose valvuloplasty failed. The freedom from valvuloplasty failure was 74.2% at 5 and 10 years and 55.3% at 15 years. Eight patients underwent reoperation because of residual aortic regurgitation, and all survived. The freedom from reoperation was 90.1% at 5 years, 80.5% at 10 years, and 63.7% at 15 years. Multiple regression analysis revealed that older age, a greater cardiothoracic ratio, perimembranous ventricular septal defect, and multiple valvuloplasties were significant contributing factors for residual regurgitation after aortic valvuloplasty.

Actuarial Analysis↗