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Biomedical subjects

J Manabe

Publications and source records attributed to J Manabe.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Bolus and maintenance infusion of high-dose methotrexate].

For 17 patients with bone and soft tissue sarcoma, 32 bolus and maintenance infusions of high-dose methotrexate (MTX) were performed to induce rapid elevation of plasma MTX concentration and to maintain it. At the doses of 200-300 mg/kg, plasma MTX concentrations were measured by enzyme assay. It needed four hours to reach the steady state by five hours' constant rate infusion, with the plasma plateau concentration at about 1 X 10(-3) M/L. On the other hand, bolus infusion of MTX needed only one hour to reach over 5 X 10(-4) M/L, and the plateau concentration lasted during the maintenance infusion period. By the constant rate infusion as well as bolus infusion, it was possible to maintain the plasma concentration over 1 X 10(-4) M/L for 12 hours, but both infusions can not maintain 1 X 10(-3) M/L for a long time. From these results, clinical effects of high dose MTX against sarcomas seemed to be evaluated by the plasma MTX plateau concentration and the maintenance time.

Bone Neoplasms↗
PubMed1988

[Urinary beta 2-microglobulin as an indicator for impaired excretion of methotrexate].

Twenty cases treated with high-dose methotrexate (MTX) infusions were studied to determine whether urinary beta 2-Microglobulin (beta 2-M) is a reliable indicator to predict impaired excretion of methotrexate. Before and after MTX infusions, the levels of urinary beta 2-M were measured along with serum creatinine, uric nitrogen, and creatinine clearance. MTX clearance was found to be impaired in four of the 20 infusions, although concentrations of serum creatinine and uric nitrogen, and creatinine clearance were normal prior to the infusions. In the four cases that resulted in impaired excretion, a significant increase of beta 2-M levels was noted before and after the high-dose MTX infusion (p less than 0.01). Although one of the four cases showed a normal level of beta 2-M before the infusion, the post-infusion level of beta 2-M extremely high. This raised level of beta 2-M was thought to be caused by impaired excretion due to decreased amounts of urine. We conclude that urinary beta 2-M is a sensitive indicator of impaired excretion of high-dose MTX infusion, and especially when levels of more than 250 ng/ml of urinary beta 2-M are found to exist, it seems to difficult to clear the drug following high-dose MTX treatment.

Blood Urea Nitrogen↗
PubMed1988

[Procedures and results of limb salvage surgery of musculoskeletal sarcoma].

During the 8-year period beginning 1979, 116 cases of musculoskeletal sarcoma were treated by limb salvage operation. Of these, the local recurrence rate was 9% and the postoperative metastatic rate was 28%. The limb salvage rate was about 80%. Limb salvage procedures were generally performed using curative surgical procedures without preoperative adjunctive therapy. However, reduction of the surgical margin to achieve local cure was made possible by combined therapy with preoperative adjunctive chemotherapy or radiotherapy. The wide procedures combined with preoperative adjunctive therapy achieved a local curability rate equal to curative procedures. Marginal procedures following preoperative radiotherapy were also undertaken in those cases in which the tumor was located in an area for which curative or wide procedures were not feasible. Also, similar procedures were performed for patients of advanced age, patients with lung metastasis, patients who refused ablative surgery, and for extirpation of lymph node metastases. Accordingly, we were able to determine which procedures best ensure local curability. Also, the most significant prognostic factor was found to be local recurrence caused by inadequate surgical margin. This was especially true in the treatment of high malignant sarcoma. Moreover, from analysis of recurrent cases, the suggested factors contributing to local recurrence were: the invasive character of the tumor, lymph node metastasis, skip metastasis, tumor dissemination due to pathological fracture, previously performed inadequate surgery, venous invasion, and multicentrical occurrence of certain tumors.

Adult↗
PubMed1988

[Surgical treatment for bone and soft tissue sarcomas of the shoulder part].

Since 1977 we have treated 18 bone sarcomas and 16 soft tissue sarcomas of the shoulder part. For 10 bone sarcomas of the proximal humerus, four fore-quarter amputations, two curative wide resections, and four wide excisions were performed as radical operations. The reconstructive procedures after the six resections were two spacer insertions, one total shoulder replacement, and three arthrodeses with autografts. Considering the functional result, the arthrodesis is the most-recommended method. For eight bone sarcomas of the scapula, three total resections and four partial resections of the scapula, and one debulking operation were performed. For 16 soft tissue sarcomas, we performed two ablative operations, three curative wide resections, five wide excisions, and six conservative operations after adjunctive chemo-and/or radiotherapy. Among all 34 bone and soft tissue sarcomas, the success rate for limb salvage was 74%, while the recurrence rate was 18%. The functional result of the limb salvage operations was far better than that of ablative operations of the shoulder part. In fact the rate of satisfactory ADL (excellent and good) was 81% among the limb salvage cases, while for ablative operations, the ADL ratings were all poor.

Bone Neoplasms↗
PubMed1987

Lung fibrosis induced by diquat after intratracheal administration.

Diquat toxicity to lung was evaluated at various intervals after intratracheal administration to rats. Twelve hours after the injection, both type I and type II pneumocytes developed degenerative changes which were similar in nature to those induced by paraquat. A much larger dose of diquat, however, was needed for the changes compared to paraquat, which is known to be actively taken up by the lung. This morphological evidence suggests that diquat may cause alveolar damage by the same mechanism as paraquat, although it is not actively taken up by the lung. Moreover, initial alveolar damage induced by diquat was followed by lung fibrosis, as with paraquat. Since paraquat is a well known fibrogenic agent, the common property of these two agents in alveolar damage may be a key to interpreting the development of lung fibrosis.

Animals↗
PubMed1987

[Intra-arterial infusion of cisplatinum in bone and soft tissue tumors].

Cisplatin was administered by intravenous injection, intra-arterial injection, and balloon-occluded arterial infusion. The total Pt, ultrafiltrated Pt, and free Pt levels were measured. Intra-arterial injection, in which ultra-filtrated Pt level on the normal side is the same as in intravenous injection, acts to increase the ultrafiltrated Pt level on the affected side. Thus, intra-arterial injection is as effective as preoperative chemotherapy. In two-route chemotherapy, free Pt level on the affected side is extremely high, so for only local control of tumors, two-route chemotherapy is very effective.

Animals↗
PubMed1987

[The value of limb-saving surgery in the treatment of osteosarcoma].

Since 1981, 38 limb-saving operations for malignant bone tumors have been performed. Of these, 22 cases were osteosarcomas. The principle of limb-saving surgery for osteosarcoma is the same as for curative wide resection in cases of soft tissue sarcoma. Among the osteosarcoma cases for which limb-saving procedures were carried out, five complicated cases (two skip metastases and two infections) were noted. However, in the other cases, patients had better functional benefits and psychological acceptance compared with those subjected to radical ablative procedures. Indication for limb-saving surgery is usually decided by patient age, existence of skip metastasis and venous infiltration, effect of preoperative adjunctive therapy and the relationship of the tumor with the major artery necessary for preserving the affected limb. If the adjunctive therapy is effective, local control can be achieved by establishing a wide margin.

Adolescent↗
PubMed1987

[Surgical treatment of malignant soft tissue tumors].

The ultimate survival of patients with soft tissue sarcoma is determined by a number of factors. Radical removal by adequate surgery is one of the most important factors together with early treatment and chemotherapy. We usually select curative wide resection, amputation, or resection after radiotherapy as forms of radical surgery for soft tissue sarcomas according to each clinical stage. The method of curative wide resection is based on biological barrier effects. In this report we discuss the operative results obtained in 148 cases of soft tissue sarcoma which we have treated over the past ten years, and also discuss the causes of recurrence after radical operation. Among 55 primary NoMo which were treated by the curative wide resection cases, the recurrence rate was 5.5%, the metastatic rate was 21.8%, and 5-year survival was 79.3%. These results were better than those for 30 recurrent and additional NoMo cases. Of cases involving the extremities, 81% were controlled by limb-saving operations.

Adult↗
PubMed1987

[Combination chemotherapy including cis-platinum in Ewing's sarcoma].

A clinical study of cis-platinum was conducted on 5 patients with Ewing's sarcoma. Cis-platinum was preoperatively administered at doses of 70-100 mg/m2. Good response on imaging diagnosis was recorded in all cases. With regard to side effects, 2 of the 5 patients suffered from hearing loss, but only slight bone marrow suppression was observed. We concluded that cis-platinum was effective for the preoperative treatment of Ewing's sarcoma.

Adolescent↗
PubMed1986

The toxic effect of diquat on the rat lung after intratracheal administration.

Diquat toxicity to the lung was evaluated in rats. Diquat was administered intratracheally (i.t.) and its toxic potential was compared with that of paraquat. Diquat showed toxic effects in the lung when administered i.t. In previous research, diquat administered by the intravenous (i.v.) or oral (p.o.) route had little effect on the lung. a sufficient dose of diquat administered i.t. would be potentially toxic to the lung, but diquat is much less toxic to the lung than paraquat, which is actively taken up by lung tissue. This suggests that diquat is not actively taken up by lung tissue when administered i.t., but may be passively taken up by the lung tissue and induce lung damage.

Animals↗
PubMed1984

[Curative limb saving operation (curative wide resection)].

The recent results of surgical treatment of soft tissue sarcomas have dramatically improved. The result of the group study of soft tissue sarcomas, which was supported by the Ministry of Health and Welfare (1962-1976) showed that the local recurrence rate was 50%, and the metastatic rate was 60%. In contrast with this result, the recent results of our curative wide resection showed the local recurrence rate of 10%, and the metastatic rate of 30%. These procedures are based on the clinico-pathological findings which we studied. Curative wide resection is a method of radical wide resection, similar to radical local resection (reported by Enneking) and radical local excision (reported by Stenar). Our procedures are the least aggressive of the three radical wide resections, but our results are the same as the other wide resection methods. To obtain good results with these procedures, accurate preoperative diagnosis and skillful surgery are necessary.

Adult↗