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Biomedical subjects

K Amino

Publications and source records attributed to K Amino.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1988

[Improvements in placement of implantable drug delivery catheter for prevention and treatment of hepatic metastases from colorectal cancer].

Intra-arterial infusion chemotherapy was carried out using a subcutaneously implantable drug delivery system in 7 patients with rectal cancer, 5 patients with sigmoid colon cancer, 2 patients with transverse colon cancer, and 1 patient with ascending colon cancer, for prevention and treatment of hepatic metastases. The transport of intra-arterially infused drugs to the liver was examined during surgery using an infusion catheter, which was inserted by the fluorescence technique using Fluorescein-Na. The gastroepiploic artery was shifted to the abdominal wall to avoid leaving the infusion catheter as a foreign body after removal of the port. The fluorescein test, which is safe and can be performed in a short period by a simple procedure, is considered to be useful for intraoperative evaluation of the distribution of the drug to the liver. Since the infusion catheter remaining in the body after removal of the port may cause thrombosis and infection, measures to avoid leaving foreign bodies are considered to be necessary.

Antineoplastic Agents↗
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↗
PubMed1985

[Multidisciplinary treatment of bone and soft tissue sarcomas].

The result of the group study on adjuvant chemotherapy with HD-MTX, ADR and CPM for 25 cases of osteosarcomas is as follows: Overall survival at three and a half years is 58.4% and the disease-free survival is 40%. In our clinics, 66 cases of osteosarcomas were treated by the radical surgery from 1955. Overall survival of these cases at five years was 49%. Overall survival between 1955 and 1974 was 43% and that from 1975, the year when ADR was introduced, to date was 55%. The data of the group study of soft tissue sarcoma sponsored by Ministry of Health and Welfare show that in 318 cases of soft tissue sarcomas of extremities, the recurrence rate during the period between 1962 and 1976 is 52%, metastasis rate 69%, and overall survival at 5 years 42%. From 1972 to 1983, in 414 cases treated by the orthopaedic clinics of the same group the recurrence rate become as low as 23% metastasis rate 45% and overall survival at 5 years 56%. In our clinics, 89 patients with soft tissue sarcomas were treated by the curative wide resection and the recurrence rate is 12%, metastasis rate 25%, and overall survival at 5 years 78%. In this series, in 80% of cases limb salvage is succeeded.

Adult↗
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↗
PubMed1983

Experimental studies on the hemodynamics of the small intestine following increased intraluminal pressure.

Experimentally, we produced obstruction of the intestine in dogs, and the intraluminal pressure of the small intestine was measured without inducing anesthesia and with the abdominal wall closed. The maximum active intraluminal pressure reached 44.1 +/- 3.3 milligrams of mercury three days after the obstruction was produced. The pressure rose further to 95 millimeters of mercury, or higher, after an intravenous injection of physostigmine or during vomiting. When the intraluminal pressure is artificially increased and the vascular structure is observed by the resin-casting method, impairment of the villous circulation of the mucosa is already seen when the pressure reaches 20 millimeters of mercury. When the pressure was further increased, the circulation impairment spread toward the outer layer of the intestine. Mesenteric blood flow, peripheral vascular resistance and submucosal blood flow did not show significantly lower values than did the control group, unless the intraluminal pressure was 100 millimeters of mercury, or higher, but the oxygen consumption of the intestinal tissues was significantly lower than that for the control group when the intraluminal pressure was 40 millimeters of mercury, or higher. The resin-casting method showed that, at this pressure, a finding believed to indicate an arteriovenous shunt was already present at the mucosal villous base. The aforementioned results indicate that selective mucosal ischemia may occur when the intraluminal pressure increases to a range that is clinically possible when obstruction of the intestine occurs.

Animals↗
PubMed1982

[Tissue concentration of methotrexate in osteosarcoma after high-dose infusion].

Tissue concentrations of methotrexate (MTX) in osteosarcomas were examined with special reference to their histologic findings. Primary tumors in five cases and metastatic tumors in two cases were removed at 6-18 days after MTX administration. The concentrations of MTX in osteosarcoma tissues were higher than those in normal tissues and serum, ranging from 15.0 to 168 ng/g. Necrotic portions of the tumor lesion were less in MTX concentration than cellular portions. As the cellularity increased, the tumor tissue showed higher MTX concentration. Tissue concentrations of MTX in nude mice with transplanted osteosarcoma from human were also studied after the high-dose 3H-MTX infusion. MTX total, which contains dihydrofolate reductase-bound MTX, free MTX and its metabolites, decreased gradually with time in the tumor tissues. The concentrations of MTX total in tumor were proportional to the administrated dose and the clearances of MTX were prolonged according to the dose-increase of MTX. Tissue concentrations of MTX total in the lung, kidney and liver were higher than that in tumor itself at 192 hours after the injection. The value for MTX total includes some MTX active fraction which can inhibit the activity of dihydrofolate reductase. Tissue concentrations of MTX active also increased dose-dependently. The proportions of MTX active to MTX total in tumors decreased with the increment of the MTX dose, and the same findings were observed in the kidney and liver.

Adolescent↗