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Biomedical subjects

K Eguchi

Publications and source records attributed to K Eguchi.

At least 469 records · Page 26Linked to original sources
PubMed1989

Prognostic factors in small cell lung cancer: multivariate analysis in the National Cancer Center Hospital (Japan).

Consecutive series involving 172 patients with small cell lung cancer were analyzed retrospectively using eight pretreatment and two treatment-related prognostic factors in respect of their influence on survival. All the patients received chemotherapy with or without chest irradiation, according to phase II or phase III trial protocols of the National Cancer Center Hospital, Tokyo, from 1970 to 1987. The influence on survival of the various factors was investigated using univariate methods and Cox's proportional hazards model. In patients who survived for more than one year, a performance status of 0-1, limited disease, an age greater than 60 years, the absence of liver metastasis, radiotherapy to primary site and response to chemotherapy were determined by univariate analysis to be favorable prognostic factors. By multivariate analysis, performance status (P = 0.005), age (P = 0.026) and response to induction chemotherapy (P = 0.0001) proved to be valuable prognostic survival factors. The extent of disease which had been considered one of the most significant prognostic factors, was shown not to be a significant independent variable by multivariate analysis. Staging procedures may influence the prognostic analysis. Although classifying the limited or extensive stage of disease is still recommended, the current staging system lacks stringency and may not, in fact, reflect the tumor burden accurately. A simpler and meaningful staging system needs to adopted universally in order to continue the build-up of data for comparison from all institutions.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Increment of Tal positive cells in peripheral blood from patients with rheumatoid arthritis.

Recently it was demonstrated that the Tal antigen is a marker for activated T cells and the population of Tal+ cells includes memory T cells. Our study was undertaken to analyze Tal+ cells in peripheral blood from patients with rheumatoid arthritis (RA) and examine the correlation between the proportion of Tal+ cells and disease activity. Using a dual immunofluorescent method, T cell subsets were analyzed in peripheral blood from 46 patients with RA, 10 patients with osteoarthritis (OA) and 10 healthy subjects. Patients with RA had a significantly higher percentage of T cells bearing the Tal antigen than patients with OA and healthy subjects. Furthermore, the percentage of CD3+Tal+ cells in peripheral blood from patients with RA was significantly correlated with disease activity including erythrocyte sedimentation rate, morning stiffness and the Lansbury index, whereas CD3+ HLA-DR+ cells did not correlate. In serial observations in patients with RA, the percentage of CD3+ Tal+ cells decreased in accordance with the improvement of disease activity. Thus, we suggest that the percentage of Tal+ cells may be a marker of the disease activity in patients with RA.

Aged↗
PubMed1989

Elevation of a tumor associated antigen CA 19-9 levels in patients with rheumatic diseases.

We investigated the incidence and characteristics of an elevated tumor associated antigen CA 19-9 in patients with rheumatic diseases. Serum concentration of CA 19-9 was increased in 13 of 39 patients (33.3%) with definite or classical rheumatoid arthritis (RA), in 6 of 19 patients (31.6%) with systemic lupus erythematosus (SLE), in 3 of 9 patients (33.3%) with progressive systemic sclerosis (PSS) and in 9 of the other 35 patients (25.7%). Malignant neoplasm was not detected in any of the patients with rheumatic diseases. Pretreatment of mouse serum with patients' sera did not reduce the measured CA 19-9 values obtained by the conventional assay. The CA 19-9 antigen found in sera from patients with RA was present in a non-IgG fraction, and had the same molecular weight as that in one patient with pancreatic cancer, as determined by gel filtration. These results demonstrated that serum CA 19-9 levels were increased in some patients with rheumatic diseases.

Adult↗
PubMed1989

[Pharmacokinetic and clinical studies on cefodizime in the field of obstetrics and gynecology].

We have conducted pharmacokinetic and clinical trials of a new cephem derivative, cefodizime (THR-221, CDZM), and obtained the following results. 1. We administered CDZM to 4 cases with abdominal simple hysterectomy due to myoma uteri at a dose level of 1 g by drip intravenous injection and studied average levels of transfer measured at various locations in the uterine tissues and adnexa at an average of 2 hours after administration. CDZM level was highest in the oviduct, 13.7 micrograms/g (ratio with respect to the uterine arterial blood: 91.3%), followed by the ovary, portio vaginalis, cervix uteri and endometrium, and was lowest in the myometrium, 8.3 micrograms/g (55.3%). CDZM concentrations were higher than 6.04 micrograms/g in any tissues. 2. To study CDZM transfer to pelvic cavity fluid, we administered CDZM to 5 cases with total hysterectomy due to cervical cancer of uteri at a dose level of 2 g using drip intravenous injection. The drug was transferred at high levels to the pelvic cavity fluid. A level of 11.7 micrograms/ml was observed at 3 hours after injection. The drug levels in the pelvic cavity fluid were maintained continuously higher levels than those of venous blood. These concentrations in the uterine tissues and pelvic cavity fluid were higher than the MIC against many strains of Gram-positive and Gram-negative bacteria, hence we considered them to be therapeutically effective concentrations. 3. Eleven cases of gynecological infections receiving in totals of 8 to 48 g of CDZM demonstrated "excellent" results in 3 cases, "good" in 8 cases. Eight strains of organisms were isolated from 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[A case of progressive systemic sclerosis accompanied with rheumatoid arthritis].

A 37-year old man was suffered from Raynaud's phenomenon, sclerodactyly, and polyarthritis involving knees, shoulders, and hands. Recurrent skin ulcers were present in finger tips. Laboratory studies showed positive RA test, antinuclear antibody (nucleolar type), and anti-Scl 70 antibody. So diagnosis of progressive systemic sclerosis (PSS) was made. Progressed destructive arthritis with rheumatoid nodules developed in the patient. The joint destruction was severe and he was satisfied with the criteria of the American Rheumatism Association (ARA). This patient appears to be an overlapping case of PSS and rheumatoid arthritis (RA).

Adult↗
PubMed1989

Rapidly progressive glomerulonephritis undetected by routine school urinalysis: a case report.

A twelve year old girl with rapidly progressive glomerulonephritis (RPGN) is reported. First symptoms of renal failure developed in August 1987 just five months after a routine school urinalysis which detected no abnormalities. The patient developed end stage renal failure within 2 months of onset. Continuous ambulatory peritoneal dialysis (CAPD) was introduced to manage the renal failure, and open renal biopsy was performed simultaneously in order to elucidate the underlying renal disease in this patient. Microscopic examination of the biopsy specimen demonstrated marked formation of crescents in about 90% of the glomeruli, and some of the glomeruli were already sclerotic. Granular depositions of IgG(trace), IgA(1+), IgM(3+), properdine(3+), Clq(3+) and C3(3+) were observed by immunofluorescence staining. A definite diagnosis of rapidly progressive glomerulonephritis was made as the cause of renal failure in this patient. It was suggested that open renal biopsy is useful in diagnosing the underlying kidney disease of end stage renal failure in cases where the clinical course is relatively short.

Child↗
PubMed1989

Continuous ambulatory peritoneal dialysis in a diabetic patient with renal insufficiency and ventricular aneurysm.

A diabetic patient with renal insufficiency and a giant ventricular aneurysm was treated by continuous ambulatory peritoneal dialysis (CAPD). No apparent exacerbation of the patient's cardiovascular function was observed after starting CAPD therapy, although his ejection fraction remained low and his angina attacks persisted. It is suggested that CAPD therapy has no deleterious effects on the cardiovascular system of patients with ventricular aneurysms, and that the benefits outweigh the risks.

Angina Pectoris↗
PubMed1989

Glomerular T cell and monocyte populations in patients with IgA nephropathy.

Renal tissues from 19 patients with the minimal or slight stage of IgA nephropathy were examined for evidence of glomerular T cell or monocyte infiltration using monoclonal antibodies to identify T cells (OKT3, OKT11), T cell subsets (OKT4, OKT8), and monocytes and null cells (OKM1) by indirect immunofluorescence. Renal tissues from 12 patients at the same stage of mesangial proliferative glomerulonephritis without IgA deposition were also investigated by these procedures. Light microscopic examination of the same renal tissues was also performed. Reactive glomerular mononuclear cells were found to be numerous in patients with IgA nephropathy. The most prominent type of glomerular cells was OKT8 positive. T cell subsets and OKM1 positive cells in glomeruli from patients with IgA nephropathy were significantly increased as compared to those from patients with mesangial proliferative glomerulonephritis. Focal segmental proliferation of mesangial cells was observed in glomeruli which showed an accumulation of OKT8 positive cells. It is concluded that the immuno-regulatory mechanism involving T cells and/or monocytes might be one of the exacerbating factors in patients with IgA nephropathy.

Glomerulonephritis, IGA↗
PubMed1989

Control of cisplatin-induced delayed emesis with metoclopramide and dexamethasone: a randomized controlled trial.

Forty-two patients with advanced lung cancer undergoing chemotherapy containing cisplatin (80 mg/m2) were submitted to a randomized controlled trial to evaluate the effect of the combination of metoclopramide and dexamethasone for the treatment of delayed cisplatin-induced emesis occurring more than 24 hours after cisplatin administration. All patients received intravenously (i.v.) high-dose metoclopramide and dexamethasone on the day of cisplatin treatment. Excellent emetic control (no emesis during the 24 hours following cisplatin administration) was achieved in 30 out of 41 patients (73%) with this combination. Patients treated i.v. with metoclopramide and dexamethasone on days 2-7 experienced less delayed emesis, nausea and anorexia compared to those treated with a placebo (delayed emesis, 25 vs 50%, respectively, P = 0.105; more than four days of nausea, 10 vs 35%, respectively, P = 0.059; less than three days of anorexia, 80 vs 50%, respectively, P = 0.048). Although the results of the study showed no statistically significant advantage with the combination of i.v. metoclopramide and dexamethasone for patients treated with cisplatin, in view of the short duration of anorexia and the marginal reduction in nausea. Female patients tended to have more emetic episodes and extrapyramidal side effects (except akathisia) than male patients, but the differences were not statistically significant except for acute emesis (P less than 0.005).

Adult↗
PubMed1988

Evaluation of the effects of chemotherapy in lung cancer by thoracic computed tomography.

In thoracic-computed tomography (CT) before and after chemotherapy against lung cancer in 23 patients, the percentages of the reduction of tumor size were calculated by three different methods of measurements, including (1) the product of the largest perpendicular diameter of the tumor, (2) the area of the tumor determined by the tracing method on the image which has the largest tumor mass visualized, and (3) the sum of the areas of all tumors measured by the tracing method. The tumor reduction percentages measured by these three different methods showed good correlation (1 versus 2, 2 versus 3, 3 versus 1; P less than 0.001). Therefore, it was assumed that the percentage of tumor reduction determined by the thoracic CT can be calculated correctly by the product of the perpendicular diameters of tumors on the selection of the image which has the largest tumor mass visualized.

Adult↗
PubMed1988

Cytogenetic effect of carboplatin on human lymphocytes.

Carboplatin, a second generation cisplatin analogue, was tested for induction of sister chromatid exchange (SCE) as well as chromosomal aberrations in human lymphocytes in vitro and in vivo. A dose-dependent effect was observed for increased frequency of metaphases with SCE (r = 0.984, P less than 0.001) as well as chromosomal aberrations (r = 0.994, P less than 0.001), primarily chromatid gap or break, in vitro. SCE induction by carboplatin was less than that by cisplatin at the same concentration. When patients were treated with a single dose of carboplatin at a dose of 450 mg/m2, the frequency of SCE and chromatid type aberrations increased significantly. However, even when considering dose and peak plasma concentration in patients receiving carboplatin, it appears that the ability of carboplatin to induce SCE and chromosomal aberrations is weaker than that of cisplatin. SCE frequencies induced by carboplatin decreased with time going by, and in one patient who was tested 5 weeks after treatment, SCE frequency showed a decrease to the pretreatment level. It thus appears that carboplatin has an improved therapeutic index over the parent compound, cisplatin, because of its less mutagenic or carcinogenic hazard, in addition to the largely reduced incidence of untoward effects.

Aged↗
PubMed1988

Phase II study of carboplatin in small cell lung cancer.

Carboplatin (CBDCA; cis-diammine-1, 1-cyclobutane dicarboxylate platinum II), a new platinum analogue, was administered to 18 patients with small cell lung cancer (SCLC) at a dose of 300-450 mg/m2 intravenously every four weeks, in a phase II study. All patients could be evaluated to assess response and 17 for toxicity. The overall response rate was 28% (5/18), including one complete response. Of eight patients previously untreated, four (50%) showed a response, including one complete response. The response rate in patients with no previous cisplatin-treatment was 50% (5/10). Response durations in five responders were 2, 3, greater than 4, greater than 10 and 11 months. Toxicity was primarily hematologic, with thrombocytopenia being dose-limiting. Thrombocytopenia (less than 75,000/mm3) was observed in 12 patients (71%), six requiring platelet transfusion. Leukopenia (less than 3,000/mm3) was observed in 11 patients (65%). There were no episodes of serious infection or bleeding, however. Myelosuppression was more severe in heavily pretreated patients than in patients previously untreated. Dose reductions were required following multiple treatments for cumulative myelotoxicity. Mild to moderate nausea and vomiting occurred in seven patients (44%). Nephrotoxicity and ototoxicity were not observed. Carboplatin was demonstrated to be an active agent against SCLC. Further investigation into dose and schedule of CBDCA in combination chemotherapy is warranted.

Aged↗
PubMed1988

Three schedules of recombinant human interleukin-2 in the treatment of malignancy: side effects and immunologic effects in relation to serum level.

Recombinant human interleukin-2 (rIL-2) was administered to 34 patients with advanced malignancy. Three schedules of rIL-2 administration employed were as follows: (A) 2-hr iv infusion of 6.7 X 10(5) U/m2/day (A1, 6 cases) or 2.2 X 10(6) U/m2/day (A2, 8 cases) for five consecutive days; (B) 24-hr continuous iv infusion of 3.3 X 10(5) U/m2/day (B1, 3 cases), 6.7 X 10(5) U/m2/day (B2, 7 cases) or 1.1 X 10(6) U/m2/day (B3, 5 cases) for 28 consecutive days; and (C) 24-hr continuous iv infusion of 6.7 X 10(5) U/m2/day (C, 5 cases) for 5 consecutive days per week for four weeks. The common side effects were fever (79%), eosinophilia (61%), malaise (56%), erythema or rash (50%), chills (38%) and nausea or vomiting (35%), with the dose-limiting toxicities being hypotension in group A, and renal dysfunction with fluid retention in groups B and C. In the case of 2-hr iv infusion, rIL-2 was rapidly cleared from the plasma, with a half life of about 30 min, while in the case of 24-hr continuous infusion, more than 1 U/ml serum IL-2 activity was maintained for 14 days in group B3. Natural killer (NK) and lymphokine-activated killer (LAK) activities were augmented by rIL-2 administration in patients of groups A, B3 and C. In eight patients of group B, NK and LAK activities transiently decreased after rIL-2 administration, and recovered by day 3. The percentage of IL-2 receptor and Leu HLA-DR positive cells reached the peak level on day 7 in group B. In patients of group C, the percentage of Leu HLA-DR positive cells as well as NK and LAK activities increased upon rIL-2 administration and decreased during an intermission of two days. However, the percentage of rIL-2 receptor positive cells increased during the intermission of rIL-2. The most effective schedule of rIL-2 administration was considered to be the schedule of group C on the basis of this study.

Adult↗
PubMed1988

Detection of glomerular sialic acids in patients with diabetic nephropathy.

A study on immunofluorescence of sialic acids in glomeruli from patients with diabetic nephropathy is described. Measurement of sialic acid in sera from 25 patients with diabetes mellitus was also performed. Renal biopsy specimens from 12 patients with diabetic nephropathy were stained with FITC-labeled antihuman IgG antiserum and rhodamine-labeled Triticum vulgaris (WGA) or Limulus polyphemus (LPA). These specimens were also stained with such reagents after treatment with neuraminidase, trypsin or citrate buffer. Both deposition of IgG and binding of WGA in the glomerular capillary walls were observed in all patients with diabetic nephropathy. The binding of WGA in the glomerular capillary walls in diabetic nephropathy was significantly increased compared with that in four normal renal tissues. However, the binding of LPA was hardly observed in the glomerular capillary walls of patients with diabetic nephropathy. The binding of WGA in the glomeruli was markedly decreased after treatment with neuraminidase although it was hardly decreased after treatment with trypsin or citrate buffer. The levels of sialic acid in sera from patients with diabetic nephropathy were markedly increased. It is suggested that accumulated substances in the glomerular capillary walls with an affinity for WGA are mainly composed of N-acetyl glucosamine and/or N-acetyl neuraminic acid in patients with diabetic nephropathy.

Adult↗
PubMed1988

Levels of circulating IgA immune complexes after gluten-rich diet in patients with IgA nephropathy.

Measurement of IgA circulating immune complexes (IgA-CIC) in sera from patients with IgA nephropathy after a gluten-poor diet, an unrestricted diet and a gluten-rich diet is described. High levels of IgA-CIC in sera were detected in patients after these diets. However, the levels of IgA-CIC in sera 2 weeks after the gluten-rich diet were not significantly increased compared with those after the other diets. It is suggested that, for a short duration, the gluten-rich diet might not increase the levels of IgA-CIC in sera from Japanese patients with IgA nephropathy.

Adolescent↗
PubMed1988

Natural killer and natural killer-like cell activity of peripheral blood and intrathyroidal mononuclear cells from patients with Graves' disease.

This study was undertaken to investigate the natural killer (NK) and natural killer-like (NK-like) cell cytotoxic activity toward autologous thyrocytes of peripheral blood mononuclear cells (PB-MNC) and thyroid gland mononuclear cells (TG-MNC) from previously hyperthyroid patients with Graves' disease, and the effects of recombinant interleukin-2 on such cytotoxic activity. The average cytotoxicities of PB-MNC from Graves' patients toward K562 cells (NK-sensitive cells), Raji cells (NK-resistant cells), and autologous thyrocytes were 23.9 +/- 10.8 (+/- SD) lytic units (LU), 7.4 +/- 3.8 LU, and 11.7 +/- 4.4 LU, respectively. There were no differences in the NK and NK-like cell activity of PB-MNC between Graves' disease patients and normal subjects. In contrast to PB-MNC from patients with Graves' disease, NK and NK-like cell activity was markedly decreased in TG-MNC (NK cell activity, 2.1 +/- 2.3 LU; NK-like cell activity, 1.5 +/- 1.5 LU). TG-MNC from Graves' patients had no cytotoxic activity against autologous thyrocytes. Using the monoclonal anti-Leu 7 and anti-CD16 antibodies and a two-color immunofluorescence method, the NK cell subsets were examined in PB-MNC and TG-MNC from Graves' patients. The percentage of CD16+ cells was significantly decreased in TG-MNC compared to PB-MNC, whereas there was no significant difference in the percentage of Leu 7+ cells between PB-MNC and TG-MNC. Incubation of TG-MNC with medium only did not increase the NK and NK-like cell activity of these cells. Furthermore, incubation of autologous PB-MNC with supernatants of minced thyroid tissues did not alter their NK and NK-like cell activity. The decreased NK and NK-like cell activity of TG-MNC was augmented when these cells were incubated with recombinant interleukin-2. These results suggest that the reduction of NK cell activity in TG-MNC may allow perpetuation of B-cell activation and lead to excessive production of autoantibody in thyroid tissue.

Adolescent↗