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Biomedical subjects

K Fujiyoshi

Publications and source records attributed to K Fujiyoshi.

At least 19 recordsLinked to original sources
PubMed2001

[A modified administrated schedule for combination therapy with irinotecan and cisplatin as a neoadjuvant chemotherapy in locally advanced cervical cancer--a report of 2 cases as a pilot study].

To shorten the treatment term of neoadjuvant chemotherapy (NAC) for locally advanced cervical cancer, a combination of irinotecan (CPT-11) and cisplatin was administered on a modified administrated schedule for 2 eligible patients as a pilot study. CPT-11 70 mg/m2 was administered (div) on days 1 and 8, followed by cisplatin 70 mg/m2 given (div) on day 1. Treatment was repeated every 3 weeks for a total of two cycles. Both patients showed a complete clinical response. No severer toxicities were observed than with the usual regimen, and both cases could undergo radical hysterectomy after NAC. The results suggest that this modified regimen of combination of CPT-11 and cisplatin can be effective as an NAC in cases of locally advanced cervical cancer, especially in terms of shortening treatment term. This regimen is worthy of further study.

Adult↗
PubMed2000

Successful treatment of two patients with recurrent endometrial cancer by weekly paclitaxel.

OBJECTIVE: The aim of this study was to evaluate the toxicity and efficacy of weekly paclitaxel in patients with recurrent endometrial cancer. METHODS: Paclitaxel (70 mg/m(2) by 1-h infusion weekly) was administered to two patients with recurrent endometrial cancer of the lung. RESULTS: After 5 cycles, both patients with platinum-resistant disease achieved clinical partial responses confirmed by computed tomography (CT) scan. The serum CA125 levels of case 1 decreased to cut-off level. The response duration of both patients was 4 months. The toxicity was acceptable and probably less pronounced than that characterize of the standard tri-weekly schedules. CONCLUSION: Although conclusions regarding survival are premature, weekly paclitaxel might offer better quality of life during treatment.

Adenocarcinoma↗
PubMed2000

[Improved QOL with cancer chemotherapy in two patients with breast cancer suffering form carcinomatous pleurisy and carcinomatous peritonitis].

One of the breast cancer patients introduced here suffered from recurrent carcinomatous pleurisy and the other from recurrent carcinomatous peritonitis. The patient with recurrent carcinomatous pleurisy was a 47-year-old female with stage IIIa breast cancer. She underwent a standard mastectomy and, following surgery, radiotherapy (50 Gy) and CAF therapy (30 mg of ADM, 1,800 mg of futraful and 100 mg of CPA, administered p.o.). Dyspnea occurred 4 years after surgery. Pleural exudate cytodiagnosis proved positive and the patient was diagnosed with carcinomatous peritonitis. Continuous thoracic cavity drainage was carried out, and 30 mg of ADM was injected into the thoracic cavity. CAF therapy was performed. The dyspnea and thoracic effusion disappeared. At present, after one year and 7 months, the patient is receiving outpatient treatment and remains under observation. The patient with recurrent carcinomatous pleurisy was a 43-year-old female. The breast cancer was detected in a diagnosis of metastasis to the axillary lymph nodes. An increased CA15-3 level and ascitic retention were observed postoperatively at 5 months. Following administration of 600 mg of UFT and 1,200 mg of MPA, the ascites decreased and improvement of the thickened peritoneum was noted. The CA15-3 level was also lowered. It is anticipated that chemotherapy for carcinomatous pleurisy and carcinomatous peritonitis will contribute to an improvement in patients' QOL.

Adult↗
PubMed2000

[Neoadjuvant chemotherapy with cisplatin and CPT-11 for advanced cervical cancer].

Neoadjuvant chemotherapy (NAC) is currently used for the treatment of advanced cervical cancer by many institutions. We investigated the value of NAC followed by radical surgery and/or radiotherapy for patients with locally advanced cervical cancer. Sixteen patients with stage Ib2-IIIb cervical cancer were enrolled in this study. CPT-11 (60 mg/m2) in 500 m/5% glucose was given intravenously on Days 1, 8, and 15, before cisplatin (60 mg/m2) in 500 ml normal saline. The treatment was repeated every 4 weeks for 2 or 3 cycles. All patients were evaluable for response and toxicity. Two achieved a clinical complete response (CR), 11 had a partial response (PR), 2 had no change (NC) and 1 had progressive disease (PD), for an overall response of 81.3%. Neutropenia was observed in 100% (> grade 3: 70.6%) and diarrhea was recorded in 55.9% (> grade 3: 5.9%). The combination of CPT-11 and cisplatin in locally advanced cervical cancer is thus an active regimen with a manageable toxicity as a neoadjuvant chemotherapy.

Adult↗
PubMed1999

Combination therapy with irinotecan and cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer.

To evaluate the response rate and toxicity of the combination of irinotecan (CPT-11) and cisplatin in a neoadjuvant setting, a phase II study was conducted regarding the regimen of this combination in patients with locally advanced cervical cancer. Eligibility included patients with previously untreated stage Ib2, IIb, or IIIb squamous cell carcinoma with good performance status. CPT-11 (60 mg m(-2)) was administered intravenously on days 1, 8 and 15, followed by cisplatin (60 mg m(-2)) given intravenously on day 1. Treatment was repeated every 4 weeks for a total of two or three cycles. Among 23 eligible patients (median age: 59 years), three showed complete response (13%), 15 showed partial response (65%), for an overall response rate of 78% (95% confidence interval 58-90%). Stable disease was observed in four cases (17%) and progressive disease in one (4%). The median time to failure and median survival time have not yet been reached. Of the 52 treatment cycles administered, diarrhoea and grade 3 or 4 neutropenia were observed in 10% and 75% respectively. There were no therapy-related deaths. The combination of CPT-11 with cisplatin is a promising regimen for neoadjuvant chemotherapy in locally advanced cervical cancer. The toxicities of this regimen are well tolerated.

Adult↗
PubMed1999

[Trends in comprehensive treatment for gynecologic malignancies].

Advances in many areas, including oncology-epidemiology, chemotherapy, diagnosis, surgery, radiology, and clinical research have all had a positive impact on the treatment of gynecologic malignancies, so that today we have achieved an improved quality of life concomitant with increased survival rates in patients. The improvements in therapy for gynecologic malignancies have been in diagnostic procedures, such as tumor markers, molecular biologic methods, and image analysis. Considerable progress has been made in surgical management, from focal excision of primary lesions to minimal debulking surgery after the initial chemotherapy for advanced cancer. Chemotherapy has advanced markedly after the introduction of cisplatin, and various regimens or anticancer drug-analogs of cisplatin, camptotesin, and paclitaxel have been introduced. In recent years, the quality of life of patients with malignancies has been one of the most important factors in treatment. Intensive and combination therapies will be put to greater use for gynecologic malignancy in the future.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Neoadjuvant intraarterial chemotherapy followed by radical hysterectomy and/or radiotherapy for locally advanced cervical cancer.

OBJECTIVES: We assessed neoadjuvant intraarterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. METHODS: Over 5 years, 48 consecutive women with International Federation of Gynecology and Obstetrics stage IIb-IVa cervical cancer were enrolled. Treatment consisted of bilateral internal iliac artery infusion of cisplatin (100 mg/m2, day 1) or carboplatin (400 mg/m2, day 1) and peplomycin (20 mg/m2, day 1) for two courses separated by 3 weeks. Doxorubicin (30 mg/m2, day 1) was added for patients with adenocarcinoma. Stage III patients who responded to NAC and Stage IIb patients underwent radical hysterectomy with pelvic lymphadenectomy. Stage III patients not responding to NAC and all stage IVa patients were treated with pelvic radiotherapy. RESULTS: Complete response was achieved in 5 (10.4%) of 48 patients, while a partial response was noted in 32 (66. 7%) and stable disease in 11 (22.9%). Of 25 patients with stage IIIb disease, 16 (64.0%) were able to undergo surgery. The 4-year disease-free survival (DFS) was 80.0% in patients with stage IIb and 62.3% in patients with stage III. In stage IIIb, the 4-year DFS in patients receiving surgery (75.2%) was higher than the DFS for those receiving radiotherapy (44.4%) (P < 0.05). Grade 3 or 4 leukopenia developed in 17 (35.4%) patients. Nausea and vomiting of grade 2 or higher occurred in 34 (70.8%). Creatinine clearance transiently decreased (>/= grade 2) in 16.6%. Patients negative for serum squamous cell carcinoma-associated antigen (SCC) responded better to NAC than to SCC-positive cases, and SCC-negative survival was significantly better than SCC-positive survival (P < 0.05). CONCLUSIONS: Neoadjuvant intraarterial chemotherapy with platinum was safely performed, and a survival benefit followed radical surgery with or without radiotherapy after response to NAC.

Adult↗
PubMed1997

Working pressure for full balloon inflation during intraaortic balloon pumping.

With changes in heart rate and mean aortic pressure, an intraaortic balloon (IAB) works with incomplete inflation. The effects of initial peak positive pressure and plateau holding positive pressure on IAB volume were investigated and minimum pressures necessary to inflate an IAB to a desired volume were established with a standard IAB catheter (Datascope type, 9.5 Fr, 40 ml). Initial peak pressure greater than 200 mm Hg was adequate to attain the desired volume of the IAB. Plateau positive pressure should be altered in accordance with hemodynamic changes.

Analysis of Variance↗
PubMed1997

Adenoma malignum: MR imaging and pathologic study.

PURPOSE: To evaluate the clinical, pathologic, and magnetic resonance (MR) imaging findings in adenoma malignum, a rare variant of uterine cervical adenocarcinoma. MATERIALS AND METHODS: Medical records of all patients (n = 7) with adenoma malignum of the uterine cervix diagnosed pathologically between 1988 and 1996 were retrospectively reviewed. Unenhanced T1-weighted and T2-weighted images and gadolinium-enhanced T1-weighted MR images were evaluated, and findings were correlated with gross pathologic and microscopic features. RESULTS: In five of seven patients, enlargement of the cervix was seen. All lesions were detected as multiple cystic lesions that extended from the endocervical gland to the deep stroma of the cervix. They appeared isointense (n = 5) or slightly hyperintense (n = 2) relative to the uterus on T1-weighted images and markedly hyperintense relative to the uterus on T2-weighted images. Solid portions of variable size were seen between cystic lesions, and both the multiple cystic component and the solid portion were most apparent on the gadolinium-enhanced T1-weighted images. Microscopic parametrial invasion was seen in two patients but was not detected at MR imaging. CONCLUSION: Adenoma malignum was depicted on MR images as a multicystic mass with solid portions located in the deep cervical stroma. Gadolinium enhancement helped identify the solid portion of the tumor.

Adenocarcinoma↗
PubMed1996

Changes of intraaortic balloon volume during pumping in a mock circulation system.

The effects of hemodynamic changes on intraaortic balloon (IAB) volumes were studied experimentally using a helium tachometer in a mock circulatory system. The IAB volume decreased with increases in the heart rate and mean aortic pressure, but the degree of reduction in the IAB volume was different among 4 commercially available IAB drivers. Improvements in IAB consoles are needed to compliment the progress made in percutaneous techniques for IAB insertion resulting in smaller balloons.

Arrhythmias, Cardiac↗
PubMed1996

Optimal control algorithm for pneumatic ventricular assist devices: its application to automatic control and monitoring of ventricular assist devices.

We developed a control and monitoring unit for pneumatic ventricular assist devices (VADs), which provides optimal fill and empty control and real-time evaluation of pump performance. The flow signal of the inflow cannula is integrated every beat to yield pump filling volume per pump diastole. The ejection signal is triggered when pump filling reaches a preset level. The instantaneous mean flow of each beat (stroke volume/cycle length) is compared with the previous beat, and the threshold level is readjusted to optimize flow. This feedback loop is repeated every beat, and pump filling is immediately adjusted to yield maximum pump flow. Simultaneously the mean flow of every 10 beats is compared with that of the previous 10 beats; then, the ejection time is readjusted to optimize flow. Initial clinical application of this unit supports its effectiveness and reliability.

Aged↗
PubMed1996

[A case of aortic dissection associated with congenital bicuspid aortic valve].

It is known that bicuspid aortic valve with dilatation of the ascending aorta is one of risk factors of the aortic dissection. A case of acute aortic dissection (DeBakey type-II) associated with bicuspid aortic valve who underwent successfully operation 8 hours after onset is reported. This patient went into cardiogenic shock because of cardiac tamponade and aortic valve regurgitation immediately after onset. Aortic valve and the ascending aorta were replaced using composite graft (#23 SJM prosthetic aortic valve and 26 mm woven Dacron vascular graft) combined with coronary artery reconstruction by Cabrol's technique. Aortic valve showed bicuspid and histological examination revealed cystic medionecrosis and loss of elastic fiber. Postoperative course was uneventful and this patients is doing well 3 years after the operation.

Acute Disease↗
PubMed1995

Detection of lymph node metastasis in ovarian carcinoma and uterine corpus carcinoma by preoperative computerized tomography or magnetic resonance imaging.

OBJECTIVE: Preoperative CT or MRI findings were compared with the results of staging the laparotomy to evaluate the accuracy of CT or MRI for detecting pelvic and para-aortic lymph-node metastases. METHODS: In evaluating CTs in 95 ovarian carcinomas, we examined plain and contrast images made in 1- to 1.5-cm-thick slices from the pubis to the xiphoid process. Lymph nodes 1.5 cm or larger were considered to be positive. MRIs of 60 uterine corpus carcinomas utilized T1-weighted contrast, T2-weighted, and short-inversion time inversion-recovery (STIR) images. RESULTS: CT had a sensitivity of 60.9% and a specificity of 93.1%. The positive and negative predictive values were 73.7% and 88.2%, respectively. The diagnostic accuracy of CT for detecting para-aortic lymph-node metastases exceeded that for pelvic node metastases. The results of MRI indicated that the T1-weighted image and STIR image were the most accurate in identifying metastatic nodes. CONCLUSIONS: These results indicate that the most practical approach might be to search for enlarged lymph nodes by CT, and to follow-up with MRI when CT scans are questionable.

Carcinoma↗
PubMed1993

[Angiotropic lymphoma presenting with subacute dementia: treatment with combination chemotherapy (CHOP) based on antemortem diagnosis--a case report].

We report a 64-year-old male with angiotropic lymphoma. He developed subacute dementia with right hemiparesis. Laboratory abnormalities included elevated serum lactic dehydrogenase (LDH) (715 U/l) erythrocyte sedimentation rate (38 mm/hr) and CSF protein (90 mg/dl). Precontrast MR imaging of the brain demonstrated lesions involving the left internal capsule, subcortical white matter in the right frontal lobe and splenium within the atrophic corpus callosum. A brain biopsy revealed intravascular lymphoid cells, strongly suggestive of angiotropic lymphoma. By combination chemotherapy (CHOP), serum LDH and CSF protein normalized through the patient remained demented. He died of bronchopneumonia about 2 years and 5 months after the onset. Coronal sections of the brain showed infarct in the left internal capsule as well as markedly thin corpus callosum with necrotic lesions involving both the genu and splenium. Microscopic examination showed many small vessels occluded by lymphoma cells (B-lymphocyte) predominantly in the corpus callosum, cerebral white matter, thalamus, midbrain, medulla oblongata, thoracic and lumbar segments of the spinal cord. By combination chemotherapy, our patient survived longer than most of previous patients with angiotropic lymphoma. An early diagnosis and subsequent combination chemotherapy may improve neurological manifestations, and make possible longer survival in angiotropic lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Periventricular spread of malignant lymphoma: report of two cases.

Two cases of intracranial malignant lymphoma with an atypical feature on CT scan are reported. Both patients presented subacute progressive dementia. CT scan showed high density lesion extending all the way along the ventricular wall, which was homogeneously enhanced and resembled severe ventriculitis. Differential diagnosis on CT scan is discussed.

Aged↗
PubMed1987

Reduction of arginine-vasopressin in the cerebral cortex in Alzheimer type senile dementia.

Arginine-vasopressin (AVP) concentrations in five cortical areas were measured post mortem in nine patients with senile dementia of Alzheimer's type (SDAT), and compared with the control group of comparable ages. In SDAT patients, AVP was significantly reduced in Brodmann areas 4, 7 and 10 (p less than 0.05). In areas 17 and 22, the detectability and the mean concentrations of AVP were also lower than those of control patients, although not significantly.

Aged↗