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Biomedical subjects

K Hara

Publications and source records attributed to K Hara.

At least 973 records · Page 54Linked to original sources
PubMed1986

[A phase II study of etoposide (VP-16) injection in primary lung cancer by cooperative study group].

A Phase II Study of VP-16 was performed in 58 patients with primary lung cancer. VP-16 was administered via infusion at a dosage of 60-100 mg/m2 daily for 5 days, and repeated every 3 to 4 weeks. Of the 58 patients who entered into the study, 38 were evaluable. Partial response was observed in 6 patients who had been diagnosed as having small cell carcinoma of the lung. Response rates were 15.8% for all evaluated patients and 33.3% for the patients with small cell carcinoma of the lung. As for dose-limiting toxicity, leukopenia (less than 3,000/mm3) was observed in 53.1% of cases. Other major adverse reactions were hematologic toxicities such as anemia and thrombocytopenia, gastrointestinal toxicities and alopecia, but these were all well tolerated.

Adenocarcinoma↗
PubMed1986

[Mitral regurgitation due to abnormal reinsertion of chordae tendineae (looping) of the posterior mitral leaflet: clinical and echocardiographic features].

Two-dimensional (2D) echocardiographic and clinical characteristics of patients with mitral regurgitation (MR) due to abnormal reinsertion of chordae tendineae (looping) in the middle scallop of the posterior leaflet were described and compared with those of patients with chordal rupture of the posterior leaflet. Twenty-five patients with posterior mitral valve prolapse who underwent mitral valve replacement were studied. They were categorized in three groups; 14 patients with MR due to ruptured chordae tendineae (RCT) of the posterior leaflet (RCT group); three patients with looping of the chordae tendineae in the middle scallop of the posterior leaflet (looping group); and eight patients with both RCT and looping (looping + RCT group). It was difficult to distinguish the looping group from the other two groups by their 2D echocardiographic findings, which were characteristic of those of RCT. However, the following findings were more frequently encountered in the patients with looping than in those without: 1) aberrant or absent systolic coaptation with salient arc of the posterior leaflet, observed in six of the RCT group (43%), two in the looping group (67%) and seven in the looping + RCT group (88%); 2) with thickened edges of the posterior leaflet, shown in three of the RCT group (21%), two of the looping group (67%) and five of the looping + RCT group (63%) in the long-axis view, and also noticed in four of the RCT group (29%), two of the looping group (67%) and six of the looping + RCT group (75%) in the short-axis view. In the clinical history, the onset of a heart murmur, congestive heart failure and surgical treatment occurred at significantly younger ages in the looping group than in the RCT group. As for hemodynamic parameters, pulmonary hypertension was significantly milder in the looping group than in the RCT group. In conclusion, although 2D echocardiographic findings of patients with looping were similar to those of patients with RCT, it seemed possible to differentiate the looping group from the RCT group by the 2D finding of a prolapsed posterior mitral valve with a salient arc and a thickened edge. It was also suggested that the looping of chordae tendineae in the middle scallop of the posterior leaflet was congenital in origin.

Adolescent↗
PubMed1986

[Neo-adjuvant therapy in childhood osteogenic sarcoma: a pilot study of selective postoperative chemotherapy based on response to preoperative high-dose methotrexate].

"Neo-adjuvant therapy" with preoperative high-dose methotrexate (HD-MTX) and CF rescue therapy was investigated in four children with osteogenic sarcoma. Immediately after the diagnosis of osteogenic sarcoma from biopsy, the patients were treated with three to five courses of weekly HD-MTX (300 mg/kg) with CF rescue. Three patients had en bloc tumor resection and one patient underwent disarticulation of the hip joint after the pre-operative HD-MTX. The effect of HD-MTX was evaluated on the basis of pathological changes between the specimen of the primary tumor taken at biopsy and that during surgery. Two out of four patients showed marked tumor cell reduction (greater than 50%) of the specimen upon surgery. Two patients who responded to the preoperative HD-MTX were further treated with HD-MTX on a post-operative adjuvant therapy basis for 18 months. Both of these patients survived with no evidence of disease for 35.6+ and 20.9+ months. Two patients who responded poorly to HD-MTX were treated with a multi-drug postoperative adjuvant therapy including cis-platinum, adriamycin, cyclophosphamide, actinomycin D, and bleomycin. One patient had a solitary lung metastasis at 12.2 months after amputation. Wedge resection of the metastatic tumor was performed and adjuvant therapy with cis-platimum has been given for 20 months. He has remained with no evidence of disease for more than 30 months. Another patient has been receiving multi-drug neo-adjuvant therapy without any evidence of disease for 11.9 months after surgery. These data suggest that neo-adjuvant chemotherapy based on the response to preoperative HD-MTX is more useful for increasing the cure rate of childhood osteogenic sarcoma.

Adjuvants, Immunologic↗
PubMed1986

Suppression of myocardial protein degradation by the protease inhibitor bis[ethyl(2R,3R)-3-[(S)-methyl-1-[4-(2,3,4-tri-methoxy-phenyl-methyl) piperazine-1-ylcarbonyl]butyl-carbonyl]oxiran-2-carboxylat e]sulfate under hypoxia.

The synthetic protease inhibitor bis[ethyl(2R,3R)-3-[(S)-methyl-1-[4-(2,3,4-tri-methoxyphenyl-methyl) piperazine-1-ylcarbonyl]butyl-carbonyl]oxiran-2-carboxylate] sulfate (NCO-700) suppressed both activities of calcium-activated neutral protease and cathepsin B isolated from cardiac muscle, showing 50% inhibition at 46 and 0.8 mumol/l, respectively. A kinetics study using 14C-labelled NCO-700 suggested its incorporation into cultured myocardial cells, demonstrating the half-maximal saturation time at 17 min. Under both aerobic and hypoxic conditions, the reagent inhibited the peptide release from cultured myocardial cells dose-dependently. The amino acid release from heart slices of adult rabbit was also blocked by the drug under hypoxic and glucose-depleted condition. These data and the myocardial infarction size reducing action of NCO-700 might support the view that NCO-700 sensitive protease(s) - possibly, calcium-activated neutral protease and/or cathepsin B - is (are) working to induce an irreversible proteolysis in the process of myocardial cell degradation.

Aerobiosis↗
PubMed1986

[Pseudoaneurysm of the left ventricle serially demonstrated from on-set using two-dimensional echocardiography: a case report].

A case of so-called pseudoaneurysm of the left ventricle without pericardial adhesion, serially demonstrated by two-dimensional echocardiography, was reported. A 76-year-old man developed congestive heart failure 10 hours after gastrectomy, and was diagnosed as having acute myocardial infarction. Two-dimensional echocardiography on the 21st day after onset revealed moderate pericardial effusion and an echo-free space in the posterolateral myocardium of the left ventricle. The echo-free space gradually expanded exteriorly and formed an aneurysm, which remained unchanged after the resolution of the pericardial effusion. Clinical diagnosis of pseudoaneurysm of the left ventricle was made by left ventriculography and coronary angiography. At autopsy, there was an aneurysm measuring 2.3 X 3.0 X 5.0 cm which communicated with the left ventricle via two small ostia, 5 mm each in diameter. There was a loose fibrous adhesion between the pericardium and the epicardium. The wall of the aneurysm consisted of organized fibrous tissue without any elements of the myocardium. Both myocardium and fibrous tissue were located at the junction of the left ventricular wall and the aneurysm. It is surmised that dissection of the infarcted myocardium expanded so greatly as to form an aneurysmal cavity, resulting in the formation of a so-called pseudoaneurysm of the left ventricle after fibrous changes of the outer wall in the infarcted myocardium. Therefore, this aneurysm might be termed a "dissecting" aneurysm of the left ventricle. The hypothesis that a pseudoaneurysm is derived from a localized hemopericardium should be reconsidered.

Aged↗
PubMed1986

[Metastatic thyroid cancer to the right ventricle causing obstruction of the right ventricular outflow tract and associated with disseminated intravascular coagulopathy: a case report].

A case of thyroid cancer causing right ventricular outflow tract obstruction is described. A 72-year-old woman was admitted because of shortness of breath, some ecchymoses, and marked anasarca. Her liver was palpable four fingerbreadths below her costal margin. Laboratory findings included leukocytosis, marked thrombocytopenia, and an increase in fibrinogen degradation products due to disseminated intravascular coagulopathy. Two-dimensional echocardiography demonstrated a solid mass in the right ventricle, which protruded into the right atrium and main pulmonary artery. Right ventricular outflow tract obstruction and tricuspid regurgitation were demonstrated by contrast echocardiography. These findings were confirmed by CT scans, RI angiography, and contrast angiography. The mass was partially resected from her right ventricle and her tricuspid valve was replaced successfully, but she died of sepsis three weeks after surgery. At autopsy, undifferentiated thyroid cancer and cardiac metastasis were verified. To date, only eight cases with initial symptoms of congestive heart failure due to right ventricular outflow tract obstruction caused by metastatic intracavitary tumors have been reported. Very rarely have cardiac tumors resulted in disseminated intravascular coagulopathy.

Aged↗