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Biomedical subjects

K Hirabayashi

Publications and source records attributed to K Hirabayashi.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Comparison of preoperative and postoperative chemotherapy in the treatment of advanced ovarian cancer].

Temporary blockage of uterine and ovarian vessels with forceps led to an approximately two-fold increase in the transfer of LMOX and Carboplatin to uterine muscle, ovarian tissue and pelvic lymph-nodes after the release of forceps. This result suggests the importance of preserving these main vessels for the effective transfer of chemotherapeutic agents to target tissues. Ten cases in stage III or IV underwent cytoreductive surgery followed by three courses of CDDP, ADM, CPA chemotherapy and SLO (postop. group). A further 27 cases were given diagnostic laparotomy followed by the same chemotherapy and SLO (preop. group). Examination of both groups revealed the following: The efficacy rate of the CAP regimen was 77.8% in the preop. group and 50.0% in the postop. group; the surgical extirpation rate exceeding 90% at SLO was 76.1% and 50.0% in the preop. and postop. groups respectively. The survival period was longer in the preop. group, ie., two years in 69% versus 40% and three years 43% v 20% of the preop. and postop. groups, respectively. Preoperative (Neo-adjuvant) chemotherapy followed by aggressive surgery was concluded to be preferable to carrying out enforced reduction surgery first on such advanced cases where the mass of the residual disease cannot be left untouched is unavoidable.

Antineoplastic Agents↗
PubMed1988

Mechanism of inhibitory effect of glycyrrhizin on replication of human immunodeficiency virus (HIV).

Glycyrrhizin (GL) achieved a dose-dependent inhibition of the replication of human immunodeficiency virus type 1 (HIV-1) in MOLT-4 (clone No. 8) cells within the concentration range of 0.075 to 0.6 mM. Within this concentration range, GL also effected a dose-dependent reduction in the protein kinase C (PKC) activity of MOLT-4 (clone No. 8) cells. A well-known PKC inhibitor, 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7), also proved inhibitory to HIV-1 replication in MOLT-4 (clone No. 8) cells. PKC inhibition may thus be considered as one of the mechanisms by which GL inhibits HIV-1 replication. In addition, GL may also owe its anti-HIV-1 activity, at least in part, to an interference with virus-cell binding, since the compound at 1.2 mM partially inhibited the adsorption of radiolabeled HIV-1 particles to MT-4 cells. At this concentration GL also suppressed giant cell formation induced by co-culturing MOLT-4 (clone No. 8) cells with MOLT-4/HTLV-IIIB cells, whereas the PKC inhibitor H-7 failed to do so.

Adsorption↗
PubMed1988

Inhibition of the tumor-promoting action of 12-O-tetradecanoylphorbol-13-acetate by some oleanane-type triterpenoid compounds.

Since glycyrrhetinic acid was proved to suppress tumor promoter effects, several oleanane-type triterpenes which were chemically derived from oleanolic acid and hederagenin were tested in vitro and in vivo against the action of tumor promoter, 12-O-tetradecanoylphorbol 13-acetate. By in vitro experiment monitoring with 12-O-tetradecanoylphorbol-13-acetate-induced stimulation of 32Pi incorporation into phospholipids and an in vivo test on skin tumor formation in mice initiated with 7,12-dimethylbenz[a]anthracene and promoted with 12-O-tetradecanoylphorbol-13-acetate, 18 beta-olean-12-ene-3 beta,28-diol (= erythrodiol), 18 beta-olean-12-ene-3 beta,23,28-triol, 18 alpha-olean-12-ene-3 beta,28-diol, and 18 alpha-olean-12-ene-3 beta,23,28-triol showed remarkable suppressive effects. Especially 18 alpha-oleanane derivatives having a CH2OH grouping converted from the COOH group initially allocated at C-17 were 100 times more effective than glycyrrhetinic acid both in vitro and in vivo.

Animals↗
PubMed1988

Level diagnosis of cervical myelopathy using evoked spinal cord potentials.

The ESCPs (evoked spinal cord potentials) resulting from both median nerve and spinal cord stimulation were recorded from the interlaminar yellow ligaments posteriorly or intervertebral discs anteriorly on patients with cervical myelopathy in order to determine the most significant lesion in the spinal cord electrophysiologically. The normal median-nerve-evoked spinal cord potential (MN-ESCP) consisted of P1N1 and N2(P2) deflections, while normal spinal cord-ascending evoked spinal cord potential (SC-AESCP) consisted of N1 and N2 deflections. The abnormal ESCPs obtained from 65 patients were classified into three grades. The spinal level recording the highest grade of ESCP, which was mostly positive wave, generally corresponded to the level that was clearly diagnosed as the main lesion by neurologic and radiologic examinations, such as a case of single level disc hernia. With these techniques, the level diagnostic rates of primary lesions were 94.7% in posterior recordings and 74.1% in anterior recordings.

Adult↗
PubMed1988

[Phase II study of carboplatin in ovarian cancer].

A phase II study of carboplatin was conducted in ovarian cancer by a cooperative study group consisting of 22 institutions nationwide. The overall response rate of 50 evaluable cases was 38.0%. The response rate in cases with no prior chemotherapy was 54.2% and that with prior chemotherapy was 23.1%. In addition, the response rate was 26.3% in cases that received prior CDDP-based chemotherapy. Histologically, the response rate was high in serous cystadenocarcinoma and endometrioid adenocarcinoma. Hematologic toxicities, particularly leukopenia and thrombocytopenia, were frequently observed, but well tolerated, while renal and neurologic toxicities were rare. These results suggested that carboplatin is useful in the treatment of ovarian cancer.

Adenocarcinoma↗
PubMed1988

[Phase III study of carboplatin in ovarian cancer].

A phase III study of carboplatin vs cisplatin in CAP regimen for ovarian cancer was conducted by a cooperative study group consisting of 22 institutions nationwide. The response rate for 23 cases allocated to carboplatin regimen group was 34.8% and 42.1% for 19 cases allocated to cisplatin regimen group. No significant difference was observed between these two regimens in response rates, and no significant differences were noted between the two regimens in each of the clinical toxicities and abnormalities in laboratory findings. Since the carboplatin regimen group did not require hydration, or the use diuretics or antiemetics, these results suggested that carboplatin is more useful in the treatment of ovarian cancer than cisplatin.

Adult↗
PubMed1988

[Fundamental and clinical study on cefuzonam in the field of obstetrics and gynecology].

Cefuzonam (L-105, CZON), a new beta-lactam antibiotic, was studied for its transfer into intrapelvic tissues and for clinical efficacy in the treatment of obstetrical and gynecological infection. 1. Following an intravenous 1 hour drip infusion of 1 g, the transferred CZON into uterine tissues reached and was maintained at effective concentrations which were defined as levels exceeding MICs against clinical isolates frequently obtained from patients in the field of obstetrics and gynecology. The peak concentration of CZON in the pelvic dead space exudate was estimated to be 20 micrograms/ml at 0.5-1 hour after infusion. 2. Subjects studied were 5 patients with the following infections: pyometra (3 cases), puerperal intrauterine infection (1 case), vaginal cuff infection (1 case). Clinical efficacies were good in 4 cases and poor in 1 case. No notable side effects or abnormal laboratory test results were noted.

Adnexa Uteri↗
PubMed1988

Treatment in fractures of the odontoid process.

Fifty-eight cases of odontoid fractures treated at Keio University Hospital and affiliate hospitals from 1965 through 1985 were reviewed. Six patients under age 7 years (group A), were characterized as having epiphysiolysis. Among 52 patients over 8 years of age (group B), there were two Type I, 31 Type II and 19 Type III fractures. All cases in group A were treated conservatively by a plaster cast or a neck brace, and achieved bony union in 6 to 27 weeks. Five of 24 fractures in group B, treated conservatively, failed to unite. Nineteen cases of Type II and six cases of Type III were treated surgically. Transoral fusion was performed in six cases, internal fixation using a compression screw in ten, bone peg fixation in one, posterior fusion in eight, and posterior decompression in one. Two cases treated with transoral fusion and two with screw fixation failed to unite. We recommend conservative treatment of group A patients, Type I, and acute cases of Type III with minimal displacement in group B. Surgery should be performed in acute cases of Type II, Type III with significant displacement, and nonunion cases in Type II and Type III.

Adolescent↗
PubMed1988

[Pharmacokinetic and clinical studies of imipenem/cilastatin sodium in the perinatal period].

Pharmacokinetic and clinical studies on imipenem/cilastatin sodium (IPM/CS), a parenteral carbapenem antibiotic combination drug, were carried out in patients in the perinatal period. The obtained results are summarized as follows. 1. Concentrations of IPM and CS in umbilical cord blood, amniotic fluid and maternal blood were determined in 13 patients after 500 mg/500 mg of IPM/CS was administered by a drip infusion over a period of 30 minutes. Peak levels of both drugs in umbilical cord blood were about 30% of those in maternal blood. Although the levels gradually declined thereafter, the decline was slower in umbilical cord blood than in maternal blood and the levels became higher in the former than in the latter after 2 hours or more. The transfer of both drugs into amniotic fluid was slower than into umbilical cord blood. Peak levels were observed 5-6 hours after administration, averaging about 30% of that in the maternal blood for IPM and 45% for CS. 2. A 500 mg/500 mg dose of IPM/CS was administered to 10 patients with postpartum infections by a drip infusion over a period of 30 minutes or more twice daily in the morning and in the evening. Clinical responses were excellent in 6 patients and good in 4, with an efficacy rate of 100%. Bacteriologically, all of the 19 strains identified previous to the treatment were eradicated except for 1 strain. However, one new strain of Enterococcus sp. appeared in 1 patient. No side effects or abnormal laboratory findings were observed. These results suggest that IPM/CS will be useful for the treatment of various infections in the perinatal period.

Adult↗
PubMed1988

[Use of ceftriaxone against parametritis after radical surgery for cancer of the uterine cervix].

1. The bacteria isolated from pelvic dead space drainage well reflect the characteristics of prophylactic drugs. As drugs advance from penicillin (PC) to tetracycline (TC) to the first, second and third generation cephems, detection rates for Gram-negative bacilli, mainly Escherichia coli, decrease remarkably, while those for Gram-positive cocci, mainly Enterococcus faecalis, increase. 2. The bacteria isolated from the drainage and those which later caused parametritis and purulent lymphocyst were closely related. It is therefore very important to identify bacteria present in the drainage. 3. Judging from changes occurred in blood levels of ceftriaxone (CTRX) and its effective transfer to the pelvic dead space when CTRX 2 g was administered once daily, this administration regimen is considered to control even parametritis and purulent lymphocyst satisfactorily. 4. CTRX 2 g was administered once daily for 5 consecutive days to each of 4 patients with parametritis, and it was observed that the general efficacy was good in 3 of the 4 cases.

Ceftriaxone↗
PubMed1988

[Pharmacokinetic and clinical studies on ceftriaxone in the perinatal period].

Ceftriaxone (CTRX), a new cephalosporin antibiotic, was studied for its pharmacokinetic features and clinical efficacy in the perinatal period and the obtained results are summarized below. 1. Following a one shot intravenous injection of 1 g of CTRX into each of 29 parturient women, CTRX levels were between 4.5 and 19.5 micrograms/ml at 6 hours postdose and between 4.5 and 4.7 micrograms/ml at 24 hours postdose in the amniotic fluid and between 11.7 and 22.7 micrograms/ml at 6 hours postdose and between 4.5 and 4.7 micrograms/ml at 24 hours postdose in the umbilical cord serum. It was shown that CTRX was maintained there at high levels for a long time and the transfer of CTRX into the umbilical cord serum was better than that of other antibiotics. 2. Following a one shot intravenous injection of 1 g of CTRX into each of 12 cases of puerpera, CTRX was detected in the mother's milk until 10 hours postdose, though at a very low level averaging 0.32 to 0.79 microgram/ml. It was considered, however, that CTRX affected little infants through the mother's milk. 3. CTRX was evaluated to be very effective in 2, effective in 5 and ineffective in 1, of 8 cases of infections during the perinatal period. From the above results, CTRX appeared to be effective against infections during the perinatal period.

Amniotic Fluid↗
PubMed1987

[The influence of the right or left ventricular pressure overload on right and left ventricular diastolic behaviors as examined by pulsed Doppler echocardiography].

The influence of morphological and dynamic changes in the interventricular septum (IVS) on right ventricular (RV) and left ventricular (LV) fillings in cases of LV or RV pressure overload was evaluated. Using pulsed Doppler echocardiography, LV and RV inflow signals were recorded in 20 healthy subjects, in 36 cases of chronic pulmonary disease (CPD) with pulmonary hypertension, and in 46 cases of essential hypertension (HT). Two-dimensional short-axis echocardiograms were recorded at end-diastole (ED) and end-systole (ES) in the healthy subjects and in the cases with CPD. M-mode echocardiograms of the LV were recorded in the healthy subjects and in the cases with HT. We measured (1) the ratio of the peak velocity of inflow due to atrial contraction to that of rapid inflow (A/R), (2) the deceleration half-time of rapid inflow (delta TD), (3) the corrected radius of curvature of the IVS at ED and ES, (4) the % change of lengthening (CL) of 16 radial grids using a fixed method on the ED and ES short-axis images, and (5) the IVS end-diastolic thickness (IVSEDTh). The results were as follows: 1. In the patients with CPD, (1) the diastolic behavior was impaired not only in the RV, but in the LV as well, as shown by the increased A/R and prolonged delta TD in both ventricles, (2) the IVS was flattened at ED, as shown by the decreased corrected radius of the curvature, (3) the regional wall motion of the IVS was impaired, as shown by the decreased CL of the IVS. 2. In the patients with HT, (4) the RV diastolic filling was not impaired, (5) the LV A/R correlated with IVSEDTh, but the RV A/R did not correlate with IVSEDTh. We concluded that RV pressure overload interferes with IVS motion during diastole, and that the regional impairment of diastolic behavior of the IVS causes impairment of LV diastolic filling. Furthermore, the increased IVS wall thickness due to LV pressure overload has a little or no influence on the RV inflow pattern because the RV free wall was so distensible as to overcome the effect of increased IVS stiffness.

Aged↗