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Biomedical subjects

K Kawabata

Publications and source records attributed to K Kawabata.

At least 217 records · Page 12Linked to original sources
PubMed1993

Comparison of survival curves of gastric cancer patients after surgery according to the UICC stage classification and the General Rules for Gastric Cancer Study by the Japanese Research Society for gastric cancer.

OBJECTIVE: This study compared the UICC classification with the General Rules for Gastric Cancer Study (GRGCS) of the Japanese Research Society by analyzing recent results of gastric cancer surgery in Japan. SUMMARY BACKGROUND DATA: The present UICC stage classification for gastric cancer was published in 1987 and the Japanese GRGCS were published in 1985. Both are based on the results of surveys conducted in the early 1970s. METHODS: The survival curves of 926 patients, who underwent gastric cancer surgery between 1982 and 1985 at Kyoto University Hospital and its 31 associated hospitals, were analyzed according to the UICC classification and the GRGCS using SAS computer software. RESULTS: There was no difference in survival rate between UICC stages IA and IB. GRGCS stage III was found to include UICC stages II, IIIA, and IIIB, and GRGCS stage IV included UICC stages IIIA, IIIB, and IV, with significantly different survival rates. In contrast, each UICC stage included different GRGCS stages with no significant differences in survival rates. The survival rate of stage IV patients of both classifications who underwent gastrectomy was significantly higher than that of stage IV patients receiving bypass or exploratory surgeries. CONCLUSIONS: The UICC classification is better than the GRGCS for classifying gastric cancer in Japan. However, UICC stage I does not need to be subdivided into stages IA and IB, and stage IV should be further subdivided into stages IVA and IVB according to the surgery performed: IVA, gastrectomy, and IVB, bypass or exploratory surgery.

Humans↗
PubMed1993

A comparative I-123 IMP SPECT study in Binswanger's disease and Alzheimer's disease.

The regional cerebral blood flow in 31 patients was semiquantitatively measured with SPECT using N-isopropyl iodo-amphetamine (I-123 IMP). Of the 31 patients, 9 had Binswanger's disease (BD) (mean age: 64.2 years), 10 had Alzheimer's disease (AD) (mean age: 66.8 years), and 12 were neurologically normal (mean age: 67.8 years). Tracer activity was determined in 7 pairs of cerebellar, cortical, and subcortical regions and was expressed as two ratios: the activity in each region of interest (ROI) compared to the mean count in the cerebellar region (ROI/CER ratio) and compared to the mean count in the occipital cortex (ROI/OCC ratio). Patients with BD showed a reduction of the ROI/CER ratio in the temporal cortex, thalamus, and basal ganglia compared to normal subjects. However, the ROI/CER ratio for the occipital region was higher than that of normal controls, suggesting that cerebellar blood flow was reduced in patients with BD. AD patients showed a decreased ROI/CER ratio in the frontal, temporal, and parietal cortices. Both BD and AD patients showed decreased ROI/OCC ratios in all the cortical and subcortical regions compared to the neurologically normal patients. In BD patients, the most marked reduction of both ratios was found in the thalamus, while for AD patients the most prominent reduction was seen in the parietal cortex. Our results indicate that these two types of dementia show characteristic regional cerebral blood flow patterns, which may be associated with their clinical features.

Aged↗
PubMed1993

Three-dimensional surface display using 123I-IMP in a case of motor neuron disease with dementia.

A case of motor neuron disease with dementia is presented. A brain CT showed atrophic changes mainly in the left frontal cortex, and 123I-IMP SPECT disclosed a decrease in 123I-IMP uptake in the frontal regions. To distinguish a subregion related to dementia from that related to motor system disorders, a three-dimensional surface display with 123I-IMP was reconstructed. The imaging method clearly demonstrated cortical hypoperfusion in the inferomedial frontal cortex and the motor-sensory cortex. These findings suggest that dementia may be due to the former lesion and motor system disorders due to the latter lesion, respectively.

Amphetamines↗
PubMed1993

Relationship between CPITN and oral health behaviour in Japanese adults.

Many studies on toothbrushing have concentrated on clinically diagnosing plaque and measuring periodontal status as indicators of oral health behaviour. From a behavioural point of view, however, the more important objective is the health behaviour itself. To investigate the relationship of oral health behaviour to periodontal status, 517 urban employees in Japan (249 men and 268 women aged 20-59 years) responded to a 20-item dental health behaviour questionnaire, entitled the HU-DBI, and had their periodontal conditions examined using the CPITN. Only 1 per cent were found with a healthy periodontium (Code 0), and 9 per cent had bleeding on probing (Code 1). Calculus (Code 2) was the most prevalent condition with 51 per cent of subjects having this code as the worst condition, followed by shallow pockets (Code 3) in 30 per cent, and deep pockets (Code 4) in 9 per cent of the sample. The mean HU-DBI score was 4.2 (out of 12). Females had somewhat higher scores than males (4.4 vs. 4.0, p < 0.05). CPITN had a negative relationship with the HU-DBI (r = -0.26, p < 0.001), and a positive relationship with age (r = 0.40, p < 0.001). Similar relationships were observed in each gender. These data demonstrate the relationship of age with periodontal status, and periodontal status with oral health behaviour. A two-dimensional matrix of HU-DBI score by CPITN may provide a simple and effective means of identifying low and high risk individuals.

Adult↗
PubMed1993

Effect of local anaesthetics on the stimulus-secretion coupling in bovine adrenal chromaffin cells.

This study was carried out to determine the relative potencies of local anesthetics to inhibit the cholinergic synaptic transmission using cultured bovine adrenal chromaffin cells, and to clarify if the inhibitory action would correlate with biophysical and pharmacological properties. Local anaesthetics (bupivacaine, etidocaine, tetracaine, lignocaine and procaine; 0.02-2 mM) inhibited carbachol-induced catecholamine release from the cells in a concentration-dependent manner. This inhibition was completely reversible. IC50 (concentration of 50% inhibition) of each anaesthetic showed no correlation with the lipid solubility. The local anaesthetics showed greater inhibitory potency at a higher extracellular pH. The results suggest that clinically relevant concentrations of local anaesthetics inhibit the stimulus-secretion coupling in the chromaffin cells. The un-ionized based form plays a major role, and the inhibitory potency does not depend on the lipid solubility of the anaesthetics.

Adrenal Medulla↗
PubMed1993

Dumbbell-shaped schwannoma of the jugular foramen.

A 49-year-old male patient with schwannoma of the jugular foramen is described. T1-weighted magnetic resonance imaging with gadolinium showed an enhanced dumbbell-shaped mass with its smaller part occupying the left cerebellopontine angle and its larger part in left parapharyngeal space. The mass was totally removed with a left mastoidectomy and suboccipital craniotomy. The dura mater was closed with anterior lamina of the rectus sheath, and the large defect of the neck was obliterated with free rectus abdominis muscular flap. The postoperative course was uneventful, except for some sputum aspiration and hoarseness. He underwent surgical mediation and cricopharyngeal myotomy for his left, paralyzed vocal cord, and both speech and swallowing function improved quite well. This paper reports our experience in managing this dumbbell-shaped neurinoma of the jugular foramen.

Cerebellar Neoplasms↗
PubMed1993

[Research and development of new oral cephems, cefixime and cefdinir].

This article reviews the structure-activity relationships, biological properties and synthesis of two new oral cephalosporin antibiotics, cefixime (CFIX) and cefdinir (CFDN). Our research into new oral cephalosporin antibiotics began in the late 1970's. The first goal of our research was to discover a new oral cephem possessing similar antibacterial activity and resistance to beta-lactamase as the 3rd generation injectable cephalosporins. We focused our attention on searching for a non-prodrug type cephem, that is, a new parent structure with high intrinsic absorption. We selected ceftizoxime (CZX) as a seed compound due to its relatively high excretion rate (8.5%) in the urine after oral administration to rats. We concentrated our research on the chemical modification of the oxime moiety in CZX based on our hypothesis for oral absorption, and discovered a lead compound with a carboxymethoxyimino group which displayed better urinary excretion (41.0%). Optimization studies led to a new oral cephem, CFIX. However, CFIX shows only low to moderate antibacterial activity against gram-positive bacteria such as S. aureus. Hence, the second goal of our research was to discover a new oral cephem with enhanced activity against gram-positive bacteria. From a consideration of structure-absorption relationships, we studied the activity and absorbability of cephems bearing other acidic functional groups at the oxime moiety of CFIX. As a result, we found a new oral cephem, CFDN with a hydroxyimino group at the 7-position. CFIX has excellent biological properties, displaying potent antibacterial activity against a wide range of gram-positive bacteria except S. aureus and gram-negative bacteria including opportunistic pathogens, high stability towards beta-lactamases and long acting efficacy. CFDN exhibits excellent and well balanced antibacterial activities against gram-positive and gram-negative bacteria. The pharmacokinetic of CFDN in healthy volunteers showed that serum levels were high enough to make CFDN as an effective antibacterial agent. The proposed mechanisms of intestinal absorption of CFIX and CFDN are briefly described. The efficient synthetic methods to CFIX and CFDN were achieved via a common intermediate, 7-amino-3-vinylcephalosporanic acid diphenylmethyl ester from 7-ACA.

Administration, Oral↗
PubMed1993

[Event-related potential and visual evoked potential in patients with Parkinson's disease].

The event-related potential (ERP) and visual evoked potential (VEP) were recorded in 28 patients with Parkinson's disease (PD) and 28 normal subjects. Nine of the PD patients had dementia and 19 did not. Dementia was evaluated according to the criteria for dementia assigned by the DSM III-R, and mental faculties were estimated using the Mini-Mental State Examination (MMSE). ERP was recorded during auditory discriminative tasks. The latencies of N100, P200, N200 and P300 from the Pz region were measured. VEP was recorded during pattern reversal stimulation. The latency of P100 was measured for each eye stimulated. PD patients with dementia showed significant prolongation of the N200 and P300 latencies of ERP and of the P100 latency of VEP compared with the values in normal subjects and in PD patients without dementia. There was a significant correlation between the N200 latency of ERP and the P100 latency of VEP in PD patients with dementia. The findings indicate that the N200 and P300 latencies of ERP are related to cognitive information processing and also suggest that dysfunction in the central visual system plays a role in abnormal pattern VEP in patients with dementia. Furthermore, the disturbance of early sensory processing in response to visual stimuli may roughly parallel the impairment of cognitive information processing in terms of ERP in PD patients with dementia.

Aged↗
PubMed1993

[Multiple primary cancers in patients with head and neck cancer and history of tobacco smoking and drinking].

In a total of 2083 cases of hollow organ cancer of the head and neck region treated in our institute in the past 20 years, the relative risk of second primary cancers was statistically studied by the person-year approach. The organ association in multiple primary cancers and the relationship between tobacco and alcohol consumption and the development of second primary cancers were also reviewed. The incidence of second primary cancers was significantly (p < 0.05) higher in patients having a lesion at the tongue (n = 502), mesopharynx (n = 188), hypopharynx (n = 224) and larynx (n = 621) and in the oral cavity (n = 203) than in the general population. With regard to organ association in multiple primary cancers, cancers in the oral cavity, esophagus and at the pharynx were found to occur as second primary cancers of the tongue, oral cavity, meso-hypopharynx and larynx at significantly high rates in males. Male laryngeal cancer was related to the lung. No relation of female lingual cancer to the esophagus was noted. The incidence of second primary cancer was very high in persons who had been heavy smokers and/or heavy drinkers before the occurrence of their primary cancer in the head and neck region. In these people, second primary cancers were found to occur at high rates as cancers related to tobacco smoking and drinking. Otherwise, in cases with head and neck cancers less related to tobacco smoking and drinking, the incidence of second primary cancers was low. From the above results, tobacco smoking and drinking may be closely related to a high incidence of second primary cancer following the first primary cancer in the head and neck region.

Aged↗
PubMed1993

[The current state of surgical pathology of the breast--the practice in our department].

The following developments have considerably influenced the pathological management of breast materials: The wide use of aspiration cytology, increase of specimens from small non palpable lesions detected by mammography, an increase of cases difficult to diagnose histologically, increase in the number of conservative surgery cases which require examination of semi-serial sections, and the development of immunohistochemical procedures using breast cancer tissues. Under these changing circumstances in the department of pathology, we report our current practices and some of the results; About 75% of breast cancer cases initially treated in our hospital were diagnosed by aspiration cytology only. A retrospective, simulation study on quadrantectomy of breast cancers for selected T1N0N1a examined by semi-serial sections in non-conservative mastectomy cases revealed residual carcinoma foci located in a region outside the primary quadrant in about 25% cases. GCDFP-15 (Gross cystic disease fluid protein-15) is a fairly specific marker for breast cancer. Good correlation was obtained using estrogen and progesterone receptors routinely measured by ICA (Immunocytochemical assay), instead of the biochemical method using DCC (Dextran-coated charcoal). c-erbB-2 and p53 which were positive in 45.8%, and 28.6%, respectively, in our breast cancer cases, seemed to be good markers of biological malignancy in the breast cancer.

Biomarkers, Tumor↗
PubMed1993

[Anesthesia for pneumonectomy in a patient with an amphetamine psychosis].

We report a 50 year old male patient with an amphetamine psychosis who had anesthesia for a pneumonectomy. The patient had been intoxicated with methylamphetamine since 1976. After drug abuse for 2 years, he suffered from hallucination and delusion. He was diagnosed to have amphetamine psychosis by psychiatrists and treated with major tranquilizers. During the treatment for the psychosis, a squamous cell carcinoma in the lung was found. Pneumonectomy was scheduled. Anesthesia was induced with thiopental 300 mg and maintained with isoflurane, nitrous oxide, oxygen and epidural lidocaine. In the recovery room, he was injected with a major tranquilizer. Epidural buprenorphine was used to lighten the pain stress. Psychotic state did not appear after the surgery. We also discuss amphetamine psychosis in Japan.

Amphetamine↗
PubMed1993

[Clinical application of calculation software of the four rules of arithmetic on computed tomography].

Calculation program software of the four rules of arithmetic in computed tomography (CT) has been introduced for clinical purposes since 1990. Evaluation of hemodynamic reserve and cerebral autoregulation can be calculated using this software in ischemic cerebrovascular diseases and delayed cerebral vasospasm after ruptured intracranial aneurysms. Eight hemodynamic maps can be entered and calculation based on the four rules of arithmetic can be performed between them and shown visually. For example, delta CBF [CBF after administration of acetazolamide (B)-CBF before its administration(A)] and % CBF [(B - A)/A x 100] maps are useful in evaluation of the capacity of hemodynamic reserve in ischemic cerebrovascular diseases. And delta CBF [CBF before induced hypertension using intravenous dopamine administration (B)-CBF during induced hypertension (A)] and % CBF [(B - A)/A x 100] also can be used in evaluation of cerebral autoregulation and decision concerning indication of the need for induced hypertension during the period of delayed cerebral vasospasm after subarachnoid hemorrhage.

Brain↗
PubMed1992

Primary non-Hodgkin malignant lymphoma of the breast. An immunohistochemical study of seven patients and literature review of 152 patients with breast lymphoma in Japan.

BACKGROUND: The breast is rarely a primary site for extranodal malignant lymphoma. Most reported primary non-Hodgkin malignant lymphomas of the breast (PBL) are of B-cell phenotype. METHODS: Histologic and immunohistochemical analyses of seven patients with PBL and a statistical analysis of 152 patients with PBL reported in the Japanese literature were performed. RESULTS: Malignant lymphoma could not be predicted preoperatively with clinical and radiologic findings; breast carcinoma, fibroadenoma, and phyllodes tumor were the preoperative diagnoses. All patients were women; they ranged in age from 31 to 80 years (mean, 57.6 years). The right breast was involved initially in five patients. In four, only the breast was involved (Stage I), whereas in three, the ipsilateral axillary lymph nodes (Stage II) were involved at diagnosis. According to the Working Formulation, all patients belonged to the intermediate grade and were classified as having diffuse large cell (five patients) or mixed (two patients) lymphoma. Immunophenotypic analysis revealed that all patients had B-cell lymphoma. No patients had lymphoepithelial lesions, which is the characteristic feature in categorizing a lymphoma as a mucosa-associated lymphoid tissue (MALT) lymphoma. A statistical analysis of the patient reported in the Japanese literature has divided PBL into two types: a bilateral type that affects younger women and a unilateral type that has a broad age distribution, but preponderantly occurs in older women. The age and stage at diagnosis were significant prognostic factors in predicting the survival time, but the location and size of the tumor at initial presentation, histopathologic type, terminal leukemic manifestation, and treatment modality were not. CONCLUSIONS: This study indicates that most PBL are diffuse large cell lymphoma of B-cell phenotype and that the age and stage at diagnosis are significant prognostic factors.

Adult↗
PubMed1992

Experimental chemotherapy for xenograft cell lines of human bile duct and gall bladder cancers in nude mice.

Most biliary tract cancers are advanced and inoperable when first diagnosed. Even if surgery can be performed, the postsurgical prognosis of these diseases is poor. In the present study, we investigated effective chemotherapies for a human bile duct cancer xenograft cell line (undifferentiated carcinoma, BDC-SN) and a gall bladder cancer xenograft cell line (well-differentiated adenocarcinoma, GBC-GN), which were transplanted into nude mice. Eight anticancer agents (CDDP, 5-FU, VDS, MMC, ADR, EPIR, CQ, and VP-16) and their various combinations were evaluated at 2-4 times the clinical dose. When used singly, CDDP, 5-FU, and VDS were effective against BDC-SN, and only CDDP was effective against GBC-GN. Among the various 2-agent combinations, CDDP + 5-FU was the most effective against both BDC-SN and GBC-GN. However, 3-agent combinations consisting of CDDP + 5-FU + another agent were less effective than the CDDP + 5-FU double regimen and caused significant loss of weight as well as high mortality. These results suggest that CDDP + 5-FU may be the most useful regimen against biliary tract cancers in clinical application.

Adenocarcinoma↗
PubMed1992

Comparative effects of a recombinant and a mutein type of granulocyte colony stimulating factor on the growth of Meth-A fibrosarcoma with 5-fluorouracil chemotherapy.

The present study was designed to evaluate the effects of a recombinant human G-CSF (rhG-CSF) and a mutein G-CSF (KW-2228) on leucopenia and tumor growth in mice treated with 5-fluorouracil (5-FU). In normal mice, the number of leucocytes (white blood cell, WBC) reached the peak 12 hours after a single injection of either type of G-CSF and decreased to the normal level after 24 hours. Daily administration induced a continuous increase in the WBC count, however, administrations at intervals did not. Meth-A fibrosarcoma was subcutaneously inoculated into the backs of syngeneic BALB/c mice. The mice were treated with 5-FU alone or with G-CSFs. Chemotherapy with 5-FU alone resulted in leucopenia and an insignificant inhibition of tumor growth. The conjunctive administration of G-CSFs with 5-FU resulted in a significantly augmented inhibition of tumour growth, and leukopenia was not seen. This augmenting effect was more prominent with KW-2228. These results suggest that in 5-FU chemotherapy G-CSFs may be beneficial in restoring the number of leucocytes from leucopenic state and in augmenting the tumor inhibitory effect. Furthermore, KW-2228 may be more beneficial than the natural type rhG-CSF.

Amino Acid Sequence↗