Search PubMed⌕ Search

Biomedical subjects

K Kawakami

Publications and source records attributed to K Kawakami.

At least 253 records · Page 14Linked to original sources
PubMed1997

[Assessment of cerebral benzodiazepine receptor distribution in epilepsy by 123I-iomazenil-SPECT].

123I-Iomazenil (123I-IMZ) and 123I-IMP imaging were performed in 8 epileptic patients (EP) in the interictal phase and 6 normal volunteers (NV). On 123I-IMZ delayed imaging, the 8 EP showed abnormally decreased findings. Two EP showed decreased perfusion in the same region on 123I-IMP imaging. 123I-IMZ imaging for the detection of epileptic foci showed relatively high specificity compared with EEG recording. On 123I-IMZ early images, the count ratio of the right lower frontal cortex was lower the cerebellar cortex in EP was lower than that in NV. On 123I-IMZ delayed images, the count ratio of the bilateral occipital and the right upper and lower frontal cortices to the cerebellar cortex in EP was lower than that in NV. On 123I-IMZ delayed images, the count ratio of the right upper frontal cortex to the occipital cortex in EP was lower than that in NV. On 123I-IMZ delayed images, the count ratio of the left lower frontal cortex to the occipital cortex in EP was higher than that in NV. These results pointed to the involvement of the benzodiazepine receptor complex in epilepsy.

Adult↗
PubMed1997

Retrospective analysis of 70 operations for gallbladder carcinoma.

BACKGROUND: The clinical course of patients with carcinoma of the gallbladder depends on the depth of tumour invasion. This study was conducted to clarify the prognostic factors affecting survival and appropriate surgical strategy based on depth of invasion of gallbladder carcinoma according to the pathological tumour node metastasis (pTNM) classification. METHODS: A total of 70 patients who underwent surgical resection were reviewed retrospectively with regard to the type of operation, histopathological findings of the resected gallbladder carcinoma and clinical follow-up after operation. RESULTS: Twelve patients with pT1 gallbladder carcinoma fared favourably following cholecystectomy or extended cholecystectomy. In 13 of 26 patients with pT2 gallbladder carcinoma, lymph node metastasis was evident: pN1 in eight and pN2 in five. The 3-year survival rate of patients with pT2 gallbladder carcinoma was 28 per cent after cholecystectomy, 91 per cent after extended cholecystectomy and 67 per cent after hepatectomy. In 21 of 28 patients with pT3 or pT4 gallbladder carcinoma, surgical margins were affected by malignant cells. The 1-year survival rate of patients with pT3 or pT4 gallbladder carcinoma was 24 per cent, even after hepatectomy. Significant prognostic factors were age, macroscopic type, histological grade, depth of invasion, lymph node metastasis, pathological stage, lymphatic invasion, venous invasion, perineural invasion and involved surgical margins. CONCLUSION: Cholecystectomy was adequate for pT1 gallbladder carcinoma. Extended cholecystectomy or hepatectomy with extrahepatic bile duct resection and lymph node dissection (pN1 and pN2) were justified for pT2 gallbladder carcinoma. The survival of patients with more advanced gallbladder carcinoma remains dismal.

Adult↗
PubMed1997

[Myelogenous leukemia in children. ANLL9205 study by Children's Cancer and Leukemia Study Group (CCLSG)].

Treatment results were evaluated in 45 children with acute myeloblastic leukemia (AML) treated on the ANLL-9205 protocol of the Children's Cancer Leukemia Study Group (CCLSG, Japan). In this protocol, terarubicin (THP-ADR), vincristine and continuous infusion of cytosine arabinoside (Ara C) were applied for remission induction therapy (AVC), and VP16+ high dose Ara C were used sequentially for 32 or 48 weeks. Eleven patients received stem cell transplantation. Thirty-eight out of the 43 eligible patients (88.4%) achieved complete remission, and the overall 3-year event-free survival (EFS) was 55.6% (S.E.,10%). This favorable response was attributed mainly to the high induction rate of patients with the M5, M7 FAB subtypes and higher WBC counts (> or = 10 x 10(9)/L). There was no difference in the 3-year EFS of these patients who discontinued treatment between 32 weeks and 48 weeks. Serious toxicities were not observed in this study. These findings suggest that the ANLL-9205 protocol is an effective and safe treatment regimen for childhood AML. When comparing the treatment period of 32 or 48 weeks, the difference was not statistically significant.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[Usefulness of 99mTc-MIBI SPECT in the metastatic lesions of thyroid cancer].

99mTc-MIBI is widely used as a tumor-seeking agent for parathyroid tumor, lung cancer, etc. We tried to detect the metastatic lesions of thyroid cancer by 99mTc-MIBI SPECT and evaluated 131I-uptake in the region of 99mTc-MIBI accumulation. Twenty-seven cases of thyroid cancer (23 papillary adenocarcinoma, 3 follicular adenocarcinoma, 1 unknown) were examined by 99mTc-MIBI. All cases were confirmed by surgery. Thyroglobulin was measured in all cases before 99mTc-MIBI SPECT. 131I-therapy (4.5-5.5 GBq) was performed on 24 patients and whole body scintigram was taken 7-10 days after. Thirty minutes after an injection of 99mTc-MIBI (740 MBq), SPECT with a three-head gamma camera was performed. Abnormal accumulation of 99mTc-MIBI was noted in 14 patients, all cases detected on CT or MRI. In 11 of the 13 cases in which accumulation was not visualized, no metastasis was detected. Most cases of abnormal accumulation on 99mTc-MIBI showed a high level of thyroglobulin. Metastatic lesions of follicular adenocarcinoma in three patients (right humerus, axillary region and sternum) showed strong accumulation of 99mTc-MIBI, and 131I was strongly taken up in these lesions. 131I was also taken up in the metastatic lesions of papillary adenocarcinoma with marked accumulation of 99mTc-MIBI. 99mTc-MIBI did not accumulate in a case with diffuse pulmonary uptake of 131I. 99mTc-MIBI SPECT could detect occult metastatic lesions in the soft tissue more clearly than CT or MRI. In conclusion, 99mTc-MIBI study might be useful as a follow-up study of patients after surgery for thyroid cancer.

Adenocarcinoma, Follicular↗
PubMed1997

Effects of resistive load on the phase difference between chest and mouth flow in patients with chronic obstructive pulmonary disease.

The influence of the resistive load on the phase difference (PD) between chest wall and mouth flow in patients with chronic obstructive pulmonary disease (COPD) was investigated, and the factors that induce an enlargement of the PD were assessed. After a resistance tube (R = 2.8 hPa/l/s) was applied to the mouth of the subjects, the PDs increased significantly both in normal (pre: 2.20 +/- 0.89, post: 5.60 +/- 2.04, P < 0.01) and in COPD (pre: 10.86 +/- 3.81; post: 13.12 +/- 3.64, P < 0.01). A significant correlation between the airway resistance and PD was noted (r = 0.730, P < 0.001). These results suggest that airway resistance is an important determinant for the PD. The predicted phase difference (PD') was then calculated by the Runge-Kutta method, using the measured chest flow, the time domain functions of airway resistance and the thoracic gas volume during a respiratory cycle, assuming that the respiratory system was a single compartment. The PD/PD' at pre-resistive load was significantly larger in COPD than in normal subjects (normal: 1.03 +/- 0.11; COPD, 1.45 +/- 0.19, P < 0.01), whereas the PD/PD' at a post-resistive load was significantly smaller than at the pre-resistive load in COPD patients. These results agree well with the two parallel or serial compartment model with inhomogeneous airway resistance, where the mechanical property of the partitioning tissue between the two compartments was taken into account. The pattern of the increase in the work energy consumed within the airway lumen calculated from this model was almost the same as for PD. Thus, we conclude that the PD may be a good index of the overload of the respiratory movement and available to predict muscle fatigue in COPD patients.

Adult↗
PubMed1997

Quantitative assessment of the spatial distribution of low attenuation areas on X-ray CT using texture analysis in patients with chronic pulmonary emphysema.

An automated and quantitative assessment of the spatial distribution of low attenuation areas (LAA) on X-ray CT was performed using texture analysis in chronic pulmonary emphysema (CPE) patients. LAA was defined as those areas having a density less than the mean minus one SD of the control (-960 HU). The probability of change from non-LAA to LAA between a given pair of pixels with horizontal intervals of i pixels (RNi) was evaluated, because this reflects the interaction between LAA and non-LAA regions with different resolutions. The relationship between the percentage area of the LAA over the total area of the entire lung field (LAA%) was subsequently estimated. The RNi increased sharply as the i value increased from 1 to 5, but then almost became a plateau for i values larger than 5. This suggests that the fundamental structures in the LAA areas ranged from 1 x 1 to 5 x 5 pixels in size. RN1-LAA% and RN5-LAA% plots produced curves which were convex, with peak values at approximately 50 LAA% of 0.09 and 0.18, respectively. In the RN5/RN1-LAA% plot, the RN5/RN1 ratio remained constant at 2.0 regardless of the LAA%. A random process simulation was performed to determine the patterns of LAA proliferation if the spatial distribution of the LAA units was random. When the unit size was kept constant, the results of the simulation did not fit the empirical relationship between the LAA% and the three parameters (RN1, RN5 and RN5/RN1). The simulation provided the best-fitting curves when the unit size of the LAA increased in proportion with the LAA%, starting from a 1 x 1 pixel size increasing at a ratio 1 x 1/(5 LAA%). This suggested that the LAA units do not proliferate randomly in spatial orientation at a fixed unit size, but rather spread throughout the whole lung field in a congregated form whilst increasing their unit size. Thus, it may be concluded that healthy lung tissues near emphysematous lesions have a high probability of suffering from emphysema in the future. This may be due to a direct effect of the neighboring emphysematous lesion or due to a pathologic change in the larger bronchii which dominate both the healthy tissues and the emphysematous lesions.

Aged↗
PubMed1997

[Usefulness of measurement of blood flow by RI plethysmography].

We have developed the RI plethysmography, and have applied it to ordinary clinic diagnosis and the evaluation of treatment. The subjects were 58 cases (39 cases of the obstruction of the peripheral blood circulation: ASO 24 cases, TAO 4 cases and arterial sclerotic change 11 cases; the non-abnormal control was 19 cases). The clinical benefit of this method was evaluated. In the cases with 1 and 2 degrees of Fontaine's classification and ASO and TAO, the blood flow of legs measured by our method significantly decreased in association with symptoms and angiographic findings. This method is suitable to the determination of angiography and evaluation of the effect of treatment.

Adult↗
PubMed1997

[The possibility of evaluation on inflammatory change at respiratory tract in chronic bronchial asthma using 67Ga scintigraphy].

67Ga scintigraphy was performed in 17 patients with chronic bronchial asthma to grasp the inflammatory change of respiratory tract. On 67Ga scintigraphy, abnormal accumulations were detected on lung fields in 6 cases (35.3%) of 17 cases. In 5 cases of these 6 cases, the defect areas which were pointed out on 81mKr ventilation scintigraphy were matched to the abnormal accumulation areas which were pointed out on 67Ga scintigraphy. In dynamics, the abnormal accumulation areas which were pointed out on 67Ga scintigraphy were matched to the defect areas which had been at all times pointed out on 81mKr ventilation scintigraphy. 67Ga scintigraphy was expected to be one of index to grasp the inflammatory change of respiratory tract in patients with chronic bronchial asthma.

Asthma↗
PubMed1997

Standardization of low attenuation area versus total lung area in chest X-ray CT as an indicator of chronic pulmonary emphysema.

We examined the methods for measuring the LAA% (100 x low attenuation area/total lung area) on thoracic X-ray CT scans in order to develop a useful indicator of chronic pulmonary emphysema (CPE). First, we modified the method for calculating the LAA% to be applicable by the programming tool installed in a commercially available CT machine in order to minimize manual procedures. This new method proved to be applicable in all CT machines produced after 1987. Second, we examined the difference in the Hounsfield Unit (HU) between different CT machines using two kinds of phantoms. One phantom was composed of Styrofoam, which has a density similar to the low attenuation areas. The other phantom was composed of Styrofoam and water, which has a density similar to the lung. We proved that the difference of LAA% with the correct value was 5% at maximum among four different CT machines. Thus, the phantom developed in the present study may play an important role in the standardization of HU. Finally, the possibility of decreasing the X-ray levels was examined. Twenty-five percent of the standard electrical current provided the same LAA% in cases where the subject was an established CPE patient, whereas the LAA% was overestimated in subjects with a normal LAA% value. However, a correction using a linear regression equation may be possible in the latter cases. It may be concluded that LAA% analysis can easily be performed in many city hospital, without much investment of manual procedures or any corrections to the HU levels between different CT machines. This method may be useful as a routine follow up for CPE patients because of the smaller irradiated dose given when using a CT machine.

Algorithms↗
PubMed1997

[Prognostic implication of DNA contents on long-term outcome of childhood acute lymphoblastic leukemia].

Prognostic value of cellular DNA content was evaluated in 189 children with acute lymphoblastic leukemia. Treatment outcome of the three different DNA index (DI) groups (Group A, DI = 1.0 vs. Group B, DI 1.01-1.15 vs. Group C, DI > or = 1.16) was compared between the two treatment risk groups (standard-risk and high-risk groups) stratified by the initial leukocyte count and age. In the standard-risk group, these groups had 10-year event free survival (EFS) rate (SE) of 62% (6%), 40% (21%) and 87% (6%), respectively (p < 0.05). In the high risk group, they had 10-year EFS rate of 30% (5%), 33% (27%) and 60% (19%), respectively (p < 0.01). Use of the DI, leukocyte count and age may be sufficient to distinguish the patients with an extremely low risk of failing to the standard ALL therapy from the patients with a relatively high-risk of treatment failure.

Child↗
PubMed1997

[Endoscopic transthoracic sympathectomy for angina pectoris: a case report].

We performed endoscopic transthoracic sympathicotomy (ETS) for angina pectoris in a 77-year-old female. She had multiple coronary disease of a history of failed percutaneous transluminal coronary angioplasty (PTCA). Bilateral ETS of Th2 to Th5 was carried out under general anesthesia without surgical complication, hemodynamic change and ECG change. Postoperatively she was free from angina and increased working capacity. ST depression on ECG was remarkably improved and the increase of heart rate and systolic blood pressure was suppressed on exercise test after a month of ETS. The effect of ETS to angina pectoris was suspected not to relieve anginal pain but also to reduce myocardial oxygen demand on exercise. We conclude that ETS is a safe, simple and low invasive procedure and it can be done in patients who are judged unsuitable for coronary artery bypass grafting (CABG) or PTCA.

Aged↗
PubMed1997

[Relationship between redistribution rate (RD rate) of 123I-IMP SPECT and prognosis by Barthel index in cerebral infarction].

A comparative study of RD rate and the Barthel index was performed in 26 patients who had cerebral infarction. On 123I-IMP SPECT, the RD rate was calculated as follows, RD rate = (I-II)/I x 100(%). (I = (B-A)/B, where A is the mean count of the low density area (LDA) on brain CT on the early image and B the mean count of the opposite portion of LDA on the early image. II = (B'-A')/B', where A' is the mean count of the LDA on the delayed image and B' is the mean count of the opposite portion of the LDA on the delayed image. delta Barthel index (delta B. I.) was defined as follows: delta B. I. = B. I. (post-rehabilitation)-B. I. (pre-rehabilitation). In the group with B. I. (pre rehabilitation) < 85, the RD rate and delta B. I. were well correlated. In the group with B. I. (pre-rehabilitation) > or = 85, the RD rate and delta B. I. were not correlated. This result suggests that the RD rate might be useful in predicting prognosis and selecting the principle of therapy.

Adult↗
PubMed1997

[Treatment results of intermittent and cyclic regimen with ATRA and chemotherapy in childhood acute promyelocytic leukemia. Children's Cancer and Leukemia Study Group].

An intermittent and cyclic regimen with All-Trans Retinoic Acid (ATRA) and intensive chemotherapy was conducted due to pharmacokinetic studies on ATRA for acute promyelocytic leukemia (APL) in children. We have treated 17 children with APL using ATRA for remission induction followed by an intermittent schedule of ATRA plus intensive chemotherapy (APL-ATRA protocol). There were 10 males and 7 females. The median age was 9.0 years old. The median baseline white blood cell count was 12.1 x 10(3)/microliter, hemoglobin 7.8 g/dl, platelet 4.5 x 10(4) microliters at diagnosis. Sixteen patients showed t(15; 17) translocation. RT-PCR analysis was available in 15 patients and showed PML/RAR alpha rearrangement in all patients. Overall, 13 or 17 newly diagnosed patients (88%) achieved complete remission and EFS was 67%. Compared to the control (same chemotherapy without ATRA regimen), remission induction and EFS were significantly increased. The toxicity of ATRA consisted of retinoic acid syndrome in 1 and pseudotumor cerebli in another. Other toxicities included headache, chelitis, gastrointestinal trouble and bone pain. These results suggest that intermittent and cyclic regimen with ATRA and intensive chemotherapy (APL-ATRA protocol) is highly effective for APL patients.

Aclarubicin↗
PubMed1997

Mechanotransduction and intracellular signaling mechanisms of stretch-induced remodeling in endothelial cells.

We investigated the signaling mechanism of stretch-induced cell remodeling in human umbilical vein endothelial cells (HUVECs). Freshly dissociated HUVECs were cultured on an elastic silicon membrane and subjected to uniaxial cyclic stretch (20% in length, 1 Hz). The cells started to change their morphology as early as 15 min after stretch onset, and most cells eventually aligned perpendicularly to the stretch axis within 1 h. This remodeling was dependent on the increase in intracellular calcium concentration ([Ca2+]i) via a Ca(2+)-permeable stretch-activated (SA) channel. During the process of remodeling, extensive rearrangement of stress fibers and focal adhesions was observed, which may be close to the final step in the intracellular signaling cascade. This event was [Ca2+]i-dependent, suggesting the existence of a Ca(2+)-dependent intermediate cascade that links [Ca2+]i to the rearrangement of cytoskeletons and focal adhesions. We found that some proteins, including pp125FAK (focal adhesion kinase) and paxillin, were tyrosine phosphorylated during cyclic stretch in a Ca(2+)-dependent manner. Inhibition of this tyrosine phosphorylation prohibited the stretch-dependent rearrangement of cytoskeletons and focal adhesions as well as the remodeling. Finally the tyrosine kinase src, which could phosphorylate pp125FAK, was found to be activated in a [Ca2+]i-dependent way during stretch. All of the above molecular events were consistently Ca(2+)-dependent, which led us to propose the signaling cascade: SA channel activation-->[Ca2+]i increase-->src activation-->protein tyrosine phosphorylation-->rearrangement of cytoskeletons and focal adhesions-->cell remodeling.

Calcium↗