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Biomedical subjects

K Ota

Publications and source records attributed to K Ota.

At least 523 records · Page 29Linked to original sources

[Clinical study of acute cardiotoxicity of anti-cancer agents-- analysis using Holter ECG monitoring].

To investigate the features of acute cardiotoxicity caused by the anticancer agents, adriamycin (ADM), THP-adriamycin (THP), epirubicin (epi-ADM) and mitoxantrone (MIX), Holter electrocardiograms were recorded before and after administration of these drugs and some of the electrocardiographic parameters were analyzed. The heart rate tended to increase after ADM administration, but other agents had no effect. The basic rhythm was sinus rhythm in many cases except for only one case in which intermittent atrial fibrillation developed after ADM administration. These agents had no effects on the specialized conduction system. With regard to supraventricular premature beats, no increase in preexisting supraventricular premature beats was observed, but there was a slight tendency for the fresh appearance of supraventricular extrasystoles after administration of these agents. On the other hand, ventricular premature beats tended to increase in number and severity after ADM therapy. The other three agents induced no significant increase in ventricular extrasystoles. Development of ST-T changes was seen after the administration of ADM and THP, but epi-ADM and MIX produced no significant changes. In conclusion, epi-ADM and MIX were less cardiotoxic than ADM and THP.

Adult↗

Restorative activity of muroctasin on leukopenia associated with anticancer treatment.

The restorative effect of N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a muramyl dipeptide derivative, was studied in patients with leukopenia associated with anticancer chemotherapy and radiation therapy. The drug was subcutaneously administered to 102 cancer patients in a single doses of 200 or 400 micrograms, and each dosage was given either every day for 6 days or every other day over a 5-day period. White blood cell (WBC) counts were made before, during and after treatment. MDP-Lys(L18) was most effective in patients receiving the drug every day and the 400 micrograms dose was somewhat superior to the 200 micrograms dose in augmenting the WBC population. Overall, the response to MDP-Lys(L18), in terms of the increase in number of WBCs, was good to excellent in 41.6% of patients. MDP-Lys(L18) was considerably more effective in patients with solid tumors than in those with hematological malignancies. The most common side effect was fever, which was dose-dependent, more pronounced with alternate-day dosing, and generally well controlled with antipyretics. The results of this study indicate that MDP-Lys(L18) is useful in improving the WBC count in leukopenic cancer patients treated with anticancer therapy. Considering the efficacy and side effect profiles together, it is suggested that 200 micrograms/day for 6 consecutive days is the optimal treatment regimen.

Acetylmuramyl-Alanyl-Isoglutamine↗

[Two cases of acute idiopathic subdural hematoma with delayed intracranial hypertension].

Two cases of acute idiopathic subdural hematoma with delayed intracranial hypertension were presented. The first case was a 68-year-old man admitted for vomiting following headache for eight days. There was no history of head trauma. A CT scan revealed a high-density mass that had a concave inner margin in the left temporo-parietal region with a slight midline shift. No vascular lesion was noted on the angiogram. The consciousness of the patient deteriorated suddenly on the 12th day. An operation was performed because of a marked midline shift on the CT. At operation, a subdural clot was removed. The postoperative recovery was good. The patient was discharged 7 days later without any neurological deficit. The second case was a 69-year-old man who was admitted with sudden onset of headache. There was no history of head trauma. A CT scan showed a high density mass in the right temporoparietal subdural space with a slight midline shift. The consciousness of the patient deteriorated suddenly on the 15th day. An operation was performed because of a marked midline shift on the CT. At operation, a subdural hematoma was removed. Two days later, suddenly his consciousness deteriorated. A CT scan showed his severe brain edema with a marked midline shift without increased hematoma. External decompression was performed immediately. The postoperative recovery was very good and 40 days after the second operation, the patient was discharged with no neurological deficit. The delayed intracranial hypertension appeared in these two cases about 10 days after the initial symptom. Two kinds of mechanisms are suspected: 1) swelling of the hematoma because of the adsorption of cerebrospinal fluid, 2) the occurrence of secondary brain edema. From our experience, a repeated CT scan is necessary for 2 to 3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

[Prognostic factors of malignant lymphomas].

As prognostic factors of malignant lymphomas, many factors such as histopathology, clinical stage, surface phenotype, primary site, and serum LDH are listed. But when we analyse the data according to the period accumulated for a long time, big differences in survivals are always observed. This fact means that the therapeutic factors become a very important prognostic factors, and the importance of other prognostic factors are influenced by the therapeutic factors. The main subjects in the treatment of lymphomas are the improvement of therapeutic results and the reduction of the intensity of treatment of the patients in whom the cure are expected in high probability. In these situation, statistical analysis of the prognostic factors include therapeutic factor will contribute strongly to the improvement of treatment results.

Age Factors↗

B-cell lymphoma of probable thymic origin: case report.

A case of B-cell lymphoma of probable thymic origin is reported. A 34-year-old woman was found to have an anterior mediastinal tumor in November 1986. The surface lymph nodes were not palpable. A total resection of the tumor mass was performed. The tumor invaded the right pleura, the right lung and the pericardium. Histologically, normal thymus was found at the margin of the tumor tissue. The neoplasm was predominantly composed of large lymphoid cells, separated by rather thick fibrous bands of nodular fashion in some areas. Immunohistochemical staining demonstrated monoclonal cytoplasmic IgG and kappa chains in a small portion of the neoplastic cells in fixed tissue. The cells showed positive staining with cluster of differentiation (CD) 20 (B1) but negative staining with antibodies reactive with T-cells in unfixed tissue. "Malignant lymphoma, diffuse, large cell type (B)" was the diagnosis. The arrangements of immunoglobulin (Ig) and T cell receptor (TCR) beta genes were studied. Clonal rearrangement bands of IgH and Ig kappa genes were observed in the same sizes in both the tumor and the peripheral blood before chemotherapy. The patient received chemotherapy until September 1987, and is in complete remission at present (January 1988). The peripheral blood showed germ line patterns of IgH and Ig kappa genes in complete remission. No rearrangement bands of TCR beta genes were detected throughout. The B-cell lineage was proved both from gene arrangement analysis and with immunohistochemistry.

Adult↗

[Current studies of sequential methotrexate and 5-fluorouracil treatment in cancer chemotherapy].

This paper reviews the data on the clinical studies of sequential methotrexate and 5-fluorouracil in advanced colorectal, gastric, head and neck, and breast cancer. To date, a lot of phase II studies have been conducted, but there are many distance in each clinical data concerning response rate and side effect by the difference between their clinical methods with respect to the interval between methotrexate and 5-fluorouracil, or the dosage of each drugs. There are several reports with high response rate in those phase II studies, but randomized controlled studies recently reported have not yet confirmed the sequential effect of MTX-5-FU treatment. Therefore, it is concluded that the randomized controlled studies with the most available methods must be performed to evaluate the true efficacy of sequential methotrexate and 5-fluorouracil treatment.

Antineoplastic Combined Chemotherapy Protocols↗

An apparently higher molecular weight gamma-chain variant in a new congenital abnormal fibrinogen Tochigi characterized by the replacement of gamma arginine-275 by cysteine.

A gamma-chain variant with an apparently higher molecular weight than the normal gamma-chain was detected in a new congenital abnormal fibrinogen with impaired polymerization of the fibrin monomer and with normal release of fibrinopeptides A and B in a 51-year-old male. Purified fibrinogen analyzed on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under the reduced condition in the system of Laemmli contained two protein bands in the gamma-chain region (molecular weight, 50,500 as compared with 50,000 for the normal), both with normal crosslinking ability. The presence of two types of gamma-chains was more clearly detected when reduced and carboxymethylated fibrinogen was analyzed by SDS-PAGE or when reduced fragment D2 was analyzed on SDS-PAGE followed by Western blotting, and identified by positive staining for anti gamma-chain monoclonal antibody. Cyanogen bromide- or lysylendopeptidase-cleavage of purified gamma-chains analyzed on reverse-phase high performance liquid chromatography showed the decrease of one peptide compared with the normal and the appearance of an abnormal peptide peak. Amino acid sequence analysis demonstrated that the gamma arginine-275 of gamma-chain variant was replaced by a cysteine. These data suggest that some regions or conformations containing gamma 275 will affect the polymerization of fibrin monomers. The propositus' two daughters had the same abnormal fibrinogen. This unique inherited abnormal fibrinogen was designated as fibrinogen Tochigi, and the gamma-chain variant as gamma Tochigi.

Arginine↗

Major prognostic factors of adult patients with advanced B-cell lymphoma treated with vincristine, cyclophosphamide, prednisone and doxorubicin (VEPA) or VEPA plus methotrexate (VEPA-M).

Eighty-two adult patients with advanced B-lymphoma, treated between 1981 and 1983 with VEPA (vincristine, cyclophosphamide, prednisolone and doxorubicin) or VEPA-M (VEPA plus methotrexate) in a prospective randomized fashion, were evaluated for pretreatment characteristics. The overall complete response (CR) and the 4-year survival rates were 74% and 45%, respectively. The relapse rate was 51%. Stage of disease only was negatively associated with the CR rate in a multivariate analysis. The primary extranodal tumor site other than upper gastrointestinal (GI) tract and high grade pathology were found to affect disease-free survival adversely in a Cox proportional hazards model. Poor performance status, advanced stage, primary extranodal tumor site other than upper GI tract, advanced age, high grade pathology and prior therapy by either surgery or radiation, were significantly associated with shortened survival in a Cox proportional hazards model. These results indicate advanced B-lymphoma in Japan to be generally similar to advanced non-Hodgkin's lymphoma in the West in terms of prognostic factor characteristics, but the importance of the primary site in predicting survival has not been reported in the West. Also, the lack of a survival plateau in patients with diffuse large cell lymphoma indicates more intensive chemotherapy regimens than VEPA or VEPA-M to be needed. It was also found that the significant prognostic factors in patients with advanced B-lymphoma were very different from those with T-lymphoma. The five factors: pathology, stage, primary site, age, prior therapy by surgery or radiation, for which the risk ratio was more than 2.3, were used to construct a model containing 23 categories of patients running an increasing risk of shortened survival; this divided patients into three groups. The CR and 4-year survival rates of low-, moderate- and high-risk groups were 90% and 74%, 74% and 58%, and 50% and 5%, respectively. The risk-grouping provides indications for determining optimal therapy for individual patients and the need for new therapeutic trials in patients at high risk.

Adult↗

[Chemotherapy of malignant lymphomas].

According to recent advances in chemotherapy containing adriamycin, now complete remission can be obtained in more than 80 percent of patients with stage 3 and 4 diffuse large cell lymphomas, and the cure rate could also be expected in more than 60 percent of patients. The easiest way to obtain better results would be the introduction of chemotherapy in stage 1 and 2. The kinds of chemotherapy chosen in planning the design of the treatment should be such as to eradicate microdisseminated disease, and only such chemotherapy will contribute to improvement in survival rates.

Aged↗

Effect of membrane trapping in plasma fractionator on separative characteristics.

Several kinds of plasma fractionators have been introduced to actively separate protein fractions between albumin and globulins in double filtration plasmapheresis. However, relatively large molecular weight proteins are known to be partially trapped by the membrane in a plasma fractionator. In this paper, effects of membrane trapping on separation characteristics in plasma fractionators were examined during in vitro and in vivo studies. All in vitro experiments were done with a closed circuit under constant-flow rate filtration. Protein concentration in feed tank kept constant at no filtration in AS-14H, Evaflux 4A and 2A, while 20-40% of IgG and 40-60% of beta-lipoprotein in 2 liter plasma were removed by membrane trapping for 300 min when filtration fraction equaled 0.87. Protein plugging to the membrane seems to be a major factor in these proteins. And, Dead-end and Partially Discarded modalities with relatively high filtration fraction are effective for the separation between albumin and globulin. Twenty-seven DFPP treatments in 13 patients with autoimmune diseases were done to allow us to estimate the effects of membrane trapping during an in vivo study. All treatments using 6 types of plasma fractionator were performed under constant operating conditions with Partially Discarded modality. In any plasma fractionator, beta-lipoprotein was fairly trapped at 30 min after the start of treatment.

Adsorption↗