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Biomedical subjects

K Senda

Publications and source records attributed to K Senda.

At least 37 records · Page 2Linked to original sources
PubMed1993

Phase I clinical and pharmacokinetic study of a 14-day infusion of etoposide in patients with lung cancer.

PURPOSE: A phase I study was conducted to determine the maximum-tolerated dose (MTD) of a 14-day continuous infusion of etoposide, and to evaluate the pharmacokinetics in patients with lung cancer. PATIENTS AND METHODS: Etoposide was administered continuously through a central venous catheter using a pump. The starting dose level was 300 mg/m2 over 14 days, with dose escalations of 100 mg/m2 over 14 days until unacceptable toxicities occurred. Pharmacokinetic studies were performed in all patients. RESULTS: Twenty-one patients, 20 with non-small-cell lung cancer and one with refractory small-cell lung cancer, received 37 courses. No World Health Organization (WHO) grade III or greater toxicity occurred at doses up to 400 mg/m2 over 14 days. At 700 mg/m2 over 14 days, all four patients experienced grade III or IV leukocytopenia, and two developed grade III stomatitis. No cumulative toxicity was observed. A steady concentration of etoposide was achieved 24 hours after the start of chemotherapy, and it was significantly correlated with surviving fractions of leukocytes (r = -.64, P = .001) and platelets (r = -.68, P < .001). The leukocyte count at the termination of chemotherapy predicted the nadir count (r = .93, P < .001). CONCLUSION: Steady blood levels of etoposide were maintained for prolonged periods, during 14-day continuous infusions. Leukocytopenia and stomatitis were dose-limiting. Nadir counts and surviving fractions of leukocytes were predicted by the leukocyte count at the end of chemotherapy and the concentration of etoposide, respectively. The recommended dose for phase II trials is 600 mg/m2 over 14 days.

Adult↗
PubMed1992

Small caliber catheter drainage for spontaneous pneumothorax.

Excellent results have been reported after small caliber catheters were used for iatrogenic pneumothoraces. However, the value of using such catheters for spontaneous pneumothoraces is not clear. The purpose of this study, therefore, is to examine the efficacy of small caliber catheters in managing spontaneous pneumothoraces. Seventy six episodes of spontaneous pneumothorax were treated using a small caliber catheter (No. 5.5 or 7.0 French) connected to a Heimlich valve. All catheters were inserted by physicians. The treatment was considered successful when there was no air leakage and little or no residual pneumothorax. Before the lungs were fully expanded, four patients had died and one had refused to comply with further treatment. The remaining 71 episodes of pneumothoraces were evaluated for efficacy. The treatment was successful in 60 patients (84.5%) and ineffective in the remaining 11. The conventional large caliber tube was inserted in 10 of the 11 failures, but they were successful in only six. No major complications resulting from catheter insertion occurred, and no catheters became occluded. The catheter was easy to insert, and the scar that remained after removal of the catheter was very small. Not only are small caliber catheters effective for managing spontaneous pneumothoraces, they are the initial treatment of choice.

Catheterization↗
PubMed1992

Mucin-producing pancreatic tumor: CT findings and histopathologic correlation.

Twenty patients with mucin-producing pancreatic tumor and 60 with other pancreatic diseases underwent computed tomography (CT) to establish the CT characteristics of mucin-producing pancreatic tumor. Scans were obtained with thin sections by administering a large volume of contrast material (200 mL). Mucin-producing pancreatic tumors were divided into three subgroups, and the CT characteristics were as follows: Main duct type tumors consisted of a cystic mass in or communicating with the dilated main pancreatic duct (MPD). Excrescent nodules and/or septa were found in the cyst. The MPD was markedly dilated over its entire length. Branch duct type tumors consisted of clustered small cysts that were all approximately the same size in diameter (1-2 cm). Excrescent nodules or septa were not always seen. The MPD near the lesion was often slightly dilated. Peripheral type tumors consisted of a well-defined cystic mass with excrescent nodules and/or septa. Even if the cyst was multilocular, a large main cyst was in it. The MPD usually was not dilated. The CT findings corresponded to macroscopic findings. Mucin-producing pancreatic tumor can be differentiated from other pancreatic diseases with these criteria.

Adenoma, Islet Cell↗
PubMed1992

[Clinical significance of regional cerebral blood volume and flow-to-volume ratio in ischemic cerebrovascular disease measured by SPECT].

Regional cerebral blood volume (rCBV) and flow-to-volume ratio (rCBF/rCBV) were evaluated for clinical significance in comparison to rCBF and findings in X-ray CT (XCT) and radionuclide (RNA) and contrast angiography (CAG). A total of 109 cases were studied within 90 days after cerebrovascular ischemic attack. CBV SPECT was performed following CBF SPECT with I-123-IMP and RNA with Tc-99m-RBC, and processed for subtraction of I-123 contamination fraction. CBF/CBV image was obtained as the count ratio of CBF to CBV image at the same slice-level. Parametric rCBV and rCBF/rCBV were estimated as the count ratio of the focus to the contralateral normal region of interest. Image findings were scored by visual judgement. Student's t-test was applied for statistical analysis with a significance level of p = 0.01. The rCBV-ratio was inversely proportional to rCBF/rCBV-ratio, and was different between the two groups with high and low score on flip-flop perfusion in RNA and among three groups with different postictal neurological course. The ratio was the highest for the group of improved course. The rCBF/rCBV-ratio was possibly correlated to rCBF-ratio, and was different between the two groups with high and low score on low density area in XCT, early perfusion in RNA and arterial stenosis in CAG. In the group of improved course, the ratio was different between the second and the third postictal week's duration. These results, therefore, suggest that rCBV-ratio reflects collateral perfusion, and is valuable for assessing postictal prognosis in cerebrovascular disease, and that rCBF/rCBV-ratio may reflect regional oxygen extraction fraction, and is valuable for speculating cerebral perfusion reserve.

Adult↗
PubMed1990

[Simultaneous bilateral spontaneous pneumothoraces].

Seven cases (1.9%) of simultaneous bilateral pneumothoraces were found in a retrospective study of 377 patients with spontaneous pneumothorax during the period from July, 1977 to June, 1989. Their symptoms were essentially those of unilateral pneumothorax, but with more severe dyspnea. All but two cases, both young, had underlying pulmonary diseases. Three (two lung cancers and one metastatic lung disease) had malignant pulmonary disease. During this period, five lung cancer patients were complicated with pneumothorax, and two of them had simultaneous bilateral pneumothoraces. Therefore the frequency of bilateral pneumothoraces in the lung cancer patients associated with pneumothorax is high. In these three patients with malignant disease, tube drainage was carried out but all died of respiratory failure. Two senile patients had small bilateral pneumothoraces. Bed rest without invasive treatment led to successful cure. Two younger patients without underlying pathology initially underwent tube drainage, followed by operation. We conclude that many patients with simultaneous bilateral spontaneous pneumothoraces have underlying pulmonary disease, the frequency of lung cancer being particularly high. Young patients without underlying disease should be operated on following alleviation of symptoms by tube drainage. Older patients and patients with malignancy should be treated with great care and individually.

Adolescent↗
PubMed1989

[A case of retroperitoneal liposarcoma].

We reported a case of retroperitoneal well differentiated liposarcoma, which consisted of lipoma-like type and sclerosing type. The latter was represented as solid density tumor on CT, which was difficult to differentiate from undifferentiated liposarcoma and other soft tissue tumors. Angiographically, ureteral artery developed and became a main feeder.

Aged↗
PubMed1987

Evaluation of diffusely high uptake by the calvaria in bone scintigraphy.

The present study was undertaken to evaluate the finding of diffusely high uptake by the calvaria in a series of 994 consecutive whole body scans in regard to the incidence and degree, and to discuss the mechanism. A total of 86 patients had positive scans (73 women and 13 men) and there were 71 malignant (27 breast, 16 lung, and 28 other malignancies), and 15 benign disease cases (5 degenerative bone, 3 blood, and 7 miscellaneous diseases). Positive rate of the finding was 8.7% in total, 14.9% in women, and 2.6% in men. The difference between women and men was significant (P less than 0.001). The finding was significantly correlative with the ages of patients. Also the finding is shown to be predominant in women ranging 50-59 years of age. On the other hand, the same finding as was made by Creutzig and his coworker was confirmed in malignant cases under high-dose anticancer drug therapy. On the basis of these results, the finding may be not only a side effect of intensive cytotoxic medication on the skeleton, but also a physiological event relative to bone change with age and postmenopausal osteoporosis.

Adolescent↗