Search PubMed⌕ Search

Biomedical subjects

K Shibata

Publications and source records attributed to K Shibata.

At least 307 records · Page 17Linked to original sources
PubMed1996

[Evaluation of chemotherapy in the treatment of advanced colorectal cancer--pilot study of 5-FU by biochemical modulation].

We undertook a randomized trial in patients with advanced colorectal cancer, comparing 5-fluorouracil and leucovorin versus combination of these agents with additional cisplatin. Between July 1991 and October 1994, 21 patients with advanced measurable colorectal cancer previously unexposed to chemotherapy were randomly assigned to treatment with either 5-FU (500-750 mg/body) and LV (30 mg/body) for 5 days, or the combination of 5-FU and LV in the same daily dose plus cisplatin (10 mg/body). The overall responses were 30% and 36.3% for the 5-FU/LV and the 5-FU/LV/CDDP treatment arms, respectively. The three-drug combination appeared superior to 5-FU/LV for response duration. A comparative analysis of the toxicities experienced by the patients in the two treatment groups showed a comparable rate, although moderate leukocytopenia was prolonged in one patient treated with 5-FU/LV for 5 days. We conclude that the 5-FU/LV/CDDP treatment arm is an effective therapy for advanced colorectal cancer, but further attempts should be made to increase response rate, prolong response duration and assure effective therapy.

Adult↗
PubMed1996

[Evaluation of the clinical usefulness of super dynamic 99mTc-HM-PAO SPECT in ischemic cerebrovascular disease--detection of hypo- and hyperperfusion area].

The purpose of this study is to assess the clinical usefulness of super dynamic SPECT of 99mTc-HM-PAO. Six patients with unilateral occlusion of middle cerebral artery (MCA) or internal carotid artery (ICA) in the chronic phase, and 5 patients with subacute cerebral infarction were studied. We used a ring-type SPECT "HEADTOME." Two types of collimator were used: a high sensitivity (HS) collimator for super dynamic scan and a high resolution (HR) collimator for static scan. First, the intravenous constant infusion of 99mTc-HM-PAO (925-1480 MBq) for 1 minute was started. After 30 seconds from the beginning of the injection, we performed the 12 seconds/frame super dynamic SPECT for 2 minutes. Then, the static SPECT for 10 minutes was done. For semiquantitative analyses, differential percentage of regional activity between affected and non-affected hemispheres was calculated in the 6th frame image of super dynamic SPECT and static SPECT image. In all 6 patients with unilateral occlusion of MCA and ICA, super dynamic SPECT images showed the better contrast of low perfusion areas in comparison with the static SPECT images. In 5 patients with subacute cerebral infarction who showed focal hyperactivities on static SPECT, focal hyperactivities (hyperperfusion or hyperemia) were displayed in 3 cases, whereas, focal hypo- or isoactivities (hypo- or isoperfusion) were shown in 2 cases on super dynamic SPECT. However, all patients with subacute cerebral infarction showed hyperfixation on static SPECT as compared with super dynamic SPECT. Although the image quality on super dynamic SPECT is not as high as that on static SPECT, cerebral hemodynamics would be detected with less backdiffusion of 99mTc-HM-PAO from the brain to blood, and with less accumulation of hydrophilic components in subacute infarct region. In conclusion, super dynamic SPECT in early distribution of 99mTc-HM-PAO using dedicated SPECT device might be helpful to detect cerebral perfusion close to true cerebral blood flow distribution.

Aged↗
PubMed1996

[Surgical treatment for recrudescent Stanford type A early closing dissection].

Two cases of recrudescent Stanford type A dissection were reported. They had non-opacified false channel on their initial CT and aortography. The first case was 65-year-old woman having a stable blood pressure and no chest pain after admission. However, recrudescent opacified false lumen was found at the mid-ascending aorta about three weeks later. She received ascending aortic replacement on 26th day after onset. The second case was 66-year-old woman having a unstable blood pressure and having periodic chest pain and back pain after admission. CT and angiography performed on the 41th day after onset revealed recrudescent descending aortic dissection and ulcer like projection at mid-ascending aorta. The ulcer like projection increased in size gradually. Ascending aorta replacement was performed on 110th day after onset. Two cases had a good post operative days. Some cases of Stanford type A early closing aortic dissection had recrudescent dissection later, even if they had a stable course after onset. Thus, careful follow up for long term is essential in these cases

Aged↗
PubMed1996

The effect of a hematopoietic-promoting factor (HPF) extracted from porcine kidney on the proliferation of human hematopoietic progenitor cells.

Hematopoietic-promoting factor (HPF), which was found in porcine kidney, has been demonstrated to act synergistically with colony-stimulating factor and erythropoietin on murine myeloid colony formation. We investigated the effect of HPF on the proliferation of human hematopoietic progenitor cells prepared from cord blood cells (CB) and peripheral blood cells (PB). HPF enhanced granulocyte colony-stimulating factor plus interleukin-3 and erythropoietin-induced colony formation, where the number of colonies were increased by 7.9-fold in CB and by 1.8-fold in PB, respectively. When we compared the effect of HPF with stem cell factor (SCF) on the colony formation derived from PB in serum-free cultures, HPF enhanced the number of erythroid burst-forming units (BFU-E) to the same extent as SCF. But the effect of HPF on promoting the growth of granulocyte-macrophage colony-forming units (CFU-GM) was less than SCF. When the enriched CD34+ cells from CB and PB were incubated in liquid culture with HPF and IL-3 for 7 days, CFU-GM was increased by 48-fold in CB, and by 25-fold in PB, respectively. The data demonstrate that HPF can potentiate expansion of hematopoietic stem cells to the same extent as SCF, and that the effects of HPF on hematopoitic stem cells differ from that of SCF.

Adult↗
PubMed1996

[Costal chondritis treated by resection of the entire costal arch].

A 68-year-old man had chronic pleural empyema, an alveolar fistula, and purulent perichondritis. The pericostal abscess extended beneath both sides of the costal arch and had a cutaneous sinus in the right hypochondrium, but it did not communicate with the cavity of the pleural empyema. In separated operations, the entire costal arch was resected and the alveolar fistula was closed with the pedunculate latissimus dorsal muscle. Neither tuberculosis bacilli nor tubercular granulomas were seen in resected specimens. The postoperative course was uneventful and the pericostal abscess healed, but the alveolar fistula recurred and the patient died of pneumonia 3 years and 6 months after the first surgery.

Aged↗
PubMed1996

[FLAIR images of subarachnoid hemorrhage].

We studied MR fluid attenuated inversion recovery (FLAIR) pulse sequences in 37 cases with subarachnoid hemorrhage caused by aneurysmal rupture. FLAIR sequence suppressed the CSF signal and produced very heavy T2 weighted images. This has been of particular benefit in identifying lesions at the margins of the brain, around the basal cisterns, in the brain stem and at the gray-white matter junction. Based on these findings, we were able to detect the subarachnoid hemorrhage. Subarachnoid hemorrhage was able to be demonstrated as high signal intensity on FLAIR sequences in all patients. Clear visualization of acute subarachnoid hemorrhage was able to be obtained by MR FLAIR sequences in not only Fisher's group 3 or 4, but also Fisher's group 2. Moreover it was suited for the detection of intraaxial hematoma, Sylvian hematoma, subdural hematoma and subarachnoid hemorrhage in the posterior fossa and interhemispheric fissure. Especially, it was useful for detecting intraventricular hemorrhage. Therefore, if patients suffering from subarachnoid hemorrhage present slight headache or atypical symptoms, sometimes it may be more suitable to perform MRI FLAIR pulse sequences first. Aneurysms were found in 21 cases (56.8%). When the aneurysmal size is more than 7 mm, the rate of detection becomes 100%. Aneurysms present various MR appearances because of flow characteristics. Aneurysms were demonstrated as low signal intensity except in 3 cases. In one out of 3 cases, aneurysms were revealed as high signal intensity and in the other two cases, it was revealed as mixed signal intensity. According to the previous studies, rapid flow was demonstrated as low signal intensity by vascular flow void, and delayed flow was demonstrated as high or mixed signal intensity by flow related enhancement and even echo rephasing. MR clearly delineates the size, the lumen, the flow, and the extraaxial location of aneurysms. In conclusion, MR FLAIR pulse sequences could be reliable and useful for diagnosis of subarachnoid hemorrhage, especially as screening tests for outpatients.

Adult↗
PubMed1996

[Pitfalls of three-dimensional computed tomographic angiography as an examination for cerebral aneurysm surgery].

Three-dimensional computed tomography (3D-CT) has recently become available and is being increasingly applied in the field of neuroradiology. One of the procedures, 3D-CT angiography (3D-CTA), has been reported to be more advantageous aneurysms. Some investigators insist that conventional angiography is no longer needed to make the diagnosis. We recently experienced cases in which we were misled or found it difficult to judge the relationship between the aneurysm and surrounding structures by 3D-CTA. Our findings can be summed up as follows: 1) two aneurysms in contact with each other could not be opacified separately, 2) the perforators were hardly opacified at all making it impossible to judge the relationship between the aneurysms and these vessels, an assessment which is very important for delicate operations, 3) the origin of A2 was not clearly opacified as being separate from that another near by aneurysm, 4)part of the severely tortuous middle cerebral artery was interpreted as an aneurysm shadow, 5) even M2 is sometimes not well opacified. In conclusion, 3D-CTA itself is not always a satisfactory method of evaluating the relationship between a cerebral aneurysm and its surrounding vessels. Misleading findings should be kept in mind during direct observation at surgery.

Aged↗
PubMed1996

[Serial changes of SPECT and MRI findings in a patient with herpes simplex encephalitis].

We report a case of herpes simplex encephalitis in which the patient was repeatedly examined by magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). The patient was a 36 year-old woman who had been transferred to our institution 6 days after the onset of symptoms with mild consciousness disturbance, nuchal rigidity, and high fever. Cerebrospinal fluid examination revealed an elevated mononuclear cell count with normal sugar concentration. Intravenous aciclovir was started 7 days after the onset of symptoms. The initial plain computed tomography (CT) scans did not reveal any abnormal findings, but contrast enhanced CT the next day showed a slight enhancement effect around the affected middle cerebral artery. Serial MRI showed the initial high intensity lesion starting on the medial cortex of the temporal lobe, then spreading to throughout the entire temporal lobe. During this period SPECT showed a marked, broad hot spot in the temporal lobe. The medial temporal lobe was high density on the CT 15 days after the onset. As the encephalitic lesion spread more laterally, the hot spot on SPECT moved laterally and then decreased in activity. Eleven weeks after the onset, the MRI showed intracerebral vacuolization of the lesion and it appeared as a wide cold spot on SPECT. The cause of the hot spot seen in the acute period was thought to be vasoparalysis of the affected area rather than breakdown of the blood-brain barrier, or impaired washout of the isotope, because the SPECT images after acetazolamide administration showed the cold spot even in the subacute phase.

Adult↗