Biomedical subjects

K Shimoda

Publications and source records attributed to K Shimoda.

258 records · Page 15Linked to original sources

PubMedDate not supplied

Cisplatin, vindesine, pepleomycin and concurrent radiation therapy following esophagectomy with lymph adenectomy for patients with an esophageal carcinoma.

Between 1986 and 1991, 35 patients with esophageal cancer (TNM stages II-IV) underwent transthoracic esophagectomy with lymph adenectomy and were subsequently treated with 5,000 cGy of radiation (days 1-40) and concurrently with two courses of chemotherapy (cisplatin, vindesine and pepleomycin, days 21-26 and 49-54). Results were compared with those of 26 historical control patients, treated with radiation since 1981. Tolerance in all patients was good. The survival rate at 5 years was significantly improved for the multimodality-treated patients (30.9 +/- 9.4%), as compared with findings in historical controls (5.1 +/- 4.8%). The concurrent chemoradiation therapy using these three drugs following extensive surgery is worthy of consideration for patients with a localized esophageal cancer.

Adult↗

PubMedDate not supplied

Inhibition of furosemide-induced increases in plasma renin activity by amiloride.

The effect of the potassium-sparing diuretic, amiloride, was studied in conscious rabbits bearing chronic indwelling cannulas to assess whether its reported in vitro kallikrein-inhibiting activity may produce a suppressive effect on furosemide-induced renin secretion similar to that previously demonstrated with another kallikrein inhibitor, aprotinin. Furosemide elicited a rapid and persistent rise in plasma renin activity (PRA), but pretreatment of the same rabbits with a 15-minute intravenous infusion of amiloride, which amounted to 1 mg/kg and commenced at 30 minutes before furosemide, completely prevented this rise. Amiloride also prevented furosemide-induced kaliuresis without an attenuation of the diuretic or natriuretic response and did not alter plasma potassium concentration in the absence of any change in external potassium balance, indicating that suppression of the PRA response is due neither to prevention of extracellular fluid volume contraction nor to the known suppressive effect of hyperkalemia. Mean arterial pressure tended to fall slightly but not significantly with or without amiloride pretreatment. On the basis of these findings and those of our antecedent study with aprotinin, we conclude that the striking similarity between the suppressive effects of two dissimilar inhibitors of kallikrein on pharmacologically evoked renin secretion is consistent with the hypothesis that renal kallikrein participates in the mechanism of renin secretion in vivo.

Amiloride↗

PubMedDate not supplied

Phototoxic lesions induced by quinolone antibacterial agents in auricular skin and retina of albino mice.

The phototoxic effects of quinolone antimicrobial agents on mouse auricular skin and retina were examined histologically. Sparfloxacin at 50 or 100 mg/kg, which alone causes no histologic change, was orally administered to albino Balb/c mice, which were irradiated with ultraviolet A for 4 hr immediately after administration. In the auricle, degeneration of basal epidermal cells was sporadically observed at 2 hr (during the irradiation). Foci of slight edema with degenerated fibroblasts were seen in the dermis at 4 hr. Edema and neutrophil infiltration in the dermis became severe up to 96 hr. Initial changes in the retina were observed at 2 hr. Vacuolation of the photoreceptor segments (particularly the inner segment) was occasionally associated with swelling of retinal pigment epithelial cells. The segments became disorganized with time, and the outer nuclear layer showed reduced cellularity. The segments and layer were partially thinned and lost 96 hr later. Enoxacin at 400 and 800 mg/kg induced similar lesions to those of sparfloxacin. Levofloxacin caused similar lesions in the auricle but no change in the retina. The combination of oral administration of quinolone and ultraviolet A irradiation, which never caused apparent morphological changes alone, was shown to be able to induce phototoxic lesions in albino mice. Therefore, this method is thought to be useful to examine morphological changes caused by quinolone phototoxicity.

Animals↗

PubMedDate not supplied

Factors related to malnutrition in patients with esophageal cancer.

Based on data indicating that decreases in body weight (BW), arm muscle circumference (AMC), and rapid-turnover proteins (RTPs) correlate with fatal septic complications after surgery for esophageal cancer, we examined possible factors contributing to protein-calorie malnutrition (PCM) in patients with this disease. Eight parameters of nutritional status were assessed. Associations between sex, age, stage of cancer, and degree of dysphagia and PCM were analyzed via multiple linear regression for 75 patients with esophageal cancer and 58 with gastric cancer. These four factors independently contributed to PCM in patients with esophageal cancer, whereas malignant tumor and age contributed to PCM in those with gastric cancer. The degree of dysphagia was related to decreases in serum albumin and RTP and weakly related to decreases in BW and AMC. Stage of cancer, age, and sex were associated with reductions in albumin and/or RTP. Thus, we conclude that simple starvation, malignant tumor, age, and sex contribute to PCM and probably to the occurrence of fatal septic complications postoperatively.

Adenocarcinoma↗

PubMedDate not supplied

Extended survival time for esophageal cancer patients treated with aggressive surgery and concurrent chemoradiation.

In attempts to improve overall long-term survival of patients with esophageal cancer, including medically inoperable patients and operable ones with disseminated disease, we treated operable patients with aggressive surgery and postoperative chemoradiation, and inoperable patients with chemoradiation alone. Chemoradiation consisted of 5,000-6,000 cGy of radiation and two courses of chemotherapy (cisplatin, vindesine, and pepleomycin). Of 90 patients seen between 1986 and 1991, 63 operable patients underwent surgery and 35 received postoperative chemoradiation, while 19 of 27 inoperable patients received chemoradiation. Results were compared with those of 48 unselected historical control patients treated since 1981. Survival at 5 years was significantly improved for the multimodality group (17.7 +/- 5.0%), as compared with the historical control group (10.4 +/- 4.4%). Thus, the overall therapy for patients with esophageal cancer has been improved.

Aged↗

PubMedDate not supplied

Risk factors associated with postoperative mortality in patients with esophageal cancer.

We examined how impaired host defense mechanisms contribute to fatal complications following transthoracic esophagectomy for malignancy, and compared them with other risk factors. Risks associated with operative mortality were categorized into 5 groups. Twelve of 80 patients had postoperative fatal complications. Five variables in the category of impaired defense mechanisms predicted fatal complications with an accuracy of 86.3%. The accuracy of prediction by preoperative vital organ dysfunction, other preoperative risks, intraoperative risks, and perioperative risks was 87.3%, 90.0%, 87.5%, and 85.0%, respectively. When the 5 groups of risk variables were considered together, the accuracy increased to 93.8%. We conclude that impaired defense mechanisms are one of the important risk factors that contribute to postoperative fatal complications and should be considered with other risk factors when predicting mortality of transthoracic esophagetcomy.

Antibody Formation↗