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Biomedical subjects

K Suemasu

Publications and source records attributed to K Suemasu.

At least 127 records · Page 7Linked to original sources

[A randomized controlled trial of acute and delayed cisplatin-induced emesis with metoclopramide, dexamethasone and prochlorperazine].

Forty patients with advanced lung cancer who had received chemotherapy containing cisplatin (80 mg/m2) were accrued for a randomized controlled trial to evaluate the additional effect of prochlorperazine on the combination of high-dose metoclopramide and dexamethasone for the treatment of acute cisplatin-induced emesis. The effect of intravenous metoclopramide and dexamethasone in emesis occurring more than 24 hours after cisplatin administration was also evaluated. Excellent emetic control (no emesis during 24 hours after cisplatin administration) was achieved in 70% (14/20) and 76% (16/21) of the patients who received the combination of prochlorperazine, metoclopramide and dexamethasone and the combination of metoclopramide and dexamethasone, respectively. The overall toxicities associated with both regimens were not serious and were similar. Patients treated with metoclopramide and dexamethasone on days 2-7 experienced less delayed emesis, nausea and anorexia compared with those treated with a placebo (delayed emesis, 25% versus 50%, respectively, p = 0.105; more than 4 days of nausea, 10% versus 35%, respectively, p = 0.059; less than 3 days of anorexia, 80% versus 50%, respectively, p = 0.048). It was concluded that metoclopramide and dexamethasone showed an excellent antiemetic effect on acute drug-induced emesis, as well as on delayed emesis, induced by cisplatin.

Adult↗

[Clinical and basic studies on the treatment of cancer metastasis].

Lung resection for metastatic lung tumors from cancers of other organs has shown a significant curative success rate among affected patients. Hepatectomy also shows promise as a good curative approach for patients with liver metastasis from cancers of various abdominal organs. Descriptive data and their analysis of metastases by Bross and Viadana indicate a cascade spreading process. The fact that key-sites such as the lung and/or liver which, for some time, have proved a stumbling block to the generalization of cancers by metastases, has led to the success of therapy for metastasis in the clinical field. Chemotherapy as an adjuvant therapy to surgery for key-site metastatic foci is anticipated to raise future cure rates.

Humans↗

Serial plasma carcinoembryonic antigen measurement for monitoring patients with advanced lung cancer during chemotherapy.

The plasma carcinoembryonic antigen (CEA) levels in 243 patients with untreated advanced lung cancer were studied to assess their value for prognosis and for indicating the effectiveness of chemotherapy. Of patients with adenocarcinoma, small cell carcinoma, squamous cell carcinoma, and large cell carcinoma, 43%, 24%, 7%, and 13%, respectively, had elevated CEA levels of 20 ng/ml or greater before treatment. Pretreatment CEA levels were elevated to above 20 ng/ml for 38% of 163 patients with extensive disease and for 22% of 80 patients with limited disease (P less than 0.02). In patients with adenocarcinoma of the lung, the pretreatment CEA levels were not correlated with response to chemotherapy and patients' survival. Serial measurement of plasma CEA was a useful noninvasive technique for monitoring the response to chemotherapy in patients whose pretreatment levels were 20 ng/ml or higher. All of 18 patients with complete or partial responses and 5 of 6 patients with minor responses showed greater than 36% decrease in the CEA level compared with the pretreatment level. In all of nine patients with progressive disease, the CEA levels increased after chemotherapy. Therefore, an increase of greater than 36% beyond the baseline level was a useful guideline criterion for a significant change for determination of tumor response to chemotherapy, although 41% of 22 patients with stable disease exceeded the pretreatment level by 36% or more in either direction (mean percent change +/- standard deviation, -4.1% +/- 52.2%), and 4 of 9 patients with progressive disease did not have levels greater than 36% above the baseline levels.

Adenocarcinoma↗

Biological, pathological and clinical features of small cell lung cancer.

Small cell lung cancer, which is not uncommon, and is one of the most malignant and relatively well investigated solid tumors of adults, has been reviewed concerning its biology, pathology and clinical aspects. Although it is histologically very simple, its poorly differentiated epithelial cell characteristics are complicated by features of neuroendocrine cells, such as amine and peptide hormone production and specific enzyme activities, some of which have been found to be good monitoring markers during and after treatment. Because of the relative ease of establishing cell lines in vitro, cell characteristics have been studied in detail. This has led to subtyping of cell lines and may further lead to subtyping of histology. However, accumulation of further evidence has disclosed exceptions and unclassifiable cell lines. The same can be said about chromosomal abnormality. The reactivity of monoclonal antibodies and also oncogenes supports the prevalent concept discriminating small cell cancer from non-small cell cancer. However, concepts concerning histogenesis are still changing. Although it is one of the solid tumors most sensitive to radiation and chemotherapy, the response rate of the tumor to non-surgical treatment appears to have reached a plateau. In order to make a breakthrough in the treatment, strategies based on biological findings must be applied.

Antibodies, Monoclonal↗

Adult T-cell leukemia/lymphoma not associated with human T-cell leukemia virus type I.

We describe five patients with adult T-cell leukemia/lymphoma (ATL) with neither integration of human T-cell leukemia virus type I (HTLV-I) into their leukemia cells nor anti-HTLV-I antibody in their sera. These findings indicate that HTLV-I may not have been involved in leukemogenesis in these patients. The clinicohematological, cytopathological, and immunological features of HTLV-I-negative ATL were exactly the same as those of HTLV-I-associated ATL. Leukemia cells with pleomorphic nuclei, generalized lymphadenopathy, hepatosplenomegaly, skin lesions, hypercalcemia, and elevated lactate dehydrogenase levels, all of which are characteristic features of typical ATL, were also seen in these patients with HTLV-I-negative ATL. Leukemia cells expressed T3, T4, and pan-T-cell antigens in three cases, and T3 and pan-T-cell antigens in two. All five patients had lived in ATL-nonendemic areas. The finding of HTLV-I-negative ATL suggests that factor(s) other than HTLV-I infection may be involved in ATL leukemogenesis.

Adult↗

The protective effect of 2-mercapto-ethane sulfonate (MESNA) on hemorrhagic cystitis induced by high-dose ifosfamide treatment tested by a randomized crossover trial.

High-dose ifosfamide (one or two courses of 6 g/m2) with or without mesna was administered to 13 patients with advanced non-small cell lung cancer. The protective effect of 2-mercapto-ethane sulfonate (mesna) against the urotoxic side effects induced by ifosfamide was examined by a randomized crossover trial. A significant reduction in the incidence of hematuria was observed in the patients receiving mesna. Macroscopic hematuria was observed in only one patient who received treatment with mesna versus seven patients treated with ifosfamide alone. Other symptoms, such as frequency and dysuria, tended to be diminished in the patients receiving mesna, although the difference was not statistically significant. Our results suggest that mesna is effective in preventing or diminishing ifosfamide-induced hemorrhagic cystitis. Concomitant use of mesna should allow the administration of a high dose of ifosfamide although more extensive studies are needed to define the optimal dose and schedule of administration of mesna to prevent or attenuate the hemorrhagic cystitis.

Adult↗

Expression of vimentin in surgically resected adenocarcinomas and large cell carcinomas of lung.

The expression of vimentin in pulmonary carcinomas was studied in 285 cases of surgically resected lung cancer from our hospital files. Formalin fixed, paraffin-embedded sections were studied by immunoreactive staining techniques using two monoclonal antibodies against vimentin. Cases demonstrating vimentin positivity by the avidin-biotin-peroxidase method included 11 of 129 adenocarcinomas studied (8.5%), and 15 of 61 large cell carcinomas studied (24.6%). Vimentin expression was not seen in any of the 51 squamous cell carcinomas or 35 small cell carcinomas in our series. The positive cases of adenocarcinoma were in moderately and poorly differentiated cancers. Four of the eight giant cell carcinomas (50%) demonstrated vimentin expression. All cases that exhibited vimentin positivity were studied for cytokeratin expression. Coexpression of vimentin and cytokeratin was demonstrated not only within the same tumor but also within the same cells in some cases stained by double antibody technique, including both adenocarcinomas and large cell carcinomas. Similar immunoreactive methods were also applied to sections from human lung cancer transplants grown in the nude mouse. Of 28 tumors studied, four of 11 adenocarcinomas (36%) and all 4 large cell carcinomas demonstrated coexpression of vimentin and cytokeratin, while none of the five squamous cell carcinomas or eight small cell carcinomas expressed vimentin.

Adenocarcinoma↗

A retrospective evaluation of the medical treatment of malignancy-associated hypercalcemia.

Little is known about the relative effectiveness and potency of a variety of treatments for malignancy-associated hypercalcemia, or how beneficial the reversal of hypercalcemia is to these patients. Therefore, 146 trials of treatment for hypercalcemia between 1980 and 1983 at the National Cancer Center Hospital, Tokyo, were evaluated retrospectively. Serum calcium levels exhibited the largest decrease in the mithramycin-treated group (decrease; 5.4 +/- 1.8 mg/dl, mean +/- SD, n = 22), followed by the groups given calcitonin plus glucocorticoids (3.1 +/- 2.3, n = 11), glucocorticoids (2.3 +/- 2.3, n = 18), calcitonin (1.8 +/- 1.6, n = 51), hydration (1.3 +/- 2.5, n = 27), and indomethacin (1.0 +/- 2.3, n = 17). The effective rate was the highest with mithramycin (100%) and then with calcitonin plus glucocorticoids (73%) and with glucocorticoids (61%); it was less than 50% in the other modalities of treatment. In patients with pretreatment serum calcium levels of 14 mg/dl or more, the survival rate improved significantly in those whose serum calcium levels decreased below 12 mg/dl compared with those whose serum calcium remained above 12 mg/dl (50% survival; 35 vs. 9 days, P less than 0.01). These data provide a good guideline and a rationale in choosing the modality of treatment. In addition, the data show that the gain in the survival time achieved by successful treatment of hypercalcemia is clinically significant, because it is long enough to conduct additional antitumor therapy.

Adult↗

A clinico-pathological study of surgical treatment for small cell carcinoma of the lung.

Thirty-seven patients with histologically confirmed small cell carcinoma (SCLC), who underwent surgical resection at the National Cancer Center Hospital between 1963 and 1983, were reviewed. They were divided into two groups, 25 patients who were operated on between 1963 to 1979 and 12 who were operated on between 1980 and 1983. When these two groups were compared, a significant difference in 5-year survival was found (8% vs 50%). An accumulation of various factors including adjuvant chemotherapy was considered to contribute to the improvement in survival. After carefully analyzing these factors, we have come to the conclusion that adjuvant chemotherapy was the most important factor among them. An additional six patients with SCLC, who were operated on in 1984 and 1985, were also studied. They were either those who were given an adequate dose of combination chemotherapy before surgical resection or those whose local carcinoma which recurred after complete response was achieved by chemotherapy and/or chest radiation was surgically removed. In two cases, a tumor-like mass which was clearly visible on X-ray film and in the surgeon's hand at the time of thoracotomy revealed a histopathological "cure." In another two cases, tissue diagnosis of SCLC which was obtained without thoracotomy before chemotherapy and/or radiation was started was reported as NSCLC after the resected specimen was histo-pathologically examined. In both of them, the cancer tissue was made up of NSCLC of small cell type. A discrepancy between clinical TNM after treatment and pathological TNM was noted in two cases. Microinvasion and micrometastases, which were the reasons for the discrepancy, are considered to be a core of eventual recurrence following induction of complete response.

Actuarial Analysis↗

Cytogenetic effects of multiagent chemotherapy on the peripheral lymphocytes of patients with small cell lung cancer.

Peripheral lymphocytes of 8 patients with small cell lung cancer (SCLC), who received combination chemotherapy consisting of cisplatin and VP-16 (PVP), were examined for frequency of sister chromatid exchange (SCE) and chromosomal aberrations. Three of the 8 patients were treated with the PVP regimen only; however, the others had previously been treated with multiagent chemotherapy consisting of a cyclophosphamide, adriamycin, and vincristine (CAV) regimen or a cyclophosphamide, ACNU and vincristine (CAV') regimen with or without radiotherapy. Significantly increased SCE frequency was observed in previously untreated patients 3 or 4 days after PVP treatment, compared with the pretreatment values. The earlier analysis in the previously treated patients also showed increased SCE frequency, which seemed to return to the normal value as time elapsed after PVP. In addition, abnormal chromosome count distribution and/or increased incidence of structural changes were observed in cultures from all the patients. In general, striking changes in chromosomes were observed in previously treated patients. The aberrations observed in pretreated patients consisted of chromatid gaps and breaks, exchanges, fragments and dicentric chromosomes. In addition to these abnormalities, double minutes like microchromosomes were seen irrespective of radiotherapy. Further studies are needed to elucidate whether any of the chromosomal aberrations observed in this study could participate in the induction of secondary neoplasms.

Aged↗

Cytogenetic effects of etoposide (VP-16) on human lymphocytes; with special reference to the relation between sister chromatid exchange and chromatid breakage.

The effects of etoposide (VP-16) on sister chromatid exchange (SCE) and chromosome abnormalities were studied by using human peripheral lymphocytes. This drug produced a significant increase in the SCE frequency and chromosomal aberrations such as breaks, exchanges, and tetraploidy with or without endoreduplication. Analysis of the breakpoints of chromatid deletion with respect to their association with SCE in the metaphases from the second division demonstrated that VP-16-induced deletions arose with little dependence on the site of SCE. It is suggested that chromatid deletions induced by this drug derive from unrepaired chromatid breaks rather than from incomplete exchanges.

Cells, Cultured↗

T-zone histiocytes in adenocarcinoma of the lung in relation to postoperative prognosis.

Infiltration of T-zone histiocytes (Langerhans' cells and their precursors) and macrophages was investigated by immunohistochemical methods with the use of anti-S100 protein and anti-lysozyme antibodies in 40 Stage Ia cases of adenocarcinoma of the lung. Varying population densities of S100+ T-zone histiocytes were demonstrated in 31 (77.5%) of 40 adenocarcinomas; however, lysozyme+ macrophages were found in almost equal quantities in all cases of adenocarcinoma. The distribution of T-zone histiocytes was clearly different from that of macrophages. Namely, the former was mainly interspersed among the tumor cells, whereas macrophages were found in the stroma and around necrotic foci. The prognosis of Stage Ia adenocarcinoma cases was related to the density of T-zone histiocytes in tumor tissues. Patients with marked infiltration of T-zone histiocytes survived longer than those without or with only slight infiltration (P less than 0.05). Such relationship was not observed with regard to macrophages. This indicates that T-zone histiocytes infiltrating within the tumor and regional lymph nodes may play a role in host defense mechanisms against tumor in the early stage of adenocarcinoma of the lung.

Adenocarcinoma↗

A new method of preparing specimens for cytodiagnosis of lung cancer.

A simple and effective method for concentrating sputum in the preparation of smears for cytodiagnosis of lung cancer was developed. The procedure, which utilizes a fixative consisting of 2,3-dihydroxy-1,4-dithiol-butane, 3,5-ditert-butyl-4-hydroxy-toluene, polyoxyethylene-cetyl-ether, polyethylene glycol 1540, and ethyl alcohol in distilled water permitted preparation of an amucoid, thin smear. Sputum was collected in a screw-cap plastic tube containing the fixative. After 12 hours mucus in the sputum was liquefied and the cellular elements were obtained from the bottom of the tube. Cellular morphology was well preserved for cytodiagnosis. Microscopic observation was facilitated by lysis of the mucus. Estimation of cellular origin was rather easy because of the distinct fixation. Cells from the sputum sediment following liquefaction were more representative of the entire specimen than with a random selection method. The new method should be useful not only in hospitals but also in mass surveys.

Adenocarcinoma↗

Lung cancer in chromate workers--analysis of 11 cases.

We have experienced 11 cases of lung carcinoma in workers at a chromate factory during the past 14 years. All patients were males. The age of onset ranged from 41 to 68 years. Ten of the 11 were heavy smokers. The time of exposure to chromate was from 17 to 29 years and the average was 23.9 years. Seven patients had perforation of their nasal septa. The primary sites of the cancers were from the lobar to the subsegmental bronchi. There were nine squamous cell carcinomas and three small cell carcinomas. Four squamous cell carcinomas were hilar type early stage cancers and two of them were found in one patient at the same time. The chromium content of the lung tissue in the seven patients tested was from 13.9 to 2,368.4 micrograms/g of dry tissue and was higher than that of lung cancer or non-lung cancer cases without chromate exposure. There was no severe dysplasia of the bronchial epithelium in these 11 patients.

Adult↗