Biomedical subjects

K Takamura

Publications and source records attributed to K Takamura.

129 records · Page 8Linked to original sources

PubMedDate not supplied

Comparative therapeutic evaluation of intrathecal versus epidural methylprednisolone for long-term analgesia in patients with intractable postherpetic neuralgia.

UNLABELLED: BACKGROUND AND OBJECTIVES The goal of this study was to evaluate the analgesic effects of intrathecal versus epidural methylprednisolone acetate (MPA) in patients with intractable postherpetic neuralgia (PHN). METHODS: We studied 25 patients with a duration of PHN of more than 1 year. The patients were randomly allocated to one of two groups: an intrathecal group (n = 13) and an epidural group (n = 12). Sixty milligrams of MPA was administered either into the intrathecal or the epidural space four times at 1-week intervals depending on the treatment group. Continuous and lancinating pain and allodynia were evaluated by a physician unaware of group assignment with a 10-cm visual analogue scale before treatment, at the end of treatment, and 1 and 24 weeks after treatment. In addition, cerebrospinal fluid (CSF) was obtained for measurement of interleukin (IL)-1beta, -6, and -8 and tumor necrosis factor-alpha before and 1 week after treatment. RESULTS: We found marked alleviation of continuous and lancinating pain and allodynia in the intrathecal group (P < .001). The improvements were much greater in the intrathecal group than in the epidural group at all time points after the end of treatment (P < .005). IL-8 in the CSF decreased significantly in the intrathecal group as compared to the epidural group at the l-week time point (P < .01), whereas the other cytokines were undetectable. CONCLUSIONS: Our results suggest the effectiveness of intrathecal as compared to epidural MPA for relieving the pain and allodynia associated with PHN. Also, our findings, together with the decrease in IL-8, may indicate that intrathecal MPA improves analgesia by decreasing an ongoing inflammatory reaction in the CSF.

Aged↗

PubMedDate not supplied

Effect of athrombogenic therapy, especially high dose therapy of dipyridamole, after prosthetic valve replacement.

In order to prevent thrombo-embolism after prosthetic valve replacement, a high dose therapy with 450 mg/day of Dipyridamole and 3,000 mg/day of Aspirin was carried out for 1 year and 2 months in 91 cases (26 cases with aortic valve replacement, 40 cases with mitral valve replacement and 25 cases with multiple valve replacement). In the treated group, the incidence was 1.9% in cases more than 5 years after valve replacement and 2.9% in cases less than 5 years after valve replacement. In contrast, in the control group of 89 cases (47 cases of aortic valve replacement, 30 cases of mitral valve replacement and 12 cases of multiple valve replacement), the incidence was 9.1% and 14.7%, respectively. Thus, in both time intervals following prosthetic valve replacement the incidence of thrombo-embolism in the treated group was significantly lower than in the control group.

Aortic Valve↗

PubMedDate not supplied

Results of prophylactic adjuvant chemotherapy for early stage non-Hodgkin's lymphoma of the head and neck.

Results were reviewed in 46 patients who had stage I and II head and neck non-Hodgkin's lymphoma, and received five to six cycles of CVP chemotherapy after regional irradiation. Disease-free survival, pattern of relapse, and time of relapse were compared with those of 64 patients, who received regional irradiation alone. Adjuvant, post irradiation CVP significantly improved five-year survival in stage I (and IE) disease, 49.6% to 81.9% (p less than 0.05), but was less successful in patients with heavier tumor burden, such as stage II disease or advanced loco regional disease in Waldeyer's ring (48.3% to 63.7%; p greater than 0.10 in stage II patients). In addition, in those who relapsed, the time and pattern of relapse were not altered by adjuvant CVP chemotherapy. This easily tolerated, mild adjuvant chemotherapy, we conclude, failed to prove significant in preventing relapse, especially in patients with heavier tumor burden.

Antineoplastic Combined Chemotherapy Protocols↗