Biomedical subjects

K Tayama

Publications and source records attributed to K Tayama.

At least 91 records · Page 5Linked to original sources

PubMed1995

A phase II trial of oral tegafur and uracil plus cisplatin in patients with inoperable nonsmall cell lung cancer.

BACKGROUND: The combination of uracil and tegafur in a 4:1 molar concentration (UFT) has a greater antitumor activity than 5-fluorouracil (5-FU) and tegafur. Because the combination of 5-FU and cisplatin has been proven to have a synergistic antitumor effect in many experimental and clinical studies, a Phase II study was conducted using the combination of UFT and cisplatin in patients with inoperable nonsmall cell lung cancer. METHODS: Thirty-one patients with measurable disease were entered into the study; all were evaluable for toxicity and response. Their median age was 61 years (range, 36-75 years). There were 13 patients with Stage III and 17 with Stage IV disease. Twenty-two (71%) patients had received no prior treatment. UFT (400 mg/m2) was administered orally on days 1 through 21 and cisplatin (80 mg/m2) was injected intravenously on day 8. This treatment was repeated every 4 weeks. RESULTS: The median number of treatment cycles was two (range, 1-4 cycles). There were 11 partial responses (35%; 95% confidence interval, 19%-52%). The median response time was 6 months (range, 3-13 months). The median survival time was 11 months (range, 4-27+ months) for Stage III and 8 months (range, 2-22 months) for Stage IV. This chemotherapy regimen was well tolerated. The hematologic toxicities, such as leukopenia and thrombocytopenia of grades 3 and 4, occurred in only 2 of 31 (6%) patients. Nonhematologic toxicities of grades 3 or 4 were not observed. CONCLUSIONS: Oral UFT plus cisplatin administration demonstrated an activity comparable with that of other combinations based on cisplatin and an extremely low incidence of side effects. These observations suggest that this chemotherapy regimen is worthy of further investigation in a multi-institutional trial to determine the antitumor effect and the quality of life of patients.

Administration, Oral↗

PubMed1995

Use of a pericardial fat pad flap for preventing bronchopleural fistula: an experimental study focusing on the angiogenesis and cytokine production of the fat pad.

An experimental study was conducted to determine whether pericardial fat tissue could induce neovascularization and produce cytokines related to tissue repair. Neovascularization was examined using chick chorioallantoic membranes. Pieces of pericardial fat tissue, omentum, and intercostal muscle were individually placed on a number of chorioallantoic membranes and neovascularization induced by each material was assayed 6 days after the implantation. The intensity of neovascularization was in the order of pericardial fat > or = omentum > muscle. Cytokines, such as interleukin 1 (IL-1) alpha and beta, tumor necrosis factor-alpha (TNF alpha), interferon-gamma (IFN-gamma), and interleukin 6 (IL-6) were assayed in a culture supernatant of pericardial fat tissue. The latter was obtained 24 h after the addition of lipopolysaccharide (LPS) following various incubation times. All cytokines other than IFN gamma are known to play a part in tissue repair, whereas IFN gamma is negatively related to tissue repair because it inhibits fibroblast growth. The pericardial fat tissue incubated with LPS produced a certain amount of IL-1 on day 1, and TNF alpha on days 1 and 8, whereafter these values decreased to an undetectable level. Irrespective of the addition of LPS, a large amount of IL-6 was observed in the supernatant of pericardial fat tissue and it was detectable until day 29. On the contrary, INF gamma was not detected at any assay time. These observations suggest that a pericardial fat pad flap could possibly be beneficial in the prevention of bronchopleural fistula after pulmonary resection.

Adipose Tissue↗

PubMed1995

Left partial anomalous pulmonary venous connection found during a lobectomy for lung cancer: report of a case.

We report herein the case of a 68-year-old man in whom a partial anomalous pulmonary venous connection (PAPVC) was found during an operation for primary lung cancer. The preoperative clinical findings did not suggest a vascular shunt, and intraoperatively the anomalous vein was seen to drain only from the left upper lobe into the left innominate vein. The lower pulmonary vein connected normally, and there was no atrial septal defect nor any other anomalous condition. A left upper lobectomy with ligation of the anomalous connected vein was performed uneventfully. This type of PAPVC is extremely rare, and is especially noteworthy because there were no clinical signs.

Aged↗

PubMed1995

Aortic dissection after aortic valve replacement. Report of a case with an aortocameral fistula.

A 58-year-old Japanese woman who had a history of aortic valve replacement for congenital bicuspid valve, was admitted for investigation of facial edema and of pulselessness of the right leg. Physical examination disclosed the patient suffering from a superior vena cava syndrome. On auscultation, a continuous murmur was heard at the left lower sternal border. Computed tomographic scans revealed aortic dissection extending from the ascending aorta to the bifurcation. Echocardiography showed an intimal flap in the dilated ascending aorta, but not abnormal blood flow from the aorta to the right atrium was detected. Cardiac catheterization and aortography, however, allowed a correct diagnosis of aortic dissection with fistula to the right atrium and with obstruction of the right common iliac artery. The patient received emergency aortic root replacement and reconstruction of the coronary arteries and then recovered uneventfully.

Aortic Dissection↗

PubMed1995

Clinicopathologic characteristics of stage I lung adenocarcinoma in women.

A total of 75 cases of surgically resected Stage I lung adenocarcinoma in women were analyzed. The patients were divided into three age groups: less than 50, between 50 and 70, and more than 70 years old. On the basis of the pathological T factor, 45 of 75 (60%) were T1 and 30 of 75 (40%) were T2 tumor. On the basis of pleural involvement, 47 of 75 (63%) cases revealed p0. On the basis of differentiation, all but two cases (97%) were well to moderately differentiated. On the basis of structure, papillary adenocarcinoma were 64 of 75 (85%). There was no difference among the three age groups in the pathological findings. Survival curves of each group indicated no statistically significant difference. We suggest that hormonal factors related to age do not affect the characteristics of lung cancer in women nor the survival of the patients.

Adenocarcinoma↗

PubMed1995

Results of a limited resection for compromised or poor-risk patients with clinical stage I non-small cell carcinoma of the lung.

BACKGROUND: Patients with stage I non-small cell carcinoma of the lung may be unable to undergo a standard curative resection, such as lobectomy, due to various medical reasons. Whether or not a limited resection is superior to radiotherapy in these patients, both in terms of long-term prognosis and treatment morbidity, is unknown. STUDY DESIGN: We retrospectively reviewed our results in treating compromised or poor-risk patients with clinical stage I non-small cell carcinoma of the lung who had received either a limited resection or radiotherapy. Seventeen patients underwent a limited resection (nine wedge resections and eight segmentectomies), while 18 patients received radiation therapy. RESULTS: The five-year survival rates for patients in the limited resection group and the radiation treatment group were 55.0 and 14.4 percent, respectively. A log-rank analysis showed a significant difference between the two groups (p = 0.004). Furthermore, the survival rate of the patients having a limited operation was significantly better than that of patients achieving either complete response or partial response from radiotherapy (18.8 percent at five years, p = 0.008). Recurrence at the surgical margin occurred in four patients in whom the tumor was greater than 2 cm in longest diameter. The incidence of severe treatment-related complications was not different between the limited operation group and the radiotherapy group (11.8 compared to 11.1 percent). CONCLUSIONS: The results indicate that a limited resection for patients with poor-risk clinical stage I carcinoma of the lung has an advantage over radiotherapy, especially for tumors measuring less than 2 cm in longest diameter.

Adenocarcinoma↗

PubMed1994

Surgical treatment for acute aortic dissection and coexistent degenerative aortic aneurysm. Report of three cases.

Acute aortic dissection occurring in an aorta previously afflicted with degenerative, atherosclerotic is unusual. We report three cases with acute aortic dissection (DeBakey type III-b) occurring in an aorta which had a preexistent degenerative aortic aneurysm. Two of the three patients had acute aortic dissection originating from the distal end of the degenerative aneurysm, and the remaining one had the acute aortic dissection and degenerative aneurysm at different segments of the aorta. Since the risk of rupture is likely to be much higher in the patients with coexistence of acute aortic dissection and degenerative aortic aneurysm, compared with patients with DeBakey type III acute aortic dissection alone, we believe that a prompt and aggressive surgical approach is essential to prevent rupture, and that digital subtraction angiography (DSA) is more helpful in making a correct diagnosis and in helping to decide surgical procedures and supportive methods than other noninvasive diagnostic procedures.

Acute Disease↗

PubMed1994

Surgical treatment of aneurysms of the aortic arch using a simplified selective cerebral perfusion technique.

Between April 1989 and October 1993, 35 patients underwent aortic arch reconstruction for aneurysms using cardiopulmonary bypass (CPB) with selective cerebral perfusion (SCP). Of the 35 patients, the initial 19 (Group P) consecutively received simplified SCP (partial brachiocephalic perfusion; PBP), and the next 16 (Group S) were consecutively treated with standard SCP. For cerebral protection, blood was supplied to the right axillary artery in Group P, and to the right axillary and the left common carotid arteries in Group S. The aneurysms was aortic dissection in 24 patients, and was secondary to arteriosclerosis in the remaining 11. Partial replacement of the aortic arch together with the ascending aorta was the most commonly performed procedure in both groups. The cardiopulmonary bypass time and the cardiac arrest time were not significantly different between the two groups. The overall cerebral perfusion time was significantly longer in Group S (100 min) than in Group P (65 min); however, when 2 patients with an accidental prolongation of the cerebral perfusion time in Group S were excluded, there was no significant difference in the cerebral perfusion time between the two groups. Early death occurred in 3 patients (15.8%) in Group P, and 2 patients (12.5%) in Group S, however, there were no deaths related to the selective cerebral perfusion technique, and there were no late deaths in either group. Cerebral complications were seen in 1 patient in each group (6.3% vs. 6.7%, not significant). These results suggest that the simplified SCP (PBP) under hypothermic CPB provides as satisfactory cerebral protection as standard SCP, so long as the patency of the circle of Willis is confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Development of pigmented scales on rat skin: relation to age, sex, strain, and hormonal effect.

Development of brownish scales on the skin was examined in seven inbred strains of laboratory rats, Rattus norvegicus (F344, WM, WF, LOU, BUF, ACI, and LEJ rats) up to 104 weeks old. Pigmented scales appeared mainly on the dorsum of the body but also on the perineum and the tail. The distribution of the scales changed with age and showed sex and strain differences. In males of all seven strains except F344, the scales on the dorsal region appeared at puberty then gradually developed and spread extensively in a strain-dependent pattern, until the rats were of adult age. The coloring gradually decreased with further aging. However, in F344 rats, the coloring did not spread after puberty, and in adult rats, it was partial and very weak. Among female rats, scales appeared only in LEJ rats when they were of adult and old age. Gonadectomy in WM and WF rats caused fading of the dorsal scales in males but slightly induced coloring in females. Androgen administration to the gonadectomized rats increased the pigmented scales in both sexes of both strains. In F344 rats, however, skin color was hardly changed by gonadectomy and/or the subsequent androgen administration in either sex. In F344 male rats, the testosterone concentration in serum was not significantly lower than that of WM and WF male rats. These results indicate that the development of brownish scales on rat skin is dependent on age, sex, strain, and androgen, and it is suggested that the ability producing the scales is genetically poor in the F344 strain.

Aging↗

PubMed1994

The first site of recurrence after complete resection in non-small-cell carcinoma of the lung. Comparison between pN0 disease and pN2 disease.

In the present study, we assessed whether the pattern of postoperative recurrence of non-small-cell lung cancer differed between patients with pathologic N0 disease and those with pathologic N2 disease. We reviewed 231 patients with pathologic N0 disease and 63 with pathologic N2 disease, who had undergone a complete resection from 1980 to 1990, and investigated the first recurrence sites. Seventy-two patients with pathologic N0 disease and 52 with pathologic N2 disease were found to have had postoperative recurrence. Both pathologic N0 disease and pathologic N2 disease recur frequently in distant organs, and the ratio of distant metastasis to local recurrence did not differ between the two diseases. The brain, lung, and bone were the common initial metastatic sites in both pathologic N0 disease and pathologic N2 disease. The brain was the most frequent site of distant metastasis in patients with pathologic N0 disease, whereas, on the other hand, pulmonary metastasis was observed more frequently than brain metastasis in those with pathologic N2 disease. Despite histologic types, the presence of different patterns of initial metastatic sites between pathologic N0 and pathologic N2 diseases was observed. Our results suggest that the sites of metastasis after resection depend largely on such anatomic factors as drainage routes. Namely, in contrast to pathologic N0 disease, pathologic N2 disease has an additional drainage route, which is from the N2 nodes to the superior vena cava (pulmonary circulation). Therefore, the frequency of pulmonary metastasis may increase in patients with pathologic N2 disease.

Carcinoma, Non-Small-Cell Lung↗

PubMed1994

Postrecurrent survival of patients with non-small-cell lung cancer undergoing a complete resection.

The postrecurrent survival of 215 patients who had undergone a complete resection of non-small-cell lung cancer was examined on the basis of various factors, which included gender (female, male), age (< 65, > or = 65), the pathologic stage of disease at the time of operation (I, II, III), histologic type (squamous cell, nonsquamous cell carcinoma), type of operation (pneumonectomy, other), the selection of adjuvant treatment before recurrence (no treatment, mild chemotherapy, intensive chemotherapy and/or radiotherapy), recurrent site (local, distant), and the disease-free interval (< or = 365, > or = 365 days). A univariate analysis of the postrecurrent survival showed that the significant factors influencing the survival consisted of gender, pathologic stage, recurrent site, selection of adjuvant treatment, and the disease-free interval. Namely, female patients or patients who had pathologic stage I disease, local recurrence, no adjuvant treatment, or a disease-free interval of more than 365 days would be expected to have a prolonged survival after recurrence. Of the five significant factors, only two factors (gender and the selection of the adjuvant treatment) were found to be predominant postrecurrent prognostic factors by multivariate analysis. These observations suggest that the biologic behavior of a recurrent tumor may therefore be influenced by gender and adjuvant treatment before recurrence.

Aged↗

PubMed1994

Surgical results and prognostic factors of pathologic N1 disease in non-small-cell carcinoma of the lung. Significance of N1 level: lobar or hilar nodes.

The surgical outcome of pathologic N1 disease is controversial. To clarify whether pathologic N1 disease is a uniformly intermediate group or a mixed group of potentially early stage disease and advanced stage disease, we reviewed our previous cases with pathologic N1 disease. We retrospectively investigated 78 patients with pathologic N1 disease who had undergone a complete resection with mediastinal lymph node dissection during the period from April 1972 to December 1990. The cumulative postoperative survival at 5 years was 49.2%. No significant difference in the survival was found according to the following variables: sex, primary site, pathologic T factor, histologic type, type of resection, performance of adjuvant therapy. The lobar lymph nodes (Nos. 12 and 13) were only involved in 30 patients (38.5%), whereas the hilar nodes (Nos. 10 and 11) were involved in 48 patients (61.5%). The survival associated with lobar N1 disease was significantly better than that of hilar N1 disease (64.5% versus 39.7% at 5 years; p = 0.014). In lobar N1 disease, the brain was the most frequent site of distant metastasis, whereas the lungs were the most frequent site in hilar N1 disease. It was suggested that pathologic N1 disease is a mixed group of potentially early stage disease and advanced stage disease with regard to the postoperative prognosis.

Adult↗

PubMed1993

Cloning and sequencing the recA+ genes of Acetobacter polyoxogenes and Acetobacter aceti: construction of recA- mutants of by transformation-mediated gene replacement.

The recA+ gene of Acetobacter polyoxogenes was cloned as a gene that conferred methyl methanesulfonate resistance (MMSR) on the RecA- Escherichia coli HB101. The cloned recA+ gene also conferred (i) resistance to UV irradiation, (ii) enhanced intrachromosomal recombination, and (iii) permitted prophage phi 80 induction in E. coli recA- lysogens. Nucleotide sequence determination revealed that the recA product consists of 348 amino acids (aa) corresponding to 38 kDa, and shows significant similarity to RecA proteins from other Gram- bacteria. Next, a portion of recA from Acetobacter aceti was cloned by using polymerase chain reaction with oligodeoxyribonucleotide primers design based on the A. polyoxogenes recA sequence. Due to availability of efficient host-vector and transformation systems in A. aceti, recA mutants of A. aceti were obtained by transformation-mediated gene replacement with the cloned A. aceti recA gene which was inactivated by insertion of the kanamycin-resistance-encoding gene from pACYC177. The recA mutants obtained in this way showed similar phenotypes to those of E. coli recA strains, such as increased sensitivity to MMS and to UV irradiation, and decreased homologous recombination.

Acetobacter↗

PubMed1993

Dose-response relation and time course of action of pipecuronium in patients anesthetized with nitrous oxide and sevoflurane.

The dose-response relation of pipecuronium, the time course of its neuromuscular blocking effects, and the reversibility of the residual block by neostigmine have been investigated in patients under sevoflurane/N2O Anesthesia using a neuromuscular transmission analyzer (Accelograph, Biometer, Denmark). After an initial dose of pipecuronium (0.04 mg.kg(-1), i.v.), the maximum block rate, onset time, the time from administration until 25% recovery and 50% recovery of control twitch height of the first response to train-of-four nerve stimulation and the interval time of administration of maintenance dose (0.005 mg.kg(-1), i.v.) were 93.7 +/- 7.68%, 5.0 +/- 1.84, 55.4 +/- 23.92, 73.0 +/- 29.44 and 38.7 +/- 15.50 minutes, respectively. The average intubation score (excellent; 0, good; 1 fair; 2, poor; 3) was 0.63 +/- 0.56 at the level of 95.88 +/- 5.06% block. Neostigmine (1.5 mg) promptly reversed the residual neuromuscular blockade induced by pipecuronium (reversal time: 10.1 +/- 2.98 minutes). No side effects attributable to pipecuronium was seen in this study. In conclusion, pipecuronium is a very useful nondepolarizing neuromuscular blocking agent especially for moderately long surgical procedure over 4-5 hours.

Journal Article↗

PubMed1993

Characterization of a cytochrome a1 that functions as a ubiquinol oxidase in Acetobacter aceti.

The terminal oxidase for ethanol oxidation in Acetobacter aceti was purified as a complex consisting of four subunits (subunits I, II, III, and IV) with molecular masses of 72, 34, 21, and 13 kDa, respectively. Spectrophotometric analysis and catalytic properties determined with the purified enzyme showed that it belonged to a family of cytochrome a1 (ba)-type ubiquinol oxidases. A polymerase chain reaction with two oligonucleotides designed for amino acid sequences that are conserved in subunit I of the aa3-type cytochrome c oxidases from various origins and of an Escherichia coli o (bo)-type ubiquinol oxidase was used for cloning the cytochrome a1 gene. A 0.5-kb fragment thus amplified was used as the probe to clone a 4.5-kb KpnI fragment that contained a putative open reading frame for the whole subunit I gene. The molecular weight and amino acid composition of the product of this open reading frame (cyaA) were the same as those of the purified protein from A. aceti. The amino acid sequence of CyaA was homologous to that of subunit I of the E. coli o-type ubiquinol oxidase. Nucleotide sequence analysis of the region neighboring the cyaA gene revealed that the genes (cyaB, cyaC, and cyaD) encoding the other three subunits (subunits II, III, and IV) were clustered upstream and downstream of the cyaA gene in the order cyaB, cyaA, cyaC, and cyaD and with the same transcription polarity, forming an operon. As expected from the enzymatic properties, CyaB, CyaC, and CyaD showed great similarity in amino acid sequence to the corresponding sununits of the E. coli o-type ubiquinol oxidase and as(3)-type cytochrome c oxidases.

Acetobacter↗

PubMed1993

Stage I adenocarcinomas of the lung: survival of females and males.

Seventy-two cases of Stage I lung adenocarcinomas in females were analyzed and compared with 84 cases in males, all of which were surgically resected at the National Kyushu Cancer Center Hospital in Japan. The females with Stage I adenocarcinomas had a tendency, that was not significant, towards a longer survival than the male patients. When subdivided by age into less than 50, between 50 and 70, and more than 70 years-old, the female patients had a tendency, that was not significant, towards a longer survival in each group. In each age group, the ratio of smokers to non-smokers was higher in the males. The female group of ages 50 to 70 had the best 5-year survival rate. By multiregression analysis, age was found to be the most important factor for improved survival. The results indicate that a hormonal factor in Stage I lung adenocarcinoma does not influence survival.

Adenocarcinoma↗

PubMed1993

[Chemotherapy with cisplatin and daily administration of UFT for unresectable non-small cell lung cancer].

A combination chemotherapy of cisplatin and UFT was administered to fourteen patients with unresectable non-small cell lung cancer. To determine the maximum safety dose of UFT combined with CDDP (80 mg/m2), patients were assigned to three groups as follows: step 1: UFT (400 mg/m2) from day 1 to day 14; step 2: from day 1 to day 21; step 3: from day 1 to day 28. Cisplatin was administered on day 8 in each group. Myelosuppression with grade 3-4 and gastrointestinal toxicity of grade 3 were observed in one and two patients, respectively. The other toxicity was mild. There was no difference in the degree of toxicity among the three groups. The response rate of twelve evaluable patients was 50%; CR 0, PR 6, NC 4 and PD 2. Thus, chemotherapy using cisplatin 80 mg/m2 with daily administration of UFT 400 mg/m2 was considered to be well tolerated and effective in the treatment of non-small cell lung cancer.

Adenocarcinoma↗

PubMed1992

[Clinical significance of posttetanic count (PTC) during onset and spontaneous offset of neuromuscular blockade induced by vecuronium].

To compare the clinical difference of posttetanic count (PTC) during onset and spontaneous offset, the changes of PTC during an intense neuromuscular blockade induced by vecuronium (0.08 mg.kg-1, i.v.) were measured using a neuromuscular transmission analyzer in 64 adult patients anesthetized with nitrous oxide and halothane. Furthermore, intubation score was evaluated when zero PTC was obtained. The obvious movement of diaphragm associated with endotracheal intubation was observed in 9 out of 20 patients (45%) even when it was performed after obtaining zero PTC. The difference of PTC responses between the onset and the offset was found. The difference was that, during the onset, a tetanic response was observed obviously and the height of the posttetanic single twitch was low, and during offset, even when no response was observed, the height of a posttetanic single twitch response was high with the same PTC. These facts indicate that the same PTC has different clinical significance during onset and offset.

Adult↗