Search PubMed⌕ Search

Biomedical subjects

Katsunori Ami

Publications and source records attributed to Katsunori Ami.

6 recordsLinked to original sources

[A case report of small cell carcinoma of the esophagus successfully treated by irinotecan and cisplatin].

Small cell carcinoma of the esophagus is regarded as having a poor prognosis with frequent and early recurrence against various treatments. We have experienced a case of small cell carcinoma of the esophagus manifested by massive lymph node metastasis in the upper mediastinum successfully treated by CPT-11 and CDDP, and that a patient survived for 17 months after the initial treatment. A 62-year-old man underwent endoscopy due to a disturbance of the food passage. Pathological evaluation of biopsy specimen revealed small cell carcinoma of the esophagus. As he was diagnosed with bilateral lymph node metastasis in the upper mediastinum by CT scan, a systemic chemotherapy with CPT-11 and CDDP was adopted. After 2 courses of chemotherapy he could be discharged as the size of the tumor was reduced. After 3 courses of additional chemotherapy 8 months after the initial treatment, a recurrent tumor was indicated at the right side of the lymph node of the neck. A weekly radiation with concurrent administration of docetaxel was carried out as a second line treatment. He is surviving for 17 months after the initial treatment without any evidence of recurrence. Due to histo-pathological similarity, a treatment for small cell carcinoma of the esophagus resembles that of the lung. Recently, the combined treatment of CPT-11 and CDDP was reported to demonstrate a better influence on a patient's survival for small cell carcinoma of the lung. For the esophagus, CPT-11 and CDDP was also an effective treatment.

Antineoplastic Agents↗

[A case of a gastric cancer patient who obtained good treatment in spite of a nontreatment decision].

The patient was a 57-year-old male who had received schizophrenia and alcoholism treatments for ten years. Hospitalization and release was repeated many times over in the psychiatry department of the hospital up to the present time. He received an upper endoscopy because of a stomach ache in May, 2004. He was diagnosed as having gastric cancer (L, post, Type 2, T2 (SS), N2, stage IIIA). Neoadjuvant chemotherapy TS-1+CDDP was begun from the beginning. However, he refused the operation afterwards and we changed the treatment. The chemotherapy was maintained until January, 2005, to enforce seven courses of the treatment and to maintain the long NC for about ten months. Afterwards, he refused the treatment again and did not come to the hospital. After six months, he came to hospital again for pyloric stenosis due to a stomach cancer that developed. We placed a PEG to keep the route for access to the pylorus in August. And we used it to induce the self-expandable metal stent (EMS) to the pylorus. As a result, oral ingestion became possible. He was able to obtain a good QOL for three months until dying thereafter. It is thought that stenting is one of the most effective treatments to correspond to the diversification of the treatment policy.

Alcoholism↗

[A case of unresectable hilar cholangiocarcinoma treated with an insertion of biliary stent and herbal medicine obtaining a good quality of life].

An advanced hilar cholangiocarcinoma was poor in prognosis and required a biliary duct drainage tube insertion to prevent jaundice. An endoscopically placed metallic biliary stent is efficient for improving QOL of patients with the disease. This case was of a 65-year-old man. He was admitted to our hospital with obstructive jaundice. Hilar cholangiocarcinoma was diagnosed by computed tomography (CT) and MR cholangiopancreatography (MRCP). Abdominal angiography revealed an unresectable cholangiocarcinoma through the portal vein obstruction and stenosis of the left hepatic artery for tumor invasion. After a second opinion and informed consent, he was inserted a biliary stent (non-covered metallic stent) under an endoscopy. The jaundice was improved further and other laboratory data showed normal results except for tumor markers. After the patient left the hospital, he came to our hospital as an outpatient basis for observation. He was prescribed herbal medicine from the other hospital. Now after ten months since the biliary stent insertion, he has been free from symptoms with normal laboratory data.

Aged↗

[A case of ascities decrease in malignant peritoneal mesothelioma by weekly intra-peritoneal administration of cisplatin and paclitaxel].

We report a case of malignant peritoneal mesothelioma (MPM) in a 63-year-old man. He had body weight loss and abdominal distension for one month, and was admitted to our hospital. Abdominal sonography showed a large mass occupying the right lower abdomen and an existence of a lot of ascites. Computed tomography and magnetic resonance image showed a lot of ascites and omentum cake. Cytology of the ascites was Class V but its histological classification was unknown. Then we performed biopsy of the tumor into the omentum with abdominal sonography. The histological diagnosis was MPM because the tumor cells showed positive for calretinin. He received a combination chemotherapy of weekly intra-peritoneal administration of cisplatin (70 mg/ day) and paclitaxel (100 mg/day). The ascites was decreased and per os (PO) was possible, but omentum cake was not changed. MPM was poor in prognosis and the control of ascites was difficult. We suggest that the chemotherapy of intra-peritoneal administration was a better procedure than others to control ascites with malignant tumors.

Antineoplastic Agents↗

[Weekly docetaxel in combination with concomitant radiotherapy for esophageal cancer].

Docetaxel (DOC) has demonstrated an activity as a radiation sensitizer in head and neck cancer. We have experienced four cases of esophageal cancer treated by weekly DOC in combination with concomitant radiotherapy. Three cases of advanced esophageal cancer and a case of relapsed esophageal cancer after administration of 5-FU and CDDP were enrolled in this pilot trial. The schedule of treatment included a weekly administration of DOC (10 mg/m2/w) and six weeks of radiotherapy in 2.0 Gy daily fractions up to 60 Gy. Combination treatments were completed successfully without any side effects except a case of developed grade 1 dysphagia. Two cases showed a complete response and others showed a partial response. One case showed a complete response developed abdominal para aortic lymph node and liver recurrence 12 months after the treatment. However, the targeted lesion within radiotherapy for this patient still showed a complete response. A weekly administration of low dose DOC in combination with radiotherapy was very effective for advanced esophageal cancer. DOC has demonstrated an activity as a radiation sensitizer.

Aged↗

IFN-gamma production from liver mononuclear cells of mice in burn injury as well as in postburn bacterial infection models and the therapeutic effect of IL-18.

Hosts after severe burn injury are known to have a defect in the Th1 immune response and are susceptible to bacterial infections. We herein show that liver NK cells are potent IFN-gamma producers early after burn injury. However, when mice were injected with LPS 24 h after burn injury, IFN-gamma production from liver mononuclear cells (MNC; which we previously showed to be NK cells) was suppressed, and the serum IFN-gamma concentration did not increase, while serum IL-10 conversely increased compared with control mice. Interestingly, a single injection of IL-18 simultaneously with LPS greatly restored the serum IFN-gamma concentration in mice with burn injury and also increased IFN-gamma production from liver MNC. Nevertheless, a single IL-18 injection into mice simultaneously with LPS was no longer effective in the restoration of serum IFN-gamma and IFN-gamma production from the liver MNC at 7 days after burn injury, when mice were considered to be the most immunocompromised. However, IL-18 injections into mice on alternate days beginning 1 day after burn injury strongly up-regulated LPS-induced serum IFN-gamma levels and IFN-gamma production from liver and spleen MNC of mice 7 days after burn injury and down-regulated serum IL-10. Furthermore, similar IL-18 therapy up-regulated serum IFN-gamma levels in mice with experimental bacterial peritonitis 7 days after burn injury and greatly decreased mouse mortality. Thus, IL-18 therapy restores the Th1 response and may decrease the susceptibility to bacterial infection in mice with burn injury.

Animals↗