[Pending stand by-IABP and pending stand by LVAD (time loss and MOF)].
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Biomedical subjects
Publications and source records attributed to M Endo.
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A multi-institutional cooperative phase II study of Cisplatin for esophageal carcinoma was conducted. Cisplatin was administered by i.v. infusion at 10-20 mg/m2 body surface area daily for 5 days and repeated every 3-4 weeks (method A) or at 50-100 mg/m2 body surface area once every 3-4 weeks (method B). Out of 78 cases entered, 47 were evaluable. No complete response (CR) was obtained and partial responses (PR) were observed in 10 cases, the overall response rate being 21.3%. Response rates by administration methods A and B were 12.5% and 25.8%, respectively. Responders to treatment exhibited significantly longer survival periods compared to non-responders (p less than 0.05, generalized Wilcoxon test). Major adverse reactions were gastrointestinal symptoms, generalized malaise, bone marrow suppression and renal disorders. One case of leukopenia leading to eventual death from pneumonia was observed.
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The operative mortality has decreased in recent years, nevertheless, a similar improvement in the long term results remains to be seen. To improve the long term results, the extensive operation with multidisciplinary treatment has been performed. The dissection of lymph nodes is ordinarily carried out systematically beginning from the uppermost thoracic tracheal lymph nodes as far as the celiac and the common hepatic artery lymph nodes. In the extensive dissection, the thoracic tracheal lymph nodes are dissected circumferentially additionally to this procedure. The incidence of a3 cancer cases of the esophagus was 25%. The infiltration was seen mainly in the trachea, the bronchus and the aorta. The combined resection of these important invaded organs was carried out in several institutions, however, the improvement in the prognosis remains to be seen yet. The exact diagnosis and the definite indication are required for these extended operations.
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Clinical, hemodynamic and angiographic features of coronary obstructive disease (greater than or equal to 90% diameter reduction) in Kawasaki disease were evaluated in 30 patients. The mean age at the onset of Kawasaki disease was 2.9 +/- 1.9 years and that at cardiac catheterization was 6.3 +/- 2.8 years. Obstructive lesions were observed in the right coronary artery in 12 patients (group 1), in the left anterior descending coronary artery (LAD) in 6 (group 2), in both right coronary artery and LAD in 10 (group 3) and in the left main coronary artery in 4 (group 4). Twenty-two patients (73%) had cardiac symptoms, including myocardial infarction in 10 (33%). Cardiac symptoms were observed in 41% in group 1, 100% in group 2, 80% in group 3 and 100% in group 4. Left ventricular (LV) end-diastolic pressure, end-diastolic volume and ejection fraction were abnormal in 32% of the patients in group 1, a frequency less than that in other groups (83% in group 2, 78% in group 3 and 100% in group 4). Fifty percent had mitral regurgitation and 73% had left ventricular wall motion abnormalities. No patient in groups 1 or 2 has died, but 8 of 14 patients in groups 3 and 4 have died. These observations indicate that coronary obstruction owing to Kawasaki disease can cause depressed LV function, mitral regurgitation and LV wall motion abnormalities in children.(ABSTRACT TRUNCATED AT 250 WORDS)