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Biomedical subjects

M Kubota

Publications and source records attributed to M Kubota.

At least 343 records · Page 19Linked to original sources

Myelodysplastic syndrome with t(9;11)(p22;q23) after treatment for B-cell acute lymphoblastic leukemia without epipodophyllotoxins.

Secondary myelodysplastic syndrome (MDS) with t(9;11)(p22;q23) developed in a child after intensive treatment for B-cell acute lymphoblastic leukemia diagnosed 12 months earlier. His chemotherapy had consisted mainly of cyclophosphamide and methotrexate, but no epipodophyllotoxins. The combination of MDS, the cytogenetic anomaly involving bands at 11q23 and no previous exposure to epipodophyllotoxins represents a unique case of therapy-related leukemia.

Antineoplastic Combined Chemotherapy Protocols↗

Simultaneous occurrence of three primary lung cancers.

We present a patient with three lung cancers composed of adenosquamous carcinoma, adenocarcinoma, and squamous cell carcinoma. Marked response was obtained in squamous cell carcinoma components following chemotherapy, but not in adenocarcinoma components. Even multiple malignant lesions of the lung might have a chance to be controlled by a combination of chemotherapy and surgery.

Adenocarcinoma↗

Serum c-erbB-2 in breast cancer patients.

The c-erbB-2 oncogene product in serum (serum c-erbB-2) was measured by an enzyme-immunoassay kit. The 12 U/ml cut-off level was estimated as the mean plus two standard deviations for 250 healthy women. With this cut-off level increased serum c-erbB-2 was found in 12.0% of primary breast cancer cases (n = 25), in 4.9% of non-recurrent breast cancer patients (n = 82), and in 31.4% of patients with recurrent breast cancer (n = 35). In patients with primary and recurrent breast cancer, whose sera were assayed concurrently for serum c-erbB-2, CEA and CA15-3, the positive rates of these markers were fairly similar. However, their combined use significantly increased the sensitivity as compared to the use of any one marker alone.

Adult↗

Characterization of enamel and dentin surfaces after removal of temporary cement--effect of temporary cement on tensile bond strength of resin luting cement.

This study was performed to investigate the effect of temporary sealing with cement on the tensile bond strength of resin luting cement to tooth substrate. Five temporary cements and five resin luting cements were used. Six hundred bovine incisor teeth were randomly divided between each group. Effect of temporary sealing on the tensile bond strength of resin luting cement varied in accordance with the temporary cement used. Temporary sealing with both the eugenol-containing and the eugenol-free temporary cements decreased the tensile bond strength of resin luting cement. The tensile bond strength with one of the resin luting cements was most stable on both enamel and dentin pretreated with all temporary cements tested.

Animals↗

[Laparoscopic pelvic lymphadenectomy--experimental operation using young pigs and clinical experience in 21 cases with prostate and bladder cancer].

In order to gain the technical skills for performing laparoscopic pelvic lymphadenectomy, we selected the young pigs (12-15 kg) as the experimental model. Five pigs (male 2, female 3) underwent laparoscopic pelvic lymphadenectomy under intravenous anesthesia. Postoperatively, the pigs were euthanized, and laparatomy was performed to demonstrate the area of dissection. Operation time was from 50 to 80 minutes, and no complication occurred in all cases, mastery came rapidly. Following experimental operation, 21 cases with prostate and/or bladder cancer underwent laparoscopic pelvic lymphadenectomy for staging operation from Nov. 1991 to Oct. 1993. Operation time was from 60 to 310 minutes (mean 137). In one of 21 cases, lymph node metastasis was proved. Eighteen of 21 cases underwent radical prostatectomy or cystectomy between 6 to 24 days after laparoscopic pelvic lymphadenectomy. On radical operation, the adhesion of the post-lymphadenectomy was severe in the patients 8 days after laparoscopic pelvic lymphadenectomy, compared with those within 7 days. Radical operation was seemed to be recommended within 7 days after laparoscopic pelvic lymphadenectomy.

Adenocarcinoma↗

[A case of Fusobacterium necroforum sepsis].

A 26-year-old man was admitted to our hospital with a 10-day history of sore throat, high fever, and right knee joint pain. On physical examination, the pharynx was considerably inflamed, and the right knee joint was swollen and extremely tender. Chest radiography showed multiple, bilateral nodules and masses with pleural effusions. Fusobacterium necorforum grew from samples of blood, pleural effusion, and pus taken from the knee joint. The patient was treated with intravenous clindamycin, ventilatory support, and continuous chest and knee joint drainage. His condition progressively improved and he was discharged on the 66th hospital day. A disease caused by an oropharyngeal infection with secondary suppurative thrombophlebitis of the internal jugular vein, and complicated by multiple metastatic infections is called postanginal septicemia, or Lemierre syndrome. Before the discovery of antibiotics, this disease usually was fatal. The widespread use of antibiotics for treat oropharyngeal infections may have caused a number of reported cases. Lemierre syndrome is an uncommon complication of oropharyngeal infection, and it may be fatal if diagnosis is delayed. Careful attention must be directed to patients with oropharyngeal infection who have signs and symptoms that suggest metastatic infection.

Adult↗

[Compression of medulla oblongata by the dissecting aneurysm of the vertebral artery 7 years after its rupture: case report].

A 56-year-old female, who suffered a subarachnoid hemorrhage (SAH) due to spontaneous dissection of the right vertebral artery 7 years previously, was admitted to our hospital with headache and vertigo. She hadn't had any attacks of SAH for 7 years. A magnetic resonance imaging (MRI) showed a high signal intensity mass and a low signal intensity due to calcification on the right ventrolateral surface of the medulla on both T1 and T2 weighted images. Vertebral angiography showed complete occlusion of the cervical segment of the right vertebral artery (VA). Left vertebral angiography didn't reveal any retrograde filling of the intracranial segment of the right VA through VA union. Thus, the spontaneous entrapment by dissection of the vertebral artery was demonstrated 7 years after SAH with MRI and serial angiography.

Aortic Dissection↗

[201Tl scintigraphic evaluation of tumor mass and viability of bone and soft-tissue tumors].

To characterize 201Tl uptake in patients with bone and soft-tissue tumor, we studied 49 patients with surgically proven tumors and one patient with a tumor diagnosed arteriographically. In 37 of our 50 patients, the tumor was evaluated with 201Tl and arteriography. Moreover, in 14 of patients with pre-operative chemotherapy, pathologic changes were graded on the basis of percent tumor necrosis as defined histologically. The percent tumor necrosis histologically was compared with changes in the scintigraphic and conventional angiographic studies. Radiologic comparisons demonstrated a high degree of correlation with images of 201Tl and both arterial and blood pool phase of 99mTc-HMDP. Ninety-six percent of 28 malignant tumors had positive 201Tl uptake. None of the patients showed any thallium accumulation in the soft tissues or skeleton adjacent to the lesion. Activity of 201Tl was mainly dependent upon a tumor blood flow and a vascular density. In of 14 cases with the preoperative chemotherapeutic treatment, 201Tl scintigraphic changes showed concordance with % tumor necrosis. Thallium-201 was superior to 99mTc-HMDP in predicting tumor response to chemotherapy. Interestingly, delayed images of 99mTc-HMDP of 5 responders with > 90% tumor necrosis showed decreased uptake in the adjacent bone to the tumor mass lesions. It seems to be quite all right to consider that a major determinant of 201Tl uptake is intratumoral angiogenecity, which is closely connected with tumor viability. Therefore, 201Tl is a sensitive radiopharmaceutical for detection of vascular rich bone and soft-tissue tumors, and appears to be a simple and an accurate test for evaluating the response to specific therapeutic regimens of malignant bone and soft-tissue tumors.

Adolescent↗

[Chemotherapy with autologous stem cell support for breast cancer].

The importance of dose intensity in breast cancer chemotherapy has been stressed in recent years with clear correlations demonstrated between dose intensity and clinical outcome of the patients in both therapeutic and adjuvant settings. In addition to various and intense supportive care, autologous stem cell support (ASCS) has been used over the past 15 years in order to overcome myelotoxicity of cancer chemotherapy. ASCS was initially practiced in the form of bone marrow transplantation, and more recently peripheral stem cell transplantation has been combined in addition to administration of G-CSF. Our pilot study in patients with recurrent/advanced breast cancer showed a higher response rate and a higher survival rate as compared to conventional chemotherapy, and there have been some long-term disease-free survivors with probable cures among complete responders with ASCS-supported chemotherapy. In adjuvant settings for patients with a high risk for recurrence who had been given a high-dose, the ASCS-supported regimen showed a higher disease-free survival rate as compared to those who were treated with conventional adjuvant therapy. Whether these apparently better results in our pilot studies hold true generally remains to be seen with well-scheduled randomized clinical trials.

Antineoplastic Agents↗

Two adult cases of IgM-associated mesangial proliferative glomerulonephritis.

Two adult patients with mesangial proliferative glomerulonephritis with diffuse IgM deposition in the glomeruli are reported. Case 1 was a 25-year-old female with nephrotic syndrome who showed complete remission after treatment with prednisolone (PSL). Case 2 was a 46-year-old male with asymptomatic proteinuria who showed incomplete remission (0.5-1.0 g/24 hr) of urinary protein without any medication. In light microscopy, these patients revealed minimal or slight proliferation of glomerular mesangial cells without glomerular sclerosis and crescent formation. Deposition of IgM and C3 was observed in the glomerular mesangial areas and capillary walls by immunofluorescence. Electron-dense deposits were observed in the glomerular mesangial areas in these patients. Mesangial proliferative glomerulonephritis associated with diffuse IgM deposition in the glomeruli appears to have a benign clinical course. It has also been suggested that this disease has variant clinical courses since we recently experienced two other patients with mesangial proliferative glomerulonephritis with focal IgM deposits who showed renal tubular dysfunction or chronic renal failure.

Adult↗

[Quantification of reversible perfusion abnormality using exercise-stress thallium SPECT before and after coronary revascularization].

Reversible myocardial perfusion abnormality was quantified by bull's eye and unfolded surface mapping methods in exercise thallium SPECT before and after coronary revascularization in 47 patients with angina pectoris, including 34 patients with previous myocardial infarction (PMI) and 13 with effort angina (AP). There was no difference in the incidence or extent of myocardial ischemia between the 2 groups before revascularization. However, the ischemic scores were significantly smaller in PMI group preoperatively than the reductions of the ischemic scores after revascularization. The ischemic scores, preoperatively estimated reversible perfusion abnormality was 32%, 69% and 48% of the improvement of the ischemic score (extent score, severity score, and ischemic area, respectively). Using the 3 ischemic scores, the improvement of perfusion abnormality was well predicted in 70-89% of AP patients but 35-57% of PMI patients. Thus, quantitative analysis in stress thallium SPECT is useful for detecting myocardial ischemia and evaluating the effect of coronary revascularization. However, about a half of myocardial viability was underestimated in one third of PMI patients by the conventional exercise-stress thallium SPECT study.

Adult↗

[A case of intrathoracic meningocele associated with neurofibromatosis].

A rare case of intrathoracic meningocele associated with neurofibromatosis was reported. A 47-year-old female was admitted to our institute because of an abnormal shadow on chest X-ray. The chest X-ray film showed homogenous opacity with a well defined margin in the right apex. Chest CT showed an enlarged intervertebral foramen and defect of the vertebral arch around the tumor. There was no scoliosis. Though preoperative diagnosis was dumbbell type neurinoma, the tumor was found to be a protrusion of dura mater with spinal fluid out of the spinal canal, covered by thickening tumorous tissue. Part of the wall was excised and the residual opening was carefully repaired and wrapped by the pedicled parietal pleura. Retrospectively, MRI showed characteristic findings of intrathoracic meningocele. The tumorous part of it was diagnosed as neurofibroma on histological examination.

Female↗

Intrahepatic arteriovenous shunting due to hepatocellular carcinoma and cirrhosis, and its change by transcatheter arterial embolization.

OBJECTIVES: To investigate intrahepatic arteriovenous shunt rate due to cirrhosis and hepatocellular carcinoma (HCC), complicated by cirrhosis, and its change after transcatheter arterial embolization. METHODS: The shunt rate was measured by hepatic artery infusion of labeled macroaggregated albumin. Counts were taken over the liver and both lungs for calculation of the shunt rate: cpm in lungs divided by (cpm in liver and lungs) x 100%. RESULTS: The intrahepatic arteriovenous shunt rate of cirrhosis ranged from 6.8% to 16.6% (12.6% +/- 3.4%, mean +/- SD). In HCC, it ranged from 7.2% to 27.1% (16.0% +/- 4.9%, mean +/- SD). The difference between the groups was statistically significant (p < 0.05). When the liver was more than 20% replaced by tumor, the intrahepatic arteriovenous shunt rate was higher than when less than 20% occupied (n = 6, 20.1% +/- 4.8% vs. n = 15, 14.4% +/- 4.0%; p < 0.05). Although the former was significantly different from liver cirrhosis, the latter was not significantly different from the shunt rate observed in liver cirrhosis without HCC. After transcatheter arterial embolization, excluding one patient who developed a visible hepatofugal arterioportal shunt, the mean change in shunt rate between the effective treatment group (n = 9, -2.1% +/- 2.8%, mean +/- SD) and the ineffective treatment group (n = 5, 3.0% +/- 3.3%, mean +/- SD) was statistically significant (p < 0.05). CONCLUSIONS: We found that intrahepatic arteriovenous shunt rate more sensitively detects intrahepatic arteriovenous shunting due to HCC than does angiography alone. Measuring intrahepatic arteriovenous stunt rate may provide useful information regarding response to treatment.

Adult↗

A multicenter study with once a week or once every two weeks high-dose subcutaneous administration of recombinant human erythropoietin in continuous ambulatory peritoneal dialysis.

OBJECTIVE: To investigate the effectiveness of administering relatively high doses of r-HuEPO subcutaneously once a week or once every 2 weeks in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Multicenter prospective analysis. The trial was divided into two phases: an initial 8-week phase (once a week dosing) followed by a 12-week maintenance phase (once every 2 weeks dosing). A response was defined as a change in hematocrit (Ht) of 3% or more. Results were analyzed using Sheffe's test, Mantel-Haenszel's test, and Dunnett's test. SETTING: Eleven renal units in Japan providing a CAPD program. PATIENTS: Forty-one CAPD patients with a Ht of 28% or less. RESULTS: After the initial 8 weeks, 13 (81.3%) of 16 patients showed a response to 6000 U (106.9 +/- 20.0 U/kg) subcutaneously (sc), once a week. Eleven (84.6%) of 13 in the 9000 U (166.5 +/- 27.7 U/kg) group and all 12 (100%) in the 12,000 U (210.7 +/- 42.1% U/kg) group also showed responses. At the end of both phases, that is, at 20 weeks, 7 (53.8%) of 13 patients in the 6000 U group with once every 2 weeks dosing, 7 (63.6%) of 11 in the 9000 U group, and 10 (90.9%) of 11 in the 12,000 U group maintained responses with the same dosing interval. There were no significant changes in mean blood pressure during the study period, and only 2 patients developed treatable hypertension with mild headache. CONCLUSION: Administration of relatively high doses of r-HuEPO to CAPD patients once a week or once every 2 weeks is safe and potentially an effective regimen for the correction of renal anemia.

Adult↗

Aphidicolin potentiates apoptosis induced by arabinosyl nucleosides in human myeloid leukemia cell lines.

We investigated the effect of aphidicolin, an inhibitor of DNA polymerase alpha and delta, on the induction of apoptosis by arabinosyl nucleosides in a human promyelocytic leukemia cell line, HL-60. Pretreatment of HL-60 cells with aphidicolin (2 microM) significantly increased the number of morphologically apoptotic cells induced by 1-beta-D arabinofuranosylcytosine (ara-C) during 4 hr of incubation. This is consistent with the appearance of DNA fragmentation as determined quantitatively by diphenylamine or by agarose gel electrophoresis. The inhibition of cell growth on day 3 after drug exposure was correlated with the degree of apoptosis: Such synergistic interaction between aphidicolin and ara-C has also been observed in other human myeloid leukemia cell lines, U937 and KG-1. In addition, the induction of apoptosis by 9-beta-D arabinofuranosyladenine or 9-beta-D arabinofuranosylguanine is augmented by aphidicolin.

Aphidicolin↗