Biomedical subjects

M Ohtsuka

Publications and source records attributed to M Ohtsuka.

At least 253 records · Page 14Linked to original sources

PubMedDate not supplied

Breast cancer shortly after the diagnosis of interstitial pneumonia associated with polymyositis.

Polymyositis is sometimes associated with pulmonary fibrosis or malignant diseases, however, rarely with both simultaneously. For such patients, no criterion for initial treatment and tapering of steroid has been reported. We describe a patient who had breast cancer and interstitial pneumonia associated with polymyositis. In this case, slow tapering of the steroid was an important aspect of the treatment, and close clinical follow-up was necessary to monitor for disease exacerbation.

Aged↗

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Management of small cell lung cancer in elderly.

BACKGROUND: There is increasing interest in the treatment of elderly small cell lung cancer (SCLC) patients, however the patients enrolled in clinical studies are strictly selected elderlies. MATERIALS AND METHODS: We retrospectively reviewed the treatment of consecutive unselected patients more than 70 years of age in whom SCLC were diagnosed over the past 22 years. RESULTS: In patients who received cisplatin-containing chemotherapy, response rate(RR) and mean survival time(MST) were 53.8% and 9 months. Whereas, in patients who were treated with carboplatin-containing chemotherapy, RR and MST were 72.0% and 7 months. The latter group included the patients whose doses of carboplatinum was reduced 20 to 50% in the first course of treatment. There was no difference found in RR, survival, and incidence of toxicity between these chemotherapy groups. CONCLUSION: Our results showed that in elderly SCLC patients, carboplatin could be substituted for cisplatin without apparent loss of therapeutic efficacy.

Aged↗

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Smoking and smoking-related lung cancer in female patients.

Smoking is the primary factor responsible for the epidemic of squamous cell lung cancer (SqLC) and small cell lung cancer (SCLC), however, there have been few studies which reported the relationship between smoking and SCLC in female patients. To examine the relationship between smoking and SCLC and SqLC in female patients, a retrospective chart review was performed in 877 patients with lung cancer diagnosed at Tsukuba University Hospital. In both SCLC and SqLC, the proportions of non-smokers were higher in female patients than those of male patients (p = 0.0001, p = 0.0001, respectively). A significant difference in smoking history was found between female and male patients who were diagnosed with SqLC and SCLC (p = 0.0001). In female patients, active smoking seems less responsible for the occurrence of smoking-related lung cancer compared with male patients, which suggests passive smoking influence the development of smoking-related lung cancer, especially in female patients.

Aged↗

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Disseminated metastasis of neuroblastomatous component in immature mediastinal teratoma: a case report.

A 17-year-old man with high levels of serum AFP and hCG was diagnosed as having primary mediastinal GCT. Cisplatin-based chemotherapy decreased the biomarkers, but the mass showed further growth. Pathological examination of the resected mass revealed a mixture of immature and mature teratomas. Six months after the surgery, the patient died of a dissemination of neuroblastomatous cells, which were similar to those in the immature neural component of the primary tumor. A disseminated metastasis of neuroblastoma in immature mediastinal teratoma is a rare complication. Serum NSE can be a useful marker in detecting the metastasis.

Adolescent↗

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Lung cancer patients with chronic obstructive pulmonary disease.

The aim of this study is to evaluate characteristics in lung cancer patients with chronic obstructive pulmonary disease (COPD). Among 966 lung cancer patients admitted to our division over a period of 24 years, 73 patients were diagnosed as having COPD. There were 68 (93.2%) men and 5 women; of the tumors 43 (58.9%) were squamous cell carcinomas. Although 41 (56.2%) patients had stage IA-IIIA, only 11 (15.1%) had surgery. Coexistence of COPD was proved to be a prognostic factor (p=0.0451). Adequate palliative care to provide quality survival would be the primary goal of therapy for lung cancer patients with COPD.

Adenocarcinoma↗

PubMedDate not supplied

An approach to intrapericardial inferior vena cava through the abdominal cavity, without median sternotomy, for total hepatic vascular exclusion.

In surgical resection for hepatocellular carcinoma with tumor thrombus extending into the inferior vena cava and other malignancies involving the retrohepatic inferior vena cava, the usefulness of total hepatic vascular exclusion has been reported by several authors. Total hepatic vascular exclusion usually consists of clamping at three points; at the infrahepatic inferior vena cava, at the suprahepatic inferior vena cava, and in Pringles' maneuver. Tumor thrombus extending into the inferior vena cava at the intrapericardial level below the right atrium can be resected without the use of cardio-pulmonary bypass. The inferior vena cava at the intrapericardial level has been reported to be usually approached by median sternotomy such as Chevron incision. We herein demonstrate an approach to the intrapericardial inferior vena cava through the abdominal cavity without median sternotomy.

Aged↗

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Effects of nilvadipine, a new calcium entry blocker, on systemic blood pressure, cardiac hypertrophy and venous distensibility in spontaneously hypertensive rats.

We investigated the effects of three different drugs, nilvadipine (NV), nicardipine (NC) and hydralazine (HD), having calcium entry blocking and/or vasodilating properties, on blood pressure, heart weight and venous distensibility in spontaneously hypertensive rats (SHRs). All of these drugs (1.0 and/or 3.2 mg/kg/day, s.c., 12-14 weeks) countered to almost the same extent the development of hypertension in young SHRs and lowered high blood pressure in the older SHRs. In both age-groups, on the other hand, ventricular weight/body weight ratios for the NV-treated group, but not for the NC- or HD-treated group, were significantly smaller than those for the corresponding vehicle-treated group. In addition, lower body venous pressure-volume curves, which were measured on the day after the last drug administration, shifted dose-dependently in the direction of the volume for the NV-treated group, indicating that venous distensibility was expanded by NV. NC and HD did not have such an effect at the same hypotensive doses. We conclude that NV prevented the development of hypertension and lowered high blood pressure in SHRs. NV also improved cardiac hypertrophy and decreased venous capacity. The depressant effect of NV on cardiac hypertrophy may be due not only to its hypotensive effect, but also, at least partially, to its venodilating effect.

Aging↗

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A successful treatment for hepatocellular carcinoma with atrial tumor thrombus.

A 66-year-old man with an advanced hepatocellular carcinoma and tumor thrombus extending into the right atrium was treated by transcatheter arterial infusion of lipiodol and aclarubicin. This brought about a remarkable reduction of the tumor and the disappearance of the right atrial tumor thrombus. The tumor was then radically resected by hepatic posterior segmentectomy with combined resection of the right hepatic vein, where the tumor thrombus remained. He is doing well without any signs of recurrence 22 months after the operation.

Aclarubicin↗

PubMedDate not supplied

Outcome of patients with lung cancer detected by mass screening versus presentation with symptoms.

Lung cancers in the early stages are frequently detected via mass screening in Japan. The aim of this study is to evaluate the outcome of patients with lung cancer detected via mass screening and to compare them to those in whom the malignancy was detected by symptoms. A total of 774 untreated patients with lung cancer who were admitted to Department of Respiratory Medicine, Tsukuba University Hospital over a 20 year period up to 1995, were analyzed with reference to their reasons for detection of the cancer. In the mass screened group(116 patients), 50.0% of lung cancer was detected at stage I of TNM classification, while only 8.2% of patients with symptoms(561 patients) had stage I lung cancer (p = 0.0001). As lung cancers detected via mass screening were more often at operable stage (stage I, II or IIIA) (p = 0.0001), surgical treatment was chosen more frequently in the mass screened group(p = 0.0001). The outcome of patients with lung cancer detected via mass screening was more favorable than that of the patients detected by their symptoms (p = 0.0002). The early detection of lung cancer via mass screening contributes to improvement of the outcome.

Adenocarcinoma↗

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Surgical outcome in early gastric cancer with lymph node metastasis.

BACKGROUND/AIMS: Definitive surgical management of early gastric cancer with lymph node metastasis has not been established. This paper describes the clinico-pathologic characteristics of early gastric cancer with lymph node metastasis. MATERIALS AND METHODS: A retrospective study of early gastric cancer with lymph node metastasis (32 patients) was performed to compare clinico-pathologic features with patients without lymph node metastasis (283 patients). RESULTS: All patients with lymph node metastasis had submucosal gastric invasion. The incidence of histologically proven curative resection in patients with lymph node metastasis was significantly lower than in those without metastasis (40.6% versus 93.3%). The 5-year survival rate was poorer in patients with positive nodes than in those with negative nodes (83.8% versus 96.2%). Recurrence was more frequent in patients with involved nodes (12.5% versus 0.4%). Lymph node metastasis was more frequent with the following: submucosal invasion, tumor over 5 cm in size, positive venous involvement, and an advanced growth pattern. CONCLUSIONS: Pre-operative and intra-operative evaluation for lymph node metastasis is essential for the appropriate surgical treatment of early gastric cancer.

Adenocarcinoma↗

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Surgical treatment of gastric cancer detected by mass screening.

BACKGROUND/AIMS: It is crucial to improve the postoperative prognosis of patients with gastric cancer in geographic regions where the incidence of gastric cancer is high. This study compared the efficacy of surgical treatment in patients with gastric cancer detected by a mass screening survey with that of patients diagnosed in accordance with standard medical practice. METHODOLOGY: The subjects included 189 patients with gastric cancer detected by a mass screening survey (screening group) who underwent surgical treatment from 1988 to 1995, and 517 patients who underwent a standard medical work-up (non-screening group). RESULTS: The incidence of early gastric cancer, curative resectability rate, and 5-year survival rates between the screening and non-screening groups were 73.0% versus 48.4% (p < 0.01), 90.5% versus 66.7% (p < 0.01), and 86.2% versus 61.0% (p < 0.01), respectively. CONCLUSIONS: Surgical treatment for patients with gastric cancer identified by mass screening is effective in saving lives and reduces the mortality from gastric cancer in the target population of mass screening. However, a further prospective randomized controlled study of this screening method will be necessary in the future.

Adult↗

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Arterial ketone body ratio during hepatectomy.

The arterial ketone body ratio (AKBR) has been proposed as an accurate indicator of liver mitochondrial redox potential. However, the efficacy of the AKBR as a biochemical marker has been recently called into question. To resolve this issue, we studied the effect of temporary vascular occlusion on the AKBR during hepatectomy. Twenty patients undergoing hepatectomy were divided into two groups: those with hepatocellular carcinoma with a history of hepatic cirrhosis (n = 10; cirrhotic group) and those with liver disease without cirrhosis (n = 10; non-cirrhotic group). To minimize blood loss during hepatectomy, temporary vascular occlusion was applied using the Pringle maneuver. Acetoacetate and beta-hydroxybutyrate concentrations in the arterial blood and the AKBR were determined before and after vascular occlusion. In 25% of the two groups combined, the AKBR increased following normothermic ischemia, as compared with the levels prior to clamping; in 20% of cases in the cirrhotic group, it increased immediately following reperfusion, as compared with the levels prior to clamping. Changes in the AKBR during hepatectomy did not correlate with preoperative hepatocellular function. An AKBR of less than 0.7 prior to clamping which persisted during surgery was not a consistent risk factor for postoperative complications. The AKBR was not a useful predictor of liver viability in partial liver resection with temporary vascular occlusion.

3-Hydroxybutyric Acid↗

PubMedDate not supplied

Pleural effusion as a significant prognostic factor in non-small cell lung cancer.

UNLABELLED: In non-small cell lung cancer (NSCLC), pleural effusion is a frequently observed complication, and often provides a treatment difficulties. The aim of this study is to evaluate prognostic significance of pleural effusion in patients with NSCLC. MATERIALS AND METHODS: Seven hundred and eight untreated patients with NSCLC who were consecutively admitted to our department over a 20 year period up to December 1996, were analyzed using uni- and multivariate analyses. RESULTS: Univariate analysis showed pleural effusion to be a significant prognostic factor for NSCLC, in addition to gender, stage, performance status(PS). Multivariate analysis proved pleural effusion to be one of the significant prognostic factors, especially in patients with poor PS. CONCLUSION: Adequate palliative care to provide prolonged quality survival remains the primary goal of therapy for patients with poor performance status and pleural effusion until better treatments are developed.

Adult↗

PubMedDate not supplied

Surgery for gastric cancer in patients older than 80 years of age.

BACKGROUND/AIMS: Although the number of elderly patients who undergo surgery for gastric cancer has increased in recent years, the clinical features associated with this group of patients, including their postoperative survival rate, remain unclear. METHODOLOGY: The cases of 50 patients > or = 80 years of age (the older group) with gastric cancer who underwent surgical treatment in our Department from January 1988 to December 1995 were reviewed and compared to the records of 239 patients < or = 60 years of age (the younger group) who had surgery during the same time period. RESULTS: The incidence of advanced gastric cancer in the older versus younger groups was 59.6% versus 27.9%, respectively (p < 0.01). The tumor size was significantly larger in the older group. The tumor location in the older group predominantly involved the upper third of the stomach, while in the younger group, the middle third of the stomach was primarily involved. Histologically, the incidence of differentiated tumor types was 65.1% versus 50.5% (p < 0.05), and undifferentiated types, 34.9% versus 49.5% (p < 0.05), in the older and younger groups, respectively. Retrospective comparisons conducted between the older and younger groups revealed the following: curative resectability rate: 52.0% versus 74.5% (p < 0.01); hospital mortality rate: 2% versus 0%; overall 5-year survival rate: 46.1% versus 71.1% (p < 0.01); and a 5-year survival rate in patients who underwent curative resection of 65.0% versus 88.8% in the older versus younger age groups, respectively. CONCLUSIONS: These results suggest that the survival of elderly patients with gastric cancer is worse than that of younger patients because of a lower curative resection rate of the advanced cancer. However, the survival rate in elderly patients is identical to that in younger patients if a curative resection is performed.

Age Factors↗

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Combined effects of TNP-470 and taxol in human non-small cell lung cancer cell lines.

The effects of TNP-470, one of the promising antiangiogenic agents and taxol when combined were evaluated in two human cultured cell lines derived from non-small cell lung cancer(NSCLC). Cytotoxicity was determined using a tetrazolium salt(MTT) assay. The inhibitory effects of TNP-470 on cell proliferation were dose related and the 50% inhibitory concentration on these cell lines were 50.0 to 62.5 microM. Evaluation of drug interactions with isobologram and the combination index values showed that sequential exposure to taxol followed by TNP-470 produced synergistic effects in these cell lines tested. Our findings suggest that such an angiocytotoxic chemotherapy might be promising for the treatment of NSCLC.

Antineoplastic Combined Chemotherapy Protocols↗

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Analysis of long-term survivors after platinum containing chemotherapy in advanced non-small cell lung cancer.

Among 195 patients with locally advanced or metastatic non-small cell lung cancer(NSCLC), we evaluated the characteristics of two-year survivors. All the patients with stage IIIA-IV disease received platinum containing combination chemotherapy at Tsukuba University Hospital between 1985 and 1996. Fourteen patients (7.2%) and 7 patients (3.6%) survived for more than 2 and 3 years, respectively. Ten of the 14 responded to initial chemotherapy, and 9 patients received additional treatment such as thoracic irradiation and/or surgical resection. Three of the 14 patients survived more than 5 years disease free, one of them survived more than 10 years. From the results uni- and multivariate analyses of these patients, early stage of the disease, low number of metastatic site, without associated lung disease were confirmed as significant determinants of survival. This study revealed that a small proportion of patients with advanced NSCLC might be potentially curable with appropriate treatment.

Adult↗

PubMedDate not supplied

Predictive value of preoperative serum sialyl Lewis X-i antigen levels in non-small cell lung cancer.

BACKGROUND AND STUDY OBJECTIVE: Serum sialyl Lewis X-i antigen has been shown to be one of the most specific markers for monitoring non-small cell lung cancer(NSCLC). We evaluated the correlation between serum levels of sialyl Lewis X-i antigen and mediastinal lymph node involvement in NSCLC patients. METHODS: One hundred patients with untreated NSCLC were included in this study. All the patients received surgical treatment and the lymph nodes were evaluated pathologically. Pretreatment sera from these patients examined for the levels of sialyl Lewis X-i antigen, using a radioimmunoassay. RESULTS: Serum levels of sialyl Lewis X-i antigen levels in patients with N2 were higher than those of N0-1(p = 0.0049). According to the receiver characteristic curve analysis, the recommended cut-off level of the antigen between N0-1 patients and N2 patients was 38.0 U/ml. CONCLUSION: Measurement of serum levels of sialyl Lewis X-i antigen might provide preoperative information in patients with NSCLC.

Aged↗

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Patterns of pancreatic metastasis from lung cancer.

BACKGROUND: Metastatic involvement of the pancrease is not an uncommon autopsy finding, however, pancreatic metastasis is an infrequent clinical condition and the pattern of the metastases have not been studied. We conducted a retrospective study in order to evaluate the pattern of the metastasis from lung cancer. PATIENTS: From 1976 to 1997, 26 patients with pancreatic metastasis were identified by searching the medical records of 850 patients with lung cancer. RESULTS: The usual pattern of pancreatic metastasis involved a solitary nodule in 19 patients (73.1%); multiple nodules in 3(11.5%), and diffuse swelling in 4(15.4%). Nineteen(73.1%) and 18(69.2%) of 26 patients had liver and adrenal gland metastases, respectively. CONCLUSIONS: Pancreatic metastasis represents a common site of extrathoracic spread of disease for the small number of patients with advanced lung cancer, especially in small cell lung cancer. The usual pattern of the metastasis is a solitary nodule. In order to diagnose exactly, abdominal CT scan would be helpful in such metastasis.

Adult↗