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Biomedical subjects

M Sakurai

Publications and source records attributed to M Sakurai.

At least 811 records · Page 45Linked to original sources
PubMed1986

Antiemetic efficacy of high-dose intravenous metoclopramide and dexamethasone in patients receiving cisplatin-based chemotherapy: a randomized controlled trial.

High-dose intravenous (IV) metoclopramide has shown efficacy with few side effects for the treatment of nausea and vomiting on the day of cisplatin administration. From November 1984 to January 1986, two randomized trials in an antiemetic study were conducted. In trial I, the antiemetic effect of a short course of high-dose dexamethasone was compared with that of high-dose metoclopramide in 29 patients with lung cancer receiving chemotherapy containing cisplatin (80 mg/m2 IV) in a randomized controlled trial. Dexamethasone was given IV at a dose of 16 mg 1/2 hr before and 8 mg, 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Metoclopramide was given IV at a dose of 2 mg/kg, 1/2 hr before and 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Major emetic control (0-2 episodes of vomiting) during the 24 hr after cisplatin administration was achieved in 55% (6/11) and 67% (12/18) of the patients receiving dexamethasone and metoclopramide, respectively, without serious toxicity. The duration of nausea or anorexia was similar for the two treatment groups. In trial II, the combination of metoclopramide and dexamethasone was compared with metoclopramide alone to assess the additive antiemetic effect of the two drugs in 23 patients with lung cancer receiving cisplatin at a dose of 120 mg/m2 IV in a randomized cross-over study. A major antiemetic response was observed in 27% (3/11) and 92% (11/12) of the patients receiving metoclopramide alone and metoclopramide plus dexamethasone, respectively (p less than 0.005). The duration of nausea and anorexia was similar for the two treatment groups. Patients tended to prefer the combination of metoclopramide and dexamethasone; however, the difference was not statistically significant (p = 0.14) in the small number of patients entered in this study. Despite excellent control of acute chemotherapy-induced emesis, 45% of 52 patients experienced delayed nausea and vomiting more than 24 hr after cisplatin administration even among those who had had an excellent short-term response to the antiemetic agents.

Adult↗
PubMed1986

A trial of chemotherapy for lung cancer in short-term hospitalization.

Recently the number of patients with lung cancer who receive chemotherapy has been increasing rapidly. Therefore it has become difficult to treat all patients with advanced lung cancer on the basis of accurate protocol in long-term hospitalization. Accordingly we tried to treat patients within one week in each of a number of chemotherapy protocols (short-term hospitalization) and to follow them in the outpatient department. We were able to accept 61 admissions of 38 patients for chemotherapy from June to December 1985. Thus it was possible to take care of more than three times as many patients as could be cared for by long-term hospitalization for chemotherapy. Three patients could not be discharged within one week and eight had to be readmitted because of leucopenia, thrombocytopenia, or dehydration. It was considered to be possible to decrease the number of such patients by more careful and appropriate hydration and to detect them by appropriate intervals of examination in the outpatient department. We concluded that short-term hospitalization is one of the methods which can make chemotherapy of lung cancer more effective.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Rapid growth and rupture of a newly originated aneurysm near the clipped middle cerebral artery aneurysm].

A 38-year-old man was admitted to our hospital because of severe headache following reduced level of consciousness on February 13, 1979. He was lethargic and showed neck stiffness. A lumbar puncture revealed bloody cerebrospinal fluid. Left carotid angiography showed a berry aneurysm of 11 mm in diameter at the bifurcation of the middle cerebral artery (MCA). Rebleeding occurred on February 21, and he fell into semicoma. But, his consciousness recovered to lethargy on the next day. On February 26, a direct intracranial operation was performed and a Sugita clip was placed to the aneurysmal neck. The postoperative course was uneventful. But, left carotid angiography on 8th day after operation showed a newly originated aneurysm proximal to the operated aneurysm. On the 12th postoperative day, he suddenly fell into coma. CT showed subarachnoid blood in the basal cisterns and intraparenchymal hematoma in the left temporal lobe. On the same day, left carotid angiography was performed and it showed the enlarged aneurysm. He died on the 19th day after operation. Autopsy was not performed. Three factors have been considered dealing with the recurrence of the operated aneurysm in the previous reports: first, local fragility of the vascular wall due to the clip edge. Secondly, macro- or microscopic residual aneurysmal neck, thirdly, broken or slipped clip. Our case had the following characteristics from the angiographical and operative findings: the orifice of the operated aneurysm was situated on the superior side of the parent artery and the aneurysm protruded posterosuperiorly at an angle of approximately 90 degrees to the long axis of M1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Fundamental study and clinical testing of human tumor clonogenic assay (HTCA)].

Through our retrospective analysis of HTCA and clinical effects as well as fundamental studies, the following results were obtained: In this retrospective study, HTCA for lung cancer showed a predictive accuracy of 71%, a true positive rate of 50% and a true negative rate of 77%. To obtain good predictive accuracy, HTCA should be modified to provide conditions comparable to those in vivo with regard to drug concentration and drug exposure time. More precise analysis of the pharmacokinetics of anticancer agents might yield methodological improvement. A decrease in the chemosensitivity spectrum in vitro was observed after chemotherapy. This might be related to evidence that patients with prior chemotherapy exhibited a poor response rate to chemotherapy. There were no active anticancer agents against specimens with aplating efficiency of more than 0.04%. More extensive prospective trials will be necessary to determine the clinical value of HTCA. HTCA could be a superior assay for detecting the anti-tumor activity of new agents and a useful method for in vitro phase II study.

Antineoplastic Agents↗
PubMed1986

[Concentration of cefotaxime and its metabolite in human bone marrow blood].

Cefotaxime (CTX) was intravenously administered in an amount of 2.0 g to each of 34 adult patients before the surgery mainly of the hip joint. Samples of the blood from the bone marrow around the trochanter were taken at the time of the operation. At the same time blood samples were taken from peripheral veins. The sample was centrifuged and the supernatant was analyzed for CTX and desacetyl-CTX. The concentration of CTX in the marrow blood was 150.9 micrograms/ml and that in the blood was 182.5 micrograms/ml in the earliest samples taken at 20 minutes after injection. In the 44 pairs of samples, the concentration of CTX in the marrow blood was lower than that in the peripheral blood in all the cases except 4. The concentration of desacetyl-CTX (Des-CTX), however, in the marrow blood was higher than in the peripheral blood in 33 of the 44 pairs of specimens. Since the degradation of the drug progresses with time, the ratio of Des-CTX to CTX increased with time. This trend was particularly marked in the bone marrow blood and can be expressed as Y = 113.0 + 0.32 t, when Y is the ratio percentage (Des-CTX/CTX) and t is time after the injection of the drug in minute. Thus, CTX transferred into the bone marrow tends to remain there and transformed into the desacetyl form.

Adolescent↗
PubMed1986

[Clinical observation of urolithiasis in Mie University Hospital].

The urinary tract calculus patients seen at our Department between January, 1974 and December, 1983 were reviewed to determine the trend of urolithiasis. The urinary tract calculus patients accounted for 10.1% of all the outpatients. Recurrent calculus diseases were seen in 16.9% of male patients and in 12.1% of female patients. The frequency of recurrence was very high in the patients in their forties. Upper urinary tract calculi were seen most frequently in the patients in their forties. We could expect spontaneous passage of stone for at least 6 months in the case of a middle-sized stone (less than 6 X 10 mm). The percentage of calcium oxalate-containing stone was 73.2% in male patients and the percentage of phosphate-containing stones was 81.6% in female patients. Hypercalciuric patients were seen in 34.0% of the calculus inpatients. Urinary bacterial culture revealed positive in 33.0% of the calculus inpatients.

Adolescent↗
PubMed1986

[Left axis deviation investigated by body surface mapping and phase image analysis].

Relationship between left axis deviation and left anterior fascicular block (LAFB) was investigated by estimating the ventricular excitation and contraction sequence using body surface potential mapping and phase image analysis by radionuclide ventriculography. This study included seven normal persons, eight patients with complete right bundle branch block (RBBB) without left axis deviation (LAD), twelve with RBBB and unblocked axis (determined by the first half of the QRS complex) of 0 degrees or farther deviated to the left (RBBB with LAD), and three with isolated LAD. The isochrone ventricular activation maps (VAT maps) were obtained by body surface mapping technique. Planar phase images in the left anterior oblique projection and short-axis ventricular tomographic phase images using a seven-pinhole collimator were constructed by ECG-gated equilibrium blood pool scintigrams. On the VAT maps of RBBB, there was a markedly delayed conduction to the right ventricle, however, in the left ventricle, the excitation was initiated in the anterior paraseptal region, and it proceeded rapidly toward the lateral and posterior walls, and in the same direction as normal. The VAT maps of RBBB with LAD were categorized in three types according to the activation sequence in the left ventricle. Type I, the same as maps of RBBB, consisted of three cases. Type II, four cases, showed excitation starting from the apex and ascending in the anterior wall. There were five cases of type III, which showed the earliest excitation in the basal posteroparaseptal region, proceeding toward the apex and ascending in the anterior wall. Type II was considered compatible with block of the left anterosuperior fascicle, and type III was that of left anterosuperior and midseptal fascicles. In types II and III, the phase delay in the left anterior wall was recognized in tomographic phase images, and the difference between right and left ventricular mean phase angles in planar phase images was significantly smaller than in cases of isolated RBBB, These were thought to support the existence of LAFB. The range of the unblocked axis of RBBB with LAD was -3 degrees approximately 13 degrees (-7.7 +/- 5.0 degrees) in type I, -8 degrees approximately -30 degrees (-19.8 +/- 9.1 degrees) in type II, and -33 degrees approximately -60 degrees (-51.0 +/- 10.9 degrees) in type III. All cases with left axis deviation beyond -30 degrees were of type III, and suspected to have extensive damage, including the midseptal fascicle.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

Clinical and hematologic characteristics in acute leukemia with 11q23 translocations.

We studied the clinical, morphological, and immunologic characteristics of 11 patients with 11q translocation-associated acute leukemia. There were three patients with t(9;11)(p22;q23), one with a variant of the t(9;11), three with t(11;19)(q23;p13), two with t(1;11)(p32;q23), one with t(10;11)(p15;q22or23), and one with t(11;17) (q23;q25). The breakpoints in chromosome 11 clustered in band q23. The morphological feature was FAB-M5 in two patients, FAB-M2 in one, FAB-L1 in six, and lymphoblastic lymphoma in one. The remaining patient underwent morphological changes from FAB-L1 seen at the time of diagnosis to M5b at relapse. Immunologic marker studies in ten patients revealed that one had T cell type; another pre-B cell type; three CALLA- Ia- non-T, non-B type; two CAL-LA- Ia+ non-T, non-B type; two monocytic type (positive Fc-receptor); and the remaining one underwent phenotypic changes from CALLA+ Ia+ non-T, non-B type to monocytic type. The patients were usually young; five were under 1 year and two were 9 and 13 years. Hyperleukocytosis was observed in eight of the ten patients with acute leukemia, and two of the eight died of intracranial hemorrhage within two days of admission, associated with disseminated intravascular coagulation. These findings indicate that leukemia with the 11q23 translocation share certain characteristics in common, irrespective of the recipient chromosome, even though the latter may have some influence on the morphological and immunologic phenotype. Our data provide a hypothesis that multipotent stem cells are involved in the genesis of the 11q translocation-associated leukemia.

Age Factors↗
PubMed1986

[Studies on adequate intervals of cisplatin administration to ameliorate cisplatin-induced nephrotoxicity].

Experimental studies were designed in order to ameliorate cisplatin-induced nephrotoxicity. Cisplatin was injected intravenously into DS mice at a dose of 5.0 mg/kg. Plasma platinum levels declined in a biphasic fashion and were undetectable after 5 days post-infusion. Renal platinum levels decreased in the same manner as the plasma levels and revealed detectable plateau levels 5 days after single injection. Cisplatin was administer once a week for 3 consecutive weeks; serial plasma and renal platinum levels and BUN were measured 7 days after each injection. The results showed that there was no significant change in the levels of plasma platinum and BUN but that the renal platinum levels increased progressively (1.6 +/- 0.3, 3.1 +/- 0.4, 4.8 +/- 2.7 micrograms/g wet wt.). After another 6 successive weeks of cisplatin administration, 55% of mice died. The renal platinum levels and BUN of the survivors were highly increased. The renal tissue revealed histologically acute renal failure. However the renal concentration of platinum was decreased to a low level of 1.1 +/- 0.4 micrograms/g wet wt. 4 weeks after the third injection. These results suggested that cisplatin-induced nephrotoxicity could be ameliorated by adequate intervals of cisplatin administration.

Animals↗
PubMed1986

[Chromosome translocations and cellular oncogenes in hematologic neoplasms].

Chromosome translocations found in hematologic malignant diseases are correlated with the cytologic and histologic features of the neoplastic cells as well as with clinical features, such as the patient's age, response to therapy and prognosis. Thus, the 8; 21 and 15; 17 translocations, respectively, are associated with acute myeloblastic and acute promyelocytic leukemias. Likewise, the 8q24 translocations including 8; 14, 2; 8, and 8; 22 translocations seen in Burkitt's lymphoma, and the 1; 19 and 11; 14 translocations seen associated with pre-B-cell and T-cell leukemias, respectively, are examples of similar correlations with regard to lymphoproliferative disorders. With the exception of the cases of 9; 22 (Ph1) and 11q23 translocations, each of which is found in both myeloid and lymphoid neoplasms, any one abnormality is rarely encountered in association with both categories of malignancy. Recent studies indicate that, with regard to many of the known chromosome translocations, the break occurs at a point close to the location of a specific cellular oncogene. Thus, c-myc and c-abl, which reside in 8q24 and 9q34, respectively, are known to undergo rearrangement in cases of 8q24 and 9; 22 translocations. These rearrangements have been proved to give rise to the production of an abnormal protein, which seems to cause the malignant transformation of cells with such chromosome translocations. Chromosome translocations are now believed to be directly related to oncogenesis through the mechanism of activation of the cellular proto-oncogene.

Chromosomes, Human, 13-15↗
PubMed1985

Clinicopathologic study of thyroid carcinoma infiltrating the trachea.

Eighteen patients (10 women and 8 men), ranging in age from 37 to 80 years, with thyroid carcinoma infiltrating the trachea comprised this series. Eleven had primary and 7 had recurrent cases. Total laryngectomy was performed in 4 patients, and tracheal resection was carried out followed by end-to-end anastomosis in 13 patients. In one patient, reconstruction was done with Naville's artificial trachea after tracheal resection. Eleven patients were alive after 1 year and 8 months to 6 years and 7 months after the operation. This result was significantly better than that of a group of ten patients without resection of the infiltrated trachea (seven patients died within 6 months). Thus, combined resection of the upper airway improved the prognosis of advanced thyroid carcinoma with tracheal infiltration. Histologic examination of surgical specimens demonstrated well-differentiated carcinoma in seven patients, poorly differentiated carcinoma in seven patients, undifferentiated carcinoma in three patients, and squamous cell carcinoma in one patient. The result showed a higher frequency of poorly differentiated carcinoma than in the control group of 70 patients without tracheal infiltration.

Adenocarcinoma↗
PubMed1985

Possible association of a new translocation, t(7;11)(p15;p15), with Ph1 chromosome-negative chronic myelogenous leukemia.

A Ph1 chromosome-negative chronic myelogenous leukemia (CML) with t(7;11)(p15;p15) in a 6-year-old girl is reported. Three cases of 7;11 translocation have been reported so far. The patients concerned were between 37 and 72 years of age; 2 of them had CML and the other had acute myelomonocytic leukemia. Data from these 4 cases suggest that the 7;11 chromosome translocation may be related to a subgroup of Ph1-negative CML, specifically to one that may easily proceed to blast phase, or to "subacute" myelogenous leukemia. The present case demonstrates that CML with this chromosome abnormality is not restricted to adults but also affects children. The t(1;11)(q21 or 23;p15) reported in another case with Ph1-negative CML may be a variant of this translocation.

Bone Marrow↗
PubMed1985

Chromosome abnormalities in malignant histiocytosis.

Chromosome and pathologic studies were performed on two patients (a 12-year-old boy and a 62-year-old woman) with malignant histiocytosis (MH). Both patients had chromosome abnormalities in their neoplastic cells: the boy's karyotype was 45,Xp+,-Y,9p+,18q-, and the woman's 48,XX,+16, inv(1),mar(5),6p-,10p+,12q+,i(18q),+i(18q). The boy had typical clinical and pathologic findings of MH, and died without achieving remission by chemotherapy. At the initial stage the woman had the clinical and hematologic findings of MH. Chemotherapy was given, but had no beneficial effects. At the terminal stage the bone marrow (BM) biopsy and aspirate, and the autopsy findings, were consistent with those of non-Hodgkin lymphoma, diffuse large cell type, although some histiocytes or abnormal cells in monocyte-macrophage lineage remained in the BM and the autopsied lymph nodes. This study and a review of data on six other cases have failed to establish any specific chromosome changes in MH.

Adolescent↗
PubMed1985

B-prolymphocytic leukemia cells that form rosettes with sheep red blood cells through monoclonal surface immunoglobulin.

The neoplastic cells from a patient with B-cell prolymphocytic leukemia exhibited sheep red blood cell (SRBC) rosette formation. Immunochemistries revealed no reactivity with T-cell monoclonal antibodies OKT 3, 4, 8, and 11. However, the neoplastic cells expressed characteristics of B-cells including surface IgM and IgD associated with lambda light chains, Ia-like antigenicity, and reactivity to monoclonal antibodies against B-cell antigens B1, B2, and B4. Inhibition procedures revealed that SRBC rosette formation was the result of binding activity of surface immunoglobulin to SRBC. Pretreatment of the leukemic cells with antihuman IgM or lambda antisera, or pronase or trypsin blocked rosette formation with SRBC. Circulating antibody to SRBC was also suspected by the fact that preincubation of SRBC with heat-inactivated patient's serum resulted in agglutination of the SRBC.

Aged↗