Biomedical subjects
M Yasue
Publications and source records attributed to M Yasue.
[Influence of immunopotentiators on the activation of 5-FU derivatives].
As it has been shown that various kinds of immunopotentiators inhibit the hepatic microsomal drug-metabolizing enzymes and reduce the activation of masked compounds such as tegafur, we investigated the influence of immunopotentiators (OK-432 and PSK) on the activation of carmofur (HCFU), which is known to be transformed spontaneously in to the tumor-active substance, 5-fluorouracil (5-FU), in vivo, and compared the results to those obtained for tegafur. After oral administration of tegafur, the area under the plasma concentration curves of 5-FU in rats pretreated with OK-432 and PSK were 72% and 79% of those in untreated rats, while in the case of HCFU almost similar plasma concentration curves for 5-FU were obtained in both treated and untreated rats. These results show that the activation of HCFU to 5-FU is not influenced by treatment with these immunopotentiators. Furthermore, our clinical investigation showed that the survival curves of cancer patients given combination therapy of tegafur with OK-432 tended to be lower than those given a single therapy of tegafur, supporting the above mentioned basic results.
[A controlled study of surgical adjuvant chemoimmunotherapy with FT-207 and OK-432 for advanced stomach cancer: the fourth study].
A prospective randomized trial of surgical adjuvant chemoimmunotherapy was conducted in patients who had undergone palliative gastrectomy for previously untreated advanced stomach cancer. Immediately after surgery, one hundred and forty-seven patients were randomized to receive either chemoimmunotherapy with FT-207 plus OK-432 (group A) or chemotherapy with only FT-207 (group B). The number of patients subjected to this analysis was 134 cases (group A: 70 cases, group B: 64 cases) because thirteen patients were excluded. FT-207 was administered orally and OK-432 was administered intracutaneously. There were no differences in the background factors influencing survival time between the two groups. While the survival rate of group A patients was higher than that of group B patients, the difference in the survival rate between the two study groups was not statistically significant. However, in patients with less differentiated cancer (poorly differentiated adenocarcinoma, signet-ring cell carcinoma) the survival rate of group A patients was significantly (p less than 0.05) higher than that of group B patients. The results of the present study show that OK-432 administered intracutaneously is effective in elevating the survival rate of patients receiving chemotherapy with FT-207 for advanced stomach cancer (especially for less differentiated cancer).
[A case of toxic leucoencephalopathy induced by 5FU derivatives].
A case of toxic leucoencephalopathy induced by 5 FU derivatives is reported. A 46-year-old woman was diagnosed as having breast cancer, and radical mastectomy was performed on May, 1982. After operation, she was given irradiation and 5FU derivative (tegafur or carmofur) 600 mg and Nolvadex 20 mg (tamoxifen citrate) were administered every day. After taking the medication for a month, she began to stagger and developed a tremor in both arms. She was admitted to our hospital on August 16, because she showed evidence of dysarthria and memory disturbance in addition to her initial complaints. Soon after admission, she developed akinetic mutism, and metastasis in the brain stem was suspected. In spite of her severe condition, she was given radiation over the posterior fossa and continued the medication. On September 22, CT disclosed low density area in the centrum semiovale bilaterally. She died of DIC on November 30. An autopsy was performed. The brain weight was 1110 g and the outer surface of the brain was normal. In frontal cut surfaces stained with K.B., bilateral degeneration of the centrum semiovale was apparent. Microscopically, the degree of myelin degeneration was stronger than that of axon, and numerous fatty granular cells were found in the degenerated area. There were no bizarre shaped astrocytes, inclusion body or cellular infiltration. Fibrillary gliosis was scanty. No metastasis was found in the central nervous system or other organs. Based on these pathological findings and clinical history, toxic leucoencephalopathy induced by 5 FU derivatives was suggested.
Surgical treatment of cavernous hemangioma of the liver.
This report describes our experiences with 12 cases of cavernous hemangioma of the liver. Eight patients were submitted to surgical procedures. Five out of eight underwent liver resections that ranged from simple excision to hepatic lobectomy. Three patients underwent hepatic artery ligation. There were no surgical deaths or any late deaths. Four more asymptomatic patients have been observed for up to 11 years (mean 4.0 years). None of the patients in this group has evidenced intensification of symptoms or any remarkable change of the size of lesions.
[On the ancient manuscript named "San'emon Imai's Application"] (Jpn).
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[Discrepancy in the "Biography of N. Nagai" written by S. Kanao] (Jpn).
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["Shokokusanbutsurei" a writ of an inquisition about the domestic products] (Jpn).
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[History of remedies--investigation into their real values in use] (Jpn).
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[The manuscript "Togoku-Ohayashi-Ninjin" and the scholar Kunzan Matsudaira] (Jpn).
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Major surgery in patients undergoing hemodialysis.
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[Diagnosis and surgical treatment of renal hyperparathyroidism].
Forty-three patients with chronic renal failure and secondary hyperparathyroidism underwent parathyroid surgery. The first 20 patients were submitted to subtotal parathyroidectomy, and the last 23 patients underwent total parathyroidectomy and parathyroid autotransplantation in the forearm. Non-invasive image diagnosis, CT, ultrasonography and scintigraphy are valuable for 1) making a definite diagnosis of secondary hyperparathyroidism, 2) locating the tumor 3) determining the effectiveness of treatment, and 4) differentially diagnosing thyroid tumors. For surgical treatment, we recommend total parathyroidectomy and autotransplantation in the forearm because the second operation for recurrence may be done more safely and easily than after subtotal parathyroidectomy.
[Origin of short latency somatosensory evoked potential following median nerve stimulation].
Short latency somatosensory evoked potentials (S-SEP) to median nerve stimulation recorded from scalp-shoulder derivation consisted of four positivities (P1, P2, P3 and P4) and one negativity (N). There is still, however, significant controversy regarding the generators of these peaks. The purpose of the present study is to attempt to solve some of the controversies by comparing the potentials recorded on surface montages with intrasurgical tracing obtained while monitering evoked potentials. This is complemented by analysis of S-SEP in patients with disorders of the cervical cord, brain stem or thalamus. Average latency of each component in normal subjects (N = 17) was as follows; P1: 7.6 +/- 0.6 ms P2: 9.6 +/- 0.7 ms, P3: 11.8 +/- 0.8 ms, P4: 12.9 +/- 0.5 ms, N: 17.7 +/- 0.8 ms. The peak latency of P1 was always shorter than that of negativity recorded over the Erb's point following the median nerve stimulation. The peak latency of P2 corresponded to that of the earliest negativity of spinal evoked potential, recorded from the epidural dorsal surface of the lower cervical cord during the operation, which was considered as the potential of afferent volley at the posterior root or spinal entry portion. In a case with severe spondylotic radiculopathy, P2 and following components were abolished. The peak latency of P3 corresponded to that of negative potential recorded over the high cervical dorsal column or cuneate nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
[Total pelvic exenteration for primary and locally recurrent rectal cancer].
Thirteen patients with advanced carcinoma of the lower colon and no evidence of extrapelvic metastasis were submitted to total pelvic exenteration with urinary diversion. The operative mortality rate was 7.7%. Determinate 5-year survival rate of 40% was achieved. Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Six patients with deeply invading recurrent lesions had pelvic exenteration combined with sacral resection. This procedure seems a reasonable treatment for palliation and the chance of cure in selected patients. CT examination of the pelvis is very valuable for the early detection and localization of recurrence.
[Pelvic exenteration combined with sacral resection for recurrent rectal cancer. The roles of carcinoembryonic antigen and pelvic computed tomography for early detection].
Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. CT study of the pelvis revealed recurrent tumor images in relation to the adjacent pelvic structures. Six patients with deeply invading recurrent lesions were subjected to pelvic exenteration combined with sacral resection. No postoperative deaths were encountered. The postoperative sharp drops of serum CEA levels are useful for judging the adequacy of this procedure. The follow-up status of the 6 patients is as follows, respectively: 16 months dead from pulmonary & hepatic metastasis, 11 months and 9.5 months alive without symptoms but with slightly elevated CEA level, and 5 months, 2 months and 2 weeks alive with no evidence of disease. All patients who were relieved of perineal or sciatic nerve pain are now able to walk without any assistance or trouble. Total en bloc residual pelvic exenteration combined with sacral resection is a reasonable treatment for locally recurrent rectal cancer.
Ligation and catheterization of the hepatic artery for palliative treatment of malignant hepatic tumors.
Eleven unresectable hepatoma patients and three metastatic tumor patients with colonic cancer underwent ligation and/or catheterization of the hepatic artery of the main tumor-bearing zone. Mitomycin C (liquid or microcapsulated) or Adriamycin were administered via the catheter intermittently or continuously with a portable pump device. In follow-up study the tumor size was frequently visualized by arteriography via the cannula. Some tumors became smaller with calcification. The levels of alpha-Fetoprotein of CEA in some cases dropped remarkably and stayed low for a fairly long period. There was no immediate postoperative death. Six of 11 unresectable hepatoma patients survived longer than 8 months with a maximum survival of 17.5 months. Two of three metastatic patients have survived more than 11 months at this writing. This method seems effective for prolongation of patient survival.
Pelvic exenteration combined with sacral resection for recurrent rectal cancer.
Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Computed tomographic (CT) study of the pelvis revealed recurrent tumor images in relation to the adjacent pelvic structures. Five patients with deeply invading recurrent lesions were submitted to pelvic exenteration combined with sacral resection. No postoperative deaths were encountered. The postoperative sharp drops of serum CEA levels are useful for judging the adequacy of this procedure. The follow-up status of the 5 patients, respectively: 14 months alive with pulmonary metastasis, 9 months alive without symptoms but with slightly elevated CEA levels, and 8 months, 3 months, and 3 weeks alive with no evidence of disease. All patients who were relieved of perineal or sciatic nerve pain are now able to walk without any assistance or trouble. Total en bloc residual pelvic exenteration combined with sacral resection is a reasonable treatment for locally recurrent rectal cancer.
Image diagnosis of parathyroid glands in chronic renal failure.
Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with 201TlCl and 99mTcO4+, and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment.