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Biomedical subjects

N Kawaguchi

Publications and source records attributed to N Kawaguchi.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Preoperative radiotherapy of bone and soft tissue sarcomas].

UNLABELLED: The role of preoperative radiotherapy was evaluated in 16 cases with soft tissue sarcoma and 13 cases with osteosarcoma. Nine osteosarcoma cases underwent radiotherapy of whole lesion, and 4 cases had radiotherapy only of the surgically incurable portion. There were no local recurrences in M0 cases, but skin necrosis occurred in the whole radiation group. As for the soft tissue sarcomas, local recurrence was not seen in virgin cases, but two cases which had received previous treatment showed local recurrence. There were no cases with severe side effects. CONCLUSION: 1. Partial radiotherapy was effective as preoperative treatment for osteosarcoma. 2. preoperative radiotherapy is better than postoperative radiotherapy from many standpoints.

Adolescent↗
PubMed1989

[Evaluation method of surgical margin in musculoskeletal sarcoma].

The evaluation of surgical margin is useful in determining the curability of surgical treatment of musculoskeletal sarcoma and the degree of possibility to reduce later surgery as part of preoperative therapy. However, at present there has been no worthwhile evaluation method developed for these purposes. In this paper we propose a new evaluation system for surgical margin as drafted by the Bone and Soft Tissue Tumor Committee of JOA. This system was applied in 197 cases at the Cancer Institute Hospital to determine the clinical significance in the treatment of musculoskeletal sarcoma. In this method, surgical margin was classified into four types according to the distance between the surgical margin and the reactive zone of the tumor. The types of surgical margins (in order of surgical extent) are curative margin, wide margin, marginal margin, and intralesional margin. Surgical margin is said to be curative if the margin is more than 5cm outside the reactive zone. It is referred to as wide if the margin is less than 5cm and marginal if the margin is at the reactive zone. In our evaluation, a thin barrier is estimated as a 2cm thickness of normal tissue, a thick barrier as a 3cm thickness of normal tissue, and joint cartilage as 5cm thickness. Moreover, in all cases the surgical margin is considered to be curative if the margin is outside a barrier and there is normal tissue between the barrier and the reactive zone of the tumor. The results of the study were as follows.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Neoplasms↗
PubMed1989

[Bolus and maintenance infusion of high-dose methotrexate].

For 17 patients with bone and soft tissue sarcoma, 32 bolus and maintenance infusions of high-dose methotrexate (MTX) were performed to induce rapid elevation of plasma MTX concentration and to maintain it. At the doses of 200-300 mg/kg, plasma MTX concentrations were measured by enzyme assay. It needed four hours to reach the steady state by five hours' constant rate infusion, with the plasma plateau concentration at about 1 X 10(-3) M/L. On the other hand, bolus infusion of MTX needed only one hour to reach over 5 X 10(-4) M/L, and the plateau concentration lasted during the maintenance infusion period. By the constant rate infusion as well as bolus infusion, it was possible to maintain the plasma concentration over 1 X 10(-4) M/L for 12 hours, but both infusions can not maintain 1 X 10(-3) M/L for a long time. From these results, clinical effects of high dose MTX against sarcomas seemed to be evaluated by the plasma MTX plateau concentration and the maintenance time.

Bone Neoplasms↗
PubMed1989

[A case of aortitis syndrome with left coronary ostial stenosis treated by aorto-coronary bypass grafting].

A 22 years-old woman who was suffered from effort angina caused by aortitis syndrome was hospitalized. The coronary arteriogram showed the left main trunk stenosis more than 99% with the visualization of the left anterior descending and left circumflex through the co-lateral vessels from right coronary artery. After successful sequential aorto-coronary bypass grafting to left anterior descending artery, the patient has been free from anginal pain.

Adult↗
PubMed1989

[Distribution of the muscle coat at the pars pylorica in swine stomach].

Distribution of the muscle layers around the pars pylorica of the swine stomach was examined. In the antrum pyloricum of the pars pylorica, a distinct stratified structure of the tunica muscularis was found and the muscle bundles of the stratum longitudinale showed rectangular crossing over those of the stratum orbicularis. In the canalis pyloricus of the pars pylorica, on the contrary, stratified structure was indistinct. It is because the running direction of the muscle bundles changes continuously from longitudinal to orbicular layers. In the tunica muscularis of the canalis pyloricus, the authors successfully identified two wide streams of muscle bundles, which were supposed to play an important role in the mechanism of closing the ostium pyloricum. One of the streams was such muscle bundles that distributed annularly around the distal end of the canalis pyloricus forming a broad thick plate inside the curvature ventriculi major. The plate was thick at the curvatura ventriculi major, then became thin toward the curvature ventriculi minor, and finally disappeared. The second of the streams was such muscle bundles that distributed annularly in an area from distal to central part of the canalis pyloricus and, turning its direction to the distal end of the curvatura ventriculi minor, ran in the canalis pyloricus obliquely. Finally it entered into the torus pyloricus where it ran brush-wise, inclining distally, to the tip of the torus pyloricus, and ended as a stump-like form. It is clear that these two streams of muscle bundles functions to narrow the lumen of the distal portion of the canalis pyloricus at the phase of either contraction or relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Clinical and electrocardiographic characteristics of responders and nonresponders to class IA antiarrhythmic drugs.

A retrospective analysis of 44 patients was carried out to evaluate the efficacy of class IA antiarrhythmic drugs (disopyramide and/or procainamide), and of drugs of one or more other classes by means of 24-hour Holter recording. This study included only patients who exhibited 5000 or more ventricular premature complexes (VPCs) during a 24-hour pretrial baseline recording. The drugs that reduced the frequency of VPCs by at least 50% were considered effective. Eighteen patients (41%) responded to class IA drugs (responders) and 26 patients (59%) did not (nonresponders). There was a significant difference between the two groups in relation to the types of disease (p less than 0.01), but no significant difference with regard to other clinical and electrocardiographic characteristics. There was a significant discordance between trials of class IA drugs and class IC drugs (p less than 0.05). The efficacy of class IA drugs is very similar to that of class IB drugs, and only class IC drugs represent the highest efficacy in patients refractory to both class IA and class IB drugs. In conclusion, when ventricular arrhythmias do not respond to class IA or IB drugs, class IC drugs could be chosen as the next regimen.

Adult↗
PubMed1988

[Urinary beta 2-microglobulin as an indicator for impaired excretion of methotrexate].

Twenty cases treated with high-dose methotrexate (MTX) infusions were studied to determine whether urinary beta 2-Microglobulin (beta 2-M) is a reliable indicator to predict impaired excretion of methotrexate. Before and after MTX infusions, the levels of urinary beta 2-M were measured along with serum creatinine, uric nitrogen, and creatinine clearance. MTX clearance was found to be impaired in four of the 20 infusions, although concentrations of serum creatinine and uric nitrogen, and creatinine clearance were normal prior to the infusions. In the four cases that resulted in impaired excretion, a significant increase of beta 2-M levels was noted before and after the high-dose MTX infusion (p less than 0.01). Although one of the four cases showed a normal level of beta 2-M before the infusion, the post-infusion level of beta 2-M extremely high. This raised level of beta 2-M was thought to be caused by impaired excretion due to decreased amounts of urine. We conclude that urinary beta 2-M is a sensitive indicator of impaired excretion of high-dose MTX infusion, and especially when levels of more than 250 ng/ml of urinary beta 2-M are found to exist, it seems to difficult to clear the drug following high-dose MTX treatment.

Blood Urea Nitrogen↗
PubMed1988

[Procedures and results of limb salvage surgery of musculoskeletal sarcoma].

During the 8-year period beginning 1979, 116 cases of musculoskeletal sarcoma were treated by limb salvage operation. Of these, the local recurrence rate was 9% and the postoperative metastatic rate was 28%. The limb salvage rate was about 80%. Limb salvage procedures were generally performed using curative surgical procedures without preoperative adjunctive therapy. However, reduction of the surgical margin to achieve local cure was made possible by combined therapy with preoperative adjunctive chemotherapy or radiotherapy. The wide procedures combined with preoperative adjunctive therapy achieved a local curability rate equal to curative procedures. Marginal procedures following preoperative radiotherapy were also undertaken in those cases in which the tumor was located in an area for which curative or wide procedures were not feasible. Also, similar procedures were performed for patients of advanced age, patients with lung metastasis, patients who refused ablative surgery, and for extirpation of lymph node metastases. Accordingly, we were able to determine which procedures best ensure local curability. Also, the most significant prognostic factor was found to be local recurrence caused by inadequate surgical margin. This was especially true in the treatment of high malignant sarcoma. Moreover, from analysis of recurrent cases, the suggested factors contributing to local recurrence were: the invasive character of the tumor, lymph node metastasis, skip metastasis, tumor dissemination due to pathological fracture, previously performed inadequate surgery, venous invasion, and multicentrical occurrence of certain tumors.

Adult↗
PubMed1987

Biliary penetration of cefbuperazone in the presence and absence of obstructive jaundice.

In thirteen patients with normal liver function, the mean concentrations of cefbuperazone in hepatic bile, gall bladder bile and gallbladder tissue 30 min after injection were 1134.8 +/- 36.8 (mean +/- S.E.M.) mg/l, 6.6 +/- 3.0 mg/l and 26.1 +/- 7.6 mg/l, respectively. In patients with obstructive jaundice, cefbuperazone concentrations in bile were 99 +/- 29.2 mg/l (mean +/- S.E.M.) 1 h post-dose and decreased to 13.9 +/- 5.1 mg/l 6 h post-dose. In both groups of patients biliary concentrations of cefbuperazone were higher than the MICs of most organisms causing biliary infection.

Bile↗
PubMed1987

Development of the bovine ileal mucosa.

The development of the bovine ileal mucosa was studied with particular reference to maturation during the fetal and neonatal period. In this region, by 4-5 months of fetal development, vacuolation of the epithelial cells had occurred on the villi, and the goblet and absorptive cells in the crypts were present. By 6-9 months, the villi were longer and more numerous than in the previous stages. At the same time, the vacuolated cells could be seen predominantly on the upper half of each villus. The absorptive cells and goblet cells were more distinct in the crypt and lower half of each villus. Moreover, the goblet cells showed differences in mucin, while in the submucosa the lymphoid follicles were seen to have enlarged to become a prominent feature of the Peyer's patches at this stage. At birth, in suckled animals, the ileal cells on the lower area of each villus and in the crypt appeared more like mature cells. In contrast, there were numerous inclusion bodies in epithelial cells on the upper half of each villus. They appeared in the apical portion of the cytoplasm as vacuoles with stainable or dense contents. By 1 week, however, epithelial cells no longer contained inclusion bodies, and absorptive and goblet cell populations had begun to emerge from the crypts. These histological results suggest that the bovine ileal mucosa has two distinct turning points during its development in the fetus and the neonate. Initially all the mucosal structures are present in fetuses at 6-7 months of gestation, and then the vacuolated cells covering the ileal villi are replaced by mature, nonpinocytosing epithelium which emerges from the crypts on or before the 7th day after birth (ileal closure).

Animals↗
PubMed1987

[Intra-arterial infusion of cisplatinum in bone and soft tissue tumors].

Cisplatin was administered by intravenous injection, intra-arterial injection, and balloon-occluded arterial infusion. The total Pt, ultrafiltrated Pt, and free Pt levels were measured. Intra-arterial injection, in which ultra-filtrated Pt level on the normal side is the same as in intravenous injection, acts to increase the ultrafiltrated Pt level on the affected side. Thus, intra-arterial injection is as effective as preoperative chemotherapy. In two-route chemotherapy, free Pt level on the affected side is extremely high, so for only local control of tumors, two-route chemotherapy is very effective.

Animals↗