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Biomedical subjects

N Kodama

Publications and source records attributed to N Kodama.

At least 73 records · Page 4Linked to original sources
PubMed1996

Dose-escalation study of oral etoposide and carboplatin in patients with advanced lung cancer.

A dose-escalation study of daily etoposide and carboplatin was carried out on 23 patients with advanced lung cancer using a starting dose of 40 mg/m2/day etoposide given orally for 21 days and 250 mg/m2 carboplatin given intravenously (IV) on day 1. A total of 41 courses were given. Myelosuppression was the major dose-limiting toxicity. The maximum tolerated dose was reached at the fourth level with 40 mg/m2/day etoposide for 21 days and 400 mg/m2 carboplatin on day 1, once every 4 weeks. Non-hematological toxicities were generally mild or reversible. The recommended doses of this combination chemotherapy are 40 mg/m2/day etoposide for 21 days and 350 mg/m2 carboplatin on day 1. The response rate for non-small cell lung cancer and small cell lung cancer was 16.7% and 60% (95% confidence intervals of 3.6% to 41.4%, and 14.7% to 94.7%), respectively. A phase II study is necessary to define the efficacy and safety of this combination chemotherapy.

Administration, Oral↗
PubMed1996

Determinants of myelosuppression in the treatment of non-small cell lung cancer with cisplatin-containing chemotherapy.

Data on 16 potential risk factors for myelosuppression were assessed in 134 patients who received either vindesine and cisplatin (VP) or mitomycin C, vindesine and cisplatin (MVP) for inoperable stage III or IV non-small cell lung cancer in a randomized trial. Determinant factors for myelosuppression were evaluated by using univariate analysis and the logistic regression model. Recursive partitioning and amalgamation (RPA) was also used to define patient subgroups frequently suffering from severe bone marrow toxicity. Overall, 33 (25%) of 134 patients experienced at least one episode of grade 4 leukopenia. In univariate analysis, age, body surface area, serum creatinine, and pretreatment hemoglobin concentration were associated with severe leukopenia. A multivariate analysis using the logistic regression method showed that only raised creatinine level was an independent predictor for grade 4 leukopenia (P = 0.049). The RPA model generated three distinct subgroups based on age, body surface area and regimen. The three subgroups were distinguished by the frequency of severe (grade 4) leukopenia (50%, 25%, and 2.4%, respectively) (P < 0.001). Grade 4 leukopenia occurred more frequently in patients in class 3 (age > or = 65 years and treatment with MVP). The RPA model was useful in identifying the risk factors for myelosuppression induced by cisplatin-based chemotherapy, and in defining patient subgroups with elevated risk of toxicity.

Adult↗
PubMed1996

Partial monosomy 10q and partial trisomy 9q with anal atresia due to maternal translocation: t(9;10)(q32;q26).

We report a case of a boy with a partial deletion of the long arm of chromosome 10 and partial duplication of the long arm of chromosome 9 due to maternal balanced translocation. The karyotype was 46,XY,-10, +der(10)t(9;10)(q32;q26)mat. Our patient had imperforate anus and as this finding is usually not observed in association with trisomy 9q, it suggests that partial monosomy of the long arm of chromosome 10 might be associated with anogenital anomalies.

Abnormalities, Multiple↗
PubMed1996

Deletion polymorphism in the angiotensin I converting enzyme (ACE) gene as a genetic risk factor for sarcoidosis.

BACKGROUND: Genetic control of serum angiotensin I converting enzyme (SACE) levels has been suggested. A study was undertaken to elucidate the role of this polymorphism in sarcoidosis. METHODS: Three hundred and forty one unrelated healthy controls and 103 consecutive patients with sarcoidosis participated in the study. SACE levels and an insertion/deletion (I/D) polymorphism in intron 16 of the ACE gene were studied in each subject and new reference intervals for SACE activity for each genotype were determined. The difference in genotype and allele frequencies between controls and patients was analysed and odds ratios were calculated to estimate the relative risk. RESULTS: A significant association was seen between ACE gene polymorphism and SACE levels in both patients and controls. The new reference intervals for each genotype discriminated abnormal SACE levels in patients more accurately, especially those with genotype II. In women the frequencies of allele I were 0.68 (allele D 0.32) in controls and 0.58 (allele D 0.42) in patients, and the difference between the two female groups was significant (p < 0.05). Thus, an excess of genotype ID or DD was observed in female patients (odds ratio 2.18; 95% confidence interval 1.18 to 4.01; p = 0.01). CONCLUSIONS: These findings suggest that ACE gene polymorphism is associated with SACE levels in both patients with sarcoidosis and controls. ACE gene polymorphism should be further evaluated as a candidate marker for an increased risk of sarcoidosis.

Adult↗
PubMed1996

Bilateral internal carotid artery disease secondary to cervical radiation. A case report.

A patient with radiation-induced bilateral carotid artery disease is presented. A fifty-six-year-old man was admitted to hospital for evaluation of recurrent transient ischemic attacks. He had received cervical radiation for pharyngeal squamous cell carcinoma five years earlier. The radiation was directed at the cervical fields bilaterally and the anterior cervical field using x-rays for a total of 120 Gy. Computed tomography of the brain obtained at admission revealed a low-density area in the right parietal lobe. Carotid arteriograms revealed a completely occluded right internal carotid artery and a severely narrowed left internal carotid artery. There was good collateral supply from the posterior communicating arteries to the internal carotid arteries, bilaterally. The patient was medically treated with anticoagulant and antiplatelet therapy and has been free of subsequent cerebral ischemic attacks.

Carcinoma, Squamous Cell↗
PubMed1996

Multimodal evoked potentials in Alzheimer's disease and Binswanger's disease.

Somatosensory evoked potentials (SEPs), brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs), and auditory event-related potentials (ERPs) were studied in 15 patients with Alzheimer's disease (AD), eight patients with Binswanger's disease (BD), and 15 normal subjects. Patients with BD showed significant prolongation of the interpeak latency between N13 and N20 (N13-N20) and N20-P40 of SEPs as compared with the normal controls, whereas patients with AD only demonstrated significant prolongation of N20-P40. The interpeak latency between waves I and V of BAEPs in patients with both AD and BD was significantly longer than that of controls. There were no significant differences in P100 latency of VEPs among these three groups. Both groups with dementia showed significant prolongation of N200 and P300 latencies of ERPs compared with normal controls. In addition, patients with AD showed significant prolongation of P200 latency. We conclude that these two dementing diseases have different electrophysiologic features that may be related to their underlying pathogenetic mechanisms. Furthermore, the measurement of multimodal evoked potentials may be helpful in the differential diagnosis of AD and BD.

Aged↗
PubMed1996

Binaural interaction of stapedius reflex.

It is known that stapedius reflex (SR) shows bilateral interaction and that its center is located in the brainstem. In the present study, the pattern of SR was compared in two different conditions, either with binaural acoustic stimuli or with monaural stimuli using the impedance measurement method. When the sound source was placed in front of the head model, the amplitude of impedance change was higher in the binaural hearing condition than in the monaural condition, suggesting bilateral superposition. When the sound source was placed laterally to the head model, the amplitude of impedance change was higher in the ipsilateral ear than in the contralateral ear in the binaural condition. In the monaural condition, the amplitude of impedance change in the ipsilateral ear was as high as that obtained in the ipsilateral ear in the binaural condition, whereas it was markedly low in the contralateral ear. It is assumed that sense of sound direction cannot be well maintained without binaural interaction of SR.

Acoustic Impedance Tests↗
PubMed1996

Aneurysm formation and rupture at the site of anastomosis following bypass surgery. Case report.

Four years after undergoing a superficial temporal artery-middle cerebral artery bypass procedure, this patient presented with a ruptured aneurysm at the anastomosis site. The ruptured aneurysm caused subarachnoid and intracerebral hemorrhages and was treated by surgically clipping its neck. Characteristics of the aneurysm included: 1) a relatively large size (8 x 6 x 6 mm): 2) a thickened wall; 3) a location apart from the suture line; 4) a projection in a direction consistent with hemodynamic stress; and 5) a time interval from bypass surgery to rupture that lasted 4 years. These features, along with the well-known fact that hemodynamic stress can cause aneurysms, led the authors to believe that this aneurysm was a true one. The authors present a case of this unusual complication following bypass surgery and provide a brief review of the literature.

Anastomosis, Surgical↗
PubMed1996

Olfactory evoked potentials: experimental and clinical studies.

Olfactory evoked potentials (OEPs), obtained by electrical stimulation of the olfactory mucosa, were recorded in dogs and humans to develop an objective method for evaluating olfactory functions. In dogs, OEPs were recorded from the olfactory tract and the scalp. The latency of the first negative peak was approximately 40 msec. A response was not obtained after stimulation of the nasal mucosa and disappeared after sectioning of the olfactory nerve. With increasing frequencies of repetitive stimulation, the amplitude was reduced, suggesting that the response was synaptically mediated. These results demonstrate that evoked potentials from the olfactory tract and the scalp following electrical stimulation of the olfactory mucosa originate specifically from the olfactory system. In humans, a stimulating electrode with a soft catheter was fixed on the olfactory mucosa. The OEPs from the olfactory tract, recorded with a negative peak of approximately 27 msec, had similar characteristics to OEPs found in dogs. The OEPs from the olfactory tract in humans also originate specifically from the olfactory system. The authors postulate that OEPs obtained by electrical stimulation of the olfactory mucosa may prove useful for intraoperative monitoring of olfactory functions.

Animals↗
PubMed1995

Pneumocephalus caused by fistulas of the mastoid air cells treated with a temporoparietal fascial flap.

Using a temporoparietal fascial flap and hydroxyapatite ceramics, we treated a patient for complications after a neurosurgical operation for glossopharyngeal neuralgia. These consisted of pneumocephalus and cerebrospinal fluid rhinorrhea resulting from fistulas of mastoid air cells associated with a subcutaneous dead space. By means of the temporoparietal fascial flap, we were able to fill the dead space and reinforce the repaired dural and mastoid lesion as well. Hydroxyapatite ceramics were also useful for closing the mastoid air cell fistulas.

Bone Diseases↗
PubMed1995

Mannose-binding protein recognizes glioma cells: in vitro analysis of complement activation on glioma cells via the lectin pathway.

The lectin pathway is a novel pathway for activation of the complement cascade, which is initiated by the binding of mannose-binding protein (MBP) to its carbohydrate ligands. We investigated whether the complement system was activated in vitro by glioma cells through this pathway to the C3 level. MBP was found to bind to all six glioma cell lines tested by using flow cytometric analysis. Binding of a complex of MBP-associated serine protease and MBP was observed in two of the cell lines examined, thereby resulting in C4 consumption. Activation of C3 was hemolytically evaluated in these two lines. C3 consumption was also observed in one. Based on these results, it is likely that recognition by MBP followed by complement activation occurs in certain glioma cell lines.

Carrier Proteins↗
PubMed1995

Association between high serum total IgE levels and D11S97 on chromosome 11q13 in Japanese subjects.

The genetic linkage of atopy to chromosome 11q13 through maternally derived alleles has been previously reported. Linkage analysis in Japanese families did not confirm the existence of a major gene for atopy at this locus under the model of autosomal dominant inheritance. However, we observed a significant association between serum total IgE levels and genetic markers at this locus both in 14 Japanese atopic families and in 120 unrelated Japanese subjects. We detected eight alleles at the D11S97 locus and eight alleles in the CA/GT repeat region in the fifth intron of the Fc epsilon RI beta gene. A significantly increased frequency of the D11S97/PstI 0.96 kb allele was observed in the chromosomes of the subjects with high serum total IgE levels both in the family study (p < 0.001) and in the population study (p < 0.05). However, multipoint linkage analysis again did not show any evidence for the existence of a major gene regulating atopy on chromosome 11q13 with location scores to -35 under the model of maternal inheritance. Evidence against linkage was confirmed by the non-parametric linkage analysis, using the affected pedigree member method. Also, there was no substitution of isoleucine for leucine in the fourth transmembrane domain of Fc epsilon RI beta (Leu181), which was reported to be responsible for a subset of atopy in the British population. Therefore, the association of serum total IgE levels with chromosome 11q13 indicates that a gene or genes at this locus may contribute to the expression of high IgE levels in the Japanese population as well as in the British population, but the heterogeneity of the genetic regulation of serum total IgE levels is evident between the two populations.

Adolescent↗
PubMed1995

Phase II study of concurrent radiotherapy and chemotherapy for unresectable stage III non-small-cell lung cancer. Southern Osaka Lung Cancer Study Group.

PURPOSE: To evaluate the response rate, toxicity, and 2-year survival rate of concurrent radiotherapy and chemotherapy for unresectable stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Between July 1989 and October 1990, 65 patients with histologically or cytologically proven unresectable stage III NSCLC without T3N0-1M0 disease were entered onto this study. Sixty-one patients were eligible for response, survival, and toxicity analysis. Chemotherapy consisted of vindesine (3 mg/m2 on days 1, 8, 29, and 36), cisplatin (100 mg/m2 on days 1 and 29), and mitomycin (8 mg/m2 on days 1 and 29). Radiotherapy was administered for 3 weeks (2 Gy given 13 times, five fractions per week), followed by 10-day rest periods and then the previous schedule of radiotherapy repeated for 3 weeks. RESULTS: Of 61 eligible patients, 53 (86.9%) had a partial response (PR). The median response duration was 39.1 weeks (range, 8.4 to 163+). The median survival time was 16 months and the 2-year survival rate was 36.7%. Of 53 responding patients, 10 (16.4%) are alive and disease-free after 2 years. The major toxicity was leukopenia (> or = grade 3, 95%). Other toxicities of > or = grade 3 included thrombocytopenia (45%), anemia (28%), nausea/vomiting (16%), fever (11%), and esophagitis (6%). Treatment-related death occurred in two patients. One patient died of pulmonary toxicity (interstitial pneumonitis) and the other of esophagobronchial fistula with pulmonary infection. CONCLUSION: Concurrent radiotherapy plus chemotherapy with mitomycin, vindesine, and cisplatin (MVP) can be safely administered to patients with stage III NSCLC, with excellent response rates and 2-year survival rates.

Adult↗
PubMed1995

Transthird ventricular approach for a high basilar bifurcation aneurysm. Report of three cases.

Three cases of ruptured aneurysm at the basilar bifurcation accompanied by megadolichobasilar anomaly were successfully treated using a transthird ventricular approach. A translamina terminalis approach was used to enter the third ventricle. In two cases, the floor of the third ventricle had been partly destroyed by aneurysm rupture, and a small split in the third ventricular floor was necessary to gain a wide operative field. In the third case, an intact floor was opened along the midline. Clipping was accomplished in all three cases after preserving the perforating arteries. Postoperatively, no complications from splitting the floor were observed. Key surgical points and the prospective view of the transthird ventricular approach are discussed.

Aged↗
PubMed1995

[Traumatic carotid-cavernous aneurysm after removal of cancer of the upper jaw: a case report].

A case of a traumatic carotid-cavernous aneurysm after removal of cancer of the upper jaw was reported. A 63-year-old male complaining of massive epistaxis from the left nostril was admitted to our clinic. He had suffered from cancer of the left upper jaw and had been treated with radical operation. During the surgical procedure, massive bleeding which was considered to be from the left internal carotid artery, suddenly occurred. The hemorrhage was somehow controlled by packing with oxidized cellulose. He experienced recurrent massive epistaxis after admission. Cerebral angiograms revealed an anterior-medially projecting aneurysm arising from the cavernous portion of the left internal carotid artery. He had a good cross circulation from right to left on compression of the left carotid artery. This aneurysm at the carotid-cavernous portion was produced as a result of injury during an operation for cancer of the upper jaw. To prevent disastrous bleeding from the aneurysm, the aneurysm was then successfully treated by the trapping of extra-and intracranial carotid ligation in combination with left STA-MCA anastomosis. There was no recurrence of epistaxis after the operation. However, a low-grade fever persisted before operation and a blood culture showed MRSA sepsis after the operation. Intensive chemotherapy was performed for this MRSA sepsis, he died of the accompanying DIC. Although aneurysmal epistaxis following a severe closed head trauma is a well-known phenomenon, an iatrogenic carotid-cavernous aneurysm presenting with recurrent massive epistaxis is rare. Several comments were made about the iatrogenic carotid cavernous aneurysm, and the necessity of early diagnosis and treatment was emphasized.

Aneurysm, Ruptured↗
PubMed1995

[Chronic subdural hematoma with bleeding tendency; clinical analysis of 11 surgical cases].

Eleven patients with chronic subdural hematoma (CSDH) with bleeding tendency (BT) were surgically treated in the last 12 years. To study the clinical problem of CSDH with BT, 11 surgical cases were divided into 3 groups, Group A; CSDH with primary BT (1 case of hemophilia A), Group B; CSDH with BT secondary to a basic disease (3 cases of leukemia, 2 cases of malignant tumor with DIC, 1 case of chronic renal failure and 1 case of liver cirrhosis), Group C; CSDH with BT by anticoagulants (warfarin) (2 cases of replacement of mitral valve, 1 case of A-C bypass). Evacuation of the hematoma was performed by means of one or two burr holes with irrigation of the hematoma cavity and a drainage tube was placed in the subdural space. The outcome was excellent in Groups A and C. In Group B, two patients with DIC due to gastric cancer and prostatic cancer died, and 3 patients with leukemia recovered dramatically from CSDH, but the poor course of the disease itself resulted in death. The outcome of other patients in Group B was excellent. Since CSDH with BT is often fatal, those patient had usually been treated conservatively. However, from this analysis, we stress that CSDH with BT should be surgically treated after checking the blood conditions carefully to determine whether or not the patient has need for surgery.

Adult↗