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Biomedical subjects

N Miyazawa

Publications and source records attributed to N Miyazawa.

At least 109 records · Page 6Linked to original sources
PubMed1990

Phase II study of 5-day continuous infusion of cis-diamminedichloroplatinum(II) in the treatment of non-small-cell lung cancer.

cis-Diamminedichloroplatinum(II) (CDDP) was given as a single agent at a dose of 25 mg/m2 daily for 5 days by continuous infusion; treatment was repeated every 4 weeks in 30 previously untreated patients with advanced non-small-cell lung cancer (NSCLC). The median age of the patients was 61 years; 13 patients had limited disease and 17, extensive disease. The overall response rate was 40% (12/30; 95% confidence limits, 23-58%), with a median survival of 8 months. Vomiting was observed in 37% of patients; elevated serum creatinine levels (greater than 1.5 mg/dl), in 7%; leukopenia (less than 3,000/mm3), in 39%; thrombocytopenia (less than 70,000/mm3), in 26%; and anemia (hemoglobin less than 9.5 g/dl), in 60% of patients. In all cases, these toxicities were mild and transient, requiring no dose modification. The exposure to filterable platinum, determined from the area under the concentration-time curve, was 9.08 +/- 3.21 micrograms h ml-1. We conclude that CDDP given by 5-day continuous i.v. infusion is safe and effective for treatment of NSCLC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Preparation and characterization of monoclonal antibodies to an N-linked oligosaccharide.

Two monoclonal antibodies to an N-linked oligosaccharide, MT-5 and MT-9, have been prepared by immunization with a pyridylaminated, asialylated, galactosylated, fucosylated, bisected biantennary sugar. The reactivity of these antibodies was monitored by their reaction with human asialoglycophorin in a solid-phase enzyme-linked immunosorbent assay. Both antibodies reacted with the sugar chains of various human glycoproteins such as immunoglobulin G, transferrin, gamma-glutamyl transpeptidase, alpha 1-acid glycoprotein, and alpha-fetoprotein. Treatment of asialoglycophorin with beta-N-acetylhexosaminidase or alpha-mannosidase resulted in reduction of the binding to these antibodies. The reactivity of MT-5 to asialoglycophorin was slightly inhibited by D-mannose and N-acetylglucosamine, whereas that of MT-9 was inhibited by D-mannose, N-acetyl-D-glucosamine, chitobiose, and L-fucose. The epitope specificity of MT-5 appears to be a sugar chain containing biantennary N-acetyl-D-glucosamine residues, the bisected N-acetyl-D-glucosamine residue, and a trimannosyl core. The epitope to which MT-9 is directed may be a complex made up of beta-mannose, chitobiose, and L-fucose. These studies indicate that immunization with pyridylaminated sugars can produce antibodies that recognize N-linked oligosaccharides. Monoclonal/polyclonal antibodies to the N-linked sugar chains of glycopeptides would be useful in such studies of proteins.

Antibodies, Monoclonal↗
PubMed1990

Small nodular lesions in the lung periphery: new approach to diagnosis with CT.

To evaluate relationships between lesions in the lung periphery and surrounding structures, particularly vessels and bronchi, axial multiplanar reconstruction (AMPR) computed tomography (CT) was used to study 26 patients who underwent surgical resection of pulmonary nodules less than 3 cm in diameter. Findings at AMPR CT, conventional CT, and digital radiographic tomography were compared with findings obtained at evaluation of the resected specimen with regard to the ability to display the relationships between vessels, bronchi, and lesions. AMPR CT was significantly superior to conventional CT and digital radiographic tomography in detecting involvement of pulmonary vessels (P less than .001). Involvement of pulmonary veins was seen in all lung cancers, whereas such involvement was seen in only one of eight nonneoplastic lesions. Thus, involvement of pulmonary veins is strongly suggestive of malignancy. AMPR CT permits three-dimensional visualization and morphologic assessment of pulmonary nodules.

Adenocarcinoma↗
PubMed1990

[A case of invasive thymoma displaying endobronchial polypoid growth].

A 58-year-old woman was admitted due to an abnormal shadow on chest X-ray film and two episodes of hemoptysis during the past two years. Chest radiography showed a mass with calcification in the left upper lobe of the lung. A white polypoid lesion in left B3b + c bronchus was discovered by fiberoptic bronchoscopy. Biopsy specimen of the polypoid lesion demonstrated fungi like aspergilli in the necrotic tissue. We suspected pulmonary aspergillosis combined with old tuberculosis and treated with antifungal and antituberculous drugs. After nine months, however, we recognized that the mass had become larger radiologically. A polypoid tumor with a brown, glossy surface in the left B3 bronchus was again noted endoscopically. Histologic findings of the biopsy specimen obtained from this tumor were suggestive of thymoma. Thymectomy and left upper lobectomy were performed. The cross-section of the surgical specimen revealed that the tumor extended not only in the mediastinum but also in the pulmonary parenchyma with polypoid growth into the lumina of bronchi. Microscopically, the tumor was an invasive thymoma composed of both epithelial and lymphocytic elements.

Bronchi↗
PubMed1990

[A resected case of endobronchial metastasis from breast carcinoma].

A 54-year-old woman, who had received left radical mastectomy 12 years previously, was admitted with persistent cough and hemoptysis. Plain chest X-ray film showed no abnormality but fiberoptic bronchoscopy revealed that a polypoid lesion occluded the right truncus and the surrounding bronchial mucosa was firm and edematous. Biopsy specimen demonstrated adenocarcinoma. Right middle and lower sleeve bilobectomy was performed. The tumor occupied mainly the outer and submucosal layer of the bronchial wall. Histologically, this tumor showed scirrhous adenocarcinoma with the same pathologic appearance as the primary breast lesion. It is considered that endobronchial metastasis from breast carcinoma is not particularly uncommon, therefore any patient with a past history of breast cancer and respiratory symptoms should undergo fiberoptic bronchoscopy, particularly when the chest X-ray is normal or shows non-specific changes.

Adenocarcinoma↗
PubMed1990

[Comparison of intravenous buprenorphine or fentanyl and epidural buprenorphine for pain relief after upper abdominal surgery].

In three groups [(1) intravenous buprenorphine (0.1mg) or (2) fentanyl (100 micrograms.hr-1) and (3) epidural injection of buprenorphine (0.1mg diluted with 10ml normal saline)], we determined the effects of postoperative pain relief in patients after upper abdominal surgery. There are no differences in postoperative analgesia in the three groups, but respiratory depression was seen in some patients who had intravenous buprenorphine or fentanyl. We conclude that epidural injection of buprenorphine is a useful method for postoperative analgesia because of little adverse effect. As respiratory depression caused by buprenorphine was reversed with naloxone, it is not necessary to employ fentanyl instead of buprenorphine.

Abdomen↗
PubMed1989

Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up.

Pulmonary resection of metastatic lesions from colorectal cancer was performed in 62 patients, and their cumulative 5-year and 10-year survival rates were 42% and 22%, respectively. The overall median survival was 24 months. The survival curve decrease even after 5 years after pulmonary resection; four of 13 patients who survived more than 5 years subsequently died of metastatic disease and only two patients survived more than 10 years. The number and size of the pulmonary metastases were significantly correlated with postthoracotomy survival. Solitary metastases less than 3.0 cm in diameter were good indicators of favorable postthoracotomy survival. There were no significant differences in survival based on Dukes' classification or location of the primary lesion. Sex, age, disease-free interval between the primary tumor and appearance of metastasis, and extent of pulmonary resection had no influence on survival. It is impossible to say from our experience that surgical resection of pulmonary metastases increased the cure rate. Presumably a good 5-year survival rate after thoracotomy would be a reflection of a length bias caused by the biologic behavior of the metastatic pulmonary lesions.

Colonic Neoplasms↗
PubMed1989

[Multiple myeloma manifesting as a solitary cranial tumor. Case report].

A 76-year-old female struck her head in the parietal region and noticed a soft scalp mass. Approximately 3 months later, the mass was enlarged and she was evaluated at a local hospital. Although the tentative diagnosis was old subcutaneous hematoma, incision of the scalp revealed not hematoma but rather a tissue and bony defect. On admission to the authors' institution, she was found to have a round, smooth, subcutaneous mass in the upper left parietal region. The tumor was about 5 cm in diameter and 4 cm in height, and was soft, nonpainful, and pulsatile. Plain X-rays revealed an osteolytic lesion in the left parietal bone. Computed tomography demonstrated a high-density lesion corresponding to the bony defect, which was homogeneously enhanced by contrast material. Left external carotid angiography showed the mass to be vascular, its main feeder being the middle meningeal artery. It was concluded that the tumor originated from the diploë. The tumor was subtotally removed, and histopathological examination showed it to be a plasmacytoma. Laboratory tests, including protein electrophoresis, disclosed hypergammaglobulinemia with M-spikes. Immunoelectrophoresis demonstrated a serum paraprotein of immunoglobulin G kappa specificity. Multiple myeloma diffusely involving bone is well known, but a soft mass alone with a bony defect in the cranial vault is very rare. The clinical features and treatment of silent, solitary masses associated with multiple myeloma are discussed.

Aged↗
PubMed1989

[Brain metastasis of ovarian cancer treated by chemotherapy including cis-platin: a case report].

A 57-year-old woman was admitted to our department with headache and dizziness. About 8 months ago, she suffered from ovarian cancer disseminated in pleura and peritoneum, and was treated successfully with CAP therapy only (Cis-platin, Adriamycin and Cyclophosphamide). Intracerebellar metastasis of ovarian cancer was suspected on CT scan, and CAP therapy was employed again. She was relieved from all symptoms a week after starting the therapy. Follow up CT scan showed complete remission of the lesion. She was well for about 3 months, but was admitted again because of consciousness disturbance and headache with multiple brain metastasis. PVB therapy (Cis-platin, Vinblastine and Pepleomycin) was employed this time, and complete remission was seen again. But regrowth of intraabdominal mass lesion appeared, and she died from multiple organ failure 5 months after PVB therapy. Autopsy was not permitted, but CT scan 3 days before death revealed no intracranial lesion. Distant metastasis of ovarian cancer may become more prevalent with the development of combination chemotherapy, but no case of brain metastasis has been reported to have been treated with chemotherapy only. The authors suggest the possibility of successful treatment of such a lesion with chemotherapy including Cis-platin.

Adenocarcinoma↗
PubMed1989

[Pilot phase II study of 5-day continuous infusion of cisplatin in treatment of non-small cell lung cancer].

We administered cisplatin (CDDP) as a single agent at a dose of 25 mg/m2/day for 5 days by continuous infusion in 15 patients with inoperable non-small cell lung cancer (3 squamous cell carcinoma, 11 adenocarcinoma and 1 large cell carcinoma), and studied the pharmacokinetics of CDDP, the response rate and toxic effects. The maximum concentration (Cmax) of filtrable platinum (Pt) was 0.092 +/- 0.03 microgram/ml and AUC was 9.3 +/- 3.5 micrograms.hr/ml. The response rate was 40% (6/15). Nausea without vomiting was noticed in 53% of patients and vomiting in 27%. Leukopenia (less than 3,000/mm3) was seen in 53%, thrombocytopenia (less than 70,000/mm3) in 27% and anemia (Hb less than 9.5 g/dl) in 67%. Peak serum creatinine greater than 1.5 mg/dl was not observed. The Cmax of the filtrable Pt was low but AUC level was high compared with that in reported data in which CDDP as a single agent was infused at the same dose in short-term infusion. This was presumably associated with the good response rate in this study. The incidence of hematologic toxicity was slightly high, while that of vomiting and nephrotoxicity was rather low. The 5-day continuous infusion appears to be a safe and effective method of CDDP administration for non-small cell lung cancer, and improved therapeutic results may be expected when this is combined with other effective drugs.

Adenocarcinoma↗
PubMed1989

Epidermoid tumors of Meckel's cave: case report and review of the literature.

Lesions of Meckel's cave are extremely uncommon and difficult to diagnose. The symptoms and signs are variable, and the lesions may not appear on routine roentgenographic or computed tomographic examination. A patient with a small epidermoid tumor of Meckel's cave that was diagnosed by magnetic resonance imaging is herein reported. The epidermoid appeared as a low-intensity mass on the T1-weighted image and as a high-intensity mass on the T2-weighted image. Coronal sections defined the anatomic relationship to the trigeminal nerve. Preoperative recordings of the trigeminal sensory evoked response may be predictive of postoperative recovery of neurological deficits. Furthermore, intraoperative recording was extremely useful in avoiding inadvertent neurological injury. Review of the literature confirms the rarity of this lesion and the usefulness of magnetic resonance imaging in diagnosing it, although based on a limited number of cases.

Adult↗
PubMed1988

Intraoperative monitoring of the motor function: experimental and clinical study.

Manipulation of the lesions adjacent to the primary motor area or the motor pathway is troublesome for neurosurgeons because they lack an effective method to determine the primary motor area or to monitor motor function in the operative room. It will be of great value to establish a monitoring method of the corticospinal tract under general anaesthesia. We recorded the motor evoked potential (MEP) from direct motor cortex stimulation in cats and showed that it derives almost purely from the corticospinal tract. Then we used this technique during the operation of the resection of tumours near the primary motor area or the motor pathway. 1. Experimental study: Twenty adult cats were used in this study. Recording electrodes were flexible bipolar catheter electrodes inserted into the spinal epidural space. Stimulating electrodes were silver ball electrode on the cortex (anode) and needle electrode in the temporal muscle (cathode). Stimulation of 4-24 V, 5-10 Hz and 0.2 msec in duration were done and evoked potentials signals were averaged 60 to 512 times. MEP with multiple peaks was obtained that had a 112 msec conduction velocity in the spinal cord. We found the same signals from the stimulation of ipsilateral cerebral peduncle. Radiofrequency lesioning of ipsilateral cerebral peduncle produced a loss of MEP. These results show that MEP derives from the corticospinal tract. Significant wave form change, with components of short latency, was noted by the excessively intense stimuli. We supposed that superimposition of the signals from the extrapyramidal pathways, excited in the brain stem, results in this change.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗