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Biomedical subjects

T Kotake

Publications and source records attributed to T Kotake.

At least 199 records · Page 11Linked to original sources
PubMed1988

Computed tomographic diagnosis of enterovesical fistulae: barium evacuation method.

We reviewed and compared the computed tomographic (CT) findings for 5 patients suspected of having enterovesical fistulae with convential radiographic studies and the results of cystoscopy. Prior to scanning, patients were rectally administered 200 ml of 0.8% wt/vol barium solution, and then evacuated before they were administered 200 ml of olive oil via the anus and 100 ml of olive oil via the urethra. The CT following the barium evacuation successfully demonstrated the enterovesical fistulae in 4 patients. It was also diagnostic in a clinically suspected case in verifying the absence of an enterovesical fistula.

Barium Sulfate↗
PubMed1988

LH-RH agonist, Zoladex (Goserelin), depot formulation in the treatment of prostatic cancer. Randomized dose-finding trial in Japan.

Ninety patients with advanced prostatic cancer (15 with stage B, 23 with stage C, and 52 with stage D) were randomized to receive 0.9, 1.8, or 3.6 mg, respectively, of Zoladex depot subcutaneous injection every 28 days for 12 weeks. The serum levels of LH, FSH, and testosterone were elevated after the first injection, and followed by a significant decrease. The suppression of testosterone levels in the blood to castrate levels was observed in all patients except two treated with 0.9 mg. Objective response (CR and PR) was seen in 63.6% (0.9 mg), 47.8% (1.8 mg), and 68% (3.6 mg) of patients according to the Japanese Prostatic Group Criteria. Subjective improvement (performance status, analgesic consumption) was also observed in 75-88% of patients but without a statistically significant difference between each dose group. Only minor adverse effects were found during the treatments. The drug was detected dose dependently in the blood by radioimmunoassay. These results suggest that endocrine therapy with Zoladex depot in doses of 3.6 mg subcutaneously every 4 weeks is a useful alternative to surgical castration in patients with prostatic cancer.

Aged↗
PubMed1988

Vesical dome tumors: significance of extravesical extension on CT.

Thirteen cases of vesical dome tumors were diagnosed on the basis of computed tomographic (CT) findings. Six were urachal carcinomas, and seven were of vesical origin. All six urachal carcinomas were characterized by predominantly extravesical growth along the urachus; the seven vesical carcinomas did not demonstrate this finding. Calcification in the soft-tissue-density mass was detected in three of the six urachal carcinomas and in none of the vesical carcinomas. The CT finding of vesical dome tumor was an important factor in the choice of management.

Adenocarcinoma↗
PubMed1988

[The current management of testicular cancer].

The dramatic improvements made in the management of testicular cancer provides one of the most advances in oncology over the last decade. Many developments in chemotherapy, particularly the introduction of cis-platinum, have been largely responsible for this dramatic improvement. Although 70% of patients with disseminated testicular cancer will achieve a disease-free status with PVB or VAB-6 therapy, there still remains a patient population eligible for salvage therapy. There are still about 30% of patients who have unresectable PR (or no response at all to primary chemotherapy) and another 10% who will relapse from a chemotherapy-induced CR. Approximately 20-40% of these refractory cases can be salvaged and potentially cured with cisplatin +VP-16 or VM-26 combination salvage chemotherapy. Furthermore 10-20% of these patients are eligible for salvage surgery when serum marker results are negative. The treatment goal for this disease is cure. To achieve disease-free status, an adequate combination of chemotherapy, surgery and radiation therapy is essential.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Endocrine therapy of prostatic carcinoma with slow release (depot) formulation of the LH-RH analog ICI 118630 (Zoladex)].

To investigate the clinical efficacy, safety and endocrinology of ICI 118630 (Zoladex) depot formulation at 3 different dose levels (0.9, 1.8 and 3.6 mg), 90 patients were randomized to receive either one of the 3 doses from April, 1985 to March, 1986 in 28 centers. The depot preparation was injected subcutaneously every 4 weeks 3 times (for up to 12 weeks). Clinical efficacy was evaluated in terms of tumor response and overall subjective response. In 70 patients eligible for tumor response evaluation, 14 out of 22 (63.6%) in the 0.9 mg group, 11 out of 23 (47.8%) in the 1.8 mg group, and 17 out of 25 (68.0%) in the 3.6 mg group showed clinical improvement, that is, either complete response or partial response. In 72 eligible patients for overall subjective response evaluation, clinical subjective improvement was observed in 75.0, 81.8 and 88.0% of the patients in the 3 groups, respectively. There was no significant difference between the groups. As for endocrinology, there were 75 eligible patients. Endocrinological effect was observed in 23 out of 25 (92.0%) in the 0.9 mg group, 100% in both 1.8 mg and 3.6 mg groups. There was no significant difference between the groups. Castration was achieved by week 3.5 +/- 1.7 of therapy on average and by week 2 in the earliest case. There was no significant difference in incidence of side effects between the 3 groups: 5 out of 26 (19.2%) in the 0.9 mg group, 8 out of 29 (27.6%) in the 1.8 mg group, and 2 out of 30 (6.7%) in the 3.6 mg group. Flares presented as an increase in bone pain in 2 and as ureteric obstruction in 2 all in the 1.8 mg group but none in the other 2 dose groups. These flares disappeared on further treatment with Zoladex. These patients showed a clinical-response. The blood level of Zoladex was dose dependent, reaching its peak at week 2 of therapy in all 3 dose groups. There was no evidence of accumulation. Since these results demonstrate that 3.6 mg produces medical castration earlier, it may well be considered as an optimal dose in men.

Buserelin↗
PubMed1988

[Clinical efficacy of long-term treatment with LH-RH analogue, ICI 118630 (Zoladex), in prostatic cancer patients. The Zoladex Multicenter Study Group].

The Zoladex (ICI 118,630) multicenter trial included 149 patients with stage B +o D prostatic cancer recruited from 1984 to date. Of them 53 clinical responders on the treatment for 40 weeks or longer were subjected to assessment of antitumour response, overall subjective response, endocrinological response, safety and usefulness. The responders consistently showed a clinical response as evidenced by antitumour response in 32 of 50 patients (64.0%) at week 12 and in 35 of 51 (68.6%) at week 40, and overall subjective response in 42 out of 47 patients (89.4%) at both week 12 and week 40. Endocrinologically, all of the 47 eligible patients maintained a 40-week or longer response. Adverse reactions were observed in 19 out of 73 patients (26.0%), subdivided by the time of occurrence as 15/73 (20.5%) up to week 12, 3/71 (4.6%) between week 12 and week 40, and 5/53 (9.4%) in and after week 40. No patient required the discontinuance of treatment. Usefulness of the drug was observed in 51 out of 52 patients (98.1%). The results indicated that Zoladex in a once monthly regimen may be of great advantage to elderly patients with prostatic cancer, and allow an improved patient compliance: Zoladex may not only produce clinical remission but also improve the quality of life.

Buserelin↗
PubMed1988

[Endocrine therapy for prostatic carcinoma--the clinical trial to compare the efficacy of LH-RH analogue, ICI 118630 (Zoladex) with castration or estrogen].

A multicenter randomized clinical trial was carried out between May, 1986 and May, 1987 involving 82 patients with stage B-D prostatic carcinoma from 29 centers. The clinical efficacy, endocrine effect, safety and usefulness of the luteinizing hormone-releasing hormone (LH-RH) analogue and other endocrine manipulations in the treatment of prostatic carcinoma. Zoladex depot containing 3.6 mg of ICI 118,630, an LH-RH analogue, was administered every four weeks 3 times in total. Patients in the control group received either 300 mg of diethylstilbestrol diphosphate orally daily for 12 weeks or orchidectomy. An antitumor effect (CR + PR) was observed in 21 of the 33 patients (63.6%) in the Zoladex group and in 22 of the 33 (66.7%) in the control group, showing no significant difference between the two groups. There was no significant difference in overall subjective response either; 21 of the 24 (87.5%) in the Zoladex group and 24 of the 30 (80.0%) in the control group. In both groups, 100% endocrine effect was obtained as shown by achievement of castration in all patients. Adverse reactions were observed in 14 of the 39 (35.9%) patients treated with Zoladex as compared with 19 of the 34 (55.9%) control patients, resulting in no significant difference in the incidence between the two groups. These adverse reactions were not so severe as to require withdrawal from the study. In both groups, the treatment was assessed as slightly or more useful in 29 of the 33 (87.9%) patients. From these results, it is concluded that Zoladex, 3.6 mg depot, is a useful drug for treatment of prostatic cancer, having clinical efficacy and endocrine effects comparable to those of the conventional endocrine manipulations, being safe, and causing less physiological and psychological pain.

Aged↗
PubMed1988

[Clinical study on the effect of CSF-HU (colony stimulating factor human urine) on leukopenia and granulocytopenia induced by cancer chemotherapy--a double-blind study in patients with genito-urinary cancer].

The ability of CSF-HU (P-100) to inhibit and improve the leukocytopenia and granulocytopenia which occur following cancer chemotherapy was investigated in a double-blind study which included an inactive placebo. The drug was administered, 2 vials/day (8 X 10(6)U of P-100), by intravenous drip infusion consecutively for 7 days starting from the 5th day after cancer chemotherapy was initiated. The total cases included in the study numbered 261. The efficacy rate was 53.0% for the P-100 group and 38.9% for the placebo group, while the usefulness rate was 54.8% for the former and 38.1% for the latter. In either case, statistically significant differences were observed in favor of the P-100 group. The reduction in the number of days before the leukocyte count returned to 4,000/mm3 was statistically significant in the P-100 group. While side effects appeared in both the P-100 (4.8%) and the placebo (4.4%) groups, none of them were considered to be serious. Judging from these results, p-100 was considered to be a useful therapeutic drug for the treatment of leukocytopenia and granulocytopenia following cancer chemotherapy.

Adolescent↗
PubMed1988

[Anti-cancer drug sensitivity test against human testicular cancer xenograft--comparison with clinical results of chemotherapy].

The antitumor effect of vinblastine (VBL), vincristine (VCR), etoposide (VP-16), teniposide (VM-26), cisplatin (CDDP), CBDCA (JM-8, Carboplatin), CHIP (JM-9), DWA2114R and recombinant human tumor necrosis factor (TNF) on four human testicular cancers heterotransplanted in nude mice were studied. The treatments with CDDP, CBDCA or CHIP significantly reduced the transplanted tumors. Combination chemotherapy with CDDP, bleomycin and VBL or VCR or VP-16 or VM-26 also revealed significant tumor regression. The antitumor effect of TNF on human testicular xenografts was much more evident when it was given intratumorally than when given intravenously. Teratoma was resistant to TNF even when it was administered intratumorally. Those results are briefly discussed and compared with the clinical results of chemotherapy. Several problems in anticancer drug sensitivity test against human tumor xenografts are also discussed.

Animals↗
PubMed1988

[Prognostic factors in genitourinary cancer].

Prognostic factors in genitourinary cancers, renal cell carcinoma, bladder cancer, prostatic cancer, and testicular tumor, were discussed from several aspects on the basis of the analysis of own cases and reviews of literatures. The anatomical distribution of disease, particularly beyond the kidney, and degree of tumor differentiation were mostly related to prognosis in renal cell carcinoma. In bladder cancer, macroscopic growth pattern, histopathological intramural mode of spread, lymphatic and venous invasion, played an important role in prognosis, as do tumor grade and stage including metastasis. Hormone dependency and tumor markers were reconfirmed to be important and complementary as prognostic indicators as well as stage and grade in prostatic cancer. In testicular tumors, the most important factors for survival were extent of disease and tumor size, and histological cell type and determination of tumor markers, AFP and HCG, were also important and complementary as prognostic indicators.

Age Factors↗
PubMed1987

Postoperative systemic adjuvant chemotherapy for bladder cancer.

Forty-six patients with bladder cancer without distant metastasis (M0) were treated by chemotherapy as an adjuvant after total cystectomy using three protocols (protocol I: adriamycin 50 mg/m2, cyclophosphamide 500 mg/m2, and cis-platinum 50 mg/m2 i.v., starting at least 2 weeks after surgery every 3 weeks for three cycles; protocol II: adriamycin 30 mg/m2 on the 1st postoperative day, cyclophosphamide 300 mg/m2 on the 1st and the 7th days; protocol III: FT-207 60 mg/m2, p.o. every day for 1 year). Average follow-up periods after surgery by protocol were 18 months for protocol I, 31 for protocol II, and 43 for protocol III. Analysis of the survival curves showed no statistically significant differences among the three groups or between a historical control group of 106 patients and the entire patient population examined in the present study. The histopathological grades recorded in the 46 patients were G1, G2, and G3 in 1, 22, and 23, respectively. However, from a study of 48 pT3 and pT4 cases, the survival rate of 10 patients receiving protocol I therapy was statistically significantly higher than those of 12 patients treated according to protocol II and of 26 historical controls, at 1 year and 2 years, respectively. Toxic effects, with gastrointestinal symptoms including nausea and vomiting and myelosuppression (including leukopenia and anemia) were more frequent with protocol I. Alopecia occurred in about 80%-90% of patients treated according to either protocol I or II. Almost all patients could tolerate adjuvant chemotherapy, and none of them died as a result of these regimens. The results recorded in this study justify the evaluation of combination adjuvant chemotherapy with adriamycin, cyclophosphamide and cis-platinum in a prospectively randomized trial.

Adult↗