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Biomedical subjects

T Ohki

Publications and source records attributed to T Ohki.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Usefulness of hyper sensitive PSA assay kits for determination on low range of prostate specific antigen in prostate cancer].

Prostate specific antigen (PSA) levels after total prostatectomy or radiation therapy to localized prostate cancer and also during endocrine therapy are within normal range. Therefore, it is necessary to use hyper sensitive PSA assay kits for early detection of relapse. The present study was undertaken to evaluate two hyper sensitive assay kits (Delfia kit, lower limit 0.1 ng/ml, Kabi Pharmacia Diagnostics Co. and Markit M kit, 0.5 ng/ml, Dainippon Pharmaceutical Co.) and to compare them with conventional PSA kit (Eiken Chemical Co., 1.0 ng/ml). Total of 291 sera were examined: patients consisted of 10 total prostatectomy+endocrine therapy, 9 radiation therapy+endocrine therapy, 5 radiation therapy alone and 44 endocrine therapy alone. Values of endocrine therapy alone were divided into two groups according to duration after start of treatment; more or less than 5 years. The following results were obtained. 1. In non-relapse patients after total prostatectomy+endocrine therapy and radiation+endocrine therapy, PSA showed under lower limit with hyper sensitive kit. On the contrary, conventional kit indicated more than 1.0 ng/ml. 2. Radiation therapy alone kept PSA in detectable range with hyper sensitive kit in spite of no sign of relapse. 3. In non-relapsed patients under endocrine therapy alone, long duration (more than 5 years after start of treatment) decreased PSA in non detectable values with hyper sensitive kits. In this case, conventional kit still showed PSA as more than 1 ng/ml. 4. Doubling time at relapse was estimated similar with Delfia kit and Markit M kit, and much longer with conventional kit. It is concluded that hyper sensitive kit is more useful to manage patients after therapy than conventional kit.

Aged↗
PubMed1995

[A case report of a 6-year-old boy with intracranial yolk sac tumor treated by VAB-6 regimen].

Several clinical trials have demonstrated that cisplatin-based chemotherapy for primary intracranial germ-cell tumors is effective as a neoadjuvant chemotherapy. In this report, we describe a 6-year-old boy, Down syndrome and Hirschsprung's disease with intracranial pure yolk sac tumor treated by combined chemotherapy with cisplatin, vinblastine, bleomycin and cyclophosphamide (modified VAB-6 regimen). He had been admitted to our hospital because of intractable vomiting, and left facial nerve palsy since 1 month before. An MRI revealed an enlarged mass, 4cm in diameter, in the left cerebello-pontine angle with uniformal enhancement by Gd-DTPA, and bilateral ventricular dilatation. He was found to have increased serum alpha-fetoprotein level (AFP 11, 786ng/ml), but not human chorionic gonadotropin beta-subunit. After a partial resection of the tumor, diagnosed as pure yolk sac tumor, and ventriculo-peritoneal shunt, three courses of combined chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide (modified VAB-6 therapy) were carried out. The serum AFP level returned to normal, and the tumor mass entirely disappeared (a complete response) on MRI after the second course of chemotherapy. However, cisplatin-induced vomiting and mild neutropenia and renal tubular injury developed after the third course of chemotherapy. Irrespective of administration of recombinant human G-CSF and broad spectrum antibiotics, he suffered from pneumonia and died of septic shock and multiple organ failure. Autopsy showed microscopic residual tumors. The combination chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide is effective for initial treatment of childhood intracranial yolk sac tumor. It is necessary, however, to reevaluate the cisplatin dosage and treatment schedule in order to reduce such side effects as bone marrow suppression and renal damage.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Evolutional changes of cortical hypometabolism in West's syndrome.

The pathophysiological basis of the epileptic encephalopathy West's syndrome remains unknown. We have done serial positron emission tomography (PET) with fluorine-18-labelled 2-deoxy-3-fluoro-D-glucose (FDG) in twelve patients with newly diagnosed West's syndrome. Throughout follow-up, PET revealed diffuse or focal cortical hypometabolism in eleven patients, whereas magnetic resonance imaging (MRI) showed morphological abnormalities in only five. At disease onset, PET showed cortical hypometabolism in eight patients (diffuse in three, focal in five). The second PET showed normal metabolism in six of these patients but focal abnormalities in three of the four with normal results on first PET. In all seven patients with normal findings on the second PET, tonic spasms ceased after initial treatment and no epileptic seizure occurred thereafter. In the five patients with cortical hypometabolism on the second PET, tonic spasms persisted or recurred, or partial seizures appeared. However, in two patients PET abnormalities disappeared in accordance with the later resolution of epileptic seizures. All patients with normal MRI and second PET results had normal psychomotor development. Diffuse or focal cortical hypometabolism that cannot be detected by MRI or computed tomography is common in patients with West's syndrome. However, this anomaly is not permanent and changes with clinical symptoms. These functional abnormalities in the cerebral cortex may be associated with the development of West's syndrome.

Cerebral Cortex↗
PubMed1994

Chemotherapy for endocrine-therapy-refractory prostate cancer.

The effects of various chemotherapy regimens on endocrine-therapy-refractory prostate cancer were examined in 64 patients. Chemotherapy was started from the first evidence of relapse. The regimens of the initial chemotherapy were as follows: cisplatin (CDDP, 4 cases) and ifosfamide (4 cases) were given as single agents and vincristine, ifosfamide, and peplomycin (VIP, 8 cases); cyclophosphamide, doxorubicin, and CDDP (CAP, 14 cases); ifosfamide, doxorubicin, and CDDP (IAP, 24 cases); and etoposide, doxorubicin, and CDDP (EAP, 10 cases) were given as combinations. On the basis of the results, the patients were divided into two groups: single agents plus VIP and other combinations. In the CAP, IAP, and EAP groups, the cause-specific survival was similar, and the survival of these groups was longer than that of the single agents plus VIP group. Since patients with a long duration between the start of endocrine therapy and the start of chemotherapy were contained in the CAP, IAP, and EAP groups, comparison was performed without these cases. No difference was found between the two groups, suggesting that no superior regimen was found. The short-term effect was evaluated on the basis of the changes observed in prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) levels at 3 months after the start of chemotherapy, and patients showing a complete response, partial response, or no change on any of the regimens exhibited longer survival than did those with progressive disease. Since the PSA doubling time estimated before the chemotherapy correlated with the change in the PSA values due to the chemotherapy, the rate of proliferation of the tumor influenced the effect of the chemotherapy. Thus, this finding suggests that slowly growing cancers show a better response to chemotherapy than do rapidly proliferating ones.

Acid Phosphatase↗
PubMed1994

Endobronchial metastasis from a primary uterine osteosarcoma in a patient with multiple myeloma: report of a case.

We present herein the case of a 75-year-old woman with multiple myeloma who underwent a left lower lobectomy for endobronchial metastasis from an uterine osteosarcoma. She had initially been admitted to our hospital for chemotherapy more than 1 year earlier, soon after which a primary uterine osteosarcoma was discovered and a total abdominal hysterectomy and bilateral salpingo-oophorectomy performed. One year after the operation, the patient developed hemoptysis. A flexible bronchofiberscopy demonstrated a polypoid mass obstructing the left basal bronchus, and computed tomographic scans showed three pulmonary nodules. Surgery was performed to control the hemoptysis. At thoracotomy, two metastatic nodules were identified in the left lower lobe, and the endobronchial extension of the tumor was resected en bloc with the left lower lobe. The tumor was diagnosed as lung metastasis from the uterine osteosarcoma. Although further lung tumors have recently appeared, the patient has remained well for the 3 years since her last operation without any hemoptysis.

Aged↗
PubMed1994

Photosensitive epilepsy in children.

We performed a retrospective analysis of 17 children with photosensitive seizures (PSS) who had been followed for more than 3 years (mean: 9 years). PSS were verified in all patients by simultaneous video-EEG monitoring. The seizures were precipitated by flickering stroboscopes (14 patients) or were induced by patients themselves (3) with head-nodding in front of illumination, blinking at television or close viewing of striped patterns. PSS consisted of myoclonic seizures (eight patients), generalized tonic-clonic convulsions (5), partial seizures (3) or atypical absence (1). According to the International Classification of Epileptic Syndrome, three patients were classified as having severe myoclonic epilepsy in infancy and five as having juvenile myoclonic epilepsy. The remaining nine could not be categorized as any specific epileptic syndrome. Children with age of the onset of epilepsy at 7 years or younger tended to suffer intellectual deficit in addition to intractable seizures.

Adolescent↗
PubMed1994

Diurnal rhythm of serum gamma-seminoprotein in patients with untreated prostate cancer: comparison of the original and revised assay kits.

To compare levels of gamma-seminoprotein (gamma-Sm) assayed by original and revised assay systems, blood was obtained every 4 h over a 32-h period from 8 untreated prostate cancer patients. Serum levels of prostate specific antigen (PSA) were also examined. In 6 patients, the coefficient of variation (CV) of the serum levels assayed by the revised assay was significantly different from that of the intra-assay samples. In contrast, the CV of the gamma-Sm serum levels assayed by the original assay differed significantly from that of the intra-assay samples in only 2 patients. The fluctuations in gamma-Sm assayed by the revised assay were, at least in part, similar to those of the PSA serum levels in all patients. The mean CV of the gamma-Sm serum levels assayed by the revised assay was significantly larger than that for levels measured by the original assay. After treatment, the rate of decrease in gamma-Sm serum levels determined by the original assay differed from that in the serum levels of PSA and prostatic acid phosphatase. These results indicate that the original assay for gamma-Sm do not detect diurnal differences in serum gamma-Sm levels, even at levels below 20 ng/ml. These observations indicate that the analysis of data obtained using the original gamma-Sm kit should be interpreted with caution.

Acid Phosphatase↗
PubMed1994

Radiation therapy for prostate cancer confined to pelvis.

To evaluate the usefulness of external beam radiotherapy for patients with prostate cancer confined to the pelvis, long-term results and prognostic factors were analyzed. During the period 1975-1989, 44 cases were treated with staging pelvic lymphadenectomy followed by monotherapy using external beam irradiation by Linac X-ray and/or fast neutrons and observed without any treatment until relapse was evident. All patients were followed until death or for a mean of 78.6 mo (range: 36-113 mo) for patients still alive. Four cases died of prostate cancer at 26, 28, 54, and 83 mo from the start of radiation. Eleven cases died of other causes (10-72 mo, mean 36.4 mo). Fourteen cases (31.8%) manifested clinical relapse of cancer; 4 had local relapse, 7 developed bone metastases, and 3 relapsed at lymph nodes. After relapse, endocrine therapy was effective in most cases. The five-year disease-free survival rates of pN0 (32 cases) and pN1 (8 cases) patients were 79.8% and 52.5%, respectively, but that of pN2 (4 cases) was worse. Cause-specific survival was similar between patients with pN0 and pN1 disease, the rate at 5 yr being 92.5% in the former and 100% in the latter. Those with high levels of serum prostate specific antigen (PSA) before treatment and advanced local disease (clinical stage C) showed unfavorable prognoses. The number of argyrophilic nucleolar organizer regions (AgNORs) might be a predictive factor in patients treated with irradiation. In conclusion, prostate cancer patients with stage A2-C, diagnosed as pN0-1 by staging pelvic lymphadenectomy, were successfully treated with external beam radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Measurement of serum prostatic acid phosphatase (PAP) by Delfia PAP Kit using europium and clinical evaluation in patients with prostate cancer].

Fundamental and clinical studies of serum prostatic acid phosphatase (PAP) detected by a Delfia PAP kit were performed. The system is a time-resolved fluoroimmunoassay using europium as a tracer. The lower limit of detection was 0.2 ng/ml. Sera from 54 patients with prostate cancer, 20 with benign prostatic hypertrophy, 20 with urological malignancies other than prostate cancer and 140 adult males over 46 years old were determined. From the mean + 2 S.D. of serum PAP values obtained on the adult males, 1.5 ng/ml was considered as the upper normal level of adult males. By calculating the efficiency and ROC curve using the PAP values of prostate cancer and benign prostatic cancer, 2.5 ng/ml was decided as a cut-off value of this kit. The positive rates of adult males, prostate cancer, benign prostatic cancer and urological malignancies other than prostate cancer were 0.7%, 65%, 20% and 10%, respectively. The sensitivity of stage A2, B2, C and D1 + D2 was, 0%, 0%, 64% and 83%, respectively. The efficiency of the Delfia PAP kit was 52% and that of the Markit M PA kit was 71%. The correlation between the values assayed with the Delfia PAP kit and the Dinabot PAP kit was very high; the value obtained with the Delfia PAP kit was about 80% of that obtained with the Dinabot PAP kit.

Acid Phosphatase↗
PubMed1994

[Studies on auditory brainstem responses showing absence or significantly poor formation of waves II-V in children].

We performed a retrospective study on 7 children in whom the auditory brainstem responses (ABR) showed absence or significantly poor formation of waves II-V. Two patients had degenerative diseases that affected the brains diffusely. In the remaining 5 patients, the symptoms consisted of action tremor (3 patients) or pyramidal signs (2 patients). There were neither clinical signs nor neuroimaging findings suggesting brainstem involvements. The evolutional changes of the ABRs had a good correlation with the clinical course. Absence or significantly poor formation of waves II-V of ABR occurs in various diseases and may not necessarily reflect severe organic brain lesions.

Brain Diseases↗
PubMed1993

Structural analysis of oxidation products of urofuran acid by hypochlorous acid.

The oxidation of urofuran acid derivatives (1-2) by hypochlorous acid (HOCl) was investigated with the goal to possibly simplify the detection of their metabolites in biological materials. The oxidation products of 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (1) were obtained as an isomeric mixture and confirmed to exist as cis (3a) and trans (3b) isomers, based on their 13C nuclear magnetic resonance (NMR) spectra. Similarly, the products of 5-H substituted acid 2 obtained by oxidation with HOCl were identified as 4a and 4b by 13C and 1H NMR which indicated the presence of cis and trans hemiacetal hydrogens at C-5 in a ratio of 2.11:1. The oxidation was found to proceed in a manner different from that of the F-acid, because of the presence of the electron withdrawing COOCH3 group at C-3 which favored the nucleophilic attack on the carbonyl group to afford cis- and trans-2,5-dihydroxy-2,5-dihydrofurans (3a-b, 4a-b).

Chromatography, Gel↗
PubMed1993

Preoperative use of erythropoietin for cardiovascular operations in anemia.

Erythropoietin was used in 10 patients undergoing elective cardiovascular operations who were compromised with anemia. Initially, their blood hemoglobin levels were less than 10 g/dL (range, 7.5 to 9.9 g/dL). Erythropoietin (600 to 700 units/kg per week) was administered intravenously or subcutaneously for about 2 to 12 weeks. Blood hemoglobin levels increased in each patient (11.0 to 14.5 g/dL) until the day operation, and during this course autologous blood donations (400 to 1,200 mL) were obtained from 8 patients. As a result, homologous blood transfusions were needed in only 1 patient in whom erythropoietin treatment was interrupted for other reasons. All these patients were discharged without event, and no adverse effects due to erythropoietin were found. Although the causes of anemia were not specified in some of these patients, it was noteworthy that erythropoietin was effective even in a patient with hypoplastic bone marrow. Subcutaneous use was assumed to be especially favorable in managing anemic patients, in whom preoperative erythropoietin treatment could be continued for up to 82 days. We conclude that erythropoietin would be beneficial for the anemic population to secure homologous-blood-free operations.

Aged↗
PubMed1993

[Localized intimal hyperplasia in autologous vein graft: does presence of the valve induce obliteration?].

The present study was undertaken to examine the role of venous valve in the development of focal intimal hyperplasia (IH) occurring in autologous vein graft. The jugular vein of Japanese white rabbit containing a valve, was implanted to the carotid artery. Four weeks after the operation, histological, morphometrical and immunohistochemical [using bromodeoxyuridine (BrdU)] studies were performed on the grafted vein. The contralateral jugular vein served as control. The control vein revealed marked discontinuity of internal elastic lamina (IEL) of valve sinus (VS), as compared with non-valvular region (NVR). IH developed in both VS and NVR of the grafted vein, but there was a significant difference between them. The features of IH of VS were as follows; 1) marked thickening (269 +/- 137 microns, VS; 84 +/- 25 microns, NVR P < 0.01), 2) neovascular formation (73%), some of which were accompanied by intimal hemorrhage, 3) significantly higher BrdU labeling index (3.1 +/- 2.4%, VS; 1.1 +/- 0.3%, NVR P < 0.01). These data strongly suggest that IH of VS is responsible for focal IH, and it leads to obliteration of the graft. In that process, the discontinuity of the IEL plays a paramount role in the pathogenesis of focal IH.

Animals↗
PubMed1993

[A study on ACTH dosage for treatment of West syndrome].

We conducted a retrospective study of 50 patients with West syndrome who had been treated with ACTH. The patients were classified into two groups; group I, receiving standard dose of ACTH (0.025 mg/kg/day); and group II, receiving low dose of ACTH (0.015 mg/kg/day). The short-term effect of treatment was evaluated. Each group was further divided into two subgroups; cryptogenic (I-C, II-C) and symptomatic (I-S, II-S). There was no significant difference in the control rate of clinical seizures, between the two dosage groups of cryptogenic etiology. In the symptomatic cases, a greater effectiveness was achieved in group II-S than I-S. None of the patients with cryptogenic etiology experienced any relapse of infantile spasms. Patients with symptomatic etiology had a higher incidence of relapse. The rate of clinical and EEG seizure control was lower, and the incidence of side effects was higher in group I-S patients. The poor short-term effect of treatment in group I-S patients may be due to a higher incidence of prenatal etiology.

Adolescent↗
PubMed1993

[Effectiveness of erythropoietin for cardiovascular surgery to prevent homologous blood transfusions].

Erythropoietin (EPO) was used preoperatively in 109 cardiovascular surgery cases to prevent homologous blood transfusions. Operative procedures in all these cases were coronary artery bypass grafting in 80 cases, valve replacement in 14, and a few cases of aortic vascular replacement or others, aging about average 62 years and weighing about average 54 kg. EPO was administered concomitantly with oral iron sulfate in the following three different manners; 100 units per body weight daily intravenously, 300 U./B.W. twice in a week intravenously, and 600 U./B.W. once in a week subcutaneously. Autologous blood donations were also performed as long as the blood hemoglobin levels were over 12 (g/dl) and repeated until the date of operation, and these blood deposits were returned to each patient at the time of operation. The blood hemoglobin level had increased on average from 12.6 (+/- 1.5 SD) to 13.6 (+/- 1.2 SD) after 23 days (+/- 13 SD) administration of EPO, while autologous blood deposit of 536 ml (+/- 353 SD) was obtained. Homologous blood transfusions were unnecessary in 89% of all cases, especially good in 96.7% of the group with over 12 of hemoglobin level before EPO administration. However, it remained within 79.6% of those with lesser to 12, so there was still room for improvement in this anemic group. No adverse effects were recognized in all cases. It was concluded that preoperative use of EPO is efficient to promote autologous blood donation, and its application will be expanded to anemic cases. EPO could offer an excellent means of preventing homologous blood transfusion. Further study concerning the appropriate application of erythropoietin seems to be required.

Anemia↗
PubMed1993

[Case report of metastatic cutaneous angiosarcoma causing bilateral pneumothorax].

The patient was a 72-year-old man who underwent operation for bilateral pneumothorax due to rupture of cystic lung lesions. Two months after the operation, intrathoracic bleeding redeveloped. The patient developed a tumor on his head. Pathological examination of the scalp lesion revealed cutaneous angiosarcoma. A biopsy of thickened pleura showed that the bleeding was due to pleural metastatic angiosarcoma of the skin. The multiple cystic lesions were considered to be metastases of angiosarcoma. We conclude that pneumothorax or hemothorax in the elderly should be differentiated from malignant metastatic lung tumor. Cystic lung lesions should be considered as possible metastatic angiosarcoma from the skin.

Aged↗
PubMed1993

[Atypical early infantile epileptic encephalopathy with suppression-burst].

We report an 8-month-old infant with tonic spasms that started at the age of 38 days and occurred in clusters. He had no myoclonic seizures, or erratic myoclonus. Repeated simultaneous video-EEG monitoring revealed abrupt flexion of the neck and extremities associated with high voltage slow waves preceded by multiple spikes and/or sharps, which resembled spasms seen in West syndrome. Interictal EEGs, before and after the onset of epilepsy, showed suppression-burst. The bursts consisted of irregular high voltage slow waves mixed with poorly developed spike before the onset of epilepsy. On the other hand, duration of suppression phase ranged from 1 to 27 seconds, and burst-burst interval from 2 to 30 seconds after the onset of epilepsy. He was considered as having an atypical early infantile epileptic encephalopathy with suppression burst.

Diagnosis, Differential↗