Bone-marrow transplantation for Epstein-Barr-virus-associated natural killer cell-large granular lymphocyte leukaemia.
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Antineoplastic Combined Chemotherapy Protocols↗
Biomedical subjects
T Teshima
Publications and source records attributed to T Teshima.
A comparison of the structure of radiation oncology in the United States and Japan.
PURPOSE: The United States and Japan have very different backgrounds in their medical care systems. In the field of radiation oncology, national surveys on structure have been conducted for both countries and compared to illustrate any similarities and differences present from 1989-1990. METHODS AND MATERIALS: The Patterns of Care Study Facility Survey conducted in 1989 in the United States and the National Survey of Structure in Japan in 1990 were compared to evaluate the equipment pattern, staffing pattern, compliance rate with the "blue book" (3) guideline, and the geographic distribution of institutions. RESULTS: In the United States, a total of 598,184 (49% of the total of newly diagnosed) patients were treated with radiation therapy. In Japan, 62,829 (approximately 15% of the total of newly diagnosed) patients were treated. The numbers of external megavoltage treatment machines were 2,397 in the United States and 494 in Japan. The numbers of full time equivalent (FTE) radiation oncologists were 2,335 in the United States and 366 in Japan. Only 15% of United States facilities and 11% of Japan facilities complied with the narrow blue book guideline for the patients per FTE radiation oncologist (200-250), while the most common ratio was 151-200 patients/FTE in the United States and 51-100 in Japan. In Japan, more than 60% of institutions were staffed by a part-time radiation oncologist (FTE < 1.0). Between geographic regions, there was variation in the percentage of cancer patients treated with radiation therapy for both the United States (42-56%) and Japan (6-25%). CONCLUSION: There is a major difference in the usage of radiation therapy for treating cancer between the United States and Japan with 49% of all new cancer patients treated in the United States and approximately 15% treated in Japan. Equipment structure in the United States is more complete than in Japan with important differences in treatment simulators, treatment planning computers, and support personnel. High dose rate intracavitary radiation is commonly available in Japan and there are geographic differences in radiation oncology utilization in both countries.
Cancer Care Facilities↗
Biphasic changes in serum hepatocyte growth factor after transarterial chemoembolization therapy for hepato-cellular carcinoma.
To investigate the physiological significance of hepatocyte growth factor (HGF) after transcatheter arterial chemo-embolization (TACE), we measured serum HGF levels in 23 patients who underwent angiography (n = 3) or TACE (n = 20). HGF levels increased biphasically after TACE. It rapidly increased to 10-fold higher levels immediately after heparin-injection even before embolization. Serum HGF then decreased to below 1.0 ng/ml at 6 hours after the procedure. The second peak (a 2-fold increase) appeared 1-3 days after TACE. The first increase may be due to the injection of heparin which releases HGF from the cell-surface and extracellular matrix of the liver. Patients treated to a larger extent showed higher increase in serum HGF levels, and thus the impaired hepatic HGF clearance and size of regeneration may cause second elevation of serum HGF levels. Six out of eleven patients whose serum HGF levels before TACE were more than 0.5 ng/ml died in the follow-up period whereas no patients died with serum HGF under 0.5 ng/ml. Therefore, serum HGF levels before the procedure have the potential to be a good indicator of outcome.
Aged↗
Induction of hepatocyte growth factor in the liver, kidney and lung following total body irradiation in rat.
Hepatocyte growth factor (HGF) has been shown to have a pleiotropic function to act as a potent organotropic factor in the regeneration of injury in various organs, including the liver, kidney and lung. To examine the involvement of HGF in radiation injury, the authors analysed the changes in HGF mRNA and HGF protein levels in the rat organs (liver, lung, kidney) and plasma following 6 Gy of total body irradiation. Expression of HGF mRNA in the liver and kidney increased 6-48 h after total body irradiation and returned to previous values 1 week later. HGF protein levels in lung and liver showed 1.3-2-fold elevations 1-2 weeks after irradiation (P < 0.05). HGF levels in plasma stayed at undetectable levels up to 1 month after total body irradiation. The labelling index determined 2 weeks and 1 month after total body irradiation indicated no enhancement of regeneration. Thus, total body irradiation induced transient HGF elevation in these organs without enhancement of regeneration.
Alanine Transaminase↗
Granulocyte colony-stimulating factor-induced mobilization of peripheral blood stem cells for autologous and allogeneic transplantation. Fukuoka Bone Marrow Transplantation Group.
Peripheral blood stem and progenitor cells (PBSC and PBPC), which circulate at very low levels during steady-state hematopoiesis, show a transient but marked increase during hematologic recovery from marrow-suppressive chemotherapy. To ensure rapid and sustained hematologic engraftment after autologous PBSC transplantation, sufficient PBSC or PBPC must be infused. To confirm the utility of granulocyte colony-stimulating factor (G-CSF) in chemotherapy-induced PBSC mobilization, we investigated the effect of G-CSF on PBSC mobilization in leukemia and lymphoma patients. The study design was such that PBSC mobilization with and without G-CSF was assessed in the same patients. The results indicate that PBSC mobilization can be enhanced significantly when G-CSF is given during the recovery phase postchemotherapy. Interestingly, progenitor cells of different lineages could be mobilized by G-CSF. We subsequently investigated the effect of increasing G-CSF dose on PBSC mobilization during steady-state hematopoiesis in healthy adult donors. The results indicate that not only committed but also primitive progenitor cells are mobilized into the circulation in a dose-and time-dependent manner when G-CSF at 5, 10, or 15 micrograms/kg was given on each of 5 days and leukapheresis was performed on day 6. From our data we estimate that sufficient PBSC for engraftment after allogeneic PBSC transplantation can be collected on day 5 of administration of G-CSF at 10 micrograms/kg and by 10-1 leukapheresis on days 5 and 6. Furthermore, we found that some G-CSF-mobilized PBSC retained their self-renewal capability. These observations suggest that hematopoietic stem cells for allogeneic PBSC transplantation can be mobilized by short-term administration of relatively high-dose G-CSF.
Animals↗
Cyclosporine-related encephalopathy following allogeneic bone marrow transplantation.
A 46-year-old man with chronic myelogenous leukemia received allogeneic bone marrow transplantation (BMT) from a partially human leukocyte antigen (HLA)-mismatched sibling. Cyclosporine (CYA)-related encephalopathy developed on days 10 and 21 following BMT, and CYA-related thrombotic thrombocytopenic purpura (TTP) developed on day 45 following BMT. We measured serum concentrations of thrombomodulin (TM) as a marker of endothelial injury. The concentrations of TM were increased during the encephalopathy or TTP and decreased following recovery. Since CYA can cause endothelial injury, we suggest that CYA-induced endothelial injury is common to the pathogenesis of both the encephalopathy and the TTP. CYA therapy should be reinstituted with extreme caution in patients with a past history of CYA-related encephalopathy, since readministration of a low-dose CYA can evoke the immediate return of the encephalopathy.
Bone Marrow Transplantation↗
A fluorescent assay method for GDP-L-Fuc:N-acetyl-beta-D-glucosaminide alpha 1-6fucosyltransferase activity, involving high performance liquid chromatography.
An assay method for GDP-L-Fuc:N-acetyl-beta-D-glucosaminide alpha 1-6fucosyltransferase (alpha 1-6FucT; EC 2.4.1.68) activity has been developed, involving a fluorescent pyridylaminated substrate. A glycopeptide derived from bovine gamma-globulin was coupled with 4-(2-pyridylamino)butylamine (PABA) through the peptide bond, and the following substrate was obtained. [equation: see text] The substrate and guanosine diphospho-fucopyranoside (GDP-Fuc) were incubated with a crude enzyme extract for 2 h, and then the enzymatic product was separated by reversed phase HPLC. Quantitation of the product involved measurement of the fluorescence intensity of the fucosylated pyridylaminated sugar. The structures of both synthesized GnGn-bi-Asn-PABA (substrate), and synthesized GnGnF-bi-Asn-PABA (product) were analyzed by 1H NMR. The enzymatic product was also analyzed by 1H NMR and was found to have alpha 1-6fucose at the reducing end GlcNAc. This method is highly specific for alpha 1-6FucT and is applicable for various experiments, including purification and cell culture ones.
Animals↗
Expression of Phaseolus vulgaris leukoagglutinin-binding oligosaccharides in oral squamous cell carcinoma: possible association with the metastatic potential.
The expression of -GlcNAc beta 1-6Man-(beta 1-6) branched oligosaccharides in carcinoma cells has been considered to influence their metastatic potentials. In the present paper, the lectin histochemistry of oral squamous cell carcinomas obtained in biopsy from 34 patients with Phaseolus vulgaris leukoagglutinin (L-PHA), which potentially binds to N-glycosidic carbohydrates with beta 1-6 linked lactosamin antennae, was studied in order to analyze the relationship between their staining patterns and metastases. The L-PHA-binding oligosaccharides of the carcinomas were expressed on the cell surface in the following patterns: (i) all cells were positive for the staining ('positive'); (ii) some cells were positive but the rest of the carcinoma cells were negative ('weakly positive'); and (iii) all were negative ('negative'). Statistical analysis revealed that the incidence of the metastasis to regional lymph nodes in the 'positive' cases was significantly higher than that in the 'negative' cases. Moreover, the number of the CD14 positive cells including macrophages in the stroma adjacent to the carcinomas in the 'positive' cases was less than that in the 'negative' or 'weakly positive' cases. The expression of L-PHA-binding oligosaccharides in oral squamous cell carcinoma may be responsible for their metastatic potential to regional lymph nodes, possibly including their ability to escape macrophage recognition.
Carcinoma, Squamous Cell↗
Focal residual contrast media in the kidney 24 hours after angiography.
PURPOSE: To examine the relationship between focal renal cortical retention (FRCR) and contrast-associated nephropathy (CAN). MATERIAL AND METHODS: We investigated the incidence of both phenomena in 105 patients. CAN was defined as an increase in the creatinine level > 0.3 mg/dl and > 20% on days 1, 3, or 7. We compared predisposing factors for FRCR and CAN. Serum creatinine and blood urea nitrogen (BUN) for renal function were determined on the morning of the day of the angiography. The BUN/creatinine ratio was used as an indicator of the degree of hydration. RESULTS: FRCR was demonstrated in 17 patients (16%) by delayed CT 24 h after angiography, and CAN was found in 16 patients (15%). No significant relationship between CAN and FRCR was found. We found a correlation between high total volumes of contrast and FRCR. Advanced age, high blood urea nitrogen, high creatinine, and dehydration were risk factors for CAN. CONCLUSION: Delayed CT showed a higher incidence of injury to the renal parenchyma than previously detected by conventional radiography.
Angiography↗
Late local recurrence after radiotherapy for tongue and early glottic carcinoma.
BACKGROUND/AIM: Late local recurrence after radiotherapy for tongue and early glottic carcinoma is rarely discussed. In the head and neck cancer, approximately 90% of local recurrence occurred within 2 years after radiotherapy. However, we found that late local recurrence after radiotherapy for glottic cancer was not rare. Our aim was to evaluate the late local recurrence after radiotherapy for early glottic and tongue cancer. PATIENTS AND METHODS: From 1967 through 1982, 633 patients with tongue carcinoma and 330 patients with early (T1T2N0) glottic carcinomas were treated at the Department of Radiology, Osaka University Hospital. Of these 821 patients, 329 patients with tongue carcinoma and 221 patients with early glottic carcinoma survived at 5 years after radiotherapy without local recurrence. For tongue carcinoma, patients were divided by T category. For early glottic carcinoma, patients were divided by the tumor response at 40 Gy. RESULTS: Late local recurrence occurred in 23 of 329 patients (7%) with tongue carcinoma, and in 9 of 221 (4%) with early glottic carcinoma. For tongue carcinoma, late recurrence occurred in 19 of 249 patients (8%) in stage I and II, and 4 of 80 patients (5%) in stage III and IV. For glottic carcinoma, late recurrence occurred in 8 of 137 patients (6%) with tumor clearance at 40 Gy and 1 of 63 patients (2%) with tumor persistence at 40 Gy. The incidence of double cancer was also evaluated. Of 329 5-year survivors with tongue carcinoma, 39 patients (12%) had another malignancy, and 26 patients of 221 5-year survivors with early glottic carcinoma (12%) had also another malignancy. Of 39 double primaries of tongue carcinoma, 10 patients (26%) had head and neck malignancies, and none of 26 double primaries of early glottic carcinoma. CONCLUSION: Late local recurrence was not rare in tongue and early glottic cancer. Poor prognostic group showed lower incidence of late recurrence than good prognostic group. This result suggests that secondary tumor at the same site of primary tumor is late local recurrence.
Carcinoma↗
[Perioperative fractionated high dose rate brachytherapy in bone and soft-tissue tumors].
The 13 lesions of 11 patients with bone and soft-tissue tumors (four primary and nine recurrent lesions) were treated with surgery and postoperative fractionated high dose rate (HDR) brachytherapy started on the 6-7th day after surgery. The total dose was 40-50 Gy/7-10 fr/6-7d(bid) at 5 mm from the source. Local control was achieved in eight of 13 lesions (62%). Four of the five uncontrolled lesions had macroscopic residual tumor after the surgery. There was one peripheral nerve damage as a side effect. This study indicates that the use of perioperative fractionated HDR brachytherapy is feasible and well tolerated.
Adolescent↗
Radiation therapy for early glottic carcinoma (T1N0M0). The final results of prospective randomized study concerning radiation field.
PURPOSE: To investigate the effect of radiation field on the local control of early glottic carcinoma by prospective randomized study. PATIENTS AND METHODS: From May 1982 through February 1992, a total of 273 patients with early glottic carcinoma (T1N0M0) was treated at our department with a wedge filter technique using a shell to improve the dose distribution and immobilization during radiotherapy with 4 MV X-ray. Patients were randomly allocated to either treatment group A (radiation field size: 5 x 5 cm) or B (6 x 6 cm) using bilateral parallel opposed portals. Total radiation dose administered was 60 Gy in 30 fractions over a 6-week period. RESULTS: The 5-year recurrence-free survival rates were 88% in groups A and B (no significant difference). Minor chronic complication such as persistent arytenoid edema lasting more than 6 months or benign polypoid lesion of vocal cord was more frequently observed in group B (23%) than in group A (17%) (p = 0.038) while acute mucosal reaction and skin reaction showed no significant differences. CONCLUSION: A small field (5 x 5 cm) with an appropriate angle of wedge filter and shell fixing device is recommended to avoid adverse effect with keeping local control of early glottic carcinoma.
Actuarial Analysis↗
Radionuclide venography and its functional analysis in superior vena cava syndrome.
UNLABELLED: In addition to imaging, radionuclide venography maybe used for the functional assessment of superior vena cava (SVC) syndrome by applying the indices of transit time (TT), time of half-peak count (TH) and peak count ratio (PC ratio). METHODS: Ten healthy subjects (Group N) and 107 patients with SVC syndrome (64 symptomatic and 43 asymptomatic) were studied. Images were visually assessed for collaterals or jugular venous reflux and values of the indices were calculated. RESULTS: The 107 patients were subclassified into three groups according to the images obtained. Collateral circulation was seen in 37 patients (Group C). In 20 patients, jugular venous reflux was observed (Group J). Fifty patients who showed neither collaterals nor reflux were included in Group P. In comparison to Group N [3.6 +/- 0.56 see (sem)], TT values were significantly higher (p < 0.05) for Group J (7.13 +/- 1.16 sec) and Group C (7.00 +/- 0.87 sec). Values of TH were significantly prolonged (p < 0.05) for Group J (23.6 +/- 4.8 sec) and Group C (18.8 +/- 2.2 sec) in comparison to Group N (9.2 +/- 1.5 sec). PC ratio values were higher in all patient groups in comparison to Group N (3.4 +/- 0.57). CONCLUSION: These indices are potentially useful in the initial diagnosis and post-therapeutic evaluation of SVC syndrome. In the absence of other causes, appearance of jugular venous reflux may be considered a sign of SVC syndrome.
Adult↗
Pretreatment prostate-specific antigen values in patients with prostate cancer: 1989 patterns of care study process survey.
PURPOSE: A Patterns of Care Study (PCS) national survey was conducted to show the national averages for processes of radiation therapy care for prostate cancer patients in 1989. In the current study we report an analysis of pretreatment prostate-specific antigen (PSA) by stage, grade, and ethnic origin. METHODS AND MATERIALS: Process data were collected from 672 patients treated in 1989 at 71 separate institutions. Four hundred and twenty-seven (64%) of these patients had a pretreatment PSA value recorded. Three hundred and forty-three of the 427 patients were treated with external beam irradiation alone and were selected for the current analysis. The 1992 AJCC staging system was used. RESULTS: There was a significant increase in pretreatment PSA with increasing stage. The median values of PSA were 8.3 ngm/ml in the T1 group (n = 65), 11.2 ngm/ml in the T2 group (n = 178), and 20.9 ngm/ml in the T3 group (n = 90) (p < 0.001). Ten patients were not staged. There was a significant increase in pretreatment PSA with decreasing differentiation. The median pretreatment PSA was 9.7 ngm/ml in well-differentiated tumors (n = 109), 13.0 ngm/ml in moderately differentiated tumors (n = 163), and 22.0 ngm/ml in poorly differentiated tumors. (n = 61) (p < 0.001). Ten patients had no differentiation recorded. African Americans (24) showed a significant increase in pretreatment PSA compared to Caucasians (304). The respective medians were 23.2 ng/ml and 11.9 ng/ml (p = 0.04). They also show more poorly differentiated tumors (33% vs. 17%) and more T3 tumors (46% vs. 25%). Other minorities, although small in number (n = 9) were similar to African Americans. CONCLUSION: Pretreatment PSA levels were established for patients treated with external beam irradiation in 1989 in the United States. They increase with stage and decreasing differentiation. African Americans and other minorities show a doubling of median values compared to Caucasians' pretreatment PSA with an increase in stage and grade. The adverse prognosis observed for African Americans is predicted by their pretreatment PSA. The cause of this PSA elevation is not known and may be related to lack of access to care or to a more aggressive biology for prostate cancer in African Americans.
Biomarkers, Tumor↗
A case of cardiac sarcoidosis with remarkable atrophy of the left ventricular septum on two-dimensional echocardiography.
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology which mainly affects the lungs, skin, the lymphoreticular system, and the heart. We report a case of cardiac sarcoidosis in which a remarkably thin ventricular septum was demonstrated on two-dimensional echocardiography.
Atrophy↗
Establishment of a cell line from an adenocarcinoma of the lung producing carcinoembryonic antigen (CEA) and CA19-9.
An adenocarcinoma cell line was established from pleural effusion of a 67-year-old woman and designated as TK-SA. The population doubling time of the cells was 100.4 hr. Chromosomal analysis revealed the TK-SA to have human aneuploid chromosomes with a near-triploid mode. Ultrastructurally, the TK-SA was compatible with adenocarcinoma. The cell line was highly tumorigenic. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide dye assay demonstrated resistance of the cell line to Cis-platin (CDDP), Cyclophosphamide (CPM) and Tegafur/Uracil (UFT). High carcinoembryonic antigen (CEA) and CA19-9 levels were similar in patient's serum and conditioned medium.
Adenocarcinoma↗
[Development of Elderly Diabetes Impact Scales (EDIS) in elderly patients with diabetes mellitus].
To assess the quality of life (QOL) in elderly diabetic patients, 452 elderly outpatients aged over 60 years old who lived in 4 districts near our hospital were visited at home and of them were asked to follow 83 questionnaires concerning QOL by professional interviewers. Using the 37 questions about the impact of diabetes on elderly diabetic patients, we have developed the Elderly Diabetes Impact Scales (EDIS). The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry). Responses to questions were estimated with a 4-point multiple-choice assessment. The impact was rated from 1 (no impact, never worried, or very satisfied) to 4 (very burdened, always worried, or very dissatisfied) for each question and total EDIS scores were calculated by summing up the scores of the 37 questions. The internal consistency of the EDIS and its six subscales were of a satisfactory magnitude (0.66-0.88). There was also a significant correlation between the EDIS and PGC morale scales (r = -0.48, p < 0.001) and between the EDIS subscales and 3 moral components suggesting a convergent validity of the EDIS. The EDIS may be useful in evaluating the quality of life in elderly patients with diabetes mellitus.
Activities of Daily Living↗
[Factors associated with increased diabetes burden in elderly diabetic patients].
To define the factors that determine the increased burden of diabetes in elderly diabetic patients, we examined the relationship between the Elderly Diabetes Impact Scales (EDIS) and physical or social factors in 383 elderly outpatients aged over 60 years old who answered QOL questionnaires by professional interviewers. The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry) and total EDIS scores were calculated by summing up the 4-point scores of 37 questions. The EDIS scores were highest in patients who received insulin therapy. In univariate analysis, high EDIS scores were significantly associated with high HbA1c, low Roken ADL score, and the presence of retinopathy or neuropathy. Among social factors, leisure activities, housework or jobs, social network, and positive social support were significantly associated with low EDIS scores, while negative social support was associated with high EDIS scores in elderly diabetic patients. Multiple linear regression analysis revealed that age (younger), sex (women), low ADL (or diabetic complications), insulin therapy, low positive social support, high negative social support, economical dissatisfaction, and the low adaptative feeling of diabetes were significant and independent determinants of a high burden in diabetic patients indicated by EDIS scores in Japanese elderly diabetic patients.
Activities of Daily Living↗