Biomedical subjects

J Okamura

Publications and source records attributed to J Okamura.

At least 73 records · Page 4Linked to original sources

PubMed1995

Herpes zoster in children with bone marrow transplantation: Report from a single institution.

Herpes zoster (HZ) has been often observed after bone marrow transplantation (BMT) in childhood. The occurrence of HZ was reviewed in children who received BMT. The clinical features of HZ were reviewed in 44 children who underwent BMT at Kyushu Cancer Center. Among the 35 recipients with a history of varicella before BMT, several factors associated with BMT and the lymphocyte subsets were compared between the patients who developed HZ (HZ+ group) and those who did not (HZ- group). Twenty-two recipients (50%) developed HZ; in two-thirds of these cases (15/22: 68%), HZ occurred between 80 and 120 days after BMT (median 101 days). The recipients treated with busulfan had a higher occurrence of HZ than those treated without it. The patients with Grade II-IV acute graft-versus-host disease (GVHD) developed HZ more frequently. In the HZ+ group, the absolute number of lymphocytes, CD3+, CD4+ or CD8+ cells at 3 months was significantly lower than that observed at 12 months after BMT and the CD4/CD8 ratio was significantly lower at 1 month than after 3 months of BMT. In conclusion, recipients were susceptible to HZ at around 100 days after BMT. The development of HZ may be associated with unbalanced T lymphocytes at that time.

Adolescent↗

PubMed1995

Interferon-gamma therapy for infection control in chronic granulomatous disease.

Interferon (IFN)-gamma was subcutaneously administered to four patients with chronic granulomatous disease (CGD) in order to evaluate its effects in controlling infection. Patients 1 to 3 were all males, while patient 4 was female. In patients 2 and 4, the length of infection-associated hospitalization during the year of IFN therapy was significantly shorter than that during the whole observed period prior to IFN therapy. In patients 1 and 2, the length of hospitalization during a year of IFN therapy was shorter than that during 1 year prior to the therapy. Patient 3 exhibited no reduction in terms of the length of infectious disease during IFN therapy, because he suffered from a liver abscess before and during the therapy. As soon as the IFN therapy was stopped, patient 2 developed pneumonia and lymphadenitis, which were promptly relieved by readministering the agent. During 1 year of IFN therapy, patients 1, 2 and 4 showed no significant changes in either the nitroblue tetrazolium test, O2- production or the expression of NADPH oxidase components in neutrophils. On the other hand, the O2- generating ability of neutrophils from patient 3 slightly increased. Our limited observations suggest that IFN-gamma may be variably beneficial for infection control in CGD-patients, irrespective of the in vitro phagocyte functions. A longer follow-up time is needed to confirm the IFN response in CGD-patients.

Adolescent↗

PubMed1995

Treatment of young relapsed Hodgkin's disease patients with high-dose chemotherapy followed by peripheral blood stem cell transplantation.

Four patients less than 20 years of age with Hodgkin's disease, who had developed either second or third relapse, were treated with high-dose chemotherapy followed by peripheral blood stem cell transplantation (PBSCT). Peripheral blood stem cells (PBSC) were collected after the administration of high-dose cytosine arabinoside (HD-AraC, 1g/m2 x 4). The conditioning regimen for PBSCT contained cyclophosphamide (50mg/m2 x 4), etoposide (150mg/m2 x 6) and ranimustine (250mg/dose x 1) (CVM regimen). A significant tumor regression was thus obtained after HD-AraC in 3 cases. The amount of PBSC harvested ranged from 1.2 to 4.5 x 10(5)/kg CFU-GM. Several cycles of conventional therapy were performed prior to the transplantation. PBSCT was done only after achieving a complete remission (CR) in 3 cases, but during relapse in another case. All patients showed both a rapid and sustained hematological recovery without any critical side effects. After this treatment, the 3 patients who were in CR at transplantation maintained a CR for 27, 26, and 4 months, respectively, while another developed a bone relapse despite achieving a CR by PBSCT. These results suggest that a combination of HD-AraC and CVM followed by PBSCT is therefore considered to be beneficial in the treatment of relapsed Hodgkin's disease.

Adolescent↗

PubMed1995

[A comparison of intra-arterial chemoembolization and infusion chemotherapy for liver metastases of breast cancer].

Seventeen patients with liver metastases of breast cancer were treated with a combination of intra-arterial chemotherapy and endocrine therapy at our hospital from 1986 to 1994. Of 17 patients, 9 were treated with transarterial chemoembolization through hepatic artery using 40-50 mg/body of 4'epi-adriamycin (epi-ADM) and lipiodol, and the other 8 were treated with hepatic infusion chemotherapy using 20-30 mg/body of epi-ADM every 2 weeks. All patients were followed by endocrine therapy with oral administration of 800-1,200 mg/day of medroxyprogesterone acetate (MPA). The results were as follows: 1) The comparison of response rate between the two groups was not substantially changed (44.4% x 4/9 in TAE group and 50.0% x 4/8 in Reservoir group). 2) Duration of response was 4-45 months (mean 25 months) in TAE group and 3-15+ alpha months (mean 8.7 months) in Reservoir group. But in the latter group, 3 patients are now under treatment. 3) At one year, the survival rates were 44.4 percent in TAE group and 50.0 percent in Reservoir group. We conclude that combination of intra-arterial chemotherapy and endocrine therapy is a useful treatment modality for controlling liver metastases of breast cancer.

Adult↗

PubMed1995

Detectability of hypervascular hepatocellular carcinoma by arterial phase images of MR and spiral CT.

The ability of arterial phase images of breath-hold MR imaging and spiral CT to detect hypervascular hepatocellular carcinomas (HCCs) was evaluated. Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, MR images and spiral CT during i.v. bolus injection of contrast medium (IV-MR imaging and IV-spiral CT) and spiral CT during intraarterial injection of contrast media through catheter (IA-spiral CT) of the entire liver were obtained in 24 consecutive patients with 93 HCCs. In the detection of HCCs less than 1 cm in diameter, IA-spiral CT (87.3%) was superior to IV-MR imaging (63.5%) and IV-spiral CT (54.0%) (p < 0.001). There was no significant difference in detectability in any tumor size between IV-MR imaging and IV-spiral CT. IA-spiral CT was the best for detecting hypervascular HCCs, and there was no significant difference between IV-MR imaging and IV-spiral CT.

Adult↗

PubMed1995

[Treatment results of acute nonlymphocytic leukemia in childhood--Kyushu Yamaguchi Children's Cancer Study Group].

Seventy-three children with acute nonlymphocytic leukemia (ANLL) have been treated with ANLL-85 and ANLL-88 protocol at Kyushu-Yamaguchi Children's Cancer Study Group between June, 1985 and February, 1993. Ten boys and 10 girls (0y4m-16ylm) were treated with the ANLL-85 protocol. The complete remission (CR) rate was 75% and the 5-year event free survival (EFS) was 20 +/- 9%. It was terminated because of frequent early relapse (within 6 months after CR). Thirty-four boys and 19 girls (0y3m-17ylm) were treated with the ANLL-88 protocol. The CR rate was 85% and the 5-year EFS was 32 +/- 7%. Early relapse rate with ANLL-88 was lower than that of ANLL-85, however 9 cases relapsed after terminating therapy. Although bone marrow transplantation (BMT) from related donors during the first CR was effective in ANLL-88, EFS was not improved. Recognition of risk factors and appropriate chemotherapy regimens with or without the support of stem cell transplantation may be necessary to cure children with ANLL.

Adolescent↗

PubMed1994

Effective cases of transcatheter arterioportal chemoembolization with high-dose iodized oil for hepatocellular carcinoma.

By administering an excessive amount of iodized oil via the hepatic artery, anticancer drugs in the iodized oil flow into the portal vein through the arterioportal communication. This phenomenon permits chemotherapy against extracapsular infiltration by a hepatocellular carcinoma (HCC) nourished by the portal blood flow. From May 1983 through July 1992, 240 cases of HCC underwent transcatheter arterioportal chemoembolization (TAPCE) with more than 5 ml of iodized oil (mean, 15 ml) in our hospital. In all, 32 patients survived for more than 3 years, and the factors favoring the efficacy of TAPCE therapy were investigated. Doxorubicin (mean, 46 mg) was given to 31 patients and 20 mg mitomycin C was given to 1 patient. The patients included one Stage 1 case, 13 Stage 2 cases, 17 Stage 3 cases, and one Stage 4 case. The mean tumor size was 5.0 cm, and portal invasion was suggested in 8 cases by angiography. The tumors were divided into 5 types: 13 cases of the single nodular type (SN), 7 cases of the single nodular type with proliferation (SN-P), 3 cases of the multinodular fused type (MN-F), 5 cases of the multinodular type (MN), and 4 cases of the massive type. A complication of liver dysfunction was detected in 14 cases, and half of them were Child's class C. In all, 7 patients underwent hepatectomy and 6 received percutaneous ethanol injection after TAPCE. The treated area of TAPCE was classified as segmental, lobar, or total. Segmental and lobar administration of TAPCE yielded statistically effective results, and their tumor response rate was 86%. All of the MN-F and massive types showed a good tumor response. The incidence of intrahepatic distant metastasis was higher in the localized TAPCE group than in the total TAPCE group. Segmental and lobar TAPCE should be applied for localized infiltrating HCCs, even in cases associated with liver cirrhosis, but these methods have a limited capacity to prevent distant intrahepatic metastasis.

Adult↗

PubMed1994

Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma--a comparison between L-TAE with farmorubicin and L-TAE with adriamycin: preliminary results (second cooperative study). Cooperative Study Group for Liver Cancer Treatment of Japan.

A randomized controlled clinical trial was conducted to compare the use of farmorubicin (FARM) and adriamycin (ADR) in Lipiodol transcatheter arterial chemoembolization (L-TAE) as a treatment of hepatocellular carcinoma. In all, 192 hospitals participated, and 415 patients were enrolled in the study during the period from October 1989 through December 1990, and their data were collected. The patients were randomly allocated to group A (FARM) or group B (ADR) by a central telephone registration. Several clinical characteristics were slightly worse in group A than in group B, but there was no statistically significant difference. The actual doses of FARM and ADR were 72 mg/body and 48 mg/body, respectively. Additional treatments, including repeated TAE or surgery, were given to 248 patients. The 1- and 2-year survival rates were 69% and 44% for group A and 74% and 57% for group B, respectively. The difference was marginally significant (P value in the log-rank test, 0.038). When each group of patients was classified into two subgroups, i.e., high-risk and low-risk categories, based on the severity index calculated by the Cox regression model from significant prognostic factors, the ADR subgroup was significantly superior to the FARM subgroup in the low-risk category, but there was no significant difference between the subgroups in the high-risk category. The change in the serum alpha-fetoprotein level, the extent of Lipiodol accumulation in the tumor, and the extent of tumor reduction did not show any significant difference between the groups. At the above-mentioned doses, ADR seemed to have efficacy almost the same as or slightly superior to that of FARM in L-TAE for the treatment of hepatocellular carcinoma.

Adult↗

PubMed1994

Follow-up study of combination treatment (TAE and PEIT) for unresectable hepatocellular carcinoma.

The subjects were 35 patients with unresectable hepatocellular carcinoma. The patients were divided into a transcatheter arterial embolization group (TAE group, 18 cases) and a combination therapy group receiving both TAE and percutaneous ethanol injection therapy (TAE+PEIT group, 17 cases). The 50% survival period was 21.1 months for the TAE group and 37.8 months for the TAE+PEIT group (P < 0.05). The longest survival period in the TAE group was 89 months. In the TAE+PEIT group, one patient has survived for 59 months. The actuarial 1-, 2-, and 3-year survival rates for the TAE group were 82%, 45%, and 22%, respectively. For the TAE+PEIT group the rates were 83%, 64%, and 64%, respectively. The TAE+PEIT group showed a significantly higher survival rate in the 895- to 1,074-day period as compared with the TAE group (P < 0.05). Overall, the survival rate tended to be higher in the TAE-PEIT group (P < 0.1). The therapeutic responses of tumors were measured by the maximal reduction rate within 6 months of TAE and PEIT. In the TAE group, a PR was seen in only four cases. In the TAE+PEIT group, CRs and PRs were achieved significantly more frequently than in the TAE group. When the patients were divided into a responder group (CR, PR, and MR) and a nonresponder group (NC and PD), survival was significantly longer in the responder group. The findings of the present study suggest that the combination therapy was useful for improving the survival of patients with unresectable hepatocellular carcinoma.

Adult↗

PubMed1994

Extraserosal invasion in advanced gastric cancer: evaluation with MR imaging.

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging in the diagnosis of extraserosal invasion in advanced gastric cancer. MATERIALS AND METHODS: MR imaging was performed in 48 patients with advanced gastric cancer, and the results were correlated with the histopathologic findings. Images perpendicular to the gastric wall with cancer were obtained with spoiled gradient-recalled acquisition in the steady state (GRASS). The degree of serosal invasion was classified on the basis of the appearance of a low-signal-intensity band around the lesion. RESULTS: Advanced gastric cancer appeared as a thickened wall of high signal intensity after the administration of contrast material. A low-signal-intensity band disappeared or showed irregularity in the area of extraserosal invasion by the gastric cancer. The MR imaging-determined grade correlated with the histopathologic findings for 11 of 14 (79%) pT2 tumors, 23 of 24 (96%) pT3 tumors, and eight of 10 (80%) pT4 tumors. The overall accuracy was 88%. CONCLUSION: Presence of a low-signal-intensity band at MR imaging is useful for the preoperative evaluation of serosal invasion.

Adult↗

PubMed1994

[Bone marrow transplantation for a patient with ALL from her 75-year-old mother using cryopreserved bone marrow cells].

We report a 42-year-old woman with acute lymphoblastic leukemia who received allogeneic bone marrow transplantation (BMT) in the first remission from her 75-year-old, HLA-identical, MLC-non-reactive mother. Considering the difficulty to obtain a sufficient number of bone marrow cells from such an old donor, we harvested the cells (2.31 x 10(8)/kg) on day -37 and cryopreserved them until use. BMT was performed on June 3rd, 1993 after conditioning regimen with total body irradiation, high-dose AraC and cyclophosphamide. Graft-versus-host disease (GVHD) prophylaxisis was attempted by cyclosporin A and short-term methtrexate. Her hematopoietic recovery was favorable with no signs and symptoms of GVHD as far as day 218.

Adult↗

PubMed1994

Time-of-flight MR angiography of portal system and collaterals in portal hypertension using a 2-DFT fast spoiled gradient recalled steady-state precession technique.

MR angiographic examinations were performed in 26 patients. Approximately 30 contiguous fast spoiled GRASS images (8.1/3.1/30 degrees, TR/TE/flip angle) were acquired during single breath-holding for about 35 s, and then new images were reconstructed with maximum intensity projection technique. Spoiled GRASS images (40/12/40) of 2 to 3 slices were taken during breath-holding for about 13 s, and these processes were repeated to obtain about 30 individual images for conventional MR angiography. The new MR angiograms were compared quantitatively and qualitatively with conventional MR angiograms with arterial portography as the gold standard. The new MR angiograms could visualize blood vessels with smooth margins, and provided almost the same anatomic information about the portal vein and collateral vessels as the conventional MR angiograms. Contrast-to-noise ratios between the portal or hepatic vein and liver parenchyma were significantly higher with fast spoiled GRASS images. The new MR angiograms using fast spoiled GRASS images provided useful diagnostic mapping of the collateral venous pathways within a shorter examination time.

Adult↗

PubMed1994

[Early detection of non-palpable (T0) breast cancer: the diagnostic procedure for pathological discharge from the nipple].

Detection of non-palpable (T0) breast cancer by pathological nipple discharge is possible 3 years or more earlier than tumorous breast cancer. However, the definite diagnosis of T0 breast cancer has been considered to be very difficult because the standard diagnostic method such as exfoliative cytology and ductography were not totally reliable. In 1985 we first demonstrated the significance of CEA measurement in nipple discharge for diagnosis of T0 breast cancer. Since then CEA activity in nipple discharge was estimated in 60 patients with breast diseases by means of enzyme immunoassay using monoclonal anti CEA antibody. They include 17 with T0 breast cancer, 9 with borderline lesion, 20 with intraductal papilloma and 14 with fibrocystic diseases. When the cut off value of CEA concentration was set at 600 ng/ml, the sensitivity, specificity and accuracy were 76.5%, 100% and 92.2%, respectively. These levels were higher than those for mammography or cytology. In the past 7 years, 13 cases of T0 breast cancer were detected in our hospital. They accounted for 2.5% of total breast cancer cases. In conclusion, CEA measurement in nipple discharge is a useful method for the diagnosis of non-palpable breast cancer.

Biomarkers, Tumor↗

PubMed1993

Esophageal squamous cell papilloma, suspected of squamous cell carcinoma.

A 46-year-old male without any subjective complaints was diagnosed by radiography as having one polypoid lesion at the distal esophagus. Endoscopy indicated a semipedunculated polyp about 1 cm in size, the specimens of which included atypical cells with a high N/C ratio in the submucosa. Squamous cell carcinoma of the esophagus was suspected. Cytological studies of PAS, CEA and keratin staining to atypical cells were all negative, with Lugol solution staining of the tumor. After polypectomy the lesion was diagnosed as a squamous cell papilloma of the esophagus; and the atypical cells were determined to be immature fibroblasts and/or endothelium.

Carcinoma, Squamous Cell↗

PubMed1993

[Studies on combination therapy with TAE and percutaneous ethanol injection therapy for unresectable hepatocellular carcinoma].

We studied and analysed the effects of combination therapy with TAE and PEIT for unresectable HCC. The subjects were 28 patients (21 males, 7 females) with 31 tumors treated in the Department of Surgery, Osaka Teishin Hospital. The patients were divided into four groups on the basis of the tumor size (< 3 cm, 3-5 cm, 5-8 cm, > 8 cm). The therapeutic effect on the tumors was evaluated on the basis of the maximum reduction rate within 3 months after TAE and PEIT. The response rates after treatment were 87.5%, 60.0%, 25.0% and 0% for < 3 cm, 3-5 cm, 5-8 cm, and > 8 cm tumor size, respectively. The 50% survival period was 50.9 months. The 1-, 2-, 3- and 5-year survival rates were 92%, 76%, 52% and 32%, respectively. In the cases of over 8 cm, this combination therapy had no effects on the survival period. The findings of the present study suggest that the combination therapy was useful for the unresectable HCC of under 5 cm in diameter.

Carcinoma, Hepatocellular↗

PubMed1992

Multiple colorectal carcinomas and colorectal carcinoma associated with extracolonic malignancies.

In this study, we analyzed 149 surgical cases of colorectal cancer between January 1983 and August 1989. Thirteen cases (8.7 percent) of colorectal primary cancer associated with extracolonic primary malignancy of 14 lesions and 10 cases (6.7 percent) of multiple primary colorectal cancers were included. Among the 14 lesions of extracolonic primary malignancy, there were 6 gastric carcinomas, 2 endometrial carcinomas, 2 urinary bladder carcinomas, and one each in the esophagus, liver, bile duct and jejunum. The second tumor was not detected preoperatively in 3 of 4 cases of synchronous multiple primary colorectal carcinoma. A curative resection was done in 10 (77 percent) out of 13 cases of colorectal cancer associated with extracolonic malignancy, while 7 (88 percent) out of 8 cases of multiple colorectal cancers had a curative resection. Nine patients (69 percent) with colorectal cancer associated with extracolonic malignancy were disease-free for 2 months to 14 years. Seven patients (88 percent) with multiple colorectal cancers were disease-free for one to 22 years. We recommend, therefore, that in any patient with colorectal cancer, the entire large bowel should be thoroughly searched for any other primary tumors, by taking the existence of extracolonic tumors into account. A curative resection should be performed, and the follow-up period should be life-long.

Adenocarcinoma↗

PubMed1992

A case of splenic vein occlusion caused by the intravenous tumor thrombus of nonfunctioning islet cell carcinoma.

We report herein a case of successfully treated advanced, nonfunctioning islet cell carcinoma associated with left-sided portal hypertension. The splenic vein was obstructed by a huge intravenous tumor thrombus developing from the main pancreatic tumor. Direct invasion to adjacent organs such as the spleen, colon, left kidney and stomach was also observed, although liver metastasis was not present. Radical resection was carried out with removal of these five involved organs and the patient is alive without recurrence more than 5 years after surgery.

Adenoma, Islet Cell↗

PubMed1992

Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma--a comparison of lipiodol-transcatheter arterial embolization with and without adriamycin (first cooperative study). The Cooperative Study Group for Liver Cancer Treatment of Japan.

A randomized, controlled clinical trial comparing the use of lipiodol-transcatheter arterial embolization (L-TAE) in the presence versus the absence of Adriamycin (ADR) for the treatment of hepatocellular carcinoma was conducted from August 1988 through September 1989. In all, 125 Japanese hospitals participated in this study and 289 patients were entered in the trial. The patients were randomly allocated into group A (L-TAE) or group B (L-TAE + ADR) by telephone registration. There was no significant difference in background factors between group A and group B. Additional treatment, including repeated TAE or hepatic resection, was given to 189 patients. Among the four endpoints analyzed, the rate of tumor reduction and lipiodol accumulation in the tumor did not significantly differ between the two groups. The 3-year survival values for groups A and B were 33.6% and 34.9%, respectively; the difference was not significant. The serum alpha-fetoprotein level, however, decreased to a significantly greater extent in the group that received ADR than in the group that did not (P < 0.05). This result suggests that ADR has some favorable additional effect in L-TAE for the treatment of hepatocellular carcinoma.

Adult↗