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K Inoue

Publications and source records attributed to K Inoue.

At least 253 records · Page 14Linked to original sources
PubMed2001

[High-dose rate Iridium-192 brachytherapy with flexible applicator--a trial toward decrease of stress during treatment and improvement of quality of life].

PURPOSE: We tried to improve the materials and methods of high-dose rate Iridium-192 brachytherapy for localized prostate cancer and evaluated the stress during the treatment in 20 patients with whom the therapy was performed. MATERIALS AND METHODS: Rigid applicators made of stainless steel of 1.6 mm in diameter were indwelt with a template as usual for 30 hours in 14 patients (group A). Flexible applicators made of polyoxymethylene rosin (POM) of 2.0 mm in diameter were indwelt without a template for 30 hours after the applicator insertion in 6 patients (group B). We made inquiries about lumbago, inconvenience and necessity of assistant help and sleep in the course of therapy, and urinary incontinence and erectile function after the course of therapy as the QOL. RESULTS: The stress during the course of therapy in the patients of group B was obviously less than that of group A. There were no significant differences in urinary incontinence and erectile function after the course of therapy between group A and B. CONCLUSION: In this study, our trial successfully reduced the stress during the course of therapy in the patients with localized prostate cancer in the course of high-dose rate Iridium-192 brachytherapy.

Aged↗
PubMed2001

[High-dose rate iridium-192 brachytherapy combined with external beam radiotherapy for localized prostate cancer].

PURPOSE: We report our technique and also preliminary results in the cases with localized prostate cancer treated by the combination of high-dose rate Iridium-192 (HDR-Ir192) brachytherapy and external irradiation. MATERIALS AND METHODS: From June 1999 to August 2000, 17 patients were treated by the combination of HDR-Ir 192 and external beam. The mean age of patients was 72 years (range, 48-81 years). The clinical stage was B1 in 5, B2 in 7 and C (no cancer with seminal vesicle) in 5 cases. Of 10 patients without neoadjuvant hormonal therapy, the median initial pretreatment PSA was 15.3 ng/ml (6.93-222.32 ng/ml). The treatment was given by HDR-Ir 192 brachytherapy (6 Gy x 3 times/2 days) and external beam irradiation (40 or 45 Gy). The brachytherapy was given using TRUS guided percutaneously inserted temporary needles with a high dose rate remote afterloading control. Local control was evaluated by digital rectal examination. TRUS-guided biopsies and serum PSA evaluations. Follow-up ranged from 2 to 14 months, with a median of 8 months. RESULTS: In 4 (40.0%) of 10 patients without neoadjuvant hormonal therapy the level of serum PSA was decreased to less than 4.0 ng/ml within 3 months after the therapy. The effective grade in the biopsy specimens of 8 patients without neoadjuvant hormonal therapy was Grade Ob in 4, Grade 1 in 1, Grade 3 in 3 cases at 3 months after the therapy. No severe intra- or peri-operative complications occurred. CONCLUSION: The combined radiotherapy treatment is safe and effective for use in the patients with localized prostate cancer. However, more comprehensive studies involving long-term follow-up and great numbers of the cases with localized prostate cancer treated by the combination of HDR-Ir 192 brachytherapy and external irradiation will be necessary to determine whether this therapy contributes to better prognosis.

Aged↗
PubMed2001

[Antimicrobial resistant test of H. pylori].

The resistance of Helicobacter pylori (H. pylori) to antibiotics leaves great influence on treatment outcome. Agar and broth dilution techniques are difficult to perform and not practical. E-test has the advantage of allowing visualization of resistant subpopulations of bacteria within zones of inhibitions. We studied point mutation of 23s-rRNA gene for H. pylori strains. (74 clarithromycin (CAM)-resistant, 6 CAM-susceptible) The results of these assays were well correlated with these of E-test. The cure rate of triple therapy with metoronidazole (MTZ) for CAM-resistant H. pylori is 100%(11/11), and that with CAM for MTZ-resistant H. pylori is 94.4% (17/18). It is very difficult to eradicate CAM and MTZ-resistant H. pylori.

Clarithromycin↗
PubMed2001

[Enucleation of renal tumor using microwave tissue coagulator: a case report].

A 69-year-old man was referred to our department for a cystic tumor, 4.0 cm in diameter, in the lower portion of the right kidney, which was detected by computed tomography. The patient had been admitted to the department of surgery in our hospital for treatment of ileus caused by transverse colon cancer. With a diagnosis of cystic renal cell carcinoma. T2N0M0, in situ non-ischemic tumor enucleation was performed using a microwave tissue coagulator (Microtaze, Heiwa Electronics Industry Inc., Tokyo). The enucleation was accompanied by a defect of the renal pelvis, but it was easily repaired. The operation time was 120 minutes and blood loss was 110 cc. The histological diagnosis was renal cell carcinoma, pT2N0M0V1, expansive, alveolar type, clear cell subtype, G1 > G2. Diagnostic imaging done postoperatively showed no sign of damage to renal function. At the present time, the patient has been disease-free with interferon-alpha for 12 months and is being followed on an outpatient basis. In this report, the advantages of nephron-sparing surgery, especially in situ non-ischemic tumor enucleation using a microwave tissue coagulator for renal tumor are discussed. In particular, the technique of performing tumor enucleation with repair of the defect of renal pelvis used in this case may extend the indication of nephron-sparing surgery.

Aged↗
PubMed2001

[A case of lung and pleural metastases from breast cancer responding to toremifene].

A patient with lung and pleural metastases from breast cancer treated effectively with toremifene is reported. A 62-year-old woman underwent mastectomy for breast cancer, and had high levels of estrogen and progesterone receptor. After 2-years of adjuvant UFT therapy, lung and pleural metastases were seen on a chest x-ray. The patient received a high-dose of toremifene (120 mg/day). After five months with toremifene, a chest x-ray and CT scan showed the disappearance of lung and pleural metastases. No recurrence or metastases have been detected for twenty months to date. No serious side effects were noticed. High-dose toremifene might be an effective therapy for cases of postmenopausal metastatic breast cancer, with high levels of estrogen and progesterone receptor.

Antineoplastic Agents, Hormonal↗
PubMed2001

[Broad old anteroseptal myocardial infarction with coronary aneurysm showing marked improvement of myocardial perfusion by intravenous myocardial contrast echocardiography after successful coronary angioplasty: a case report].

A 56-year-old man with old anteroseptal myocardial infarction was admitted to treat a gradually expanding coronary aneurysm. Coronary angiography demonstrated the aneurysm and delayed flow in the left coronary descending artery. The aneurysm was successfully treated with stenting. Technetium-99m-sestamibi single photon emission computed tomography (SPECT) showed a persistent defect in the anterior infarcted area after stenting. Myocardial contrast echocardiography was performed using SystemFIVE and EchoPAC. Levovist was injected (1 ml, 1.5 ml/sec; bolus + 1 ml/sec; continuous infusion) by Pulsar. Myocardial reperfusion was observed by B-mode and anatomical M-mode before and after intervention. Time-intensity curves from the region of interest positioned within the interventricular septum showed the mean value at plateau increased from 10.8 to 25.1 dB. The persistent defect area demonstrated by SPECT was enhanced by myocardial contrast echocardiography after intervention. Myocardial contrast echocardiography is useful for the assessment of outcome after intervention and evaluation of improved coronary blood flow.

Angioplasty, Balloon, Coronary↗
PubMed2001

[Cholesterol embolism after percutaneous transluminal coronary angioplasty procedure: a case report].

A 68-year-old man with chest pain was treated under a diagnosis of angina pectoris based on coronary angiography by percutaneous transluminal coronary angioplasty including stent implantation performed by the femoral approach. About 1 month after intervention, his renal function deteriorated and purpura appeared on both feet, especially at the toe tips. He was treated under a tentative diagnosis of cholesterol embolism conservatively at the out-patient clinic. However, he was admitted by ambulance due to worsening renal failure 2 months later and died from multiple organ failure 2 weeks after admission. Autopsy examination identified cholesterol embolism due to crystal emboli in several organs. Cholesterol embolism rarely occurs after angiographic or interventional procedures, but is difficult to diagnose clinically and there is no established therapy. The number of intervention and angiography procedures is increasing, so the occurrence of embolism as a complication of these procedures might also increase.

Aged↗
PubMed2001

[A lung cancer patient whose renal scintigram showed transient renal dysfunction after administration of contrast material for CT].

We encountered a patient whose renal scintigram showed renal tubular damage four days after administration of contrast material for CT. As no secretion of radioisotope to the urinary tract was observed on the scintigram and the renogram did not show a secretionary phase, renal tubular damage was suspected. As the renal damage disappeared six days after administration of the contrast material, the damage seemed to be transient, disappearing within five days. Caution is needed with the use of renotoxic drugs such as anti-tumor drugs, especially within five days after administration of contrast materials.

Aged↗
PubMed2001

[Incidence and severity of coronary artery disease in patients with acute aortic dissection: comparison with abdominal aortic aneurysm and arteriosclerosis obliterans].

OBJECTIVES: The incidence and severity of coronary artery disease were studied in patients with acute aortic dissection (AAD), and compared with coronary artery disease in patients with abdominal aortic aneurysm (AAA) or arteriosclerosis obliterans (ASO). METHODS: A total of 71 patients(42 males, 29 females, mean age 61.4 +/- 10.0 years) with AAD, undergoing coronary angiography between 1988 and 1999, were studied including 38 patients with open communication type and 33 patients with thrombosed type. According to the Stanford classification, 18 patients were type A and 53 patients were type B. Patients with AAD following Marfan syndrome or chest trauma were excluded from the study. Selective coronary angiography was performed in age- and sex-matched patients with AAA(n = 57; 42 males, 15 females, mean age 63.9 +/- 4.6 years) or ASO (n = 95; 66 males, 29 females, mean age 62.4 +/- 9.4 years). Coronary artery disease was defined as > or = 75% stenosis (left main trunk lesion of > or = 50% stenosis) by multidirectional imaging. RESULTS: Significant coronary artery disease was demonstrated in 14 patients with AAD (19.7%), 25 patients with AAA (43.9%), and 49 patients with ASO (51.5%). The incidence of coronary artery disease was significantly lower in the AAD group than in the other two groups (p < 0.05). One-vessel disease was present in approximately 70% of the patients with AAD and coronary artery disease. In contrast, multivessel disease was observed in approximately 50% of patients with AAA and ASO. Classification of the patients with AAD according to the blood flow in the false lumen showed coronary artery disease was more highly associated with the thrombosed type [10 (30.3%) of 33 patients] than the open communication type [4 (10.5%) of 38 patients]. Multivariate logistic regression analysis of the patients with AAD showed coronary artery disease was associated with a high serum total cholesterol level (p = 0.025) and the thrombosed type (p = 0.043). CONCLUSIONS: The incidence of coronary artery disease was significantly lower among patients with AAD than among age- and sex-matched patients with AAA or ASO. Coronary artery disease developed in 30% of the patients with the thrombosed type of AAD, although the prognosis seemed to be good.

Acute Disease↗
PubMed2001

[Perspectives on regenerative therapy].

Organ transplantation and artificial organs are the only effective treatments for loss of organ and tissue function. These treatments, however, are associated with serious problems such as a critical shortage of donor organs, rejection, the need for life-long immunosuppression, and unstable biocompatibility. These shortcomings have stimulated the development of tissue engineering. Tissue engineering is defined as an interdisciplinary field that applies the principles of engineering and the life sciences to the development of biological substitutes that restore, retain, or improve tissue function. Tissue engineering is composed of three factors: cells; growth factors; and scaffolds. Regenerative medicine includes two important fields: tissue engineering; and regenerative biology. Regenerative therapy is a newly developed medical therapy based on the research results of regenerative medicine. The fields of regenerative therapy includes broad areas of basic and clinical sciences, bioethics, and medical economics in addition to the area of regenerative medicine. Cell sources and cell expansion are important issues in regenerative medicine. Great efforts are being made to isolate and identify the characteristics of stem cell populations of various tissues. The use of stem cells may provide an almost limitless supply of cells for transplantation. Although there are still many important issues to be resolved, regenerative medicine has been making rapid progress using a multidisciplinary approach. The success of this approach will lead to the widespread application of regenerative therapy and may ultimately be able to replace lost tissue function in the 21st century. We should, however, keep in mind the importance of bioethics in using any new therapy.

Cell Transplantation↗
PubMed2001

New polymorphic short tandem repeats for PCR-based Charcot-Marie-Tooth disease type 1A duplication diagnosis.

BACKGROUND: Charcot-Marie-Tooth disease type 1A (CMT1A) accounts for 70-90% of cases of CMT1 and is most frequently caused by the tandem duplication of a 1.4-Mb genomic fragment on chromosome 17p12. Molecular diagnosis of CMT1A has been based primarily on pulsed-field electrophoresis, fluorescence in situ hybridization, polymorphic allele dosage analysis, and quantitative PCR. We sought to improve the fidelity and applicability of PCR-based diagnosis by developing a panel of novel, highly polymorphic short tandem repeats (STRs) from within the CMT1A duplicated region. METHODS: We used a recently available genomic sequence to identify potentially polymorphic simple repeats. We then amplified these sequences in a multiethnic cohort of unaffected individuals and assessed the heterozygosity and number of alleles for each STR. Highly informative markers were then tested in a set of previously diagnosed CMT1A duplication patients, and the ability to identify the genomic duplication through the presence of three bands was assessed. RESULTS: We identified 34 polymorphic markers, 15 of which were suitable for CMT1A diagnosis on the basis of high heterozygosity in different ethnic groups, peak uniformity, and a large number of alleles. On the basis of the fluorescent dye and allele range of each marker, we developed two panels, each of which could be analyzed concurrently. Panel 1, which comprised 10 markers, detected 37 of 39 duplications, whereas panel 2, which comprised the remaining 5 markers, identified 21 of 39 duplications. Through the combination of both panels, we identified 39 of 39 duplications in previously diagnosed CMT1A patients. CONCLUSIONS: The newly developed 15-marker set has the capability of detecting > 99% of duplications and thus is a powerful and versatile diagnostic tool.

Asian People↗
PubMed2001

[Female paraurethral cyst: a case report].

We experienced a case of paraurethral cyst in a 42-year-old woman. A paraurethral cyst, the diameter of which was about 2 cm, was observed in the septum between urethra and vagina. No communication between the cyst and urthra or vagina was detected. The resected cyst did not reveal malignant findings. Sixty-one cases of paraurethral cyst in the Japanese literature are also reviewed.

Adult↗
PubMed2001

Expression of P-glycoprotein in human placenta: relation to genetic polymorphism of the multidrug resistance (MDR)-1 gene.

To evaluate whether mutations in the human multidrug resistance (MDR)-1 gene correlate with placental P-glycoprotein (PGP) expression, we sequenced the MDR-1 cDNA and measured PGP expression by Western blotting in 100 placentas obtained from Japanese women. Nine single nucleotide polymorphisms (SNPs) were observed with an allelic frequency of 0.005 to 0.420. Of these SNPs, G2677A (allelic frequency = 0.18) and G2677T (0.39) in exon 21 were associated with an amino acid conversion from Ala to Thr and to Ser, respectively. Sixty-one of 65 samples (93.8%), which had a C3435T allele, also had a mutant G2677(A,T) allele, suggesting an association between the two SNPs. Correlations of mutations with expression levels were observed; individuals having the G2677(A,T) and/or T-129C (p < 0.05) allele had less placental PGP. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)-based genotyping tests were developed for the detection of these SNPs. The PCR, in which genomic DNAs obtained from healthy subjects (n = 48) are used as samples, was successful. The frequency of mutations in placental cDNA was identical with that in genomic DNA. When genotype results were compared between Caucasians and Japanese, ethnic differences in the frequency of polymorphism in the MDR-1 gene were suspected. Although it remains to be determined whether these SNPs influence the pharmacokinetic and dynamic properties of clinically useful drugs that are substrates of PGP, the polymorphism of the MDR-1 gene presented here may provide useful information in in vivo study of these issues.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2001

[Three cases of advanced gastric cancer resected after successful treatment with the novel oral anticancer drug TS-1].

We operated on 3 patients with advanced gastric cancer after successful treatment with novel oral 5-fluorouracil derivatives (TS-1). In all 3 patients, gastrointestinal fiberscopy revealed a considerable reduction in the tumor after oral administration of TS-1 in our clinic. Case 1 underwent surgery after an interval of 1 day following oral administration of TS-1 for 18 days. Pathologically, no cancer cells were found in the resected stomach and a few cancer cells were found only in resected lymph nodes. In case 2, who underwent surgery after an interval of 7 days following oral administration of TS-1 for 14 days, a few cancer cells were found only in the submucosal layer of the stomach and no viable cancer cells remained in the metastasized lymph nodes. In case 3, who underwent surgery after an interval of 11 days following administration of TS-1 for 26 days, scattered cancer cells, mostly fibrotic, were found as far as the subserosal layer. The pathological effectiveness of chemotherapy was grade 2 or 3 in each case. Case 2 and 3 followed a satisfactory postoperative course; however, case 1 suddenly had endotoxinemia on the 7th postoperative day. Although the patient had temporary multiple organ failure, he recovered eventually. All 3 patients have been well without any signs of recurrence for more than a year after surgery.

Administration, Oral↗