[Preliminary results of a combination therapy of irradiation, MCNU, carboplatin (CBDCA) and IFN-beta (MCI therapy) for gliomas].
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Adolescent↗
Biomedical subjects
K Tsuno
Publications and source records attributed to K Tsuno.
[Two cases of metastatic brain tumor treated by interstitial brachytherapy].
The prognosis of patients with metastatic brain tumor is very poor. Median survival of these patients has ranged from 1 month with no therapy, to 2 months with steroid, and from 3 to 6 months with brain radiation therapy of the whole brain. A more recent study comparing radiation therapy alone with surgery plus radiation, has shown good results in the combined surgery and radiation therapy group. But surgical excision is usually limited to patients with a surgically accessible solitary metastasis. And therapeutic options are limited once the tumor recurs locally after whole brain irradiation. Interstitial irradiation allows the delivery of a high dose of localized irradiation in the area of tumor recurrence with minimal risk of radiation damage to the surrounding brain tissue. But brachytherapy for brain metastasis has been performed in few cases. We reported two patients with unresectable metastatic brain tumors who were successfully treated with iridium-192 interstitial brachytherapy, and we discuss the strategy of the treatment. Case 1: A 78 year-old-man underwent a total gastrectomy for gastric cancer. Five months after surgery, he developed right hemiparesis. CT scan revealed a left occipital tumor with massive brain edema and a tiny nodule of tumor in the left thalamic region. The primary site was well-controlled and no systemic disease was seen during subsequent whole body examination. The occipital lesion was surgically excised and he received a postoperative radiation therapy of 50 Gy to the whole brain. The thalamic tumor had not responded to the irradiation and the size of tumor rapidly increased.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
[A case of glial microtumor treated with brachytherapy using MRI guided stereotactic system].
A 34 year old male suffered from convulsion on his right side with loss of consciousness. Neither plain nor enhanced CT could clearly demonstrate a lesion. However, a Gd-DTPA enhanced T1 weighted image (T1WI) demonstrated an enhancing lesion (2 cm in diameter) in the left frontal lobe including the motor cortex. This lesion was not identified on plain T1WI. A T2 weighted image (T2WI) showed a high intensity lesion without mass effect slightly larger than the enhanced area on T1WI. This lesion was suspected to be a glial microtumor, but, because it was difficult to differentiate it from a cerebral infarction, it was confirmed to be a neoplasm by means of an MRI guided stereotactic biopsy. The histological diagnosis of the frozen section was a grade 2 astrocytoma. Subsequently brachytherapy with 192Ir seeds was performed, and about 80Gy of interstitial irradiation was given to the edge of the enhanced area on MRI. The minimum dose in the high intensity area on T2WI was about 50Gy. The patient was discharged with no neurological deficits. The Gd-DTPA enhanced lesion decreased in size six months after the treatment. MRI guided stereotactic system makes it possible to target a high intensity lesion on T2WI in brachytherapy. Brachytherapy using this system is considered to be useful in the treatment of glial microtumor in an area in which it is difficult to identify it on CT.
Adult↗
A study on the lung function in alpha 1-antitrypsin-deficient (PiMZ) patients.
Laurel and Eriksson published the first report indicating that alpha 1-antitrypsin deficiency predisposed patients to the development of Chronic Obstructive Pulmonary Disease (COPD). For the purpose of early detection, disturbances of pulmonary function in alpha 1-antitrypsin mild deficiency cases (PiMZ) were compared with those of normal cases (PiMM) in caucasian Americans. The marked results are as follows. 1) Parameters of flow-volume curves were more disturbed in PiMZ cases than in PiMM cases. 2) Volumes of isoflow are specially different between PiMZ and PiMM cases. 3) Mechanical properties, like lung work of breathing, were larger in PiMZ cases than in PiMM cases.
Adult↗
Spontaneous formation of helical structures from phospholipid-nucleoside conjugates.
Phospholipid-nucleoside conjugates containing two myristoyl groups and a nucleotidyl group, collectively designated as dimyristoyl-5'-phosphatidylnucleosides, were enzymatically synthesized and their self-organization, morphology, and physicochemical properties investigated. The dimyristoyl-5'-phosphatidylnucleosides spontaneously assembled to form various types of helical strands. Neutral and alkaline solutions of dimyristoyl-5'-phosphatidyladenosine (DMPA) produced multihelical strands. The multihelical strand consisted of several single helical strands of approximately 50 A in diameter and helical pitch approximately 100 A. DMPA produced cigar-like scrolls (tubular structures) in acidic solution, which consisted of many double-helical strands aligned parallel to each other. Diacyl-5'-phosphatidyladenosine with a shorter chain length as long as an alkyl group, dilauroyl-5'-phosphatidyladenosine (DLPA), didecanoyl-5'-phosphatidyladenosine (DDPA), and dioctanoyl-5'-phosphatidyladenosine (DOPA) formed extended tape structures having double-helical strands aligned parallel. Dimyristoyl-5'-phosphatidylcytidine (DMPC) produced network structures at an early stage, which were slowly transformed into multihelical strands. The multihelical strands contained some single-helical strands of approximately 55 A in diameter and helical pitch approximately 150 A. DMPA produced no definite helical structure in acidic solution but rather large lamellar structures. Dimyristoyl-5'-phosphatidyluridine (DMPU) produced crystalline platelet structures of approximately 1000 A in width in both alkaline and acidic solution. A 1:1 mixture of DMPA and DMPU formed a new hybrid helical strand having a wide and thick ribbon structure of approximately 300 A in diameter and helical pitch approximately 2000 A. The formation of different helical strands and effects of chain lengths of alkyl groups and a nucleotidyl group in phospholipid-nucleoside conjugates on that of helical strands in aqueous solution are discussed.
Aniline Compounds↗
Preliminary results of interstitial 192Ir brachytherapy for malignant gliomas.
Twenty-six patients with recurrent or unremovable malignant gliomas were treated by interstitial brachytherapy with iridium-192 seeds. Stereotactic implantation of the afterloading catheters using the Brown-Roberts-Wells computed tomography (CT)-guided stereotactic system was performed in 24 patients and surgical implantation in two patients with pontine glioma. The response to therapy was measured by serial CT, magnetic resonance imaging, and clinical examination. Tumor regression was seen in 17 patients 1-3 months after implantation. Tumor progression was seen in only three patients. After interstitial brachytherapy, the most commonly observed CT finding was central low density. Median survival time was 18 months after implantation. Autopsies in five patients revealed the delayed effects of radiation injury such as typical vascular changes, microcalcification, and coagulative necrosis in the implant area and tumor recurrence at the periphery. The results suggest that brachytherapy is not curative but prolonged the median survival time by 6 months.
Adult↗
[Analysis of tumor-infiltrating lymphocyte in primary malignant lymphoma of the central nervous system using double immunofluorescence staining method].
Three cases of malignant lymphoma were examined immunohistochemically using anti-Leu monoclonal antibodies (MAB) against B lymphocytes, T lymphocytes subsets, NK cells, IL-2 receptor. In all three cases tumor cells were stained with anti-B cell's MABs, that is they were diagnosed as B cell type of malignant lymphoma. Moderate tumor-infiltrating lymphocytes in the parenchyma or around blood vessels were observed, and majority of these cells were T lymphocytes, demonstrating Leu 2a or Leu 3a + 3b positive phenotypes. IL-2 receptor positive cells also found in the parenchyma of these tumors. T lymphocyte subsets, such as Leu 2a positive cells and Leu 3a + 3b positive cells, were analyzed by means of double immunofluorescence staining method using the combination of Leu 2a and Leu15, or Leu 3a + 3b and Leu 8 MABs. This method demonstrated that most of Leu 2a positive cells were negative for Leu 15 and that the majority of Leu 3a + 3b positive cells were negative for Leu 8. These results suggested that tumor-infiltrating lymphocytes in the malignant lymphoma were mainly activated cytotoxic or helper T cells.
Brain Neoplasms↗
[Study on the extent of peritumoral edema in glioma: its correlation with the proliferative potential and tumor-infiltrating mononuclear cells].
The correlation between the extent of peritumoral edema and the proliferative potential or the infiltration of mononuclear cells was studied in 17 gliomas. The peritumoral edema was evaluated on contrast enhanced CT scan as the ratio of the low density area around the tumor to the enhanced high density area. The proliferative potential and the infiltration of mononuclear cells into the tumor were investigated immunohistochemically using monoclonal antibody (MAb) against DNA polymerase alpha and anti-Leu MAb's respectively. There was a significant correlation between the extent of the peritumoral edema and the percentage of DNA polymerase alpha positive cells. The degree of the infiltration of mononuclear cells into the tumor tissue also correlated with the extent of peritumoral edema. In gliomas with high proliferative potential and/or severe infiltration of mononuclear cells, the peritumoral edema may be aggravated by disruption of the blood-brain-barrier and increased vascular permeability.
Brain Edema↗
Intraoperative management of a patient undergoing extracorporeal liver surgery (bench surgery).
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Journal Article↗
Histopathologic pulmonary changes from mechanical ventilation at high peak airway pressures.
We investigated the histopathologic pulmonary changes induced by mechanical pulmonary ventilation (MV) with a high peak airway pressure and a large tidal volume in healthy baby pigs. Eleven animals were mechanically ventilated at a peak inspiratory pressure (PIP) of 40 cm H2O, a respiratory rate (RR) of 20 min-1, a positive end-expiratory pressure (PEEP) of 3 to 5 cm H2O, and an FIO2 of 0.4. High airway pressure MV was terminated in 22 +/- 11 h because of severe hypoxemia in the animals. Five of the baby pigs were killed for gross and light microscope studies. The pulmonary changes consisted of alveolar hemorrhage, alveolar neutrophil infiltration, alveolar macrophage and type II pneumocyte proliferation, interstitial congestion and thickening, interstitial lymphocyte infiltration, emphysematous change, and hyaline membrane formation. Those lesions were similar to that seen in the early stage of the adult respiratory distress syndrome (ARDS). The remaining six animals were treated for 3 to 6 days with conventional respiratory care with appropriate ventilator settings. Prominent organized alveolar exudate in addition to lesions was also found in the five animals. These findings were indistinguishable from the clinical late stage of ARDS. Six control animals were mechanically ventilated at a PIP of less than 18 cm H2O, a RR of 20 min-1, a PEEP of 3 to 5 cm H2O, and an FIO2 of 0.4 for 48 h. They showed no notable changes in lung functions and histopathologic findings. Aggressive MV with a high PIP is often applied to patients with respiratory distress to attain adequate pulmonary gas exchange.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Chromosomal rearrangement In(2)TY and linkage maps of the second chromosome of Drosophila virilis.
A chromosomal rearrangement In(2)TY, found in a natural population of Drosophila virilis, was examined cytologically, and its genetical characterization was carried out by the use of some marker isozymes and visible marker loci. From the interspecific hybridization between D. virilis and D. americana or D. texana, we deduced that the origin of In(2)TY was from a member of a closely related species of virilis.
Animals↗
Formation and morphology of helical structures from phospholipid-ribonucleoside conjugates in an acidic solution.
Phospholipid-ribonucleoside conjugates containing two myristoyl groups and a ribonucleotidyl group, dimyristoyl-5'-phosphatidyl-ribonucleosides, have been synthesized, and their self-organization and morphology have been investigated in acidic solutions. In acidic solutions, dimyristoyl-5'-phosphatidyl-ribonucleosides produced much different helical structures from those produced in neutral and alkaline solutions.
Hydrogen-Ion Concentration↗
[Increased polyamine levels of normal-appearing mucosa and cancers in DMH induced cancer-bearing colon in rats].
Polyamine levels (putrescine, spermidine, spermine) in normal-appearing colonic mucosa of DMH administrated rats were measured in order to assess their importance as markers of precancerous changes. Mean putrescine, spermidine and spermine levels of normal-appearing mucosa were more than three times mean putrescine, more than twice mean spermidine and more than 1.5 times mean spermine levels of normal colonic mucosa. Mean polyamine levels of colon cancers were higher than those of normal-appearing mucosa but only spermidine level was significantly different between them. The mucosal polyamine levels may be a good biochemical marker to detect precancerous changes. There was no correlation between the polyamine levels and the growth rate of the colon cancers.
Animals↗
[The effect of drug therapy and stellate ganglion block with or without oxygen inhalation on sudden hearing loss].
Forty-one patients suffering from sudden hearing loss were studied by the following method. Twenty patients (group A) were treated with oral administration of prednisolone, intravenous administration of vitamin B and C, furosemide and stellate ganglion block. Another 21 patients (group B) were treated with oral administration of these drugs, stellate ganglion block and oxygen inhalation. Forty six percent of all these patients, 35 percent of group A and 57 percent of group B, regained less than 20 dB of their normal hearing level. The patients who are younger, having shorter duration from first finding of symptoms to starting of therapy and smaller average deficiency of hearing, without dizziness are easy to recover. Oxygen inhalation with drug therapy and stellate ganglion block is a useful treatment for sudden hearing loss.
Adolescent↗
[Basal ganglia germinoma treated with interstitial brachytherapy; case report].
A case of primary intracranial germinoma in the left basal ganglia treated with interstitial brachytherapy was reported. A 15-year-old boy was referred to our hospital for evaluation of right hemiparesis. A CT scan showed a slightly hyperdense mass with multiple cystic low density in the left basal ganglia. The mass was heterogeneously enhanced after intravenous administration of contrast material. T1 weighted image showed a slightly hyperintense mass with cystic components and the mass was heterogeneously enhanced with Gd-DTPA. T2 weighted MR image showed a mixed intensity mass and peritumoral edema. Stereotactic needle biopsy and implantation of 3 catheters for interstitial brachytherapy were performed simultaneously using BRW CT guided stereotactic apparatus. After the histological diagnosis was confirmed to be two cell pattern germinoma, 9 iridium-192 seeds were inserted into the catheters and maintained for 10 days to give 35Gy of irradiation at the tumor periphery. Subsequent CT scans showed marked tumor regression and the clinical symptoms were improved. Germinoma originating in the basal ganglia is rare and hard to diagnose previous to biopsy. Histological confirmation is essential before initiation of treatment because germinoma is commonly thought to be radiosensitive tumor. The interstitial brachytherapy enables selective irradiation of the tumor and actually causes no complications such as bone marrow suppression or cerebral atrophy. The neuroradiological findings, especially of CT scan and MRI, were presented and the strategy for treatment of germinoma in basal ganglia was discussed.
Adolescent↗
[Raised polyamines in erythrocytes of DMH administrated rats with colonic cancers and those relationship to tumor volume].
The objective of this study was to assess, in a controlled experimental system, whether the concentrations of polyamines (Pa) in urine or erythrocytes increase during the process of colon carcinogenesis in rats, and whether such changes reflect tumor volume. Colon carcinoma was induced in Sprague-Dawley rats by subcutaneous injection of 1, -2 dimethylhydrazine (DMH). 24-hour urine and blood samples were collected and analysed for their Pa consent, with high pressure liquid chromatographic method. The levels of any Pa derivatives in either urine or erythrocytes at 32 weeks after the administration of DMH were not significantly high compared with the control group at the same week. However, certain increases of Pa in erythrocytes were observed in the levels of putrescine (1.3 times), spermidine (1.3 times), and spermine (1.5 times) respectively compared with the control group and there were high positive correlations between tumor volume and the levels of each Pa derivatives. On the ground of the results, Pa in erythrocytes seems to be the sensitive parameter for tumor volume compared with Pa in urine.
1,2-Dimethylhydrazine↗
Treatment of hypoxemia during esophagectomy by high frequency jet ventilation.
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Journal Article↗
Acute lung injury from mechanical ventilation at moderately high airway pressures.
We have explored adverse pulmonary effects of mechanical ventilation at a peak inspiratory pressure of 30 cmH2O in paralyzed and anesthetized healthy sheep. A control group of eight sheep (group A) was mechanically ventilated with 40% oxygen at a tidal volume of 10 ml/kg, a frequency of 15 breaths/min, a peak inspiratory pressure less than 18 cmH2O, and a positive end-expiratory pressure of 3-5 cmH2O. During the ensuing 48 h, there were no measurable deleterious changes in lung function or arterial blood gases. Another 19 sheep were ventilated with 40% oxygen at a peak inspiratory pressure of 30 cmH2O under a different set of conditions and were randomly assigned to two groups. In group B, the respiratory rate was kept near 4 breaths/min to keep arterial PCO2 in the normal range; in group C, the frequency was kept near 15 breaths/min by including a variable dead space in the ventilator circuit to keep arterial PCO2 near baseline values. There was a progressive deterioration in total static lung compliance, functional residual capacity, and arterial blood gases. After some hours, there were abnormal chest roentgenographic changes. At time of death we found severe pulmonary atelectasis, increased wet lung weight, and an increase in the minimum surface tension of saline lung lavage fluid.
Air Pressure↗