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Biomedical subjects

M Kashimura

Publications and source records attributed to M Kashimura.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Autologous bone marrow transplantation following high-dose busulfan and etoposide for a patient with non-Hodgkin's lymphoma].

A 26-year-old man was admitted to our hospital with cervical tumor and facial edema on July 8, 1991. Examination of chest X-ray and chest CT showed a bulky tumor in the mediastinum and pleural effusion. A pathological diagnosis of non-Hodgkin's lymphoma (diffuse large cell, immunoblastic type) was made by biopsy of the cervical lymph node. MACOP-B chemotherapy or other combination chemotherapy did not achieve complete remission. The man was given a preparative regimen consisting of busulfan at 16 mg/kg orally and 60 mg/kg of etoposide (Bu-Et); 30 mg/kg of etoposide was administered by continuous intravenous infusion for 12 hours on day-5 and day-4, before he received autologous bone marrow on February 20. He was then given 300 micrograms of G-CSF was given to him to accelerate recovery of hematopoiesis from one day after BMT. The neutrophil count to 500/microliters recovered on day 28, and residual tumors disappeared. Although moderate-grade stomatitis and nasal bleeding developed, these toxicities were controllable and no veno-occlusive disease resulted. Regimen-related toxicities of Bu-Et preparatory regimen have been generally considered to be severe, but continuous and separate administration of etoposide as reported in this case may be useful to reduce side effects of this preparatory regimen.

Adult↗
PubMed1993

[Problems in Papanicolaou classification].

There are several reasons why Papanicolaou classification should not be used for the interpretation of cytologic findings. First, many different classification criteria are sometimes used for a single pathologic condition. Second, inflammatory change or hormonal evaluation are not included in the system. Third, the classification is not compatible for the evaluation of endometrial lesions or chorionic diseases. Fourth, mismanagement of the patient is sometimes encountered when this classification is only used. Instead of Papanicolaou classification, descriptive diagnosis should be used for cytologic interpretation.

Aged↗
PubMed1993

Chemical modification of erythromycins. IX. Selective methylation at the C-6 hydroxyl group of erythromycin A oxime derivatives and preparation of clarithromycin.

Although erythromycin A contains five hydroxyl groups, regioselective methylation at the C-6 hydroxyl group was achieved to the extent of 90% when a 9-O-substituted erythromycin A 9-oxime was employed as substrate. The methylation and its selectivity are dependent on an O-protecting group at the 9-oxime, solvent, base, and methylating reagent. In particular, the use of a polar aprotic solvent is indispensable for the methylation. Among the 9-oxime derivatives, 2'-O,3'-N-bis(benzyloxycarbonyl)-N-demethylerythromycin A 9-[O-(2-chlorobenzyl)oxime] was the most important intermediate for the synthesis of clarithromycin (6-O-methylerythromycin A).

Clarithromycin↗
PubMed1993

[Immunoelectron microscopic localization of human chorionic gonadotropin in the syncytiotrophoblast of hydatidiform moles].

The immunocytochemical localization of hCG in the syncytiotrophoblast of hydatidiform moles was observed by means of the immunoglobulin gold technique with rabbit anti-human hCG serum. Immunoreactive gold particles of hCG are preferentially localized in the distal portion of the Golgi complexes, Golgi-derived secretory granules 200-300 nm in diameter, and large electron dense bodies 500-1,000 nm in diameter. The secretory granules exist throughout the cytoplasm above the nuclear region and are occasionally released by exocytosis from the syncytiotrophoblast. On the other hand, the large electron dense granules seem to be cytolysosomes in nature and are involved in uptake and storage of hCG.

Chorionic Gonadotropin↗
PubMed1992

Siblings of 21-hydroxylase deficiency (non-salt-losing) with aldosterone hypersecretion.

We describe siblings with the non-salt-losing form of 21-hydroxylase deficiency who had hypersecretion of aldosterone and plasma renin activity (PRA). Blood pressure and serum electrolytes in both cases were normal despite the aldosterone hypersecretion. Aldosterone secretion was elevated markedly with ACTH administration and with sodium deprivation and/or volume depletion during ACTH suppression by dexamethasone. With suppression by dexamethasone, aldosterone hypersecretion was decreased with lowering of the steroids proximal to the block in the biosynthetic pathway. However, urinary sodium excretion was decreased. These results suggest that the biosynthetic pathway for aldosterone production was preserved. Furthermore, aldosterone hypersecretion and high PRA may serve to compensate for the sodium loss which results in turn from the overproduction of the sodium-losing steroids, such as progesterone and 17 alpha-hydroxyprogesterone which are aldosterone antagonists.

Adolescent↗
PubMed1992

[Evaluation of myometrial invasion in patients with endometrial cancer by magnetic resonance imaging].

Magnetic Resonance Imaging (MRI) has been widely used for the diagnosis of gynecologic disease. We studied the clinical usefulness of MRI in 34 patients with endometrial cancer from July, 1988 to August, 1991. Pre-operative pelvic MRI was carried out to evaluate the myometrial invasion in these patients. MRI was accurate in predicting the presence or absence of myometrial invasion in 23 of 34 cases (68%), while echo or CT (computed tomography) was accurate in 26% and 8%. In conclusion, MRI is considered to be the most useful examination for the evaluation of myometrial invasion in endometrial cancer.

Adult↗
PubMed1991

[Disorder of serum electrolytes following CAP therapy].

Combination chemotherapy with Cyclophosphamide, Adriamycin and Cisplatin (CAP) is one of the most effective chemotherapies for ovarian cancer. Severe vomiting induced by this treatment may cause a disorder of the serum electrolytes. Severe hyponatremia was observed in one patient who complained of convulsions and unconsciousness. Accordingly we studied the disorder of serum electrolytes in 158 courses of CAP treatment (44 patients) during the five years from 1984 to 1988. The serum electrolytes were influenced by the amount of vomiting in this study. Consequently frequent examination of serum electrolytes is necessary during this treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Placental site trophoblastic tumor: immunohistochemical and nuclear DNA study.

A rare case of placentae site trophoblastic tumor (PSTT) studied by immunohistochemistry and nuclear DNA analysis is reported. The patient, a 24-year-old Japanese female, complained of amenorrhea. Dilatation and curettage revealed a small specimen that contained trophoblastic cells and caused intractable bleeding. Pelvic sonography revealed a 5-cm mass in the posterior uterine wall with multiple cystic lesions of several sizes. The cystic lesions were shown to be dilated vessels by magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). Serum beta-hCG (beta subunit of human chorionic gonadotropin) was 3.7 ng/ml. Total abdominal hysterectomy revealed a well-circumscribed, yellow, soft mass in the posterior uterine wall. Microscopic findings were consistent with PSTT and the mitotic count was extremely low. Immunohistochemically, most of the tumor cells were intensely stained with human placental lactogen, whereas few were stained with human chorionic gonadotropin. The nuclear DNA content of the trophoblastic cells showed a sharp peak at the triploid range coexistent with a few cells of higher ploidy. This is the first report of sonographic findings and nuclear DNA analysis by spot cytometry in a case of PSTT.

Adult↗
PubMed1990

An adenocarcinoma in situ of the uterine cervix that developed into invasive adenocarcinoma after 5 years.

An extremely rare case of in situ adenocarcinoma of the uterine cervix that developed into invasive cancer is reported. The patient was a 54-year-old Japanese female who complained of vaginal spotting. Pelvic examination revealed no abnormalities and routine Papanicolaou smear was misinterpreted as negative. Multiple wedge biopsies of the uterine cervix were done because Papanicolaou smears taken after 7 months were reported as suspicious. The wedge biopsy revealed dysplastic changes of the endocervical glands. It was diagnosed as being in situ adenocarcinoma by a later review. The patient was examined by cytology and colposcopy every 3 to 12 months. An advanced adenocarcinoma was found in the uterine cervix after 5 years. Total abdominal hysterectomy, resection of the vagina and cardinal ligament, and postoperative irradiation were performed. The patient is alive and well at this writing. This is the second case of in situ adenocarcinoma of the uterine cervix that developed into invasive cancer.

Adenocarcinoma↗
PubMed1990

[The follow-up of trophoblastic disease by using an hCG-CTP enzyme immunoassay].

In the management of a chorionic disease, human chorionic gonadotropin (hCG) is the most reliable tumor marker. However, hCG has a low titer, so that it cannot be strictly distinguished from the human luteinizing hormone (hLH) by the traditional method that uses a hemagglutinin reaction (HAR) or by a radioimmunoassay (RIA). Recently, however, the detection of the beta-COOH-terminal peptide of hCG (hCG-CTP) by an enzyme immunoassay has made it possible to clearly distinguish hCG from hLH, and from April, 1987 to December, 1989, 13 trophoblastic diseases have been managed using this new technique. Results have shown that human chorionic gonadotropin-CTP, when compared to other methods of measurement, is the most sensitive tumor marker and as it is the most accurate, it should be used in careful follow-up observations of a chorionic disease.

Adult↗
PubMed1990

[Multiple primary cancers associated with gynecologic malignancies].

Seventeen multiple primary cancers including 16 double cancers and one triple cancer were found in 316 patients with gynecologic malignancies who were treated in our department from 1984 to 1988. All pathologic slides but one were reviewed, and cases with possible metastasis or recurrence were not included in this study. The incidence of multiple primary cancers in gynecologic malignancies was 5.4%. Multiple primary cancers were encountered in 4.4% of 205 cervical cancers (including carcinoma in situ), 15.2% of 33 endometrial cancers, and 8.6% of 58 ovarian cancers (including low potential malignancy), respectively. The most frequent sites of other cancers were seen in the large intestine and rectum (5/17), breast (4/17), and gynecologic organs (3/17). Higher incidences were seen in our study that in those in domestic literature. This is probably because detailed anamnesis and gastrointestinal series were obtained in most gynecologic malignancies (especially in endometrial or ovarian cancer).

Adult↗
PubMed1989

[Mass screening for endometrial cancer according to the Law of Health for the Elderly].

Due to the gradual increase of endometrial cancer, mass screening for this type of cancer began from 1987 in Japan in accordance with the Law of Health for the Elderly. However, a screening system for endometrial cancer has many controversial problems when compared with that for cervix cancer. Criteria for screening, methods of screening, management after screening, and executive systems are all controversial points in the performance of mass screening. The actual condition in the detection of endometrial cancer in Fukuoka Prefecture based on a questionnaire is discussed in this paper.

Aged↗
PubMed1989

A comparative study of the estrogen receptor ratio in myometrium and uterine leiomyomas.

Estrogen receptor (ER) content in myoma and myometrium was determined by radio-receptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e. the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be hither than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (P less than 0.05). These results suggest that myoma contains more ER positive cells to obtain estrogen effects than myometrium.

Female↗