Biomedical subjects

M Ohkuwa

Publications and source records attributed to M Ohkuwa.

3 recordsLinked to original sources

PubMed2001

New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife.

BACKGROUND AND STUDY AIMS: For one-piece resection the conventional technique of endoscopic mucosal resection (EMR) is limited to gastric mucosal tumors of 10 mm or less in size. In this retrospective study, we investigated the efficacy and complications associated with a new EMR method, using an insulated-tip diathermic knife (IT-EMR). PATIENTS AND METHODS: In a total of 41 patients gastric mucosal tumors were resected using IT-EMR. RESULTS: One-piece resection rates were 82% (14/17) for lesions of 10 mm or less, 75% (12/16) for those between 11 and 20 mm, and 14% (1/7) for those of over 20 mm. Complication rates for severe bleeding and perforation were 22% and 5%, respectively. With a median follow-up period of 32 months, no recurrence was observed after these procedures. CONCLUSIONS: Compared with conventional EMR, this new method may have significant benefits, particularly regarding one-piece resection of lesions between 11 and 20 mm in size, and may also have a lower recurrence rate.

Adenocarcinoma↗

PubMed2000

[Correlation between response and survival].

The true endpoints of cancer chemotherapy have to be prolongation of survival, palliation of symptoms, or improvement of quality of life in cancer patients, while the response rate is considered to be a surrogate endpoint. When conducting a phase III trial, not only the response rate but also data on survivals in the phase II study should be taken into consideration. New response evaluation criteria and various objective markers in analyzing survival have been developed recently. Our data on chemotherapy for gastrointestinal malignancies reveal correlations between CR cases and survival prolongation among esophageal cancer patients treated with chemoradiotherapy, and between responder and survival prolongation in gastric cancer patients treated with chemotherapy. A review of the literature might reveal a correlation between response and survival prolongation in colorectal chemotherapy patients, though our data did not support such a correlation. At present, it is necessary to recognize that "evidence" should be based on the results of randomized phase III trials with large sample sizes and good quality assurance other than the response rates in phase II trials.

Antineoplastic Agents↗

PubMed1996

A case of advanced gastric cancer complicated by severe toxicity induced by a combination of tegafur, uracil and mitomycin C, and associated with abnormal pharmacokinetics.

A 60-year-old female patient with gastric cancer and lymph node and liver metastases was treated with a combination of tegafur and uracil (UFT) (375 mg/m2/day) and mitomycin C (MMC) (5 mg/m2 once weekly). On day 15, when diarrhea appeared, chemotherapy was stopped immediately. On day 21, the WBC decreased to 900/microl and high fever developed. Despite treatment with granulocyte colony-stimulating factor and antibiotics, leukopenia persisted and the patient went into septic shock on day 26. On day 34, WBC increased to 5,400/microl and she recovered, with reduction in the size of the lymph node and liver metastases. Pharmacokinetic examination after intravenous injection of low-dose MMC (0.5 mg/m2) showed a markedly high peak plasma concentration (PPC), a large area under the time-versus-concentration curve (AUC) and reduced clearance. Similarly, oral administration of UFT (tegafur 300 mg/body) produced a relatively higher PPC and a larger AUC of 5-fluorouracil (FU). The activity of dihydropyrimidine dehydrogenase, the rate-limiting enzyme in the metabolism of FU, in peripheral mononuclear cells was within the normal range (0.265 nmol/min/mg). MMC is believed to have played a large part in inducing the severe toxicity observed in this patient. Physicians should be aware of the possibility of severe toxicity during treatment with UFT and MMC, although details of its incidence and mechanism are unclear.

Adenocarcinoma↗