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Biomedical subjects

M Tsukuda

Publications and source records attributed to M Tsukuda.

At least 91 records · Page 5Linked to original sources

[A study on the reliability of evoked response audiometry in infants below one year of age; a long-term follow-up].

The reliability of brainstem evoked response audiometry (ERA) as an objective audiometric study was evaluated in long term follow-up infants with moderate to severe sensorineural hearing loss. None of the infants had either brain damage (cerebral palsy, mental retardation) or other severe complications (genetic diseases). The thresholds of ERA at 1 kHz and 4 kHz were measured in 234 infants below one year of age, from 1983 to 1990, in our hospital. These infants were followed-up to the age when conditioned oriented response audiometry (COR) and play audiometry could be conducted. Pure tone thresholds obtained by COR and play audiometry were compared with those of ERA. In addition, speech problems in these patients were evaluated. In all of those infants, hearing aids were fitted before one year of age to achieve early habilitation. As a results, ERA was found to be a reliable and efficacious test for determining auditory thresholds, and providing hearing aids for early habilitation in one-year old infants with moderate to severe sensorineural hearing loss.

Audiometry, Evoked Response↗

[Neo-adjuvant chemotherapy in patients with head and neck cancer].

Standard treatment for head and neck carcinomas consists of surgery, and/or radiotherapy. However, standard treatment alone is less successful for advanced head and neck carcinomas. With the development of cisplatin (CDDP), the efficacy of chemotherapy including CDDP has markedly increased in head and neck carcinomas. Accordingly, neo-adjuvant chemotherapy has been applied for advanced carcinomas. The purpose of neo-adjuvant chemotherapy for head and neck carcinomas is to improve the curability by means of this chemotherapy strategy followed by standard treatment, to eradicate micro-metastatic lesions, and, more recently, organ preservation without compromising overall survival. The previous studies have demonstrated that this chemotherapy is efficacious for patients with complete response (CR), especially pathological CR, after chemotherapy in terms of preserving primary organ and overall survival. Therefore, the development of intensive chemotherapy regimen showing a high CR rate is necessary. Furthermore, the control of the secondary malignancies frequently occurring in patients with head and neck cancer, and the management of complications caused by aging and/or heavy drinking, are also indispensable to improve survival in advanced head and neck cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗

[A randomized crossover comparison of azasetron and granisetron in the prophylaxis of emesis induced by chemotherapy including cisplatin].

The clinical application of 5-HT3 receptor antagonists has enabled continuation of the course of chemotherapy including cisplatin, which induces strong nausea and vomiting, and to prevent the delay of curative treatment for cancer patients receiving neoadjuvant chemotherapy. However, with the development of basic research on the mechanisms of vomiting, each 5-HT3 receptor antagonist has appeared to have different pharmacological actions and, subsequently, the difference in the clinical efficacy of each drug has been reported in Europe and USA. In freshly advanced head and neck carcinoma cases, a randomised crossover study was performed to compare the efficacy and safety profile of a single intravenous dose for 7 days of azasetron (10 mg/day) or granisetron (3 mg/day) in the prophylaxis of nausea and vomiting induced by multi-drug chemotherapy including cisplatin (50 mg/m2 or 60 mg/m2). Anti-emetic effects were evaluated by the protective rates for nausea and vomiting for 7 days following the start of cisplatin administration. Both 5-HT3 receptor antagonists were highly effective in the prophylaxis of acute and delayed emesis induced by chemotherapy, whereas the efficacies of azasetron on day 3 and 4 were superior to those of granisetron. No adverse effect of either drug was observed in this study.

Aged↗

[Comparison of granisetron alone and granisetron plus dexamethasone or hydroxyzine hydrochloride for the prevention of nausea and vomiting during chemotherapy including cisplatin].

The comparative study among granisetron alone and granisetron combined with hydroxyzine hydrochloride or dexamethasone was undertaken for the prevention of nausea and vomiting during chemotherapy including cisplatin in patients with advanced head and neck carcinomas. The results indicated that the combination antiemetic therapies were more effective than granisetron alone for acute nausea and vomiting, whereas a significant difference was not observed among these three groups in the acute adverse effects. Otherwhile, there were statistically significant improvements in the prevention of delayed nausea and vomiting for patients receiving granisetron combined with the other antiemetic drugs, especially the combination antiemetic therapy with dexamethasone. These results confirm the antiemetic activity of granisetron in acute nausea and vomiting induced by cisplatin and show that it has an additive effect in combination with dexamethasone.

Adult↗

[A study of ceftriaxone concentration in serum and tissue of patients with chronic sinusitis].

After an intravenous drip infusion of 1 g or 2 g of ceftriaxone (CTRX), its concentrations in serum and tissue were determined using the bioassay for 18 surgical patients with chronic paranasal sinusitis. 1. The serum levels observed at 75-105, 135-165, 195-225 minutes after an intravenous drip infusion of 1 g, averaged 98 +/- 38, 92 +/- 13 and 73 +/- 13 micrograms/ml, respectively. 2. The tissue levels at 75-105, 135-165, 195-225 minutes after an intravenous drip infusion of 1 g, averaged 27 +/- 13, 27 +/- 7 and 25 +/- 9 micrograms/g. 3. CTRX appears to be a useful drug for the treatment of chronic paranasal sinusitis.

Adult↗

Coexistence of galanin and substance P in the mouse nasal mucosa, including the vomeronasal organ.

Immunohistochemical fluorescent double labeling revealed the coexistence of galanin and substance P in nerve fibers in the mouse nasal mucosa. At the base of and in the epithelium, all galanin fibers also contained substance P, but around the blood vessels and glands, most of them did not. Since substance P fibers in the nasal mucosa originate from the trigeminal ganglion, these results suggest that galanin fibers in the submucosal region originate from ganglia other than the trigeminal.

Animals↗

One-step determination of herpes simplex virus types I and II by polymerase chain reaction.

A rapid and sensitive one-step polymerase chain reaction (PCR) assay was developed for use in identifying type I and type II herpes simplex virus (HSV). Although the nucleotide sequences of the two HSV subtypes are quite similar, common and type-specific sequences 20 nucleotides in length could be deduced in the thymidine kinase gene. Oligonucleotide primers targeted to the type-specific regions generated products of different sizes that served to distinguish two HSV types. Type-specific PCR amplification products were verified by restriction enzyme digestion. Specificity of the HSV PCR was established by the lack of amplification of other herpes-group viruses including cytomegalovirus, Epstein-Barr virus, and varicella zoster virus. Extraction of DNA from clinical materials (throat swabs, vesicular swabs, cerebrospinal fluid and eye discharge) yielded an amplification product of the predicted size for each HSV type. Thus, this PCR system provides a rapid, sensitive and specific assay that can supplement the currently available modalities for detecting and typing HSV.

Base Sequence↗

Two cases of head and neck cancer with carotid artery reconstruction.

A carotid artery reconstruction was performed on two patients of head and neck cancer with infiltration into the carotid artery. To detect any possibility of cerebral ischemia at the time of ligation of the carotid artery, a temporary occlusion test of the internal carotid artery with a balloon catheter (balloon Matas test) was performed in both cases. An artificial vessel (Case 1) and a greater saphenous vein (Case 2) were used as an implanted vessel. No neurological sequelae were observed during or after the surgery in these cases. With a recent advance in various imaging diagnosis and an improvement in surgical techniques, the radical treatment including carotid artery reconstruction is expected to improve the prognosis for the cases demonstrating tumor infiltration into the carotid artery.

Anastomosis, Surgical↗

Modified combination chemotherapy of cisplatin and 5-fluorouracil in squamous cell carcinomas of the head and neck.

Randomized studies on the efficacy of two courses of different types of chemotherapy, including cisplatin and 5-fluorouracil (5-FU), were performed on 130 previously untreated cases with advanced squamous cell carcinomas of the head and neck. Cisplatin, followed by 120-hr continuous 5-FU infusion given in the conventional way, was administered to 60 patients (Group A), while cisplatin was administered 72 hr after the initiation of continuous 5-FU infusion in 70 other patients (Group B). The overall response rates (complete response plus partial response) were 58% in group A and 69% in group B, respectively. A superior complete response rate was obtained in cases receiving modified chemotherapy (10% in group A vs 20% in group B). There was no significant difference in the incidence of side effects between the two groups. These findings indicate that the modified cisplatin plus 5-FU combination chemotherapy tested here is more efficacious regimen than that of the conventional one to achieve high complete response rate and subsequently, to improve the survival of advanced carcinoma cases of the head and neck.

Adult↗

Induction chemotherapy in advanced head and neck cancer.

Induction chemotherapy, followed by definitive treatment, was performed in patients with advanced squamous-cell carcinoma of the head and neck. In this study, carried out between 1984 and 1991, testing the effectiveness of multimodality therapy in patients with previously untreated advanced (stage III and IV) squamous-cell carcinoma of the pharynx, patients received two different induction chemotherapy regimens: cisplatin, vincristine (Oncovin) plus peplomycin (COP), and cisplatin plus continuous 120-hr 5-fluorouracil (5-FU) infusion (CF) for two courses. Overall response rates (complete response plus partial response) to each of the two induction chemotherapy regimens were high: 76 and 82%, respectively. Superior complete response rate in the group receiving CF therapy was 16% versus 10% for COP therapy. Responders to induction chemotherapy had significantly better survival compared with non-responders. The toxicity of these two regimens was tolerable and manageable. It is indispensable to develop the more efficacious chemotherapy regimen with the potential to induce complete disappearance of tumors in patients with advanced head and neck carcinomas.

Adolescent↗

[Analysis of DNA ploidy using fresh frozen tissues from head and neck squamous cell carcinomas].

The DNA ploidy of fresh frozen tissues from head and neck squamous cell carcinomas was determined by flow cytometry, with the aim of investigating whether DNA ploidy correlates with various clinical and pathological parameters. The subjects were 51 patients who had undergone radical surgery in our department. The DNA ploidy pattern was classified into three types, diploid, single aneuploid and multiploid, according to the DNA index and the DNA histogram. This is our original classification. No particular correlation could be detected between the DNA ploidy pattern and sex, age, primary tumor site or disease stage. The degree of tissue differentiation tended to be poorer in aneuploid than in diploid tissues. The efficacy of chemotherapy was higher in aneuploid than in diploid cases. The recurrence rate was significantly lower in diploid than in multiploid cases. When disease stage, degree of histological differentiation, the efficacy of chemotherapy and the DNA ploidy pattern were subjected to multivariate analysis for correlation with prognosis, the DNA ploidy pattern showed the highest correlation. Our results suggest that the DNA ploidy, as analyzed by flow cytometry, can serve as useful prognostic factor.

Adult↗

[A prospective randomized trial of adjuvant chemotherapy with UFT for head and neck carcinoma. Head and Neck UFT Study Group].

A prospective randomized trial was performed in 67 institutions for the purpose to evaluate the efficacy of adjuvant chemotherapy after radical treatment of head and neck carcinoma. A comparison was made between the following two groups; one-year oral administration of UFT, 300 mg/day, after radical treatment (UFT group); and a non-treatment group. Patients were classified under the following three categories; 1) stage II-IV, receiving radical surgery; 2) stage II, receiving radical radiotherapy; and 3) nasopharyngeal cancer. The numbers of cases were 424, 111 and 25, respectively, and they were randomized into two groups. The numbers of eligible cases were 398, 105 and 25, respectively. Statistical analysis was performed in the cases receiving radical surgery and in those receiving radical radiotherapy. As the results, in cases receiving radical surgery no significant difference was observed in 3-year survival rates (77.9% for UFT group vs 72.9% for non-treatment group) or 3-year relapse-free rates (73.4% for UFT group vs 66.2% for non-treatment group) between the two groups. However, the distant relapse rate was significantly lower in the UFT group than in the non-treatment group (7.9% vs 14.6%; p = 0.034). In the cases receiving radical radiotherapy, no significant differences was observed in either 3-year survival rates or 3-year relapse-free rates. Thus it was suggested that UFT maintenance therapy might suppress the distant metastasis after radical surgery. We considered a further confirmative trial for patients at high risk of distant metastasis after radical surgery to be advisable.

Administration, Oral↗

An immunohistochemical study of adenoid cystic carcinoma of the external auditory canal.

Specimens from five cases of adenoid cystic carcinoma of the external auditory canal were studied by immunohistochemical staining, and findings were compared with those from adjacent non-neoplastic tissues containing ceruminous glands. In the ceruminous gland, cytokeratin showed diffuse positive staining, while myoepithelial cells were stained for smooth muscle actin, desmin, S-100 protein and vimentin. The epithelial markers used were cytokeratin, carcinoembryonic antigen and secretory component and stained at various densities the inner cells of the tubular component and duct-lining cells in the cribriform component of tumor tissues. In contrast, the muscular markers, smooth muscle actin and desmin, and the mesenchymal marker, vimentin, were positive in the outer cells of the tubular component and in the cyst-lining cells of the cribriform component. S-100 protein immunoreactivity showed paradoxical results; positive findings occurred in the myoepithelial cells of the ceruminous glands and in the inner cells of the tubular component and duct-lining cells of the cribriform component of the tumor. Present findings demonstrate that adenoid cystic carcinoma of the external auditory canal had dual epithelial and myoepithelial differentiation and can mimic the ceruminous glands of the auditory canal.

Actins↗

Chemotherapy for recurrent adeno- and adenoidcystic carcinomas in the head and neck.

We have investigated the effectiveness of chemotherapy for patients with recurrent adeno- and adenoidcystic carcinomas in the head and neck. Fourteen cases received a monthly combination chemotherapy regimen of cyclophosphamide, pirarubicin and cisplatin (CAP therapy). A response rate of 36% (5/14) was achieved. There was one complete response and four partial responses. The median duration of response was 37 months in the complete response case and 16 months (range, 6 to 20) in the partial response cases. The toxicity of this chemotherapy was acceptable. The result demonstrates that CAP therapy is an effective regimen for adeno- and adenoidcystic carcinomas. It may also be available as induction or adjuvant chemotherapy for patients with advanced tumors of these cancers.

Adenocarcinoma↗

Suppressed cellular immunity in patients with nasopharyngeal carcinoma.

The subsets and functions of lymphocytes were investigated in patients with nasopharyngeal carcinoma (NPC). The patients were divided into two groups comprising tumor-bearing patients and those in remission. There was no difference in the proportion of T cells among tumor-bearing, remission and healthy control groups. The percentages of inducer/helper T cells and natural killer cells were smaller in the tumor-bearing group than in the control group whereas the percentage of suppressor T cells was greater in the tumor-bearing group. Phytohemagglutinin-stimulated blastogenesis was markedly suppressed in the tumor-bearing group. The responsiveness to interleukin-2 of blastogenesis and of natural killer and lymphokine-activated killer activities was lowered in the tumor-bearing group. These parameters in the remission group were intermediate between those of the tumor-bearing and control groups. These results suggest that cellular immunity is suppressed in patients with NPC and that the suppressed condition still remains even in remission. Immunotherapy is considered to be indispensable for the proper treatment of NPC.

Adult↗

Clinical application of recombinant human erythropoietin for treatments in patients with head and neck cancer.

The therapeutic effects of intravenous recombinant human erythropoietin (r-hEPO) administration on anemia induced by radiation therapy (3 cases), chemotherapy (18 cases) and combined therapies (5 cases) in patients with head and neck malignancies were examined. The effectiveness was evaluated by the changes in the hemoglobin concentration examined before and after the r-hEPO administration. The r-hEPO administration combined with anticancer therapies improved anemia induced by all three treatments. The therapeutic effectiveness of r-hEPO injection was also noted on anemia induced by all of four different chemotherapeutic regimens that have been ordinarily used for head and neck malignancies. Furthermore, the efficacy of the different dose schedules, 3000 IU (12 cases) or 6000 IU (14 cases), three times a week, was compared. Both of the r-hEPO dose schedules were effective for anemia, but the efficacy of 6000 IU was superior to that of 3000 IU. No significant changes were observed in the number of white blood cells and platelets and the results of biochemical examinations after the r-hEPO injection. There were no objective side-effects related to the r-hEPO administration. These results suggest that anemia induced by chemotherapy and/or radiotherapy could be prevented by r-hEPO administration. The addition of r-hEPO to anticancer therapies would make it possible to pursue the planned therapeutic schedules, prevent the decrease of immunity after allogeneic blood transfusion and bring about an-improvement in the prognosis of patients with malignancies.

Adult↗

Autologous tumor cell killing activity of tumor-associated lymphocytes in patients with head and neck carcinomas.

In order to select the most cytotoxic effector cells for adoptive immunotherapy, lymphokine activated killer (LAK) cells, tumor infiltrating lymphocytes (TILs) and autologous mixed lymphocyte tumor cell culture (MLTC) cells derived from peripheral blood mononuclear cells (PBMC) in the same subject with head and neck carcinomas were prepared. The autologous tumor cell killing activity and cell surface phenotypes of each of the three effector cells were studied. MLTC cells cultured with interleukin-2 (IL-2) showed the strongest cytotoxic activity among these three different effector cells. Although TILs had suppressed killing activity immediately after isolation, after successive cultivations with IL-2, a cytotoxic activity against autologous tumor cells stronger than that of LAK cells appeared. Both IL-2 stimulated MLTC cells and TILs showed an enrichment of CD8 positive and CD11 negative cells in a CD3 positive subpopulation.

Antigens, Surface↗

The synergistic effects of interleukin 2 and interleukin 7 on the proliferation and autologous tumor cell lysis of tumor-associated lymphocytes.

Interleukin-7 (IL-7) has an ability to stimulate the proliferation of pre-B cells. It has been shown that IL-7 can also activate T lymphocytes. We here demonstrate that IL-7 in combination with interleukin-2 (IL-2) can drive cell proliferation and enhance the autologous tumor cell lysis by peripheral blood mononuclear cells (PBMC) and autologous mixed lymphocyte tumor cell culture (MLTC)-derived effector cells (MLTC cells). These synergistic effects of IL-2 and IL-7 on the proliferation and the augmentation of autologous tumor cell lysis were found for both effector cells. These effects were inhibited by neutralizing antibodies to IL-2 or IL-7, and by a combination of both antibodies, significantly. In terms of phenotypical expression, CD3 positive cells comprised the vast majority of MLTC cells after culture in medium containing IL-2 and IL-7 with an increase of IL-2 receptor positive cells.

Cell Division↗