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Biomedical subjects

N Miyaji

Publications and source records attributed to N Miyaji.

At least 19 recordsLinked to original sources

[A case of advanced esophageal cancer successfully treated by concurrent use of radiotherapy and low-dose CDDP and continuous infusion of 5-FU].

A 75-year-old male patient with advanced esophageal cancer was treated by radiotherapy and chemotherapy. External radiotherapy was performed by the field in field method. A total dose of 60 Gy was used in the small field (7 x 5 cm) (2.4 Gy/f and 25 f/5 wks) and a total dose of 45 Gy in the large field (14 x 6 cm) (1.8 Gy/f, 25 f/5 wks). Concurrent chemotherapy was performed at the 2nd and 5th weeks of the radiation therapy. In this chemotherapy of CDDP plus 5-FU, CDDP (25 mg/day) was given on days 1,3 and 5 of the week and 5-FU (500 mg/day) was given for 5 days by continuous infusion for the same week. By this treatment, a complete response (CR) was obtained, and no serious side effects were observed. After 1 year and 6 months, he is alive with no evidence of recurrence.

Aged↗

[Results of radiotherapy combined with CDDP (BAI) plus VP-16 in the treatment of inoperable non-small cell lung cancer].

Twenty-six patients with unresectable non-small cell lung cancer were treated by chemotherapy alone or chemotherapy followed by radiotherapy from June 1988 to May 1990. CDDP (80 mg/m2) was given by bronchial arterial infusion (BAI) on day 1 in each course, VP-16 (80 mg/body) was given by drip intravenous infusion on days 1 and 2, and VP-16 (150 mg/body) was given orally on days 3 and 5. The patients were irradiated after this regimen with a single dose of 1.8-2.0 Gy, five times each week, to a volume which encompassed only the primary tumor. A total dose of 60 Gy or more was delivered. There were 10 squamous cell carcinomas, nine adenocarcinomas, five large cell carcinomas, one adenosquamous cell carcinoma and one poorly differentiated carcinoma. Median survival time (MST) was 354 days in stage III B patients and 280 days in stage IV patients. MST was 155 days in adenocarcinoma and 310 days in squamous cell carcinoma. MST was 372 days in PS 0 to 1 patients and 140 days in PS 2 patients. With chemo-radiotherapy in 17 cases resulted in no complete remissions and 10 partial remissions. The overall response rate was 58.8%. It is concluded that CDDP via BAI combined with VP-16 administration and sequential irradiation is useful to acquire a high response rate in non-small cell lung cancer. However, further studies on this modality are required.

Aged↗

Carpal tunnel syndrome: evaluation of median nerve circulation with dynamic contrast-enhanced MR imaging.

PURPOSE: To identify mechanism(s) responsible for carpal tunnel syndrome (CTS). MATERIALS AND METHODS: At dynamic gadolinium-enhanced magnetic resonance (MR) imaging, the enhancement pattern of the sagittal section of the median nerve in 10 wrists of nine patients with CTS (two men and seven women, aged 43-60 years [mean, 52 years 10 months]) was studied while each wrist was in a neutral, flexed, and/or extended position. Five asymptomatic volunteers (four men and one woman, aged 23-54 years [mean, 31 years 5 months]) also underwent MR imaging to establish the normal enhancement patterns. RESULTS: Two distinctly abnormal patterns of median-nerve enhancement were revealed: marked or no enhancement. Marked enhancement was attributed to nerve edema, and the lack of enhancement was attributed to ischemia. Marked enhancement changed to no enhancement changed to no enhancement when the wrists were in a flexed or extended position. This change was associated with an aggravation of the symptoms of CTS. CONCLUSIONS: CTS may result from a circulatory disturbance rather than from deformation or compression of the nerve.

Adult↗

[A comparative study of psycho-social factors in peptic ulcer disease].

To evaluate the psycho-social factors of peptic ulcer, we carried out a comparative study. Seventy-six men and 19 women with peptic ulcers diagnosed at seven hospitals in Kyoto, Osaka and Hyogo Prefectures in Japan were surveyed during November 1990 about their daily hassles, depressive state, social support and life style using a self-administered questionnaire. The results were compared to those for two control groups. One control group was diagnosed with normal, atrophic gastritis, or superficial gastritis by the gastro-duodenal endoscopic examinations in the same hospitals. The other control group consisted of participants in a health-screening examination at one of the above hospitals. There were no significant differences between patients and controls in daily hassles, depressive state, and social support. However, being unmarried, smoking and eating irregular meals significantly increased the relative risk of peptic ulcer in men and family history of peptic ulcer significantly increased the risk in women.

Adolescent↗

[Treatment results of small cell lung cancer: referring to the clinical value of BAI combined with radiotherapy].

Results of 65 cases of small cell lung cancer (SCLC) treated from Jan. 1981 to May 1991 were reviewed. There were 58 male and 7 female patients and their age was ranging from 37 to 86 (mean 65). There were 41 limited disease (LD) and 24 extensive disease (ED) cases. According to TNM (UICC 1987) staging system, there were 2 cases of stage I, 4 of stage II, 9 of stage III A, 28 of stage III B and 22 of stage IV. Among 65 cases, 60 cases received radiotherapy and 55 cases of them received radiotherapy for primary site. There were 29 cases received radiotherapy combined with BAI (bronchial artery infusion) and 20 cases received systemic chemotherapy. On survival, the 2-year survival rate was 26% and MST was 13 months in LD patients (n = 41). No 2-year survivors were seen in ED patients and MST was 10 months. Tumor response of primary site was as follows. In systemic chemotherapy group, CR 35%, PR 59%, NC 6% and PD 0% before radiotherapy and CR 59% after radiotherapy were obtained. In BAI group (including BAI + systemic chemotherapy), CR 6% and PR 88% before radiotherapy in BAI group. BAI did not seem to improve response rate compared to systemic chemotherapy. On survival, BAI group did not show significant better survival compared to BAI (-) group in LD cases (n = 31). In responders (evaluable LD cases, n = 24), the MSTs were 25 months in CR cases and 13 months in PR cases. No 2-year survivors were seen in PR cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Percutaneous injection of cisplatin lipiodol suspension (CLS) in rabbit lung, aiming at intratumoral injection therapy for lung cancer].

Cisplatin lipiodol suspension (CLS: cisplatin 20 mg/ml) was percutaneously injected (cisplatin dose, 2, 4 or 6 mg/kg) in normal lungs of 10 rabbits (1.9-2.3 kg) to assess the safety and feasibility of intratumoral injection of CLS for lung cancer. Histological study revealed acute and chronic infiltrates with bronchiolitis and immature fibrosis at the injected lung tissue even at four weeks after injection. Intrathoracic leaks of CLS produced mild and focal fibrinous pleuritis. Intrabronchial leaks of CLS produced peripheral bronchiolitis with regenerative epithelia. However, no noxious parenchymal damage in the lung and surrounding tissues was noted. Neither oil embolism in brain nor renal toxicity was demonstrated. Seven of eight rabbits showed an increase in body weight. Concentration levels of plasma platinum were lower when compared with intravenous injection of cisplatin in the rabbit: highest at 30 minutes and unmeasurable one week after injection. Lipiodol accumulation in mediastinal lymph nodes was demonstrated in two of nine rabbits by X-ray examination, suggesting intralymphatic drainage of CLS. Intratumoral injection of CLS is safe even with CLS leaks in surrounding normal lung tissues and may be a potent therapy for controlling mediastinal lymph nodes metastasized from lung cancer as well as the primary tumor.

Administration, Cutaneous↗

[Angiographic features of alveolar soft-part sarcoma].

The angiographic findings were analyzed in five patients with alveolar soft-part sarcoma. The angiographic appearance of the tumors was the same in all five cases: hypervascularity of the tumor including encasement, dilatation, tortuosity and displacement of feeding arteries, remarkable tumor stain and early venous filling. These angiographic findings are considered to be characteristic of alveolar soft-part sarcoma in the differential diagnosis of hypervascular soft tissue mass.

Adult↗

[Results of radiotherapy combined with BAI (bronchial artery infusion) for non-small cell lung cancer--analysis of 104 cases].

Results of 104 cases of non-small cell lung cancer (NSCLC) treated by radiotherapy combined with BAI (bronchial artery infusion) were analyzed retrospectively. In 104 cases (84 males and 20 females), 14 cases of stage I, 10 of stage II, 33 of stage IIIA, 29 of stage IIIB and 18 cases of stage IV were included. Overall cumulative survival rate was 11.4% and 50% survival time was 12 months. On PS (performance status), 50% survival time was 1 year and 3 months for both PS 0 and PS 1, 8 months for PS 2 and 2 year for PS 3 (n = 3), respectively. On stage, 50% survival time was 3 year and 4 months for stage I, 1 year and 2 months for stage II, 12 months for stage IIIA, 11 months for stage IIIB and 8 months for stage IV. There was no significant difference of survival rate between squamous cell carcinoma (n = 41) and adenocarcinoma (n = 43). On anticancer agents used for BAI, CDDP group (n = 68) showed better significant 2-year survival rate than that of MMC and/or ADR group (n = 36). Response rate (CR + PR) was 85% (75/88) by radiotherapy with BAI, and 10 cases of CR were obtained. Among 27 cases of 2-year survivors, 21 cases of responders (CR + PR) were included and 4 cases of them showed CR. On these results, radiotherapy combined with BAI seemed to contribute to improve long-term treatment results of NSCLC by higher response rate with the progress of anticancer agent used for BAI.

Adult↗

[A case of a rare anomaly of the abdominal aorta--magnetic resonance image and angiographic finding].

A case of a rare anomaly of the abdominal aorta was reported. The abdominal aorta was divided into two abnormal vessels and one vessel was celiac artery, and the other was considered to be abdominal aorta. To review literature, this type of anomaly of abdominal aorta is rare. Anatomy of this case had been well demonstrated by MR imaging and angiography. Those findings and the embryological basis of this case were discussed.

Aorta, Abdominal↗

[Three cases of alveolar soft part sarcoma and MRI findings].

Three cases of alveolar soft part sarcoma were reported with characteristic MRI findings. On MRI findings, slightly higher signal intensity than muscles on T1 weighted image and remarkably high signal intensity on T2 weighted image were thought to be characteristic of alveolar soft part sarcoma.

Adult↗

Multiple primary malignant neoplasms of the head and neck.

This report analyzed the 7,763 cases treated at T.W.M.C., where radiotherapy has been mainly used, between 1968 and 1984. Of these, 258 cases (3.3%) had multiple primary malignant neoplasms, among which 88 cases involved head and neck cancer. The incidence averaged 1.6% during the first 5 years, but increased to an average of 5.7% during the last 5 years. Among head and neck cancer the incidence of multiple primary malignant neoplasms was 8.5% (88/1,033) and the incidence has been gradually increasing annually. Cancers of the head and neck were frequently combined with another primary lesion in the head and neck area or in the digestive tract, especially esophagus and stomach, followed by one in the both cases. The great majority of cancers in the head and neck occurred as the first cancer at age 60-70. The head and neck region is where the respiratory system and digestive system, including lymphatic organs originate and where the external carcinogenic factors enter into the body. These data suggested that multiple primary malignant neoplasms have been increasing in number and becoming an increasing problem. The possibility of multiple primary malignant neoplasms should not be forgotten in routine cancer related clinical work.

Adult↗

Bio-adhesio-chemo (BAC) therapy for patients with malignant pleural effusion.

Eighteen patients with serious pleuritis carcinomatosa with remarkable pleural effusion were treated with a new pleurodesic therapy, and all the patients treated obtained favorable results. After removing pleural effusion, fibrinogen solution was intrapleurally instilled and then, our newly devised material, G.T.XIII and an anticancer drug, Adriamycin (ADM), were administered as chemosclerosing agents in an attempt to prevent recurrence of the effusion and also to provide locoregional antineoplastic effects. Recurrence of pleural effusion was nil in all patients treated, and subjective complaints of the patients were remarkably relieved. There were 14 patients evaluable, and all the response of these patients resulted in partial response (PR) according to the World Health Organization (WHO) criteria. Improvement of performance status (PS) was observed in 61% (11/18). Eight patients could be discharged. Three patients have remained alive. Fifteen patients died after the therapy, and their median survival was 67 days. Eight patients were autopsied. The postmortem examinations confirmed that fibrous adhesion in the pleural cavity with these materials was significant, and evidence of recurrence of pleural fluid was not seen. Topical oncolytic effects of the ADM were histologically remarkable. This pleurodesis was called "Bio-adhesio-chemo (BAC) therapy."

Adult↗

Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases.

A prospective randomized clinical trial comparing small, large and twice-a-day fraction for the relief of painful bone metastases was performed from 1981 to 1986 at Tokyo Women's Medical College Hospital. Eighty patients with painful bone metastases (92 sites) were divided into three radiation methods which were conventional fraction scheme of 5 times/week at 2 Gy/day for a total of 30 Gy/15 fractions (Group I, TDF: 49), 2 times/week at 4.5 Gy/day for a total of 22.5 Gy/5 fractions (Group II, TDF: 50) and 3 times/week at 2 Gy/day twice a day at a minimum interval of 6 h for a total of 20 Gy/10 fractions (Group III). Pain was assessed using a score and response rate was 76% in Group I, 75% in Group II and 78% in Group III which were not statistically significant mutually. Group II and III regimes were found to have an earlier shorter onset of pain relief than Group I, but the dose of onset of pain relief was almost the same. Our data suggested that individualization of radiotherapy schedules based on to assess the patient's condition and the expected quality of life and to consider radiation site and size of field, was more important than the fractionation regime in the treatment of painful bone metastases.

Adult↗

[Clinical research of radiotherapy in brain metastasis].

One hundred and four patients with brain metastasis were received the conventional radiotherapy from 1980 to 1985 at 3 hospitals. Results were as follows. 1. Primary sites were lung (41 cases), breast (34) and others (29). 2. Tumor was 3.15 cm in mean size (0.6-8.2 cm) and 2.6 in number of average (1-15) 3. Radiation dose was 46.5 Gy in average (30-66 Gy) and almost of all cases were irradiated with whole brain field. 4. Over all response rate on CT findings was 65.4% (CR rate: 23.1%) and 63.4% for lung and 73.5% for breast cancer. 5. Survival rate were 25.5% in 1 year, 8.8% in 2 year, 5.4% in 3 year and 3.6% in 5 year. 6. The longer interval was between onset of brain metastasis and primary treatment, the longer survival after brain irradiation. 7. No significant differences of survival rate were seen in size and in number of brain metastasis and with on without improvement of neurological symptoms. 8. The better response was on CT, the better prognosis after radiotherapy. 9. Identification of treatment for brain metastasis according to patient's characteristics and tumor factors were important.

Adult↗

[Arterial perfusion study with 99mTc-MISA in monitoring intra-arterial chemotherapy of head and neck tumor].

RI-angiography with 99mTc microsphere albumin (MISA) was performed to evaluate the distribution during intra-arterial infusion chemotherapy from October 1985 to November 1987 at Tokyo Women's Medical College. Thirty studies were carried out in twenty-one patients with oropharyngeal (11), oral cavity (6), maxillary sinus (3) and laryngeal cancer (1). Six mCi of 99mTc-MISA was slowly injected through the intra-arterial catheter in 1-2 minutes. The evaluation of RI-distribution was classified into the following three categories: Excellent, all of the tumor are covered; Good, more than 50% of the tumor; Poor, less than 50% of the tumor. Good or excellent distribution was obtained in 18 of 21 cases (86%). Sequential perfusion studies were performed on 8 cases. Three cases had evidenced excellent or good distribution during the treatment. Five cases showed poor distribution in the first study. In three of these cases, distributions were improved after replacement of the catheter, RI-distribution at the internal carotid arterial area was seen in three patients, and in two of them, excellent or good distribution was obtained after replacement of the catheter. These data suggested that RI angiography with 99mTc-MISA was useful for evaluation of the drug distribution during intra-arterial infusion chemotherapy, especially for detection of abnormal distribution in the internal carotid arterial area.

Adult↗

[A case of metastatic brain tumor from prostatic cancer showing remarkable shrinkage following CDDP administration].

A patient with brain metastases from prostatic cancer received chemotherapy using CDDP alone. A dose of 80 mg of CDDP was administered twice intravenously, followed by intra-arterial injections of 70 mg and 50 mg for the primary lesion over the course of three months. The main brain tumor showed a 70% decrease in size when estimated by CT, along with improvement of clinical symptoms related to the brain metastases. Intravenous injection of CDDP may thus have potential therapeutic value against metastatic brain tumors.

Aged↗