Biomedical subjects

T Teshima

Publications and source records attributed to T Teshima.

At least 127 records · Page 7Linked to original sources

PubMed1993

High-dose rate and low-dose rate intracavitary therapy for carcinoma of the uterine cervix. Final results of Osaka University Hospital.

BACKGROUND: High-dose rate (HDR) intracavitary radiation therapy for carcinoma of the uterine cervix has gradually found wider acceptance. In 1983, the authors first presented the results of prospective randomized comparative study of HDR versus low-dose rate (LDR) therapy. In the current study, the final results of this study with a longer follow-up are presented. METHODS: From January 1975 through August 1983, 430 previously untreated patients with carcinoma of the uterine cervix in Stages I-III were treated with either HDR 60Co therapy or LDR 137Cs therapy at our department. HDR was administered to a total of 259 patients: 32 patients in Stage I, 80 in Stage II, and 147 in Stage III. LDR was administered to a total of 171 patients: 28 patients in Stage I, 61 in Stage II, and 82 in Stage III. RESULTS: The 5-year cause-specific survival rates of Stage I-III patients treated with HDR were 85%, 73%, and 53%, respectively. The corresponding figures for LDR were 93%, 78%, and 47%, respectively. There was no significant difference between these survival rates. Moderate-to-severe complications developed in 10% of the patients treated with HDR and 4% of those with LDR. This difference in the incidence of complications was statistically significant (P = 0.023). CONCLUSIONS: Treatment results in terms of cause-specific survival were equivalent for HDR and LDR treatment. However, the incidence of complications was higher for the HDR group, although within acceptable levels, than for the LDR group.

Actuarial Analysis↗

PubMed1993

Prognostic factors in telecobalt therapy for early supraglottic carcinoma.

BACKGROUND: The local control rates of T1 and T2 supraglottic carcinoma treated with radiation alone were reported as 71% to 92% and 59% to 83%, respectively. The factors that affect the local control rate for early supraglottic carcinoma were investigated. METHODS: From 1967 through 1985, 100 cases with early supraglottic carcinoma (T1N0, 51; T2N0, 49) were treated with telecobalt therapy at the Department of Radiology, Osaka University Hospital. RESULTS: The 5-year actuarial survival rates of cases with T1 and T2 were 69% and 74%, respectively. The 5-year local control rates of cases with T1 and T2 were 77% and 62%, respectively. The local control rate for the epilarynx (94%) was significantly better than that for the lower supraglottis (66%; P < 0.05). For the lower supraglottis, the local control rates of 24 tumors that disappeared at 40 Gy and 58 tumors that persisted at 40 Gy were 88% and 55%, respectively (P < 0.05). CONCLUSIONS: The tumor site was an important prognostic factor in radiation therapy for the supraglottis, as was the tumor response at 40 Gy for the lower supraglottis.

Cobalt Radioisotopes↗

PubMed1993

Identity of a major 3-deoxyglucosone-reducing enzyme with aldehyde reductase in rat liver established by amino acid sequencing and cDNA expression.

We have purified a rat liver enzyme that catalyzes the NADPH-dependent reduction of 3-deoxyglucosone (3-DG), a major intermediate in the Maillard reaction and a potent cross-linker responsible for the polymerization of proteins. Comparison of the amino acid (aa) sequences of nine peptides obtained from the rat 3-DG-reducing enzyme by lysylendopeptidase digestion with the aa sequence of human aldehyde reductase (ALR) [Bohren et al., J. Biol. Chem. 266 (1991) 24031-24037] strongly suggested that the purified enzyme was rat ALR. We cloned the cDNA encoding ALR from a rat kidney cDNA library using a human ALR cDNA fragment, amplified by polymerase chain reaction, as a probe. All nine peptides identified in the purified rat 3-DG-reducing enzyme were found in the aa sequence deduced from the rat ALR cDNA. Moreover, cell extract from COS-1 cells transfected with the rat ALR cDNA exhibited NADPH-dependent 3-DG-reducing activity and cross-reacted with antiserum raised against the purified rat 3-DG-reducing enzyme. All the above data indicate clearly that the 3-DG-reducing enzyme is identical with ALR. Northern blot analysis of total mRNA from a variety of rat tissues showed fairly high levels of expression of ALR mRNA. This suggests that sufficient ALR is present to detoxify 3-DG when it is formed through the Maillard reaction in vivo.

Aldehyde Reductase↗

PubMed1993

A randomized phase II trial of low-dose aclarubicin vs very low-dose cytosine arabinoside for treatment of myelodysplastic syndromes.

We performed a randomized phase II trial comparing low-dose aclarubicin (LC-ACR) with very low-dose cytosine arabinoside (VLD-AC) in 39 consecutive untreated patients with myelodysplastic syndromes (MDS), including refractory anemia (RA), RA with excess of blasts (RAEB) and RAEB in transformation (RAEB-t). Nineteen patients received the VLD-AC therapy; 2 good responses (GR) and 2 partial responses (PR) were obtained in 11 patients with RAEB and RAEB-t, while 2 PR were obtained in 8 RA patients. Eighteen patients received the LD-ACR therapy; 2 GR and 4 PR were obtained in 11 RAEB/RAEB-t patients while 2 PR in 7 RA patients. There was no significant difference in the therapeutic effects and survival between these two groups of patients. These observations suggest that the LD-ACR therapy is effective in some patients with MDS and can be used as an alternative to the low-dose Ara-C therapy.

Aclarubicin↗

PubMed1993

X-Neu5Ac: a novel substrate for chromogenic assay of neuraminidase activity in bacterial expression systems.

A chromogenic substrate 1, 5-bromo-4-chloroindol-3-yl 5-acetamido-3,5-dideoxy-alpha-D-glycero-D-galacto-2-nonulopyranosidon ic acid (X-Neu5Ac), has been synthesized to facilitate the screening of bacterial colonies or plaques for the detection of either natural or mutant neuraminidase activity. Substrate 1 was hydrolyzed by neuraminidase isolated from Clostridium perfringens to release a halogenated indol-3-ol 2 that undergoes rapid aerobic oxidation to form the dark blue pigment, 5,5'-dibromo-4,-4'-dichloroindigo 3. Preliminary kinetic studies indicate that this compound is a good substrate (Km 0.89 x 10(-3) M) for neuraminidase and is quite stable under identical conditions in the absence of enzyme. These results suggest that X-Neu5Ac 1 can be useful to screen for bacterially-encoded enzyme production directly on agar plates.

Chromogenic Compounds↗

PubMed1993

Treatment of indolent non-Hodgkin's lymphoma localized in the head and neck.

A total of 25 patients with indolent non-Hodgkin's lymphoma localized in the head and neck region was analyzed. Of these, 21 patients were classified as clinical Stage I, and 4 as Stage II. In 22 patients the extranodal site was involved, and it was a remarkable characteristic of this series of patients. Overall treatment results were as follows: survival rate 100% at 5 years, and relapse-free survival rate 81% at 2 and 5 years. There was only 1 death at 6 years and 2 months after treatment, and 4 relapses occurred by 2 years after treatment. Relapse was observed in 3 of 8 patients with follicular mixed/follicular medium type, which was in contrast to the other indolent histologies (SL, DSCl, ILL) with very few relapses.

Adult↗

PubMed1993

Granulocyte colony-stimulating factor (G-CSF)-induced mobilization of circulating haemopoietic stem cells.

We studied the utility of G-CSF for harvesting circulating haematopoietic stem cells in patients with leukaemia or lymphoma based on a comparative study in a single patient. Two successive cycles of leukapheresis following cytotoxic chemotherapy were performed in 22 patients as follows: the first cycle was performed with cytotoxic mobilization in all patients while the second cycle was randomized into two groups: cytotoxic (n = 10) and cytotoxic plus G-CSF (cytotoxic/G-CSF) (n = 12) mobilization. Repetitive cytotoxic mobilization did not alter the yields of mononuclear cells (MNC), myeloid (CFU-GM), and erythroid (BFU-E) progenitors. In contrast, cytotoxic/G-CSF mobilization produced significantly higher yields of MNC (2.6-fold), CFU-GM (5.5-fold), and BFU-E (3.9-fold) than did cytotoxic mobilization alone (P < 0.01). The ratio of CFU-GM to BFU-E was not affected by G-CSF. Furthermore, G-CSF led to an earlier peak of CFU-GM following chemotherapy. G-CSF is thus effective in expanding the pool of circulating haematopoietic progenitors.

Acute Disease↗

PubMed1993

Evaluation of leukaemic contamination in peripheral blood stem cell harvests by reverse transcriptase polymerase chain reaction.

A major issue in autologous blood stem cell transplantation (ABSCT) for leukaemia is whether peripheral blood stem cell (PBSC) harvests are less contaminated with leukaemic cells than bone marrow mononuclear cells (BMMNC). We compared leukaemic contamination in PBSC harvests and BMMNC, obtained simultaneously, by using reverse transcriptase polymerase chain reaction (RT-PCR) of leukaemia-specific chimaeric messenger RNA (mRNA), in three patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukaemia (ALL), one with Ph-positive acute myelogenous leukaemia (AML), and two with acute promyelocytic leukaemia (APL). Our two-step PCR method employed 'nested primers' in the second step and can detect one leukaemic blast diluted into 10(6) HL-60 cells. In three of four patients with Ph-positive ALL and AML we detected leukaemic contamination in both PBSC harvests and BMMNC. In the remaining patient with ALL, both PBSC harvests and BMMNC were PCR-negative. Both PBSC harvests and BMMNC from one patient with APL were PCR-positive. In contrast, PBSC harvests from another patient with APL, whose BMMNC could not be obtained because of bone marrow necrosis, were PCR-positive after the first course of consolidation chemotherapy, but became PCR-negative after the second course. The present study does not support the hypothesis that PBSC harvests are less contaminated by leukaemic cells than BMMNC, but suggests that PBSC harvests are contaminated when BMMNC are contaminated.

Adult↗

PubMed1993

Cytokine production by peripheral blood monocytes and T cells during haemopoietic recovery after intensive chemotherapy.

We studied the production of cytokines by peripheral blood monocytes and T cells during the period of haematological recovery following intensive chemotherapy. Twelve adults with haematological malignancies received consolidation chemotherapy of complete remission. Monocytes and T cells were collected during the phase of recovery from intensive chemotherapy, and were incubated for 24 h in a culture medium with 10% FCS. Concentrations of cytokines in the culture supernatant were measured with an enzyme-linked immunosorbent assay. During the recovery phase, concentrations of IL-6, G-CSF and IL-1 beta in the culture supernatant of the collected monocytes significantly exceeded those of the monocytes obtained from normal healthy subjects. Similarly, the concentrations of GM-CSF and IFN-gamma in the supernatant of recovery phase T cells significantly exceeded those of normal T cells. Plasma levels of these cytokines were also elevated. These data suggest that the monocytes and T cells may be activated in vivo to produce haemopoietic cytokines during haematological recovery, and that, during haematological recovery, the monocytes and T cells may be actively involved in the induction of haematopoiesis following the myelosuppression induced by chemotherapy.

Adolescent↗

PubMed1993

Comparison of early glottic and supraglottic carcinoma treated with conventional fractionation of radiotherapy.

There were a few reports to compare the treatment results of glottic and supraglottic carcinoma. We investigated the difference of glottic and supraglottic carcinoma. From 1967 through 1985, 338 cases with early glottic (T1: 210, T2: 52) and supraglottic carcinoma (T1: 34, T2: 42) were treated with the conventional fractionation of radiation and evaluated the tumor response during radiation at the Department of Radiology, Osaka University Hospital. The ten-year actuarial survival rates of T1, T2 glottic and T1 and T2 supraglottic carcinoma were 63%, 64%, 58% and 46%, the corresponding ten-year cause-specific survival rates 92%, 89%, 88% and 78%, and the corresponding ten-year local control rates 76%, 67%, 69% and 59%, respectively. Tumor clearance rates of T1 and T2 glottic and T1 and T2 supraglottic carcinoma at 40 Gy were 68%, 40%, 35% and 24%, respectively. The local control rate of the tumor which disappeared at 40 Gy was 84%, that persisted at 40 Gy and disappeared at 60 Gy 69%, and that persisted at 60 Gy 33%. The local control rate and the tumor clearance rate of T1 glottic carcinoma were the highest among early laryngeal carcinoma, and those of T2 glottic carcinoma were the same as those of T1 supraglottic cases. The local control rate, the cause-specific survival rate, and the actuarial survival rate of T2 supraglottic were significantly lower than other cases.

Actuarial Analysis↗

PubMed1993

[192Ir brachytherapy].

Modern high technology has recently brought a precision treatment modality in the field of brachytherapy for cancer patients. Ir-192 manual afterloading (hair pin technique of Ir-192 wire) replaced the technique utilizing Ra-226 needles at our department in 1973. In May 1991, microSelectron-HDR (Ir-192 micro-source of 370 GBq) was installed in Osaka University Hospital. Preliminary analysis of phase I/II study resulted in no significant differences between the incidence of an acute mucosal reaction as well as early tumor response after high and low dose rate interstitial brachytherapy for oral cancer. Since April 1992, a phase III study has been under way to completely eliminate the problem of hospital personnel exposure to radiation in the field of brachytherapy. The introduction of remote after-loading of Ir-192 micro-source has resulted in improvements in elderly patient care during the interstitial brachytherapy for malignancies. The indications for HDR brachytherapy have been expanded, and new technology was developed to improve the local cure of the disease, such as linked double button technique for oral cancer, template interstitial brachytherapy for perineal cancer, and postoperative brachytherapy using intraoperative flexible catheter placement for locally unresectable disease or microscopically residual disease. Through these meticulous efforts, HDR interstitial brachytherapy will soon become a satisfactory substitute for traditional LDR interstitial brachytherapy.

Adult↗

PubMed1993

Radiation therapy for early glottic carcinoma: indication for the wedge filter.

From 1977 to the end of 1987, 244 patients with early glottic carcinoma (T1N0M0) were treated with radiation therapy. For 95 patients (group A), a styrofoam head holder and band were used to ensure immobilization during treatment without a wedge filter and for 149 patients (group B) a shell fixing devise and wedge filter were used. Total radiation dose administered was 50 to 70 Gy over a period of five to seven weeks with fields of 5 x 5 cm (group A) and 5 x 5 cm (group B1: n = 74) or 6 x 6 cm (group B2: n = 75). The five-year relapse-free survival (RFS) rates for group A and B were 85% and 90%, respectively, and RFS was essentially the same (p = 0.241). In group B, RFS was also basically the same for groups B1 and B2 (p = 0.78). According to tumor size, however, in patients with large T1a lesions (total length of one vocal cord) five-year RFS rates for groups A and B were 62% and 88%, respectively, and RFS was statistically significantly different (p = 0.003). Up to five years, seven patients (9%) of group A and 23 patients (17%) of group B showed minor chronic complication. As a minor chronic complication, arytenoid edema was found more frequently in group B (n = 15) than group A (n = 0). Eleven of these 15 cases were treated with large field (6 x 6 cm). For large T1a lesions of glottic carcinoma, a wedge filter was useful. A small field (5 x 5 cm) with an appropriate angle of wedge filter is recommended to avoid late arytenoid edema and achieve a more homogeneous dose distribution.

Adult↗

PubMed1993

Cyclosporine combined with methylprednisolone or methotrexate in prophylaxis of moderate to severe acute graft-versus-host disease.

To evaluate the efficacy of cyclosporine (CYA) regimens in preventing moderate to severe acute graft-versus-host disease (GVHD), 25 patients received immunosuppressive therapy consisting of either CYA and methylprednisolone or CYA and methotrexate (MTX) and the incidence and severity of acute GVHD was compared. These patients had leukemia or myelodysplastic syndrome (MDS) and received bone marrow transplants (BMT) from genotypically HLA-identical siblings. The incidence of grade I-IV acute GVHD in patients on the CYA/methylprednisolone regimen was 64% (7 of 11) compared with 50% (7 of 14) in those on the CYA/MTX regimen. Five of 11 patients with the CYA/methylprednisolone regimen developed moderate to severe acute GVHD (grade II-IV), fatal in 3 cases. No patient on the CYA/MTX regimen developed moderate to severe acute GVHD. Engraftment was faster in the CYA/methylprednisolone group than in the CYA/MTX group. The incidence of toxicity observed soon after BMT was comparable between groups. The CYA/MTX regimen may be superior to the CYA/methylprednisolone regimen for preventing moderate to severe acute GVHD.

Acute Disease↗

PubMed1993

Prognostic factor of radiotherapy for squamous cell carcinoma of oropharynx without clinically positive nodes.

Local control rates of oropharynx carcinoma treated with radiation alone were reported as 40 to 71%. We investigate the factors which affect the local control rate for oropharynx carcinoma. From 1967 through 1982, 62 cases of squamous cell carcinoma of oropharynx without positive neck nodes were treated with external radiation at the Department of Radiology, Osaka University Hospital. Five-year actuarial survival rates of T1, T2, T3 and T4 cases were 53%, 63%, 47% and 0%, respectively. Five-year local control rates of T1, T2, T3 and T4 cases were 51%, 46%, 34% and 0%, respectively. In 52 cases treated with a total dose of 60 Gy or more, tumor response could be evaluated at the dose level of 40 and 60 Gy. The local control rates of tumors which disappeared and persisted at 40 Gy were 88% (7/8) and 39% (17/44), respectively (p < 0.05). Of 44 cases which persisted at 40 Gy, the local control rates of tumors which disappeared and persisted at 60 Gy were 48% (11/23) and 29% (6/21), respectively (p > 0.30). Evaluation of tumor response at 40 Gy was an important indicator of local control for N0 oropharynx carcinoma.

Adult↗

PubMed1993

High-dose-rate remote afterloading intestinal radiotherapy employing the template technique for recurrent cancer in the pelvic area.

Between December 1991 and August 1992, five patients with recurrent cancer in the pelvic area (four gynecological cancers and one rectal cancer) were treated at Osaka University Hospital with a remote afterloading interstitial implantation employing the template technique. External irradiation (40 to 50 Gy) was performed in four cases one to four weeks before brachytherapy. Interstitial high-dose-rate brachytherapy (24 to 40 Gy/four to eight fractions/two to four days) was performed twice a day. Three of the five patients achieved complete local tumor control. The remaining two patients obtained symptom relief. There were no complications serious enough to need surgical treatment. Moreover, this procedure is well tolerated and therefore an effective modality for elderly and frail patients.

Adenocarcinoma↗

PubMed1993

[Study on the inhibitory effect of oral granisetron against nausea/vomiting induced by cytosine arabinoside containing chemotherapy for tumors in the hematopoietic organs].

We investigated the antiemetic effect, safety and usefulness of granisetron tablet on nausea/vomiting induced by cytosine arabinoside (Ara-C) in the chemotherapy for tumors in the hematopoietic organs. Out of 52 cases with malignant tumors in the hematopoietic organs including acute leukemia, 30 in granisetron group had no antiemetic treatment, were evaluated for the clinical efficacy of granisetron and 22 in control group. Their chemotherapies were combination therapy with Ara-C and daunorubicin (DNR), Ara-C and mitoxantrone (MIT), or Ara-C and etoposide (VP-16). In the trial, the dosage of granisetron tablet was 2 mg once a day, and the drug was given before each chemotherapy for 6 consecutive days. In clinical efficacy the effective rate of granisetron (the percentage of cases in which the trial drug was assessed as "Remarkably effective" or "Effective") was more than 80% on each day of administration. There was no adverse event. As the abnormal laboratory test value, only 1 case tested positive in urine protein, whose causal relation to the trial drug was judged as "Unassessable". Granisetron was judged as "Safe" in 31 out of 32 cases (96.9%). In terms of usefulness, the drug was rated "Extremely useful" or "Useful" in 26 out of 30 cases (86.7%). The above results have shown that granisetron tablet, when administered orally once daily at a dose of 2 mg, has an excellent antiemetic effect, and is a safe and useful drug.

Administration, Oral↗

PubMed1993

Radiation therapy for carcinoma of the major salivary glands. Results of conventional irradiation technique.

From January 1967 through November 1991, a total of 135 patients with carcinoma of the major salivary glands (parotid: 95; submandibular: 39; sublingual: 1) were treated at our department. 40 patients had adenocarcinoma, 29 adenoid cystic carcinoma, 24 mucoepidermoid carcinoma and 16 squamous cell carcinoma. 100 patients were irradiated postoperatively and the remaining 35 were treated with radiation alone. Total radiation doses delivered were 50 Gy for the postoperative group and 50 to 66 Gy for the group receiving only radiation using a 60Co single portal with or without wedged paired or single electron portal boost. Actuarial five-year survivals after radiation therapy were 55% for the postoperative group and 26% for radiation only group (p = 0.0004). The local control rates for the postoperative group were 83% for adenocarcinoma, 81% for adenoid cystic carcinoma, 83% for mucoepidermoid carcinoma and 62% for squamous cell carcinoma. Corresponding figures for the radiation only group were 40% for adenocarcinoma, 38% for adenoid cystic carcinoma and 33% for mucoepidermoid carcinoma. Conventional irradiation techniques continue to play an important role because they offer superior local control for postoperative patients with carcinoma of the major salivary glands. However, the local control rates for the radiation only group were only 30 to 40%, so that new irradiation modalities such as provided by a high LET machine are needed for these patients.

Adenocarcinoma↗

PubMed1993

Role of total body irradiation as based on the comparison of preparation regimens for allogeneic bone marrow transplantation for acute leukemia in first complete remission.

The role of total body irradiation (TBI) for allogeneic bone marrow transplantation (BMT) for acute leukemia in first complete remission was reevaluated in this study. From Japanese BMT Registry, data of 123 acute leukemia patients in first complete remission who underwent allogeneic bone marrow transplantation in 22 hospitals between 1988 and 1990 were available for the present comparative study of preparation regimens with or without total body irradiation. Two-year survivals were 77% and 51% in the TBI containing regimen group and in the non-TBI regimen group, respectively (p = 0.0010). Corresponding two-year relapse rates were 16% and 37%, respectively (p = 0.0197). Corresponding probabilities of developing interstitial pneumonitis were 21% and 24%, respectively (p = 0.8127). The analysis of causes of death indicated that non-TBI regimen increased the incidence of septicemia and lethal organ failures, such as liver, heart, lung and other multiple sites. It was emphasized that an additional role of total body irradiation was to disperse the treatment-related toxicity in allogeneic bone marrow transplantation for acute leukemia.

Acute Disease↗