Biomedical subjects

D Kondo

Publications and source records attributed to D Kondo.

33 records · Page 2Linked to original sources

PubMed1992

Transfer of beta-lactam preparations created in Japan to lung tissue and the drug selection for chemotherapy of respiratory tract infections.

Intraoperative transfer of eight beta-lactam preparations to lung tissues was investigated by one-gram one-hour intravenous drip infusion immediately prior to operation. The Japanese drugs used were piperacillin, cefotiam, ceftizoxime, cefuzonam, latamoxef, flomoxef, cefotetan and cefbuperazone. The serum peak level was highest with cefotetan, 104.1 micrograms/ml, followed by cefbuperazone, latamoxef, ceftizoxime, cefotiam, piperacillin, flomoxef and cefuzonam, in decreasing order. Except for cefuzonam, there was a correlation between the serum peak level and the human serum protein binding rate (r = 0.89). There was a correlation (r = 0.98) between the Cmax of normal lung tissue (alveoli) level and the serum peak level (Cmax), but no correlation between the former and the human serum protein binding rate. The tumour level was lower than that in normal lung tissue (alveoli), but the tissue level at the obstructive pneumonia area was higher. The Cmax of bronchiolar tissue level was highest with cefuzonam, followed by latamoxef. There was no correlation between the Cmax of bronchiolar tissue level and the serum peak level, human serum protein binding rate or the Cmax of lung tissue (alveoli) level. It is therefore presumed that the drug level in tissue of the acute pneumonia area can be determined from the serum peak level of the respective drug. An appropriate drug for chemotherapy may be selected from beta-lactam preparations which are effective against main causative organisms in acute respiratory tract infections. Cefuzonam and latamoxef are especially useful for chemotherapy in patients with acute bronchiolitis.

Adult↗

PubMed1991

[A case report of mediastinal paraganglioma and a review of the literature in Japan].

Paraganglioma is a tumor arising from the extra-adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the upper posterior mediastinum. The patient was a 40-year-old female in whom abnormal shadows were noted in chest X-ray films taken in March, 1989. She was examined at our hospital with a diagnosis of mediastinal tumor in June of the same year. CT of the chest revealed a tumor in the upper posterior mediastinum and it was shown to be hypervascular by a DSA study. Urinary hormone levels were normal. The tumor was resected in May, 1990. The tumor, measuring 6.8 X 4.0 X 3.5 cm, was encapsulated, appeared dark red and had relatively clear borders. A histopathologic diagnosis of paraganglioma was made. The patient remains disease-free at present, 6 months after operation. Problems concerning diagnosis and treatment of mediastinal paraganglioma were evaluated with a review of cases reported in Japan.

Adult↗

PubMed1991

[A clinical study on pulmonary tissue uptake of flomoxef].

Based on the results of a study on pulmonary tissue uptake of flomoxef (FMOX), a new antibiotic agent, in 45 patients undergoing thoracotomy, the following conclusions were drawn: 1. Immediately preoperative 1 hour-drug infusion of 1 g FMOX led to maximum serum concentration (averaging 42.4 micrograms/ml) 1 hour later, with a half-life of its beta phase of 1.26 hours. 2. Normal lung (alveolar) tissue concentration was Cmax 17.98 micrograms/g with its ratios to serum peak value being 31.8, 27.1, 22.2, 9.4, 5.9 and 5.0% at 1, 2, 3, 4, 5 and 6 hours later, respectively. 3. Bronchiolar tissue concentration was Cmax 31.91 micrograms/g, with its ratios to serum peak value being 27.8, 19.3 and 10.1% at 2, 3 and 4 hours later, respectively, indicating its good bronchiolar intra-tissue transition. The above results suggested the usefulness of FMOX for both the treatment of respiratory infections and the prevention of postoperative infections.

Adolescent↗

PubMed1990

Endoscopic ultrasound examination for mediastinal lymph node metastases of lung cancer.

Among patients with primary lung cancer who were admitted to the National Cancer Center Hospital from July 1987 to April 1988 for surgical treatments, 132 underwent preoperative transesophageal endoscopic ultrasound examination (EUS) on mediastinal lymph nodes. Of the 132 patients, 101 were pathologically evaluated and studied in this article. A GF-UM2 radial scanner with 7.5-MHz (Olympus Co Ltd) was used for image examination. The lymph nodes were diagnosed as positive for metastasis when they had thickened images, clear contours, and low echoing images of fusion or lobulation. The results obtained from 509 sites were as follows: sensitivity, 53.6 percent; specificity, 97.5 percent; positive predictive accuracy, 77.1 percent; negative predictive accuracy, 93.1 percent; and overall accuracy, 91.6 percent. The sensitivity rate was 80.6 percent excluding the result of the right superior mediastinal lymph nodes that were difficult to examine for anatomic reasons. Although EUS was considered to be an excellent method in diagnosing lymph node metastases, it had a blind angle in the field. More accurate diagnoses of mediastinal lymph node metastases could be achieved by using EUS and computed tomography (CT) together.

Adult↗

PubMed1990

[A case of primary tracheal adenoid cystic carcinoma performed curative surgical resection].

A 67-year-old woman who was diagnosed as a relative early primary tracheal adenoid cystic carcinoma by preoperative examination underwent surgical resection. The histopathological extension of this carcinoma into the tracheal wall was much greater than was suggested before operation and 6 tracheal rings was curatively resected circumferentially. Median sternotomy and transection of the left brachiocephalic vein facilitated access to the trachea. To resect the extensive segment of the trachea, the right pulmonary ligament and hilum were mobilized. Additionally Dedo's laryngeal release was performed to lessen the tension at the anastomosis. Then the flap of the pleura and adipose tissue with the right internal mammary artery and vein was wrapped around the anastomosis for revascularization and protection of brachiocephalic artery. The postoperative course was not eventful. The postoperative dysphagia by Dedo's laryngeal release was mild and resolved within 7 days after operation. And the postoperative mammary arteriography showed the vessels around the anastomosis. This wrapping procedure is easy and does not need a laparotomy. So we think it is beneficial for prevention against postoperative complications of tracheoplasty.

Aged↗

PubMed1990

[Management of acute empyema with leakage of bronchial anastomosis after right sleeve upper lobectomy--a case report].

Bronchopleural fistula developing empyema after pulmonary resection is a fatal complication. But we have successfully treated this complication after right sleeve upper lobectomy. The patient was a 61-year-old male, who has a squamous cell carcinoma originating in the right upper lobe of the lung in the clinical stage of IIIa. Right sleeve upper lobectomy with pericardiotomy to reduce the tension of bronchial anastomosis and R2a lymph node dissection. The leakage of bronchial anastomosis was complicated on 5th postoperative day and developed aspiration pneumonia of right middle and lower lobe and empyema. Reoperation was done on 7POD and completion pneumonectomy, omentopexy and open window thoracotomy were performed. Then endotracheal tube had been inserted into the left main bronchus and he controlled under respirator. Six weeks after that fistula was cured. Empyema, which caused by methicillin resistant staphylococcus aureus, was cured by open drainage for 2 weeks and closed drainage and irrigation for 14 weeks. He discharged 16 weeks after reoperation.

Anastomosis, Surgical↗

PubMed1990

[A case of multiple occult thyroid cancers with tracheal stenosis by invasion from metastatic lymph node].

A 59-old woman visited to our hospital with complaint of uttering stenotic sound at expiratory stage. Her chest X-ray film showed a suspicious intratracheal tumor, which was arising from the left side of the tracheal wall and confirmed 4 cm from the vocal cord by bronchofiber scope. The biopsy specimens showed well differentiated papillary adenocarcinoma. The lesion was judged to be a intrathoracic thyroid carcinoma and to infiltrate the trachea. Her air way failed to be ensured with YAG-LASER. Therefore, a subemergency operation was done. The intrathoracic lesion had no sequence of the thyroid gland. Two occult thyroid carcinomas were intraoperatively discovered. She underwent total thyroidectomy and sleeve trachectomy whose anastomosis was wrapped up in an omental flap. The intraluminal part of the tumor histologically showed poorly differentiated carcinoma, in contrast to the extratracheal part of the tumor showing well differentiated carcinoma. She was treated with radioactive iodine due to her positive 131I scintigraphy. Nine months later, a very similar lesion newly developed at the left side of trachea and made same symptoms.

Adenocarcinoma, Papillary↗

PubMed1990

[Two resected cases of pulmonary aspergilloma in acute leukemia].

Remission rate of leukemia has been improved by development of recent antileukemic chemotherapy. But opportunistic infection in secondary immunodeficiency has increased. Especially pulmonary mycoses often occurs and its prognosis is poor. But if patient with leukemia complicates pulmonary mycoses, it should be cured as soon as possible and antileukemic chemotherapy should be continued. We successfully performed surgical treatment for 2 pulmonary aspergillosis, which were complicated in stage of remission induction of acute leukemia.

Adult↗

PubMed1989

[Use of the pedicled omentum in chest surgery].

The pedicled omentum finds use in chest surgery for management of complicated problems and prevention of serious complications. Nine patients have been treated with the pedicled omentum. In four patients the goal was preventive, to avoid anastomotic leakage or infection, or to provide a source of neovascularity. In five patients the pedicled omentum was used to obtain healing in the presence of infection. Bronchial fistula, esophageal fistula with pyothorax or mediastinal infections treated successfully. This series demonstrates the efficacy of the pedicled omentum in management of chest problems.

Adult↗

PubMed1989

[A clinical study of pulmonary tissue uptake of cefuzonam and its use in prophylaxis of postoperative infections].

From our study on cefuzonam (CZON), a new antibiotic agent, with regard to pulmonary tissue uptake and use in prophylaxis of postoperative infections in 20 patients undergoing thoracotomy, we were able to reach the following conclusions: 1. Following intravenous infusion over 1 hour of 1 g of CZON immediate preoperatively, the mean serum concentration at 1 hour after commencement of the infusion reached at 41.5 micrograms/ml (serum peak value), then gradually decreased with a half-life in the beta-phase of 1.20 hours. 2. The mean CZON concentration in normal pulmonary tissue at 1 hour after commencement of the infusion was 12.7 micrograms/g with a half-life in the beta-phase of 1.28 hours. Although the number of cases examined was small at only 4, the mean pulmonary tissue level in obstructive pneumonitic lesions was 13.7 micrograms/g, and an average half-life in the beta-phase was 1.65 hours. 3. Mean bronchiolar CZON concentrations at 2, 4, and 6 hours after commencement of the infusion were 14.5, 3.1, and 2.8 micrograms/g, respectively, with a half-life in the beta-phase of 3.53 hours. 4. Among the patients undergone thoracotomy with use of CZON, no postoperative infections occurred nor severe adverse reaction was observed. CZON attained good transfer in the pulmonary tissues, particularly in the bronchiolar tissue, hence it appears useful as a prophylactic against postoperative infections in respiratory disease.

Aged↗

PubMed1989

[Surgical treatment in pulmonary metastases of colorectal cancer].

From 1962 to 1987, 72 patients with primary colorectal cancer underwent surgical treatment for pulmonary metastases. The overall cumulative 5 year survival rate was 41.3%. But the cumulative 1 year survival rate of patients with incomplete resection was 20.0%. Reduction surgery should not be employed. Twenty-nine of 66 patients with complete resection have recurred. The most of first manifested recurrences were in the lung and within 18 months after thoracotomy. This tendency was remarkable in patients with multiple pulmonary metastases and all recurrences of them were within 18 months and 80% were multiple in bilateral lung. Almost all multiple pulmonary metastases seemed to be only one manifestation of generalized metastatic disease. So indication of surgical treatment for them should be cautious. Type of pulmonary resection had no influence on post-thoracotomy survival rate. But in patients with partial resection, 7 recurrences at surgical margin and one recurrence on regional lymph nodes were doubted. Four metastatic lesions less than 3cm in maximum diameter had metastases to the regional lymph nodes. To resect more curatively, lobectomy and systemic lymphadenectomy should be recommended as the standard operation for pulmonary metastases of colorectal cancer.

Adult↗

PubMed1972