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Biomedical subjects

K Usuda

Publications and source records attributed to K Usuda.

At least 55 records · Page 3Linked to original sources
PubMed1998

What kind of hilar lung cancer can be a candidate for segmentectomy with curative intent?: Retrospective clinicopathological study of completely resected roentgenographically occult bronchogenic squamous cell carcinoma.

Although a randomized control trial demonstrated that limited surgery for small peripheral lung cancers was not as curative as lobectomy, there have been no reports concerning segmentectomy for small hilar lung cancers. In this study, we analyzed the clinicopathological features of roentgenographically occult bronchogenic squamous cell carcinomas in order to select candidates for limited resection with curative intent. From April 1982 through June 1995, 105 roentgenographically occult bronchogenic squamous cell carcinomas whose proximal edge of the lesion was more peripheral than the orifice of the segmental bronchus were completely resected. The bronchoscopic findings of the lesions were classified into three categories: remarkable, minute and hidden. Moreover, in terms of the range of endoscopic visibility, the lesions were classified into two categories: lesions within the range of endoscopic visibility and those beyond it. If lymph nodes show no signs of metastasis, roentgenographically occult bronchogenic squamous cell carcinoma is regarded as localized carcinoma and can be a candidate for segmentectomy with curative intent. In cases with minute or hidden bronchoscopic findings or of lesions within the range of endoscopic visibility, metastatic lymph nodes were never observed. Accordingly, roentgenographically occult bronchogenic squamous cell carcinomas with minute or hidden bronchoscopic findings or those within the range of endoscopic visibility can be candidates for curative segmentectomy.

Bronchoscopy↗
PubMed1998

Sequential loss of heterozygosity in the progression of squamous cell carcinoma of the lung.

Radiographically occult bronchogenic squamous cell carcinomas are early lung cancers that localize mainly in the bronchial wall, and are thought to be a good model for investigating genetic alterations through lung cancer progression. In order to elucidate sequential genetic changes in lung cancers, we analysed the incidence of allelic losses on chromosome regions 2q33, 3p21, 5q21, 7q31, 9p21 and 17p13 for 40 cases of radiographically occult bronchogenic squamous-cell carcinomas and 40 cases of advanced lung cancers microdissected. In this study we used eight microsatellite dinucleotide polymorphic markers. Frequent loss of heterozygosity (LOH) was observed on 3p21 (53%), 5q21 (44%) and 17p13 (61%) in roentgenographically occult bronchogenic squamous cell carcinomas. 2q, 7q and 9p were lost less frequently in both roentgenographically occult bronchogenic squamous cell carcinomas and advanced lung cancers. These results suggest that several tumour-suppressor genes are associated with lung cancer progression and that genetic changes on 3p21, 5q21 and 17p13 are early events.

Carcinoma, Bronchogenic↗
PubMed1997

Effect of long-term administration of ethyl eicosapentate (EPA-E) on local cerebral blood flow and glucose utilization in stroke-prone spontaneously hypertensive rats (SHRSP).

The objective of this study was to determine the effect of ethyl eicosopentate (EPA-E) on local cerebral blood flow (1-CBF) and local glucose utilization (1-CGU) in specific regions of the brain in stroke-prone spontaneously hypertensive rats (SHRSP). EPA-E (100 mg/kg body weight) or saline was orally administered to 8-week-old SHRSP. L-CBF and 1-CGU in the EPA-E-treated, saline-treated, and 8-week-old control rats were measured autoradiographically using 14C-iodoantipyrine and 14C-deoxyglucose (Sakurada's and Sokoloff's methods). The 1-CBF of the saline-treated group decreased significantly with age in all areas measured. EPA-E treatment alleviated the age-dependent decrease in 1-CBF in all areas, especially those in the basal ganglia. The 1-CGU of the saline-treated group did not change with age, however EPA-E treatment increased 1-CGU in all areas measured, though the changes were not significant. EPA-E ameliorated the decrease in cerebral blood flow and improved glucose metabolism in SHRSP suffering from severe hypertension. These results suggest that EPA-E may be useful in the prevention of stroke.

Animals↗
PubMed1997

Increased alveolar fluid clearance following thoracotomy: report of a case and results of an analysis.

Alveolar fluid clearance was studied in the resected lung of a 58-year-old man who had undergone exploratory thoracotomy 9 days earlier. An isosmolar albumin solution was instilled into the distal air spaces, and the albumin and electrolyte concentrations were measured over 4 h. Alveolar sodium and fluid clearance had increased by nearly 200% from the control values in the resected lungs of patients without prior thoracotomy (n = 5), and histological examination showed that the number of alveolar type II epithelial cells was markedly elevated. These results suggest that an increase in the number of alveolar type II cells may accelerate alveolar fluid clearance under certain clinical conditions.

Aged↗
PubMed1997

Serum boron concentration from inhabitants of an urban area in Japan. Reference value and interval for the health screening of boron exposure.

Boron (B) levels were determined in the serum of 980 healthy inhabitants living in an urban area of Japan by means of inductively coupled plasma emission spectrometry (ICPES). The results showed a log-normal distribution of serum B for both sexes, although there are age-related differences. In male subjects, serum B increases rapidly up to 49 yr of age, reaching a plateau between ages 50 and 69 yr old, followed by a gradual increase up to 70 yr or older. Female subjects exhibit a gradual increase up to the age of 70 yr old. The reference value for male and female subjects was 79.8 micrograms/L and 67.9 micrograms/L, and the reference interval was 33.3-191.2 micrograms/L and 29.5-154.9 micrograms/L, respectively. The obtained reference value and interval of the nonexposed group may be useful for health screening for B exposure, either for people living in regions with high levels of B in the environment, or for workers who are exposed to this element.

Adolescent↗
PubMed1997

The effect of hemodialysis upon serum levels of fluoride.

Serum and dialysate ionic fluoride (F-) were determined in 29 patients under hemodialysis (HD) treatment. Serum creatinine (Cr), blood urea nitrogen (BUN) and phosphorus (P) were also examined before and after HD in 92 patients including the above 29 patients under the same treatment. Results reveal that serum F- levels of the patients before and after HD were statistically higher than those of the healthy subjects. The dialysis clearance of F- was 55.6 +/- 101.3 ml/min and the value was statistically significantly lower than those of Cr, BUN (95%, p < 0.001) and P (95%, p < 0.01). Based on these results, it is concluded that despite a net clearance of F- during a given HD procedure, serum F- failed to return to normal.

Adult↗
PubMed1997

Primary antiphospholipid syndrome and pulmonary hypertension with prolonged survival. A case report.

The outcome of patients with pulmonary hypertension (PHT) and antiphospholipid syndrome (APS) is usually fatal. The authors report the rare case of a patient with primary APS and nonthrombotic PHT who has survived for twenty years after the onset of PHT. In this case, the patient's PHT resembled the primary idiopathic variety with clear lung fields and normal perfusion on the lung scan, and the combination therapy with nitrate, digoxin, and diuretics had been performed. During her clinical course over twenty years, she had not experienced any critical pulmonary thrombosis that influenced the progression of nonthrombotic PHT or any other severe systemic involvement of APS.

Adult↗
PubMed1997

[The significance of surgical treatment for T4 lung cancer].

A total of 114 pT4 patients underwent pulmonary resection from January 1980 to December 1993 at our hospital. The overall five-year survival rate of the 114 cases was 17%. There was no significance between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. Five-year survival rates of 17 patients with N0 disease, 29 patients with N1 disease, 51 patients with N2 disease, 1 patients with N3 disease, and 16 patients with NX disease were 40%, 21%, 21%, 0%, and 0%, respectively. Five-year survival rate of 89 cases with single factor of T4 was 24% and that of 25 cases with more than one factor was 4% (0.05 < P < 0.1). In the patients with only single factor of T4, five-year survival rates of 6 patients with left atrium invasion, 13 patients with major vessel invasion, 9 patients with trachea/carina invasion, and 18 patients with vertebral body, were 50%, 38%, 22%, and 0%, respectively. Furthermore, in 38 pT4 patients with involvement only to single adjacent structure, five-year survival rates were 47% in curative operation (n = 17) and 10% in non-curative operation (n = 21) (P < 0.05). We conclude that surgical treatment for T4 lung cancer should be performed to patients with single structure invasion which is expected to have a curative operation. N0 disease is more favorable than N1 or N2 disease.

Adenocarcinoma↗
PubMed1997

[A case of systemic origin of an aberrant artery to the basal segment of the lung].

We report on a rare case of systemic origin of an aberrant artery to the basal segment of the lung (Pryce I type intralobar pulmonary sequestration) that caused occasional bloody sputum. The patient was admitted to our hospital after an abnormal image was discovered in Chest X-ray film. The chest MRI showed an abnormal vessel originating from the descending aorta. The aortagram showed an abnormal artery originating from the descending aorta and entering the left lower lobe, and the left pulmonary angiogram revealed a poorly blood supply to the left basal segments. The preoperative diagnosis of systemic origin of an aberrant artery to the basal segment of the lung was given. The patient was subjected to surgical treatment. During surgery, it was found that the abnormal artery, 12 mm in diameter, which was connected from the descending aorta to the left basal segments. The abnormal artery was dissected, and the left basal segments was removed. The postoperative course was uneventful.

Aorta, Thoracic↗
PubMed1997

[Scanning electron microscopic studies on mucosal coating by barium mixtures].

The purpose of this study was to observe and evaluate mucosal coating by barium mixtures using electron microscopy. Specimens from the ileum of two pigs, about 50cm in length from the terminal ileum, were divided into 3 groups with different in concentrations and additives of barium mixture. The 50cm length of ileum was cut into 10cm long pieces. Four specimens from each group were evaluated by double contrast study for coating by the barium layer. Then the specimen was frozen with liquid nitrogen solution, and fixed. Afterward, the specimen was cut into about 1cm sections, fixed again, dehydrated, dried, and observed by scanning electron microscopy (SM). In the double contrast study, the differences in barium coating were correlated with the concentration of barium sulphate. The scanning electron microscopic findings were correlated with those of the double contrast study. The various additives in the barium mixture did not cause any distinctive differences. Although barium particles have been studied by electron microscopy, barium mixture coating state on the mucosa of biological materials has not been reported. In conclusion, a correlation of the coated barium layer on double contrast study and the images of scanning electron microscopy was observed using pig ileum specimens.

Animals↗
PubMed1997

[A child of malignant lymphoma diagnosed by transbronchial aspiration cytology under general anesthesia with a laryngeal mask].

A 8-year-old male with Wiskott-Aldrich syndrome was admitted to our hospital because of left hilar swelling on a chest roentgeonogram. Bronchofiberscopy and transbronchial aspiration cytology (TBAC) was performed under general anesthesia with a laryngeal mask. The specimen obtained by TBAC was immediately stained and diagnosed as malignant lymphoma. One month later, thoracotomy was performed in order to get more detail diagnosis, which is necessary to determine the regimen of chemotherapy, and the nodal specimen were diagnosed as Hodgkin's disease. The ABVD therapy was performed which induced the complete remission. The laryngeal mask is a useful device for bronchofiberscopy in children.

Anesthesia, General↗
PubMed1997

Boron diffusion across the dialysis membrane during hemodialysis.

To investigate the movement of boron across the dialysis membrane, serum and dialysate boron levels of long-term hemodialysis (HD) patients (n = 17) were determined using inductively coupled plasma emission spectrometry in both the inlet and the outlet side of the dialyzer. Results revealed that 77.8% of the serum boron in the inlet side of the dialyzer was filterable and 94.4% of filterable boron was actually filtered during HD. Boron dialysance was found to be 138.6 +/- 16.1 ml/min, and this value was higher than the clearance value of blood urea nitrogen (not significant), phosphorus and creatinine (p < 0.001). It is concluded that HD is effective in eliminating serum boron even at low concentrations, and boron can be classified as an element that is easily diffusible across the dialysis membrane. There seems to be relatively little relation of boron to serum constituents of macromolecules that are reported to have a major impact on the diffusion of trace elements across the HD membrane.

Aged↗
PubMed1997

[Surgical treatment for small cell lung cancer].

Results of surgical treatment for small cell lung cancer were reviewed to confirm the role of surgery. Most of the surgical therapy was performed with post or pre-operative chemotherapy. Clinical staging of small cell lung cancer treated by chemotherapy and/or radiotherapy has not been classified according to the TNM staging system, which made it difficult to compare the results of surgical treatment with non-surgical treatment in detail. Results of surgical treatment for small cell lung cancer according to the TNM staging system reported in 1990's were as follows. For stage I diseases, nearly all the patients underwent complete resection followed by standard chemotherapy. Five-year survival rates were over 50% in most of the reports. Surgical resection followed by chemotherapy is the standard therapy for stage I diseases. For stage II diseases, the greater part of patients were treated by complete resection followed by chemotherapy, which resulted in five-year survival rates of 28-35%. Nationwide statistics on surgical resection for small cell lung cancer in Japan revealed that the stage I and II diseases are actually resected, and the five-year survival rate reached 37%. Thus, surgery followed by chemotherapy for stage II diseases is becoming the standard therapy. For stage IIIA diseases, surgical resection after chemotherapy followed by chemotherapy and/or radiotherapy has been tried investigationally. The five-year survival rates of 16-48% in these patients suggests the increasing role of surgery for these patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Hemodialysis effect on serum boron level in the patients with long term hemodialysis.

Serum and dialysate boron levels in 17 patients with long term hemodialysis (HD) were determined by inductively coupled plasma emission spectrometry (ICPES). Serum boron level was compared with the value of age matched 467 healthy controls and the relationship between serum and dialysate boron level was analyzed. The results showed that serum boron level was significantly higher at the beginning of HD, and lower at the completion of HD in comparison with controls. Although the dialysate was contaminated with trace boron, HD resulted in an excessive decrease of serum boron, rather than boron exposure from the dialysate. Boron hemodialyzability was almost proportional to the gradient of the boron level at the beginning of HD and it could be controlled by the adjustment of the gradient. In conclusion, the serum boron level was very much disturbed in long term HD patients. If boron excess in serum at the beginning of HD, or deficiency at the completion of HD may contribute to the complications of HD patients, fine adjustment and close surveillance of the gradient should be taken into account.

Acute Kidney Injury↗
PubMed1996

Preservation of alveolar epithelial fluid transport mechanisms in rewarmed human lung after severe hypothermia.

Although hypothermia abolishes alveolar fluid clearance in the in situ goat lung and in the ex vivo human lung, it is unknown whether alveolar fluid clearance resumes in lungs that are rewarmed after severe hypothermia. An isosmolar albumin solution was instilled into resected human lungs that were rewarmed to 37 degrees C after hypothermia (7 +/- 3 degrees C), and then alveolar fluid clearance was measured by the concentration of albumin in the alveolar fluid sample after 4 h. In control experiments in lungs that had not been cooled and rewarmed, alveolar fluid clearance was 11 +/- 2% over 4 h. In separate experiments, hypothermia completely abolished alveolar fluid clearance. However, alveolar fluid clearance resumed to a normal level of 12 +/- 1% over 4 h in the lungs that were rewarmed after hypothermia. Amiloride decreased alveolar fluid clearance by 47% in the rewarmed lungs. Terbutaline increased alveolar fluid clearance by nearly 300% in 2-h experiments in the rewarmed lungs (P < 0.05). The results of this study indicate that alveolar sodium-channel transport mechanisms are preserved in resected human lungs that are exposed to rewarming after hypothermia.

Aged↗
PubMed1996

Compensatory enlargement of angiographically normal coronary segments in patients with coronary artery disease. In vivo documentation using intravascular ultrasound.

Intravascular ultrasound (IVUS) frequently reveals plaque formation at sites with a normal angiographic appearance. However, whether angiographically normal coronary arteries undergo adaptive expansion in vivo remains uncertain. The authors studied 12 patients (11 men, 1 woman; mean age fifty-three +/- ten years [mean +/- SD]) with focal coronary stenosis. Sixty IVUS images from angiographically normal coronary segments were analyzed (14 left main, 44 left anterior descending, and 2 left circumflex coronary arteries). The mean percent area stenosis was 36 +/- 5% and the circular shape factor of the lumen cross section averaged 0.97 +/- 0.02. Both total arterial area and internal elastic lamina area increased as the plaque area expanded (y = 2.13x + 8.07, r = 0.87, P = 0.0001; y = 2.06x + 4.57, r = 0.87, P = 0.0001, respectively), suggesting that for every 1 mm2 increase in plaque area, the total arterial area increased by approximately 2.13 mm2 and the internal elastic lamina area increased by approximately 2.06 mm2. The lumen area also increased as the plaque area expanded (y = 1.06x + 4.57, r = 0.68, P = 0.0001), suggesting that for every 1 mm2 increase in plaque area, the lumen area increased by approximately 1.06 mm2. The medial area did not correlate with the plaque area (r = 0.15, P = 0.26). Thus, compensatory enlargement precedes development of angiographically, detectable coronary atherosclerosis. Furthermore, in early stages of atherosclerosis, arterial enlargement may overcompensate for plaque area. The reduction of the total medial mass does not appear to contribute to the mechanism of compensatory enlargement.

Adaptation, Physiological↗
PubMed1996

[Ischemic neuronal damage in early recovery. A morphological study on evolution of damage in hyperglycemia and normoglycemia].

The evolution of neuronal damage in various regions during ischemia and in early recovery was investigated morphologically using hyperglycemic and normoglycemic Wistar rats. Hyperglycemia (20-35 mu mol/ml plasma) was achieved with the infusion of glucose (i.v.) prior to ischemia. Forebrain ischemia (10 minutes) was induced by bilateral common carotid artery occlusion and hypotension. Normoglycemic rats were fasted prior to ishcemia. Ischemic changes of neurons were quantified by a five-point scale in the caudoputamen (CPu), globus pallidus (GP), hippocampus CA 1 (CA 1), parietal cortex (Par), and substantia nigra reticulata (SNR) during ishcemia and for 90 minutes after recirculation. In the hyperglycemic group, (1), CPu, CA 1 and Par; severely damaged neurons were seen at 60-90 minutes after recirculation. (2) GP; there was little neuronal damage. (3) SNR; immediately after recirculation damaged neurons were observed, and more damage was observed at 90 minutes post recirculation. In the normoglycemic group, no prominent neuronal damage was observed in any region. Hyperglycemia exacerbated ischemic neuronal damage after reperfusion. The evolution of neuronal damage was similar in the CPu and Par regions, but was different in the GP and SNR regions.

Animals↗