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Biomedical subjects

S Fujimura

Publications and source records attributed to S Fujimura.

At least 181 records · Page 10Linked to original sources

Development of low potassium solution (EP4 solution) for long-term preservation of a lung transplant: evaluation in primate and murine lung transplant model.

The results of recent studies on long-term preservation using low potassium flush solution, which was originally produced in our department, are presented and discussed. In the primate model, a lung preserved for 24 h with EP4 solution retained sufficient function in single lung allotransplantation. In the murine experiments, we have evaluated the ion transport properties across alveolar epithelial cells in the transplanted lung using the tools of alveolar fluid clearance tests. The alveolar fluid clearance rate, which can be inhibited by 10(-3) M ouabain, is also well preserved for the first 24 h, indicating that the alveolar epithelial Na-K-ATPase is still functioning and that the 72 h preservation decreases those function of Na-K-ATPase in a time-dependent manner. In conclusion, because 24 h hypothermic preservation with EP4 solution did not show any obvious disadvantage on primate lung allografts and the cellular and molecular viability of the preserved lung flushed with EP4 solution could be retained for 24 h, this kind of solution with extracellular electrolyte composition can be applicable in the clinical settings.

Animals↗

Binding of hemoglobin to the envelope of Porphyromonas gingivalis and isolation of the hemoglobin-binding protein.

The binding activity of the Porphyromonas gingivalis envelope and hemoglobin was examined over a wide range of pH values from 4.5 to 9.0. The binding activity in low-pH buffers was much higher than that at high pH; the optimum pHs for the binding were found to be 4.5 and 5.0. Since the hemoglobin bound to the envelope was found to dissociate in the pH 8.5 and 9.0 buffers, the binding is reversible. We hypothesized that hemoglobin-binding protein (HbBP), responsible for the binding to hemoglobin, exists in the envelope and confirmed its presence by dot blot determination with peroxidase-conjugated hemoglobin. Then we attempted to isolate HbBP from the solubilized (by a detergent) materials of the envelope by affinity chromatography. The molecular mass of HbBP was 19 kDa, and the isoelectric point was 4.3.

Bacterial Proteins↗

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↗

Sleeve superior segmentectomy of the right lower lobe for endobronchial neurinoma. Report of a case.

A 30-year-old woman was found to have an obstructive intrapulmonary tumor at the right intermediate bronchus which caused atelectases of both right middle and lower lobes. The diagnosis of endobronchial neurinoma was made by bronchofiberscopic biopsy. Since the tumor was benign, we considered an operative procedure which would enable both complete resection of the tumor and preservation of the pulmonary function. By utilizing the techniques of sleeve superior segmentectomy of the right lower lobe and telescoping bronchial anastomosis, both objectives were achieved.

Adult↗

Simultaneous estimation of filtration variables in isolated rat lungs in zone 3 conditions.

Estimation of filtration variables (filtration coefficient, perimicrovascular pressure, and reflection coefficient) is important for evaluating pulmonary microvascular permeability to fluids, especially when the lungs are inflamed, injured, or being preserved for transplantation. Here we report a new method for estimating filtration variables simultaneously in isolated rat lung lobes in zone 3 conditions (pulmonary arterial pressure > pulmonary venous pressure > alveolar pressure). We used Krebs-Henseleit solution containing 6% bovine serum albumin for the perfusate and maintained perfusion using a constant-pressure circuit system. Pulmonary venous and alveolar pressures were kept at 2.5 and 2.0 cmH2O, respectively, and pulmonary arterial pressure was set so that lung weight did not change. Then we increased both pulmonary arterial and venous pressures by 3 cm H2O simultaneously, and recorded the weight gain. Next, we diluted the perfusate with Krebs-Henseleit solution to about half the original concentration, and recorded the weight gain. Using the Starling equation, the values we obtained for the filtration variables were filtration coefficient, 5.3 mg. min-1.cmH2O-1.g-1; perimicrovascular pressure, 1.1 cmH2O; reflection coefficient, 0.54. These values agree with values from previous reports. Since these 3 filtration variables are interrelated, this method for simultaneous measurement is more accurate than independent measurements are. The advantages of this method are that it does not require direct measurement of interstitial pressure or collection of lymph fluid. What we need to calculate these filtration variables are the initial filtration rates and the albumin osmotic pressures for perfusate.

Animals↗

[Reconstruction after wide resection of the chest wall: application of plates as rigid prosthetic materials].

Wide resection of the chest wall requires reconstruction with rigid prosthetic material to protect the thoracic organs and to avoid flail chest. We tried to use three kinds of plates for chest wall reconstruction in 4 cases: acrylic plate for 1, ultra-high-molecular-weight polyethylene (UHMWP) plate for 1 and methyl metacrylic resin (MMR) plate for 2. Marlex mesh was utilized to strengthen the rebuilt chest wall sandwiching rigid prosthesis in UHMWP plate and MMR plate. Except for somewhat local accumulation of serous fluid in two cases of acrylic plate and MMR plate, postoperative courses were uneventful in all cases. Acrylic plate which was used for patient with metastatic sternal tumor was easily damaged by heat. UHMWP plate which was used for patient with large benign sternal tumor was expensive and took a long time to make. On the other hand, MMR plates which were used for two patients with malignant lateral chest wall tumor were easy to handle on the spot and not expensive. MMR plate sandwiched by Marlex mesh seems to be more suitable and available for chest wall reconstruction.

Adolescent↗

Relaxation of human isolated pulmonary arteries by amrinone.

Amrinone, a selective phosphodiesterase III inhibitor, has been developed as a nonglycoside, noncatecholamine agent with positive inotropic effect. In this study, we examined the effect of amrinone on human pulmonary arterial strips in vitro to understand its action on human pulmonary circulation. Amrinone (10(-5)-10(-3) g/ml) caused dose-dependent relaxation of human pulmonary arterial strips precontracted with 60 mM KCl. Preincubation with either meclofenamate (3.1 microM), a cyclooxygenase inhibitor, or L-N(G)-nitroarginine (100 microM), a competitive inhibitor of EDRF/NO, failed to inhibit amrinone-induced pulmonary vasodilation. The cyclic AMP (cAMP) levels in the supernatant of the lung vessel homogenates increased after incubation with amrinone (10(-3) g/ml). These findings indicate that amrinone causes vasodilation of human pulmonary artery in vitro, and suggest a possible role for cAMP in the mechanisms of amrinone-induced pulmonary vasodilation. Because it is suggested that amrinone has not only positive inotropic effect but also pulmonary vasodilative effect in human in this study, we speculate that amrinone could be an useful agent for the treatment of an increase in right heart afterload and consequent pulmonary hypertension and right heart failure after lung resection in human.

Adult↗

[Effects of subacute hypoxia on alveolar epithelial ion transport in rats].

To study the effects of subacute hypoxia on alveolar epithelial ion transport, alveolar fluid clearance was measured in isolated fluid-filled rat lungs. After instillation of a solution containing about 5% bovine albumin, an increase in alveolar fluid clearance was measured over 2 hours. Alveolar fluid clearance was lower when rats were kept in hypoxic conditions (FiO2 = 0.1) for 48 hours. Neither 10(-5) M amiloride (a Na(+)-channel blocker) nor 10(-3) M ouabain (an inhibitor of Na(+)-K(+)-ATPase) inhibited fluid clearance in the hypoxia group, but they did in the normoxia group. These results indicate that subacute hypoxia may down-regulate both the Na(+)-channl and Na(+)-K(+)-ATPase, and thus decrease the absorption of excess alveolar fluid.

Animals↗

[Two cases of clear cell tumor of the lung].

We report two cases of benign clear cell tumor of the lung, which were found as well-circumscribed lesions on chest X-ray films without any symptoms, and removed surgically. Light microscopy showed proliferation of clear cells filled with glycogen in both cases. Immunohistochemical examination performed in a case suggested that the tumor cells might be associated to a derivation from neural and/or smooth muscle cells, because of positive staining for NSE and SMA. In another case, the tumor formed a necrotic cavity, which could be detected by the preoperative MRI examination. This report might introduce a note of caution for the pathologic and radiographic diversity of this disease.

Adult↗

[Effect of time in culture on modulation of Na(+)-K(+)-ATPase activity in rat alveolar type II cells].

To determine the effect of time in culture on epithelial cell function, we evaluated the modulation of Na(+)-K(+)-ATPase activity in rat alveolar type II cells in culture. Ouabain sensitivity testing revealed that the alpha-1 predominance in the enzyme's isoforms was maintained over the 120 hours in culture. Basal Na(+)-K(+)-ATPase activity in the whole cell homogenate did not differ significantly between cells cultured for 48 hours and those cultured for 120 hours. Terbutaline (10 mM) did not activate Na(+)-K(+)-ATPase in the cells cultured for 48 hours, but, it significantly increased the activity of this enzyme in the cells cultured for 120 hours cells cultured for 48 hours, produced intracellular cyclic AMP after exposure to 10 mM of terbutaline. These results indicate that the coupling between Na(+)-K(+)-ATPase and the beta-adrenergic pathway in alveolar type II cells can be influenced by the time in cell culture.

Adrenergic beta-Agonists↗

[Long-term effect of a beta-adrenergic agonist on sodium uptake into cultured rat alveolar type II cells].

To evaluate the long-term effect of a beta-adrenergic agonist on Na(+)-channel function in cultured rat alveolar type II cells, we measured 22Na+ uptake into type II cells cultured in the presence and absence of 0.1 mM terbutaline for up to 5 days. Terbutaline did not influence the growth, morphology, or protein content of the cells. Terbutaline increased amiloride-inhibitable 22Na+ uptake into the cells at day 2 in culture, but there was no significant difference at day 5. Because amiloride-inhibitable 22Na+ uptake reflects Na(+)-channel function, these data indicate that terbutaline may transiently upregulate Na(+)-channel function. This study provides direct evidence of a long-term effect of a beta-adrenergic agonist on Na(+)-channel function in alveolar type II cells.

Adrenergic beta-Agonists↗

[Clinicopathologic assessment of primary thymic carcinoma based on eighteen cases].

In order to study clinicopathologic characteristics of thymic carcinomas, 18 patients with thymic carcinoma and 56 patients with invasive thymoma were reviewed. All of them were underwent thoracotomy. Both 5-year and 10-year survival rates were 44% in the thymic carcinoma patients, while 5-year survival and 10-year survival rates were respectively 62% and 52% in the invasive thymoma patients. The survival rate of the thymic carcinoma cases was significantly lower than that of invasive thymoma cases (p < 0.05). Both surgical technique and anticancer chemotherapy. However, have been improved in these years, such as artificial vessels for great veins, panpleuro-pneumonectomy, cisplatin and so on. Those new techniques have brought the significantly higher survival rate in recent 10 cases of thymic carcinoma patients. Three-year survival rate of 10 cases after 1990 was 80% and it was 13% in 8 cases before 1989 (p < 0.01). We conclude that surgical procedure are necessary for the treatment of thymic carcinoma patients, and both chemotherapy and radiotherapy should be combined with the surgical procedures to completely remove the tumors.

Adult↗

[A case of idiopathic thrombocytopenic purpura combined with lung cancer].

A 71-year-old male was admitted to our hospital because of a chest abnormal shadow. His chest X-ray film showed a mass in the right lower lobe (S6), which was diagnosed as adenocarcinoma by transbronchial lung biopsy. A lab data on the admission showed thrombocytopenia (44,000 per cu. mm), and the results of the bone marrow aspiration was compatible with idiopathic thrombocytopenic purpura. Immediately after the right lower lobectomy with lymphnode dissection, intrathoracic bleeding from the wound due to hemorrhagic tendency appeared necessitating a re-thoracotomy. High-dose intravenous gamma-globulin infusion for 4 days and the frequent concentrated platelet transfusion were employed to prevent the hemorrhagic tendency after the 2nd operation, and the postoperative hemorrhage was successfully controlled. Perioperative high-dose intravenous gamma-globulin infusion was concluded to be useful in the patient of idiopathic thrombocytopenic purpura for preventing hemorrhagic tendency after the operation.

Adenocarcinoma↗

[Assessment of prognostic factors in surgical treatment for the pulmonary metastasis of osteosarcoma based on results of 17 patients].

Seventeen cases with surgical treatment for pulmonary metastases of osteosarcomas have been experienced for past 20 years in our institute. Disease free intervals, tumor doubling time, the number of metastatic lesions, the size of metastatic lesions, pathological features on nuclear findings were assessed in relation to their prognosis. These parameters were concluded to have no significant relations to the survival outcomes after the surgery for pulmonary lesions except for the number of metastatic lesions less than 20 in total which is likely to be associated with long survivals, supporting previous reports on the resectability of pulmonary metastatic lesions as an only reliable prognostic indicator. It was also stressed from our experience that the meticulous follow-up after each surgery for both primary and metastatic lesions is absolutely necessary for the early detection of recurrent pulmonary lesions in order not to overlook curable cases with aggressive treatment.

Adolescent↗

[Aberrations of the p 53 gene in roentgenographically occult squamous cell carcinoma of the lung].

Mutations of one p 53 allele and LOH occur in advanced lung cancers, but in early lung cancer these things were not known well. To make clear carcinogenesis of lung cancer, it is important to study p 53 alterations in early lung cancers. We studied them in 29 roentgenographically occult lung cancers by means of PCR-SSCP and microsatellite marker. PCR-SSCP was performed for exon 7 of the p 53 gene. LOH was found in 6 cases and point mutation was found in 2 cases (codon 234 T-A transversion, codon 245 G-T transition). Frequency of LOH and point mutations was lower than in the cases of advanced lung cancers. These things suggested the clonal expansion of aberrant p 53 gene occurred in the course of cancer development (i.e., roentgenographically occult lung cancer to advanced lung cancer).

Carcinoma, Squamous Cell↗

[Difference in expression of epithelial adhesion molecules between primary and metastatic lesions in small-cell lung cancer].

One crucial step in tumor metastasis is detachment of cells from the primary lesion. This involves down-regulation of homophilic binding intercellular adhesion molecules. To determine whether this occurs in metastasis of human small-cell lung cancer to lymph nodes, we examined expression of E-cadherin, carcinoembryonic antigen (CEA), and neural cell adhesion molecule (NACM) on cells from patients with small-cell lung cancer, some cells were obtained from primary lesions and others from lymph-node metastases. Cells in all of the five lines from primary lesions expressed E-cadherin, unlike those in all of the five lines from lymph-node metastases. Cells in all of the five lines from primary lesions expressed CEA, as did those in only one of the five cell lines from lymph-node metastases. Cells in lines from primary and metastatic lesions did not differ in the expression of NCAM (4/5 positive). Expression of E-cadherin and of CEA were closely correlated. Because E-cadherin and CEA are involved in the binding of epithelial cells, these findings demonstrate that metastasis of small-cell lung cancer to lymph nodes is associated with a lack of the epithelial intercellular adhesion molecules E-cadherin and CEA. The expression of these molecules is involved in the metastasis of small-cell lung cancer to lymph nodes.

Cadherins↗

[Role of Na(+)-glucose cotransport in fluid absorption across alveolar epithelium in isolated rat lungs].

To evaluate the role of Na(+)-glucose cotransport in fluid absorption across alveolar epithelial walls in isolated rat lungs, we measured the inhibitory effects of amiloride (a Na+ channel blocker) and phlorizin (a Na(+)-glucose cotrasport blocker) on the fluid absorption rate in fluid-filled lungs. Amiloride (10(-5)-10(-4) M) reduced alveolar fluid absorption by 30%. This value was similar to that obtained in the presence of 10(-3) M phlorizin. The coefficient of Na(+)-glucose cotransport was estimated to be 2.5. The strong correlation between Na+ escape and fluid absorption (r = 0.907) was not affected by phlorizin. These findings suggest that the impact of Na(+)-glucose cotransport was similar to that of Na+ transport alone, and that glucose molecules transported by Na(+)-glucose cotransport do not play an important role in alveolar fluid absorption across rat alveolar epithelium.

Absorption↗

[Experience with one-lung anesthesia using balloon catheter for patients with terminal tracheostomy].

We experienced two cases of lung cancer with terminal tracheostomy. Conventional double lumen tubes such as the Broncho-Cath or the Robertshaw were not applicable for one-lung anesthesia for these cases because of anatomical reasons due to the total laryngectomy. One left lower sleeve lobectomy and a right middle lobectomy were performed under one-lung ventilation using an occlusion balloon catheter that was introduced through a seath placed in the spiral type tracheostomy tube through a plastic connector. This method has three advantages: 1) a spiral type tracheostomy tube is easily fitted for the deformed trachea. 2) an occlusion balloon catheter with an extra lumen at its tip enables the airway aspiration and the inflation of the lung. 3) air leakage around a catheter is completely prevented by the use of a catheter introducer. The present method was concluded to be superior to the prior technique with the Forgaty catheter as an endbronchial blocker.

Aged↗