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Biomedical subjects

S Fujimura

Publications and source records attributed to S Fujimura.

At least 199 records · Page 11Linked to original sources

[Assessment of a new TNM classification produced by UICC for resected lung cancer with intrapulmonary satellite tumor(s)].

We examined the efficacy of a new classification produced by International Union Against Cancer (UICC) in 1993 for 61 patients who underwent resection of lung cancer with intrapulmonary satellite tumor(s) during 1952 to June 1991. Survival rate after resection was calculated according to the new classification. Survival rate of patients with stage I lung cancer was 67% at four years after surgery, that with stage IIIA was 33% and stage IIIB 5% at five years after surgery. There was a significant difference between the survival of stage IIIA and stage IIIB. Five year survival of patients with N0 or N1 lung cancer was 62%, which was significantly better than four year survival (3%) with N2, N3, or NX lung cancer. Five year survival for patients with squamous cell carcinoma was 61%, which was significantly better than that (9%) with adenocarcinoma. The new TNM classification produced by UICC is acceptable in investigating lung cancer with ipsilateral satellite tumor(s). It is necessary to investigate lung cancer with contralateral satellite tumor(s). Prognosis of patients with N0 or N1 lung cancer, especially squamous cell carcinoma, even if with intrapulmonary satellite tumor(s), was relatively good after resection. Such lung cancers may be synchronous multiple lung cancers from a therapeutic point of view.

Adult↗

[Detection of early cancer by lung cancer screening].

A total of 1,615,010 person-years in 64 local municipalities were screened from April 1982 through March 1990. All participants were screened annually by chest X-ray, and participants of high risk group were screened by both chest X-ray and sputum cytology. 76,522 person-years(4.7%) were screened by sputum cytology. Among 148 lung cancer patients(0.194%) detected by sputum cytology, 132 were squamous cell carcinoma, and 116(78%) were chest X-ray negative. 90 patients were proved to be Stage 0 or I after resection, and 47 were less than 10 mm in diameter. On the contrary, 166 out of 432 detected patients detected by chest X-ray only, were proved to be Stage I after resection, and 4 patients were less than 10 mm in diameter. Thus, sputum cytology for high risk group were effective to detect early lung cancer.

Carcinoma, Squamous Cell↗

[A study of surgical treatment in lung cancer over 75 years of age-effect of epidural anesthesia for protection of postoperative coughing disturbance].

29 patients over 75 years of age in 221 patients undergoing resection of lung cancer from January of 1990 through December of 1994 were studied for the occurrence of expectoration disturbance (atelectasis), the effect of epidural anesthesia for protection of it. Atelectasis was observed in 8 (27.6%) of 29. In a group received epidural anesthesia (EA) during the early postoperative phase, 1 of 5 patients developed atelectasis. In 192 patients below 75 years of age, atelectasis was observed in 40 (20.8%) of them, so in a group received epidural anesthesia (EA) during the early postoperative phase, only 2 of 42 patients (4.8%) developed atelectasis. This value was significantly lower than that value (25.3%) in a group without EA. In conclusion, in the group below 75 years of age, EA during the early postoperative phase may be useful in inhibiting the occurrence of atelectasis, an important one of the postoperative lung complications.

Aged↗

[Two cases of the congenital posterolateral diaphragmatic hernia were reported].

Case 1, a 9-year-old woman, was admitted to our hospital because of nausea, vomiting, and epigastralgia. Diagnosis of Bochdalek hernia was made by the unusual course of naso-gastric tube. At surgery through the left posterorateral thoracotomy, the herniation of the stomach, small intestine, and colon to the thoracic cavity through the dorsolateral defect of the diaphragm were revealed. Case 2, a 35-year-old man, was admitted to our hospital because of dyspnea. Similar diagnosis was made by the examination of upper G1 series and barium enema, which demonstrated the presence of multiple loops of the small intestine and colon in the left thoracic cavity. Their postoperative courses were uneventful. Most of Bochdalek hernia is observed in infancy, and adolescent or adult case is is rarely reported (approximately 10% of all cases). Since this often misdiagnosed as pleuritis or pulmonary tuberculosis, a cautious examination is necessary for the establishment of the correct diagnosis.

Adult↗

[Present international status and basic approach of lung and heart-lung transplantation].

Lung transplantation has been established as an optional treatment for variable irreversible diffuse lung diseases. To date, more than 5,000 patients have underwent lung transplantation, and nearly 1,000 procedures a year are performed recently. Although heart-lung transplantation has also been technically established, this procedure is confined to quite limited conditions due to the severe shortage of donors and many difficulties in operative procedure and the patient management. Preservation, post-transplantation edema, diagnosis of rejection, chronic rejection, shortage of donor organs, are principal problems in clinical lung transplantation, 24-hour preservation proved to be possible in several recent experimental studies, and the reperfusion injury has been revealed to be one of causes of post-transplantation edema. Establishment of methods for long-term pulmonary preservation and for the treatment of post-transplantation edema may be promising in the near future. Shortage of donor lung is one of major limiting factors. Research works on xenotransplantation and cadaver lung transplantation are on going, and these may help in solving this problem.

Heart-Lung Transplantation↗

[Long-term effect of a beta-adrenergic agonist on Na+/K(+)-ATPase activity in rat lung explants].

To test the long-term effect of a beta-adrenergic agonist on Na+/K(+)-ATPase activity in rat lung explants, we measured the activity in lung explants kept continuously in the presence or absence of 0.1 mM terbutaline for 5 days. Once it was clear that this agent increased Na+/K(+)-ATPase activity, we then performed a similar measurement in cultured alveolar type II cells from rats. Continuous exposure to 0.1 mM terbutaline enhanced the enzyme activity in those cells, and this enhancement was completely blocked by 0.01 mM of the beta-antagonist propranolol. Western blotting showed that this increase in Na+/ K(+)-ATPase activity in the cells could involve modulation of protein expression. We conclude that beta-adrenergic agonists can increase Na+/K(+)-ATPase activity in alveolar type II cell in lung explants by modulating expression of the enzyme in a long period of time.

Adrenergic beta-Agonists↗

Purification and characterization of a non-hemorrhagic metalloprotease from Agkistrodon halys brevicaudus venom.

A non-hemorrhagic metalloprotease (protease L4) was purified from the venom of Chinese Mamushi (Agkistrodon halys brevicaudus) by gel filtration and anion-exchange chromatography. Protease L4 has the molecular weight of 22,000 and its optimum pH was 8.5. The protein was stable in the pH range of 5-9 and below 40 degrees C. The proteolytic activity was inhibited by metal-chelating agents and some metal ions. Calcium ion activated the activity dose-dependently, but had only a minor effect on the thermal and pH stability. L4 showed fibrinogenase activity, hydrolyzing only the A alpha chain of fibrinogen. The protease cleaved preferentially at the N-terminal of Leu and His residues of some peptides.

Agkistrodon↗

Elevation of alkaline phosphatase activity induced by parathyroid hormone in osteoblast-like cells from the spinal hyperostotic mouse TWY (twy/twy).

We have examined the alkaline phosphatase (AP) activity of primary calvaria-derived osteoblast-like cells from the twy (tip-toe walking Yoshimura) and normal ICR control mouse. The twy mouse displays elevated osseous formation particularly in the spine, and the pathophysiological features resemble that of human ankylosing spinal hyperostosis. In the proliferative stage of cultured bone cells, parathyroid hormone (PTH) stimulation induced the elevation of AP activity of both twy and ICR mouse-derived cells. When they reached confluence, the AP activity of ICR mouse-derived cells ceased to increase with PTH stimulation. The twy mouse-derived cells, however, continued to respond to PTH, with the enzyme activity increasing even in the confluent, stationary stage. PTH stimulation also increased the intracellular cAMP content of twy mouse-derived cells but it did not influence that of ICR mouse-derived cells in the stationary stage. Moreover, stimulation with dibutyryl cAMP, but not with phorbol myristate acetate, increased the AP activity of both twy and ICR-derived bone cells irrespective of culture conditions, either in the proliferative or in the confluent stage. These data suggest that the protein kinase A-mediated pathway plays a pivotal role in bone cells with PTH stimulation, and that the uninhibited AP activity observed in twy mouse-derived bone cells might be due to some deviating process between the PTH ligand/receptor interaction and cAMP generation.

Alkaline Phosphatase↗

Effects of hypothermia and hyperpotassium on alveolar fluid clearance in the resected human lung.

The effect of hypothermia and hyperpotassium on alveolar fluid clearance in the resected human lung was examined by instilling an isosmotic albumin solution with a potassium concentration of 0.3 mEq/l or 20 mEq/l into one segment of a resected lobe within 10 min of surgical removal for bronchogenic carcinoma. The experiments were carried out at 37 degrees C, 25 degrees C, and and 8 degrees C over 4 hr, after which the alveolar fluid was aspirated. Alveolar fluid clearance was calculated by a simple equation using the changes in the albumin concentration of the alveolar fluid. It was found that although hypothermia at 8 degrees C abolished alveolar fluid clearance completely, alveolar fluid clearance at 25 degrees C was not different from that at 37 degrees C. Moreover, although the potassium concentration increased in the alveolar fluid at 37 degrees C and 8 degrees C, hyperpotassium did not affect the alveolar fluid clearance. These findings indicate that the net transport of potassium leans to influx from the alveolar epithelial cells into the alveolar spaces when the alveolar potassium concentration is low, and to efflux from the alveolar spaces when the alveolar potassium concentration is high. Thus, we conclude that hypothermia abolishes alveolar fluid clearance in resected human lungs, but that the potassium concentration in alveolar fluid does not affect alveolar fluid clearance.

Aged↗

Some binding properties of the envelope of Porphyromonas gingivalis to hemoglobin.

Porphyromonas gingivalis was found to bind to hemoproteins (hemoglobin, myoglobin, catalase, cytochrome c) and the binding properties of the envelope of P. gingivalis to hemoglobin were investigated. Maximum amount of hemoglobin bound to 1 mg of the envelope was 58 micrograms. No significant binding was observed at 4 degrees C and the binding was inhibited strongly by tosyl-L-lysine chloromethyl ketone, Leupeptin, EDTA and partially by meta-periodate. Heating of the envelope at 70 degrees C for 15 min resulted in complete loss of the binding activity. The binding activity of the envelope was not influenced by the treatment with the endogenous proteases. The envelope saturated with hemoglobin could no longer bind to other hemoproteins tested, indicating that binding site for these hemoproteins are common.

Hemoglobins↗

Adhesion molecule CD18 on polymorphonuclear cells correlates to the lung injury caused by continuous infusion of endotoxin in sheep.

We investigated the mechanisms of increase in the pulmonary vascular permeability, focusing on the changes in the peripheral white blood cell (WBC) counts and the surface expression of CD18 on polymorphonuclear cells (PMNs). Anesthetized sheep with chronic lung lymph fistulas were used in this study. We infused synthetic endotoxin (LPS) at a rate of 10 ng/kg/min (i.v.) continuously for 24 hr. We measured lung lymph flow, lymph-to-plasma protein concentration ratio and WBC counts in blood and lung lymph, and the PMNs' surface expression of CD18 before and at 2, 10 and 24 hr after the start of endotoxin infusion, respectively. CD18 was analyzed by flow cytometry using monoclonal anti-CD18 antibody. We found that the pulmonary vascular permeability increased during 2-4 hr after the start of endotoxin infusion, and returned to the baseline over 10 hr. At time 2 hr period, the number of WBCs in the lung lymph increased, the number of peripheral WBCs, mostly PMNs, decreased and the surface expression of CD18 on the peripheral PMNs was up-regulated. At time 10 and 24 hr, the number of WBCs in lung lymph decreased, the number of peripheral WBCs increased and CD18 expression was down-regulated. These data indicate that up-regulation of CD18 expression promotes the PMN adherence to the pulmonary endothelium, migration into the lung and increases the pulmonary vascular permeability. We conclude that the continuous endotoxin infusion up-regulates CD18, which contributes to the PMN migration into the lung.

Animals↗

[Effects of prostaglandin E1 (PGE1) on pulmonary hypertension and lung vascular remodeling in a rat monocrotaline model of human pulmonary hypertension].

Prostaglandin E1 (PGE1) has been shown to be a potent pulmonary vasodilator in humans and in many animals. The effects of PGE1 on the development of pulmonary hypertension and on pulmonary vascular remodeling were studied in a rat monocrotaline (MCT) model of human pulmonary hypertension. By 3 weeks after injection, MCT (80 mg/kg S.C.) had resulted in high values of mean pulmonary arterial pressure and of the ratio of right ventricular weight to left ventricle+septum weight (RV/LV+S). PGE1 inhibited the development of pulmonary hypertension (300 micrograms/kg) and right ventricular hypertrophy (300 and 100 micrograms/kg) induced by MCT. Three weeks after the injection, the media walls of pulmonary arteries in lungs from rats given MCT were significantly thicker than those from lungs of control rats. PGE1 (300, 100, and 30 micrograms/kg) resulted in significantly less of this morphologic change, in a dose-dependent manner. These results indicate that PGE1 inhibits the development of pulmonary hypertension associated with lung vascular thickening induced by MCT. PGE1 may be useful for the treatment of pulmonary hypertension in humans.

Alprostadil↗

[Effect of adhesiveness of white blood cells on pulmonary vascular permeability and resistance].

We studied pulmonary vascular injury evoked by mechanically activated white blood cells (WBCs). In isolated perfused rat lungs, changes in pulmonary vascular resistance were measured, and a gravimetric method was used to measure the pulmonary vascular filtration coefficient, which was taken as an index of pulmonary vascular injury. WBCs were activated by gentle agitation in a glass container for 10 sec. The filtration coefficient was measured under baseline conditions, and then inactive or activated WBCs were added to the perfusate. The perfusion was stopped for 90 minutes and then the lungs were reperfused. The expression of CD18 on the surface of WBCs was measured by flow cytometry. The filtration coefficient and the pulmonary vascular resistance in lungs exposed to activated WBCs were about 2.5 times and 3.3 times higher, respectively, than those in the lungs exposed to inactive WBCs. These results indicate increases in resistance and in pulmonary vascular permeability. The results of flow cytometry indicated that the mechanical agitation increased the expression of CD18 on the surface of WBCs. In conclusion, WBCs in which adhesiveness has been increased can induce pulmonary vascular injury and can increase pulmonary vascular resistance.

Animals↗

[Assessment of nucleolar organizer regions (Ag-NORs) in bronchial dysplasia and roentgenographically occult bronchogenic squamous cell carcinoma].

Mean argyrophil nucleolar organizer regions (Ag-NORs) per nucleus were determined on columnar epithelium, bronchial dysplasia, roentgenographically occult squamous cell carcinoma and squamous cell carcinoma with roentgenographically findings in 76 formalin-fixed, paraffin-embedded resected specimens. 1) Mean Ag-NOR counts per nucleus (mean +/- standard deviation) were 1.67 +/- 0.30 in 10 columnar epitheliums, 2.74 +/- 0.41 in 13 lesions with bronchial dysplasia, 3.75 +/- 0.59 in 57 lesions with roentgenographically occult squamous cell carcinoma and 4.44 +/- 0.51 in 14 lesions with squamous cell carcinoma with roentgenographically findings. There were significant differences between each two groups. 2) In lesions with squamous call carcinoma, mean Ag-NOR counts per nucleus of T2, T3 or T4 tumor were significantly higher than those of T1 tumor. Mean Ag-NOR counts per nucleus of N1 or N2 tumor were significantly higher than those of N0 tumor.

Aged↗

[Neutrophil elastase in postoperative pleural effusion of patients who had undergone pulmonary resections].

We determined whether activity of neutrophil elastase increases in pleural effusion after lobectomy for the neoplasm in the lung. Samples of pleural effusion were obtained 3 and 24 h postoperatively and samples of the peripheral blood were obtained preoperatively, 3 h, 24 h, and 1 w postoperatively, then the neutrophil counts, the levels of neutrophil elastase and alpha 1-antitrypsin by enzyme-linked immunosorbent assay, the activity of neutrophil elastase using succinyl-(L-alanine) 3-p-nitroanilide were measured. We found that the levels of neutrophil elastase increased 170 times greater in pleural effusion than in peripheral blood 3 h after lobectomy. However, the levels of alpha 1-antitrypsin did not increase in pleural effusion. The activity of neutrophil elastase increased to 0.54 +/- 0.1 mumol/min/l in pleural effusion 3 h after lobectomy, however the activity of neutrophil elastase was under the sensitivity level of detection in the peripheral blood after lobectomy. In conclusion, there is an imbalance between the levels of neutrophil elastase and alpha 1-antitrypsin in pleural effusion after lobectomy, the imbalance resulting in the increased activity of neutrophil elastase which probably is relating to tissue injury in the pleural spaces.

Aged↗

[Hydraulic conductivity of the visceral pleura with hemodynamic lung edema in dogs].

Hydraulic conductivity of the visceral pleura was measured in situ in anesthetized dogs. There were two groups: control (n = 7), and edema (n = 5). The 7th intercostal space of the left thorax was opened. In each group, a hemispherical capsule, filled with physiological salt solution, was attached to the visceral pleura of left lobe by negative pressure made with a vacuum pump. In the edema group, pulmonary venous pressure was increased by ligation of the pulmonary vein. The transpleural fluid flow (V) was measured at different intracapsular pressures (delta P). The hydraulic conductivity was calculated from the relation between the fluid flow rate (v) and the intracapsular pressure, i.e., the slope of the linear regression line. The hydraulic conductivities in the control and edema groups were 1.49 +/- 0.68 and 3.19 +/- 1.13 nL.min-1.cmH2O-1.cm-2, respectively. We conclude that the pleural tissue may play an important role in hydraulic conductivity of the visceral pleura when pulmonary venous pressure is high.

Animals↗

[Vasoactive intestinal peptide (VIP)-induced pulmonary vasodilation mediated by EDRF/NO in isolated perfused rat lungs].

We studied the effects of Vasoactive Intestinal Peptide (VIP) on the pulmonary circulation in isolated perfused rat lungs. VIP caused pulmonary vasodilation in a dose-dependent manner. This effect was inhibited by pretreatment with L-N omega-nitro-arginine (L-NNA), a competitive inhibitor of endothelium-derived relaxing factor (EDRF/NO), but not by meclofenamate, a cyclooxygenase inhibitor. Addition of L-arginine, a substrate of EDRF/NO, after treatment with L-NNA reversed VIP-induced pulmonary vasodilation. These results indicate that VIP causes pulmonary vasodilation, and they suggest a role for EDRF/NO in VIP-induced pulmonary vasodilation in isolated rat lungs.

Animals↗

[A case of necrotizing sarcoid granulomatosis diagnosed by open lung biopsy].

A 59-year-old man had an abnormal shadow on chest X-ray film. He was admitted to Tohoku-chuou Hospital, and a lung lesion in the right lower lobe was diagnosed as a benign nodule. A new nodular lesion appeared on a chest X-ray film taken two months after his discharge from the hospital. Both lesions were in the same lobe; the older one was in segment 9 and the newer one was in segment 10. For the lesion in segment 10, malignancy was not ruled out, so open lung biopsy (right lower lobectomy) was done. With the findings of angitis and focal necrosis surrounded by granulomas consisting of epthelioid cells and multinuclear giant cells, the new lesion in segment 10 was diagnosed as necrotizing sarcoid granulomatosis. The older lesion in segment 9 was a tuberculoma. We conclude that in this case the open lung biopsy was necessary to diagnose necrotizing sarcoid granulomatosis in lung.

Diagnosis, Differential↗