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Biomedical subjects

S Fujimura

Publications and source records attributed to S Fujimura.

At least 163 records · Page 9Linked to original sources

[Effect of thoracoscopic procedure versus standard posterolateral/muscle-sparing thoracotomy on pulmonary lung function].

To understand the effects of thoracoscopic approach to thoracotomy on lung function, we investigated the changes in lung function after thoracoscopic operation (n = 7) and compared them to those after standard posterolateral (n = 5) or muscle-sparing thoracotomy (n = 6). In 18 patients with benign lung tumor in which surgical treatment resected in partial resection of the lung tissue, we measured TLC, VC, RV, FEV1.0, FEV1.0%, Peak Flow and DLco preoperatively and at 2, 4 weeks postoperatively. In the standard posterolateral or muscle-sparing thoracotomy groups, FVC, TLC, FEV1.0 and Peak Flow decreased to about 80% of preoperative value at 2 weeks. At 4 weeks after operation, these values showed to increase some what, but did not reach to the preoperative value. Whereas, the thoracoscopic procedure group, did not show the decrease in lung function through the time course. There was not significant different between standard posterolateral and muscle-sparing thoracotomy. We conclude that thoracoscopic approach is an useful technique to thoracotomy because of its minimizing after thoracotomy effect of lung function loss.

Adult↗

[Increase in pulmonary vascular permeability caused by increased expression of Mac-1 on the surface of polymorphonuclear leukocytes].

We studied the expression of adhesion molecules on the surface of human polymorphonuclear leukocytes (PMNs). The effects of mechanical stimulation were measured with a flow cytometer and pulmonary vascular injury due to accumulation of PMNs in the lungs was assessed by a gravimetric method. The accumulation of PMNs in the lungs was studied by measuring the amount of myeloperoxidase. PMNs were stimulated by gentle agitation in a glass container for 10 s. Mac-1 (CD11b/CD18) was upregulated on the surface of PMNs that were mechanically stimulated. When unstimulated PMNs were exposed to isolated rat lungs, the filtration coefficient did not change from that under baseline conditions. However, when mechanically stimulated PMNs were exposed to isolated rat lungs, the filtration coefficient was about 5 times higher than that measured at baseline. When mechanically stimulated PMNs treated with anti-CD18 antibody were used, the increase in the filtration coefficient was completely blocked. The assay of myeloperoxidase revealed that PMNs stuck to isolated rat lungs only after stimulated PMNs were added. We conclude that when the adhesiveness of PMNs is increased by mechanical stimulation, these cells adhere to pulmonary vessels and increase pulmonary vascular permeability.

Animals↗

[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↗

[Prediction of postoperative pulmonary hemodynamics for the second lobectomy after the contralateral lobectomy].

We presented 7 cases who were performed the second lobectomy for the second lung cancer after the first successful lobectomy on the contralateral lung (3 cases for right upper lobectomy + left lower lobectomy and 4 cases for right upper lobectomy + left lower lobectomy). In 6 patients, the predicted postoperative FEV1 estimated by multiplying the preoperative FEV1 by the fraction of perfusion to the contralateral lung was less than 800 ml/m2BSA, which is our first cut-off for identifying lung resection candidates. Unilateral pulmonary arterial occlusion test (UPAO) revealed that total pulmonary vascular resistance (TPVRI) in 3 of those 6 patients was lower than 700 dyne.sec.cm-5/m2BSA, our second cut-off for lung resection. More precise postlobectomy pulmonary hemodynamics in another 3 of those 6 patients were then estimated by adapting selective pulmonary occlusion test (SPAO). Since TPVRI during SPAO was lower than the cut-off value, it was suggested that second lobectomy would be feasible with low incidence of post operative cardiopulmonary complication. There was no serious complications in all 7 cases during their postoperative course. We believe that more precise prediction of postoperative pulmonary hemodynamics by adapting UPAO and SPAO could be one of the tools to minimumize postoperative cardiopulmonary complications in those patients needed second lobectomy for the second lung cancer after the first successful lobectomy on the contralateral lung even though their impaired lung fung function.

Aged↗

[Video-assisted thoracoscopic surgery of bilateral dissemination of invasive thymoma: report of a case].

Eight years ago, A 29-year-old woman was admitted by complaining with facial edema and dyspnea. A chest x-ray film and computed tomography showed an anterior mediastinal tumor that invaded to the superior vena cava and the trachea. A bronchoscopic biopsy revealed that the tumor was a thymoma. We performed radiotherapy and chemotherapy because a surgical operation was not possible. The size of the tumor was slightly reduced after those therapies roentgenographically. We followed up the subsequent of history of the patient. Eight years later, July, 1995, chest computed tomography showed bilateral disseminations of invasive thymoma. The disseminated tumors were removed by two-stage video assisted thoracoscopic surgery (VATS), to preserve collateral veins so that collateral venous circulations were preserved. She discharged 20 days after second VATS uneventfully.

Adult↗

[Thoracic surgery and liver dysfunction].

Lung resection results in loss of lung parenchyma including residual healthy lung tissue and in reduction in pulmonary vascular bed. A decrease in residual pulmonary vascular bed after lung resection causes an increase in right heart afterload, and in some patients, it would be associated with an increase in right heart preload and consequent the changes in hepatic circulation which would lead to liver damage. Preceding thoracotomy, unilateral pulmonary arterial occlusion test (UPAO) was performed to simulate the hemodynamic changes after lung resection to evaluate the increase in right heart preload after surgery. Patients with the decreases in cardiac index or PaO2 during UPAO showed a higher levels of GPT during postoperative period when compared with those with the increase in either parameters. In a surgical treatment for empyema, bronchiectasis, or other infectious lung diseases, bronchial angiography (BAG) and also bronchial arterial embolization (BAE) were useful methods to prevent from exceeding bleeding during thoracotomy, which is one of the risk factors to cause liver damage after surgery. These results suggest that, in the field of thoracic surgery, the preoperative assessment of the hemodynamic changes caused by lung resection and the preoperative attempt to prevent from bleeding during thoracotomy are both important to protect from liver damage caused by surgical stress.

Empyema↗

[A case of lung abscess with elevated serum levers of sialyl Lewis X-i (SLX) and CA 19-9].

A case of lung abscess of the felt lower lobe in a 19-year-old woman with elevated serum levels of Sialyl Lewis X-i (SLX) and CA 19-9 is reported. Completing the lobectomy, serum SLX level returned to the normal range within a week postoperative day. Serum CA 19-9 level also decreased at half life of 2 weeks to the normal range within 6 weeks postoperative day. Laboratory examination demonstrated high levels of these antigens in abscess fluid. Histologically, the abscess was revealed to be associated with a markedly dilated bronchus with hyperplastic bronchial glands, and there was no evidence of malignancy. Immunohistochemical examinations using monoclonal antibodies against human SLX and CA 19-9 showed highly positive reaction with those antigens in both goblet cells in bronchial epithelia and the mucous cells in bronchial glands.

Adult↗

[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↗

[Successful two-stage approach to treating excessive hemorrhage from pulmonary arterial stump in post-lobectomy bronchopleural fistula].

A 62-year-old man underwent right lower lobectomy for adenocarcinoma (pT2N0M0) and nine days later, a bronchopleural fistula with empyema was evident. Six weeks following the lobectomy, excessive hemorrhage from the site of chest drainage and hemoptysis were noted. The bleeding and empyema were controlled by a two-stage approach. Anterior transpericardial approach was first made through the median sternotomy to clamp the right main pulmonary artery and then postero-lateral thoracotomy was conducted for the bronchopleural fistula with empyema. The right bronchial stump was covered with a pedicled muscle flap and pseudomonas aeruginosa, always positive in drainage effusion, consequently disappeared. The patient was discharged with a closed bronchus 4 months following the operation.

Bronchial Fistula↗

Expression of nucleolar protein p120 in human lung cancer: difference in histological types as a marker for proliferation.

The function of proliferation-associated nucleolar protein p120 is unclear. A recent report that a yeast protein, NOP2, 67% homologous to human p120, is up-regulated during the onset of growth and influences the morphology of the nucleolus supports the notion that this protein could serve as a marker for proliferation in neoplastic cells. Lung cancer is characteristic in that different histological types show different biological features. We attempted to evaluate the levels of p120 expression in resected human lung cancer tissues of different histological types and the relation of p120 expression and cell proliferation using human lung cancer cell lines. When 37 frozen specimens of human lung cancer and normal lung were stained with a p120 monoclonal antibody, the nucleoli of cancer cells were positively stained, whereas a few macrophages in normal lung revealed only weak staining. The labeling index of p120 in squamous cell carcinoma (67.7 +/- 12.4%) was significantly higher than that in adenocarcinoma (35.3 +/- 12.6%) or in large cell carcinoma (30.1 +/- 17.3%; P < 0.01). In six human lung cancer cell lines and one normal lung fibroblast cell line cultured in vitro, there was a significant correlation between S-phase fraction and p120 mRNA (r = 0.851, P < 0.02)/p120 protein (r = 0.869, P < 0.01) or between doubling time and p120 protein (r = -0.928, P < 0.01). In the context of the reports that indicate higher [3H]thymidine incorporation and shorter doubling time in the squamous cell carcinoma, these results indicate that p120 can be a marker for proliferation in human lung cancer cells in vivo and in vitro, and that it has an important function in the cell cycle of tumor proliferation.

Adenocarcinoma↗

Alterations of c-fos gene methylation in the processes of aging and tumorigenesis in human liver.

The state of DNA methylation in the c-fos gene was examined in human livers of different ages, cirrhosis and hepatocellular carcinoma. The degree of methylation in the intron 1 to exon 4 region increased with age, whereas all of the 10 cirrhosis samples revealed a decrease in methylation when compared to normal livers of similar ages. The 11 hepatocellular carcinomas showed varied alterations suggesting that the alteration of the c-fos gene methylation is related to aging as well as to early-step of hepatocarcinogenesis.

Adolescent↗

Usefulness of ultrasonography in operation for pulmonary arteriovenous fistula.

A 54-year-old woman presented with nonhereditary, bilateral pulmonary arteriovenous fistulas. One of them was small (10 x 10 mm) and embedded in the parenchyma; it was neither visible nor palpable from the pleural surface. We therefore used intraoperative ultrasonography and succeeded in detecting and enucleating the small fistula with minimal resection of the normal lung tissue.

Arteriovenous Fistula↗

Characterization of the purified cytosolic thymidine kinase from murine ehrlich ascites tumor: interconversion of two different relative molecular weight forms.

Cytosolic thymidine kinase was purified 18,000-fold of the homogenate from murine Ehrlich ascites tumor, using the [p-aminophenyl 3' -dTMP]-CH-Sepharose affinity column. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified enzyme showed a single protein band of molecular weight 26,000. Two different forms, relative molecular weight 50,000 and 70,000, were found by gel filtration, depending on the existence of dithiothreitol, ATP and other nucleotides. These agents also stabilize and stimulate the enzyme activity. The existence of two forms was also manifested by DEAE-Sephacel column chromatography, where the 50,000 form was eluted by 50 mM NaCl and the 70,000 form by 400 mM NaCl.

Adenosine Triphosphate↗

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↗