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Biomedical subjects

T Fujishima

Publications and source records attributed to T Fujishima.

At least 19 recordsLinked to original sources
PubMed1997

Successful treatment of blunt trauma involving complete laceration of the pancreas and duodenum in a 7-year-old child: report of a case.

The acute onset of peritoneal signs and shock in a 7-year-old boy who had been hit in the epigastrium by a log-seesaw mandated surgical treatment. Enhanced computed tomography (CT) demonstrated complete laceration of the pancreas as well as duodenal injury, and a duodenoduodenostomy with distal pancreaticogastrostomy was subsequently performed. Temporary external drainage of the stomach and distal pancreas led to an uneventful recovery in the early postoperative period. Although the patient's postoperative development was appropriate for his age, the orifice of the distal pancreas spontaneously closed 2.5 years following surgery. We present this report to stress the fact that every effort should be made to preserve the pancreas following abdominal injury in children.

Child↗
PubMed1996

Lipid analysis and surfactant-associated protein expression in lung adenocarcinoma cells from pleural effusion.

Primary lung adenocarcinomas originate from the progenitor cells of peripheral airway cells. Alveolar type II cells and Clara cells are the major progenitor cells of peripheral airway cells. Alveolar type II cells produce a lipid-protein complex called surfactant, which contains surfactant proteins SP-A, SP-B, SP-C and SP-D. Phosphatidylcholine (PC) and phosphatidylglycerol (PG) are believed to be essential for the surfactant function. Clara cells also express SP-A, SP-B and SP-D but not SP-C. In this study we examined the properties of the cancer cells isolated from the pleural effusion of a patient with primary lung adenocarcinoma by analyzing lipids, proteins and mRNAs. The cancer cells, designated as LC117 cells, were isolated from the pleural effusion of a patient with primary lung adenocarcinoma. The percent distributions of [14C]-acetate incorporated into PC and PG in the cancer cells were 55.7 and 1.1%, respectively. The disaturated species in total PC was 46.2%. Immunoblotting analysis using anti-SP-D monoclonal antibody revealed that the pleural effusion from a patient with lung adenocarcinoma contained SP-D. We determined the concentrations of SP-A and SP-D by enzyme-linked immunosorbent assay. The pleural effusions from this patient and the media incubated with cancer cells exhibited significant levels of SP-D as well as SP-A. Reverse transcriptase-polymerase chain reaction demonstrated that the tumor cells expressed mRNAs for SP-C as well as the other surfactant proteins. The results demonstrate that tumor cells from lung adenocarcinoma express all of surfactant-associated proteins, indicating that LC117 cells originate from alveolar type II cells. This study indicates that the combination of analyses of lipids, proteins and mRNAs in the cancer cells isolated from pleural effusion is useful to understand the property of lung adenocarcinoma.

Adenocarcinoma↗
PubMed1996

Lactic dehydrogenase-immunoglobulin G kappa complex in a patient with idiopathic interstitial pneumonia.

A female patient with idiopathic interstitial pneumonia (IIP) was admitted again 40 months after the diagnosis due to progression of clinical findings and increased activity of serum lactic dehydrogenase (LDH). Analysis of LDH isoenzyme disclosed a broad band between LDH4 and LDH5. Gel filtration and immunoelectrophoresis showed that immunoglobulin (Ig) G (kappa type) bound the LDH. With prednisolone and azathioprine, her symptoms and radiological findings improved concomitant with a decrease in the serum LDH activity. The LDH-IgG kappa complex disappeared in the circulation 14 months after initiation of the therapy. We report circulating LDH-Ig complex in a patient with IIP, which may be related to the disease progression of IIP.

Antigen-Antibody Complex↗
PubMed1996

[Radiation induced osteosarcoma of the chest wall].

We report a successful resection of an osteosarcoma in the chest wall developed 25 years after irradiation. A 74-year-old woman was admitted to our hospital for her swelling in the left chest wall at August 24, 1995. At 49-year-old, she had undergone an operation and postoperative irradiation for left breast cancer. A computed tomography demonstrated a mass in the left chest wall that destructed the first rib, extending into the pleural space and invaded into the left common carotid and subclavian arteries. We planned a radical resection of the mass after repeated CT scannings, since it was histopathologically diagnosed as a chondrosarcoma and showed a rapid growth. The tumor was completely removed with radical transmediastinal forequarter amputation of the partial chest wall and total left upper extremity. The left common carotid artery was partially replaced with 6 mm EPTFE vascular prosthesis. The chest wall was reconstructed with Marlex-mesh prosthesis and a myocutaneous flap. She was discharged uneventfully and has not shown any evidence of recurrence.

Aged↗
PubMed1996

[Surfactant protein A in bronchoalveolar lavage fluid from patients with idiopathic interstitial pneumonia].

We measured the levels of surfactant protein A (SP-A) in bronchoalveolar lavage fluid from patients with idiopathic interstitial pneumonia and from healthy volunteers. The SP-A levels in the patients who were smokers (1.4 +/- 0.2 micrograms/ml) were significantly (p < 0.05) lower than those in the patients who were nonsmokers (3.0 +/- 0.5 micrograms/ml). However, SP-A levels did not differ significantly between patients and volunteers who were smokers, or between patients and volunteers who were nonsmokers. The ratios of SP-A to phospholipid in patients who were smokers and in those who were non-smokers did not differ significantly from those in volunteers who were smokers and volunteers who were non smokers. The total number of alveolar macrophages in bronchoalveolar lavage fluid did not significantly correlate with the level of SP-A, although the percentage of alveolar macrophages correlated negatively (p < 0.05) with the level of SP-A. The low level of SP-A in patients with idiopathic interstitial pneumonia who are smokers may weaken the host defense functions in peripheral airways and may contribute to the poor outcomes in these patients.

Adult↗
PubMed1995

Aberrant appearance of lung surfactant protein A in sera of patients with idiopathic pulmonary fibrosis and its clinical significance.

Pulmonary surfactant protein A (SP-A) is known to be a major phospholipid-associated glycoprotein in pulmonary surfactant, which is specific to the lung. In this study, the SP-A concentrations in sera of patients with various lung diseases were determined using an enzyme-linked immunosorbent assay. Patients with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis (PAP) exhibited prominently high concentrations of serum SP-A compared to those of other lung diseases and healthy volunteers, although there were significant increases in serum SP-A concentrations in patients with pulmonary tuberculosis, chronic pulmonary emphysema, diffuse panbronchiolitis and bacterial pneumonia compared to those of healthy volunteers. Successive measurement in 2 patients with IPF showed that serum SP-A levels reflect the disease activity of IPF. In patients with IPF, serum SP-A concentrations were significantly correlated with those of serum lactate dehydrogenase, whereas there were no significant correlations of serum SP-A concentrations with erythrocyte sedimentation rate, arterial oxygen saturation, vital capacity and carbon monoxide diffusing capacity. Determination of serum SP-A will contribute to diagnosing IPF and PAP, and may reflect the disease activity of IPF.

Biomarkers↗
PubMed1995

Increased carcinoembryonic antigen concentrations in sera and bronchoalveolar lavage fluids of patients with pulmonary alveolar proteinosis.

Pulmonary alveolar proteinosis (PAP) is a rare disease in which alveoli are filled with lipoproteinaceous materials. We measured carcinoembryonic antigen (CEA) concentrations in bronchoalveolar lavage (BAL) fluids and sera from patients with PAP and from healthy volunteers (HV). Significantly increased CEA values were found in BAL fluids and sera from patients with PAP compared with those from HV. BAL fluid CEA values significantly correlated to serum CEA values in patients with PAP. Serum CEA values significantly correlated to serum lactate dehydrogenase activity and alveolar-arterial PO2 difference values in patients with PAP. Successive measurements of serum CEA showed that serum CEA values reflect the disease activity of PAP. The determination of serum CEA is useful for evaluating disease severity of PAP.

Adolescent↗
PubMed1995

Idiopathic chronic eosinophilic pneumonia associated with noncaseating epithelioid granulomas.

A 34 year old Japanese woman was referred to our university hospital due to pulmonary opacities and bilateral hilar lymphadenopathy on chest X-ray. She also had uveitis, erythematous skin nodules, and oral and genital ulcers. Laboratory data showed eosinophilia in the circulation and bronchoalveolar lavage fluid. Histological study revealed massive eosinophilic infiltration and noncaseating epithelioid granulomas in the lung and mediastinal lymph node, without evidence of vasculitis. Pulmonary opacities, lymphadenopathy, and blood eosinophilia promptly improved with corticosteroid therapy. In this patient, idiopathic chronic eosinophilic pneumonia overlapped with features of sarcoidosis and Behçet's disease.

Adult↗
PubMed1995

Lung surfactant protein-A and carcinoembryonic antigen in pleural effusions due to lung adenocarcinoma and malignant mesothelioma.

Lung surfactant protein-A (SP-A) is a major phospholipid-associated glycoprotein in surfactant, and is a useful immunohistochemical marker for lung adenocarcinoma. Carcinoembryonic antigen (CEA) has not been immunohistochemically detected in mesothelioma. In pleural effusions due to malignant mesothelioma, very low concentrations of SP-A and CEA can be expected. We studied the value of combined determinations of CEA and SP-A in pleural fluid to distinguish between lung adenocarcinoma and mesothelioma. SP-A and CEA concentrations were measured in pleural effusions from 78 patients with lung adenocarcinoma and 10 with malignant mesothelioma. SP-A concentrations in pleural effusions due to lung adenocarcinoma and mesothelioma were 516 +/- 140 and 16.9 +/- 3.6 ng.ml-1 (mean +/- SEM), respectively. CEA concentrations in pleural effusions due to lung adenocarcinoma and mesothelioma were 239 +/- 92.4 and 1.7 +/- 0.3 ng.ml-1, respectively. SP-A values did not exceed 100 ng.ml-1 in any of 10 mesotheliomas, whilst in 37 of 78 lung adenocarcinomas they did. CEA values did not exceed 10 ng.ml-1 in any of 10 mesotheliomas, whilst in 53 of 78 lung adenocarcinomas they did. Increased values of SP-A and/or CEA were found in pleural effusions from 67 of 78 lung adenocarcinomas. It is concluded that a combination of CEA and SP-A assays in pleural effusions will be helpful for discriminating lung adenocarcinoma from mesothelioma.

Adenocarcinoma↗
PubMed1995

Budgerigar breeders' hypersensitivity pneumonitis presenting as chronic bronchitis with purulent sputum.

A 49-year-old woman complained of cough and a purulent sputum (about 40 ml/day). She kept budgerigars for a period of 30 years, she first noticed a productive cough 10 years previously. Her chest roentgenogram revealed a diffuse reticulonodular pattern. She was diagnosed as having a chronic type of budgerigar breeder's lung associated with chronic bronchitis. Peptostreptococcus anaerobius was cultured from her sputum, bronchoalveolar lavage fluid, as well as from droppings of her budgerigar. This is the second case of hypersensitivity pneumonitis presenting as chronic bronchitis with much sputum in Japan.

Animals↗
PubMed1995

Pulmonary cryptococcal infection in an untreated patient with sarcoidosis.

A 36-year-old housewife was referred to our hospital in March, 1993. Her chest X ray films showed mediastinal and bilateral hilar lymphadenopathy. She was confirmed to have pulmonary sarcoidosis. We did not administer any medications for her. Four months after the diagnosis of sarcoidosis, opacities with cavitation appeared on the chest X ray. Histologic findings of lung biopsy specimens revealed granulomas with the existence of encapsulated Cryptococci. We administered an antifungal drug, itraconazole. The opacities were greatly improved by the medication. We report focal pulmonary cryptococcal infection in an untreated patient with sarcoidosis.

Adult↗
PubMed1994

[A case of pulmonary actinomycosis; histological diagnosis obtained from transbronchial lung biopsy specimen].

We report the first case of pulmonary actinomycosis that was diagnosed by histological findings of transbronchial lung biopsy specimen. A 60-year-old man was admitted because of cough and bloody sputa. His chest roentgenogram and CT scan revealed a cavitary opacity in the apex of the left lung. Histological findings of the biopsy specimen showed multiple basophilic actinomyces granules accompanied by an acute inflammatory exudate, confirming the diagnosis of pulmonary actinomycosis. We prescribed antibiotic treatment and a good response was obtained.

Actinomycosis↗
PubMed1993

[A case of atypical senile dementia of Alzheimer type].

We describe the autopsy finding in a male patient with senile dementia of unusually prolonged total duration, who had exhibited atypical neuropathologic findings. During clinical course, memory disturbance had been more prominent than deterioration of other cognitive functions. Neuropathologic examination revealed neurofibrillary changes which were prominent in the hippocampal region and scattered in the amygdala and in the predilection sites of the hypothalamus and brain stem. This distributional pattern was that in Alzheimer-type dementia. The most characteristic finding was scanty senile plaques, which were scattered predominantly in the basal and medial portion of the frontal lobe. Although the clinical course and pathological findings of this case were in slight degree and deviated from those in usual senile dementia, it is thought that the entity in this case was dementia of the Alzheimer-type.

Aged↗
PubMed1993

[A case of intrapleural rupture of pulmonary arteriovenous fistula].

The hemothorax due to rupture of arteriovenous fistula is very rare and only 6 cases of this complication have been reported in Japanese literature. 44-year-old male complained of chest pain and dyspnea. A chest roentgenogram revealed right pleural effusion and an abnormal pulmonary shadow. By further examination including pulmonary angiography, the rupture of pulmonary arteriovenous fistula into right pleural cavity was diagnosed. Partial resection of the right lung containing arteriovenous fistula was successfully performed and postoperative course was uneventful.

Adult↗
PubMed1993

[Intracavitary suction for treating giant bulla].

Examination was made of 9 consecutive patients who underwent intracavitary suction for giant bulla. A second operation was required for one patient who had multiple giant bullae. In the other 8 patients, improvement of pulmonary function and symptoms was obtained immediately following the operation. This was particularly more apparent in patients with poor pulmonary function. The following results were obtained. Functional recovery was evident from the early postoperative phase. A one-stage operation was possible. Reduction in postoperative drainage time was realized by bronchial occlusion. The present operation is particularly applicable to compromised patients. Computed tomography scanning is essential for evaluation of the drainage site. For giant bulla with some septation and multivesicular, the present mode of treatment would not be indicated.

Adult↗
PubMed1993

[Minitracheotomy].

Twenty-four consecutive patients undergoing minitracheotomy were reviewed. Postoperative sputum retention was the major indication. In one case the procedure was not possible. Nineteen patients made an uneventful recovery, and decanulation was done in 17. In four patients minitracheotomy treatment was discontinued because formal tracheotomy was performed subsequently. This method is much simpler, less invasive, and more advantageous than formal tracheotomy. It can also be used for the patients after median sternotomy. On the other hand, in the patients with misswallowing because of recurrent nerve palsy etc., conventional tracheotomy should be performed.

Aged↗