Needle tract implantation clearly visualized by computed tomography following needle biopsy of malignant mesothelioma.
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Biopsy, Needle↗
Biomedical subjects
Teruhisa Kazui
Publications and source records attributed to Teruhisa Kazui.
Which is more appropriate as a cerebral protection method--unilateral or bilateral perfusion?
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Aortic Dissection↗
Right aortic arch with aberrant left subclavian artery symptomatic in adulthood.
Congenital malformations of the aortic arch are rarely found in adulthood. We describe three cases of right aortic arch with aberrant left subclavian artery with left-sided ligamentum arteriosum presenting in adulthood as vascular rings with symptoms of tracheal compression. Varying presentation as well as surgical strategy which was individualized according to the pathological anatomy of each case are discussed.
Adult↗
Chromosomal numerical abnormality profiles of gastrointestinal stromal tumors.
BACKGROUND: Biological variations in and the heterogeneity of gastrointestinal stromal tumors (GISTs) are well known, but chromosomal numerical abnormality (CNA) has not been fully examined especially in this context. The aim of this study is to test CNA as a possible biological predictor of biological behavior of GISTs. METHOD: We applied microwave-assisted FISH protocol to pathological archives of GIST tumors displaying different clinical features to characterize the CNA profile of these tumors. A panel of 18 centromere enumeration probes (CEP) and 24 bacterial artificial chromosome (BAC) or P1-derived artificial chromosome (PAC) probes containing genes like Aurora kinases (AURKs) and other candidate genes involved in human carcinogenesis were used. CNA profiles, histopathological risk categorization and Ki-67 labeling indexes of 23 primary and/or metastatic GIST tumors of 12 subjects (both primary and metastatic in 7 subjects) were compared between primary GIST with and without metastases, and between metastatic and primary portions in 7 individuals. RESULTS: CNA in the primary sites was more extensive in the GISTs with recurrence and metastasis than in those without, especially as to the loss of chromosome 20 and genomic imbalance of AURKA-containing BAC probe on 20q in the cases with metastasis. The consistent loss of one allele of chromosome 14q was also noted. Interestingly, both primary and metastatic tumors in identical individuals had similar CNA profiles. CONCLUSION: The extent of CNA differed between GISTS with and without recurrence or metastasis; thus, FISH analysis of specimens from the primary sites may predict the biological behavior of this tumor.
Adult↗
What expectations are realistic in the surgical outcome of acute type-A aortic dissection?
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Aortic Dissection↗
Thoracic and cardiovascular surgery in Japan during 2004.
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Cardiovascular Diseases↗
Aorto-right atrial fistula following acute type A aortic dissection repair.
This report describes a rare case of aorto-right atrial fistula caused by rupture of a huge pseudoaneurysm that developed at the proximal aortic anastomotic site after total aortic arch replacement for acute type A aortic dissection. Preoperative aortography revealed that the fistula communicated with the right heart, but it was intraoperative Doppler transesophageal echocardiography that confirmed its course into the right atrium. Repeat total aortic arch replacement with concomitant direct closure of the fistula was performed successfully. The underlying cause of the pseudoaneurysm was the dehiscence of sutures at the proximal aortic anastomotic site, probably due to gelatin-resorcin-formaldehyde glue.
Acute Disease↗
Aortic arch replacement using a trifurcated graft.
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Aorta, Thoracic↗
Intrathecal injection of bone marrow stromal cells attenuates neurologic injury after spinal cord ischemia.
BACKGROUND: It has been shown that transplantation of bone marrow stromal cells (MSCs) into the ischemic brain improves functional outcome. We sought to investigate whether intrathecal injection of MSCs can attenuate neurologic injury of spinal cord ischemia. METHODS: Rabbit MSCs were expanded in vitro and were pre-labeled with bromodeoxyuridine. Spinal cord ischemia was induced in rabbits by infrarenal aortic occlusion. Group A and control A were subjected to a 20-minute ischemia and the ischemic duration was extended to 30 minutes in group B and control B. Two days before spinal cord ischemia, 1 x 10(8) MSCs were intrathecally injected into groups A and B, whereas vehicle alone was injected into the control groups. Hind-limb motor function was assessed during a 14-day recovery period with Tarlov criteria, and then histologic examination was performed. RESULTS: Marrow stromal cells survived and engrafted into the spinal cord 2 days after transplantation, and more MSCs were found in the lumbar spinal cord (ischemic segment) than in the thoracic spinal cord (nonischemic segment) at 14 days. Compared with their respective control groups, Tarlov scores were significantly higher in both groups A and B (p < 0.05, group A vs control A, at 2, 7, and 14 days; p < 0.05, group B vs control B, at 1, 2, 7, and 14 days, respectively). The number of intact motor neurons was much higher in the two experimental groups (p < 0.01 vs the corresponding control groups, respectively). CONCLUSIONS: Intrathecal injection of MSCs attenuates ischemic injury of spinal cord.
Animals↗
Total aortic arch replacement in patients with arch vessel anomalies.
BACKGROUND: The presence of anomalous arch vessels has considerable impact on aortic arch reconstruction techniques and cerebral protection methods when the separated graft technique is adopted to perform total arch replacement. We analyzed our experience of total arch replacement in patients with arch vessel anomalies. METHODS: Among the 220 patients undergoing total arch replacement at our institution, 21 patients (9.5%) had various arch vessel anomalies. Common brachiocephalic trunk was found in 8 patients (3.6%); an isolated left vertebral artery in 9 (4.1%); aberrant right subclavian artery in 3 (1.4%); and coexistent common brachiocephalic trunk and isolated left vertebral artery in 1 (0.5%). In 4 of the 9 patients with isolated left vertebral artery, preoperative diagnosis was possible with magnetic resonance angiography or three-dimensional computed tomography. In cases with common brachiocephalic trunk, total arch replacement could be performed with the usual techniques after separating the innominate and left common carotid arteries from each other. The isolated left vertebral artery was anastomosed to the left subclavian artery graft in 7 patients and to the native left subclavian artery in 2. In the aberrant right subclavian artery variety, a distal aortic anastomosis was performed distal to the orifice of this anomalous artery. The aberrant vessel was reconstructed on the right side of the trachea and esophagus. RESULTS: There was no early or in-hospital mortality. No neurologic complication attributable to the arch vessel anomalies was found. CONCLUSIONS: A precise preoperative diagnosis is very important for the selection of an appropriate surgical strategy in patients with arch vessel anomalies. Magnetic resonance angiography and three-dimensional computed tomography may be useful diagnostic tools in these patients.
Aged↗
Invited commentary.
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Aortic Aneurysm, Abdominal↗
Nonviral gene transfer of hepatocyte growth factor attenuates neurologic injury after spinal cord ischemia in rabbits.
OBJECTIVE: Paraplegia caused by spinal cord ischemia remains a serious complication after surgical repair of thoracoabdminal aortic aneurysms. Hepatocyte growth factor is a potent angiogenic and neurotrophic factor. We sought to investigate the neuroprotective effect of gene transfer of hepatocyte growth factor on spinal cord ischemia in rabbits. METHODS: Human hepatocyte growth factor expression plasmid was combined with hemagglutinating virus of Japan envelope vector. Hemagglutinating virus of Japan envelope vector containing the hepatocyte growth factor gene was injected intrathecally into the experimental rabbits, whereas control vector or saline was given to the control animals. Five days later, spinal cord ischemia was induced by means of infrarenal aortic occlusion for 30 minutes. Hind-limb motor function was assessed during a 14-day recovery period with Tarlov criteria. RESULTS: Human hepatocyte growth factor was detected in the cerebrospinal fluid 3 days after gene transfer, and the level peaked on day 5. Compared with the control animals, hepatocyte growth factor gene transfer significantly increased the capillary density in the gray matter and decreased the spinal cord edema. All rabbits pretreated with saline or control vector had hind-limb paraplegia (Tarlov score = 0) 14 days after spinal cord ischemia. However, previous transfection of the hepatocyte growth factor gene remarkably enhanced the Tarlov scores, and 8 of the 9 rabbits showed normal motor function (Tarlov score = 5) after a 14-day recovery period. Histologic examination showed that the intact motor neurons were preserved to a much greater extent in the rabbits transfected with the hepatocyte growth factor gene. CONCLUSION: Gene transfer of hepatocyte growth factor attenuates neurologic injury after spinal cord ischemia.
Animals↗
Probing the chromosome 9p21 region susceptible to DNA double-strand breaks in human cells in vivo by restriction enzyme transfer.
A restriction enzyme, MspI, was introduced into cultured human cells as a probe to detect genomic regions susceptible to DNA double-strand breaks (DSBs). A 2 h exposure to MspI at a concentration of 8 U/mul produced DSBs at MspI sites in more than 80% of HeLa cells. The sensitivity to digestion was examined on chromosomal DNAs for the region containing the p16 tumor suppressor gene and two other related genes, p14ARF and p15, by Southern blot hybridization analysis and linker-mediated capture of DNA fragments digested in vivo. DNAs for the promoter regions of the three genes, respectively, were sensitive to MspI digestion in HeLa cells, while DNA for the p16 promoter region was less sensitive in lung cancer cells with hypermethylation of the region. Breakpoints for interstitial 9p21 deletions removing the p16/p14ARF/p15 locus in a variety of human cancers were significantly over-represented in the three sensitive regions. The results suggest that the MspI sensitivity in vivo of each genomic region reflects its susceptibility to DSBs that trigger chromosome aberrations in human cells. This method could help us understand the pathogenic significance of differential susceptibility to DSBs among genomic regions in human carcinogenesis.
Cell Cycle Proteins↗
Emergency operation for distal aortic arch aneurysm in Behcet's disease.
Arterial complications of Behcet's disease rarely affect the thoracic aorta, and the incidence of aortic arch aneurysm is especially low. We present a patient who developed a rapidly expanding aneurysm of the distal aortic arch after 20 years of treatment of Behcet's disease. Emergency total arch replacement was performed with a favorable outcome. Graft anastomosis to the normal aorta involving all three layers, wrapping of the anastomotic sites with wide felt strips, as well as strict management of systemic inflammation are essential for prevention of late complications associated with graft anastomosis sites.
Adult↗
Thoracic and cardiovascular surgery in Japan during 2003: annual report by The Japanese Association for Thoracic Surgery.
The Japanese Association for Thoracic Surgery has conducted annual surveys of thoracic surgery to reveal the statistics of the number of procedures according to the operative category throughout the country since 1986. Here we have summarized the results from our annual survey of thoracic surgery performed during 2003. The incidence of hospital mortality was added to this survey to determine the nationwide status that could be useful not only for surgeons to compare their work with that of others, but also for the association to gain a better understanding of present problems as well as future prospects. Thirty-day mortality (sometimes termed operative mortality) is death within 30 days of operation regardless of the patient's geographic location. Thirty-day mortality includes death within 30 days of operation even though the patient is discharged from the hospital within 30 days of operation. Hospital mortality is death within any time interval after operation if the patient is not discharged from the hospital. Hospital-to-hospital transfer is not considered discharge; transfer to a nursing home or a rehabilitation unit is considered hospital discharge unless the patient subsequently dies of complications of the operation (the definitions of terms are based on the published guidelines of the Society of Thoracic Surgeons and the American Association for Thoracic Surgery (Edmunds LH, et al. Ann Thorac Surg 1996; 62: 932-5)). Thoracic surgery was classified into three categories as cardiovascular, general thoracic and esophageal surgery, and the pertinent data were examined and analyzed in each group. Access to the computerized data is offered to all members of this association. We honor and value your continued kind support.
Cardiovascular Surgical Procedures↗
Re-reconstruction of visceral arteries with thoracoabdominal aortic replacement using a branched graft.
A 44-year-old man, unaffected by Marfan's syndrome, had previously undergone thoracoabdominal replacement for a chronic, type B dissecting aneurysm. Reconstruction of the visceral arteries was performed using an island technique. However, approximately 3 years after the operation, the reconstructed part of the aorta containing the visceral arteries became dilated and an aneurysm formed. We have succeeded both in repairing the aneurysms and "re-reconstructing" the visceral arteries using a branched graft. We conclude that the technique of separate revascularization is worth considering from the beginning, even if the patient does not present with Marfan's syndrome.
Aortic Dissection↗
Right upper lobe venous drainage posterior to the bronchus intermedius: preoperative identification by computed tomography.
BACKGROUND: Anatomical variations of the pulmonary vessels relevant to pulmonary surgery are of concern to thoracic surgeons. Among such variations, the right upper lobe vein posterior to the bronchus intermedius (UVPBI) has received little attention thus far. METHODS: Chest computed tomographic images and medical records of 725 patients were retrospectively reviewed. The frequency, drainage pattern, diameter, and associated anatomical characteristics of the UVPBI were assessed, and our right thoracotomy cases with the UVPBI were examined. RESULTS: The UVPBI was found in 41 (5.7%) of 725 computed tomography cases, and in 9 (3.9%) of 230 right thoracotomy cases. Three UVPBI drainage sites were observed: (1) the superior pulmonary vein group, 55%; (2) the inferior pulmonary vein group, 41%; and (3) the superior segmental vein group, 4%. The diameter of the UVPBI at the level of the bronchus intermedius ranged from 1 to 7 mm (4.1 +/- 1.6 mm). The diameter of the UVPBI in the superior pulmonary vein group was significantly greater than that in the inferior pulmonary vein group (p < 0.01). The prevalence of a central vein was 43.9% for all UVPBI cases and 15.8% for large UVPBI cases (> or = 5 mm in diameter). Of the 9 right thoracotomy patients, 1 suffered UVPBI injury; this patient's UVPBI was not identified either preoperatively or intraoperatively. CONCLUSIONS: The UVPBI is not as rare as was previously believed. It can be a main drainage route of the right upper lobe. Preoperative identification of this venous variation by computed tomography is useful for safe and accurate surgical procedures.
Adult↗