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Biomedical subjects

Toshio Onitsuka

Publications and source records attributed to Toshio Onitsuka.

34 records · Page 2Linked to original sources
PubMed2003

Surgical resection of right atrial neurilemoma extending to pulmonary vein.

An asymptomatic cardiac neurilemoma was found in a 33-year-old woman. The tumor was on the anterior surface of the right atrium extending to the right upper pulmonary vein across the interatrial groove. The tumor was resected completely and right atrium, interatrial septum, left atrium and right superior pulmonary vein were reconstructed with cardiopulmonary bypass. The patient recovered uneventfully and had no recurrence 1 year after the operation. We reviewed ten reported cases of cardiac neurilemoma, including our patient.

Adult↗
PubMed2003

Pulmonary granuloma possibly caused by staples after video-assisted thoracoscopic surgery.

A 74-year-old man, with a history of colon cancer resection and video-assisted thoracoscopic surgery (VATS) resection of pulmonary metastases, was found to have a left pulmonary nodule near the previous staple-line. The size of this nodule increased during follow-up. Because of this clinical course, this nodule was considered to be a tumor recurrence at the staple-line, and pulmonary re-resection was performed. The pathologic diagnosis of this nodule was foreign body granuloma (FBG) possibly due to previous surgical staples. FBG induced by staples may be a rare complication in VATS.

Aged↗
PubMed2003

"The Law of 3": prognostic parameters for resected metastatic pulmonary tumors.

Metastatic tumors from various organs are found in pulmonary tissue because of the unique anatomical function of the lungs as a filter for systemic venous return. A retrospective study of the clinical factors used to assess the prognosis of 80 patients who underwent resections of metastatic pulmonary tumors in our surgical department between September 1978 and December 2002 is presented. The overall 5-year survival rate in our study was 31.7%. We demonstrated four significant factors used in predicting the prognosis of patients with resected metastatic pulmonary tumors: diameter of the tumor (</=3.0 cm or >3.0 cm), number of tumors (</=3 or >3), disease-free interval (>/=3 years or <3 years), and ratio of the diameter of the largest tumor to the diameter of the smallest tumor in patients with multiple metastases (</=3 or >3). Based on our results, we have applied the term "the law of 3" to these valuable prognostic factors. Among these parameters, the ratio of the diameter of the largest to the diameter of the smallest tumor may be applicable as a new prognostic parameter for surgery in patients with multiple foci. (Ann Thorac Cardiovasc Surg 2003; 9: 290-4)

Adolescent↗
PubMed2002

Clinical and immunohistochemical study of eight cases with thymic carcinoma.

BACKGROUND: Thymic carcinoma is a rare neoplasm with extremely poor prognosis. To evaluate the biological characteristics of thymic carcinoma, we reviewed 8 patients. METHODS: There were 2 men and 6 women: ages ranged from 19 to 67 years old (mean 54.8 years). None of these patients had concomitant myasthenia gravis and pure red cell aplasia. No patient had stage I disease, 1 stage II, 5 stage III, and 2 stage IV. The pathologic subtypes of thymic carcinoma included 5 squamous cell carcinomas, 1 adenosquamous cell carcinomas, 1 clear cell carcinoma, and 1 small cell carcinoma. Immunohistochemical study was performed using antibodies against p53, bcl-2, Ki-67, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), nm23-H1, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF-2) and factor VIII. RESULTS: Curative resection could be done in 4 patients (50%). Our data indicates a trend toward an association between complete resection and patient survival. Expression of p53, bcl-2, CEA, EMA, nm23-H1, VEGF and FGF-2 was detected in 5/8, 3/8, 4/8, 5/8, 6/8, 5/8 and 3/8, respectively. Mean Ki-67 labeling index and microvessel density was 7.01 and 34.36 (per 200x field), respectively. When compared with our previous studies, immunohistochemical staining of these proteins in thymomas, the expression rates of these proteins in thymic carcinomas were higher than those in thymomas. CONCLUSIONS: In this small series, it is suggested that a complete resection suggests a favorable result. Immunohistochemical results reveal that the expression of these proteins might indicate the aggressiveness of thymic carcinoma.

Adult↗
PubMed2002

A case of pulmonary metastasis from breast cancer following an 18-year disease-free interval that responded to tamoxifen treatment.

A 61-year-old woman was admitted to our hospital with an abnormal shadow on chest roentgenogram. She had undergone a radical mastectomy for right breast cancer 18 years previously. Since pleural dissemination was noted at the time of thoracotomy, only tumor biopsy was performed. Although a decisive diagnosis could not be obtained histologically, the tumor resembled breast cancer and the estrogen receptor status was positive. She underwent post-operative chemotherapy and tamoxifen treatment. After tamoxifen treatment, complete response was observed. The patient is now doing well without recurrence about 10 years after thoracotomy. Based on the clinical course, we obtained both a definitive diagnosis and complete remission.

Breast Neoplasms↗
PubMed2002

Giant cell tumor of the rib.

In a rare case of a giant cell tumor of rib origin, a 25-year-old woman to be evaluated for an abnormal mass shadow in chest radiography was strongly positive in a tuberculin skin test, but showed no evidence of active tuberculosis. Chest computed tomography showed a heterogeneous mass originating in the posterior end of the right fourth rib and containing multiple calcifications and cystic lesions. Magnetic resonance imaging showed a high signal intensity with low signal intensity areas. Bone scintigraphy showed an abnormal marked accumulation at the tumor site. A thoracoscopic examination was conducted prior to complete tumor resection, including the fourth rib and related muscles. The pathological diagnosis returned was a giant cell tumor of the bone. The patient did not undergo chemotherapy or radiotherapy, and remains well, and tumor-free at 6 months after surgery.

Adult↗
PubMed2002

Correlation between tumor angiogenesis and invasiveness in thymic epithelial tumors.

OBJECTIVE: Because it is difficult to predict the behavior of thymomas on the basis of morphology alone, other methods for determining tumor aggressiveness must be explored. This study investigated the correlation between angiogenic grade and invasiveness in thymic epithelial tumors. METHODS: Immunohistochemical studies of 46 surgically resected thymic epithelial tumors (18 noninvasive thymomas, 20 invasive thymomas, and 8 thymic carcinomas) were conducted. To highlight the microvessels, we used a specific monoclonal antibody against factor VIII. Expression of vascular endothelial growth factor and basic fibroblast growth factor was determined by using polyclonal antibodies. RESULTS: Mean microvessel density readings for noninvasive thymomas, invasive thymomas, and thymic carcinomas were 4.6 +/- 3.2, 12.4 +/- 7.5, and 34.4 +/- 16.7, respectively. Stages I, II, III, and IV of thymoma had microvessel density readings of 4.6 +/- 3.2, 8.5 +/- 4.3, 13.8 +/- 7.7, and 22.0 +/- 6.8, respectively. These findings suggest a significant correlation between microvessel density and tumor invasiveness. Vascular endothelial growth factor expression in noninvasive thymomas, invasive thymomas, and thymic carcinomas was present in 1 (5.6%) of 18, 11 (55.0%) of 20, and 5 (62.5%) of 8 patients, respectively, thereby indicating a distinct association between vascular endothelial growth factor expression and increased microvessel density. Basic fibroblast growth factor expression was present in only 8 patients. CONCLUSIONS: In patients with thymic epithelial tumors, there appears to be a significant correlation between tumor angiogenesis and invasiveness. Furthermore, our data suggests that this angiogenesis in thymic epithelial tumors might be, at least in part, dependent on vascular endothelial growth factor expression.

Adult↗
PubMed2002

Nitric oxide inhalation prompts weaning from the right ventricular assist device: evaluation under continuous-flow biventricular assistance.

OBJECTIVE: The objective of this study was to investigate the effect of nitric oxide on the recovery of right heart function under global ischemia with a continuous-flow biventricular assist device support. METHODS: Fifteen piglets were divided into three groups: continuous-flow biventricular assist support only (control group), global ischemia with continuous-flow biventricular assist support (ischemia only group), and global ischemia with continuous-flow biventricular assist support plus nitric oxide inhalation (nitric oxide group). Two continuous-flow pumps were used as left and right ventricular assist devices. In the ischemic groups (ischemia only group and nitric oxide group), global ischemia was induced for 30 minutes and followed by a 6-hour reperfusion period; the nonischemic control group underwent a 6-hour perfusion period only. The left ventricular assist device was driven at a flow rate of more than 75 to 80 mL/(min. kg). The right ventricular assist device was driven so as to sustain the left ventricular assist device flow, and the animal was weaned from it in accordance with the objective of cardiac recovery. RESULTS: Mean pulmonary arterial pressure remained low in the nitric oxide group (mean 23 mm Hg), whereas it rose from 19.9 mm Hg to 39.3 mm Hg in the ischemia group and to 26.2 mm Hg in the control group. Mixed venous saturation was maintained at more than 60% in all cases. Although no piglets in the ischemia group were able to survive without continuous-flow biventricular assist support, the right ventricular assist device flow ratio (device flow/total systemic flow) in the nitric oxide group could be reduced in all cases, and it was possible to wean the piglets from right ventricular assist device support in 4 of 5 cases. CONCLUSION: Inhalation of 40-ppm nitric oxide enabled smoother maintenance of the left ventricular assist device flow and prompted the weaning from right ventricular assist device support on continuous-flow biventricular assist.

Administration, Inhalation↗
PubMed2002

Minute pulmonary meningothelial-like nodules: high-resolution computed tomography and pathologic correlations.

Minute pulmonary meningothelial-like nodules (MPMNs), previously known as minute pulmonary chemodectomas, are relatively rare lesions. They are small (1-3 mm) and often multiple. Pathologically, they represent an interstitial nodular proliferation of small oval or spindle-shape cells arranged in a "zellenballen" nesting pattern. The function and origin of the cells are unknown. These nodules are associated with specific conditions, including thromboembolism, cardiac disease, and malignancy. We describe a patient with MPMNs and adenocarcinoma of the lung in whom HRCT showed tiny (1-3 mm in diameter) nodules of ground-glass attenuation.

Adenocarcinoma↗
PubMed2002

Down-regulation of cell surface insulin receptor and insulin receptor substrate-1 phosphorylation by inhibitor of 90-kDa heat-shock protein family: endoplasmic reticulum retention of monomeric insulin receptor precursor with calnexin in adrenal chromaffin cells.

Treatment (>/=6 h) of cultured bovine adrenal chromaffin cells with geldanamycin (GA) or herbimycin A (HA), an inhibitor of the 90-kDa heat-shock protein (Hsp90) family, decreased cell surface (125)I-insulin binding. The effect of GA was concentration (EC(50) = 84 nM)- and time (t(1/2) = 8.5 h)-dependent; GA (1 microM for 24 h) lowered the B(max) value of (125)I-insulin binding by 80%, without changing the K(d) value. Western blot analysis showed that GA (>/=3 h) lowered insulin receptor (IR) level by 83% (t(1/2) = 7.4 h; EC(50) = 74 nM), while raising IR precursor level by 100% (t(1/2) = 7.9 h; EC(50) = 300 nM). Pulse-label followed by reducing and nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that monomeric IR precursor (~190 kDa) developed into the homodimeric IR precursor (approximately 380 kDa) and the mature alpha(2)beta(2) IR (~410 kDa) in nontreated cells, but not in GA-treated cells; in GA-treated cells, the homodimerization-incompetent form of monomeric IR precursor was degraded via endoplasmic reticulum (ER)-associated protein degradation. Immunoprecipitation followed by immunoblot analysis showed that IR precursor was associated with calnexin (CNX) to a greater extent in GA-treated cells, compared with nontreated cells. GA had no effect on IR mRNA levels and internalization rate of cell surface IRs. In GA-treated cells, insulin-induced tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) was attenuated by 77%, with no change in IRS-1 level. Thus, inhibition of the Hsp90 family by GA or HA interrupts homodimerization of monomeric IR precursor in the ER and increases retention of monomeric IR precursor with CNX; this event retards cell surface expression of IR and attenuates insulin-induced activation of IRS-1.

Adrenal Glands↗
PubMedDate not supplied

A safe automatic driving method for a continuous flow ventricular assist device based on motor current pulsatility: in vitro evaluation.

We previously reported that detection of two specific points (the t-point and the s-point) in the relationship between pump speed and Motor Current Amplitude index (ICA) indicates the safe driving range for a continuous-flow ventricular assist device (CFVAD). During the first stage of the present experiment, the characteristic curves relating pump speed and ICA were determined by varying preload (left atrial pressure: -6 to 30 mm Hg), afterload (total circuit resistance: 890 to 3,180 dyne x sec x cm(-5)), and contractility of the left ventricle (total circuit flow: 0.5 to 2.1 L/min). These data showed that an ICA value of 0.18 was always located between the t- and s-points. During the second stage of the experiment, we developed an automatic driving program to control pump speed by maintaining ICA at 0.18. This program was able to drive the CFVAD, without exhibiting regurgitant flow or sucking, under various driving conditions in the mock circulation. Pump speed stabilized within 1 minute after varying the drive conditions. This sensorless method of driving the CFVAD by using a target ICA proved feasible and effective for safe automatic control, within our mock circulation.

Algorithms↗
PubMedDate not supplied

Serum carcinoembryonic antigen level in pN1 non-small cell lung cancer patients.

BACKGROUND: Although the prognostic significance of the serum carcinoembryonic antigen (CEA) level in non-small cell lung cancer has been reported in several studies, it is unknown whether the serum CEA level is a prognostic determinant for pN1 disease or not. MATERIALS AND METHODS: Seventy patients with pN1 non-small cell lung cancer who received complete resection were reviewed. The preoperative serum CEA level was measured in all patients. RESULTS: The pN1 patients with pT2-4 disease, hilar node involvement, multiple N1 station and elevated serum CEA level (>5 ng/mL) had a significantly unfavorable prognosis. Although a serum CEA level higher than 5 ng/mL was not an independent prognostic determinant, more than 10 ng/mL was an independent factor by multivariate analysis. In patients with pT1-2N1 disease, a serum CEA level more than 10 ng/mL was also a prognostic determinant. CONCLUSION: An elevated serum CEA level, especially higher than 10 ng/mL, is a significant prognostic determinant for pN1 lung cancer patients.

Adult↗
PubMedDate not supplied

Relationship between serum carcinoembryonic antigen level and T status in non-small cell lung cancer.

BACKGROUND: Controversy exists regarding the relationship between serum carcinoembryonic antigen (CEA) level and T status in non-small cell lung cancer. MATERIALS AND METHODS: Two hundred and forty-seven lung cancer patients with pN0 disease were included in the study and the relationship between serum CEA level and T status, tumor size and degree of local extension was investigated. RESULTS: Patients with tumors 0 to 1.5 cm in diameter had significantly low serum CEA level. However, there were no significant differences in serum CEA level among other tumor size groups. Serum CEA level was not related to the degree of local extension. The 5-year survival of patients with both normal serum CEA levels and T1 disease was significantly better than that of patients with high serum CEA level and 72-4 disease. CONCLUSION: Serum CEA levels do not always relate to T status. The combined use of these factors might be useful in predicting the prognosis of pN0 non-small cell lung cancer patients.

Adult↗