Accelerating biomedical engineering in Japan--the TUBERO project.
Explore the source record for details and available documents.
Biomedical Engineering↗
Biomedical subjects
Yoshimochi Kurokawa
Publications and source records attributed to Yoshimochi Kurokawa.
Outcome of laparoscopic rectopexy for complete rectal prolapse in patients older than 70 years versus younger patients.
PURPOSE: To evaluate the outcome of laparoscopic rectopexy for complete rectal prolapse in patients above 70 years of age, compared with that in younger patients. METHODS: Between October 1997 and September 2001, 14 consecutive patients with complete rectal prolapse underwent laparoscopic rectopexy. Nine patients were aged 70 years or older, and five were aged under 70 years. All of the patients were ambulant and well enough to tolerate surgery under general anesthesia. Each patient was monitored pre- and postoperatively, for fecal incontinence, constipation, recurrent prolapse, morbidity, and mortality. RESULTS: The median follow-up period was 34.5 (range 5-54) months. No significant differences were noted in the hospitalization, incidence of complications, recurrence rate, and functional outcome. CONCLUSION: The outcome of laparoscopic rectopexy in elderly patients is similar to that in younger patients. Therefore, advanced age alone should not be a contraindication to laparoscopic rectopexy.
Adult↗
Immunohistopathological and molecular genetic features of a case in which gastrointestinal stromal tumor recurred five times.
Gastrointestinal stromal tumor (GIST) is a distinct group of mesenchymal neoplasms recently shown to exhibit differentiation toward interstitial cells of Cajal. Although previous studies have shown that the clinical outcome of patients with GIST is associated with mitotic activity, the proliferation index determined by the Ki-67 labeling index, immunophenotype (CD34 and/or p53) and mutation in exon 11 of the c-kit, a definitive discrimination between benign and malignant GIST has not yet been established. We report a patient in whom malignant GIST in the abdomen recurred five times. In this case, the primary GIST and the five recurrent GIST were associated with c-kit immunoreactivity, but the mitotic index of the GIST tended to be increasingly higher with subsequent recurrences. Mutational analysis of the c-kit revealed that the primary and recurrent GIST were mutant-negative. These data indicated that 'morphologically appearing benign' tumors with lower proliferative parameters may also have the capacity of metastasis and recurrence.
Biomarkers, Tumor↗
Improved activities of daily living, psychological state and health-related quality of life for 12 months following lung volume reduction surgery in patients with severe emphysema.
OBJECTIVE: The aim of the present study was to evaluate the effect of lung volume reduction surgery (LVRS), with an emphasis on improvement in activities of daily living (ADL), psychological state and health-related quality of life (HRQL), for 12 months in patients with severe emphysema. METHODOLOGY: Eighteen male patients (mean age +/- SD: 65.2 +/- 6.4 years) who underwent LVRS following pulmonary rehabilitation (LVRS group) and 12 patients (67.0 +/- 8.1 years) who were medicated and underwent pulmonary rehabilitation (non-LVRS group) were studied. LVRS was performed by video-assisted thoracoscopic surgery. Serial measurements of lung function, 6-min walking distance (6MWD), ADL, HRQL and psychological state scores were performed before surgery and 3, 6, and 12 months after surgery (in the LVRS group), or on the day of discharge (in the non-LVRS group). RESULTS: As well as an improvement in FEV(1) and 6MWD, ADL scores were significantly improved in the items of 'face washing and teeth brushing', and 'indoor walking' at 3 months after LVRS (P < 0.05). At 12 months, an improvement was still found in 'indoor walking' and 'bathing'. HRQL scores were ameliorated at 3-12 months after LVRS. In the non-LVRS group, ADL and HRQL scores failed to improve in any items during the 12 months of observation. Psychological state scores were maintained in the LVRS group and were better than those in the non-LVRS group at 12 months (P < 0.05). CONCLUSIONS: Lung volume reduction surgery improves not only lung function and exercise performance but also ADL, HRQL and psychological state for at least 12 months.
Activities of Daily Living↗
Effects of lung volume reduction surgery for emphysema on oxygen cost of breathing.
BACKGROUND: Patients with severe pulmonary emphysema have a greatly increased oxygen cost of breathing (O(2) cost), and this is the cause of serious malnutrition, or respiratory cachexia, in such patients. STUDY OBJECTIVES: To clarify the effect of lung volume reduction surgery (LVRS) on respiratory function and the nutritional state of these patients through a reduction in the O(2) cost of the respiratory muscles. DESIGN: Prospective cohort study. Setting, patients, and interventions: Twenty-three patients who underwent LVRS in Tohoku University Hospital. MEASUREMENTS: Pulmonary function and O(2) cost were measured perioperatively by utilizing a method of continuous dead space. In addition, we calculated the proportion of oxygen consumption (O(2)) of respiratory muscles to total O(2) (%O(2)resp) from the measured energy expenditure and the predicted values. RESULTS: FEV(1) and arterial oxygen pressure increased after surgery while lung volume and dyspnea decreased (p < 0.01), and O(2) cost was also reduced from 0.044 to 0.026 log(mL/min)/(L/min) [p < 0.001]. Moreover, the change in O(2) cost had a strong negative correlation with that of FEV(1) (r = - 0.70, p < 0.001), and a moderate positive correlation with that of the ratio of residual volume to total lung capacity (r = 0.54, p < 0.01). %O(2)resp was 23.1% at rest and 55.5% at maximal ventilation. LVRS reduced %O(2)resp at maximal ventilation to 49.0% (p < 0.05), but %O(2)resp at rest did not decrease after surgery. CONCLUSIONS: LVRS reduces energy expenditure of respiratory muscles especially during exercise by decreasing small airway obstruction and hyperinflated lung volume. This may reverse the malnourished state in end-stage emphysema.
Aged↗
Accelerated clearance of Escherichia coli in experimental peritonitis of histamine-deficient mice.
We prepared a model of experimental peritonitis by introducing Escherichia coli into the peritoneal cavity of the histamine-deficient mice generated by a disruption of the gene for histidine decarboxylase (HDC), the unique histamine-synthesizing enzyme. When we inoculated E. coli into the peritoneal cavities of the HDC(-/-) (histamine-deficient) mice, they eliminated E. coli more efficiently than did the wild-type mice. Histamine was released efficiently from the peritoneal cells after E. coli inoculation in HDC(+/+) mice, although only trace amounts were detected in the peritoneal cells of HDC(-/-) mice. Two histamine agonists (6-[2-(4-imidazolyl)ethylamino]-N-(4-trifluoromethylphenyl)hepatanecarboxamide (H(1)) and dimaprit (H(2))) impaired the clearance of E. coli from the peritoneal cavity in HDC(-/-) mice, suggesting that the activation of both H(1) and H(2) receptors suppresses the clearance. In contrast, two kinds of H(1) and H(2) receptor antagonists, cimetidine and pyrilamine, promoted the clearance of E. coli in HDC(+/+) mice. Phagocytosis appeared to be enhanced in HDC(-/-) mice, since the number of neutrophils in the peritoneal cavity of HDC(-/-) mice was markedly increased. This enhanced recruitment of neutrophils was suppressed in the presence of the histamine agonists, 6-[2-(4-imidazolyl)ethylamino]-N-(4-trifluoromethylphenyl)hepatanecarboxamide and dimaprit. In this report histamine was first shown to be an important mediator in an E. coli infectious peritonitis model, causing a delay in the elimination of bacteria. This also raised the possibility of the use of antihistamine drugs for bacterial infection.
Animals↗
Experimental study on tissue engineering of the small intestine by mesenchymal stem cell seeding.
BACKGROUND: We have succeeded in regenerating the small intestine by the use of tissue engineering techniques. However, the regenerated intestine proved to lack the muscle layer, which is essential for functional peristalsis. To induce regeneration of the muscle layer, we focused on autologous mesenchymal stem cells (MSC) as a source of muscle tissue. The aim of this study was to investigate the effect of MSC seeding onto the collagen scaffold on induction of the muscle layer. MATERIALS AND METHODS: We used six female beagle dogs. The small intestine was resected over a length of 5 cm and reconstructed by a collagen sponge graft in the same way as in our previous study. Autologous MSC derived from bone marrow (10(7) cells) were seeded onto the collagen sponge just before implantation. Animals were sacrificed at 2, 4, and 16 weeks after surgery, and specimens were examined histologically. RESULTS: All six dogs survived until the scheduled time of sacrifice. At 4 weeks, regeneration of the intestine was observed at the reconstructed site. Cells positive for alpha-smooth muscle actin appeared on the scaffold in the MSC-seeded group. However, they disappeared by 16 weeks and only a thin muscle layer regenerated beneath the mucosal layer, although the regenerated mucosal layer covered the luminal surface of the regenerated intestine. CONCLUSIONS: MSC seeding induced a transient distribution of cells positive for alpha-smooth muscle actin on the scaffold, but did not induce regeneration of the muscle layer. Further investigation is necessary to achieve this aim.
Absorbable Implants↗
Functional analysis of the tissue-engineered stomach wall.
We have established a method for in situ tissue engineering of the stomach in a canine model using an acellular collagen scaffold graft. The current study was conducted to evaluate the functional aspects of the tissue-engineered stomach wall. The anterior wall of the stomach in beagle dogs was replaced with a collagen sponge scaffold measuring 4 x 4 cm. At 16 weeks after implantation, the animals were sacrificed and the stomach specimens were evaluated immunohistochemically and physiologically. Regeneration of the proton pump and thin muscle layer, which are essential for mechanical and chemical digestion by the stomach, was observed in the tissue-engineered gastric tissue. However, acetylcholine-induced contraction was not observed in the tissue-engineered stomach wall. Although there is still room for improvement, the tissue-engineered stomach wall had a highly organized structure, and it is anticipated that this approach could eventually become an alternative for stomach reconstruction after gastrectomy.
Animals↗
Progesterone production and actions in the human central nervous system and neurogenic tumors.
Progesterone has been suggested to be involved in the functions of the nervous system, but it has yet to be examined in humans. Progesterone has also been postulated to be involved in the biological behavior of various human neurogenic tumors via progesterone receptors A and B (PR-A and PR-B). In this study we examined the expression of PR and the enzymes responsible for progesterone biosynthesis (P450scc, 3betahydroxysteroid dehydrogenase, and steroidogenic acute regulatory protein) in human brain. We also examined the distribution of PR isoforms in neurogenic tumors using immunohistochemistry and RT-PCR analysis. The presence of PR and mRNA for P450scc, 3beta-hydroxysteroid dehydrogenase, and steroidogenic acute regulatory protein was detected in human brain. PR isoforms were detected in neurogenic tumors. PR-A and PR-B were equally expressed in meningiomas, but PR-B was the predominant isoform compared with PR-A in astrocytic tumors and Schwannomas. There was a statistically significant inverse correlation between PR-A and the proliferation index in meningiomas and astrocytic tumors. These findings suggest that progesterone is locally synthesized and exerts its actions through PR in the human central nervous system, and that progesterone may be involved in regulation of the growth and development of neurogenic tumors via PR, especially in the inhibition of tumor cell proliferation via PR-A.
3-Hydroxysteroid Dehydrogenases↗