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Biomedical subjects

A Shohtsu

Publications and source records attributed to A Shohtsu.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Cancer screening with whole-body FDG PET].

We are using whole-body positron emission tomography (PET) for cancer screening. A total of 1,105 healthy subjects have undergone PET studies 1,138 times in fifteen months. Emission scans were performed from the pelvis to the maxilla 45 to 60 minutes after intravenous administration of 260 to 370 MBq 2-deoxy-2-[18F]fluoro-D-glucose (FDG). Malignant tumors were detected with PET in nine patients (0.81%): 2 lung cancers, 2 colonic cancers, 1 breast cancer, 1 thyroid cancer, 1 gastric cancer, 1 renal cancer, and 1 lymphoma. Eight of these patients underwent surgery (excepting the lymphoma patient). Lymph node metastasis was not observed in any of the eight cases and surgery was curative. PET scan results were negative in the cases of three prostatic cancers, one bladder cancer, and two colonic mucosal cancers. High FDG accumulations were noticed in benign lesions such as sarcoidosis, chronic thyroiditis, pulmonary tuberculoma, Warthin's tumor of the parotid gland, and chronic sinusitis. In some cases, image artifacts caused by intense myocardial FDG accumulations resulted in incomplete examinations of the lung. Occasionally, high FDG accumulations were observed in the bowel. Our study results suggest the possibility of using whole-body PET for detecting wide varieties of cancers in resectable stages.

Adult↗
PubMed1994

Blood vessel invasion and expression of sialyl Lewisx and proliferating cell nuclear antigen in stage I non-small cell lung cancer. Relation to postoperative recurrence.

BACKGROUND: Recurrence in Stage I non-small cell lung cancer was examined with respect to vascular invasion and the immunohistochemical expression of sialyl-dimeric Lewisx (SLX) and proliferating cell nuclear antigen (PCNA). METHODS: One hundred twenty-eight patients with Stage I non-small cell lung cancer who had a curative resection were the subjects of this study. Using tumor tissues fixed in formaldehyde solution, blood vessel invasion (BVI) and lymphatic invasion stained with Victoria blue-hematoxylin and eosin and the immunohistochemical expression of SLX and PCNA were retrospectively studied with respect to postoperative recurrence. RESULTS: By univariate analysis, BVI and SLX and PCNA expression were significantly important factors of disease-free survival (P < 0.01). The disease-free survival of the patients with both BVI and SLX expression was significantly shorter than that of the patients with BVI but negative SLX expression (P < 0.02). In 35 patients with recurrence, tumors with PCNA expression showed a significantly shorter time to recurrence compared with tumors without PCNA expression (P < 0.01). CONCLUSIONS: BVI and SLX expression may be important determinants of recurrence. PCNA may be a determinant of time to recurrence.

Adult↗
PubMed1994

Right atrial myxoma developing 4 years following patch closure of an atrial septal defect: report of a case.

We report herein the rare case of a 13-year-old boy in whom a right atrial myxoma developed 4 years following patch closure of an ostium secundum atrial septal defect, at which time no other atrial abnormality had been observed. The myxoma arose from the atrial septum in the area between the orifices of the coronary sinus and inferior vena cava. The suture line was not involved. Gross and histopathological findings were characteristic of atrial myxoma. Atrial myxomas are usually considered to be slow-growing neoplasms; however, this case demonstrates that the initial period of growth may be quite rapid in some cases.

Adolescent↗
PubMed1994

Surgical treatment of infective endocarditis.

From February, 1975 through October, 1990, 26 patients underwent surgical treatment for infective endocarditis at Tokai University Hospital. The overall operative mortality rate was 11.5% (3/26). The three patients who died were suffering from aortic prosthetic valve endocarditis (PVE) in the active stage. Among 16 patients in the active stage, the mortality rate was 18.7% (3/16) Among 10 patients with native valve endocarditis (NVE) in the healed stage, all survived. Among the total of 21 patients with NVE, the mortality rate was zero and among those with PVE, the rate was 60% (3/5). Various species of streptococci were the most common organisms encountered, followed by Staphylococcus epidermides. The two PVE patients with S. epidermides died. Nine of the 11 NVE cases in the active stage were of the localized type. Only one case of the localized type of PVE suffered from an infected mitral bioprosthetic valve. The 6 extensive-type cases had aortic valve endocarditis (2NVE, 4PVE). Three patients with the extensive type of PVE died. We conclude that patients with infective endocarditis who develop progressive congestive heart failure, recurrent embolization, or progressive sepsis despite antimicrobial treatments, should undergo prompt valve replacement within 7 days after institution of therapy.

Adolescent↗
PubMed1994

Relation between recurrence and expression of proliferating cell nuclear antigen, sialyl LewisX, and sialyl Lewis(a) in lung cancer.

Blood vessel invasion, recurrence rate, and time to recurrence were examined in relation to the immunohistochemical expression of proliferating cell nuclear antigen, sialyl LewisX, and sialyl Lewis(a) in 303 patients with lung cancer who had a curative resection from 1980 to 1991. Of these, 150 had adenocarcinoma, 117 had squamous, 21 had large-cell, and 15 had small-cell carcinoma. Significant differences were detected in the expression of proliferating cell nuclear antigen and sialyl LewisX between adenocarcinomas and the other histologic types; thus the subjects were divided into 150 with adenocarcinoma and 153 with non-adenocarcinoma. In those with adenocarcinoma, the frequency of blood vessel invasion was significantly higher in tumors with strong sialyl LewisX expression, and the disease-free survival of the patients with blood vessel invasion was significantly worse when their tumors strongly expressed both sialyl LewisX and proliferating cell nuclear antigen. In those with non-adenocarcinoma, on the other hand, tumors with strong expression of sialyl Lewis(a) and proliferating cell nuclear antigen showed significantly higher frequencies of blood vessel invasion and worse disease-free survival. In patients with recurrent tumors, those with strong proliferating cell nuclear antigen expression showed a significantly shorter time to recurrence. We conclude that sialyl LewisX and proliferating cell nuclear antigen expression in adenocarcinoma and sialyl Lewis(a) and proliferating cell nuclear antigen expression in non-adenocarcinoma may be an important determinant of recurrence.

Adenocarcinoma↗
PubMed1994

Bronchoscopy findings and early treatment of patients with blunt tracheo-bronchial trauma.

Five of 238 patients who suffered blunt chest trauna required surgery to repair a tracheobronchial injury. All patients were injured in a motor vehicle accident. The site of the injury was within 2.5 cm of the carina in four patients and 5.5 cm proximal to the carina in one. Pre-, intra-, and post-operative respiratory management was facilitated by the insertion of a Univent tube, an endotracheal tube with movable blocker capable of excluding one lung. The Univent tube prevented aspiration of blood by the healthy lung and the development of acute respiratory failure. Improved control over ventilation has the secondary benefit of allowing the surgeon to assess other injuries under less duress in patients with multiple trauma.

Accidents, Traffic↗
PubMed1993

Immunohistochemical study of glutathione-related enzymes and proliferative antigens in lung cancer. Relation to cisplatin sensitivity.

BACKGROUND: With resected tumor tissue from 84 patients with lung cancer, the expression of glutathione peroxidase (GPX), glutathione reductase (GR), proliferating cell nuclear antigen (PCNA), and epidermal growth factor receptor (EGFR) was examined in relation to cisdiamminedichloroplatinum (CDDP) sensitivity. METHODS: The CDDP sensitivity was assessed from an increase of cells in the S-phase or G2M-phase by a DNA histogram after the tumor cells were incubated in a CDDP solution. The expression of GPX, GR, PCNA, and EGFR for each tumor was studied with an indirect immunoperoxidase technique on paraffin-embedded tissues. RESULTS: The percentage of patients sensitive to CDDP according to the histologic type was 86% for small cell carcinomas, 40% for large cell carcinomas, 31% for squamous cell carcinomas, and 6% for adenocarcinomas. There was an inverse relationship between CDDP sensitivity and the frequency of GPX and GR expression, and both were significantly different among histologic types. The GPX and GR expression was significantly lower in the CDDP-sensitive group than in the resistant group (P < 0.01). However, the expression of PCNA and EGFR was significantly lower in the sensitive group in non-small cell carcinomas and squamous cell carcinomas (P < 0.05). CONCLUSIONS: From the above findings, an immunohistochemical study of these antigens may be useful for predicting CDDP sensitivity in lung cancer.

Antigens, Neoplasm↗
PubMed1993

Surgical resection of a second primary lung carcinoma in a survivor of small cell carcinoma.

Resection of a second primary lung carcinoma in a long-term survivor of small cell lung carcinoma is reported. The patient had adenocarcinoma as the second primary tumor and underwent lobectomy with mediastinal node dissection. He was alive 99 months after the initial diagnosis of small cell carcinoma and 54 months after curative pulmonary resection for his second primary carcinoma.

Adenocarcinoma↗
PubMed1993

Pure yolk-sac tumor of the lung.

The first case of a pure primary yolk-sac tumor of the lung is presented. The tumor developed in the right upper lobe of a 31-year-old man; preoperatively, the serum alpha-fetoprotein concentration was elevated. Treatment consisted of pulmonary segmentectomy with postoperative combination chemotherapy. The patient is alive and well 13 months after surgery with a normal serum alpha-fetoprotein concentration.

Adult↗
PubMed1993

Selective exclusion of the injured lung.

Intratracheal bleeding and intrapleural air leakage that are uncontrollable by conventional therapy are life-threatening in patients with blunt pulmonary trauma. Selective exclusion of the injured lung is the most effective treatment in such cases. Two hundred six consecutive patients over a 5-year period with blunt pulmonary trauma who survived 5 hours or more after arriving at the hospital were divided into three categories based on mode of treatment. In 190 (92%), intratracheal bleeding, intrapleural air leakage, and intrapleural bleeding were controllable by conventional treatment (class 1). In six (3%), intratracheal bleeding and intrapleural air leakage were controllable by selective pulmonary exclusion, and intrapleural bleeding was controllable by tube thoracostomy (class 2). In ten (5%), thoracotomy was required because of uncontrollable intratracheal bleeding or intrapleural air leakage, despite selective pulmonary exclusion, or intrapleural hemorrhage was not controllable by tube thoracostomy (class 3). Among the 16 patients with class 2 or 3 trauma, 14 survived.

Adolescent↗
PubMed1993

Three-staged graft replacement for multifocal aortic aneurysms in the Marfan syndrome.

A three-staged operation for multifocal aortic aneurysms was conducted over a period of 8 months in a 52-year-old woman with the Marfan syndrome. The aortic valve and ascending aorta, the abdominal aorta and the upper half of the descending thoracic aorta were replaced. As of 9 months after the third operation, the patient's course has been uneventful, but continuous follow-up will be needed in view of the character of this disease.

Angiography↗
PubMed1993

Artificial valve replacement for congenital bicuspid aortic valves.

The congenital bicuspid aortic valve functions almost normally provided degeneration does not occur, but complications of infective endocarditis and calcification of the cusps with aging are indications for surgical intervention. We compared 22 cases with an incompetent bicuspid aortic valve (14 cases with stenosis and eight with regurgitation) with 96 cases of acquired tricuspid aortic valve (30 cases with stenosis and 66 with regurgitation) who were treated by aortic valve replacement (AVR) during the same period. Compared with the stenotic tricuspid aortic valve cases, the stenotic bicuspid aortic valve cases: 1) were older at AVR (59.3: 51.7 years, P < 0.05), 2) had a smaller diameter of preoperative valve orifice (6.9: 9.2 mm, P < 0.05), 3) had a smaller valve ring diameter (23.0: 24.3 mm, P < 0.05), 4) used artificial valves of almost identical size (22.0: 22.5), and 5) included no operative deaths (0: 10%). In contrast, compared with the tricuspid aortic valve cases with regurgitation, the bicuspid aortic valve cases with regurgitation: 1) were younger at AVR (39.5: 45.8 years), 2) had a higher incidence of infective endocarditis (62.5: 19.6%, P < 0.02) as a complication, and 3) showed a higher operative death rate (25.0: 6.1%), although this difference was not statistically significant. Suture repair of the incised portion of the aorta must be performed meticulously in patients with prominent poststenotic dilatation of the ascending aorta.

Adolescent↗
PubMed1993

Surgical treatment of non-penetrating injury to the aorta.

During a 17-year period, eight cases of blunt traumatic injury to the aorta were surgically treated at our hospital. The locations of the lesions were the descending thoracic aorta in four cases, abdominal aorta in two cases, and traumatic DeBakey type IIIb dissection in two cases. Surgical repairs were carried out during the acute or subacute period in four cases and others were electively treated during the chronic period. One patient suffering from acute traumatic dissection of the aorta died of acute renal failure following acute ischemia in the lower extremities 10 days after surgery. Accordingly, the overall mortality rate was 12.5% in this series. We believe that elective operations should be carefully considered if they are possible.

Adolescent↗
PubMed1993

[Effect of Ca-antagonists on pulmonary blood flow during single-lung ventilation in the dog].

Experiments were conducted in 21 adult mongrel dogs to clarify the effects of Ca-antagonist (nifedipine sublingual administration 2.5 mg or 5 mg, or nicardipine intravenous administration 30 micrograms/kg or 60 micrograms/kg) on pulmonary blood flow under the condition of collapsed lung on the side of thoracotomy. Under anesthesia, an endotracheal tube with a movable blocker was used to intubate the trachea and the thoracotomized lung was collapsed. Subsequently, a Ca-antagonist was given and the ratio of the left main pulmonary artery/ascending thoracic aorta blood flow was used as an index of hypoxic pulmonary vasoconstriction (HPV). The following results were obtained. 1. Ca-antagonist administration under lung-collapse on the thoracotomy side resulted in inhibition of HPV of the collapsed lung, whereas, arterial blood oxygen tension (PaO2) remained in the acceptable range. 2. The maintenance of the lowered PaO2 within the acceptable range may have been due to the increase in cardiac output and the elevation of mixed venous blood oxygen tension resulting from Ca-antagonist administration, as well as the residual HPV even after administration of the Ca-antagonist.

Animals↗
PubMed1993

[An experimental study on the relation between lung volume and pulmonary blood flow].

The purpose of this study was to elucidate whether or not the reduction of lung volume is related to the mechanism of blood flow reduction in the atelectatic lung. In adult mongrel dogs, whose main stem bronchus in the thoracotomized lung was obstructed, the change of blood flow in the lung containing N2 was compared with that in the collapsed lung. 1) Under a low partial pressure of O2 in the broncho-alveolar system by obstruction of the main stem bronchus, the blood flow did not change, even when the N2 volume in the lung was varied. Therefore, the change of blood flow in the collapsed lung is not attributable to the reduction of lung volume. 2) The lung blood flow increased when the partial pressure of O2 in the broncho-alveolar system was elevated by infusion of O2 into the collapsed lung, and it decreased with the subsequent O2 absorption leading to lung collapse. Therefore, the change of lung blood flow is due to the change of intraalveolar partial pressure of O2. 3) The reduction of blood flow in the atelectatic lung is caused by hypoxic pulmonary vasoconstriction, and is not influenced by the reduction of lung volume due to the lung collapse.

Animals↗
PubMed1993

[Successful excision of a left ventricular fibroma in an adult patient].

A 48-year-old woman with negative T waves in leads I, a VL and V4-6 in the ECG was examined. The cross-sectional echography and the MRI revealed that she had a tumor in the free wall of the left ventricle. Under the cardiopulmonary bypass, the intramural fibroma (6 by 6 by 4 cm) of the left ventricle was resected and the defect was repaired by sutures of the outer myocardial layers to keep the left ventricular volume. Forty eight days after the initial operation, a reoperation was performed by interrupted sutures of the whole myocardial layers. She is doing well without any troubles 14 months after the reoperation.

Electrocardiography↗