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Biomedical subjects

K Kodama

Publications and source records attributed to K Kodama.

At least 109 records · Page 6Linked to original sources
PubMed2000

Effects of aniracetam on bladder overactivity in rats with cerebral infarction.

Aniracetam has been used to improve the mental condition of patients with cerebrovascular disease. Previous studies have demonstrated that aniracetam activates the residual functions of cholinergic neurons in damaged brain areas. In this study, the effects of aniracetam on bladder overactivity after left middle cerebral artery occlusion were assessed through oral or i.c.v. administration in sham-operated and cerebral infarcted rats. Oral administration of aniracetam (100 and 300 mg/kg) resulted in a significant and dose-dependent increase in bladder capacity in cerebral infarcted rats but had no effect on bladder capacity in sham-operated rats. Intracerebroventricular administration of aniracetam (0.25 and 2.5 microg/rat) resulted in a significant and dose-dependent increase in bladder capacity in cerebral infarcted rats but not in sham-operated rats. Aniracetam had no significant effect on bladder contraction pressure or micturition threshold pressure in either sham-operated or cerebral infarcted rats. Furthermore, i.c.v. administration of atropine (1 microg/rat), a muscarinic acetylcholine receptor antagonist, completely inhibited the enhancing effects of aniracetam on bladder capacity in cerebral infarcted rats. The effects of aniracetam on bladder overactivity are thought to be mediated in part by activation of cholinergic inhibitory mechanisms in the brain. These results indicate that aniracetam may improve the neurogenic voiding dysfunction observed in patients with cerebrovascular disease.

Animals↗
PubMed2000

Diagnostic value of intravesical lidocaine for overactive bladder.

PURPOSE: To determine the diagnostic use of intravesical lidocaine, we evaluated its effects on the overactive bladder in patients with brain lesions, spinal lesions, benign prostatic hyperplasia (BPH) and idiopathic overactive bladder. MATERIALS AND METHODS: Cystometry was performed before and 15 minutes after intravesical instillation of 20 ml. 4% lidocaine in 57 patients with an overactive detrusor in the storage phase. RESULTS: The percentage increase in bladder capacity for patients with spinal lesions was 136%, compared to 56%, 29% and 41% for patients with brain lesions, BPH and idiopathic bladder overactivity, respectively (significant difference p <0.01 to 0.05). Of the patients with an increase of 50% or more 55% had brain lesions, 80% spinal lesions, 23% BPH and 31% idiopathic bladder overactivity. The incidence of the disappearance of detrusor contractions in patients with spinal lesions was greater than that in the others. CONCLUSIONS: These results suggest that intravesical instillation of 4% lidocaine is useful for identification of overactive bladder attributable to spinal or other lesions.

Administration, Intravesical↗
PubMed2000

[Use of percutaneous cardiopulmonary support (PCPS) for extended surgery in patients with T4 tumor].

Since 1991, we have performed operations for tumors invading the upper airway, left atrium or main pulmonary artery with percutaneous cardiopulmonary support (PCPS) stand by support available. Of 15 cases with PCPS stand by, 6 patients actually underwent operation using PCPS. There were three esophageal cancers invading the carina, two lung neoplasms with left atrial invasion and one neoplasm extending to the main pulmonary artery. One of three patients with esophageal cancer had massive bleeding in the trachea resulting in airway obstruction. For this patient, emergency PCPS was carried out followed by the total removal of the thoracic esophagus and combined resection of membranous portion of the carina. As a result, a substantial amount of time (6 hours) was required. The two patients with reconstruction of the carina due to esophageal cancer were also successfully treated by using PCPS. Two patients with malignant pulmonary neoplasms invading the left atrium underwent combined resection of the lung and left atrium using a combination of PCPS and ventricular fibrillation under normothermia. In conclusion, PCPS should be accepted as a standard technique for patients with advanced thoracic malignancies in whom cardiac arrest or ventilation support is thought to be necessary for the complete removal of the tumor.

Adult↗
PubMed2000

[Prognostic assessment of resected lung cancer based on the new international staging system: analysis by histologic types].

The purpose of this study is to assess the validity of the new international staging system for lung cancer revised in 1997 and to clarify the prognostic value of histologic type. Of 1,042 patients with primary lung cancer who underwent resection from 1982 to 1995, 549 patients with adenocarcinoma (AD) and 363 with squamous cell carcinoma (SQ) were included in this study. Overall deaths including operative deaths were treated as the terminal event. For patients with AD, 5-year survival rates were 83% in T1N0M0, 70% in T2N0M0, 46% in T2N1M0, 45% in T3N0M0, 43% in T1N2M0, 32% in T1N1M0, 27% in T2N2M0, 25% in T3N1M0, and 10% in T3N2M0, respectively. For patients with SQ, 5-year survival rates were 80% in T1N0M0, 78% in T1N1M0, 67% in T1N2M0, 60% in T3N0M0, 56% in T2N0M0, 47% in T2N1M0, 36% in T3N1M0, 26% in T2N2M0, and 10% in T3N2M0, respectively. Survival of T1N2M0 was significantly better than that of T2N2M0 and similar to that of T3N0M0 and T2N1M0 both in AD and SQ. In AD survival was dominantly affected by N factor, while in SQ survival was strongly correlated with T factor. In conclusion, we propose that T1N1M0, T2N1M0, T3N0M0 and T1N2M0 should be classified as stage II and T3N2M0 be included into stage IIIB for AD. The TNM grouping for SQ is same as that for AD except setting T1N1M0 as stage IB and T2N0M0 as stage II.

Aged↗
PubMed1999

Up-regulation of Lewis enzyme (Fuc-TIII) and plasma-type alpha1,3fucosyltransferase (Fuc-TVI) expression determines the augmented expression of sialyl Lewis x antigen in non-small cell lung cancer.

Sialyl Lewis a and x antigens are well-known tumor-associated antigens expressed in many cancer tissues. The expression of the genes encoding 5 alpha1,3fucosyltransferases, which are able to synthesize the sialyl Lewis antigens, was examined in normal and cancerous lung tissues of patients with non-small cell lung carcinoma. In all 20 cases examined, the transcripts only for the Lewis gene, encoding the Lewis enzyme (alpha1,3/4fucosyltransferase, Fuc-TIII), were abundantly expressed in lung tissue, and interestingly they were markedly up-regulated in the lung cancer tissues of all 20 cases in comparison with normal lung tissues. Myeloid-type alpha1,3fucosyltransferase (Fuc-TIV) was expressed at an intermediate level but was not up-regulated in lung cancer tissues. The transcripts for plasma-type alpha1,3fucosyltransferase (Fuc-TVI) gene were detected at a very low level but were apparently up-regulated in cancer tissues. Fuc-TVI was found to exhibit stronger relative activity for sialyl Lewis x synthesis (almost 6. 4-fold that of Fuc-TIII). The amount of sialyl Lewis x antigen on mucins in the lung cancer tissues was found to be determined by both enzymes, the Lewis enzyme (Fuc-TIII) and Fuc-TVI. However, the amount of the sialyl Lewis a antigens was not determined by any of the alpha1,3-fucosyltransferases, although the expression of sialyl Lewis a antigens definitely required the Lewis enzyme.

Adenocarcinoma↗
PubMed1999

A novel molecular staging protocol for non-small cell lung cancer.

A molecular staging protocol using reliable markers is of importance in predicting the prognosis of patients with non-small cell lung cancer (NSCLC) and for instituting their appropriate post-surgical treatment. We analysed tumor tissues from 187 NSCLC patients. The DNA and mRNA were extracted from frozen specimens, and then polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and direct sequencing were performed to investigate mutations of p53 from exons 5-8, and mutations of K-ras at exon 1. To determine MRP-1/CD9 gene and KA11/CD82 gene expression, which have been postulated to be metastasis suppressor genes, we have applied quantitative RT-PCR. A Cox multivariate regression analysis showed that nodal status, MRP-1/CD9 and K-ras status were significant factors for prognosis (P<0.0001, P=0.0083 and P=0.0004, respectively). Based on these results, we classified the patients into three groups according to their MRP-1/ CD9 and K-ras status. Patients with both MRP-1/CD9 positive and wild K-ras tumors were defined as group A, patients with either reduced MRP-1/CD9 or mutant K-ras tumors were defined as group B and patients with both reduced MRP-1/CD9 and mutant K-ras tumors were designated as group C. This new classification was significantly correlated with the tumor status and pathological stage (P=0.0098 and P=0.0017, respectively). The overall survival rate of the group A patients was significantly better than the group B patients (59.6% vs 27.9%, P=0.0001) and also that of group B patients was better than the group C patients (27.9% vs 20.0%, P=0.0378). This tendency was also found in patients with 110 node-negative NSCLCs (A vs B vs C=75.8% vs 34.9% vs 0.0%, P<0.0001). A Cox multivariate regression analysis in NSCLC patients demonstrated that an evaluation for both MRP-1/CD9 expression and K-ras mutations had a significant prognostic effect as well as nodal status (P<0.0001).

Adult↗
PubMed1999

Study of the association between the serotonin transporter gene regulatory region polymorphism and personality traits in a Japanese population.

Recently a relationship between serotonin transporter transcriptional control region (5-HTTLPR) polymorphism and anxiety related personality traits in Caucasians was reported. We performed PCR of DNAs from the blood for determining the 5-HTTLPR genotypes of 191 Japanese subjects, which were medical staff and students, and obtained Revised NEO Personality Inventory (NEO-PI-R) and the Temperament and Character Inventory (TCI) in 144 subjects. The association was analyzed by one-way ANOVA. The present study demonstrated that allelic frequency of 5-HTTLPR (s allele frequency was 0.785) in our subjects was considerably different from that in Caucasians. No significant differences were found in the anxiety-related personality traits among genotypes, while cooperativeness in TCI showed a significant difference among genotypes. The property of 5-HTTLPR may not be reflected directory on the personality inventories.

Adult↗
PubMed1999

Pelizaeus-Merzbacher disease: three novel mutations and implication for locus heterogeneity.

We report a mutational and polymorphic analysis of the proteolipid protein gene in members of 27 Japanese families with Pelizaeus-Merzbacher disease. We found causative mutations in 6 members of 27 families (22.2%); 5 of the 6 mutations, including two novel mutations, Leu45Arg and 231 + 2T --> G, resulted in the typically severe clinical symptoms. Paradoxically, the Cys219Tyr mutation, presumed to disrupt the tertiary structure of proteolipid protein by removing the disulfide bond between Cys200 and Cys219, was associated with a mild clinical presentation wherein the patient could walk with assistance and speak. It was inferred that the structural change prevented the toxicity associated with a gain of function mutation. Moreover, in one family 3 patients exhibited a intragenic polymorphism that did not segregate with the disease, suggesting a locus heterogeneity for Pelizaeus-Merzbacher disease.

Adult↗
PubMed1999

Mucosa-associated lymphoid tissue lymphoma of the duodenum forming multiple polypoid lesions: report of a case.

We report herein the case of a patient found to have mucosa-associated lymphoid tissue (MALT) lymphoma of the duodenum forming multiple polypoid lesions. Endoscopic examination revealed multiple small nodules with a yellow-white, rough surface in the duodenal bulb. Histopathological and immunological findings subsequently suggested low-grade B-cell MALT lymphoma. Cytologically, MALT lymphoma is similar to multiple lymphomatous polyposis (MLP); however, this case, which involved multiple polypoid lesions, was confirmed not to be MLP.

Aged↗
PubMed1999

Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in the surgical treatment of lung cancer: report of a case.

A 63-year-old man was referred to our institute for the treatment of squamous cell carcinoma of the upper lobe of his right lung. A right upper lobectomy of the lung was performed with a mediastinal lymph node dissection. The postoperative pathological examination of the dissected specimens revealed one of the superior mediastinal lymph nodes to be morbid with micrometastasis of occult thyroid cancer, while no node involvement was seen due to lung cancer. A right lobectomy of the thyroid gland with a modified radical neck dissection was done 4 years later after the confirmation of the absence of any recurrent sign of lung cancer. In the resected specimen, papillary thyroid microcarcinoma was observed with several intraglandular metastases and right regional lymph node involvement. Eight months later, a new primary lung cancer developed in the left lung, and a left upper lobectomy of the lung with a mediastinal lymph node dissection was performed. At that time, the absence of mediastinal lymph node metastasis from lung cancer or thyroid cancer was confirmed. Mediastinal lymph node involvement as the initial manifestation of occult thyroid cancer in surgical treatment for lung cancer is rare, but it is important to be aware of the possibility of incidentally detecting occult thyroid cancer in surgical dissections in this area for lung cancer. The appropriate surgical treatment should be determined while carefully considering the prognosis of the lung cancer as well as that of any coexisting malignancy.

Carcinoma, Papillary↗
PubMed1999

Mechanism for abnormal thallium-201 myocardial scintigraphy in patients with left bundle branch block in the absence of angiographic coronary artery disease.

Patients with left bundle branch block (LBBB) often show abnormal images on exercise thallium (T1)-201 scintigraphy without evidence of significant coronary stenosis. We investigated the mechanism for this phenomenon. Six patients with LBBB and without significant coronary stenosis underwent T1-201 SPECT, ECG-gated SPECT imaging with Tc-99m-methoxyisobutyl-isonitrile (MIBI), and atrial pacing stress test. The % count amplitude in Tc-99m-MIBI images was calculated as [(maximal counts) - (minimal counts)]/(minimal counts) x 100. Though all patients had a low count in the septal and inferior wall in T1-201 SPECT images, there was no ischemic production of lactate during an atrial pacing stress test. Nevertheless, gated SPECT images showed attenuated septal activity during systole. In patients with LBBB, the ratios of % count amplitude at the septum to that at the lateral wall at rest (0.47 +/- 0.05, mean +/- SE) were significantly less than the controls (n = 5, 0.83 +/- 0.12, p = 0.014). In conclusion, these results suggest that abnormal T1-201 SPECT images of the septum in patients with LBBB are partially caused by impaired septal wall thickening during systole. Such an abnormal wall motion may reduce blood flow demands to the septum, resulting in reduction of coronary blood flow with little ischemia.

Bundle-Branch Block↗
PubMed1999

Surgical treatment for metastatic lung tumors with incidentally coexisting lung cancer.

We report four surgically resected cases of a metastatic lung tumors with incidentally coexisting lung cancer. Two patients (Cases 1 and 2) were admitted for surgical treatment for pulmonary metastases from colon cancer, and the other two (Cases 3 and 4) were for pulmonary metastases from renal cell carcinoma. In only one patient (Case 3), one lesion among the multiple shadows on the preoperative computed tomography examination was rather strongly suspected to be primary lung cancer. In three patients (Cases 1, 2 and 3), one of the resected lesions in each individual case was diagnosed as lung adenocarcinoma by an intraoperative examination using frozen sections, and was later histologically confirmed. In Case 4, one of the resected lesions was postoperatively determined to be lung adenocarcinoma. All coexisting lung cancers, treated with partial resection of the lung, were well-differentiated small-sized adenocarcinoma (T1N0), while the other lesions resected in each case were metastases from the individual cancer. Problems in preoperative diagnosis and surgical treatment for metastatic lung tumors with incidentally coexisting lung cancer are discussed.

Adenocarcinoma↗
PubMed1999

Survival and postoperative complications after extended surgery for non-small-cell lung cancer. A retrospective study.

OBJECTIVE: We evaluated survival after extended surgery in patients with non-small-cell lung cancer and the effects of induction therapy on results and complications. SUBJECTS AND METHODS: Between April 1987 and March 1998, 127 patients with pathological T3 (pT3) or T4 (pT4) non-small-cell lung cancer underwent extended surgery combined with resection of neighboring organs. Of these, 35 received induction therapy. In the remaining 92, surgery preceded other therapy. Long-term results and postoperative respiratory complications were analyzed and compared between the patients with and without induction therapy. RESULTS: Overall 5-year survival after extended surgery was 37%. Five-year survival rates in the pT3 was 41% and that in the pT4 group 28% (p = 0.030). Five-year survival rate in the pN0-1 was 46% and that in the pN2-3 group 26% (p = 0.003). No significant difference was observed in survival curves between patients with and without induction therapy. Induction therapy responders showed better survival than nonresponders. To prevent postoperative fatal complications due to bronchopleural fistula, we prophylactically covered the bronchial stump using autologous tissue in 31 induction therapy patients, and no mortality due to complications was seen in this group. CONCLUSION: Long-term survival after extended surgery was observed in pT3 and pT4 patients, especially among those with a pN0-1 status. Induction therapy responders may be considered good candidates for extended surgery because of the favorable prognosis in contrast to that for nonresponders.

Carcinoma, Non-Small-Cell Lung↗
PubMed1999

Combined resection of the aorta for an esophageal carcinoma invading the aorta through a right transthoracic approach.

The prognosis of esophageal carcinoma invading the thoracic aorta has been extremely poor, as it has been either not resected or only palliatively resected. In recent years a remarkable improvement in survival has been achieved in advanced esophageal carcinoma through an aggressive dissection of the upper mediastinal lymph nodes. This implied that resection only of the aorta without lymph node dissection in these patients was not adequate for curability. Although a resection of the aorta would seem to be performed more easily through a left thoracotomy than through a right thoracotomy, the upper mediastinal lymph node dissection was unsatisfactory through a left thoracotomy. Therefore, we performed combined resection of the aorta using a temporary aorta-aorta bypass together with upper mediastinal lymph node dissection through a right thoracotomy for four patients with the esophageal carcinoma invading the thoracic aorta. This operative procedure was performed safely, and had the advantage that full observation on the extent of the carcinoma was attained together with subsequent radical lymph node dissection in the same field through only the right thoracic approach. This operation may provide a possibility for cure to patients with an esophageal carcinoma invading the aorta, who would otherwise receive only palliative treatment.

Aged↗
PubMed1999

Overexpression of bax associated with mutations in the loop-sheet-helix motif of p53.

Recent investigations have revealed that mutations of the loop-sheet-helix motif of p53 is a significant factor for a poor prognosis in patients with non-small-cell lung cancer (NSCLC). To clarify this mechanism, bcl-2 and bax expression were evaluated in relation to mutations of p53. Tumor tissues of 203 patients with NSCLC were analyzed. Immunohistochemistry was performed to evaluate bcl-2 and bax expression, and polymerase chain reaction single-strand conformation polymorphism following direct sequencing was performed to investigate p53 status. A total of 79 carcinomas were bcl-2 positive, 146 carcinomas were bax positive, and 72 carcinomas had missense mutations of p53. There was no difference in bcl-2 expression in relation to p53 status. On the other hand, tumors with structural mutations of p53 had significantly lower expression of bax than those with wild-type p53 (P = 0.0026). In contrast, tumors with mutations of the loop-sheet-helix motif of p53 had significantly higher expression of bax than those with wild-type p53 (P = 0.0236). The frequency of a bcl-2/bax ratio of >/=1 was significantly lower in tumors with mutations of the loop-sheet-helix motif than that in tumors with wild-type p53 (P = 0.0240). The bcl-2/bax ratio status was a significant factor for a prognosis in patients with NSCLC (P = 0.0083). Mutations of the loop-sheet-helix motif of p53 were correlated with overexpression of bax, while other mutations of p53 were correlated with low levels of bax expression. This variation in pattern of bax expression in relation to mutant p53 might reflect the biological behavior of tumors in patients with bcl-2-positive NSCLC.

Adenocarcinoma↗
PubMed1999

Prognostic value of bronchiolo-alveolar carcinoma component of small lung adenocarcinoma.

BACKGROUND: Bronchiolo-alveolar carcinoma (BAC) is often observed in lung adenocarcinoma, but its clinicopathological and prognostic significance, especially in small peripheral lung adenocarcinoma, remains undetermined. METHODS: We assessed 206 consecutive cases of surgically resected small peripheral lung adenocarcinoma (less than 2 cm in diameter) recorded between 1973 and 1997. According to the component area of well differentiated BAC within maximally cut surface specimens of tumor tissue, we semiquantitatively classified the tumors into four types: those in which the BAC component comprised 0% (type I), 1% to 49% (type II), 50% to 99% (type III), and 100% (type IV) of the tumor tissue. RESULTS: Forty tumors were classified as type I, 75 as type II, 74 as type III, and 17 as type IV. The tumors with less BAC, especially type I and II, showed a significantly more aggressive nodal involvement and tumor stage, and consequently a worse prognosis, while type IV tumors had no nodal involvement and the most favorable prognosis. The patients with type III showed clinicopathological characteristics somewhere between those of type II and type IV patients. Among stage I patients, however, those with type II had the worst prognosis, while those with type I showed as good a prognosis as the other two groups. CONCLUSIONS: This novel classification based on the degree of BAC involvement in small peripheral lung adenocarcinoma may reflect clinicopathological and prognostic characteristics. This classification may prove practical for planning therapeutic strategies, in particular surgical treatment.

Adenocarcinoma↗
PubMed1999

Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue in the lung: a report of a case with pleural dissemination.

A 79-year-old man with an abnormal shadow on a chest radiograph was referred to our hospital for further examination. Open lung biopsy revealed numerous nodules on visceral pleura and the tumor, obtained by wedge resection of the left upper lobe of the lung, consisted of centrocyte-like cells and lymphoplasmacytoid cells, expressing CD20 and CD79a. These cells invaded bronchiolar epithelium to form lymphoepithelial lesions. The pleural-based nodules were similarly composed of the same cells as those in the left upper lobe tumor. To our knowledge, pleural dissemination of low grade B-cell lymphoma of mucosa-associated lymphoid tissue has not been reported previously.

Aged↗