Search PubMed⌕ Search

Biomedical subjects

K Mizutani

Publications and source records attributed to K Mizutani.

At least 91 records · Page 5Linked to original sources
PubMed1997

Comparison of the surgical results of lobectomy with bronchoplasty and pneumonectomy for lung cancer.

BACKGROUND: We retrospectively compared sleeve lobectomy (SL) and pneumonectomy (PN) for lung cancer in terms of surgical complications and postoperative disease-free survival, as well as incidence and pattern of recurrent disease. METHODS: From 1977 to 1993. 29 patients with primary lung cancer underwent sleeve resection at our institution. The pneumonectomy group consisted of 29 cases that had been selected during the same period according to the following criteria: (1) in a tumor located in the upper lobe, there was no invasion within 1 cm from both the carina and the orifice of the middle and the lower lobe bronchus, whereas in a tumor located in the middle or lower lobe, there was no invasion within 1 cm of the orifice of the upper bronchus, (2) there was no invasion to the trunks of the pulmonary vessels, (3) there was no invasion to any other lobes, (4) a complete resection was achieved. RESULTS: No differences were observed between the two groups regarding stage, histological population, or age. The incidence of postoperative complications was 13.7% in the SL group (2 cases each of pneumonia and arrythmia), and 24.1% in the PN group (3 bronchopulmonary fistula, 2 bleeding, 1 instance each of arrythmia and acute cardiac failure, and 2 operation-related deaths) (P < 0.05). The 3-year disease-free survival was 65.7% in SL, 58.8% in PN (no statistical significance in the log-rank test). Recurrent disease was observed in the local regions of three patients in the SL group and six patients in the PN group, and at distant organs of six patients in the SL group and seven in the PN group. CONCLUSIONS: These findings thus suggest that as a curative treatment, lobectomy with bronchoplasty may be a safer procedure than pneumonectomy for lung cancer.

Adult↗
PubMed1997

Treatment of esophageal cancer in patients over 80 years old.

A total of 828 patients with esophageal cancer were treated at the Second Department of Surgery of Tokai University in the 20-year period from 1975 to June 1994, including 45 patients over 80 years old. We reviewed these elderly patients to assess the optimum therapeutic approach for such individuals. In recent years, the number of elderly patients with esophageal cancer has steadily been increasing. Advanced cancer is more common among this group, but early cancer has also been detected more frequently in recent years. Of the 45 elderly patients (80%) in our series, 36 were encountered in the last 10 years. As 28.9% of the patients had multiple cancers, a careful workup was necessary preoperatively. Since most patients (88.9%) had complications and were also in a poor general condition, limited surgery was recommended in consideration of the postoperative quality of life. The indications for endoscopic mucosal resection (EMR) may be able to be extended to submucosal1 (sm1) cancer without lymph node swelling. Postoperative complications occurred in 60% of those undergoing surgical resection or esophageal bypass, although death only resulted in 1 case. The 5-year survival rate after surgical resection was 30.8%. These results therefore support the use of surgical treatment for selected elderly patients with esophageal cancer.

Adult↗
PubMed1997

The diagnosis and treatment of esophageal perforations resulting from nonmalignant causes.

Esophageal perforations are extremely difficult to diagnose and treat. We report herein our results of a review of 26 patients with esophageal perforation which were spontaneous in 11, iatrogenic in 11, and caused by a foreign body in 4. Surgical treatment was performed in 7 of the patients with spontaneous rupture, but the remaining 19 patients were treated conservatively. The abnormality was found by plain radiography (X-ray) in 22 (85%) of the 26 patients, and by computed tomography (CT) in all 13 patients who underwent this procedure. The detection rates by esophagography and esophagoscopy were 100%, or all of 25 patients examined, and 60%, or 9 of 15 patients examined, respectively. Of 12 patients with underlying diseases, 4 (33%) died after the perforation, whereas only 1 (7%) of 14 patients without any underlying disease died. Postoperative empyema developed in all of 3 patients treated by intraoperative unfixed intrathoracic drainage (UID), but in none of the 4 treated by fixed intrathoracic drainage (FID). Conservative treatment achieved satisfactory results for spontaneous esophageal ruptures confined to the mediastinum, and for iatrogenic perforations and esophageal perforations caused by foreign bodies, provided there was no serious underlying disease such as advanced cirrhosis. Moreover, intraoperative FID proved useful in helping to prevent postoperative empyema.

Adult↗
PubMed1997

Binding nature and denaturation of protein during interaction with galloylglucose.

Analysis of insoluble complexes between tetragalloylglucose and proteins following a series of successive washes with buffer indicated (1) heterogeneity of binding between galloylglucose and protein and (2) irreversible denaturation of protein during interaction with galloylglucose. Relatively large amounts of tetragalloylglucose were removed by initial washes, indicating weak, low affinity binding, whereas smaller amounts removed by subsequent washes suggest bonds with a higher affinity. Although the maximum number of bindings sites, calculated per 10,000 M(r) of protein, was similar for BSA, myoglobin and lysozyme, the proportion of these sites that appeared to have high affinity, varied from 8 to 29%. The low proportion of strongly binding sites in lysozyme explains its relatively low tannin-complexing ability. Solubility decrease in protein during successive washing and decrease in the beta-glucosidase activity indicate that irreversible denaturation of protein occurs, which progresses with an increase in the incubation time with galloylglucose and galloylglucose/protein molar ratio in the mixture. Relative affinity of galloylglucose is directly related to the ability to cause irreversible denaturation.

Hydrolyzable Tannins↗
PubMed1997

The current status of postoperative complications and risk factors after a pulmonary resection for primary lung cancer. A multivariate analysis.

OBJECTIVE: The purpose of the present study is to identify the current postoperative complications after a pulmonary resection for primary lung cancer and the associated risk factors. METHODS: From 1988 to 1992, 291 patients with primary lung cancer, excluding T4 diseases, consecutively underwent a pulmonary resection at our institute. The observed postoperative complications were divided into non-life-threatening ones (simple arrhythmia, atelectasis, liver dysfunction, etc.) and life-threatening ones (respiratory failure, pyothorax, pneumonia, bronchopleural fistula, cardiac failure, cerebral infarction, myocardial infarction, etc.). Using logistic regression procedures, both univariate and multivariate analyses of the association between various perioperative factors and the incidence of postoperative complications were performed. RESULTS: Non-life-threatening complications occurred in 60 patients (20.6%) while life-threatening ones occurred in 36 (12.4%), and resulted in five in-hospital deaths (1.75%). Multivariate analyses showed that an age of 70 or older, a combined resection, an abnormality on preoperative ECG, and diffusing capacity of carbon monoxide (%DLco) below 70 were all independently associated with an increased non-life-threatening morbidity. On the other hand, an age of 70 or older, the need for a pneumonectomy, and a %DLco below 70 were also independently predominant risk factors for life-threatening morbidity. CONCLUSION: The risk factors for life-threatening morbidity therefore did not completely correspond to those for non-life-threatening morbidity. Since the mortality was quite low, even risk factors for life-threatening morbidity were not solely considered to be a contraindication for a major pulmonary resection.

Adult↗
PubMed1997

Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy.

We assessed the therapeutic significance of systematic aortic and pelvic lymphadenectomy followed by adjuvant therapy in node-positive endometrial carcinoma. Among 173 stage I-III patients, 30 (17%) had positive nodes: ten in the pelvic region alone (group P) and 20 in the aortic region alone or in both regions (group A). The adjuvant therapy was administered as follows: subjects in group P received 50 Gy pelvic radiation, including three post-surgical T3 (pT3) patients who received either one or three cycles of cisplatin-based chemotherapy before radiation. Subjects in group A were given three cycles of chemotherapy followed by 50 Gy pelvic and 50 Gy extended field periaortic radiation using a four-field or conformational technique. Five-year survival was 95% for 143 patients with negative nodes and 84% for 30 patients with positive nodes (100% for group P and 75% for group A). In group A, 5-year survival was 38% for eight patients with both pT3 and histology other than endometrioid type G1, and 91% for the remaining 12 patients. Either way, both group P and group A patients had a better prognosis than previously reported. In summary, aortic and pelvic lymphadenectomy and subsequent chemotherapy and radiation therapy based on node status seem to improve the survival of endometrial cancer patients with positive nodes.

Adenocarcinoma, Clear Cell↗
PubMed1997

I.v. fentanyl decreases the clearance of midazolam.

We have examined the effect of fentanyl on the pharmacokinetics of midazolam in patients undergoing orthopaedic surgery. Thirty patients were allocated randomly to receive fentanyl 200 micrograms and midazolam 0.2 mg kg-1 (fentanyl group, n = 15) or placebo and midazolam 0.2 mg kg-1 (placebo group, n = 15) in a double-blind manner for induction of anaesthesia. Anaesthesia was maintained with nitrous oxide and isoflurane. Systemic clearance of midazolam was decreased by 30% (P = 0.002) and elimination half-time was prolonged by 50% (P = 0.04) in the fentanyl group compared with the placebo group. There were no differences in the distribution half-time or volume of distribution at steady state between the two groups. These findings indicate that elimination of midazolam was inhibited by fentanyl during general anaesthesia.

Adolescent↗
PubMed1997

The physiological effect of anti-GM1 antibodies on saltatory conduction and transmembrane currents in single motor axons.

Anti-ganglioside (anti-GM1) antibodies have been implicated in the pathogenesis of Guillain-Barré syndrome, multifocal motor neuropathy and motor neuron diseases. It has been held that they may interfere with saltatory conduction by blocking sodium channels. We tested this hypothesis by analysing action potentials from 140 single nerve fibres in 22 rat ventral roots using external longitudinal current measurement. High-titre anti-GM1 sera from Guillain-Barré syndrome or multifocal motor neuropathy patients, or anti-GM1 rabbit sera were applied to the rat ventral root, where saltatory conduction in single motor fibres was serially observed for 4-12 h (mean 8.2 h). For control experiments, we also tested anti-galactocerebroside (anti-GalC) sera, which causes acute demyelinative conduction block, and tetrodotoxin (TTX), a sodium channel blocker. Conduction block was found in 82% of the fibres treated with anti-GalC sera and 100% treated with TTX, but only in 2% (one out of 44) treated with the patients' sera and 5% (two out of 38) treated with rabbit anti-GM1 sera. All the nodes blocked by anti-GM1 sera revealed intense passive outward membrane current, in the internode just beyond the last active node. This pattern of current flow was similar to that in fibres blocked by demyelination with anti-GalC sera, and quite different from that seen in fibres blocked by reducing sodium currents with TTX. Our findings suggest that anti-GM1 sera neither mediate conduction block nor block sodium channels on their own. We conclude that physiological action of the antibody alone is insufficient to explain clinically observed conduction block in human diseases.

Action Potentials↗
PubMed1997

Inhibition of aldose reductase and sorbitol accumulation by astilbin and taxifolin dihydroflavonols in Engelhardtia chrysolepis.

Dihydroflavonol taxifolin and its glycoside, astilbin, from Engelhardtia chrysolepis inhibited rat lens and recombinant human aldose reductase. Taxifolin also inhibited sorbitol accumulation in human red blood cells. Furthermore, this dihydroflavonol aglycone maintained the clarity of rat lens incubated with a high concentration of glucose. These dihydroflavonols may be effective for preventing osmotic stress in hyperglycemia.

Aldehyde Reductase↗
PubMed1997

Fiber digestion and weight gain in guinea pigs fed diets containing different fiber sources.

The effects of different fiber sources on feed intake, weight gain and digestibility of fiber were examined in guinea-pigs fed pelleted diets containing alfalfa meal, oaten hay, beet pulp and commercial hay cubes mixed with a basal diet at ratios of 3:1 (75% in the diet), 1:1 (50%) and 1:3 (25%). The basal diet contained 50.0% corn, 4.1% wheat, 22.1% wheat flour and 17.7% corn gluten meal. Food intake increased as the amount of fiber source was increased, but not in the case of beet pulp. The most digestible fiber (ADF and NDF) was that of beet pulp. Apparent digestibility of dry matter decreased with increasing ratios of fiber source to the basal diet for all fiber sources, but fiber and crude protein digestibilities varied and depended not only on the ratio of fiber to the basal diet but also on the source of the fiber.

Animal Feed↗
PubMed1997

Gastrectomy with combined resection of other organs for carcinoma of the stomach with invasion to adjacent organs: clinical efficacy in a retrospective study.

BACKGROUND: Carcinoma of the stomach invading one or more adjacent organs raises serious concerns over en bloc dissection because en bloc resection has an associated high risk and such advanced carcinoma is frequently associated with incurable factors. Thus, it is important to understand the efficacy of gastrectomy combined with other organ resection and to refine the indications for en bloc dissection. STUDY DESIGN: Seventy-seven patients with carcinoma of the stomach directly invading adjacent organs or structures were analyzed retrospectively to investigate the efficacy of en bloc resection. Forty-one patients underwent gastrectomy combined with resection of one or more invaded organs (combined resection group), while the other 36 patients underwent gastrectomy with palliative abrasion between the primary tumor and the invasion site (noncombined resection group). RESULTS: The five-year survival rate was 23 percent in the combined resection group and 0 percent in the noncombined resection group (p < .05). The 23 curative cases and 18 noncurative cases in the combined resection group had a survival rate of 41 percent and 0 percent, respectively (p < .05). The survival rate after a single organ resection was 29 percent, and after a multiple organ resection, 0 percent (p < .05). Cases of carcinoma invading either the pancreas or mesocolon had a slightly but not significantly better prognosis. In Borrmann type IV carcinoma there was no difference in survival between the curative and noncurative operation. Cases with P1 dissemination had a better prognosis than those of P2 and P3 dissemination. CONCLUSIONS: The best indication for an en bloc combined organ resection was an invasion limited to only one other organ, not more than N2, no incurable factor, and any type except Borrmann type IV. Additionally, an en bloc combined resection would be worth trying for any type of gastric carcinoma with not more than P1 dissemination and with no other incurable factor.

Carcinoma↗
PubMed1997

[The significance of p21 expression in gastric cancer].

We examined the expression of p53, p21, cyclin D1, E, and PCNA in 75 cases of gastric cancer by immunohistochemical study and the expression of p21 RNA in cases by in situ hybridization. The rate of stage III, IV cases of p53(+) p21(-) group was significantly higher than that of any other groups. The apportinately 3-year survival rate of p53(+) p21(-) group was significantly lower than either that of p21(+) p53(-) or p53(-) p21(-) group. The 3-year survival rates of positive cases were significantly lower than those of negative cases on both cyclin D1 and E. The positive rate of cyclin E of the p53(-) p21(+) group was significantly lower than that of the p53(+) p21(-) group. The average PCNA Labeling. Index (LI) of the p53(+) p21(-) group was significantly higher than that of the p53(-) p21(+) group. The 3-year survival rate of cases with expression of p21 RNA was higher than that of cases without p21 RNA. Average PCNA L1 of cases with expression of mutant-type p53 was high and the number of poor prognostic cases in cases with expression of mutant-type p53 was large. In contrast, the average PCNA LI of cases with expression of p21 was low and the number of good prognostic cases with expression of p21 was large. These results suggest that p21 suppresses synthesis of DNA via cyclin E and PCNA.

Cyclin D1↗
PubMed1996

Sparfloxacin phototoxicity: potential photoaugmentation by ultraviolet A and B sources.

Sparfloxacin, a quinolone antibacterial agent, frequently elicits photosensitive skin reactions. Our clinical studies of patients treated with sparfloxacin have demonstrated that this photosensitivity is primarily phototoxic and that a marked erythematous response is induced by sequential irradiation with ultraviolet A (UVA) and B (UVB) but not UVA or UVB alone, suggesting potential synergism between UVA and UVB. We evaluated the phototoxicity of this agent using in vitro DNA breaking activity and in vivo murine cutaneous responses. Sparfloxacin induced DNA strand breaks in vitro and converted the supercoiled closed circular form of plasmid DNA to the open circular form by its photodynamic action. In mice, the topical application of sparfloxacin and subsequent irradiation with UVB, but not UVA, induced ear swelling responses. However, the UVB-induced ear swelling response was augmented by irradiation with UVA before or after UVB exposure. Such interaction between UVA and UVB in the production of ear swelling was further confirmed by systemic administration of sparfloxacin. Our study suggests that sparfloxacin is a unique phototoxic agent in that photosensitivity dermatitis is evoked by photoaugmentation between UVA and UVB.

Animals↗
PubMed1996

Skip metastasis to the mediastinal lymph nodes in non-small cell lung cancer.

BACKGROUND: Whether any difference exists in clinical characteristics between resected non-small cell lung cancer with either skip or ordinary mediastinal lymph node metastases (N2 disease) needs to be clarified. METHODS: There were 110 patients with stage IIIA N2 disease. Thirty-three patients demonstrating no metastasis at the hilar nodes [skip (+) group] were compared with the other 77 patients [skip (-) group]. To investigate the extent of nodal involvement, we classified the mediastinal lymph nodes into three regions (superior, inferior, or aortic). RESULTS: There were no significant differences regarding histologic type, T status, or the site of the primary tumors between the skip (+) and the skip (-) N2 groups. In the skip (+) group, mediastinal node metastasis was found in only one region (level 1) in 30 patients (90.9%) and in two regions (level 2) in 3 (9.1%), whereas 28 patients (36.4%) from the skip (-) group revealed mediastinal metastasis at two or three regions (level 2 or 3). The overall survival rate at 5 years after operation was 35% in the skip (+) group and 12.7% in the skip (-) group (p = 0.054). This favorable clinical outcome in the skip (+) group could be explained partially by the higher proportion of patients with level 1 metastases. Furthermore, regarding patients with level 1 disease, the skip (+) group tended to have a better prognosis than the skip (-) group (p = 0.096). CONCLUSIONS: These results suggest that patients with skip mediastinal lymph node metastases represent a unique subgroup of N2 disease.

Carcinoma, Non-Small-Cell Lung↗
PubMed1996

Alpha-fetoprotein-producing adenocarcinoma of the lung.

We herein present a case of metachronous primary lung cancers, the first of which was adenosquamous cell carcinoma and the second of which was poorly differentiated adenocarcinoma. At the time the second lung cancer was detected 5 years after being operated on for the first cancer, a high level of serum alpha-fetoprotein (AFP) was noticed, but no elevation of other tumor markers was observed. In addition, no liver metastases, chronic liver diseases or other systemic abnormalities were seen either. The serum AFP level was 696 ng/ml, and the profile of lectin affinity showed a tumor-derived pattern. Two weeks after the operation, the serum AFP level decreased to a normal level. An immunohistochemical analysis confirmed that the exact origin of AFP was the tumor tissue. A specimen taken from the first lung cancer was not stained by the same procedures, which thus indicated this case to be a double primary lung cancer.

Adenocarcinoma↗