Biomedical subjects

Kazuo Shimizu

Publications and source records attributed to Kazuo Shimizu.

At least 37 records · Page 2Linked to original sources

PubMed2006

Surgical experience of subacute pulmonary thromboembolism with severe pulmonary hypertension.

Surgical treatment for subacute pulmonary arterial thromboembolism has previously been considered to be inappropriate. We undertook a pulmonary arterial thrombectomy and removal of a floating right heart thrombus in a patient who had been symptomatic for over a month. The pulmonary arterial pressure, which had been equal to the systemic pressure preoperatively, decreased gradually and almost normalized one month postoperatively. Pulmonary perfusion scintigraphy revealed a dramatic improvement and the patient returned to normal life activities.

Catheterization, Swan-Ganz↗

PubMed2006

Long-term survival of Askin tumor for 10 years with 2 relapses.

An abnormal shadow was noted on a chest X-ray of a 32-year-old female in a medical check-up in March 1995, 3 months after she had given birth. Thoracic CT detected a tumor in contact with the left thoracic wall, and tumorectomy was performed in May 1995. The tumor was diagnosed as a primitive neuroectodermal tumor (PNET). After surgery, the thoracic wall to which the tumor adhered was treated with irradiation at 50 Gy. Chemotherapy was considered, but the patient did not wish to undergo this treatment. Lung metastasis occurred 5 years after the first surgery, and the left lower lobe of the lung was partially resected. Four years later, lobectomy of the left lower lobe of the lung was performed, due to further lung metastasis. The patient remains healthy as of April 2005.

Adult↗

PubMed2006

Assessment of the perioperative hemodynamics and right ventricular performance of lung cancer patients using a continuous cardiac output monitoring system: comparison between video-assisted thoracic surgery and muscle-sparing thoracotomy.

PURPOSE: This prospective study was conducted to assess the influences of hemodynamics and right ventricular (RV) performance after lobectomy by video-assisted thoracic surgery (VATS) and that by muscle-sparing thoracotomy (MST) using a continuous cardiac output (CCO) monitoring system. SUBJECTS AND METHODS: Between October 2002 and April 2004, 16 patients (VATS, 8; MST, 8) who underwent lobectomy with mediastinal lymphadenectomy were enrolled in this study. Changes in hemodynamics and RV performance were evaluated preoperatively and for 36 hours postoperatively. RESULTS: There were significant differences in operative blood loss (BL) and postoperative maxCPK/m(2) between VATS and MST groups. Postoperative values were expressed as a percentage of the preoperative values. For 36 hours perioperatively, the mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP) and total pulmonary resistance index (TPRI) decreased to greater extents in the VATS group than in the MST group. There were no significant differences between the two groups in RV performance including the continuous cardiac index (CCI), RV ejection fraction (RVEF), RV end-diastolic volume index (RVEDVI) and RV stroke index (SI) postoperatively. CONCLUSION: Considering our previous report about postoperative RV performance using the VATS procedure and posterolateral thoracotomy procedure, this study suggests that pulmonary resection using either VATS or MST could be employed as minimally invasive surgery.

Aged↗

PubMed2006

[Tuberculoma of the mediastinal lymph nodes with spinal caries].

A 65-year-old male presented with a chief complaint of back pain. Chest computed tomography (CT) demonstrated partially calcified enlargements of the anterior mediastinal lymph nodes and pleural effusion in both lungs. His spondylous lesion rapidly progressed and developed into quadriparesis approximately 2 months after he noticed the back pain. We could not determine whether the lesion was an invasion of the spinal cord by a carcinoma of unknown primary or malignant lymphomas. Therefore, we performed a lymph node biopsy using a thoracoscope for a definitive diagnosis. Histopathology showed tuberculoma with epithelioid cell growth and images of previous scars. However, the staining method for tubercle bacillus did not reveal the presence of tubercle bacillus. As in this case, not all cases of tuberculoma present tubercle bacillus. Therefore, even with poor, suspicious findings for tuberculosis, we should always consider tuberculosis. Old tuberculoma may relapse and rapidly progress. Therefore, we concluded that a biopsy should be performed when tuberculoma is suspected.

Aged↗

PubMed2006

Metastatic thoracic lymph node carcinoma of unknown origin on which we performed two kinds of immunohistochemical examinations.

Metastatic cancers of the thoracic lymph nodes without primary sites are rare. Such cancers are difficult for clinicians to manage as identifying the primary sites is difficult in using routine histologic examinations alone. We searched for the site of the primary lesion using immunohistochemical exploration of cytokeratin (CK) and thyroid transcription factors 1 (TTF-1), and 2-[18F] and fluorodeoxyglucose positron emission tomography (FDG PET) in a patient with cancer of the hilar lymph node without any known primary site. To our knowledge, there are no previous similar reports. A 45-year-old man presenting with a tumor in the right hilar region, underwent surgical resection of the tumor, resulting in a diagnosis of metastatic cancer of the bronchopulmonary lymph nodes. An immunohistochemical examination revealed the neoplastic lesion to be positive for CK7, negative for CK20, and negative for TTF-1. Repeated searches to identify the site of the primary lesion by FDG PET over the 35 months since operation have failed to locate a primary site.

Adenocarcinoma↗

PubMed2006

Rupture of a normal-sized, non-dissected distal aortic arch in a Marfan patient.

We successfully repaired a rupture of a normal-sized, non-dissected distal aortic arch in a patient with Marfan syndrome. Six years previously she had undergone repair of the thoraco-abdominal aortic aneurysm with a 24-mm knitted Dacron graft for type B chronic aortic dissection. The rupture site was located at the back of the native distal aortic arch just 10 mm above the proximal anastomosis, and just below the left subclavian artery. This unexpected situation might be related to dilatation of the knitted Dacron graft up to 34 mm (142%), thus stretching out the fragile native aorta in this Marfan patient.

Adult↗

PubMed2006

A case report on a full-thickness chest wall reconstruction with polypropylene mesh and stainless steel mesh concurrently using a transverse rectus abdominis myocutaneous flap.

A full-thickness chest wall resection requires subsequent chest wall reconstruction. A chest wall resection and reconstruction was performed using a transverse rectus abdominis myocutaneous (TRAM) flap, together with polypropylene mesh (Marlex mesh) and stainless steel mesh (SSM). A 71-year-old man was diagnosed as having recurrent lung cancer in the chest wall, and underwent surgical resection. Marlex mesh was sutured to the posterior wall of the surgical defect. A portion of the SSM was adjusted to the size of the defect and cut out. Its edges were folded to make the portion into a plate. This SSM plate was placed anteriorly to the Marlex mesh and sutured to the ribs. The Marlex mesh was folded back on the SSM plate by 2 cm and fixed. After the above procedures, a left-sided TRAM flap was raised through a subcutaneous tunnel up to the defect and sutured to the region. The patient was discharged from hospital 19 days postoperatively. The wound was fine and he had no flail chest or dyspnea, and carcinomatous pain resolved.

Adenocarcinoma↗

PubMed2005

Dietary artepillin C suppresses the formation of aberrant crypt foci induced by azoxymethane in mouse colon.

Artepillin C, a prenylated phenylpropanoid found specifically in Brazilian propolis, has been shown to be a bioavailable antioxidant. In this study, artepillin C was tested for colon cancer-preventing activity using azoxymethane-challenged ddY mice. Oral doses of 80 and 160 mg/kg body weight of propolis or 10mg/kg of artepillin C (equi-amounts to 160 mg propolis) reduced significantly the frequency of colonic aberrant crypt foci (ACF) by 39.2, 43.7 and 43.4%, respectively. In liver of the mice, glutathione S-transferase and NADPH:quinone reductase activity increased with the doses of propolis or artepillin C, and an antioxidant-responsive element (ARE) was found to be activated for binding DNA. Artepillin C is considered to suppress the formation of colonic ACF through the activation of ARE and induction of phase II enzymes in liver.

Animals↗

PubMed2005

Fucoxanthin induces cell cycle arrest at G0/G1 phase in human colon carcinoma cells through up-regulation of p21WAF1/Cip1.

Fucoxanthin, a natural carotenoid, has been reported to have antitumorigenic activity in mouse colon, skin and duodenum models. The present study was designed to evaluate the molecular mechanisms of fucoxanthin against colon cancer using the human colon adenocarcinoma cell lines. Fucoxanthin reduced the viability of WiDr cells in a dose-dependent manner accompanied by the induction of cell cycle arrest during the G0/G1 phase at 25 microM and apoptosis at 50 microM. Fucoxanthin at 25 microM inhibited the phosphorylation of the retinoblastoma protein (pRb) at Ser780 and Ser807/811 24 h after treatment without changes in the protein levels of the D-types of cyclin and cyclin-dependent kinase (cdk) 4, whose complexes are responsible for the phosphorylation of pRb at these sites. A cdk inhibitory protein, p21WAF1/Cip1 increased 24 h after the treatment with 25 microM of fucoxanthin, but not p27Kip1. In addition, the mRNA of p21WAF1/Cip1 also increased in a dose-dependent manner. According to the experiments using the isogenic human colon adenocarcinoma cell lines, fucoxanthin failed to induce G0/G1 arrest in the p21-deficient HCT116 cells, but not in HCT116 wild-type cells. All of these findings showed that fucoxanthin inhibited proliferation of colon cancer cells. The inhibitory mechanism is due to the cell cycle arrest during the G0/G1 phase mediated through the up-regulation of p21WAF1/Cip1, which may be related to the antitumorigenic activity.

Antineoplastic Agents↗

PubMed2005

Temperature-dependent biosynthesis of glucose monomycolate and its recognition by CD1-restricted T cells.

Mycolic acids are long chain fatty acids that constitute the lipid-rich cell wall framework of mycobacteria. Upon infection, mycobacteria begin to synthesize glucose monomycolate (GMM), a glucosylated species of mycolic acids, by utilizing host-derived glucose as sugar source. Accordingly, GMM production serves as a good indicator for local invasion of mycobacteria, and its detection by the host immune system would favor efficient monitoring of mycobacterial infection. Here, we found that GMM was produced abundantly at 30 degrees C rather than at 37 degrees C and recognized by a GMM-specific, CD1-restricted T cell line that was isolated from mycobacteria-infected human skin. Since the common portal sites for mycobacterial infection include ventilating alveoli of the lung and the externally exposed skin that often render invading microbes survive at reduced temperature, sampling GMM by CD1 lipid antigen-presenting molecules may allow the host to detect mycobacterial infection at its early phases.

Antigens, CD1↗

PubMed2005

Artepillin C in Brazilian propolis induces G(0)/G(1) arrest via stimulation of Cip1/p21 expression in human colon cancer cells.

Potential chemopreventive agents exist in foods. Artepillin C in Brazilian propolis was investigated for its effects on colon carcinogenesis. We had found that artepillin C was a bioavailable antioxidant, which could be incorporated into intestinal Caco-2 and hepatic HepG2 cells without any conjugation and inhibited the oxidation of intracellular DNA. Artepillin C was then added to human colon cancer WiDr cells. It dose-dependently inhibited cell growth, inducing G(0)/G(1) arrest. The events involved a decrease in the kinase activity of a complex of cyclin D/cyclin-dependent kinase 4 and in the levels of retinoblastoma protein phosphorylated at Ser 780 and 807/811. The inhibitors of the complex, Cip1/p21 and Kip1/p27, increased at the protein level. On the other hand, Northern blotting showed that artepillin C did not affect the expression of Kip1/p27 mRNA. According to the experiments using isogenic human colorectal carcinoma cell lines, artepillin C failed to induce G(0)/G(1) arrest in the Cip1/p21-deleted HCT116 cells, but not in the wild-type HCT116 cells. Artepillin C appears to prevent colon cancer through the induction of cell-cycle arrest by stimulating the expression of Cip1/p21 and to be a useful chemopreventing factor in colon carcinogenesis.

Blotting, Northern↗

PubMed2005

Lymphoepithelioma-like carcinoma of the lung: case in which the patient has been followed up for 7 years postoperatively.

Primary lymphoepithelioma-like carcinoma (LELC) of the lung is a very rare disease. There is very little long term follow-up data about this disease. A 60-year-old woman was found to have abnormalities according to a routine chest X-ray examination. She was admitted to our hospital in March 1998. Since a malignant tumor of the right lung was suspected, surgical resection was performed in April of the same year. Pathological diagnosis was LELC of the lung. Its pathological stage was T1N0M0 stage IA. It has been reported that this carcinoma is associated with Epstein-Barr virus (EBV) infection. However, the patient's tumor cells were negative for EBV as examined with RNA in situ hybridization technique. She is alive and has been free from recurrence of the disease over 7 years postoperatively.

Biopsy, Needle↗

PubMed2005

Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer.

The diagnosis of lymph node metastasis in patients with papillary thyroid cancer is an important factor when deciding to perform neck dissection at the initial surgery, as well as for evaluating the lymph node swelling after surgery. Ultrasound (US)-guided fine-needle aspiration biopsy cytology (FNAB-C) is the most useful technique for diagnosing lymph node metastasis. Recently, however, measurement of thyroglobulin in the wash-out of the needle (FNAB-Tg) has been proposed for early detection of neck lymph node metastasis in patients with differentiated thyroid cancer. The purpose of this study was to evaluate the usefulness of FNAB-Tg in detecting lymph node metastasis prior to initial or reoperative thyroid surgery. US-guided FNAB-C was performed on 129 enlarged lymph nodes of 111 patients before surgery. All of them were later histologically confirmed to contain metastasis. Immediately after obtaining an FNAB-C specimen, the needle was rinsed with 0.5 ml of normal saline solution, and the wash-out was subjected to measurement of the Tg level (FNAB-Tg). If the FNAB-Tg level was higher than the serum Tg of the patient, we diagnosed the lymph node as positive (metastatic lymph node). FNAB-Tg sensitivity was 81.4%, and FNAB-C sensitivity was 78.0%. Altogether, 4 (36.4%) of 11 cases judged "benign" and 6 (37.5%) of 16 cases judged "inadequate" by FNAB-C were positive by the FNAB-Tg measurement. Thyroglobulin measurement in fine-needle aspiration biopsy wash-out is thus a useful technique for diagnosing lymph node metastasis of papillary thyroid cancer.

Biopsy, Fine-Needle↗

PubMed2005

Favorable surgical results in 433 elderly patients with papillary thyroid cancer.

Papillary thyroid cancer (PTC) has a good prognosis among patients younger than 45 years old, but the prognosis in elder is worse and treatment strategy is not well established. We retrospectively analyzed the clinical features and outcomes of 433 patients with PTC aged 70 years or older. The patients consisted of three groups: group A (n = 327); patients receiving surgical treatment, group B (n = 51); patients with microcancer (maximal diameter, < or = 1.0 cm) who did not undergo surgical treatment, group C (n = 55); patients in whom surgery was contraindicated due to age, high surgical risk or complication by other illnesses. In group A, the mean tumor size was 2.6 +/- 1.5 cm, and 218 patients (66.7%) had pathologically confirmed lymph node metastasis; 110 patients (33.6%) had extrathyroidal invasion. The 5- and 10-year overall survival rates (OSR) in group A were 97.2% and 85%, respectively, which was significantly higher than the 5-year OSR in group C (62.6%). The 5- and 10-year disease-specific survival rates (DSSR) in group A were 98.5% and 91.3%, respectively, which was also significantly higher than the 5-year DSSR in group C (81.8%). Although the patients in group B did not receive any treatment, none of them demonstrated cause-specific death or progression of disease. Papillary thyroid cancer in elderly patients, except for microcancers, may be biologically aggressive. Thus surgery is recommended for these patients, if their general status is judged able to tolerate the stress of anesthesia and surgery.

Aged↗

PubMed2005

Surgical treatment of superior sulcus tumors.

PURPOSE: To access the clinical outcome of patients with superior sulcus tumor. METHODS: We reviewed the records of 16 patients who underwent surgery for a superior sulcus tumor between 1988 and 2003, focusing on the type of surgery. RESULTS: All 16 patients underwent en bloc lung and chest wall resection, which was done as pneumonectomy in 1 patient and lobectomy in 15. Complete resection was achieved in 11 patients, but incomplete resection was done in 5 patients because microscopic examination revealed positive surgical margins. Eight patients underwent partial vertebrectomy and 1 patient had combined resection of the subclavian artery. There was no postoperative mortality. All patients received pre- or postoperative adjuvant therapy, or both. The overall 5-year survival rate was 31.0%. The 5-year survival rate was higher after complete resection than after incomplete resection (59.3% vs 0%, P = 0.08). Patients who underwent complete resection for vertebral invasion and those who did not had 5-year survival rates of 66.7% and 0%, respectively (P = 0.17). Patients who underwent preoperative induction therapy followed by complete resection and those who did not had 5-year survival rates of 80% and 0%, respectively (P = 0.009). CONCLUSION: Although superior sulcus tumors are still complex, preoperative induction therapy followed by complete resection seemed effective for prolonging survival.

Adult↗

PubMed2005

Effects of muscle potential depression and muscle stimulation caused by different insulation coating configurations on cardiac pacemakers.

Insulation coating was added to the external pacemaker surface to prevent unnecessary electric current leakage to the periphery because the pulse generator body is used as an anode in unipolar pacing. However, a model without insulation coating has recently been used, so we studied the effects on muscle potential inhibition and muscle stimulation of pacemakers in unipolar pacing with different parts of the pacemaker body coated with insulation. Case comparisons were made for the following models: insulated except for the center of one side (33, group C), insulated except for the peripheral zone (10, group E), and noncoated models (11, group N). The muscle detection threshold voltage, muscle detection threshold pulse duration, muscle potential sensing threshold (MP), and lead resistance were measured. A comparison was made of the amount of energy (En) needed to reach the muscle stimulation threshold. For MP values, there was no significant statistical difference between group C and E, whereas a significant difference was present between group C and N and between group E and N. For En values, there was a significant difference between group C and E and between group C and N, but there was no significant difference between group E and N. The muscle potential sensing threshold dose not have a change in group E and much muscle stimulation energy is needed. The muscle potential sensing threshold was low in group N, requiring much muscle stimulation energy. Based on these results, it is usually not necessary to coat the pacemaker with insulation for unipolar pacing.

Aged↗

PubMed2005

Primitive neuroectodermal tumor/Ewing's sarcoma with long-term follow-up.

We have reported a case of primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) in a 32-year-old female who had had no symptoms until the tumor was detected in a general examination after she gave birth. Chest X-ray showed a well-defined, rounded mass in the left lower lung field. Computed tomographic scan of the chest revealed a distinct mass adjacent to the anterolateral thoracic wall. The macroscopic findings had shown a well-capsulated tumor with a stalk emanating from the thoracic wall. PNET/EWS was histologically diagnosed. The tumor was composed of atypical, small round cells. It stained positively with antibodies to the MIC2 gene product. Postoperative adjuvant radiotherapy of 50 Gy was performed. Adjuvant chemotherapies were not performed. Four years later, a small recurrent nodule in the left lung was surgically resected. Since her initial diagnosis, the patient has survived for seven years; in the three years since her second surgery, she has had no other recurrence or metastasis.

Adult↗

PubMed2005

Basaloid carcinoma of the lung.

Basaloid carcinoma (BC) of the lung is a rare and an aggressive subtype of non small cell lung cancer. We report a patient with preoperative cytologic features of either lung BC or squamous cell carcinoma. Finally, the tumor was diagnosed as a pure BC of the lung by the immunohistological findings. The patient's recovery was uneventful and remained asymptomatic without recurrence 18 months after surgery. However, considering to the biological behavior of BC, regular follow-up for this patient will be required.

Aged↗