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Biomedical subjects

Kenji Suzuki

Publications and source records attributed to Kenji Suzuki.

At least 91 records · Page 5Linked to original sources
PubMed2004

Recent results of postoperative mortality for surgical resections in lung cancer.

BACKGROUND: Changes in the postoperative mortality rates and causes of death for lung cancer surgery at the specialized hospital for cancer in Tokyo, Japan during the last 16 years were investigated. METHODS: Data on 3,270 consecutive patients who underwent pulmonary resection for primary lung cancer between January 1987 and December 2002 at the National Cancer Center Hospital were retrospectively analyzed. The postoperative 30-day and in-hospital mortality rates and causes of death after pulmonary resection for lung cancer were investigated. Patients were divided into two period groups of almost equal number, the early (1,615 patients from 1987 to 1996) and the late (1,655 patients from 1997 to 2002) periods. RESULTS: Fifty-eight operative and postoperative deaths occurred during the last 16 years. Thirty-day and in-hospital mortality were 0.6% (21/3,270) and 1.6% (58/3,270), respectively. During the last 6-year period, 30-day and in-hospital mortality were 0.5% (8/1,655) and 0.8% (21/1,655), respectively. The difference was significant between the 30-day/in-hospital mortality for pneumonectomy (3.1%/5.9%) and lobectomy (0.3%/1.3%) (p < 0.0001/p < 0.0001). The difference in mortality between lobectomy and segmentectomy or a lesser resection was not significant. The 58 deaths were caused by pneumonia/acute respiratory distress syndrome (ARDS) (36%, n = 21), bronchopleural fistula (BPF)/empyema (33%, n = 19), cerebrovascular accident (10%, n = 6), cardiac-related event (7%, n = 4), and others (14%, n = 8). The most frequent cause of death in the early period was BPF/empyema (18/45, 40%), while that in the late period was pneumonia/ARDS (6/13, 46%). Among the pneumonia/ARDS deaths in the late period (n = 6), 5 (83%) were due to acute deterioration of interstitial lung disease after lobectomy. CONCLUSIONS: Recent postoperative mortality rates (30-day, 0.5%; in-hospital, 0.8%) in the treatment of lung cancer are quite acceptable. Special care must be taken for the patient after pneumonectomy, as reported by others. Furthermore, even after lobectomy, proper management of the patient with acute deterioration of interstitial lung disease will be required to improve the future outcome.

Cause of Death↗
PubMed2004

Combined resection of superior vena cava for lung carcinoma: prognostic significance of patterns of superior vena cava invasion.

BACKGROUND: Combined resection of the superior vena cava (SVC) for lung carcinoma remains challenging in terms of technical aspect and prognosis. We attempted to clarify the surgical outcome of combined resection and reconstruction of the SVC for lung carcinoma. METHODS: Between March 1980 and May 2001, among 3,499 lung resections, 40 (1.1%) patients underwent combined resection of the SVC. Thirty-four were men and 6 were women. Ages ranged from 37 to 77 years, with median of 64 years. Lobectomy and pneumonectomy was performed in 19 and 21 patients, respectively. The SVC system was totally resected and reconstructed with grafts in 11 patients, and partially resected in 29 patients. For the latter patients, autologous pericardial patches were used in 8 patients, and a running direct suture was performed in 21 patients. The survival curves were constructed by the method of Kaplan-Meier, and the curves were compared using the log-rank test. RESULTS: Thirty-day mortality was 10%. The 5-year survival rate was 24%, with the median follow-up period for living patients 67 months (actual 5-year survivors were 7). The prognoses were compared between patients with SVC invasion by metastatic nodes (n = 15) and those with SVC invasion by a direct tumor extension (n = 25), and the survival difference was statistically significant (5-year survival rate, 6.6% versus 36%; p = 0.05). CONCLUSIONS: The pattern of SVC invasion was considered to be a significant prognostic factor, and this factor should be taken into consideration for evaluating the outcome of clinical trials for T4 lung cancer.

Adult↗
PubMed2004

Clustering of components of the metabolic syndrome and risk for development of type 2 diabetes in Japanese male office workers.

To investigate the effects of the clustering of components of the metabolic syndrome (MS) on development of diabetes, we examined 3298 Japanese male office workers aged 35-59 years who did not have type 2 diabetes (a fasting plasma glucose level of > or =7.0 mmol/l or receipt of hypoglycemic medication) or a history of cardiovascular disease. Fasting plasma glucose levels were measured at periodic annual health examinations from May 1994 through May 2001. After adjustment for potential risk factors for diabetes, the multivariate-adjusted relative risk of type 2 diabetes compared with the subjects without components of the MS was 1.58 (95% CI: 1.08-2.32), 2.48 (95% CI: 1.69-3.63), 3.10 (95% CI: 2.05-4.68), and 5.22 (95% CI: 3.49-7.83) (P-value for trend <0.001) for those with 1, 2, 3, and > or =4 components, respectively. Even after the subjects were stratified according to fasting plasma glucose level, the clustering of components of the MS was associated with an increased risk of type 2 diabetes for subjects in all three categories of low-normal fasting glucose (a fasting plasma glucose level of <5.1 mmol/l), high-normal fasting glucose (a fasting plasma glucose level of 5.0-6.0 mmol/l), and impaired fasting glucose (a fasting plasma glucose level of 6.1-6.9 mmol/l). These results indicate that clustering of components of the MS associated with diabetes precedes an increase in the risk of type 2 diabetes in Japanese men.

Adult↗
PubMed2004

Components of the metabolic syndrome as predictors of cardiovascular disease and type 2 diabetes in middle-aged Japanese men.

To determine whether the clustered features of the metabolic syndrome precede the 7 year incidence of cardiovascular disease (CVD) and type 2 diabetes, we examined 6182 Japanese male office workers aged 35-59 years without any history of CVD. The 5588 subjects without type 2 diabetes also constituted the nondiabetic cohort, and were re-examined over seven successive years. Components of the metabolic syndrome included glycemic disorder (type 2 diabetes for the risk of CVD and impaired fasting glucose for the risk of type 2 diabetes), systemic obesity, hypertension, dyslipidemia, proteinuria, and elevated white blood cell (WBC) count. After controlling for age, family history of diabetes, alcohol intake, and cigarette smoking, the multivariate-adjusted relative risk of incidence of CVD compared with absence of components was 3.18, 3.48, 12.55, and 14.15 (P for trend <0.001), for the presence of 1,2,3, and > or =4 components, respectively. The corresponding relative risks of incidence of type 2 diabetes were 1.92, 4.36, 6.44, and 15.08 (P for trend <0.001). In both non-smokers and current smokers, the multivariate-adjusted relative risks of incidence of CVD and type 2 diabetes increased as the number of components increased (P for trend <0.001 for all). Our findings indicate that clustered features of the metabolic syndrome are closely associated with development of CVD and type 2 diabetes in middle-aged Japanese.

Adult↗
PubMed2004

Inflammatory myofibroblastic tumor of the lung.

OBJECTIVE: Inflammatory myofibroblastic tumor (IMT) is a rare disease that usually occurs in the lung. Recently, several reports have suggested that IMT is a true neoplasm rather than a reactive lesion. In this retrospective study, we reviewed clinicopathological characteristics and prognoses for all patients with surgically resected IMT of the lung at our institute. METHODS: From January 1985 to December 2002, nine patients had surgical intervention for IMT of the lung at the National Cancer Center Hospital, Tokyo. The resected lesions were studied histologically, immunohistochemically, and ultrastructurally. Follow-up was complete in all patients and varied from 3 months to 16 years 2 months (median, 6 years 2 months). RESULTS: These nine patients included five men and four women. They ranged in age from 25 to 66 years. Seven patients were asymptomatic. The two symptomatic patients had problems including cough, hemoptysis, and dyspnea. For all these patients, the diagnostic procedure was surgical excision. The resected tumor size ranged from 1.0 to 4.0 cm in diameter. Histologically, a variety of inflammatory and spindle cells were observed. The spindle cells corresponded ultrastructurally to myofibroblasts or fibroblasts. With the exception of one patient who had spontaneous resolution of a recurrent tumor, there was no recurrence in these patients, and all of them are in good health. CONCLUSIONS: Histopathologically, IMT is characterized by myofibroblasts that are mixed with chronic inflammatory cells, including plasma cells, lymphocytes, and histiocytes. Surgical resection, when possible, can be chosen as the treatment. Complete resection leads to excellent survival.

Adult↗
PubMed2004

Management of primary malignant germ cell tumor of the mediastinum.

BACKGROUND: Primary mediastinal malignant germ cell tumors (GCTs) are rare and have a worse prognosis than their gonadal counterparts. Although multimodality treatment is a standard therapeutic strategy in mediastinal GCTs, the clinical implications of surgical intervention remain unclear. METHODS: Forty-eight patients with primary mediastinal malignant GCT who were treated at the National Cancer Center Hospital, Tokyo, from 1962 to 2002 were studied retrospectively with regard to their histology and clinical profile. RESULTS: Mediastinal GCT occurred predominantly in young males, with a mean age of 28.8 years at the time of diagnosis. There were 46 males (96%) and two females (4%). Histologically, seven patients (15%) were diagnosed as having pure seminoma and 41 (85%) had non-seminomatous GCT. Treatment consisted of surgery alone in nine patients, surgery followed by chemotherapy in two, and chemotherapy followed by surgery in 20. The other 17 patients received chemotherapy and/or radiotherapy without surgery. Of these latter 17 patients, 14 developed progressive disease and three were followed up with a sustained partial response. Among the 31 patients who underwent surgery, complete resection was performed in 27 (87%) and incomplete resection was performed in four (13%). Twelve (41%) patients had elevated serum tumor marker levels preoperatively. Among the 20 patients who received preoperative chemotherapy, viable cells were found in the resected specimen in six (30%). With regard to tumor recurrence in patients with surgical intervention, the preoperative serum tumor marker levels and the presence of viable cells in the resected specimen were significantly associated with recurrence. There was no significant association between surgical curability and recurrence. The 5-year overall survival rate in all 48 patients was 45.5%. CONCLUSIONS: Surgical intervention for mediastinal GCT may be needed to remove a chemotherapy-refractory tumor or to assess the pathological response to chemotherapy to determine the indications for further chemotherapy.

Adolescent↗
PubMed2004

The X-ray crystallographic study of the conformation of Z-DNA which bound to polyamine for the minor groove at room temperature and low temperature.

We succeeded in x-ray crystal analysis of d(CG)3 with N1-{2-[(2-amino-ethylamino)-ethylamino]-ethyl}-ethane-1,2-diamine complex at three conditions (1: room temperature 2: low temperature 3: highly salt condition). At room temperature two polyamines took extended form and bound to minor groove of d(CG)3, at low temperature two polyamines took U-shape form and lied in minor groove of d(CG)3, at highly salt condition two polyamines took fishhook form and one polyamine lied in upper side of minor groove and the other polyamine lied in down side of minor groove of d(CG)3.

Crystallography, X-Ray↗
PubMed2004

Grade of stromal invasion in small adenocarcinoma of the lung: histopathological minimal invasion and prognosis.

The pathologic features of invasion such as stromal disruption and pleural/vascular involvement have been shown to be of prognostic value in adenocarcinoma. However, the relationship between the degree of invasion, histologic subtype of adenocarcinoma, and prognosis remains unclear. We retrospectively studied 380 peripheral adenocarcinomas of < or = 2.0 cm in diameter with regard to histology and clinical profiles. Their degree of invasive growth was classified into four grades as follows according to the structural deformity and its location in the adenocarcinoma lesion: Grade 0 had a pure bronchioloalveolar growth pattern and no evidence of stromal invasion. Grade 1 had stromal invasion in the area of bronchioloalveolar growth. Grade 2 had stromal invasion localized on the periphery of a fibrotic focus. Grade 3 had stromal invasion into the center of a fibrotic focus. The clinicopathological data were obtained from medical records. The distribution of the histologic grade of invasion was as follows: grade 0 in 85 tumors (22%), grade 1 in 37 (10%), grade 2 in 46 (12%), and grade 3 in 212 (56%). This histologic grade of invasion was closely related to other indicators of tumor spread. Vascular/lymphatic permeation was seen in none of grade 0, in 1 lesion each of grade 1 and grade 2, and 144 (68%) of grade 3. Lymph node metastasis was seen in 57 (27%) lesions of grade 3 but not in grades 0, 1, or 2. The 5-year disease-free survival rates were 100%, 100%, 100%, and 59.6% for tumors with grade 0, grade 1, grade 2, and grade 3 invasion, respectively. Tumors with grade 1 and grade 2 invasion, like tumors with grade 0 invasion (bronchioloalveolar carcinoma), showed an excellent prognosis. Therefore, tumors with grade 1 and grade 2 invasion could be considered "minimally invasive" or "early" adenocarcinomas.

Adenocarcinoma↗
PubMed2004

Extraction of left ventricular contours from left ventriculograms by means of a neural edge detector.

We propose a method for extracting the left ventricular (LV) contours from left ventriculograms by means of a neural edge detector (NED) in order to extract the contours which accord with those traced by a cardiologist. The NED is a supervised edge detector based on a modified multilayer neural network, and is trained by use of a modified back-propagation algorithm. The NED can acquire the function of a desired edge detector through training with a set of input images and the desired edges obtained from the contours traced by a cardiologist. The proposed contour-extraction method consists of 1) detection of "subjective edges" by use of the NED; 2) extraction of rough contours by use of low-pass filtering and edge enhancement; and 3) a contour-tracing method based on the contour candidates synthesized from the edges detected by the NED and the rough contours. Through experiments, it was shown that the proposed method was able to extract the contours in agreement with those traced by an experienced cardiologist, i.e., we achieved an average contour error of 6.2% for left ventriculograms at end-diastole and an average difference between the ejection fractions obtained from the manually traced contours and those obtained from the computer-extracted contours of 4.1%.

Algorithms↗
PubMed2004

Association of lung function with atherosclerotic risk factors among Japanese Americans: Seattle Nikkei Health Study.

1. Impaired lung function has been reported to be associated with mortality from all causes, cardiovascular disease (CVD) and aortic pulse wave velocity (PWV). The aim of the present study was to examine the association between impaired lung function and atherosclerotic risk factors, including PWV, blood pressure, lipids, smoking and alcohol intake, among Japanese Americans. 2. The study subjects were 678 adult Japanese Americans who participated in CVD screening conducted under the Seattle Nikkei Health Study. Subjects with abnormal lung function were defined as those with forced vital capacity (FVC%) < 80% of predicted or forced expiratory volume in 1 s (FEV1%) < 80% of predicted. We conducted logistic regression analyses by using abnormal lung function as dependent variables. 3. The significant predictors positively associated with abnormal FVC% were age (60 years or older) and hypertension. Being a current drinker or an ex-drinker was independently and negatively associated with abnormal FVC%. The significant predictors positively associated with abnormal FEV1% were age (60 years or older), sex (male), hypertension and being a current smoker. Being a current drinker was independently and negatively associated with abnormal FEV1%. 4. In conclusion, the present study does not support the previously reported association of abnormal lung function with PWV. However, our findings imply that light and moderate drinking may be a protective factor of lung function and that hypertension and smoking may impair lung function.

Alcohol Drinking↗
PubMed2004

Alpha-1 antitrypsin deficiency with severe pulmonary emphysema.

Alpha-1 antitrypsin (AAT) deficiency is a hereditary disorder characterized by an early onset of emphysema. While this disease is common in the Caucasian population, it is quite rare in Japan. To date, only 15 traits have been reported and it can be speculated that many cases of this genetic deficiency may have been overlooked. We report an additional case of AAT deficiency with severe emphysema that is genetically determined as S(iiyama) variant by allele-specific polymerase chain reaction (PCR) analysis.

Alleles↗
PubMed2004

Radiologists' performance for differentiating benign from malignant lung nodules on high-resolution CT using computer-estimated likelihood of malignancy.

OBJECTIVE: The purpose of our study was to evaluate whether a computer-aided diagnosis (CAD) scheme can assist radiologists in distinguishing small benign from malignant lung nodules on high-resolution CT (HRCT). MATERIALS AND METHODS: We developed an automated computerized scheme for determining the likelihood of malignancy of lung nodules on multiple HRCT slices; the likelihood estimate was obtained from various objective features of the nodules using linear discriminant analysis. The data set used in this observer study consisted of 28 primary lung cancers (6-20 mm) and 28 benign nodules. Cancer cases included nodules with pure ground-glass opacity, mixed ground-glass opacity, and solid opacity. Benign nodules were selected by matching their size and pattern to the malignant nodules. Consecutive region-of-interest images for each nodule on HRCT were displayed for interpretation in stacked mode on a cathode ray tube monitor. The images were presented to 16 radiologists-first without and then with the computer output-who were asked to indicate their confidence level regarding the malignancy of a nodule. Performance was evaluated by receiver operating characteristic (ROC) analysis. RESULTS: The area under the ROC curve (Az value) of the CAD scheme alone was 0.831 for distinguishing benign from malignant nodules. The average Az value for radiologists was improved with the aid of the CAD scheme from 0.785 to 0.853 by a statistically significant level (p = 0.016). The radiologists' diagnostic performance with the CAD scheme was more accurate than that of the CAD scheme alone (p < 0.05) and also that of radiologists alone. CONCLUSION: CAD has the potential to improve radiologists' diagnostic accuracy in distinguishing small benign nodules from malignant ones on HRCT.

Diagnosis, Differential↗
PubMed2004

Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men.

OBJECTIVE: To investigate the association between serum gamma-glutamyltransferase (GGT) and risk of metabolic syndrome and type 2 diabetes in Japanese male office workers. RESEARCH DESIGN AND METHODS: This study included 2,957 metabolic syndrome-free men and 3,260 nondiabetic men aged 35-59 years who did not have medication for hepatitis, alanine aminotransferase (ALT) levels higher than three times the upper limit of the reference range, or a history of cardiovascular disease at study entry. Subjects were reexamined at periodic annual health examinations over a 7-year period. We used a modified National Cholesterol Education Program definition of metabolic syndrome with BMI instead of waist circumference and the revised criteria of the American Diabetes Association for type 2 diabetes. RESULTS: With adjustment for age, family history of diabetes, BMI, alcohol intake, cigarette smoking, regular physical activity (fasting plasma glucose for the risk of type 2 diabetes), and white blood cell (WBC) count, the risk of metabolic syndrome and type 2 diabetes increased in correlation with the levels of serum GGT, ALT, aspartate aminotransferase (AST), and alkaline phosphatase. Additional adjustment for all of the other liver enzymes attenuated these associations, but serum GGT remained a significant risk factor for the risk of both metabolic syndrome and type 2 diabetes (P for trend <0.001 for both). Top one-fifth versus bottom one-fifth relative risks of metabolic syndrome and type 2 diabetes were 2.23 (95% CI 1.51-3.30) and 2.44 (1.34-4.46), respectively. CONCLUSIONS: These results indicate that serum GGT may be an important predictor for developing metabolic syndrome and type 2 diabetes in middle-aged Japanese men.

Adult↗
PubMed2004

Age-related change in relationship between white blood cell count and some features of the metabolic syndrome.

To examine age-related change in the strength of the association of white blood cell count (WBC) with features of the metabolic syndrome (MS), body mass index, blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, fasting plasma glucose, and uric acid were assessed as the components of the MS in 5,218 Japanese male office workers aged 23-59 yr. The subjects were stratified by age into three groups of 23-39, 40-49, and 50-59 yr. WBC count showed a positive crude correlation with the components of the MS, except for HDL cholesterol (negative), in all three age groups. With an increase in age, an association between WBC count and each component of the MS declined, and an interaction with age weakened. After controlling for potential confounders, the largest differences of WBC count for each categorized feature of the MS were found among those aged 23-39 yr. Stratified analyses by smoking status and age showed that in both non-smokers and current smokers the adjusted WBC count increased as the number of features of the MS increased in all three age groups. In each category of the number of clustered features of the MS, differences of WBC count compared with the presence of no features of the MS were the largest in those aged 23-39 yr in both non-smokers and current smokers. The adjusted odds ratios of > or =3 features of the MS also increased with an increase in WBC count in all three age groups in both non-smokers and current smokers. The adjusted odds ratios of > or =3 features of the MS across quartiles of WBC count (lowest to highest) were the largest in the youngest age group. Our results indicate that a variety of features of the MS are associated with WBC count and that these tendencies are more pronounced in younger individuals in both non-smokers and current smokers.

Adult↗
PubMed2004

[Adult fetal alcohol syndrome (FAS) with various nouropsychiatric symptoms].

This is the first report of an adult patients with the fetal alcohol syndrome (FAS) in Japan, who was treated for psychiatric disorders. The case was a 35 years-old woman who had many neuropsychiatric symptoms. She had been treated for 15 years at the Kurihama Alcoholism Center, for mental retardation, schizophrenic symptoms, attention deficit hyperactivity disorder, learning disorder, trichotillomania, bipolar disorder, and impulsive behavior. She had low body weight at birth, mental retardation and a small facial malformation, which were diagnosed as FAS. At first admission, she was not diagnosed as FAS because her parent denied that her mother drank during pregnancy. Recently, her family admitted her mother's heavy drinking during pregnancy, and we diagnosed her as having FAS. She showed many pathological symptoms of the central nervous system such as very lower scores for performance IQ than for verbal IQ in the WAIS-R and enlargement of the lateral ventricle on MRI. Recently many reports have mentioned that prenatal alcohol exposure brings about severe damage of the central nervous system. Therefore, one author proposes that such disorders are referred to as fetal alcohol spectrum disorders (FASD). This patient showed many symptoms of FASD, and was difficult to treat because of these symptoms.

Adult↗
PubMed2003

Novel and potent human and rat beta3-adrenergic receptor agonists containing substituted 3-indolylalkylamines.

A novel series of 2-(3-indolyl)alkylamino-1-(3-chlorophenyl)ethanols was prepared and evaluated for in vitro ability to stimulate cAMP production in Chinese hamster ovary cells expressing cloned human beta(3)-AR. The optically active 30a was found to be the most potent and selective human beta(3)-AR agonist in this series with an EC(50) value of 0.062nM. In addition, 30a selectivity for human beta(3)-AR was 210-fold and 103-fold that for human beta(2)-AR and beta(1)-AR, respectively. Furthermore, 30a showed potent agonistic activity at rat beta(3)-AR.

Adrenergic beta-3 Receptor Agonists↗