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Biomedical subjects

M Kiriyama

Publications and source records attributed to M Kiriyama.

At least 73 records · Page 4Linked to original sources
PubMed1995

Esophageal tracheobronchoplasty for membranous laceration caused by insertion of a dumon stent--maintenance of oxygenation by percutaneous cardiopulmonary support.

A 39-year-old man, whose airway was narrowed due to relapsing polychondritis, sustained a tracheobronchial injury during intubation with an internal stent. In the posterior membranous trachea and left main stem bronchus, a 5-cm longitudinal tear extended across the carina. Oxygenation was maintained by percutaneous cardiopulmonary support (PCPS) before and during the operation. An original esophageal tracheobronchoplasty for repair of the membranous laceration is described. Currently, the patient is asymptomatic 16 months after the surgery.

Adult↗
PubMed1995

Effects of sevoflurane on respiratory activities in the phrenic nerve of decerebrate cats.

Although the depressive effect of sevoflurane on ventilation has been reported, its potency and mode of action on the neural respiratory activity is still unclear. Therefore, the effects of sevoflurane on the phrenic nerve discharge and the respiratory timing were compared with those of halothane. The efferent activity of the phrenic nerve was recorded from decerebrate, un-anesthetized and artificially ventilated cats, and its power spectrum was calculated. The inspiratory and expiratory periods were measured. Sevoflurane and halothane of the doses of 0.5-1.5 MAC were inhaled for 15 min. With 0.5 MAC, sevoflurane decreased the total power and two dominant spectral components of the high-frequency oscillation and medium-frequency oscillation in the power spectrum. With the same MAC dose, halothane had a greater depressive effect in a normocapnic condition with the vagus nerves being intact. In a state of hypercapnia or after vagotomy, the effect of halothane was considerably attenuated whereas that of sevoflurane remained unaltered. Halothane increased the neural respiratory rate much more than sevoflurane in both normocapnic and hypercapnic states. Vagotomy significantly weakened the effect of halothane to increase the respiratory rate but did not modify the effect of sevoflurane. With 1.0-1.5 MAC, both anesthetics severely decreased the phrenic power spectra and the potency difference became indistinct. The present findings demonstrate that sevoflurane has a weaker depressive effect on the respiratory nerve discharge and a smaller effect on the neural respiratory rate than halothane when the effects of 0.5 MAC were compared.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1995

Increase in total blood leukocyte count following intranasal administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in rabbits with cyclophosphamide-induced leukopenia.

We investigated the effects of intranasal (i.n.) administration of recombinant human granulocyte colony-stimulating factors (rhG-CSF) on the total count of leukocytes in peripheral blood (total blood leukocyte count) of rabbits with leukopenia who received cyclophosphamide (CPA). When CPA (30 mg/kg per d) was administered intravenously, the total blood leukocyte count decreased to levels below 5000/microliters approximately 4 d after the initiation of CPA multiple dosing. The decreased level of the total blood leukocyte count was maintained throughout the period of CPA dosing. RhG-CSF was given once a day for 3 d in CPA-treated rabbits via i.n. administration of aqueous preparations containing rhG-CSF with or without alpha-cyclodextrin (alpha-CyD). The total blood leukocyte count increased from levels below 5000/microliters to the normal physiological level following i.n. administration of rhG-CSF preparation and reduced the period of leukopenia induced by CPA. The coadministration of rhG-CSF and alpha-CyD was more effective in increasing the total blood leukocyte count. It is suggested that i.n. administration of rhG-CSF is promising for reducing the risk of cytotoxic chemotherapy (CPA)-induced leukopenia as an adverse side effect.

Administration, Intranasal↗
PubMed1995

New compressed tablet rapidly disintegrating in saliva in the mouth using crystalline cellulose and a disintegrant.

We formulated a new compressed tablet which is rapidly disintegrated and dissolved in the mouth without the need to drink water. The crushing strength increased with increasing compression force and maximum values (8-18 kgf) for the formulations comprising crystalline cellulose and low-substituted hydroxypropylcellulose (L-HPC) were obtained at the compression force of 300 kgf. Rapid disintegration (within 30 s) was obtained in vitro using various compounding ratios of crystalline cellulose to L-HPC. Tablets prepared with crystalline cellulose and L-HPC rapidly disintegrated in saliva (small amount of water) in the mouth of humans.

Cellulose↗
PubMed1995

Pharmacokinetics and pharmacodynamics of recombinant human granulocyte colony-stimulating factor (rhG-CSF) following intranasal administration in rabbits.

The objective of this study was to evaluate the pharmacokinetics and pharmacodynamics of G-CSF as well as their relationship following intranasal (i.n.) administration of aqueous rhG-CSF preparations with or without additives. In order to achieve a better understanding of the dosage regimen and the effectiveness of intranasally administered rhG-CSF in inducing leukopoiesis, we investigated rhG-CSF absorption and blood leukocyte dynamics with respect to dose in rabbits. RhG-CSF could be absorbed through the nasal cavity of rabbits when rhG-CSF aqueous preparations, especially those containing alpha-cyclodextrin (alpha-CyD) were intranasally administered. We found that serum G-CSF levels and the total count of leukocytes in peripheral blood (total blood leukocyte count) showed a dose-dependent increase with rhG-CSF. The area under the serum G-CSF concentration-time curve (AUC, a pharmacokinetic parameter) and the area under the increased total blood leukocyte count-time curve (AUL, a pharmacodynamic parameter) increased with increase of dose of rhG-CSF administered intranasally. Good agreement was observed between log AUC and AUL; thus, it is concluded that an increase of AUC leads to an increase in effectiveness of rhG-CSF in inducing leukopoiesis in rabbits. A novel rhG-CSF delivery system in the form of i.n. administration of rhG-CSF was thus achieved.

Administration, Intranasal↗
PubMed1995

[A study of chemotherapy for patients with severely advanced gastric cancer--comparison of chemotherapy and route].

We analyzed the clinical response, toxicities, ambulatory and overall survival time among 51 patients with inoperable gastric cancer, to evaluate chemotherapies and drug delivery routes. Twenty-nine patients were treated by Methotrexate/5-FU (FMTX) therapy and 22 by 5-FU/CDDP (FP) therapy. Twenty-five patients were treated by intra-arterial (IA) route and 26 by intra-venous (IV). The response rate of IA therapy was higher than that of IV therapy (p < 0.05), 48% and 19%, respectively. Median survival times of FMTX and FP were 361 and 289 days, respectively, and the 1-year survival rates of FMTX and FP were 44% and 33%, respectively, with no significant differences. Duration of home chemotherapy with FMTX was longer than that with FP, at 130 and 85 days, respectively. There was no difference between duration of home chemotherapy of IA and that of IV. IA chemotherapy showed a higher response rate than IV, but there were no differences in the incidence of side effects and ambulatory and overall survival time.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Effect of low dose CDDP/5-fluorouracil therapy on PCNA labeling index and TS inhibition rate of gastric cancer].

The response of gastric cancer to intravenous application of low-dose CDDP plus 5-fluorouracil (FP) was assessed by changes in DNA indices (DIs) and PCNA labeling indices (LIs) by flow cytometry, and by the thymidylate synthetase inhibition rate (TSIR). Pretherapy samples were compared to specimens resected at operation. FP therapy was performed in 10 of 26 specimens and not in the others (C). There was no difference between change in DIs of FP group and that of C group. In FP group, PCNA LI of resected specimen was higher than that of biopsy, although they showed almost the same values in C group. Change in PCNA LIs correlated to TSIR in FP group. These results suggest that FP therapy affects gastric cancer cells in PCNA LIs and TSIR, and that PCNA LIs could be an indicator of the effect of FP therapy as TSIR.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

[Two cases of hepatic metastasis of colorectal cancer treated effectively by intrahepatic arterial infusion immunotherapy using OK-432, rIL-2, MMC and 5-FU].

Two cases of hepatic metastasis of colorectal cancer were treated effectively by intrahepatic-arterial infusion immunotherapy using OK-432 (2 KE/week or 2 weeks), recombinant IL-2 (35 x 10(4) JRU or 40 x 10(4) JRU/week or 2 weeks), MMC (4 mg/week or 2 weeks) and 5-FU (250 mg/day during admission, 250 mg/week or 2 weeks during outpatient treatment). The levels of CEA were decreased from 17.2 ng/ml to 2.4 ng/ml after 8 weeks in the first case (50 y. o. male) and from 521 ng/ml to 66 ng/ml after 8 weeks in the second case (36 y. o. female), respectively. Abdominal CT revealed a partial response for 11 months in the first case and 6.5 months in the second case.

Adult↗
PubMed1994

[Methotrexate/5-fluorouracil therapy in gastric cancer with peritoneal metastasis].

Eighteen patients with gastric cancer with peritoneal metastasis were treated with methotrexate/5-fluorouracil sequential therapy. In four patients, a partial response was obtained and in another four, symptomatic relief was obtained by the therapy. As side effects, BM suppression was seen in 9 and GI symptoms in 6 patients. Intraaortic, low-dose and 3-hour-interval procedure are recommended in the therapy.

Adenocarcinoma↗
PubMed1994

[Patterns of mediastinal and supraclavicular metastases in apical invasive lung cancer--importance of supraclavicular lymph node dissection].

Thirty-one patients with apical invasive lung cancer, who underwent surgical therapy were analyzed. In the patients with palpable nodal metastases in the supraclavicular region, the lymph nodes were dissected through a collar incision in supine position after thoracotomy. In the patients without palpable nodes, the supraclavicular nodes were dissected through the same wound and in the same position after the tumor was resected by the hook or anterior approach. N factor was N0 in eighteen patients, N1 in two patients, N2 in seven patients, and N3 in four patients. The ratio of supraclavicular metastasis was 33.3%. Patterns of mediastinal and supraclavicular metastases were classified into three types. Type I (supraclavicular type): metastasized directly to the supraclavicular nodes via the chest wall, Type II (mediastinal type): metastasized via a common route from hilum to mediastinum, Type III (mixed type): combination of Type I and Type II. Of the nine patients who had N2 or N3 disease uncovered by supraclavicular lymph node dissection, one patient was Type I, six were Type II, and two were Type III. Of the four patients with supraclavicular node metastasis, two had palpable nodes and two histological metastasis. The nodes were metastasized via the chest wall in three patients. Two patients with N3 disease are still alive without recurrence, one patient for eighty-six months and another for twenty months after the operation. Since supraclavicular lymph nodes are local and very near from involved structures of apical invasive lung cancer, dissection of these nodes will provide improved prognosis.

Adenocarcinoma↗
PubMed1994

Bone turnover and calcium metabolism during 20 days bed rest in young healthy males and females.

Bone is a dynamic tissue that functions not only as a mechanical support, but also as a major component of the metabolic and endocrine systems maintaining mineral homeostasis. It has been shown that immobilization induces decalcification of bone. To evaluate the effect of immobilization on bone mineral density and calcium metabolism, we investigated 9 young healthy males and females during 20 days bed rest. Three methods for measuring bone mineral density were performed to quantify whole body and regional bone changes: 1) dual energy X-ray absorptiometry, 2) quantitative computed tomography, and 3) multiple scanning X-ray photodensitometry, respectively. Bone mineral density showed a rapid decreasing tendency, especially in both lumbar and metacarpal bones (mean +/- SE: 4.6 +/- 0.6% and 3.6 +/- 0.4%, respectively). Urinary daily excretion of deoxypyridinoline, a sensitive marker of bone matrix resorption, tended to increase by day 10, and to decline by day 20 (mean +/- SE: 42.2 +/- 1.4, 27.6 +/- 2.2 nmol day-1, respectively). However, neither alkaline phosphatase nor tartrate-resistant acid phosphatase, both markers of osteoclast and mature osteoblast function, changed. These results showed that in the early stage of immobilization, bone matrix might be resorbed without any activation of osteoclasts, resulting in rapid decalcification of vertebral and cortical bones without any discernible changes in anatomical structure.

Absorptiometry, Photon↗
PubMed1994

Metabolic turnover of bone and peripheral monocyte release of cytokines during short-term bed rest.

Immobilization induces abnormal bone metabolism and rapid decalcification. Measurements of bone mineral content disclosed rapid decalcification, especially in lumbar vertebral and metacarpal bones in our short-term 20-day bed rest study. Many factors could contribute to the marked demineralization. The activities of osteoclasts and osteoblasts were studied by following serum levels of tartrate-resistant acid phosphatase and alkaline phosphatase, biomarkers for osteocyte activity. There were no alterations in these enzymes during bed rest. However, urinary excretion of pyridinium cross-links, resorption markers of bone matrix itself, increased by day 10 with subsequent decrease at day 20. So decalcification was induced without any relation to osteoclast activity. As cytokines strongly modulate the function of osteoclasts, peripheral monocyte release of interleukin 1 alpha and tumor necrosis factor alpha were assayed to determine the contribution to this rapid demineralization. Cytokines were released transiently by day 7 and later rapidly decreased. However, there was no correlation between cytokine release and bone matrix resorption.

Acid Phosphatase↗
PubMed1994

Psychological effects of bed rest in young healthy subjects.

In order to evaluate the effect of immobilization during bed rest on mental health, we performed psychosomatic investigations of 6 young males and 3 young females before, during and after 20 days bed rest. The psychological state was repeatedly assessed by measuring the following indices: 1) Zung's self-rating depression scale, 2) Cornell medical index, and 3) the General Health Questionnaire. Zung's self-rating depression scale is a measure of the state of depression, while Cornell medical index and the General Health Questionnaire are utilized for detection of neurosis. Although no influence of bedrest on Cornell medical index was seen, Zung's self-rating depression scale and the General Health Questionnaire displayed a tendency to development of depression and neuroses, respectively. This tendency had disappeared 2 months after the bed rest study. Both Zung's self-rating depression scale and the General Health Questionnaire may be appropriate indices to evaluate the effects of relatively short-term psychological stress due to bed rest. The urinary excretion of 17-hydroxycorticosteroid was used as an indicator of endocrine stress factors, but no significant variation due to bed rest was seen. We concluded that there is a need for further studies combining physiological research with psychosomatic investigations.

17-Hydroxycorticosteroids↗
PubMed1994

[Hook approach for radical resection of invasive apical lung cancer].

The hook approach provides safe identification and a wide view of subclavian vessels and branchial plexus on both their extra-thoracic and intra-thoracic aspects by a long skin incision resembling a "hook" and by tilting the table and moving the arm. The hook approach permits dissection of fat pad including supraclavicular lymph nodes from the same wound. This approach is suitable for invasive apical lung cancers without involvement of sternum. A patient with invasive apical lung cancer who received combined resection of the subclavian artery, vertebral artery, lower trunk of brachial plexus, (C8, Th1), third and fourth thoracic vertebrae, and first 4 ribs is presented and details of the hook approach is described.

Humans↗
PubMed1994

[Chronic empyema associated with large cell carcinoma of lung: case report with review of the literature].

A 71-year-old female was seen with a complaint of chest pain and cough, and a history of tuberculous pleurisy and artificial pneumothorax 40 years ago. The diagnosis of empyema with carcinoma was made by chest X-ray and CT scans. The examination of lung function showed a restrictive disorder. The value of the predicted postoperative FEV1 0.75 l encouraged to perform operation. A left pleuropneumonectomy and combined resections of the invasive portion of the pericardium and left atrium was performed. Histological examination revealed large cell carcinoma of lung (pT 4 N 1 M 0). The literatures are reviewed concerning the thoracic malignant tumor arising in chronic empyema cavity on Japanese cases.

Aged↗
PubMed1993

Protective effect of AA-861 (5-lipoxygenase inhibitor) on experimental acute necrotizing pancreatitis in rats.

The effect of the 5-lipoxygenase inhibitor AA-861 on acute necrotizing pancreatitis was studied in an experimental model. Pancreatitis was induced in rats by retrograde injection of 0.4 mL/kg body wt of 6% taurocholic acid into the pancreatic duct. The animals were divided into three groups: control group; administered AA-861 in a single dose of 30 mg/kg; and administered AA-861 in a single dose of 60 mg/kg. The following parameters were examined: serum amylase, lipase, trypsin, blood sugar, and survival rate. Histology of the pancreas was also studied. The serum amylase and lipase activities in groups 2 and 3 were lower than those in group 1 in the early phase after induction of pancreatitis. The elevation of serum trypsin was not suppressed by AA-861. Blood sugar was more efficiently controlled in groups 2 and 3 than in group 1. The survival rates in groups 2 and 3 were better than that in group 1, but there were no significant differences among the three groups. Histologically, massive tissue necrosis with hemorrhage, edema, and inflammatory cell infiltration was prominent in group 1, whereas such changes were obviously suppressed in groups 2 and 3. The results suggest that AA-861 may prove useful in the treatment of acute pancreatitis.

Acute Disease↗