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Biomedical subjects

M Ohtsuka

Publications and source records attributed to M Ohtsuka.

At least 235 records · Page 13Linked to original sources

Comparison of the cardiovascular effect of FR34235, a new dihydropyridine, with other calcium antagonists.

We compared the cardiovascular effect of FR34235, a new dihydropyridine derivative, with the effects of nifedipine, nicardipine, and diltiazem on the dog using in vitro and in vivo preparations. FR34235 reduced the amplitude of coronary arterial contraction induced by K+ more so than that induced by norepinephrine in in vitro preparations. The ID50 values of FR34235 for various arterial strips contracted by K+ were smaller (1/5-1/426) than those of nifedipine and diltiazem, and almost the same as those of nicardipine. There was a greater increase in both the coronary and vertebral blood flow than in the other peripheral arterial flow in anesthetized dogs administered FR34235 (0.32-100 micrograms/kg i.v.), and the duration of effect was about two to three times longer than that of the other drugs. To obtain a vasodilating effect by the intraduodenal route, 10-30 times the intravenous dose of FR34235 was required, far lower than that required of nicardipine. In atrioventricular (AV) and sinoatrial node preparations, FR34235 was weaker in impairing AV conduction than nifedipine, in spite of their similar potencies in increasing coronary flow and decreasing sinus rate. FR34235 was more potent than diltiazem in increasing coronary flow, in spite of their similar potencies on AV conduction. It is concluded that FR34235 has: (a) potent vasodilating activity, probably due to inhibition of Ca2+ influx into the cells; (b) selective and long-lasting effects on the coronary and cerebral arteries in vivo; (c) a wide difference between doses that cause vasodilation and an impairing effect on AV conducting tissues; and (d) therapeutic effects after absorption from the intestinal tract.

Anesthesia↗

Trimethadione tolerance tests for the assessment of feasible size of hepatic resection in patients with hepatocellular carcinoma.

Pre-operative evaluation of the quantity of functional remnant hepatic parenchyma after hepatectomy was carried out to predict the optimal amount of hepatic resection using the trimethadione (TMO) tolerance test. This test is an estimate based on serum diamethadione (DMO)/TMO ratio (DMO is the only metabolite of TMO) 4 h after oral administration of TMO, and computed tomography (CT) scans of the liver in patients with hepatocellular carcinoma (HCC). The percentage of remnant hepatic parenchyma was calculated pre-operatively from the remaining non-cancerous portion and the whole hepatic parenchyma, excluding the HCC portion, using the CT scans. Presumptive remnant DMO/TMO ratio was calculated by multiplying the percentage of remnant hepatic parenchyma and pre-operative serum DMO/TMO ratio in 45 patients with HCC undergoing resection. The presumptive remnant DMO/TMO ratios were 0.31 +/- 0.10 (mean +/- s.d.) in 42 patients who survived hepatectomy and 0.13 +/- 0.02 (below 0.15) in the three patients who died from postoperative hepatic failure. Of these surviving patients, two patients who had the presumptive remnant DMO/TMO ratios under 0.15 developed postoperative severe complications. Thus, hepatectomy may not be indicated in patients where presumptive remnant DMO/TMO ratio is 0.15 and lower. These findings suggest that pre-operative measurement of presumptive remnant DMO/TMO ratio, when obtained with the CT of the liver and TMO tolerance test, is useful for prediction of the quantity of functional remnant hepatic parenchyma after hepatectomy in patients with chronic liver disease.

Adult↗

Spontaneous regression of multiple emphysematous bullae.

The etiology of emphysematous bullae is not well known; thus, the management of bullous lung disease is often difficult because of concomitant underlying emphysema and coexisting cardiac conditions. The present paper reports a case in which near complete resolution of multiple emphysematous bullae in the right lung occurred spontaneously. This case is of interest, not only because of the rarity with which spontaneous regression of multiple emphysematous bullae has been reported in the literature, but also because of the accompanying dramatic improvements in radiological results and pulmonary function of the patients.

Chest Tubes↗

Lung cancer in the octogenarian.

BACKGROUND: Older patients with lung cancer tend to have significant coexisting diseases and less aggressive treatment is often advisable. OBJECTIVE: To investigate the clinicopathological features of lung cancer in patients aged 80 years and over. METHODS: The medical records of 966 patients with lung cancer between 1976 and 1999 were reviewed retrospectively. RESULTS: There were 56 (5.8%) patients 80 years old or over. Thirty-nine (70%) were male, and 22 (39%) patients had poor performance status (2-4). Some of the patients had a medical history of cardiovascular disease (n = 23; 41%), cerebrovascular disease (n = 5; 9%), diabetes mellitus (n = 11; 20%), or malignant disease (n = 8; 14%). Twenty-one (35%) patients were diagnosed as having surgically resectable disease and 20 patients underwent radiotherapy, but 25 patients only received supportive care because of concomitant illnesses. Only 9 and 2 patients, respectively, had chemotherapy and surgery. There was no statistical difference in the survival rate of the two groups of patients receiving radiotherapy or supportive care. CONCLUSION: Adequate palliative care to provide prolonged quality survival is an appropriate primary goal of therapy for lung cancer in the octogenarian until less invasive treatments are developed.

Age Factors↗

Inverse relationship between P-glycoprotein expression and its proliferative activity in hepatocellular carcinoma.

Hepatocellular carcinomas (HCCs) from 31 patients, cirrhotic livers from 7 patients and normal liver from 8 patients were immunohistochemically assessed in frozen sections using anti-P-glycoprotein (Pgp) monoclonal antibody C219. Immunohistochemical staining with anti-Ki-67 monoclonal antibody MIB-1 was performed for 22 HCCs to assess proliferative activity. Tumor tissues expressed Pgp on the biliary surface and on the luminal surface of cancer cells, which was less extensive than in normal and cirrhotic liver hepatocytes. Expression of Pgp was closely associated with the degree of histological differentiation and the histological type of HCC. Labeling indices (LI) of Pgp expression were 0.68 +/- 0.06 (mean +/- SD) in well, 0.51 +/- 0.14 in moderately and 0.04 +/- 0.06 in poorly differentiated HCC (significant differences among the three groups). LI of Pgp expression in the trabecular (0.55 +/- 0.15) and in the pseudoglandular types (0.44 +/- 0.10) were remarkably higher than in the compact type (0.04 +/- 0.06). The extent of Pgp expression in HCC was significantly inversely related to the extent of Ki-67 expression, in which Pgp expression decreased in highly proliferating tumors. In conclusion, Pgp expression in HCC was clearly related to its proliferative activity.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Does earlier detection of lung cancer on mass screening improve outcome in younger and middle-age patients?

In order to demonstrate clinicopathological features, especially in relation to the detection of lung cancer in younger (<40 years) and middle-aged patients, a total of 850 patients with lung cancer were analyzed with reference to their basis for detection. Asymptomatic patients in their forties and fifties diagnosed on mass screening had higher prevalence rate of surgically resectable disease and better three-year survival compared with patients who required medical attention because of symptoms. Our results suggest that mass screening for patients under the age of 50 years does not change the outcome, however, patients in the age group 50-59 years receive some benefit in our screening system.

Adenocarcinoma↗

Diagnostic procedures in obtaining pathological materials for pulmonary nodules due to primary lung cancer.

This study analyzed the diagnostic procedures of 391 patients with a pulmonary nodule due to lung cancer encountered in the practice from 1987 to 1997. Transbronchial biopsy and cytological procedures under fiberoptic bronchoscopy made a diagnosis in 329 (84.1%) of the patients. In 266 patients with endoscopically invisible tumor, transbronchial biopsy gave a positive result in 74.1% and the rest were diagnosed by cytological procedures. Transbronchial biopsy with cytological procedures should be considered as the initial diagnostic procedure. The most appropriate method and combining methods can improve the diagnostic yield in patients with pulmonary nodules.

Adenocarcinoma↗

Long-term cure of a malignant lymphoma of the pleural cavity treated by irradiation.

Malignant lymphomas arise in the pleura in association with a long-standing chronic tuberculous pyothorax. We report a case of a non-Hodgkin's lymphoma of the pleural cavity, inoperable because of local invasion into thoracic wall, who has survived more than 6 years without recurrence. This patient represents the longest reported survival after radiation therapy alone. Radiotherapy holds an important role in the treatment of locally advanced lymphoma of the pleural cavity.

Aged↗

Intracranial hemorrhage due to cerebral metastasis of lung cancer - a case report.

Lung cancer often metastasizes to brain. However, hemorrhage of the metastatic lesions is uncommon. We report a case of a 68-year old man with lung cancer who underwent right upper lobectomy of the lung and presented in 15 months with a cerebral hemorrhage from a metastatic lesion of the brain.

Adenocarcinoma, Papillary↗

Unilateral metachronous lung cancers in a patient with idiopathic pulmonary fibrosis.

The incidence of lung cancer in patients with idiopathic pulmonary fibrosis is much higher than that in general population. We report on a case of large cell carcinoma in association with the additional occurrence, seven months later, of an adenocarcinoma of the lung. Surgical treatment was performed for each cancer, however, the outcome was poor. The association between the two disorders is discussed.

Adenocarcinoma↗

Atypical presentation of vertebral bone metastasis from lung cancer.

The authors describe a case of lung cancer in a 55-year-old man who complained of back pain. Initial isotopic bone scanning showed no abnormality, however, magnetic resonance (MRI) imaging revealed bone metastasis in thoracic vertebral bone. Even when there is no typical findings of metastasis in bone scintigraphy, MRI imaging would be useful if vertebral bone metastasis is suspected. MRI imaging is an important modality to evaluate extraosseous extension and marrow invasion of metastatic tumors.

Carcinoma, Large Cell↗

Patterns of brain metastasis in lung cancer.

Brain metastasis as the only site of spread in lung cancer was studied. Ninety-two (13.1%) of 701 lung cancer patients had brain metastasis at the time of diagnosis. Eighteen and 16 patients had small primary lesion and were N0-1 disease, respectively. Thirty-two patients had sole brain metastasis. Patients with sole brain metastasis had more favorable survival than patients with other metastatic sites (p=0.0165). Brain metastasis may occur even with small primary lesion and/or without regional lymph node involvement. Well-planned surgery or stereotactic radiosurgery will result in enhanced survival.

Adenocarcinoma↗

Lung cancer in middle-aged patients.

Clinicopathological features of middle-aged lung cancer patients were investigated in 1016 consecutive patients. Among them, 22.8% of patients were in their forties and fifties. The preponderance of adenocarcinomas and the higher female/male ratio in middle-aged groups compared with the older group were findings similar to those observed in younger patients. Smoking habit increased according to the age groups. Middle-aged patients had a propensity for advanced stage, however, survival was not inferior to younger patients. Middle-aged patients consisted of two different groups of patients, whose characteristics were similar to those observed in either younger or elderly patients.

Adenocarcinoma↗

Splenic metastasis of lung cancer.

Splenic metastasis from a lung cancer is infrequently noted, however, the pattern of the metastasis has not been studied, thus we conducted a retrospective study. Twelve of the consecutive 997 patients with lung cancer, who were admitted to our division, developed splenic metastasis. The pattern of splenic metastasis involved solitary nodule in 7 patients (58.3%); multiple nodules in 4, and microscopic metastasis in 1. All of the 12 patients had other abdominal organ metastasis. Splenic mass accompanying metastasis to other abdominal organs in a patient with a known lung cancer should be regarded as a metastasis.

Abdominal Neoplasms↗

Lung cancer patients with cardio- and cerebrovascular diseases.

Cardio- and cerebrovascular diseases (CCVD) and cancer are the leading causes of death for humans. The aim of this study was to demonstrate clinicopathological features of lung cancer patients with CCVD. Nine hundred and sixty-six patients with lung cancer were consecutively admitted to our division over a 24-year period. Among them, 254 (26.3%) patients were diagnosed as having CCVD based on medical records. One hundred and ninety-one were men and 143 were 70 years of age or older. There was a difference in smoking habit (p=0.0029) and 30 pack year or more history of smoking (p<0.0001) between lung cancer patients with or without CCVD. Among the 254 patients, 97 patients had stage IA-IIIA disease, however, 27 patients received chest irradiation or supportive care because of coexistence of CCVD. In 157 patients with locally advanced or metastatic disease, 58 patients had less intensive therapy. In multivariate analysis, existence of CCVD in patients with non-small cell lung cancer (NSCLC) was proven to be a prognostic factor (p=0.0466). Our results imply that existing CCVD do adversely affect the outcome of NSCLC. When we decide whether or not to offer an intensive therapy which may increase treatment-related mortality, patients' medical condition including CCVD should be taken into consideration.

Adult↗

Peritoneal carcinomatosis in lung cancer patients.

Metastatic involvement of the peritoneum is not a very rare autopsy finding. Clinically, however, peritonitis carcinomatosis from a lung cancer is infrequently encountered and the pattern of the metastasis has not been studied. A total of 1041 patients with lung cancer who were admitted to our division over a 26-year period were retrospectively analyzed. Twelve (1.2%) of the 1041 patients with advanced lung cancer developed peritoneal carcinomatosis in their clinical courses. The incidence of peritoneal carcinomatosis was high in patients with large cell carcinoma and adenocarcinoma. Six and 9 of the 12 patients had metastases in intra-abdominal sites and pleural seeding, respectively. The median survival time from the diagnosis of peritoneal carcinomatosis was 2 months. Ascites accompanying metastasis to abdominal organs and pleural seeding in a patient with a known lung cancer would be regarded as a metastasis.

Abdominal Neoplasms↗