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Biomedical subjects

R Saito

Publications and source records attributed to R Saito.

At least 145 records · Page 8Linked to original sources
PubMed1996

Analysis of results of surgery performed over a 20-year period on 500 patients with cancer of the thoracic esophagus.

This study was conducted to examine the long-term outcome of 500 patients who underwent surgery for cancer of the thoracic esophagus during the past 20 years. Favorable results were obtained with postoperative adjuvant radiation and chemotherapy and there were no surgical deaths in the last 5 years. The mortality rate decreased from 17% prior to 1980 to 5% between 1981 and 1993, this being most probably attributable to the decreased incidence of suture leakage. With respect to changes in surgical techniques, during the initial years we performed intrathoracic anastomosis, after which sternal manubrium resection with anterior mediastinal esophagogastrostomy was carried out. Subsequently, we invented a technique for performing esophagogastrostomy via the posterior mediastinum. The posterior mediastinum was selected as the most physiologic route, based on measurement of tissue oxygen tension. Using blood flow determinations obtained by laser-Doppler velocimetry, we concluded that the effectiveness of thicker gastric tubes was superior to that of thin tubes. Esophagogastrostomy was performed in a shallow field in the cervical region, with the anastomosis ultimately positioned in the superior mediastinum and covered with mediastinal pleura.

Anastomosis, Surgical↗
PubMed1996

Phase I study of a carboplatin-cisplatin-etoposide combination chemotherapy in advanced non-small-cell lung cancer.

Cisplatin (CDDP)-containing chemotherapy has become the mainstay of clinical trials in unresectable non-small-cell lung cancer (NSCLC), but the role of chemotherapy in the routine management of NSCLC remains controversial. We conducted a phase I study with the combination carboplatin (CBDCA), CDDP, and etoposide (Etop) in unresectable NSCLC. CBDCA, at a starting dose of 80 mg/m2, on day 1, was combined with a fixed dose of CDDP (80 mg/m2, day 1) and Etop (80 mg/m2, days 1-3). Escalation was performed after four patients entered at each dose level. If no World Health Organization (WHO) grade 4 toxicity developed after the first cycle in more than half of the patients or WHO grade 3/4 toxicity in more than two thirds, the dose was escalated. The maximum tolerated dose was established at 300 mg/m2 for CBDCA. Thrombocytopenia and leukopenia were the dose-limiting toxicities. No grade 3/4 nonhematologic toxicities were seen. The recommended dose of CBDCA to be combined with CDDP (80 mg/m2, day 1) and Etop (80 mg/m2, days 1-3) is 280 mg/m2. This trial suggests that our combination chemotherapy may be effective in patients with advanced NSCLC. A multicenter phase II study based on these findings is now under way.

Adult↗
PubMed1996

Granulomatous pigmented purpuric dermatosis.

We report two cases of brown pigmentation accompanied by hemorrhagic papules. A 61-year-old woman and a 53-year-old woman presented with brown pigmentation accompanied with hemorrhagic papules occurring bilaterally from the dorsal aspect of the feet to the lower legs. The clinical picture was of pigmented purpuric dermatosis, but histopathologically, they were hemorrhagic granulomatous inflammation of the upper dermis. As no systemic granulomatous lesions were observed, these cases were considered to be granulomatous pigmented purpuric dermatosis.

Chronic Disease↗
PubMed1996

Development of low potassium solution (EP4 solution) for long-term preservation of a lung transplant: evaluation in primate and murine lung transplant model.

The results of recent studies on long-term preservation using low potassium flush solution, which was originally produced in our department, are presented and discussed. In the primate model, a lung preserved for 24 h with EP4 solution retained sufficient function in single lung allotransplantation. In the murine experiments, we have evaluated the ion transport properties across alveolar epithelial cells in the transplanted lung using the tools of alveolar fluid clearance tests. The alveolar fluid clearance rate, which can be inhibited by 10(-3) M ouabain, is also well preserved for the first 24 h, indicating that the alveolar epithelial Na-K-ATPase is still functioning and that the 72 h preservation decreases those function of Na-K-ATPase in a time-dependent manner. In conclusion, because 24 h hypothermic preservation with EP4 solution did not show any obvious disadvantage on primate lung allografts and the cellular and molecular viability of the preserved lung flushed with EP4 solution could be retained for 24 h, this kind of solution with extracellular electrolyte composition can be applicable in the clinical settings.

Animals↗
PubMed1996

Immune-associated cells in basal cell carcinomas of skin.

Increased numbers of mast cells (MCs) and lymphocytes infiltrating in basal cell carcinomas (BCCs) have been observed. The presence of these infiltrating cells has been considered a sign of an immunologic anti-tumor response in the host, but the relationship of these two cell populations has not been examined. To elucidate this possible relationship, 30 non-ulcerated BCCs were analyzed. Frozen sections of the tumors were stained with monoclonal antibodies for Langerhans' cells, lymphocyte subsets and natural killer cells. Fluorescein isothiocynate (FITC)-avidin as well as anti-tryptase and anti-CD45RO monoclonal antibodies were used on formalin-fixed, paraffin-embedded sections for mast cell and T cell identification, respectively. B cells and natural killer cells were rarely observed in these tumors. MCs and T cells were quantified by direct enumeration and expressed as number of cells per high power field (hpf). FITC-avidin and anti-tryptase antibodies were equivalent in their ability to identify MCs. MC content in BCCs ranged from 1.0 to 31 cells/hpf. The number of T cells ranged from 0 to 50 cells/hpf with helper/suppressor cell ratios of 0.2 to 10. There was no correlation between helper/suppressor ratios and mast cell numbers; however, an inverse relationship was observed between the numbers of T cells and the number of mast cells in these tumors. These studies indicate that T cells and MCs are the primary immune cell populations responding to BCCs, and that decreased numbers of T cells are associated with more aggressive tumors.

Basal Cell Carcinoma↗
PubMed1996

[Clinicopathologic assessment of primary thymic carcinoma based on eighteen cases].

In order to study clinicopathologic characteristics of thymic carcinomas, 18 patients with thymic carcinoma and 56 patients with invasive thymoma were reviewed. All of them were underwent thoracotomy. Both 5-year and 10-year survival rates were 44% in the thymic carcinoma patients, while 5-year survival and 10-year survival rates were respectively 62% and 52% in the invasive thymoma patients. The survival rate of the thymic carcinoma cases was significantly lower than that of invasive thymoma cases (p < 0.05). Both surgical technique and anticancer chemotherapy. However, have been improved in these years, such as artificial vessels for great veins, panpleuro-pneumonectomy, cisplatin and so on. Those new techniques have brought the significantly higher survival rate in recent 10 cases of thymic carcinoma patients. Three-year survival rate of 10 cases after 1990 was 80% and it was 13% in 8 cases before 1989 (p < 0.01). We conclude that surgical procedure are necessary for the treatment of thymic carcinoma patients, and both chemotherapy and radiotherapy should be combined with the surgical procedures to completely remove the tumors.

Adult↗
PubMed1996

[A case of idiopathic thrombocytopenic purpura combined with lung cancer].

A 71-year-old male was admitted to our hospital because of a chest abnormal shadow. His chest X-ray film showed a mass in the right lower lobe (S6), which was diagnosed as adenocarcinoma by transbronchial lung biopsy. A lab data on the admission showed thrombocytopenia (44,000 per cu. mm), and the results of the bone marrow aspiration was compatible with idiopathic thrombocytopenic purpura. Immediately after the right lower lobectomy with lymphnode dissection, intrathoracic bleeding from the wound due to hemorrhagic tendency appeared necessitating a re-thoracotomy. High-dose intravenous gamma-globulin infusion for 4 days and the frequent concentrated platelet transfusion were employed to prevent the hemorrhagic tendency after the 2nd operation, and the postoperative hemorrhage was successfully controlled. Perioperative high-dose intravenous gamma-globulin infusion was concluded to be useful in the patient of idiopathic thrombocytopenic purpura for preventing hemorrhagic tendency after the operation.

Adenocarcinoma↗
PubMed1996

[Assessment of prognostic factors in surgical treatment for the pulmonary metastasis of osteosarcoma based on results of 17 patients].

Seventeen cases with surgical treatment for pulmonary metastases of osteosarcomas have been experienced for past 20 years in our institute. Disease free intervals, tumor doubling time, the number of metastatic lesions, the size of metastatic lesions, pathological features on nuclear findings were assessed in relation to their prognosis. These parameters were concluded to have no significant relations to the survival outcomes after the surgery for pulmonary lesions except for the number of metastatic lesions less than 20 in total which is likely to be associated with long survivals, supporting previous reports on the resectability of pulmonary metastatic lesions as an only reliable prognostic indicator. It was also stressed from our experience that the meticulous follow-up after each surgery for both primary and metastatic lesions is absolutely necessary for the early detection of recurrent pulmonary lesions in order not to overlook curable cases with aggressive treatment.

Adolescent↗
PubMed1996

[Experience with one-lung anesthesia using balloon catheter for patients with terminal tracheostomy].

We experienced two cases of lung cancer with terminal tracheostomy. Conventional double lumen tubes such as the Broncho-Cath or the Robertshaw were not applicable for one-lung anesthesia for these cases because of anatomical reasons due to the total laryngectomy. One left lower sleeve lobectomy and a right middle lobectomy were performed under one-lung ventilation using an occlusion balloon catheter that was introduced through a seath placed in the spiral type tracheostomy tube through a plastic connector. This method has three advantages: 1) a spiral type tracheostomy tube is easily fitted for the deformed trachea. 2) an occlusion balloon catheter with an extra lumen at its tip enables the airway aspiration and the inflation of the lung. 3) air leakage around a catheter is completely prevented by the use of a catheter introducer. The present method was concluded to be superior to the prior technique with the Forgaty catheter as an endbronchial blocker.

Aged↗
PubMed1996

[Rapid progression of adenocarcinoma of the lung in a patient with high levels of granulocyte colony-stimulating factor].

A 51-year-old man was referred and admitted to our hospital for further examination of an abnormal shadow on a chest X-ray film. One month before admission, a chest X-ray film had shown no abnormality. On admission, chest X-ray films and computed tomograms showed a tumor shadow in the right hilum, obstructive pneumonia in the right upper lobe, and a right-sided pleural effusion. Cytological examination of the pleural offusion revealed adenocarcinoma. The patients was given supportive care. The tumor grew rapidly and by the 13th hospital day it occupied whole right upper lobe. The patient died on the 21st day after admission. The white blood cell count had increased to 26540/mm3 as the adenocarcinoma grew. Serum granulocyte colony-stimulating factor (G-CSF), which increases the number of neutrophils in blood in vivo was examined. The serum G-CSF level reached 112 pg/ml. On immunohistochemical examination, the tumor cells stained positively with anti-G-CSF monoclonal antibody. The growth of this tumor was more rapid than expected for adenocarcinoma of the lung. These findings suggest that G-CSF induced growth of the tumor.

Adenocarcinoma↗
PubMed1996

[Two cases of the congenital posterolateral diaphragmatic hernia were reported].

Case 1, a 9-year-old woman, was admitted to our hospital because of nausea, vomiting, and epigastralgia. Diagnosis of Bochdalek hernia was made by the unusual course of naso-gastric tube. At surgery through the left posterorateral thoracotomy, the herniation of the stomach, small intestine, and colon to the thoracic cavity through the dorsolateral defect of the diaphragm were revealed. Case 2, a 35-year-old man, was admitted to our hospital because of dyspnea. Similar diagnosis was made by the examination of upper G1 series and barium enema, which demonstrated the presence of multiple loops of the small intestine and colon in the left thoracic cavity. Their postoperative courses were uneventful. Most of Bochdalek hernia is observed in infancy, and adolescent or adult case is is rarely reported (approximately 10% of all cases). Since this often misdiagnosed as pleuritis or pulmonary tuberculosis, a cautious examination is necessary for the establishment of the correct diagnosis.

Adult↗
PubMed1996

[Present international status and basic approach of lung and heart-lung transplantation].

Lung transplantation has been established as an optional treatment for variable irreversible diffuse lung diseases. To date, more than 5,000 patients have underwent lung transplantation, and nearly 1,000 procedures a year are performed recently. Although heart-lung transplantation has also been technically established, this procedure is confined to quite limited conditions due to the severe shortage of donors and many difficulties in operative procedure and the patient management. Preservation, post-transplantation edema, diagnosis of rejection, chronic rejection, shortage of donor organs, are principal problems in clinical lung transplantation, 24-hour preservation proved to be possible in several recent experimental studies, and the reperfusion injury has been revealed to be one of causes of post-transplantation edema. Establishment of methods for long-term pulmonary preservation and for the treatment of post-transplantation edema may be promising in the near future. Shortage of donor lung is one of major limiting factors. Research works on xenotransplantation and cadaver lung transplantation are on going, and these may help in solving this problem.

Heart-Lung Transplantation↗
PubMed1995

Halothane, but not alpha-chloralose, blocks potassium-evoked cortical spreading depression in cats.

The effects of two anesthetics, halothane and alpha-chloralose, on induction of spreading depression and on extracellular glutamate elevation after intracortical potassium administration were investigated in artificially ventilated (30% oxygen/70% nitrous oxide) cats. High potassium concentrations were achieved using either direct KCl injections (7 microliters, 150 mM via a micropipette) or microdialysis by supplementing 100, 300 or 500 mM KCl, respectively, for 10 min to the perfusion solution (Ringer's). Changes of the cortical DC potential were recorded adjacent (1-2 mm: electrode DC1) and distant (6-7 mm: electrode DC2) to the injection site. Either under halothane (0.75% in the respiratory gas mixture) or under alpha-chloralose (60 mg/kg i.v.) anesthesia, prolonged negative shifts of the DC potential reflecting the elevated potassium levels after KCl injection were measured near the injection site (electrode DC1). In contrast, spreading depressions (transient short DC deflections) were almost exclusively observed under alpha-chloralose. Spreading depressions recorded with electrode DC1 were superimposed on the prolonged negative DC shifts and they propagated frequently to the more distant site (DC2). Upon KCl administration, dose dependent elevations of extracellular glutamate were measured. These elevations were not significantly altered by the type of anesthesia. Our results suggest that in cats, spreading depression induction is affected by anesthesia, i.e., spreading depression induction is inhibited by halothane as compared to alpha-chloralose. Furthermore, factors other than glutamate or high potassium seem to contribute to spreading depression induction.

Animals↗
PubMed1995

Detection of human papillomavirus type 57 in a case of inverted nasal papillomatosis in Japan.

Human papillomavirus (HPV) type 57 DNA was detected in recurrent nasal inverted papillomatosis, in a 60-year-old Japanese male, using Southern blot hybridization. HPV types 6, 11, 16 and 18 were not detectable in the papilloma. Previous studies have shown that HPV types 6, 11, 16 and 18 were mainly found in nasal papillomatosis in other laboratories but the actual detection rate of virus was low. We speculate that this low detection rate may be due to the lack of a method for detecting HPV type 57.

Blotting, Southern↗
PubMed1995

Cytokine gene expression in rejecting and tolerant rat lung allograft models: analysis by RT-PCR.

UNLABELLED: Cytokine gene expression is a critical component of the lung allograft rejection (AR) response and tolerance development in rat models. In order to determine the specificity of cytokine gene expression for AR and tolerance, we examined cytokine (interleukin-2) (IL-2), (gamma-interferon) (gamma-IFN), IL-4, IL-10 and tumor necrosis factor-alpha (TNF-alpha) and control (cyclophilin) mRNA levels in two models of rat lung allograft rejection by RT-PCR (reverse transcriptase polymerase chain reaction), Southern blotting. The first model (WKY-->F344) develops a mild to moderate lymphocytic infiltrate on days 14-21 post-transplant (stage II-III AR), which spontaneously resolves by day 35 post-transplant with subsequent development of allograft tolerance (grafts surviving without evidence of AR for > 140 days). Conversely, F344-->WKY develops a similar lymphocytic infiltrate by day 14 post-transplant, but by day 21 post-transplant the graft shows severe AR (stage III-IV) and has haemorrhagic infarction with alveolar haemorrhage. METHODS: RNA was extracted from allografts removed on days 3, 7, 14, 21, 35 and 42 post-transplant. Five animals for each group (WKY-->F344) and F344-->WKY) were examined at each time point, except that no animals in the F344-->WKY were examined on day 42. cDNA was synthesized from total extracted RNA and primers specific for rat TNF-alpha, rat IL-2, rat gamma-IFN, rat IL-4, rat-IL-10 and rat cyclophilin were used for gene-specific amplification. (TNF-alpha, gamma-IFN, IL-10, 20 cycles; IL-2, IL-4, 30 cycles; cyclophilin, 20 cycles). The cycles numbers chosen for comparison were found to be optimal during preliminary experiments and occurred during the exponential phase of amplification. PCR products were electrophoresed on a polyacrylamide gel and silver-stained. Gels were subsequently electrotransferred to nylon membranes which were probed with murine cDNAs specific for IL-2, gamma-IFN IL-4, IL-10 and TNF-gamma. RESULTS: Cyclophilin gene expression was similar for both models at all time points tested; this also served as an internal standard for RT-PCR. In the WKY-->F344 tolerance model, TNF-alpha mRNA levels were not detectable on days 3 and 7 post-transplant, were at very low levels on day 14 and were undetectable on day 21 post-transplant. In marked contrast, the F344-->WKY rejection model showed TNF-alpha mRNA present on day 3 which increased markedly on day 7 and peaked on day 14 post-transplant. TNF-alpha mRNA levels decreased on days 21 and 35 post-transplant, a time when the lung was undergoing AR. The pattern of IL-2 and gamma-IFN mRNA expression was similar to that for TNF-alpha. However, IL-2 mRNA was clearly detectable in the WKY-->F344 tolerance model on day 7 and gamma-IFN was not present until day 14 post-transplant. The F344-->WKY rejection model showed very high levels of IL-2 and gamma-IFN on day 3 which peaked on day 14. The ratio of IL-2/IL-10 in the F344-->WKY rejection model was more than 5 times that seen in the WKY-->F344 tolerance model on day 3 (p < 0.0005). The ratio of IL-2/IL-4 was higher (1.5 times) in the F344-->WKY rejection model than in the WKY-->F344 tolerance model (p < 0.007) on day 3. On day 14 post-transplant, the IL-2/IL-10 ratio in the F344-->WKY rejection model was three times that of the tolerance model (p < 0.0015). The IL-2/IL-4 ratio was 3.5 times greater in the WKY-->F344 tolerance model than in the rejectin model (p < 0.003). This was due to equal expression of IL-2 and IL-4 in the rejection model, but poor IL-4 expression in the tolerance model. CONCLUSIONS: 1) The WKY-->F344 tolerance model develops mild to moderate lymphocytic infiltrates on day 14 which is associated with low level IL-2, gamma-IFN and TNF-alpha gene expression. IL-10 and IL-4 are present at day 3; however, by day 14, IL-10 is the predominantly expressed Th2 cytokine and IL-4 is not expressed. The infiltrates ultimately resolve and the animals develop a functional tolerance to their grafts.4

Animals↗
PubMed1995

Erythema gyratum repens unassociated with underlying malignancy.

A case of erythema gyratum repens occurring in a 62-year-old woman is presented together with a review of the literature. Evaluation and follow-up for the development of malignancy over a 32-month period failed to reveal any evidence of malignancy. Formerly, all cases of erythema gyratum repens were evaluated in terms of an association with an underlying malignant disorder. To date, only sixty cases have been reported in the literature; 14 (23%) were not found to be associated with any neoplasm. Therefore, this term is now also used for cases unassociated with malignancy. Erythema gyratum repens is a cutaneous eruption with a characteristic diagnostic morphology resembling a wood grain pattern.

Eosinophils↗
PubMed1995

Nitric oxide is a mediator of tachykinin NK3 receptor-induced relaxation in rat mesenteric artery.

1. The mechanism of vasodilatation induced by tachykinin peptides was studied in isolated mesenteric arteries of rats. 2. Senktide, a selective NK3 agonist, elicited potent endothelium-dependent relaxation of arteries precontracted with phenylephrine (10(-5) M), but an NK1 agonist did not. 3. A non-peptide NK3 antagonist, SR 142801, inhibited senktide-induced relaxation. However, a non-peptide NK1 antagonist, CP-96,345, and a peptide-based NK2 antagonist, L-659,877, had no effect on senktide-induced relaxation. 4. N omega-nitro-L-arginine (L-NOARG), a nitric oxide synthesis inhibitor, markedly attenuated the relaxant response to senktide. 5. These results suggest that the endothelium of rat mesenteric arteries possesses tachykinin NK3 receptors, and that NK3 agonist-induced vasodilatation is mediated by release of nitric oxide (NO) from the endothelium.

Amino Acid Sequence↗