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Biomedical subjects

R Tsuchiya

Publications and source records attributed to R Tsuchiya.

At least 55 records · Page 3Linked to original sources
PubMed1998

A protein reacted with anti-vitronectin antibody accumulates in tumors derived from B16F10 melanoma cells.

Vitronectin is a cell-adhesive glycoprotein in blood plasma and extracellular matrix. We have examined the participation of vitronectin in experimental metastasis of B16F10 mouse melanoma cells which metastasized to lung. By Western blotting, a protein reacted with anti-rat vitronectin antibody was found to be enriched more in the melanoma parenchyma in the lung than the sum of cultured melanoma cells and normal lung tissue. The protein was similarly abundant in tumors of B16F10 cells grown subcutaneously in mice. By immunofluorescence of the tissues, the signal detected with anti-rat vitronectin was found to be localized at nuclei in melanoma cells metastasized in the lung as well as in tumors just grown subcutaneously. These results indicate that the protein reacted with anti-vitronectin antibody is expressed much more in the growing mass of B16F10 melanoma cells in vivo than in vitro.

Animals↗
PubMed1998

Lobe-specific intercostal strategy in video-assisted lobectomy.

When performing video-assisted lobectomy for lung diseases, the incisional strategy for the minithoracotomy and two trocar ports is crucial for successful completion of the procedure. Our strategy is primarily determined according to three principles: The hilar bronchovascular structures should be easily accessible; the minithoracotomy should be readily convertible to a standard open thoracotomy; and the wounds should create only limited damage. To enable a quick conversion, the minithoracotomy incision must be placed on the scheduled posterolateral thoracotomy line regardless of its location. The entire procedure is best managed when the minithoracotomy is placed anteriorly on the inframammary line in the fourth intercostal space for upper and middle lobectomies and posteriorly over the auscultation triangle in the fifth intercostal space for lower lobectomies. Two trocars are used for thoracoscopy and retraction. The sequence of each operative step should be determined by the lobe to be resected. This lobe-specific incisional and operative strategy based on anatomical considerations not only facilitates the safe dissection of the hilum but also enables a rapid conversion to a standard posterolateral thoracotomy.

Adult↗
PubMed1998

[Surgical treatment for metastatic lung tumors].

Surgical treatment for metastatic lung tumors has been reported to be efficacious in selected patients by many authors. Most of these reports are retrospective studies. In our hospital, metastatic lung tumors were resected in 624 patients, and the 5- and 10-year survival rates after pulmonary metastatectomy were 38.3% and 26.6%, respectively. There are many long-time survivors without recurrence after thoracotomy. However, pulmonary metastatectomy seems to offer no survival benefit in some cancers, e.g., gastric cancer, even if the patients satisfy the criteria for surgery. Prospective studies for each type of primary cancer are needed to determine the true efficacy of pulmonary metastatectomy.

Humans↗
PubMed1997

A VATS lobectomy for lung cancer in a patient with an anomalous pulmonary vein: report of a case.

A video-assisted right upper lobectomy was successfully performed on a 58-year-old man with an anomalous segmental pulmonary vein. The tumor was a peripherally located adenocarcinoma. The anomalous vein behind the right main bronchus was identified and safely divided. This case emphasized that to perform this procedure successfully, (1) a careful preoperative evaluation of the anatomy, including the presence of any possible vascular and/or bronchial anomalies, is necessary, and (2) if any anatomical structures cannot be determined intraoperatively, a conversion into an open procedure must immediately be undertaken.

Adenocarcinoma↗
PubMed1997

On the etymology of "pancreas".

It is said that the pancreas was described first by Herophilus of Chalcedon in about 300 BC, and the organ was named by Rufus of Ephesus in about 100 AD. However, it is an established fact that the word pancreas had been used by Aristotle (384-322 BC) before Herophilus. In Aristotle's Historia Animalium, there is a line saying "another to the so-called pancreas." It is considered that the words "so-called pancreas" imply that the word pancreas had been popular at the time of Aristotle, but it had not been authorized yet as an anatomical term. However, the word pancreas presumably has been accepted as an anatomical term since Herophilus.

History, Ancient↗
PubMed1997

Thoracoscopic evaluation of histologically/cytologically proven or suspected lung cancer: a VATS exploration.

To evaluate the diagnostic value of video-assisted thoracic surgery (VATS), VATS exploration was performed in 135 patients with histologically/cytologically proven or suspected lung cancer. In 31 patients with pulmonary nodules suspected to be lung cancer, VATS exploration was intended to determine their histology by wedge resection. A histological diagnosis was made in all of the patients: 12 lung cancers (38.7%), 12 inflammatory granulomas (38.7%), four hamartomas (12.9%), and three others. VATS exploration (staging) was performed in 116 surgical candidates with documented lung cancer, including the 12 patients diagnosed by VATS wedge resection. Inoperable factors were demonstrated by this procedure in five patients (4.3%): malignant effusion without dissemination in three, malignant effusion with extensive dissemination in one, and extensive dissemination without effusion in one. Furthermore, N2 nodal metastasis at Botallo's ligament was demonstrated by this procedure in two patients, which met the eligibility criteria for a clinical study. Although the documented number of patients was relatively small, VATS exploration obviated the need for painful thoracotomy, selecting better treatment and for evaluating eligibility criteria for prospective clinical trials. The results suggest that this procedure is useful in candidates for lung cancer surgery.

Biopsy, Needle↗
PubMed1997

Targeted disruption of the mouse homologue of the Drosophila polyhomeotic gene leads to altered anteroposterior patterning and neural crest defects.

The rae28 gene is a mouse homologue of the Drosophila polyhomeotic gene (Nomura, M., Takihara, Y. and Shimada, K. (1994) Differentiation 57, 39-50), which is a member of the Polycomb group (Pc-G) of genes (DeCamillis, M., Cheng, N., Pierre, D. and Brock, H.W. (1992) Genes Dev. 6, 223-232). The Pc-G genes are required for the correct expression of the Homeotic complex genes and segment specification during Drosophila embryogenesis and larval development. To study the role of the rae28 gene in mouse development, we generated rae28-deficient mice by gene targeting in embryonic stem cells. The rae28-/- homozygous mice exhibited perinatal lethality, posterior skeletal transformations and defects in neural crest-related tissues, including ocular abnormalities, cleft palate, parathyroid and thymic hypoplasia and cardiac anomalies. The anterior boundaries of Hoxa-3, a-4, a-5, b-3, b-4 and d-4 expression were shifted rostrally in the paraxial mesoderm of the rae28-/- homozygous embryos, and those of Hoxb-3 and b-4 expression were also similarly altered in the rhombomeres and/or pharyngeal arches. These altered Hox codes were presumed to be correlated with the posterior skeletal transformations and neural crest defects observed in the rae28-/- homozygous mice. These results indicate that the rae28 gene is involved in the regulation of Hox gene expression and segment specification during paraxial mesoderm and neural crest development.

Animals↗
PubMed1997

Video-assisted lobectomy in the elderly.

STUDY OBJECTIVES: Video-assisted lobectomy for pulmonary malignancy seems to have potential merits, especially in compromised patients such as the elderly. This study was undertaken to assess the feasibility of this new approach in this special age group. PATIENTS: Video-assisted lobectomy was attempted in eight patients older than 78 years of age with preoperatively diagnosed T1N0 or T2N0 lung carcinomas of peripheral origin. In one patient with squamous cell carcinoma, the tumor was diagnosed after surgery as metastasis from tongue carcinoma. The patients ranged in age from 78 to 85 years (average, 81.3 years). RESULTS: The procedure was completed successfully in six patients (75%), while the other two patients underwent lobectomy after conversion to open thoracotomy because of bleeding from the pulmonary artery at the hilum in one and extensive pleural adhesions in another. Among the six patients who underwent video-assisted lobectomy, there were no operative deaths or serious complications attributable to this technique, although two patients had prolonged air leakage for 7 and 11 days, respectively. CONCLUSIONS: This approach, which is feasible even in patients older than 80 years, is likely to offer a benefit to such patients if they are selected properly. During this procedure, the possibility of wound extension in case of an intraoperative accident must always be borne in mind, especially in elderly patients. The advantage of this approach remains undetermined in this special age group.

Aged↗
PubMed1997

Implications of staging in lung cancer.

Lung cancer staging, based on anatomic extent of disease and described by the TNM staging system (T, primary tumor; N, regional lymph nodes; M, distant metastasis), is an important parameter for determining the clinical course of this disease. To evaluate the prognostic importance of TNM staging for lung cancer, we conducted a retrospective study analyzing survival rates according to TNM staging in 2,382 patients who had pulmonary resection for non-small cell lung cancer. Postoperatively, 3 patients were classified in stage 0, 796 in stage I, 304 in stage II, 719 in stage IIIA, 233 in stage IIIB, and 327 in stage IV. The 5-year survival rates for these patients were as follows: stage I, 68.5%; stage II, 46.9%; stage IIIA, 26.1%; stage IIIB, 9.0%; and stage IV, 11.2% (including ipsilateral, intrapulmonary metastases); 5-year survival rates for 140 patients with stage IV disease with intrapulmonary metastases in either the same lobe or another ipsilateral lobe were 17.8% and 8.3%, respectively. There was prognostic significance between stage I and stage II disease, stage II and stage IIIA disease, and stage IIIA and stage IIIB disease, but not between stage IIIB and stage IV disease. Only a few modifications will be required for the TNM staging system, which at present accurately reflects the prognosis of patients with lung cancer and is helpful in determining treatment.

Adult↗
PubMed1997

[Extended resection for lung cancer].

Only one third of the patients with lung cancer can be identified as operative candidates. For the other two thirds operation was not indicated, because they have advanced lung cancer with distant metastases or locally advanced lung cancer invading neighboring organs. The results of surgery of lung cancer depend on TNM staging. Resection of stage IIIA, IIIB and IV were not indicated because these gave poor 5-year survival rates. However, a few 5-years survivors without any evidence of recurrence of lung cancer have been reported recently. Chest wall resection and tracheal carinal resection became standard operations because they given a 5-year survival rates of 30% and 34% respectively. Left atrium resection also becomes a standard operation with 22% of 5-year survival rate. Resection of superior vena cava is applied for locally advanced cases with or without invasion to the tracheal carina. Resection of vertebra and main pulmonary artery are being tried with careful and exact evaluation of the extent of primary tumor and invading organs using information provided by new diagnostic equipment.

Heart Atria↗
PubMed1996

Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients.

We reviewed the clinical courses of 159 patients between February 1967 and May 1995 for the purpose of examining the survival of patients who had pulmonary resection for metastatic colorectal cancer. The cumulative survivals at 5 years and 10 years were 40.5% and 27.7%, respectively. Fifteen patients (10%) were alive more than 10 years after the thoracotomy without any evidence of recurrence. The cumulative survival at 5 years for 39 patients who had hepatic metastases before thoracotomy was 33%. There was a statistically significant difference in survival between patients with extrapulmonary metastases and those with only intrapulmonary metastases before thoracotomy. The number of pulmonary metastases and the presence of hilar or mediastinal lymph node metastases affected postthoracotomy survival. There was no significant difference in survival on the basis of sex, age, location of the primary cancer, size of the pulmonary tumors, mode of operation, or disease-free interval. Surgical treatment for pulmonary metastases from colorectal cancer in selected patients, even those who had hepatic metastases before thoracotomy, might improve prognosis.

Adult↗
PubMed1996

Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas: are these carcinomas candidates for video-assisted lobectomy?

To determine the clinicopathologic characteristics of peripheral non-small-cell carcinomas, the cases of 337 patients undergoing major pulmonary resection with complete lymphadenectomy were retrospectively reviewed with regard to lymph node involvement, recurrence, and prognosis. All of the tumors were 3.0 cm or less in diameter and were categorized as T1 (318 patients) or T2 (19). Eighty-eight patients (26.1%) had lymph node involvement: 32 (9.5%) at N1 nodes, 55 (16.3%) at N2 nodes, and 1 (0.3%) at N3 nodes. Although the prevalence of lymph node involvement did not differ significantly with tumor histologic type, it was quite low in squamous cell carcinomas 2.0 cm or less in diameter. Of the 56 N2/3 metastases, 14 (25%) occurred in a "skipping" manner, and all but one had a nonsquamous histologic makeup. Of the 213 patients with a follow-up period of 5 years or more, 59 patients (27.7%) showed cancer recurrence. This occurred at a distant site in 67.8% of the cases. Five-year survival rates based on nodal status were 91.9% (NO), 61.8% (N1), 44.5% (N2), and 0% (N3). Because of the relatively high prevalence of lymph node involvement, complete hilar/mediastinal lymphadenectomy should be routinely done regardless of tumor histologic type and size, as long as patients are at good risk. However, in squamous cell histologic types, mediastinal lymphadenectomy might be dispensable if the tumor is less than 2.0 cm in diameter, or if the hilar node is proved to be tumor-free on pathologic examination of the frozen section during operation. Although video-assisted major pulmonary resection currently has limited application, this new technique may represent a surgical option in resection without complete lymphadenectomy.

Adenocarcinoma↗
PubMed1996

AFP-producing squamous cell carcinoma of the lung in an adolescent.

We report a case of primary lung cancer in a 16-year-old boy. A histologic diagnosis of squamous cell carcinoma was made by bronchoscopic biopsy before surgery. The serum alphafetoprotein (AFP) level was markedly elevated at 193 ng/dl. Preoperative and postoperative evaluation revealed no evidence of scrotal mass. We performed right pneumonectomy with combined resection of the invaded portion of the left atrium under extracorporeal circulation. Despite the rapid improvement in the patient's general condition after surgery, the AFP level continued to increase without a transient decrease and reached 3160 ng/ml on the 23rd postoperative day. When the patient was readmitted because of dyspnea and headache on the 36th postoperative day, hypercalcemia of 13.9 mg/dl was noted, and this was resistant to subsequent treatment. The patient died on the 46th postoperative day.

Adolescent↗
PubMed1995

Gene trap capture of a novel mouse gene, jumonji, required for neural tube formation.

A mouse mutation, termed jumonji (jmj), was generated by a gene trap strategy. Expression of the trapped gene (jmj gene), as monitored by X-gal staining, was detected predominantly at the midbrain-hindbrain boundary and in the cerebellum, depending on the stage of development. All embryos homozygous for the jmj mutation died before embryonic day 15.5. Some, but not all, of the homozygotes developed an abnormal groove in a region just anterior to the midbrain-hindbrain boundary on the neural plate at embryonic day 8-8.5 and showed a defect in neural tube closure in the midbrain region. Analyses of jmj cDNA revealed that the jmj gene is novel, conserved among vertebrates, and disrupted by vector insertion in the jmj homozygotes. The amino acid sequence deduced from the cDNA shared a portion of significant homology with human retinoblastoma-binding protein RBP-2 and with a putative protein encoded by human gene XE169 that escapes X-chromosome inactivation. These results suggest that jmj gene is essential for normal morphogenesis of the neural tube.

Amino Acid Sequence↗