Dose response to FK 506 in canine lung transplantation.
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Animals↗
Biomedical subjects
S Hitomi
Publications and source records attributed to S Hitomi.
[The role of surgeon in treatment of chronic respiratory failure after pulmonary tuberculosis operations].
We analyzed pulmonary functions and rib cage-phrenic motions on 296 cases of chronic empyema patients who had surgical treatment. Pulmonary functions were better preserved in patients with a single step than in those with multi-step operations, and in those who had more than five operations the impairment was inevitable. Both %VC and rib cage-phrenic motions improved by decortication, and by air-plombage, but in those who developed multi-rib fractures after the latter procedure, ipsilateral chest wall motion almost disappeared. Since some restriction of rib cage-phrenic motion is inevitable after the surgery, we have developed a cuirass respirator which can synchronize with the respiration to assist the movement of the chest wall. The results attained so far are satisfactory.
Aged↗
[Bullous disease of the lung; pathogenesis, progression and therapy].
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Cysts↗
[Changes in implanted polyvinylformal sponge 35 years after intrapleural sponge plombage].
Successful removal of long-term implanted plombage sponge, its chemical analysis and changes in its mechanical characteristics are reported. A 52-year-old woman who had undergone an intrapleural sponge plombage operation because of tuberculosis, and had since shown an uneventful medical history for 35 years, was referred with a complaint of back skin induration over the previous surgical scar. Resection of the implanted sponge was performed. The ribs attached to the sponge were atrophic and had fused with each other. The sponge had invaded the 6th rib and formed a window-like defect in the fused bony ribcage. The skin induration was found to be caused by hematoma due to damage of the intercostal artery by the sponge. In the sponge, which was made from polyvinylformal, connective tissue infiltration was observed to a depth of 5 mm. The innermost part of the sponge was free from connective tissue infiltration, but the sponge had lost its initial elasticity.
Female↗
[A case of tuberculous osteomyelitis resembling metastatic cancer on bone scintigraphy].
A 48-year-old male was referred to our division, on the suspicion of lung cancer with bone metastasis. Chest radiography showed a mass shadow and bone scintigram demonstrated multiple scattered regions of increased uptake. However bronchial and bone biopsy specimens revealed granuloma with epithelial cells and giant cells. A diagnosis of tuberculous osteomyelitis was made, and antituberculous therapy was begun. Chest radiography and bone scintigrams one year later showed marked improvement.
Antitubercular Agents↗
[Preservation and improvement of chest wall function].
Anterolateral multiple rib fractures near xiphoid process impaired mechanical linkage which resists distortion between pulmonary (upper) and abdominal (lower) rib cage resulting in flail chest. Repair of fractured ribs with ceramic pins improved phase shift between the diaphragm and the rib cage and the amplitude of the injured rib cage motion, and decreased rib cage distortion. Asymmetrical motion of lower rib and upper abdomen which suggested impairment of the diaphragm action on the abdominal rib cage was found in three patients whose emphysematous bullae were located in the middle and lower lung fields, and disappeared after bullectomy. To control the pressure in the pleural cavity after pneumonectomy from excessive negative pressure to atmospheric pressure with SF6 improved pulmonary function. Chest wall function can be preserved on the basis of functional anatomy and physiology of the chest wall.
Humans↗
[Endobronchial osteochondroma--report of a case].
Endobronchial osteochondroma, a rare neoplasm of the tracheobronchial tree, was treated successfully by surgery in our hospital. A 70-year-old male was admitted with obstructive pneumonia. Bronchoscopy showed an intrabronchial tumor almost completely occluding the orifice of the right B(8+9+10). Biopsy of the tumor did not lead to a specific diagnosis. Right lower lobectomy was performed. The tumor was 1.5 x 1.0 x 1.4 cm in size. The histological diagnosis was osteochondroma. The postoperative course was uneventful, and he is in good condition 19 months after surgery.
Aged↗
The abnormal occurrence and the differentiation-dependent distribution of N-acetyl and N-glycolyl species of the ganglioside GM2 in human germ cell tumors. A study with specific monoclonal antibodies.
Human primary germ cell tumors were analyzed for the presence of the ganglioside GM2 using three specific monoclonal antibodies which can distinguish the molecular species of the sialic acid moiety: the antibody MK1-16 is specific for N-acetyl GM2, MK2-34 is specific for N-glycolyl GM2, and MK1-17 detects both N-acetyl and N-glycolyl GM2. When the occurrence of the GM2 antigen was tested in 107 cases of human germ cell tumors by the immunohistochemical technique using these antibodies, seminoma was characterized as having the highest frequency of N-acetyl GM2 (89.4%, 42 of 47 cases) among germ cell tumors, followed by embryonal carcinoma (40.0%), and teratocarcinoma (26.6%). Compared with this, yolk sac tumors and choriocarcinoma had a much lower positive incidence of the N-acetyl GM2 antigen. On the other hand, the N-glycolyl GM2 antigen was not found at all in 47 cases of seminoma (0%), and the positive incidence was very low in embryonal carcinoma (6.6%), although considerably higher incidences were obtained with choriocarcinoma (25.0%), yolk sac tumor (22.2%), and teratocarcinoma (13.3%). The presence and molecular species of the GM2 antigens in these human germ cell tumors were also ascertained chemically by the thin-layer chromatography (TLC) immunostaining of the ganglioside fractions prepared from primary germ cell tumors. These results indicate that seminoma specifically contains N-acetyl GM2 and no N-glycolyl GM2, suggesting that N-acetyl GM2 could be a good marker for seminoma. On the other hand, non-seminomatous germ cell tumors were characterized by the presence of N-glycolyl GM2, one of the Hanganutziu-Deicher antigens (H-D antigens). Moreover, the positive occurrence of N-glycolyl GM2 correlated very well with the degree of differentiation of non-seminomatous germ cell tumors, i.e., the differentiated tumors such as yolk sac tumors, choriocarcinoma, and teratocarcinoma had a higher positive incidence of N-glycolyl GM2 type H-D antigen but a lower positive incidence of N-acetyl GM2 when compared with embryonal carcinoma, the most undifferentiated tumors among non-seminomatous germ cell tumors.
Antibodies, Monoclonal↗
In vivo evaluation of 2-cyanoacrylates as surgical adhesives.
To evaluate 2-cyanoacrylates as surgical adhesives, the bond strength in vivo as well as the tissue reaction was investigated using methyl-, ethyl-, isobutyl-, and ethoxyethyl-2-cyanoacrylate. In addition, their set time and spreading on blood were studied. When the 2-cyanoacrylates were applied to an incised site of rabbit skin, they could maintain the skin closure without suturing during the first week and the bond strength increased during the second week. Significant inflammatory response was observed around the subcutaneous tissue glued with methyl- and ethoxyethyl-2-cyanoacrylate and persisted for approximately one week. All the 2-cyanoacrylate polymers were absorbed and the tissues treated were healed two weeks after the operation. There was a mild inflammatory reaction in the tissue treated with ethyl- and isobutyl-2-cyanoacrylate, and their polymers still remained at the wound site at the second week postoperatively. The disappearance rate of the 2-cyanoacrylate polymers was roughly in proportion to the inflammatory tissue response. Ethoxyethyl-2-cyanoacrylate spread more broadly on tissues than the other 2-cyanoacrylates, while its set time was shorter than that of methyl- and ethyl-2-cyanoacrylates.
Animals↗
New bioabsorbable pledgets and non-woven fabrics made from polyglycolide (PGA) for pulmonary surgery: clinical experience.
A new type of bioabsorbable pledget made from non-woven fabric of polyglycolide (PGA) fibers has been developed. After the in vivo implantation test using dogs, samples were subject to clinical evaluations in pulmonary operations in four hospitals. The total number of trial cases was 50; in 11 cases pledgets were used for repair of the bronchus and in 39 cases for lung fistulas or defects of the pleurae. Compared with the conventional nonabsorbable pledgets, these PGA pledgets showed satisfactory results. In particular, for cases of emphysematous pulmonary diseases the application of the PGA pledgets and non-woven fabrics made the post-operative air-leakage duration short. In all these 50 cases neither side effect nor complication was observed. This evaluation suggests that PGA pledgets and non-woven fabric are an acceptable and even better alternative to conventional nonabsorbable pledgets for the pulmonary surgery.
Adolescent↗
Evaluation of a bronchial anastomosis by laser Doppler velocimetry.
Healing after bronchoplasty was evaluated by assessing the bronchial mucosal blood flow by laser Doppler velocimetry in dogs. Bronchoplastic surgery at the right main bronchus was performed and bronchial mucosal blood flow was determined by laser Doppler velocimetry at proximal and distal sides of the anastomosis before and after operation. Four experimental groups were established. After operation the blood flow was adequately preserved, and healing of the anastomosis site was satisfactory in the minimum detachment group and steroid-treated group. Mucosal blood flow was markedly reduced in both proximal and distal sides in the extensive detachment group. The extent of the reduction in the blood flow was smaller in the omentum dressing group than in the extensive detachment group. The state of healing of the anastomosis site was closely related to the bronchial mucosal blood flow.
Anastomosis, Surgical↗
[Surgical treatment of small cell lung cancer].
Thirty four small cell lung cancer (SCLC) patients underwent operation in Kyoto University from 1976. The mean age was 62 years old; 25 male cases, 9 female, respectively. All case were limited disease (LD) except 2 patients with rib metastasis. Seventeen patients had a performance status (PS) of 0 and 17 PS 1, twenty eight patients were treated with chemotherapy. Of the remaining 5 patients, 2 were treated by only oral 5-FU derivatives, one died within 30 days of operation, one could not be treated owing to old-age, and one refused chemotherapy. Except one operational death 33 cases were able to be evaluated. Out of 28 patients, 16 patients were treated by only postoperative chemotherapy. Concerning operational radicality, 21 cases out of 31 were operated radically (68%). The survival rates of these 33 patients were 78% 37% at 1, 3 and 5 years respectively. The MST was 26 months. The neoadjuvant group head better results than the non-adjuvant group.
Adult↗
Down-regulation of KOLT-2 antigen (CD28) by interleukin 2; role of IL-2R (p70).
Using KOLT-2 monoclonal antibody (mAb) recognizing a 44,000 molecular weight (MW) T-cell activation antigen (CD28), we observed the co-expression of KOLT-2 (CD28) antigen and Tac (CD25) antigen, associated with a 55,000 MW chain of the interleukin-2 receptor (IL-2R) complex. IL-2R (p55), on several T-cell lines transformed by human T-lymphotropic virus-I (HTLV-I), as well as several subclones of the natural killer (NK)-like cell line YT. When YT cells (YTC3T, YT5.1) and IL-2-dependent HTLV-I+ T-cell line cells (ED, ATL35C) expressing both IL-2R (p55) and IL-2R (p70) chains were cultured with recombinant IL-2 (rIL-2), KOLT-2 antigen was down-regulated in 24 hr. However, KOLT-2 antigen on HPB-ALL (Kurume) cells expressing neither of the IL-2R chains was unaffected by IL-2. IL-2 also failed to down-regulate KOLT-2 antigen on MT-1 cells bearing IL-2R (p55)/Tac without IL-2R (p70). To clarify the role of IL-2R (p70) in the IL-2-induced down-regulation of KOLT-2 antigen, we analysed the effect of IL-2 on a Tac- subclone of YT (YT2C2) that expresses IL-2R (p70). As was the case with Tac+ YT cells, KOLT-2 antigen was down-regulated by IL-2, and this down-regulation was inhibited by anti-IL-2R (p70) mAb but not by anti-Tac mAb. These results show that the signalling through the IL-2/IL-2R system down-regulates KOLT-2 (CD28) antigen by way of the interaction between IL-2 and IL-2R (p70), irrespective of IL-2R (p55)/Tac. Possible involvement of the IL-2/IL-2R system in the CD28-mediated mitogenic mechanism is discussed.
Antigens, Differentiation, T-Lymphocyte↗
[Classification for bullous emphysema based on analysis of chest wall motion and pulmonary function before and after bullectomy].
This study proposed a new classification for giant bullae based on analysis of chest wall motion during breathing efforts in the supine position using serial chest X-rays and examined the pulmonary function before and after bullectomy. Twenty-three patients with giant bullae were divided into two groups. Eight patients (group A) had a phase shift between the diaphragm motion and the rib cage motion or abnormal diaphragmatic motion. Almost all of them had dyspnea on exertion, and their FEV1.0 and MVV% had dyspnea on exertion, and their FEV1.0 and MVV%pred. were impaired but improved soon after bullectomy. Fifteen patients (group B) had good coordination of the diaphragm motion and rib cage motion. Most of them had no dyspnea and had normal pulmonary function. In addition, patients of group B were divided into three subgroups based on a phase shift between the diaphragm motion and inflation-deflation of giant bullae during a run. First, three patients whose bullae synchronized with the diaphragm motion showed significant decrease of %VC after bullectomy, and took a year for the decreased FEV1.0 and MVV%pred. to recover following the operation. Secondly, three patients whose bullae lay on the diaphragm and reached maximum size in the early phase of expiration showed little change in pulmonary function after bullectomy. Third, three patients whose bullae reached a maximum size at the end of expiration showed improvement of %VC and FEV1.0 soon after bullectomy. Chest wall distortion, defined as one side of caudal chest and upper abdomen not moving symmetrically compared with the other side, was found in three patients whose bullae were located in the middle and lower lung fields.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Bioabsorption of polylactides with different molecular properties.
In order to study the effects of factors governing the bioabsorption rate of polylactides, implantation tests were carried out in rabbits using various samples (20 x 10 x 2 mm3) differing in their chemical composition, residual monomer content, and molecular orientation. Copolymer samples with a higher lactic acid content showed a lower rate of absorption, whereas those with a higher unreacted monomer content were absorbed faster and showed a more drastic decrease in molecular weight. In contrast, degradation of the purified polymers was slow; the purified poly-L-lactide showed no weight change and a 50% reduction in molecular weight after 6 months of implantation. Scanning electron microscopy of the samples containing monomers showed a microporous structure extending from the surface to the inner region a few days after implantation, whereas the purified poly-L-lactide did not exhibit a microporous structural change even after 10 months of implantation.
Animals↗
An evaluation of the tolerance of the autotransplanted canine lung against warm ischemia.
Left lung autotransplantation was performed in mongrel dogs to examine the limitation of tolerance of the deflated lung against warm ischemia in a warm ischemic time (WIT) range of 60-360 minutes. The animals were divided into the 4 following groups according to the duration of WIT and the use of heparin: Group 1; WIT 60-120 min., heparin (-), Group 2; WIT 120-240 min., heparin (+), Group 3; WIT 240-360 min., heparin (+), and Group 4; WIT 240-360 min., heparin (-). All the Group 1 animals tolerated a right pulmonary artery ligation on the 6th postoperative day, but some of the Group 2 animals died immediately after the reimplantation due to pulmonary edema. All the Groups 3 and 4 animals died. The PaO2 values during the right pulmonary artery occlusion, immediately after the reimplantation, correlated well with the survival of the animals. The maximum tolerable WIT of the deflated dog lung was considered to be 120 minutes.
Animals↗
Application of laser Doppler velocimetry to lung transplantation.
The relationship between healing of a bronchial anastomosis and regional blood flow was studied in adult mongrel dogs after allotransplantation of the left lung. Animals were divided into the following three groups according to the immunosuppressive regimen. Group A: no immunosuppressive treatment (n = 7); Group B: azathioprine (5 mg/kg/day) and prednisolone (2 mg/kg/day) (n = 4); Group C: cyclosporine (20 mg/kg/day) (n = 4). The mucosal blood flow was examined serially after transplantation with laser Doppler velocimetry (LDV) at the tracheal bifurcation of the recipient (1st LDV) and at the bifurcation of the upper lobe bronchus of the transplanted lung (2nd LDV). The LDV values were expressed as a ratio to the preoperative values at the same site. Healing of the bronchial anastomosis was also assessed macroscopically with a fiberoptic bronchoscope and microscopically. The 2nd LDV value of the animals in group A at 13 days after transplantation remained low (32.9 +/- 27.6%). The 2nd LDV value in group B, although not significantly different from group A, had recovered to the preoperative level by that time (93.7 +/- 23.4%). By contrast, the 2nd LDV value in group C remained significantly higher than that in group A (119.9 +/- 23.0%, P less than 0.05). The 1st and 2nd LDV values were reduced in animals having infection at the bronchial anastomosis, even those in groups B and C. Bronchial mucosal blood flow appeared to be affected by infection and rejection of the transplanted lung, and to correlate closely with the healing of the bronchial anastomosis. This LDV method is useful to evaluate bronchial mucosal blood flow in experimental, and possibly in clinical, fields.
Animals↗
Traumatic sternal segment dislocation in a child.
We present an extremely rare case of traumatic dislocation of a sternal body segment in a child. We treated this sternal segment dislocation by means of open reduction using a newly developed pin made from poly-L-lactide containing 10 percent by weight hydroxyapatite. It is not necessary to remove this type of pin later because it is degradable and absorbed within the body within about one year after implantation. A two-year follow-up of this case revealed a good clinical result.
Biocompatible Materials↗