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Biomedical subjects

S Hitomi

Publications and source records attributed to S Hitomi.

At least 127 records · Page 7Linked to original sources
PubMed1995

Reliable cryopreservation of trachea for one month in a new trehalose solution.

We previously reported that trehalose, a reduced disaccharide, was effective in the preservation of lungs. In this study, we investigated the possibility of prolonged cryopreservation of tracheas in a preservative solution containing trehalose. Five rings of cervical trachea were removed and immersed in the preservative solution. The harvested tracheas were then cryopreserved and stored in a deep freezer at -85 degrees C. One month later, five rings of mediastinal trachea were removed. The cryopreserved cervical tracheas were thawed and autotransplanted in place of the excised mediastinal trachea (n = 6). The anastomotic site and graft were then covered with an omental pedicle. All six animals survived for more than 6 months. All grafts survived without any evidence of atrophy or stenosis. Microscopic examination of the grafts showed that the integrity of the tracheal tissues was maintained. Our findings show that consistent cryopreservation of the trachea for 1 month is possible in a preservative solution containing trehalose.

Animals↗
PubMed1995

Improved 20-hour canine lung preservation with a new solution--ET-Kyoto solution.

We developed a new solution, ET-Kyoto (ET-K) solution, and compared its efficacy in 20 h lung preservation with that of Euro-Collins (EC) solution in a canine left lung transplantation model. The lungs were flushed with ET-K solution (ET-K group, n = 5), with EC solution plus prostaglandin E1 (PGE1) pretreatment (EC + PGE1 group, n = 6) or with EC solution (EC group, n = 6), and were stored at 4 degrees C for 20 h. The function of left lung grafts was assessed 40, 70, and 130 min after transplantation. The arterial pressure of oxygen (PaO2) in the ET-K group was significantly greater than in the EC + PGE1 group (p < 0.05 or p < 0.01) and in the EC group (p < 0.01). The peak inspiratory pressure and wet to dry weight ratio in the ET-K group were significantly lower than in the EC + PGE1 group and in the EC group (p < 0.05 or p < 0.01). Pulmonary vascular resistance in the ET-K group 130 min after reperfusion was significantly lower than in the EC group (p < 0.05). All the transplanted lungs in the EC + PGE1 group and the EC group showed histological evidence of pulmonary edema, whereas all in the ET-K group showed no signs of edema. We concluded that ET-K solution is superior to EC solution with or without PGE1 pretreatment in 20 h canine lung preservation.

Animals↗
PubMed1995

Treatment of Pancoast tumors. Combined irradiation and radical resection.

Eighteen patients underwent combined preoperative irradiation and radical resection for a Pancoast tumor at the Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto University between 1977 and 1993. Four patients were applied a full radiation dose of 50-70 Gy and fourteen patients were applied a reduced dose of 33-40 Gy preoperatively. Eleven of these fourteen were applied a supplemental dose postoperatively up to a total dose of at least 50 Gy. Fourteen lobectomies, three partial resections, and one pneumonectomy were performed with combined resection of chest wall or adjacent structures: rib in 14, vertebra in 4, brachiocephalic vein in 3, subclavian artery in 2, spinal nerve in 3, sympathetic truncus in 2, phrenic nerve in 2 cases. Chest walls were reconstructed with marlex mesh in 5 patients, and two subclavian arteries and one brachiocephalic vein were repaired with artificial grafts. In 13 patients complete resections were achieved, but in the other 5 only incomplete resections leaving residual tumor were achieved. Incomplete resections consisted of 4 positive stumps at the brachial plexus of the apex and one aortic involvement by a metastatic lymph node. There was one operative death. Median survival was 21.6 months and the 5-year-survival rate was 38.5% for all 18 patients. In the complete resection group 5-year-survival was 56.4%, but in the incomplete-resection group 0%, showing a significantly more favorable result for the complete resection group. It is considered that evidence of incomplete resection influences the prognosis and that particularly tumor invasion to the brachial plexus may serve as a limiting factor for surgery.

Adult↗
PubMed1995

Pulmonary metastasis of polymorphous low-grade adenocarcinoma of the minor salivary gland.

A surgical case of pulmonary metastases of polymorphous low-grade adenocarcinoma (PLGA) originating from the minor salivary gland in the soft palate in a 62-year-old woman is reported. PLGA has been to be a locally invasive carcinoma without distant metastases; thus our case is the first reported case with histologically-proven distant metastases to the lung. We emphasise that attention should be paid to distant metastases especially to the lung even in case of PLGA.

Adenocarcinoma↗
PubMed1995

Attenuation of ischaemia reperfusion injury by human thioredoxin.

BACKGROUND: Active oxygen species are thought to play a part in ischaemia reperfusion injury. The ability of a novel agent, human thioredoxin (hTRX), to attenuate lung damage has been examined in a rat model of ischaemia reperfusion injury. METHODS: Twenty eight animals were studied. At thoracotomy the left main bronchus and the left main pulmonary artery were clamped for 75 minutes and the lung was then reperfused for 20 minutes. Phosphate buffered saline was administered intravenously to nine control animals and hTRX (30 micrograms/g body weight) was given intravenously to another group of nine animals. Two experiments were carried out. The first (Exp 1) was a time matched pair experiment (five treated, five controls), and the second (Exp 2) was performed under controlled conditions (four treated, four controls; temperature 25 degrees C, humidity 65%). In another 10 nonischaemic rats and those in Exp 1 biochemical measurements of lipid peroxide, superoxide dismutase, and glutathione peroxide levels were performed. RESULTS: In both experiments rats perfused with hTRX survived longer than controls. In Exp 1 the arterial oxygen tension (PaO2) on air in the hTRX group was higher at 20 minutes than at one minute after reperfusion. In Exp 2 PaO2 at 20 minutes was higher in the hTRX group than in the controls. Lipid peroxide, superoxide dismutase, and glutathione peroxide levels in the control group were higher than in the hTRX group and in the non-ischaemic groups. Histological examination showed less thickening and oedema of the alveolar walls in the hTRX group than in controls. CONCLUSIONS: These results suggest that hTRX is effective as a radical scavenger and can limit the extent of ischaemia reperfusion injury of the lungs of experimental animals.

Animals↗
PubMed1995

Effect of the combination of human thioredoxin and L-cysteine on ischemia-reperfusion injury in isolated rat lungs.

We studied the role of human thioredoxin and L-cysteine in ischemia-reperfusion lung injury. Thirty adult Wistar rats were allocated to five groups, according to the drug added to the pulmonary artery flush solution before ischemia (groups 1 and 2: none; group 3: human thioredoxin; group 4: L-cysteine, and group 5: human thioredoxin and L-cysteine) and according to the ex vivo ischemic interval at 37 degrees C (group 1: no ischemia; groups 2-5: 90 min). After ischemia, the lungs were reperfused for 60 min with Krebs-Henseleit solution containing 4% bovine serum albumin. In nonischemic lungs, the pulmonary arterial pressure, airway pressure, wet to dry lung weight ratio and the albumin concentration in bronchoalveolar fluid were within normal ranges. In contrast, all parameters of ischemic untreated lungs were generally poor. Compared to the ischemic untreated lungs, treatment with the combination of human thioredoxin and L-cysteine significantly reduced the wet to dry lung weight ratio (group 2: 9.18 +/- 0.25, group 5: 7.88 +/- 0.27), and the albumin concentration in the bronchoalveolar lavage fluid (group 2: 78.3 +/- 17.1 micrograms/ml, group 5: 24.0 +/- 3.8 micrograms/ml). No significant improvement was found in pulmonary arterial pressure and airway pressure. These results suggested that treatment with human thioredoxin (adult T cell leukemia-derived factor) and L-cysteine attenuates ischemia-reperfusion injury in isolated rat lungs.

Animals↗
PubMed1995

Rejection and expression of thioredoxin in transplanted canine lung.

Thioredoxin (TRX) production has been shown to be induced by a variety of stresses. In this study, we examined TRX expression in lung tissues after canine lung transplantation to determine whether it could be induced by allogenic stimulations and could be used to diagnose early rejection. Thirty-five adult mongrel dogs were used in all. In group A, 24 dogs underwent allotransplantation of the left lung with no immunosuppressant and were sacrificed at various times; 5 were sacrificed on postoperative day (POD) 1; 5 on POD 2; 7 on POD 3; and 7 on POD 5. In group B, 5 donor right lungs were used for negative control. In group C, 3 dogs underwent autotransplantation. In group D, 8 dogs underwent allotransplantation of the left lung with optimal immunosuppression and were sacrificed at POD 28. Lung tissues were stained with anti-TRX antibody, and the TRX high-producer (TRXh) cells in a randomly chosen field were counted as the index of TRX expression. In group A, the number of TRXh cells were as follows: 1.68 +/- 1.14 in grade 0; 4.87 +/- 1.07 in grade 1; 10.42 +/- 4.24 in grade 2; 27.34 +/- 17.96 in grade 3; and 50.90 +/- 17.36 in grade 4. In group B, the number of TRXh cells was 1.82 +/- 1.01. There was a significant difference between each rejection grade in group A and group B (p < 0.01), and we could observe TRXh cells in the early stage of rejection. These results suggest that analysis of TRXh cells in lung tissues may be useful in the early diagnosis of rejection.

Animals↗
PubMed1995

Neurons with perineuronal sulfated proteoglycans in the human visual cortex, with special reference to their reactions to lectins.

The human visual cortex, especially its ganglionic lamina, was found to contain many neurons with perineuronal sulfated proteoglycans which were stained with cationic iron colloid and aldehyde fuchsin. It also contained many neurons with surface glycoproteins labeled with lectin Vicia villosa agglutinin (VVA) or Glycine max agglutinin (SBA). Double staining frequently showed that the neurons stained with cationic iron colloid were not labeled with lectin VVA or SBA. Hyaluronidase and chondroitinase ABC/heparitinase/keratanase digestions eliminated the perineuronal cationic iron colloid reaction, but never interfered with the cell surface lectin labeling. These findings indicate that the cell surface glycoproteins reactive to lectin VVA or SBA are neither structural elements nor adhesive molecules of the proteoglycans. Double staining further demonstrated that in some neurons with perineuronal sulfated proteoglycans, the cytoplasm was labeled with lectin Arachis hypogaea agglutinin (PNA). It was further noticed that the lectin VVA-labeled neurons were not always identical with the neurons labeled with lectin SBA or with lectin PNA.

Colloids↗
PubMed1995

[Surgical treatment of apical invading lung cancer].

Operative technique and long-term results of seventeen patients with apical invading lung cancers were evaluated. External radiation therapy was administered preoperatively in all but one. Thirteen lobectomies, three wedge resections and one pneumonectomy were performed with combined resections of chest wall (and adjacent structures) 12, vertebra 3, brachicephalic vein 2, subclavian artery 1, lower part of brachial plexsus 3, sympathetic trunk 2 and phrenic nerve 1. Chest walls were reconstructed with marlex meshes in 5, the subclavian artery and one brachiocephalic vein were with artificial grafts. Operations were considered relative curative in 10, relative non-curative in 2 and absolutely non-curative in 5. Absolutely non-curative operations were due to cancer-positive stump of brachial plexus in the apex in four and metastatic lymph node invading aorta in one. Over all five-year survival rate was 35.3% and median survival was 20 months. Five-year survivals in patients with curative operations and non-curative operations were 60% and 0%, respectively, and the former was significantly higher. Surgical margin is a large factor for long-term result and invasion to the brachial plexus is thought to be a limiting factor for surgery.

Adult↗
PubMed1995

[Clinical experience of the combined use of polyglycolide non-woven felt with fibrin glue to prevent postoperative pulmonary fistula].

Felt prepared from polyglycolide (PGA) polymer fibers was pasted with fibrin glue for prevention of postoperative pulmonary fistula, and its effects were evaluated. The subjects were 90 patients who underwent thoracotomy and were expected to develop air leakage between March 1990 and the end of 1993. The felt sheet was simply pasted in position in 67 patients, applied and fixed by suturing in 7, and sutured and pasted in 16. The duration of air leakage in the three groups were 4.6 +/- 4.1, 3.9 +/- 4.9, and 3.2 +/- 3.8 days, respectively. According to the surgical procedure employed, the duration of air leakage was 5.0 +/- 4.0 days in 41 patients who underwent pulmonary lobectomy, 5.0 +/- 4.3 days in 5 patients who underwent segmentectomym, 2.6 +/- 3.1 days in 26 cases who underwent partial pneumonectomy, and 4.9 +/- 4.0 days in the 14 cases who underwent bulla resection. In terms of disease, the leakage time was 4.6 +/- 4.2 days in patients with emphysema, 0.6 +/- 1.2 days in those with diffuse pulmonary fibrosis, 0.7 +/- 0.9 days in those with Infectious disease, 4.8 +/- 4.2 in those with lung cancer, 1.5 +/- 1.5 days in those with benign lung tumor, and 3.8 +/- 2.7 days in those with metastatic lung tumors. The procedure had no side-effect on liver or kidney function. No infection was observed even after decortication for empyema. The use of felt prevented excessive shrinking of the lung due to over-suturing. Therefore, intraoperative application of a PGA felt sheet was considered to be an effective method for prevention of pulmonary fistula.

Aged↗
PubMed1995

Surgery for complications of chronic obstructive lung disease.

Chronic obstructive lung disease (COLD) is a clinical entity characterized by chronic airway obstruction that includes pulmonary emphysema and chronic bronchitis with airway obstruction. Although most complications are treated medically, there are a few cases in which medical treatment is not effective and surgical treatment is necessary. Most complications of COLD requiring surgical treatment are those associated with bullous emphysema, such as pneumothorax, lung carcinoma associated with bulla, and infection of bulla. In this article, the indications, practical aspects, and problems and risks of surgical treatment for complications of COLD are discussed.

Humans↗
PubMed1994

A short course of FK506 can induce limited donor-specific graft acceptance.

To examine the hypothesis that a short course of FK506 would induce permanent graft acceptance after lung transplantation, left lung allotransplantation was performed in 14 mongrel dogs. In group 1 (control; n = 3), no immunosuppressive agent was given. In group 2 (n = 7), FK506 (1.2 mg/kg intramuscularly) was given on posttransplantation days 0, 1, and 2. In group 3 (n = 4), FK506 was given at the same dose on posttransplantation days 0, 1, and 2 as well as on days 29 and 30. Allograft function was evaluated by temporarily occluding the right pulmonary artery. A mixed lymphocyte reaction study was performed preoperatively and monthly thereafter. Control lungs were all rejected within 8 days. Group 2 dogs showed improved survival, with a median survival of 49.5 days. One dog in group 2 lived more than 400 days after transplantation. The mixed lymphocyte reaction data suggests that some donor-specific unresponsiveness occurs, which lasts for only a limited time. Supplemental doses of FK506 did not significantly improve survival (median, 74 days). The whole blood level of FK506 was 17.7 +/- 3.98 ng/mL on day 15; however, on day 29 the FK506 level was almost undetectable. We conclude that a 3-day course of 1.2 mg/kg of FK506 can induce donor-specific graft acceptance, but this acceptance is not permanent.

Animals↗
PubMed1994

Omentoplasty for postpneumonectomy bronchopleural fistulas.

Postpneumonectomy fistula is one of the most serious complications in general thoracic surgery and remains difficult to manage. From 1984 to 1991, we successfully used pedicled omentum for the treatment of postpneumonectomy bronchopleural fistulas (omentoplasty) in five patients, four of whom had thoracic empyema. For bronchopleural fistulas without early postoperative infection, single-stage closure was performed which was then covered with pedicled omentum. Omentoplasty was performed successfully in patients with thoracic empyema, after open or closed drainage. Open thoracotomy was useful when closed drainage was ineffective. Even after open thoracotomy, closure of the wound was achieved. All five patients could be discharged. Omentoplasty was useful in the therapy of postpneumonectomy bronchopleural fistula even in the presence of thoracic empyema.

Aged↗
PubMed1994

Effect of recombinant human adult T cell leukemia-derived factor on rat lung reperfusion injury.

The formation of reactive oxygen species (ROS) is a major factor responsible for reperfusion injury in lungs. Adult T cell leukemia derived factor (ADF), a polypeptide made of 104 amino acids, is induced by a variety of stresses including X-ray, ultraviolet, H2O2, and mitogen. ADF has a reducing activity, which catalyzes the proton transfer between thiol-radical of cystein-containing proteins. Furthermore, ADF has a protective activity of ROS which are formed by xanthine oxidase and other alternative pathways in vitro. Using a rat in vivo model of lung ischemia, we examined the protective effect of recombinant human ADF (rhADF) against ischemia reperfusion injury of the lung. Ischemia, lasting for 75 min, was induced in the left lung of rats at 23 degrees C. The lung was then reperfused. These animals were divided into two groups: group 1 (n = 6, treatment with normal saline) and group 2 (n = 6, treatment with 28 micrograms/g of rhADF). One minute after the beginning of reperfusion, arterial oxygen tension (PaO2) decreased significantly in both groups (p < 0.01), without any significant intergroup difference (55.5 +/- 9.8, 49.8 +/- 8.6 mm Hg, respectively). Twenty minutes after reperfusion, PaO2 was significantly higher (p < 0.05) in group 2 (113.0 +/- 8.1 mm Hg) than in group 1 (72.3 +/- 13.6 mm Hg). The wet/dry weight ratio was significantly higher in group 1 (7.31 +/- 0.54) than in group 2 (5.82 +/- 0.36). Histologically, lung injury tended to be milder in group 2 than in group 1. These results suggest that rhADF has a protective effect against ischemia reperfusion injury of the rat lung.

Animals↗
PubMed1994

A liquid-liquid blood-gas exchange for the treatment of acute respiratory failure. A new blood gas exchange using artificial blood as an oxygen carrier.

A new liquid-liquid blood gas exchange system was investigated using a venovenous low flow extracorporeal circuit. A 2 m2 hollow fiber dialyzer served as the interface of the blood and oxygen carrier (a 38 percent FC-43, perfluorocarbon emulsion in a buffered electrolyte solution), which was continuously recycled through a bubble oxygenator. Experiments were performed on five mongrel dogs under general anesthesia. Upon the arrest of spontaneous ventilation, the dogs' lungs were inflated with 50% oxygen gas under a positive pressure of 10 cmH2O. After 10 min of apnea the dogs' PaO2 decreased to 37 +/- 14 mmHg, and the extracorporeal circulation was started at 10 ml/min/kg b./w. At 15 min the PaO2 had risen to 80 +/- 41 mmHg and at 30 min to 121 +/- 17 mmHg. The oxygen transfer was 8.3 +/- 2.3 ml/min. The extracorporeal circulation was continued 5h, when PaO2 reached 156 +/- 90 mmHg, and PaCO2 148 +/- 43 mmHg, then stopped. Fifteen minutes later, the PaO2 had returned to 32 +/- 10 mmHg. These findings indicate that our blood gas exchange system can supply a sufficient amount of oxygen to the body under apnea with continuous positive airway pressure.

Animals↗
PubMed1994

Inhibition of reperfusion injury by human thioredoxin (adult T-cell leukemia-derived factor) in canine lung transplantation.

Human thioredoxin, which was previously recognized as adult T-cell leukemia-derived factor, has many physiologic activities, one of which is a radical scavenger effect. Its ability to reduce reperfusion injury was assessed in vivo in a canine lung transplantation model. In 19 dogs, left lung allotransplantation was performed after 100 minutes of warm ischemia. The function of the transplanted lung was assessed after clamping of the contralateral pulmonary artery. In the human thioredoxin group (n = 6), human thioredoxin 30 mg/kg was given to the recipients during reperfusion. In the N-acetylcysteine group (n = 5), N-acetylcysteine 150 mg/kg, known as a radical scavenger, was given in the same manner. In both groups, arterial oxygen tension was significantly higher than in the control group (n = 8). In the human thioredoxin group, peak inspiratory pressure was significantly lower than in the control group. Macroscopic and microscopic examinations showed an almost normal appearance of the lung tissues in the human thioredoxin and N-acetylcysteine groups, in contrast to the abnormal findings in the control group. Thus it would appear that human thioredoxin has a protective effect on transplanted lungs, as does N-acetylcysteine, and that its action may be a radical scavenger effect.

Animals↗