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Biomedical subjects

S Kodaira

Publications and source records attributed to S Kodaira.

At least 37 records · Page 2Linked to original sources
PubMed2000

Experimental parathyroid transplantation: human parathyroid grafts survived and functioned in mice treated with anti-CD4 monoclonal antibody.

Permanent hypoparathyroidism is one of the most difficult of all endocrine disorders to treat medically. To examine the possibility that xenotransplantation can be used to treat hypoparathyroidism, human parathyroid tissues were transplanted into mice. Human parathyroid tissue was taken from specimens excised from patients with hyperparathyroidism. Fresh human parathyroid tissue was implanted under kidney capsule of CBA (H2k) mice. Some mice were treated intraperitoneally with depleting anti-CD4 monoclonal antibody (mAb, YTA 3.1, 100 microg/dose, days -1. 0. 1, 2, 3, and 5). Mice were killed 30 days after transplantation. Survival of parathyroid grafts was examined microscopically and human parathyroid hormone in serum was measured by ELISA. All parathyroid grafts survived under kidney capsule and human parathyroid hormone was strongly detected in serum (621 +/- 576 pg/mL) when recipients were treated with short-course treatment of anti-CD4 mAb. Conversely, no parathyroid tissue was seen microscopically in any recipient mice without anti-CD4 mAb treatment. Human parathyroid hormone was undetectable by ELISA in naive mice and mice transplanted with human parathyroid tissue without short-course treatment of anti-CD4 mAb. Xenogeneic human parathyroid tissue survived and functioned in mice treated with short-course treatment of anti-CD4 mAb.

Animals↗
PubMed2000

Overexpression of heme oxygenase-1 protects allogeneic thyroid grafts from rejection in naive mice.

BACKGROUND: Endocrine allografts are an option for the treatment of endocrine failure. METHODS: One lobe of the thyroid was transplanted under the kidney capsule. RESULTS: C57BL/10 (H2(b)) thyroids were rejected in naive CBA (H2(k)) mice within 14 days after transplantation. When mice were treated with anti-CD4 monoclonal antibodies (mAb), all grafts survived for more than 60 days. The first grafts still survived after second C57BL/10 or Balb/c (H2(d)) thyroid grafts that were transplanted into the same recipients were rejected acutely, which suggests that the primary grafts were modified under anti-CD4 mAb treatment. To confirm this hypothesis, C57BL/10 thyroid grafts from anti-CD4 mAb-treated mice were retransplanted. All grafts survived in naive mice; this correlated with the overexpression of heme oxygenase-1 (HO-1) in the grafts. Next, an inhibitor of HO-1 (zinc protoporphyrin) or control compound (copper protoporphyrin) was injected intraperitoneally after transplantation of C57BL/10 thyroid grafts into the primary CBA recipients that had been treated with anti-CD4 mAb. The grafts in mice that had been treated with zinc protoporphyrin, but not copper protoporphyrin, were rejected when retransplanted to naive recipients. CONCLUSIONS: Overexpression of HO-1 correlated with the protection of fully allogeneic thyroid grafts from rejection when retransplanted into naive recipients.

Animals↗
PubMed2000

[Reconstruction of anal function after abdomino-perineal resection].

After abdomino-perineal resection for rectal cancer, most surgeons believe that colostomy is necessary after anal function is abolished and that patients are satisfied with this. Recently, reconstruction of anal function has been performed using new surgical techniques such as creation of an artificial sphincter, dynamic graciloplasty, gluteoplasty with pudendal nerve anastomosis, and smooth muscle implanted neoanus. However, most surgeons do not have sufficient knowledge of reconstruction of anal function. Since all reconstruction methods are associated with low mortality and morbidity rates, and can be converted to conventional colostomy when required, surgeons must consider first-line reconstruction of anal function after resection of the anal sphincter.

Anal Canal↗
PubMed2000

[Recent advances is surgical adjuvant chemotherapy for colorectal cancer].

To evaluate the significance of surgical adjuvant chemotherapy, randomized controlled trials (RCTs) of adjuvant chemotherapy after curative resection for colorectal cancer were reviewed. Several multi-drug systemic chemotherapies (MOF, MMC/FT, 5-FU, UFT p.o.) were useful as adjuvant treatment to improve survival or disease-free survival of patients with colorectal cancer. Moreover, a worldwide meta-analysis suggested that continuous intraportal 5-FU infusion improves survival. Combination chemotherapy trials utilizing 5-FU and levamisol (LEV) demonstrated a survival advantage in patients with high risk colon cancer. Recently, many RCTs have substantiated the benefits of treatment with 5-FU/Leucovorin (LV) and this treatment is widely used as adjuvant treatment for the patients with Dukes C resected colon cancer in Europe and the U.S.A. Now, with the increasing use of oral chemotherapy drugs, new trials comparing oral UFT/LV with intravenous 5-FU/LV are being implemented to investigate these drugs in terms of QOL, toxicity and cost. Furthermore, the new drug irinotecan (CPT-11) is now under investigation to see if it brings added efficacy to 5-FU/LV. In Japan, two major groups (N-SAS-CC and TAC-CR) are comparing surgery alone and UFT alone in patients with Dukes C colon and rectal cancer. From these results, surgical adjuvant chemotherapy seems to be effective in the treatment of patients with high risk colon cancer and those with rectal cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Adjuvant therapy with oral fluoropyrimidines as main chemotherapeutic agents after curative resection for colorectal cancer: individual patient data meta-analysis of randomized trials.

BACKGROUND: Oral 5-fluorouracil and its prodrugs (tegafur, carmofur) is now being studied for adjuvant chemotherapy of curatively resected colorectal cancers. To evaluate the effect of these oral fluoropyrimidines (o-FPs), an individual patient data (IPD) meta-analysis of randomized clinical trials was performed in Japan as an inter-trialist group study. METHODS: Data from the three clinical trials in which postoperative adjuvant therapy with o-FPs was compared with surgery alone in patients with colorectal cancer were sought. IPD from a total of 4960 patients with follow-up periods of at least 5 years were analyzed. RESULTS: The results of the meta-analysis on an 'intention to treat' basis demonstrated a significant benefit of o-FPs in terms of the disease-free survival (DFS) of the total patients [risk ratio (RR) 0.830, 95% confidence interval (CI) 0.742-0.929, P = 0.001]. o-FPs were also demonstrated to be effective for survival in rectal cancer (RR 0.857, 95% CI 0.734-0.999, P = 0.049) and in Dukes'C colorectal cancer (RR 0.828, 95% CI 0.711-0.965, P = 0.016). CONCLUSION: The results suggest the advantage of long term o-FPs, possibly with the injection of mitomycin C, for prognosis for curatively resected colorectal cancer patients.

Administration, Oral↗
PubMed1999

[Effect of preventive measures against central venous catheter-related infection: retrospective study in our division for recent 10 years].

A study was made of 2202 central venous catheters (CVC), which were inserted for recent 10 years, to know the effect of preventive measures against CVC-related infection. We divided 10 years in 3 periods: 1987-1990 (the first period), 1991-1993 (the second period), and 1994-1996 (the third period). Preventive measures such as thorough antiseptic precaution, shortening of CVC dwelling time, and prohibition of injection from three-way stopcocks were taken after the second period. In the third period, semiclosed infusion system (I-system) was introduced to our division. A febrile catheterized patient (higher than 38 degrees C) was diagnosed as CVC-related infection when the fever dropped immediately (within 72 hours) after removal of CVC, or when the tip of the CVC was positive for culture. The rate of CVC-related infection in the second (9.9%) or the third (7.3%) period was significantly lower than that (14.0%) of the first period (p < 0.05 and p < 0.001, respectively). The mean dwelling time of CVC was 31.5 days for the first period, 27.0 days for the second period, and 24.8 days for the third period. The rate of long-term dwelling catheters (more than 29 days) in the second (34.5%) or the third (28.7%) period was significantly lower than that (40.5%) in the first period (p < 0.01 and p < 0.001, respectively). The index of CVC-related infection (incidence of infection per 1,000 days) was 4.8 for the first period, 3.7 for the second period, and 2.9 for the third period. The rate of infection of short-term dwelling CVC (less than 28 days) in the second (9.5%) or the third (6.3%) period was significantly lower than that (16.0%) of the first period (p < 0.01 and p < 0.001, respectively). As to cultures of CVC and/or blood sample, the isolation rate of fungi decreased significantly (p < 0.001), and that of gram-negative rods showed a tendency to increase after the second period. It was concluded that shortening of CVC dwelling time and application of semiclosed infusion system were effective to reduce the rate of CVC-related infection.

Aged↗
PubMed1999

Tumor-associated macrophage infiltration in pulmonary adenocarcinoma: association with angiogenesis and poor prognosis.

The relation between tumor-associated macrophage (TAM) density and the density of microvessels was investigated in specimens from 113 patients with pulmonary adenocarcinoma, as was the influence of TAM density on prognosis. The rank correlation test revealed a significant relation between TAM density and microvessel density (y = 14.418 + 0.863x, r = 0.454, p > 0.0001). A significant difference in patient survival rate was detected between tumors with a TAM density defined as high and those with a TAM density defined as low (p < 0.01). Multivariate analysis also showed that TAM density was significantly related to survival (p < 0.05). These data indicate that TAM infiltration may contribute to tumor angiogenesis, and that TAM density is a useful prognostic marker in pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1999

[Treatment of post-operative recurrence of colorectal cancer].

The survival rate of patients with colorectal cancer is fairly good after curative surgery. Approximately 80 and 75% of patients suffering from colo-rectal cancer survive for 5 years after curative operation, respectively. However, 30% of patients experience recurrence (mainly liver, lung, and local lesions) postoperatively. Resection of the recurrence is carried out in an attempt to achieve prolonged survival. Thirty percent to 40% of patients survive after curative surgery for liver metastases and 35% to 45% after that for lung metastases. Total pelvic exenteration is performed in patients with local recurrence of rectal cancer and 30% to 40% survive for 5 years. However, for patients with unresectable recurrence, chemotherapy and radiation contribute to a better quality of life and prolonged survival. A 70% response rate is achieved in patients with liver metastases after continuous infusion chemotherapy into the hepatic artery. Currently, the most important factor in achieving prolonged survival after colorectal surgery is to follow patients carefully in order to detect recurrence as early as possible. In the treatment of recurrence, the possibility of curative surgery, a combined treatment strategy and the quality of life of patients must be considered.

Colorectal Neoplasms↗
PubMed1998

A new method of peritoneal closure following laparoscopic herniorrhaphy.

Of the three most commonly used methods of repairing inguinal hernias laparoscopically, we believe that the transabdominal (TAPP) approach is the most effective. To perform this technique successfully, complete closure of the peritoneum is recommended to avoid the formation of postoperative adhesions. Here we describe a technique that employs the Endo Stitch instrument, facilitating easier closure of the peritoneum.

Hernia, Inguinal↗
PubMed1998

The use of transbronchial lung biopsy to establish a diagnosis of benign clear cell tumor of the lung: report of a case.

Benign clear cell tumor (BCCT) is an extremely rare pulmonary neoplasm. We report herein a case of BCCT of the lung that was diagnosed by a transbronchial lung biopsy (TBLB). The findings of hematoxylin-eosin and immunohistochemistry obtained by the TBLB were consistent with a diagnosis of BCCT of the lung. Wedge resection was subsequently performed by video-assisted thoracotomy. To the best of our knowledge, this is the first reported case of BCCT diagnosed by TBLB.

Adult↗
PubMed1998

The surgical approach for descending necrotizing mediastinitis: report of two cases.

Descending necrotizing mediastinitis (DNM) is a potentially life-threatening complication that can develop after an oropharyngeal infection. Patients with DNM are usually treated with mediastinal drainage through a cervical or transthoracic approach, as well as by the systemic administration of antibiotics. We report herein the cases of two patients we recently treated for DNM. In the first patient, the DNM was limited to the upper mediastinum, and cervicomediastinal drainage was performed. In the second patient, the mediastinitis spread below the tracheal bifurcation down into the lower mediastinum, and an abscess was drained through a thoracotomy approach. The principles of the surgical approach for DNM are discussed, with a brief review of the literature following these case reports.

Abscess↗
PubMed1998

Long-term survival after repeated resections of Askin tumor recurrences.

The case of a 16-year-old boy is reported who underwent surgery for the excision of an Askin tumor and has subsequently undergone six excisions of local Askin tumor recurrences, with follow-up postoperative chemo- and radiotherapy over a 7-year period. The patient continues to survive. As far as can be determined, this patient appears to be the first reported case of long-term survival after repeated resections of local Askin tumor recurrences. It thus may be that postoperative chemo- and radiotherapy after repeated excisions of these local Askin tumor recurrences plays a role in prolonging survival.

Adolescent↗
PubMed1998

Autocrine motility factor in pulmonary adenocarcinomas: results of an immunohistochemical study.

Autocrine motility factors (AMF) have been shown to play an important role in tumor cell migration and metastasis. We have detected AMF expression in tissue specimens from 119 patients with pulmonary adenocarcinoma and examined the relationship between AMF expression, clinicopathological factors and prognosis. AMF expression was correlated with lymph node metastasis and stage. The prognosis of AMF-positive patients was poorer than that of AMF-negative patients. The expression of AMF correlated with more tumor aggressiveness and worse prognosis in pulmonary adenocarcinomas.

Adenocarcinoma↗
PubMed1997

Roles of the transforming growth factor beta 1 and its type I and II receptors in the development of a pulmonary adenocarcinoma: results of an immunohistochemical study.

BACKGROUND: In the United States, pulmonary adenocarcinomas have recently replaced squamous cell carcinomas as the most frequent type of lung cancer encountered. The incidence of pulmonary adenocarcinoma continued to increase worldwide. METHOD: To determine the roles of the transforming growth factor-beta 1 (TGF-beta 1), and TGF-beta type I receptor (T beta R-I), and the TGF-beta type II receptor (T beta R-II) in the progression of a pulmonary adenocarcinoma, their respective expressions have been immunohistologically studied in specimens from 120 pulmonary adenocarcinoma patients. RESULT: The overall prognosis was significantly poorer for patients showing positive TGF-beta 1, T beta R-I, T beta R-II expressions than for patients who were negative to all three immunostainings (P < 0.01). Our multivariate analysis also revealed that a positive TGF-beta 1 response significantly affect prognosis (P < 0.05). CONCLUSIONS: TGF-beta 1, T beta R-I, and T beta R-II play important roles in tumor progression, and a positive TGF-beta 1 expression can serve as a pulmonary adenocarcinoma marker. T beta R-I and T beta R-II expressions are necessary for TGF-beta signal transduction.

Activin Receptors, Type I↗
PubMed1997

New pathway for leads in dynamic graciloplasty.

Dynamic graciloplasty is one of the methods now used to re-establish anal function. Among complications, pain in the local tissue and skin irritation have been reported, both caused by lead wires. By passing the leads posterior to the adductor longus muscle, the wires do not irritate the local skin and are fixed well without sutures. We performed this procedure in three patients, with good results. The technique is easy, and complications involving the lead wires were minimized.

Anal Canal↗
PubMed1997

[The current status of postoperative adjuvant chemotherapy for colorectal cancer].

To evaluate the significance of postoperative adjuvant chemotherapy, randomized controlled trials of adjuvant chemotherapy after curative resection for colorectal cancer were reviewed. Several multiple-drug systemic chemotherapy (MOF, MMC/FT p.o., MMC/5-FU p.o., MMC/ UFT po) were useful as adjuvant treatment to improve survival or disease-free survival for patients with colorectal cancer. And worldwide meta-analysis found that continuous intraportal 5-FU was suggested to improve survival. Recently, combination chemotherapy trials utilizing 5-FU and levamisole, or 5-FU and leucovorin, demonstrated significant a survival advantage in the patients with high risk colon cancer, and these are widely used as adjuvant treatment for patients with Dukes C resected colon cancer. From results of many Japanese trials, although the effectiveness of adjuvant treatment for colorectal cancer still remain controversial, postoperative adjuvant chemotherapy is thought to improve the disease-free survival of patients after resection of rectal cancer or Dukes C colon cancer.

Administration, Oral↗