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Biomedical subjects

S Kusama

Publications and source records attributed to S Kusama.

At least 19 recordsLinked to original sources
PubMed1996

Pancreaticopleural fistula visualized by computed tomographic scan combined with endoscopic retrograde pancreatography.

We report a case with left pleural effusion caused by a pancreaticopleural fistula, which was formed between a small pseudocyst in the pancreatic body and the posterior mediastinal side of left costophrenic recess. The patient, a 66-year-old male with an alcohol drinking habit, had cough and chest pain but no symptoms or signs suggestive of abdominal pathology. In this case, computed tomographic scan performed immediately after endoscopic retrograde pancreatography was very useful not only in demonstrating the presence of the pancreatic internal fistula but in clarifying its anatomical relation to the surrounding organs.

Aged↗
PubMed1995

Factors influencing growth rate of recurrent stomach cancers as determined by analysis of serum carcinoembryonic antigen.

BACKGROUND: Although there are many reports regarding the growth rate of human tumors, those discussing stomach cancer are rare due to the difficulty in evaluating the growth rate of stomach cancer. Stomach cancers grow with either a large central depression or through severe invasion. Metastatic sites of stomach cancer, however, grow expandingly, as with pulmonary tumors. METHODS: The reported doubling time estimate, based on the serum level of carcinoembryonic antigen (CEA), agreed with the actual tumor doubling time investigated in 112 previously untreated patients with recurrent gastric cancers. The influencing factors of the CEA doubling time were studied clinicopathologically, and a possible correlation between postoperative survival and the CEA doubling time was noted. RESULTS: The CEA doubling time ranged from 12 to 105 days, with a mean of 37.5 +/- 20.5 days (mean +/- standard deviation) and a median of 32 days. The CEA doubling time did not differ significantly between sexes or between patients of varying ages. However, the CEA doubling time was significantly shorter in patients with papillary adenocarcinoma than in those with well or moderately differentiated tubular adenocarcinoma. The CEA doubling time of patients with poorly differentiated adenocarcinoma was divided into two groups--a shorter one and a longer one. The doubling time was also significantly shorter in patients with liver metastasis than in those with lymph node metastasis or peritoneal dissemination. Furthermore, among patients who did not receive any chemotherapy, a significant correlation was observed between the CEA doubling time and postoperative survival time. Most treated patients survived longer than untreated patients. CONCLUSION: The influencing factors on growth rates in recurrent stomach cancers were histologic type and metastatic sites. This growth rate plays an important role in determining the degree of biologic malignancy and may be influenced by some chemotherapeutic regimens.

Adenocarcinoma↗
PubMed1993

[Study of pre- and post-operative chemotherapy with oral 5-FU in patients with gastric cancer. Study Group of Pre- and Post-Operative Oral 5-FU in Gastric Cancer].

A cooperative study group consisted of 37 medical institutions evaluated the utility of pre- and post-operative chemotherapy with oral 5-FU by comparing with the historical controls of the patients treated with operation alone who were registered in Japanese Gastric Cancer List. Of 634 patients entered in this trial, 366 patients received curative operation at macroscopical stages II and III were studied as eligible cases. The relative 5-year survival at macroscopical stage II and III was 68.6% with 5-FU, significantly higher than 62.6% with operation alone (p < 0.05). Particularly, 5-year survival at macroscopical stage III was markedly different between 57.1% with 5-FU and 42.7% with operation alone. In order to make more effective comparison with the historical controls in this 1-arm trial, the background factors in 5-FU and control groups were matched in the ratio of 1:2 or 1:3 with respect to the following 4 factors: tumor site, S, N and macroscopical tumor type (by Kajitani's classification). As a result, the 5-year survival at macroscopical stages II and III was significantly higher with 5-FU (67.5%, 69.1%) than with operation alone (59.9%, 59.8%), and in particular this tendency was more marked at macroscopical stage III. These results suggest the usefulness of adjuvant chemotherapy in macroscopical stage III gastric cancer.

Administration, Oral↗
PubMed1990

Vascular lesions in the biopsied bronchus of patients with sarcoidosis changes of the endothelial cells in aggregation of eosinophils.

1) Aggregates of eosinophils closely related to the enlarged endothelial cells in the capillary vessels were recognized in 64% of 28 cases in biopsied specimens of the major bronchus of patients with sarcoidosis. 2) Electron microscopy revealed the vacuolated central cores or matrix in the specific granules of the eosinophils adjacent to the swollen vascular endothelial cells, frequent findings with attachment of the blood platelets to the damaged plasma membrane of the endothelial cells eventually becoming occluded in the lumen with platelet thrombosis, and multilayer formation of the basement membrane of the capillary vessels. 3) Sarcoidosis is suggested to be a pathological process producing both granuloma formation in each organ and vascular endothelial cell changes in the capillary vessels accompanied by aggregation of eosinophils in some periods of the disease process due to unidentified etiological factors.

Adult↗
PubMed1990

[A case of Behçet's disease with hemoptysis and chest X-ray abnormality].

A 41-year-old man was admitted to our hospital because of hemoptysis and dyspnea. Physical examination disclosed oral ulcer, acne and scrotal ulcer. Although ocular lesions were absent, the needle reaction was positive. Then we diagnosed this case as incomplete type of Behçet's disease. Chest X-ray showed diffuse retinolinear shadows in the entire lung field and an infiltrative shadow in the left middle lung field. CT-scan revealed interstitial shadows in the entire lung field, a wedge-shaped shadow in left S6 and aneurysmic dilatation of the left lower lobe pulmonary artery. Pulmonary angiography showed obstruction and aneurysmic dilatation of the left lower lobe pulmonary artery. Pathological examination of the TBLB specimen revealed thickening of the vessel wall, perivascular infiltrations of mononuclear cells, hemorrhage and slight thickening of alveolar septae. These findings were compatible with pulmonary lesions of Behçet's disease. After administration of corticosteroid, the symptoms and the chest roentgenographic findings improved. Pulmonary lesions of Behçet's disease were discussed.

Adult↗
PubMed1989

Blunted hypoxic ventilatory drive in subjects susceptible to high-altitude pulmonary edema.

It has been proposed that subjects susceptible to high-altitude pulmonary edema (HAPE) show exaggerated hypoxemia with relative hypoventilation during the early period of high-altitude exposure. Some previous studies suggest the relationship between the blunted hypoxic ventilatory response (HVR) and HAPE. To examine whether all the HAPE-susceptible subjects consistently show blunted HVR at low altitude, we evaluated the conventional pulmonary function test, hypoxic ventilatory response (HVR), and hypercapnic ventilatory response (HCVR) in ten lowlanders who had a previous history of HAPE and compared these results with those of eight control lowlanders who had no history of HAPE. HVR was measured by the progressive isocapnic hypoxic method and was evaluated by the slope relating minute ventilation to arterial O2 saturation (delta VE/delta SaO2). HCVR was measured by the rebreathing method of Read. All measurements were done at Matsumoto, Japan (610 m). All the HAPE-susceptible subjects showed normal values in the pulmonary function test. In HCVR, HAPE-susceptible subjects showed relatively lower S value, but there was no significant difference between the two groups (1.74 +/- 1.16 vs. 2.19 +/- 0.4, P = NS). On the other hand, HAPE-susceptible subjects showed significantly lower HVR than control subjects (-0.42 +/- 0.23 vs. -0.87 +/- 0.29, P less than 0.01). These results suggest that HAPE-susceptible subjects more frequently show low HVR at low altitude. However, values for HVR were within the normal range in 2 of 10 HAPE-susceptible subjects. It would seem therefore that low HVR alone need not be a critical factor for HAPE. This could be one of several contributing factors.

Adult↗
PubMed1989

Effects of polycations on pulmonary vascular permeability in conscious sheep.

The role of charged sites on the permeability characteristics of the pulmonary microvascular barrier were investigated using chronically instrumented unanesthetized sheep. In one series of experiments we studied the effects of the cationic amphiphile, dodecyl trimethylamine (DTA; 297 mol wt), and the anionic amphiphile, SDS (288 mol wt), on lung lymph flow rates (Ql), lung lymph to plasma protein ratios (L/P), pulmonary hemodynamics, and systemic hemodynamics. DTA significantly increased both Ql and L/P, whereas SDS had a more modest and transient effect on these variables. In a second series of experiments the polycations polybrene and poly-l-lysine were found to have very similar effects as those of DTA. In another series of experiments we tested the pretreatment inhibition potential of chlorpheniramine (an H1 receptor antagonist), dibutyryl-cyclic AMP (db-cAMP), and the calcium channel antagonists verapamil and nifedipine on polybrene-induced lung injury. We found that only verapamil and db-cAMP significantly attenuated the permeability effects of polybrene. We conclude that both cationic amphiphiles and polycations cause hemodynamic and permeability alterations in the pulmonary circulation of unanesthetized sheep. In addition, the permeability alterations induced by polybrene can be modulated by intracellular calcium and/or cAMP levels.

Animals↗
PubMed1989

[Outcome of adjuvant mifurol chemotherapy in patients with resected colonic carcinoma].

The effectiveness of Mifurol as an adjuvant chemotherapy in colonic cancer patients has been assessed on the basis of long-term survival at various institutions. In the curative resection cases, the outcome of administrations of MMC (0.2 mg/kg x 2) + Mifurol (6-12 mg/kg/day) (group A and MMC (0.2 mg/kg x 2)+ Tegafur (12 mg/kg/day) (group B) was compared. There was no difference in the background factors or in the total amount of the alpha rugs administrated in these two groups. The five-year survival by Kaplan-Meirer's method were 56.1% and 36.1% for group A and B, respectively, the difference being particularly remarkable in Dukes C cases.

Adult↗
PubMed1988

Pulmonary vascular response to platelet-activating factor in conscious sheep.

Hemodynamic response to an intravenous infusion of platelet-activating factor (PAF; 1 microgram/kg) was studied in conscious sheep with lung lymph fistulas. PAF induced increases in pulmonary arterial pressure and decreases in left atrial and systemic arterial pressures and in cardiac output, together with transient increases in thromboxane (Tx) A2 (as TxB2) and prostacyclin (as 6-keto-PGF1 alpha) values in plasma and lung lymph. There were also transient decreases in circulating leukocytes and platelets. The second infusion of PAF induced a reduced response compared with the first one, but the response to PAF was afterward maintained. Pretreatment with OKY 046, a thromboxane synthase inhibitor, reduced the first pulmonary vasoconstriction in response to PAF to a degree equivalent to that after successive infusions of PAF in control sheep. Pulmonary response to PAF (except on first infusion) and systemic cardiovascular response did not change whether or not TxA2 was produced. We therefore concluded that PAF mediates pulmonary and systemic cardiovascular effects via mechanisms other than TxA2 during successive infusions of PAF and that PAF-induced TxA2 contributes only to the pulmonary response to PAF on first infusion of the latter.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Effects of coronary ischemia on lung fluid balance in conscious sheep.

It has been suggested that coronary ischemia increases extravascular lung water. To determine whether pulmonary microvascular permeability is increased by coronary ischemia, we measured pulmonary hemodynamics, lung lymph flow (QL), and lymph-to-plasma protein concentration ratio (L/P) in 12 sheep with chronic lung lymph fistulas. Studies were done in 3 groups: in group 1 (n = 7) a marginal branch of the left circumflex artery (Lcx) was occluded, in group 2 (n = 5) left atrial pressure (Pla) was mechanically raised by 10 mmHg, and in group 3 (n = 5) Lcx was occluded and Pla was raised by 10 mmHg. In group 1, coronary occlusion increased QL (4.6 +/- 0.4 to 8.3 +/- 2.6 ml/h) without changes in L/P. In group 2, elevated Pla increased QL (5.1 +/- 1.2 to 10.1 +/- 3.0 ml/h) with decreases in L/P (0.71 +/- 0.02 to 0.61 +/- 0.02). In group 3, coronary occlusion with elevated Pla caused a further increase in QL (5.0 +/- 1.5 to 16.9 +/- 4.6 ml/h) without significant decreases in L/P (0.71 +/- 0.01 to 0.65 +/- 0.06). Lung lymph concentrations of 6-keto-prostaglandin F1 alpha (a degradation product of prostacyclin) increased transiently after coronary occlusion. These results indicate that coronary occlusion can increase transcapillary protein transport in lungs of conscious sheep and simultaneously increase prostacyclin production in the lung.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Thromboxane synthetase inhibition and pulmonary response to hypoxia in conscious adult sheep.

This study investigated the effects of a thromboxane synthetase inhibitor (OKY-046) and a cyclooxygenase inhibitor (ketoprofen) on hypoxic pulmonary vasoconstriction in conscious adult sheep in order to evaluate the physiological role of thromboxane and other cyclooxygenase products. In addition, we studied the effects of histamine H1 (chlorpheniramine) and H2 antagonists (cimetidine) on hypoxic pulmonary vascular tone. Hypoxia caused a 37% rise in pulmonary arterial pressure (p less than 0.05) and a 36% increase in pulmonary vascular resistance (p less than 0.05). Pretreatment with intravenous OKY-046 10 mg/kg or ketoprofen 2 mg/kg had no effect on normoxic pulmonary vascular tone and inhibited the increase in plasma TXB2 concentration during hypoxia without affecting the pulmonary pressor response to hypoxia. Cimetidine produced an increase in hypoxic pulmonary vascular tone when individual members of the group were compared, but there was no statistically significant difference when the group was compared to the control study. Chlorpheniramine had no effect on hypoxic pulmonary tone. These data suggest that hypoxic pulmonary vasoconstriction is not mediated by release of TXA2, that hypoxic vascular tone is not modulated by cyclooxygenase products, and that the histamine H2 receptor may play a modulating role in hypoxic pulmonary vasoconstriction in conscious adult sheep.

Acrylates↗
PubMed1988

The increased sympathoadrenal activity in patients with high altitude pulmonary edema is centrally mediated.

To assess the role of catecholamines in the pathogenesis of high altitude pulmonary edema (HAPE), 24-hour urinary catecholamine excretions and plasma catecholamine concentrations were measured. We also performed brain computed tomography (CT) in the same 8 serial patients with HAPE. 24-hour urinary norepinephrine excretion showed a statistically high value on admission compared with that after recovery (396.9 +/- 92.9 micrograms/24 hr, decreasing to 93.0 +/- 31.1 micrograms/24 hr, mean +/- S.E., p less than 0.01). 24-hour urinary epinephrine excretion on admission was also remarkably high, and returned later normal (62.9 +/- 25.8 micrograms/24 hr, decreasing to 12.7 +/- 4.2 micrograms/24 hr, p less than 0.05). Plasma norepinephrine concentration was also high, but returned to normal (0.260 +/- 0.073 ng/ml, to 0.11 +/- 0.043 ng/ml) by the time of discharge. Brain CT scans revealed diffuse low density of the entire cerebrum, small ventricles, disappearance of sulci, and small cistern, suggesting cerebral edema. These findings may suggest that the heightened sympathoadrenal activity that occurred in the patients concomitant with cerebral edema was related to the high altitude illness rather than to simple exposure to high altitude.

Adrenal Glands↗
PubMed1988

Cell surface analysis of purified protein derivative-induced cytotoxic cells in tuberculous pleurisy.

High NK cell activity was observed in tuberculous pleural effusions from which mycobacterium tuberculosis was cultured. Further we observed that cytotoxicity against K562 was augmented by purified protein derivative (PPD). We have now performed the surface analysis of the cells in PPD-induced cytotoxicity using various monoclonal antibodies (mAb) (anti-Leu 1, anti-Leu 7, anti-Leu 11, anti-HLA-DR). Leu 11+ cells have essential cytotoxicity in PPD-induced cytotoxicity, but neither Leu 1+ nor Leu 7+ cells have such cytotoxicity. The PPD-induced cytotoxicity eliminated by the treatment with anti-HLA-DR mAb plus complement was reconstituted by adding either interferon (IFN)-alpha or beta. From these data it was suggested that Leu 11+ cells could be activated through either IFN-alpha or beta derived from HLA-DR+ cells in tuberculous pleural effusion.

Adult↗
PubMed1988

Purified protein derivative induced cytotoxicity in carcinomatous and tuberculous pleurisy.

We have found that natural killer (NK) cells were very active in pleural effusions containing Mycobacterium tuberculosis. Cytotoxicity against K562 and Raji was augmented when the mononuclear cells were cocultured for 18 hr with purified protein derivative (PPD) derived from M. tuberculosis culture supernatants. In pleural effusions of cancer patients, PPD-activated mononuclear cells were less cytotoxic than their counterparts in peripheral blood. However, in the same patients, interferon and interleukin-2 production was greater in pleural effusions than in peripheral blood. On the other hand, in tuberculosis patients there was no significant difference in cytotoxicity between peripheral blood and pleural effusion mononuclear cells, but the production of interferon and interleukin-2 was higher in pleural effusions than in peripheral blood. Neither group of patients consistently demonstrated a correlation between production of interferon or interleukin-2 in peripheral blood and cytotoxicity. Both PPD-induced cytotoxicity and the production of interferon and interleukin-2 were lower in mononuclear cells of carcinomatous than tuberculous pleural effusion. These results indicate that peripheral blood and pleural effusion mononuclear cells differ in cytotoxicity as well as in interferon and interleukin-2 production. Further, these activities also differ in tuberculous and carcinomatous pleural effusions.

Adult↗
PubMed1988

[Estimation of regional pulmonary ventilation using perfusion lung scintigram].

Using perfusion lung scintigram, motion of the regional pulmonary area and lung edge during ventilation was analyzed in 30 patients with various respiratory diseases. Images at maximal inspiration (I) and expiration (E) were obtained after the intravenous injection of 99mTc macroaggregated albumin (222-370 MBq) using a scintillation camera coupling to a small digital computer. Radioactivity in each pixels (E and I) and number of pixels in the both lungs (AE and AI) were calculated from the image of E and I. Changes of the regional pulmonary radioactivity during ventilation were calculated according to an expression as (E-I)/I, and the image of (E-I)/I was obtained too. The image of (E-I)/I consisted of positive and negative components. The image of positive (E-I)/I visualized the motion of the regional pulmonary area, and sum of positive (E-I)/I in the both lungs was correlated with vital capacity (r = 0.83, p less than 0.001). The image of negative (E-I)/I superimposed with the edges of the lung at maximal inspiration and expiration revealed the limits of the motion of the lung edge during ventilation. These results suggest that this technique is useful to estimate the regional pulmonary ventilation and motion of the lung edge.

Humans↗