Biomedical subjects

T Fukumoto

Publications and source records attributed to T Fukumoto.

At least 91 records · Page 5Linked to original sources

PubMed1997

Oxygen delivery as a factor in the development of fatal postoperative complications after oesophagectomy.

BACKGROUND: This study was designed to assess the impact of oxygen transport variables on outcome in 115 patients undergoing elective surgery for oesophageal carcinoma. METHODS: Haemodynamic parameters were determined using a Swan-Ganz catheter in all patients on the day before operation, 6 h after operation, and daily for the first 4 days after operation. RESULTS: Oxygen delivery and consumption at 6 h were significantly higher in survivors than in non-survivors. However, oxygen delivery and consumption in both groups did not differ significantly after postoperative day 1. Of 17 patients with oxygen delivery levels lower than 445 ml min-1 m-2 at 6 h, eight died in hospital. Oxygen delivery in patients who developed either an anastomotic leak or severe pneumonia was significantly lower 6 h after surgery. Lower levels of oxygen delivery preceded postoperative complications. CONCLUSION: Oxygen delivery 6 h after oesophagectomy correlates with postoperative complications and may be a determinant of hospital mortality.

Aged↗

PubMed1997

[Antimicrobial activities of arbekacin against methicillin-resistant Staphylococcus aureus].

In order to evaluate antimicrobial activity of arbekacin (ABK), coagulase-type and minimum inhibitory concentrations (MICs) of ABK and other drugs were determined against 700 strains of methicillin-resistant Staphylococcus aureus (MRSA) that were obtained in our laboratory from 1990 to 1996, 7 years. The results are summarized as follows; 1. The MIC-distributions of ABK against 100 strains of MRSA obtained yearly did not show stochastically significant differences. 2. The coagulase-type distributions showed differences over the years. Coagulase-type II strains increased and type IV strains decreased, and MIC-distributions of ABK and other drugs were different according to coagulase-types. 3. The detection frequencies of ABK-resistant strains (MIC of ABK: > or = 12.5 micrograms/ml) were 2.0 approximately 8.0% through the years. The frequency reported in 1980 was equal to the frequency obtained in 1992 approximately 1993 in a nationwide survey. Coagulase-types II, IV and VII that were ABK-resistant strains were frequently obtained, and most of ABK-resistant strains were also highly resistant to gentamicin.

Aminoglycosides↗

PubMed1997

[A case of advanced esophageal cancer successfully treated by concurrent use of radiotherapy and low-dose CDDP and continuous infusion of 5-FU].

A 75-year-old male patient with advanced esophageal cancer was treated by radiotherapy and chemotherapy. External radiotherapy was performed by the field in field method. A total dose of 60 Gy was used in the small field (7 x 5 cm) (2.4 Gy/f and 25 f/5 wks) and a total dose of 45 Gy in the large field (14 x 6 cm) (1.8 Gy/f, 25 f/5 wks). Concurrent chemotherapy was performed at the 2nd and 5th weeks of the radiation therapy. In this chemotherapy of CDDP plus 5-FU, CDDP (25 mg/day) was given on days 1,3 and 5 of the week and 5-FU (500 mg/day) was given for 5 days by continuous infusion for the same week. By this treatment, a complete response (CR) was obtained, and no serious side effects were observed. After 1 year and 6 months, he is alive with no evidence of recurrence.

Aged↗

PubMed1997

Analysis of allogenic lymphocytes in rat thymus following sublethal irradiation.

The effects of allogeneic lymphocytes on the rat thymus following sublethal irradiation were investigated using immunofluorescence. The recovery of thymus weight following irradiation was delayed in rats 6 days after receiving lymphocytes compared to controls. Allogeneic cells forming colonies were detected by immunofluorescence in both the cortex and medulla of the host thymus, most frequently on day 15 when an appropriate number (3 x 10(6)) was injected. The allogeneic cells detected in the host thymus, presumably T lymphocytes, appeared to disturb thymic reconstitution following irradiation. However, double-immunofluorescence staining revealed that allogeneic cells did not affect the thymic stromal microenvironment. Allogeneic cells may have subsequently affected thymic tissue via cytokines. It is important to investigate not only the character of allogeneic cells in the host thymus but also the interactions of donor allogeneic cells, host immature lymphocytes and thymic epithelial cells because of the possibility that these allogeneic cells in the host thymus could prevent the rejection of allogeneic transplants.

Animals↗

PubMed1997

[Treatment of thoracic esophageal carcinoma which invades adjacent structure--significance of resection and combined therapy].

From January 1980 to December 1994, a total of 64 cases of thoracic esophageal carcinoma which invaded adjacent structure (A3) were resected and 35 cases were unresected in Kagoshima University Hospital. Adjacent structures were mainly trachea/bronchus, aorta or pulmonary vein. Combined resections were performed in 22 cases (34.4%), and no tumors remained in 12 cases (18.8%). One year survival rates and 50% survival time of the no residual tumor group were 25.7% and 8.5 months, while the rates of the residual tumor group were 15.7% and 5.1 months. But, there was no significant difference of survival rates according to the amount of residual tumor. On the other hand, 1-year survival rates and 50% survival time of unresected group were 3.1% and 4.5 months. As a postoperative adjuvant therapy, radiation was the most effective modality. As a result, operations should be done at first for the A3 carcinoma in which a complete combined resection is expected. On the other hand, radiation or chemotherapy should be selected for the cases in which the tumor may remain, even though combined resection is done.

Adult↗

PubMed1997

[Antimicrobial activities of clarithromycin against recent obtained clinical isolates].

In order to evaluate antimicrobial activities of clarithromycin (CAM), minimum inhibitory concentrations (MICs) of CAM and control drugs were determined against clinical isolates that were obtained from outpatients in 1994 and 1996. The results are summarized as follows; 1. It was not showed that CAM-resistant strains were increasing among Staphylococcus spp., beta-streptococci, Moraxella subgenus Branhamella catarrhalis, Haemophilus influenzae, Bordetella pertussis, Campylobacter jejuni subsp. jejuni, Chlamydia trachomatis and Mycoplasma pneumoniae. It appeared that resistances to CAM and macrolides (MLs) were increasing among Streptococcus pneumoniae and Peptostreptococcus spp. 2. The drug susceptibility patterns to MLs were similar and detection frequencies of induced resistant strains that were resistant to only 14-membered ring MLs including CAM and constitutive resistant strains that were resistant to 14 and 16-membered ring MLs were high among Streptococcus pneumoniae and Peptostreptococcus spp. It appears that MLs-resistance systems are linked to each other, and that this was a cause of increasing MLs-resistance among these bacterial species. 3. Notwithstanding of antibiotic resistance problems, CAM is still useful since it maintains strong antimicrobial activities against M. (B.) catarrhalis, B. pertussis, C. jejuni subsp. jejuni, C. trachomatis and M. pneumoniae, and it controls arginate producing abilities of mucoide strains of Pseudomonas aeruginosa.

Anti-Bacterial Agents↗

PubMed1997

[An elderly patient with purpura nephritis that appeared after extracorporeal shock wave lithotripsy].

We report a 63-year-old male patient with purpura nephritis, which appeared 7 days after extracorporeal shock wave lithotripsy (ESWL). He was referred to our clinic because of a petechial rash on both lower extremities, pretibial edema and massive proteinuria. Urinalysis showed proteinuria and hematuria and some hyaline casts. A 24-hour urine sample contained 5.0 g of protein. Renal function on admission was decreased: serum creatinine was 1.5 mg/dl and creatinine clearance, 21 ml/min. Immunoserological tests demonstrated an increase in serum IgA (424.3 mg/dl). A skin biopsy revealed leukocytoclastic vasculitis. A renal biopsy showed endocapillary proliferation in a diffuse, but segmental fashion. However, no crescent formation was seen. Immunofluorescence microscopy disclosed mesangial staining for IgA and C3. Electron microscopy demonstrated severe injury to endothelial and epithelial cells: detachment of endothelial and epithelial cells, foot process effacement and macrophage infiltration. Electron-dense deposits were observed in the subendothelial and paramesangial areas. Because renal function was deteriorating rapidly, methylprednisolone pulse therapy and immunosuppressive treatment were implemented. Treatment was effective and the patient's renal function and proteinuria improved remarkably. The electron microscopic findings in this case of purpura nephritis seemed to be more severe than usual, suggesting that ESWL may aggravate glomerular damage.

Drug Administration Schedule↗

PubMed1996

Nerve regeneration and origin of Schwann cells in peripheral nerve allografts in immunologically pretreated rats.

For peripheral nerve allografts, the conditions for successful nerve regeneration and the possibility of transplanting Schwann cells were examined using a model of pretreated rats. Incomplete immunosuppression was achieved in recipient rats with donor red blood cell infusions given before allogeneic nerve grafting (RBC group). The origin of Schwann cells in the grafts was assessed by immunohistochemical staining from 1 week to 12 weeks after transplantation. In the RBC group, the replacement of donor Schwann cells by recipient cells was detected at 3-8 weeks, with the graft being filled with many of these cells at all times, and successful nerve regeneration was seen after 12 weeks on morphometric and electrophysiologic evaluations. In peripheral nerve allografts, pretreatment with donor-specific blood transfusion did not induce significant immunosuppression compared with allotransplantations of some tissues and organs. Clinically, if the state of immunosuppression can be controlled by RBC transfusion, it is possible that donor tissues may be replaced by recipient tissues and that nerves will regenerate successfully.

Animals↗

PubMed1996

GB virus C infection in patients with chronic hepatitis B and C before and after liver transplantation.

Recently, a novel virus, tentatively designated GB virus (GBV-C) was identified in patients with hepatitis. The frequency of this novel virus infection was therefore investigated in 58 patients with chronic hepatitis B virus (HBV) infection and in 74 patients with chronic hepatitis C virus (HCV) infection who had received orthotopic liver transplantation (OLT) because of decompensated liver cirrhosis. Before OLT, GBV-C sequences were found by reverse transcription nested polymerase chain reaction with primers derived from the helicase-like region in six (10%) of the HBV- and in six (8%) of the HCV-infected patients. Specificity of the polymerase chain reaction products was confirmed in eight of them by direct sequencing. Pretransplant GBV-6 viremia was associated with posttransplant viremia in 75% of patients. The comparison of GBV-C nucleotide and amino acid sequences within the helicase-like region revealed that pre- and posttransplant sequences differed only in 0-7 nucleotide exchanges, and with the exception of one, all of them were silent mutations. After OLT, 29% of the HBV- infected and 12% of the HCV-infected patients became GBV-C positive,indicating a high rate of "de novo" GBV-C infection. By correlating the GBV-C status with the frequency of the occurrence of graft hepatitis in both groups of patients, it became evident that posttransplant GBV-C viremia did not increase the risk for this clinical condition. However, we found a significantly higher percentage of hepatocellular carcinoma in patients with pre-OLT GBV-C/HCV coinfection compared with patients with HCV infection alone (5/6 vs. 16/68;P<0.01).

Adult↗

PubMed1996

Conformational change in DNA induced by cationic bilayer membranes.

The effect of synthetic cationic lipids on the structure of DNA was studied. The fluorescence enhancement of ethidium bromide on intercalation into DNA was suppressed by the addition of bilayer-forming lipids, but not by micellar ones. Results on the fluorescence depolarization index suggest that ethidium bromide is not released from DNA by lipids intercalated into DNA. CD spectra of the DNA-lipid complexes revealed that the structure of DNA was changed only by bilayer-forming lipids at temperatures lower than their Tc values. Thus, the conformation of DNA is forced to change by cationic lipids forming the rigid bilayer membrane so that ethidium bromide fluorescence might be reduced, and the conformation can be controlled by selection of the appropriate lipid and temperature.

Cations↗

PubMed1996

2-Carboxyethylgermanium sesquioxide, a synthetic organogermanium compound, as an inducer of contrasuppressor T cells.

2-Carboxyethylgermanium sesquioxide (Ge-132), a synthesized organogermanium compound with immunomodulating activities, was shown to be an inducer of anti-suppressor T cells in normal mice. The suppressor cell activity of T6S cells, a clone of burn-induced CD8+ IL-4-producing suppressor T cells, was clearly inhibited when a mixed lymphocyte-tumor cell reaction of the clone was conducted with splenic mononuclear cells from mice treated orally with a 100 mg/kg dose of Ge-132. The activity of anit-suppressor cells was demonstrated in spleens of mice 2 days after treatment with Ge-132 and reached its peak on day 3. The anti-suppressor cells induced by the compound were of a contrasuppressor T cell-linage, because they were characterized as CD4+ CD28+ TCRalpha/beta+ Vicia villosa lectin-adherent T cells. These cells produced IFN-gamma but did not produce IL-2, IL-4, IL-6 or IL-10 in their culture fluids. CD4+ anti-suppressor T cells induced by Ge-132 may be different from other subsets of CD4+ T cells because Th1 and Th2 cells generated in our laboratory did not adhere to Vicia villosa lectin-coated petri dishes, and each produced specific cytokines. Th1 cells produced IFN-gamma and IL-2 while Th2 cells produce IL-4 and IL-10 in vitro. These results suggest that Ge-132 may be useful as an inducer of contrasuppressor T cells in immunocompromised individuals bearing suppressor T cells. To eliminate suppressor T cells from immunocompromised hosts may result in improved resistance from various opportunistic infections.

Animals↗

PubMed1996

Analysis of fetal rat liver using monoclonal antibodies.

BACKGROUND: In previous studies, we developed several monoclonal antibodies (mAbs) against fetal and adult rat liver to analyze the hemopoietic microenvironment of the fetal liver during the gestational period. In this study, we have developed two new mAbs against fetal rat liver cells and have examined the characteristics at various gestational ages of fetal liver and of adult liver. METHODS: The characteristics of these monoclonal antibodies were demonstrated by examining several tissues using immunohistochemical staining and flow cytofluorometry. RESULTS: Monoclonal antibodies HAM10 and HAM11 were developed against fetal rat liver cells. These reacted with the cytoplasm of fetal and adult hepatocytes. HAM10 antigen expression was strong at approximately day 18 of gestation in the active period of hemopoiesis in fetal rat liver but was much lower in adult liver. HAM10 antigen expression also increased in liver after partial hepatectomy and was reduced abruptly to a normal level thereafter. HAM11 antigen expression in fetal liver was weaker than that of HAM10 antigen expression. The degree of HAM11 antigen expression increased as gestation proceeded, reaching a maximum in adult liver. CONCLUSIONS: Both HAM10 and HAM11 antigens may play a role in the morphogenesis of hepatocytes and in the hemopoietic microenvironment for hemopoietic cells. Moreover, HAM10 antigen is may play a role in hepatocyte proliferation in the fetal liver, whereas HAM11 antigen may contribute to the maturation of fetal- to the adult-type hepatocytes.

Age Factors↗

PubMed1996

Viral dynamics of hepatitis C early after orthotopic liver transplantation: evidence for rapid turnover of serum virions.

The pathogenesis of hepatitis C virus (HCV) infection is likely to be associated with viral replication in vivo, but little is known concerning the dynamics of HCV turnover. We performed serial measurements of serum HCV-RNA levels following orthotopic liver transplantation (OLT) in nine patients with HCV-positive cirrhosis. Serum HCV-RNA levels were determined by quantitative polymerase chain reaction before, immediately after, and for up to 1 month after OLT. There was a rapid decline in HCV-RNA levels from 3.1 +/- 1.3 x 10(5) copies/ mL (mean +/- SEM) preoperatively to 0.15 +/- 0.6 x 10(5) copies/mL on the first and 0.16 +/- 0.6 x 10(5) copies/mL on the second postoperative day (mean viral half-life, 4.0 +/- 0.5 h). Thereafter, HCV-RNA levels increased in all but one patient, and by postoperative day 8 reached 3.6 +/- 1.3 x 10(5) copies/mL, exceeding the preoperative levels irrespective of the use or not of rescue immunosuppressive therapy including steroid bolus administration. In most patients, serum virions continued to increase averaging 11.6 +/- 2.8 x 10(5) copies/mL on the 30th postoperative day. These findings indicate that the half-life of HCV is quite short, and that extrahepatic viral replication contributes little to the total virus pool in serum. Furthermore, the marked HCV replication beginning as early as the third postoperative day strongly suggests that the liver graft is rapidly reinfected by HCV after OLT.

Adult↗

PubMed1996

Pharmacokinetics of intravenous adriamycin for anhepatic chemotherapy during liver transplantation.

Frequent recurrence of hepatocellular carcinoma after liver transplantation indicates the necessity to eliminate patients with advanced disease and combine transplantation with some form of perioperative adjuvant chemotherapy. This study was undertaken to elucidate adriamycin pharmacokinetics for anhepatic chemotherapy during liver transplantation. beagles of both sexes were allocated into two groups, controls (n = 4) and anhepatic animals with total hepatectomy under venovenous bypass (n = 5). In both groups, adriamycin was administered in 1 min at a dose of 1 mg/kg through the left antecubital vein and peripheral blood was obtained at intervals for up to 2 h to determine the plasma adriamycin levels. The animals were then sacrificed to determine tissue adriamycin levels in the liver, kidney, heart, lung, and skeletal muscle. Plasma adriamycin levels in anhepatic animals were significantly higher than those in controls at all measured time points after 10 min, resulting in a 50% reduction of the mean total body clearance of adriamycin compared with controls (P < 0.01). However, there was no statistically significant difference in adriamycin levels between the two groups for all measured tissues except for the liver. Despite the complete lack of hepatic function, anhepatic animals showed only a 50% reduction in total body clearance of adriamycin compared with normal controls, probably due to compensatory excretion from other organs such as the kidney. These results suggest that systemic chemotherapy with the standard dose of adriamycin may be tolerable during the anhepatic period of liver transplantation with enhanced tumoricidal effects on micrometastases.

Animals↗

PubMed1996

Difference in cytokine production in acute and chronic rejection of rat lung allografts.

In Brown Norway to Lewis rat lung transplantation, short-term administration of cyclosporine produces permanent adoption of allografts; however, the adopted grafts show symptoms of chronic rejection. To clarify the difference in cytokine production in acute an chronic rejection of the allografts, an immunohistochemical study was performed. In acute rejection, positive cells for respective cytokines were observed in infiltrating cells, increasing in number as the days after transplantation passed, and reaching a maximum on the fifth day. The strongest reactivity was observed perivenously. In chronic rejection, TNF-alpha positive cells were observed in the perivascular and peribronchial regions, especially around class II positive epithelia. The number of positive cells was, however, less than that in the vascular phase of acute rejection. Few cells were positive for IL-1 beta, IFN-gamma and, unexpectedly, for IL-4. These facts indicate the functional difference of infiltrating cells between acute and chronic rejection.

Animals↗

PubMed1996

A novel paper cuff for vascular reconstruction in canine liver transplantation.

A new, simple method of producing optimal cuffs using thin paper and then setting it in resin for vascular reconstruction in canine liver transplantation is herein described. Thin Paper was cut into a paper tape strip. By fixing both ends of this paper tape, a cylinder paper core of any desired size could thus be obtained. The paper core was immersed into a two-liquid mixture-type resin, removed, and left to harden. The paper cuffs (0.2 mm or less in thickness) were then used for anastomoses of the portal vein and the infrahepatic inferior vena cava in a series of 10 consecutive canine liver transplantations. Out of 10 animals, 8 survived for more than 5 days. The vascular patency in these 8 animals at the cuff anastomotic sites was 100% at postmortem. We therefore conclude that this paper cuff appears to be useful for various types of experimental liver transplantations in large animals.

Anastomosis, Surgical↗

PubMed1996

Percutaneous hepatic venous isolation and extracorporeal charcoal hemoperfusion for high-dose intraarterial chemotherapy in patients with colorectal hepatic metastases.

The results of treating 12 consecutive patients with unresectable colorectal hepatic metastases with a hepatic arterial infusion of high-dose Adriamycin, 100-120 mg/m2, using hepatic venous isolation (HVI) and charcoal hemoperfusion (CHP) are reported herein. Adriamycin was administered over 5-15 min under extracorporeal drug elimination by HVI-CHP. HVI was percutaneously accomplished by either the double-balloon technique using a Fogarty occlusion catheter (8/22F) or a balloon-tipped catheter (16F). During the infusion, isolated hepatic venous blood was filtered by CHP and pumped into the left axillary vein. There were no lethal complications, and good hemodynamic tolerance to HVI-CHP was confirmed. Tumor liquefaction accompanied by a sharp decrease in serum carcinoembryonic antigen levels by more than 50% of pretreatment levels was observed in 6 of the 12 patients 1 month after treatment. Apart from chemical hepatitis, which developed in 11 (92%) of the patients, the Adriamycin toxicities were well controlled following the development of nausea and vomiting in 2 patients (17%), leukopenia < 2,000/mm3 in 3 (25%), and gastric ulcer in 1 (8%). These results indicate that this method is a safe and useful procedure for otherwise hazardous high-dose intra-arterial chemotherapy in patients with unresectable hepatic tumors.

Adult↗

PubMed1996

Centrifugal pump-assisted venous bypass between the superior mesenteric vein and the umbilical vein during portal vein resection.

We describe herein our method of performing centrifugal pump-assisted venous bypass between the superior mesenteric vein and the umbilical vein, developed with the aim of preventing congestion of the small intestine and promoting strong and constant hepatic blood flow during portal vein resection. By using this bypass method, portal vein resection and reconstruction was able to be carried out with ease and safety in six patients undergoing surgery for a pancreatic mass or cancer. No coagulation abnormalities, thrombocytopenia, leukocytopenia, severe liver dysfunction, or portal vein thrombosis developed in any of the patients postoperatively. Thus, we highly recommend this simple and reliable method of bypass when portal vein resection is being performed.

Carcinoma, Acinar Cell↗