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Biomedical subjects

T Kondo

Publications and source records attributed to T Kondo.

At least 289 records · Page 16Linked to original sources

Blasticidin A derivatives with highly specific inhibitory activity toward aflatoxin production in Aspergillus parasiticus.

Blasticidin A (1), an antibiotic, has strong inhibitory activity toward aflatoxin production by Aspergillus parasiticus. We prepared some derivatives of 1 and examined their biological activities. Among them, derivatives 3 and 4 without the tetramic acid moiety of 1 maintained inhibitory activity toward aflatoxin production, but did not show antifungal activity or toxicity. RT-PCR experiments indicated that derivatives 3 and 4 as well as 1 significantly reduced the expression of genes encoding aflatoxin biosynthetic enzymes (pksA, ver-1 and omtA) and a regulatory gene (aflR) in A. parasiticus. These results suggested that derivatives 3 and 4 can inhibit aflatoxin production more specifically than 1 by inhibiting an early step prior to the expression of aflR in the pathway of aflatoxin biosynthesis.

Aflatoxins↗

[Assessment of systematic nodal dissection by VATS lobectomy for lung cancer].

The feasibility of the complete systematic nodal dissection by the video-assisted thoracic surgery was prospectively assessed in 22 cases of clinical stage I lung cancer (16 right, 6 left cases). Resection of the designated lobe with the mediastinal lymph node dissection was carried out by the small thoracotomy with the aid of the thoracoscope, followed by the standard surgery to verify the completeness of systematic nodal dissection. Although residual lymph nodes were found in 14 of 22 cases, the residual rate was 2.9% and 2.7% by the number and 2.3% and 2.1% by the weight in right and left cases, respectively. Average time and hemorrhage for performing the procedure were 196 minutes, 216.7 minutes and 157.5 g, 145 g in right and left cases, respectively. As a consequence, sufficient systematic nodal dissection in lung cancer was suggested to be feasible by VATS lobectomy.

Humans↗

[beta-thalassemia minor diagnosed in a patient with chronic myelogenous leukemia during hydroxyurea therapy].

A 55-year-old man was admitted to our hospital because of leukocytosis and microcytic anemia with hypochromia, target cells, and increased levels of hemoglobin A2 and hemoglobin F. The results of a gene analysis yielded a diagnosis of chronic myelogenous leukemia and beta-thalassemia minor. A gradual increase in hemoglobin was observed during hydroxyurea therapy, which was performed over a 12-week period. This increment appeared to be due to suppressed production of myeloid cells. It was been reported that hydroxyurea increases total hemoglobin due to increased hemoglobin F synthesis in patients with beta-thalassemia. However, hydroxyurea had no clear influence on hemoglobin concentration in this case.

Antineoplastic Agents↗

[A case of right B2 hillar lung cancer treated by sleeve segmentectomy].

A 47-year-old male, a heavy smoker, was referred to our hospital after Class IV was detected by screening of sputum cytology. His chest X-ray film showed no abnormalities, but bronchoscopy revealed a small nodular lesion at the orifice of right B2. Squamous cell carcinoma was diagnosed by transbronchial biopsy. The clinical stage was I (T1N0M0), and S2 sleeve segmentectomy with lymph node dissection (R 2 b) was performed. The pathological stage was I (T1N0M0), and it was confirmed as early hilar lung cancer. There were no post operative complications and he is well without any evidence of recurrence 5 months after surgery. It may well be considered that this segmental bronchoplastic procedure is useful for cases with early stage squamous cell carcinoma of the segmental bronchus to preserve pulmonary function.

Carcinoma, Squamous Cell↗

[A case of angiosarcoma in retroperitoneal cavity].

We report a case of angiosarcoma in the retroperitoneal cavity. A 66-year-old man was admitted to our hospital with the complaint of chest discomfort. Imaging studies including computed tomography scan and magnetic resonance imaging revealed a large solid retroperitoneal mass adjacent to the bladder. There was no evidence of metastasis. The tumor was surgically resected and histopathologically diagnosed as angiosarcoma from the positive staining for VIIIth factor, mitotic figures and abnormal endothelial cells. Six months after surgery, local recurrence adjacent to the bladder appeared. We resected the mass and started adjuvant therapy using Interleukin-2. However, he died of progressed disease one year after the first operation.

Aged↗

[Changes of serum hepatocyte growth factor in coronary artery disease].

Hepatocyte growth factor (HGF) is an endothelial cell specific growth factor involved in the repair of endothelial cells and collateral formation, however, the role for coronary artery disease is still unknown. We measured serum HGF level in various coronary artery diseases to examine the clinical significance. Serum HGF level was measured using the enzyme-linked immunosorbent assay method in patients with stable effort angina pectoris (n = 26), old myocardial infarction (n = 18), unstable angina pectoris (UAP; n = 10) and acute myocardial infarction (AMI; n = 21). As a control group, we selected 11 patients with neurocirculatory asthenia. Blood samples from peripheral veins were collected at cardiac catheterization before heparin administration. In the AMI group, blood samples were also collected at 48, 72 hr, 1, 2, 3 and 4 weeks from the peripheral veins and 48 and 72 hr after reperfusion from the coronary sinus. Serum HGF level was significantly higher in the UAP (0.41 +/- 0.12 ng/ml, p < 0.001) and AMI groups (0.38 +/- 0.26 ng/ml, p < 0.05) compared to the control group (0.19 +/- 0.09 ng/ml). Serum HGF level peaked 48 hr after reperfusion in both the peripheral veins (0.42 +/- 0.16 ng/ml) and coronary sinus (0.58 +/- 0.23 ng/ml) in the AMI group, with a significantly higher level in the coronary sinus than the peripheral veins (p < 0.05). No significant correlation between peak HGF level in the peripheral veins and peak creatine kinase (CK), CK-MB, ejection fraction and cardiac index was observed. Serum HGF was elevated in acute coronary syndrome, indicating advanced endothelial cell damage. HGF is produced, at least partially, in the heart in patients with AMI. Serum HGF level may be useful to detect endothelial cell damage rather than myocardial cell damage.

Angina Pectoris↗

[A case of emphysematous pyelonephritis improved with conservative therapy--indication for conservative therapy].

A 51-year-old female patient was hospitalized in our department with high fever and left flank pain. Laboratory examination showed leukocytosis, increase of C-reactive protein (CRP), hyperglycemia and renal insufficiency. Enterobacter aerogenes grew out of the cultured urine. The radiograph and computerized tomographic (CT) scan revealed streaky gas in the destroyed left renal parenchyma with perirenal gas. She was diagnosed with left emphysematous pyelonephritis. Antibiotics therapy, treatment for sepsis and disseminated intravesicular coagulation was initiated resulting in mitigation of inflammation. High blood glucose initially required insulin therapy, but finally returned to normal levels through administration of oral antidiabetics. Although leukocytosis and low grade fever continued, the patient was discharged on day 53 with a negative CRP. CT scan indicated that the emphysematous change was localized after three months and almost resolved after four months. Renal scintigram indicated the residual function of the affected kidney. Because of the possibility of residual renal function and the cure by conservative therapy alone, the conservative therapy is preferred when the initial treatment is effective.

Anti-Bacterial Agents↗

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (1998)].

The bacteria isolated from the patients with lower respiratory tract infections were collected by institutions located throughout Japan, since 1981. Ikemoto et al. have been investigating susceptibilities of these isolates to various antibacterial agents and antibiotics, and analyzed some characteristics of the patients and isolates from them each year. Results obtained from these investigations are discussed. In these 18 institutions around the entire Japan, 532 strains of presumably etiological bacteria were isolated mainly from the sputa of 438 patients with lower respiratory tract infections during the period from October in 1998 to September in 1999. MICs of various antibacterial agents and antibiotics were determined against 85 strains of Staphylococcus aureus, 100 strains of Streptococcus pneumoniae, 96 strains of Haemophilus influenzae, 75 strains of Pseudomonas aeruginosa (non-mucoid strains), 6 strains of Pseudomonas aeruginosa (mucoid strains), 38 strains of Moraxella subgenus Branhamella catarrhalis, 26 strains of Klebsiella pneumoniae etc., and the susceptibilities of 517 strains were assessed except for those strains that died during transportation. S. aureus strains for which MICs of oxacillin (MPIPC) were higher than 4 micrograms/ml (methicillin-resistant S. aureus: MRSA) accounted for 60.0%. Vancomycin (VCM) and arbekacin (ABK) showed the most potent activities against MRSA. But one of MRSA showed resistance to ABK with the MIC of 64 micrograms/ml. The sensitive strains of MRSA to VCM have decreased. The frequency of penicillin (PC)-intermediate S. pneumoniae (PISP) + PC-resistant S. pneumoniae (PRSP) have increased in 46.0% for 1998 comparatively from 30.9% of 1997's. But PRSP decreased, and PISP increased into 39.0% of 1998 years from 19.8% of 1997's. Panipenem (PAPM), imipenem (IPM) and faropenem (FRPM) showed the most potent activities against S. pneumoniae with MIC80s of 0.125 microgram/ml or below. Against H. influenzae and M. (B.) catarrhalis, almost all the drugs showed good activities. The sensitive strains of them against ceftazidime (CAZ) decreased in 1997, but those have increased in 1998. Inversely, the susceptibility of them against cefotiam (CTM) had been higher in 1997, but those have been lower in 1998. Tobramycin (TOB) showed the most potent activity against P. aeruginosa (both mucoid and nonmucoid strains). All drugs except ampicillin (ABPC) were active against K. pneumoniae. A quite few of K. pneumoniae showed low susceptibilities. Also, we investigated year to year changes in the characteristics of patients, their respiratory infectious diseases, and the etiology. The examination of age distribution indicated that the proportion of patients with ages over 70 years was 48.6% of all the patients showing a slight increase in every year. About the proportion of diagnosed diseases as follows: Bacterial pneumonia was the most frequent with 40.2%. The ratio of it has increased slightly, and the increased rate was 10% in patients with ages over 70 years compared with the results in 1997. Chronic bronchitis have decreased slightly with 27.6% in 1998. Number of strains isolated from patients before administration of antibiotics were more than those after administration of them in chronic bronchitis, but these were almost same number in bacterial pneumonia. Administration of antibiotics has changed the results of the frequency of isolation of bacterial species. Bacterial isolations before administration of antibiotics were as follows: S. pneumoniae 26.7%, H. influenzae 23.8%, S. aureus 13.3% and M. (B.) catarrhalis 10.8%. The frequencies of S. aureus decreased after antibiotics administration over 15 days, but the frequencies of P. aeruginosa (both mucoid and non-mucoid) was not affected. The frequencies of P. aeruginosa was 45.5% after administration over 15 days. The frequencies of S. pneumoniae decreased upon administration of antibiotics, these were only 4.5% over 15 days. The frequencies of H. (

Anti-Bacterial Agents↗

[A case of mediastinal pseudocyst with unusual cystic findings in computed tomography].

We report here a case of mediastinal pseudocyst with unusual CT findings. A 25-year-old woman was admitted to our hospital due to a chest abnormal shadow. She had a cystic mass which was located at anterior mediastinum and was adjacent to great vessels broadly without invasive findings. The intraoperative and histological findings revealed that the cystic mass was a pseudocyst which had been generated by the rupture of a thymic cyst to the mediastinum.

Adult↗

[Crescent moon-type tracheobronchial malacia alleviated by placement of stents in trachea and main bronchi].

We encountered a case of crescent-type tracheobronchomalacia in a 54-year-old male smoker. The patient experienced extreme obstructive pulmonary changes but his FVC and DLco findings were within the normal ranges. Plain chest X-ray films indicated tracheal narrowing, a diagnosis that was confirmed by fiberoptic bronchoscopy. Two Z-stents were implanted in the trachea but the patient's symptoms did not subside. Thoracic computed tomography (CT) elucidated stenosis of both main bronchi at end-expiration. The implantation of Z-stents in the main bronchi remarkably alleviated the symptoms and improved peak expiratory flow. Six months after implantation, the tracheal stents broke. A favorable course was obtained by inserting an ultraflex stent inside the broken Z-stents. DLco is important to the diagnosis of tracheobronchomalacia, whereas peak expiratory flow and thoracic CT findings are useful in evaluating the effectiveness of treatment. We concluded that ultraflex stents should be the first choice for treatment of tracheal stenosis, and that Z-stents are appropriate for the treatment of bronchial obstruction.

Bronchi↗

[Drug therapy of patients with early-stage parkinson's disease].

A guideline regarding the initial therapy for parkinsonian patients is described in this article. The basis for the selection of levodopa or a dopamine(DA) agonist for the initial therapy should depend on the patients' clinical characteristics. Young age, less severe condition of the disease, and absence of dementia are the most important determining factors to initiate DA agonist therapy. In this therapy, the dose should be based on the standard dose of the drug, which is obtained by previous clinical trials. In the case that the initial DA agonist therapy failed, or in the case that levodopa was initially used, the combined use of a DA agonist and levodopa should follow in the earlier period of the therapy.

Antiparkinson Agents↗

[The lung transplantation has come to be done in Japan].

After the establishment of transplantation law, the right pulmonary transplantation was done from the brain dead donor for the first time in Japan at the attached hospital of Institute of Development, Aging and Cancer, Tohoku University on March 29, 2000. The woman in 30's had been deteriorated from progressive lymphangiomyomatosis since 1984. She was waiting for the right lung transplantation in the related hospital of the Institute Hospital since May, 1999. A brain dead donor appeared in Tokyo. After receiving the information from Japan Organ Transplant Network, we immediately started for Tokyo in order to procure the lung. We carried the right lung by Shinkansen. The lung of the donor was transplanted to the patient under the partial extracorporeal circulation on March 29, 2000. The total operating time was 6 hours and 7 minutes: 5 hours and 20 minutes for total ischemic period of the lung and 2 hours and 7 minutes for using extracorporeal circulation. The total amount of bleeding during the operation was 3,695 ml. Postoperative course of the transplanted patient was fair except chylothorax in the operated side, which was successfully controlled by intrathoracic infusion with OK-432. The transplanted patient was discharged from the hospital after 75 days postoperatively.

Adult↗

[The application of poly (L-lactide) sternal coaptation pins for median sternotomy].

Poly (L-lactide) sternal coaptation pin has been developed as an assistant material for the fixation of sternum. We used the novel material to a patient who underwent median sternotomy. A 21-year-old male was suspected to have invasive thymoma in the anterior mediastinum. The median sternotomy was indicated as an approach for the resection of tumor. Tumor was completely resected and there was no invasion to sternum. For the fixation of sternum, three poly (L-lactide) sternal coaptation pins were inserted in the bone marrow of sternum and five stainless steel wires were used as conventional procedure. Sternum was adapted without slippage and no complication from the material was observed in the post-surgical period. The application of poly (L-lactide) sternal coaptation pin is a good option for ensuring the fixation of sternum.

Adult↗

[Successful treatment for descending necrotizing mediastinitis: a case report].

A 21-year-old female was admitted to our hospital because of high fever, neck swelling, and dyspnea. She was diagnosed as descending necrotizing mediastinitis (DNM) extended from odontogenic infection. On the day of admission, she underwent cervical drainage. Next day, the CT scan showed an abscess below the tracheal bifurcation and bilateral pleural effusion. Mediastinal drainage was performed through a right thoracotomy, and a left thoracic tube was inserted. Anaerobic Peptostreptococcus was found with bacteriological culture. After the mediastinal drainage, bilateral thoracic irrigation was performed through the thoracic tubes. Left thoracic tube was removed on the 8th day and right one was removed on the 20th day after the thoracotomy. She was discharged on the 42nd day. DNM is relatively rare, but it is lethal disease with high mortality. Immediate and sufficient mediastinal drainage is indispensable for the disease.

Abscess↗

Inhaled flow and handling of fluticasone diskhaler by asthmatic patients.

We investigated the inhaled flow and handling of a Fluticasone Diskhaler (FDH) by patients familiar with the beclomethasone dipropionate inhaler (BDI), a metered dose inhaler. Before the FDH was introduced in our hospital, 174 patients were instructed in the use of the Diskhaler and measured the flow of Diskhaler inhalation. Three months after the introduction of the FDH, approximately 95 patients were using them. During their regular visit to the hospital, we checked the patients' handling of FDH and the flow of FDH inhalation (n=81). It was found that only 22% of the patients correctly handled the FDH. The major erros concerned breath-holding and disk rotation after use, but 9.9% of the patients handled the inhaler with serious error, e.g., incomplete puncturing of the blister. The mean FDH flow was 86.5 L/min, which was significantly higher than that recorded at the first FDH trial (69.1 L/min). In 9.9% of the patients, the inhaled flow was inappropriately low (<50 L/min), in 29.6% of the patients, it was unnecessarily high (>100 L/min). In conclusion, handling the FDH is easy for patients who are already familiar with the BDI. However, in 40% of the patients, the inhaled flow rate was not sufficient.

Administration, Inhalation↗

[Reconstruction of chest wall using myocutaneous flap].

Reconstruction of chest wall using myocutaneous flap has been performed in 2 cases. A 72-year-old female referred to our hospital for locally recurrent left breast cancer without any distant metastases. The other patient was a 77-year-old female, having locally recurrent liposarcoma of the left lateral chest wall. Chest wall was resected with wide margin of normal tissue, and myocutaneous flaps of latissimus dorsi were used for reconstruction of skin defect (13 x 8 cm and 14 x 10 cm) in both cases. Although additional split-thickness skin graft was required for one of them, myocutaneous flaps were useful for the reconstruction of widely defected chest wall. By using this technique, wider margin can be obtained, which could decrease the risk for local recurrence of malignant tumor.

Aged↗