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Biomedical subjects

T Kuda

Publications and source records attributed to T Kuda.

At least 19 recordsLinked to original sources

A new devised skirted elephant trunk technique.

A simple and effective new elephant trunk technique was devised and applied to two patients with a successful result. In advance before the operation, an arch graft with a skirted elephant trunk was made. This was done by inserting a smaller, 22 mm diameter sized graft into the arch graft at the distal end and suturing it so as to leave a skirt extending over the smaller graft. This configuration facilitates the distal anastomosis and effectively shortens anastomotic time.

Adult↗

[Thoracoscopic surgery for diagnosis of interstitial pneumonia special reference to medicoeconomical effect].

We compared thoracoscopic surgery (TS) and open thoracotomy for the diagnosis of interstitial pneumonia. Intraoperative blood loss and duration of postoperative chest drainage were significantly less with TS than with thoracotomy. The length of postoperative hospital stay and social insurance costs with TS was significantly less than with thoracotomy. These results show that TS for the diagnosis of interstitial pneumonia is superior to open thoracotomy in terms of surgical stress and cost.

Adult↗

A ruptured syphilitic descending thoracic aortic aneurysm. The characteristic findings on computed tomography for the etiological diagnosis of aneurysm.

We report the case of a 72-year-old man with a ruptured syphilitic descending thoracic aneurysm who underwent an emergency operation and successful graft replacement. Preoperative physical examination showed a pulsative mass on the left back. Preoperative computed tomography showed bone destruction in the TH6 to TH10 thoracic vertebrae and ribs and penetration (or rupture) of the aneurysm into the subcutaneous tissue. During the period of preoperative evaluations, free wall rupture of the aneurysm occurred and emergency operation for graft replacement was performed. The microscopical examination of the aneurysmal wall revealed the syphilitic changes. In literature, the vertebral destruction by atherosclerotic aneurysm is usually located at the TH12 to L3 of vertebral bodies. From the findings of this patient and a study of existing literature, we concluded that the finding of vertebral bone beyond TH12 to L3 region on CT examination of the aneurysm could be a etiological characteristic finding for syphilitic aortic aneurysm.

Aged↗

Reduction of plasma glutamyl aminopeptidase activity in sporadic Alzheimer's disease.

Previously, we hypothesized that aminopeptidase-catalyzed proteolysis may limit the rate of beta-amyloid catabolism in brain and that reduction of a certain aminopeptidase activity may lead to deposition of peptidic metabolites represented by beta-amyloid and thus to Alzheimer's disease (AD). To explore this possibility in clinical situations and to seek a possible biochemical marker for the disease, we quantitated four classes of aminopeptidase activities in cerebrospinal fluids and heparinized plasma from sporadic AD patients and agematched controls collected in two independent medical institutions. We found that only plasma glutamyl aminopeptidase activity was significantly and consistently lower in AD patients. Although the mechanism leading to such a biochemical change in plasma remains to be elucidated, the results provide support for the aminopeptidase hypothesis and indicate that the enzyme activity may potentially be used as a diagnostic/ predictive marker for AD.

Aged↗

gamma-Pyrones from Gonystylus keithii, as new inhibitors of parathyroid hormone (PTH)-induced Ca release from neonatal mouse calvaria.

New gamma-pyrones, 9'-oxopodopyrone (3) and 8-methyl-9'-oxopodopyrone (4) were isolated from the leaves of Gonystylus keithii, along with known gamma-pyrones, 10'-oxopodopyrone (1) and 8-methyl-10'-oxopodopyrone (2). These gamma-pyrones markedly inhibited the bovine parathyroid hormone (PTH)-induced Ca release from neonatal mouse calvaria in vitro. It is the first time that gamma-pyrones showed inhibitory effects on bone resorption, and these compounds may be seed compounds of new drugs for osteoporosis.

Animals↗

[Analysis of DNA content in primary colorectal carcinoma and lung metastasis].

We analyzed DNA content of resected primary colorectal carcinoma and lung metastasis by flow cytometry. Of the 14 primary lesions, 5 cases showed diploid pattern, 9 cases aneuploid pattern. In contrast, 12 metastatic lung lesions of 19 showed diploid pattern and 7 lesions aneuploid pattern. DNA index of primary and metastatic lesions was 1.4 +/- 0.4 and 1.2 +/- 0.2, respectively (p = 0.08). In combination of DNA ploidy pattern between primary and metastatic lesions, there were 11 in which ploidy pattern was identical, 1 in which metastasis was aneuploid and primary was diploid, 7 in which metastasis was diploid and primary was aneuploid. Four year, survival rate from operation of metastasis was better in diploid pattern than in aneuploid pattern, but it was not significant. These results indicate that patients who have operative indication of metastasis from colorectal carcinoma have metastatic tumor which shows relatively good biological behavior (diploid tumors) and that there are heterogeneity of ploidy pattern between primary and metastatic lesions.

Adult↗

Ectopic intrapulmonary thyroid.

An 83-year-old woman underwent resection of a pulmonary tumor. Histologic examination of the tumor demonstrated thyroid follicles without evidence of malignancy or teratomatous elements. Developmental anomaly may account for the ectopic intrapulmonary thyroid, which, to our knowledge, has not been reported in the literature.

Aged↗

Purification, properties, and partial amino acid sequences of thermostable xylanases from Streptomyces thermoviolaceus OPC-520.

Two types of xylanases (1,4-beta-D-xylan xylanohydrolase, EC 3.2.1.8) were isolated from the culture filtrate of a thermophilic actinomycete, Streptomyces thermoviolaceus OPC-520. The enzymes (STX-I and STX-II) were purified by chromatography with DEAE-Toyopearl 650 M, CM-Toyopearl 650 M, Sephadex G-75, Phenyl-Toyopearl 650 M, and Mono Q HR. The purified enzymes showed single bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The molecular weights of STX-I and STX-II were 54,000 and 33,000, respectively. The pIs were 4.2 (STX-I) and 8.0 (STX-II). The optimum pH levels for the activity of STX-I and STX-II were pH 7.0. The optimum temperature for the activity of STX-I was 70 degrees C, and that for the activity of STX-II was 60 degrees C. The enzymes were completely inhibited by N-bromosuccinimide. The enzymes degraded xylan, producing xylose and xylobiose as the predominant products, indicating that they were endoxylanases. STX-I showed high sequence homology with the exoglucanase from Cellulomonas fimi (47% homology), and STX-II showed high sequence homology with the xylanase from Bacillus pumilus (46% homology).

Amino Acid Sequence↗

Postoperative adjuvant chemotherapy in non-small cell lung cancer: prognostic value of DNA ploidy and post-recurrent survival.

Eighty-six patients with non-small cell lung cancer who underwent curative operations were postoperatively randomized to control and adjuvant chemotherapy groups. In the adjuvant chemotherapy group, patients received cisplatin-based combination chemotherapy 3 or 4 weeks after operation and the average cycle of chemotherapy was 2.3 (from 1 to 6 cycles). In this trial, no evidence of improved survival or delayed recurrence was seen in the treated patients. In multivariate analysis of prognostic variables, the most important factor was the pathological stage of the disease and, second, DNA ploidy of the primary tumor. Although histology (squamous vs. non-squamous cell carcinoma) had a trend to influence the survival, it was not a significant factor. A total of 33 patients had recurrences: 17 and 16 patients were in control and adjuvant chemotherapy groups, respectively. Postrecurrent survival in the adjuvant chemotherapy group was significantly shorter than that in the control group, as determined by the generalized Wilcoxon and log rank tests. Median survival time after recurrence in the control and adjuvant therapy groups was 18.5 and 7.5 months, respectively. These results suggest that DNA ploidy of primary tumors should be considered as a prognostic factor in future trials of adjuvant therapy. Furthermore, analysis of postrecurrent survival in the adjuvant chemotherapy trial, as well as that of overall and disease-free survivals should be done.

Aged↗

Influence of surgical resection before and after chemotherapy on survival in small cell lung cancer.

We attempted to define the role of surgery in the treatment of small cell lung cancer (SCLC). Of 81 patients with clinically localized SCLC, 36 underwent surgical resection: 19 underwent initial resection with postoperative chemotherapy, while the remaining 17 were treated initially with chemotherapy, then resection. The remaining 45 patients were treated with a combination of chemotherapy and radiotherapy. The 5-year survival for the 36 surgical patients was 38%; median survival time (MST) was 33 months. Nineteen patients treated with postoperative chemotherapy showed a 42% 5-year survival, while 17 patients treated with preoperative chemotherapy showed a 33% 5-year survival. This difference was not significant. However, stage III survival tended to be better in patients with preoperative chemotherapy (MST, 29 months) than in those who had had postoperative chemotherapy only (MST, 17 months). Although survival of the 45 nonsurgical patients was poor, stage I and II patients, or those with complete remission showed a 25% 5-year survival with an MST of 33 months, and a 21% 5-year survival with an MST of 25 months, respectively. We thus concluded that initial resection combined with postoperative chemotherapy is beneficial for patients with stage I, and probably stage II disease. For resectable stage III, particularly in patients with N2 disease, adjuvant resection after chemotherapy may be a favorable choice in the management of SCLC. For advanced stage III, complete remission by chemotherapy should be attempted in combination with radiotherapy.

Aged↗

DNA ploidy patterns of tumors diagnosed as metachronous or recurrent lung cancers.

The relationship between the first tumor and the second tumor resected in 8 patients with non-small cell lung cancer was analyzed using deoxyribonucleic acid (DNA) flow cytometry. Of the 8 patients, 6 were clinically diagnosed as having metachronous lung cancers and 2, local recurrent tumors. The mean interval between operations in patients with metachronous lung cancers was 62 months (range, 15 to 128 months). Both tumors showed the same histology in 4 patients and a different histology in 2. In the 2 patients with local recurrent tumors, the interval between operations was 9 months and 39 months. In the analysis of DNA flow cytometry of the first and second tumors in the same patient, the tumors were defined as independent of each other when one tumor showed diploidy and the other, aneuploidy, or when each DNA index of abnormal clones between two aneuploid tumors was different. When both tumors showed diploidy or when at least one DNA index of abnormal clones between two aneuploid tumors was identical, the tumors were defined to be related to each other. According to these criteria, in 5 (83%) of the 6 patients clinically diagnosed as having metachronous lung cancers, the second tumor was classified as independent of the first tumor. On the other hand, in the 2 patients clinically diagnosed as having recurrent tumors, the second tumor was judged to be related to the first tumor. These data suggest that DNA flow cytometric analysis of tumors may be of value in the diagnosis of metachronous lung cancers.

Adenocarcinoma↗

Long-term survivors in resected and nonresected small cell lung cancer.

Long-term survival (greater than or equal to 3 years) was evaluated in 164 patients with small cell lung cancer (SCLC). Thirty-seven patients underwent surgical resection, and 127 did not. All but one resected patient received combination chemotherapy. Of the 20 (12%) long-term survivors, 13 (35%) were resected, and 7 (6%) were not. Eleven of these resected patients had pathologically confirmed stage I disease. All of the 7 nonresected patients achieved complete remission by treatment, 6 of these having presented with limited disease. In addition, all patients received thoracic irradiation combined with chemotherapy. Two of the 20 patients who survived beyond 3 years developed a second malignancy 11.3 and 12 years, respectively, after initial treatment for SCLC. In conclusion, surgical resection for stage I, and probably stage II SCLC followed by chemotherapy may be an appropriate therapeutic approach. For advanced limited disease, thoracic irradiation, in addition to chemotherapy, seems to improve long-term survival.

Adult↗

[Surgical indication for T1N2 disease: comparison of survival among resected T1N2, T2 N2 and non-resected T1 (M0) disease].

Based on the outcome of 28 patients with pathologically confirmed T1N2 disease who underwent surgical resection, we evaluated surgical indication for this stage. Twenty three patients underwent complete resection and 5 patients incomplete resection. The histologic type of tumor was adenocarcinoma in 20 patients and squamous cell carcinoma in 8 patients. The 5-year survival rate was 22% for all resected patients and 28% for completely resected patients. These survival rates were better than those (16% and 23%, respectively) in patients with T2N2 disease. However, there was no significant difference of survival among incompletely resected T1 N2, and non-resected T1 (M0) patients. Although 9 of 28 T1N2 patients survival more than 3 years, all but one patient underwent complete resection of tumor and had clinical N0 or N1 before surgery. In conclusion, surgery should be indicated only for patients with completely resectable tumor, even in T1N2 disease.

Adult↗

Influence of chemotherapeutic agents on superoxide anion production by human polymorphonuclear leukocytes.

The effects of 11 chemotherapeutic agents on superoxide anion (O2-) production were examined in human polymorphonuclear leukocytes (PMNL). All drugs, except predonine, were found to suppress O2- production in PMNL. Adriamycin (doxorubicin), mitomycin C, vindesine, cisplatin, etoposide, nimustine, and pepleomycin suppressed O2- production at relatively low drug concentrations, whereas methotrexate, 5-fluorouracil and vincristine suppressed O2- production at high drug concentrations. Time-dependent suppression of O2- production was evaluated in four drugs, namely Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), cisplatin, vindesine, and methotrexate. Only Adriamycin showed suppressive effect on PMNL-derived O2- production in a time-dependent manner. Production of O2- by PMNL is a fundamental element for its bactericidal activity. The authors' results showed suppression of O2- production in PMNL in the presence of chemotherapeutic agents. This indicates a relationship between chemotherapy drugs and susceptibility to infection. The influence of chemotherapeutic agents on O2- production by PMNL should thus be taken into consideration when assessing defense mechanisms and susceptibility to infection of patients treated with these drugs.

Anions↗

[Evaluation of prognostic factors in early lung cancer].

We evaluated the prognostic factors in 52 cases of resected early lung cancer: hilar early lung cancers 9 cases and peripheral early lung cancers 43 cases. All hilar lesions were squamous cell carcinoma, and peripheral lesions were adenocarcinoma (31 cases), squamous cell carcinoma (10 cases), large cell carcinoma (2 cases) and carcinoid (1 case). No relapse was found in hilar lesions, but 7 relapses and 5 deaths were found in peripheral lesions. Prognostic factors were examined in these cases. Location of lung cancer (hilar or peripheral) was found to be important in early lung cancer. In addition, age was a significant prognostic factor in peripheral early lung cancer with multivariate analysis. No other significant factor was found in our cases. Twelve out of 52 cases with lung cancer had other malignancies after or before operation. These were cancers of second primary lung, colo-rectal, uterus, stomach, breast, thyroid, liver and malignant melanoma. Therefore, we have to carefully observe other parts even after resection of early lung cancer.

Adenocarcinoma↗

[Epidural anesthesia with buprenorphine for chest surgery and its prophylactic effects of postoperative pulmonary complications].

To clarify the prophylactic effect of epidural anesthesia with buprenorphine on postoperative pulmonary complications, the incidence of pulmonary complications after chest surgery was evaluated in 2 groups: the group that underwent epidural anesthesia, namely the test group, and the control group. Pulmonary complications were classified as follows: mild complications, sustained wheezing and/or small atelectasis-like shadows seen on chest x-rays. These improved by conventional methods except for bronchial toilet. Moderate complications included pneumonia and/or respiratory failure and/or atelectasis which needed bronchial toilet. There were 56 cases (58%) with no pulmonary complications in the control group and 89 cases (77%) in the test group. The number of patients with pulmonary complications were 40 (42%) in the control group and 27 (23%) in the test group, respectively (p less than 0.01). Those with mild or moderate complications were 25 (26%), 15 (16%) in the control group and 21 (18%), 6 (5%) in the test group, respectively. There was significant difference between no complication group and moderate complication group (p less than 0.01). These results show that epidural anesthesia is useful in preventing pulmonary complications after chest surgery.

Anesthesia, Epidural↗

Long-term survival after brain metastases from tracheal carcinoma.

A case of prolonged survival after radiotherapy for primary tracheal squamous cell carcinoma and the subsequent brain metastases is reported. The patient is alive and well without any sign of relapse, approximately six years after the onset of brain metastases from tracheal carcinoma. Radiotherapy proved useful in the treatment of both the primary tracheal carcinoma and the brain metastases.

Brain Neoplasms↗