Pulmonary arterial balloon occlusion during video-assisted thoracoscopic surgery for reduction of the risk of massive hemorrhage.
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Blood Loss, Surgical↗
Biomedical subjects
T Onuki
Publications and source records attributed to T Onuki.
[Parenteral and enteral nutrition in acute renal failure].
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Acute Kidney Injury↗
A clinical trial to evaluate the effects of flumethrin or ivermectin treatment on hemoparasites, gastrointestinal parasites, conception and daily weight gain in a dairy farm in Japan.
A clinical trial was performed to compare the effects of flumethrin and ivermectin treatments of grazing heifers at one farm in central Japan. 64 heifers were randomly allocated into two groups. Flumethrin (1 mg/kg pour on) was applied approximately once every 3 weeks to heifers in one group and heifers in the second group were injected approximately once every month with ivermectin (200 microg/kg; id). Between groups, no significant differences were detected in the proportions of animals that showed parasitemia of Theileria sergenti and conception risks. Significantly lower average log-transformed nematode-egg counts and higher average daily weight gain were observed in the ivermectin-treated group. Animals with higher body weight at the start of grazing and lower log-transformed total nematode-egg and coccidia-oocyst counts had higher odds of conceiving. Animals with ivermectin treatment, lower body weight at the start of grazing and lower log-transformed coccidia-oocyst count had higher daily weight gain. Ivermectin may be more useful in this farm because of the higher productivity for cattle and lower cost for its usage.
Administration, Cutaneous↗
Combined thoracic aortic or upper digestive tract resection for lung cancer and malignant mediastinal tumor.
OBJECTIVE: We studied possible indications and combined resection in patients with lung cancer and mediastinal tumors requiring combined thoracic aortic or upper digestive tract resection. METHODS: Ten patients with lung cancer and malignant mediastinal tumors (9 men and 1 woman aged 39 to 72 years; mean: 60.5) underwent combined aortic or upper digestive tract resection. RESULTS: Five--3 [corrected] with primary lung cancer, 1 with thymic cancer, and 1 with liposarcoma--, underwent combined aortic resection. In 2 each, lung cancer and malignant mediastinal tumor had infiltrated the thoracic aorta. The remaining case of lung cancer was complicated by aortic aneurysm in the distal arch. Cardiopulmonary bypass was conducted in 4, and selective cerebral perfusion in 2. Three patients are alive after 11, 22, and 61 months without disease recurrence. Those undergoing combined upper digestive tract resection all had lung cancer, with 4 having tumors infiltrating the esophagus or corpus ventriculi. The remaining patient had both lung and esophageal cancer. The patient treated with combined corpus ventriculi resection has survived 24 months and the patient treated with combined esophageal resection has survived 12 months without disease recurrence. The 1-year survival rate was 60%, 2-year 23%, and 3-year 23%. Prognosis was generally poor with the longest survival 13 months with N2 lung cancer. CONCLUSIONS: In combined resection due to malignant mediastinal tumor, T4N0-1 lung cancer, or diseases such as aortic aneurysm, prognosis can be expected to improve. Despite the often poor prognosis in T4N2 lung cancer, surgical intervention may be indicated to avoid complications due to tumor invasion and to lengthen survival and improve quality of life.
Adult↗
Clinical assessment of unilateral pulmonary artery occlusion test with dobutamine infusion. Expansion of surgical indications in patients with primary lung cancer and impaired cardiopulmonary functions.
OBJECTIVES: We evaluated the possibility of expanding indications for pulmonary resection based on an assessment of the pressure-flow relationship in pulmonary circulation. METHODS: In 6 of 28 lung cancer patients whose total pulmonary vascular resistance index exceeded the threshold during unilateral pulmonary artery occlusion testing, we conducted unilateral pulmonary artery occlusion testing with dobutamine administration, followed by lung resection. We studied hemodynamics during testing and derived a new indication for pulmonary resection from the postoperative course. RESULTS: Cardiac output was 3.82 +/- 0.74 l/min before testing, 3.66 +/- 0.76 l/min during pulmonary artery occlusion testing, and 5.92 +/- 1.78 l/min during unilateral pulmonary artery occlusion testing with dobutamine infusion. The total pulmonary vascular resistance index was 890 +/- 350 dyne.sec.cm-5.m2 before testing, 1170 +/- 320 dyne.sec.cm-5.m2 during testing, and 800 +/- 160 dyne.sec.cm-5.m2 during testing with dobutamine infusion. Cardiac output increased (p = 0.014) during unilateral pulmonary artery occlusion testing with dobutamine infusion, and the total pulmonary vascular resistance index significantly decreased (p = 0.034). Of the 4 patients eligible for lobectomy, 2 underwent the procedure--one undergoing segmentectomy in which pulmonary metastasis was found during surgery and the other undergoing radiotherapy for cN2 disease with chest wall invasion. Of the 2 initially ineligible for lobectomy, one underwent partial pulmonary resection and the other underwent lobectomy because the total pulmonary vascular resistance index was less than 800 dyne.sec.cm-5.m2 during selective pulmonary artery occlusion testing with dobutamine infusion, indicating eligibility for lobectomy. No severe complications of cardiopulmonary function failure after surgery occurred in any of the 5 cases. CONCLUSIONS: Unilateral pulmonary artery occlusion testing with dobutamine infusion is useful in determining patient eligibility for pulmonary resection.
Aged↗
[Statistics of the operations at the Department of Urology, Tone Chuo Hospital during a six-year period (June 1993-May 1999)].
A clinical statistic survey was made on the operations performed at the Department of Urology, Tone Chuo Hospital between June 1993 and May 1999. The total number of operations was 1296, consisting of 97 (7.5%) operations of the kidney, 67 (5.2%) operations of the ureter, 190 (14.7%) operations of the bladder, 454 (35.0%) operations of the prostate, 63 (4.9%) operations of the urethra, 92 (7.1%) operations of the penis, 149 (11.5%) operations of the scrotum and 184 (14.2%) other operations. With the aging society, the number of operations for those over 60 years old has exceeded 60%.
Adolescent↗
[Three cases of primary pulmonary malignant lymphoma].
Primary pulmonary malignant lymphoma is a rare disease that is thought to belong to a category of malignant lymphomas arising from mucosa- or bronchus-associated lymphoid tissue (MALT or BALT). We encountered 3 cases of primary pulmonary malignant lymphoma, Case 1: In a 51-year-old male, an abnormal shadow was detected in chest radiography in the right S9 after an operation for thyroid carcinoma. A right lower lobectomy was performed. The diagnosis was malignant lymphoma (marginal zone B-cell lymphoma). Immunohistochemical staining for IgM gave a positive result. Case 2: Multiple nodular shadows were noted in both lungs of a 55-year-old man after a bout of pneumonia. Video-assisted thoracoscopic surgery was performed, and the diagnosis was malignant lymphoma (marginal zone B-cell lymphoma). Gene analysis revealed rearrangement of a heavy chain gene. Case 3: An abnormal shadow was seen in the chest radiograph of a 60-year-old man. He was treated by right upper and middle lobectomy. The diagnosis was Hodgkin's disease, nodular sclerosing type. Chemotherapy was given after surgery and the patient is now alive without recurrence. As the pulmonary malignant lymphoma was difficult to diagnosepreoperatively, it was necessary to resect the mass for diagnostic purposes. The prognosis of a resected solitary lesion in the lobe was good. Therefore lobectomy was performed as the treatment of choice. Systemic chemotherapy is performed for the diffuse type of pulmonary lymphoma.
Humans↗
De novo synthesis of sphingolipids is required for cell survival by down-regulating c-Jun N-terminal kinase in Drosophila imaginal discs.
Mitogen-activated protein kinase (MAPK) is a conserved eukaryotic signaling factor that mediates various signals, cumulating in the activation of transcription factors. Extracellular signal-regulated kinase (ERK), a MAPK, is activated through phosphorylation by the kinase MAPK/ERK kinase (MEK). To elucidate the extent of the involvement of ERK in various aspects of animal development, we searched for a Drosophila mutant which responds to elevated MEK activity and herein identified a lace mutant. Mutants with mild lace alleles grow to become adults with multiple aberrant morphologies in the appendages, compound eye, and bristles. These aberrations were suppressed by elevated MEK activity. Structural and transgenic analyses of the lace cDNA have revealed that the lace gene product is a membrane protein similar to the yeast protein LCB2, a subunit of serine palmitoyltransferase (SPT), which catalyzes the first step of sphingolipid biosynthesis. In fact, SPT activity in the fly expressing epitope-tagged Lace was absorbed by epitope-specific antibody. The number of dead cells in various imaginal discs of a lace hypomorph was considerably increased, thereby ectopically activating c-Jun N-terminal kinase (JNK), another MAPK. These results account for the adult phenotypes of the lace mutant and suppression of the phenotypes by elevated MEK activity: we hypothesize that mutation of lace causes decreased de novo synthesis of sphingolipid metabolites, some of which are signaling molecules, and one or more of these changes activates JNK to elicit apoptosis. The ERK pathway may be antagonistic to the JNK pathway in the control of cell survival.
Acyltransferases↗
[Indications for lung transplantation and its selection of the candidates in Japan].
Although the annual number of lung transplant operation performed in the United States and Europe is over 1000, five year survival rate is under 50%, mainly because of obstructive bronchiolitis that is considered chronic rejection. Lung transplantation may be difficult to justify on the ground of survival consideration alone for the certain disease, such as emphysema and pulmonary hypertension. But functional recovery after lung transplantation especially, bilateral is reported very good. Among the diseases of indication of lung transplant, Cystic Fibrosis and alpha antitrypsin deficiency are very rare disease in Japan and emphysema that is most frequently reported indication in the United States, is also rare disease in the age group of lung transplantation candidate. So, idiopathic interstitial pneumonitis, pulmonary vascular disease and other miscellaneous disease are most possible indications for lung transplantation in Japan. These disease have different prognosis, we discussed the timing of registration and operation of lung transplantation in each disease.
Humans↗
The attenuated effect of ATP-sensitive K+ channel opener pinacidil on renal haemodynamics in spontaneously hypertensive rats.
In hypertension, impairment of hyperpolarization by K+ efflux through ATP-sensitive K+ (K(ATP)) channels may contribute to the elevated renal vascular resistance. To elucidate such a role for K(ATP) channels in the renal vasculature, we used micropuncture techniques to examine the effect of K(ATP) channel opener, pinacidil (0.15 mg/h per kg body wt i.v.), on renal and glomerular haemodynamics in spontaneously hypertensive rats (SHR) and in normotensive controls (Wistar Kyoto, WKY). Since pinacidil reduced blood pressure significantly in both groups, the abdominal aorta was clamped before pinacidil administration to yield a renal perfusion pressure equivalent to that during pinacidil infusion. Pinacidil significantly decreased renal vascular resistance in both groups, but the relative change from baseline value was greater in WKY than in SHR. These effects of pinacidil were abolished by pretreatment with glibenclamide (3 mg/kg body wt i.v.). Proximal tubular stop-flow pressure (Psf), an index of glomerular capillary pressure, was significantly elevated by pinacidil infusion in WKY, a response abolished by pretreatment with glibenclamide, but not in SHR. The tubuloglomerular feedback response of Psf was not affected by pinacidil in either group. These data suggest that the activity of K(ATP) channels in SHR may be attenuated in the renal microvasculature. This may contribute to the elevated vascular tone in the renal preglomerular vasculature in SHR.
Animals↗
Modification of anterior approach to superior sulcus tumors.
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Carcinoma, Bronchogenic↗
The K(ATP) channel opener nicorandil: effect on renal hemodynamics in spontaneously hypertensive and Wistar Kyoto rats.
Adenosine triphosphate-sensitive K channels (K(ATP)) may subserve vasodilation in the renal microvasculature. Using micropuncture techniques, we examined whether the renal vasomotor action of K(ATP) differs in hypertensive and normotensive animals. Nicorandil (NC), a K(ATP) opener, was given i.v. (1 mg/hr/kg) to spontaneously hypertensive rats (SHR) or Wistar Kyoto rats (WKY). Mean arterial blood pressure decreased in both groups. Renal blood flow was almost unchanged in SHR but increased significantly in WKY. This effect was completely abolished by pretreatment with glibenclamide (GC; 3 mg/kg i.v.). To investigate the effect of NC on the regulatory mechanism of renal microcirculation, we measured proximal tubular stop-flow pressure (SFP) and assessed tubuloglomerular feedback (TGF) by monitoring SFP during loop perfusion with artificial tubular fluid. NC significantly increased SFP in WKY, an effect abolished by pretreatment with GC. In SHR, however, treatment with NC elicited no significant change in SFP. TGF response was not affected by NC treatment in either group. The data suggest that K(ATP) may modulate preglomerular vascular resistance, especially in the larger vascular segments not subject to TGF regulation, and may be attenuated in SHR. This might, at least in part, be attributable to the increased vascular resistance in SHR.
Adenosine Triphosphate↗
Effect of adenosine on adrenergic neurotransmission and modulation by endothelium in canine pulmonary artery.
To determine the effect of adenosine on adrenergic neurotransmission in pulmonary vasculature and its modulation by endothelial cells, we studied canine pulmonary arteries under isometric conditions in vitro. Adenosine decreased the contractile responses to electrical field stimulation but had no effect on those to norepinephrine. This inhibitory effect was concentration dependent, with a rank order of potency of NECA > 2-chloroadenosine > adenosine >> APNEA (an A3-adenosine-receptor agonist) > CGS-21680 (an A2a agonist) > CCPA (an A1 agonist). Adenosine reduced the electrical field stimulation-evoked 3H overflow in superfused pulmonary artery previously soaked in [3H]norepinephrine. Pretreatment with the adenosine uptake blocker dipyridamole or the adenosine deaminase inhibitor deoxycoformycin enhanced the adenosine action, and this enhancement was not observed in the endothelium-denuded tissues. Adenosine deaminase activity was found in endothelial cells. Therefore, adenosine inhibits norepinephrine release via an A2b-receptor mechanism, an effect that may be modulated by uptake and metabolism by endothelial cells.
Adenosine↗
[Report on a case of adult rhabdomyosarcoma subjected to tumorectomy and lobectomy].
Rhabdomyosarcoma (RMS) rarely occurs in adult and intra thoracic activity. This is a report on a case we experienced of adult RMS, which was subjected to tumorectomy and lobectomy. The patient was a 23 years old male, who first consulted a hospital in his neighborhood due to anterior chest pain suffered since May 1995. Since the examination showed an abnormal shadow in right anterior mediastinum, the patient was referred to our department. By biopsy under CT, the patient was diagnosed as having embryonal type of RMS and underwent surgery. The outcome was good and the patient is currently in the course of chemotherapy using IRS (Inter-group Rhabdomyosarcoma study)-III.
Adult↗
Effects of a calcium channel blocker, manidipine hydrochloride, on the regulatory mechanism of glomerular capillary pressure in SHR.
In an attempt to clarify whether glomerular capillary pressure (Pgc) in hypertension can be reduced by a calcium channel blocker (CaB), renal clearance and micropuncture experiments were carried out on male heminephrectomized spontaneously hypertensive rats (SHR; n = 15). Renal circulatory parameters (RBF and GFR) and proximal tubular stop flow pressure (Psf) were measured during the control period, during manual aortic clamping, and after administration of manidipine hydrochloride (MDP, 10 micrograms/kg body weight in bolus). Because Psf only represents Pgc during zero tubular flow, the responsiveness of tubulo-glomerular feedback (TG feedback) was also assessed to obtain the "steady state Pgc", an operating point in each experimental period. Administration of MDP decreased systemic blood pressure (SBP) and renal vascular resistance (RVR), but increased renal blood flow (RBF) significantly. Psf decreased following the administration of MDP (33.65 +/- 1.45 mmHg), reaching a lower level than during aortic clamping (39.93 +/- 2.37 mmHg) or in the control period (50.78 +/- 2.73 mmHg). TG feedback responsiveness was attenuated during clamping, and was incompletely inhibited by MDP, whereas the operating point (29.3 mmHg) was lower than during clamping (32.9 mmHg) or in the control period (41.0 mmHg). The stability of RBF during the alteration of renal perfusion pressure (RPP) was not abolished by MDP. From these results, we suggest that MDP significantly decreases Pgc in the steady state not only by the reduction of RPP, but also by the amelioration of renal microcirculation.
Animals↗
[A case of ACTH-releasing lung carcinoid tumor presenting Cushing's syndrome].
The patient was a 47-year-old female who had undergone hypophysectomy due to Cushing's syndrome when 46 years old. In April 1992, about 1 month after the operation, chest CT-scan revealed a lesion of 8 x 8 mm in size in the right upper lobe. A high value of serum ACTH was obtained from the A3b wedge blood by cardiac catheterization. She was operated on suspicion of ACTH releasing lung tumor. During the operation, it was histologically diagnosed as lung carcinoid by a frozen section of the lesion. In addition, ACTH of the blood obtained from the right superior pulmonary vein was as high as 37,300 pg/ml, but that in the right main pulmonary artery or the radial artery was 850-970 pg/ml. Right upper lobectomy with dissection of mediastinal lymph nodes was so performed. Post-operative value of serum ACTH was significantly decreased. She was in good course, and is still asymptomatic 8 months after the operation.
Adrenocorticotropic Hormone↗
[Eight cases of thymic carcinoma].
Eight cases of thymic carcinoma (mean age 62 years, 5 males and 3 females) were treated in our hospital from Apr. 1988 to Mar. 1993, which were 21% of thymic epithelial tumors. The histologic subtypes of thymic carcinoma were 3 squamous, 4 undifferentiated, and 1 adenocarcinoma, respectively. Computed tomography showed extrathymic metastases to the mediastinal lymph nodes in 6 cases. All cases underwent thoracotomy, and postoperative radiotherapy or chemotherapy were performed. A case of squamous cell carcinoma in stage II who underwent total resection followed by irradiation is alive and disease free 5 years after surgery. However, the remaining 7 cases died of the disease within 29 months. 8 cases of thymic carcinoma and 7 of thymoma were studied immunohistologically on the formalin-fixed and paraffin-embedded tissues. Higher positivity of EMA in thymic carcinoma was noted comparing to ordinary thymoma, suggesting that EMA is a useful parameter of potential malignancy of the thymic epithelial neoplasms.
Adenocarcinoma↗
[Pulmonary hemodynamics following pneumonectomy].
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Humans↗