Biomedical subjects

Tatsuo Fukuse

Publications and source records attributed to Tatsuo Fukuse.

15 recordsLinked to original sources

PubMed2006

Isoflurane inhalation after circulatory arrest protects against warm ischemia reperfusion injury of the lungs.

BACKGROUND: Non-heart-beating donors are expected to ameliorate shortages of donors for organ transplantation. The issue of preventing warm ischemic injury after circulatory arrest must be investigated. In the current study, we investigated whether isoflurane inhalation during warm ischemia could attenuate ischemia reperfusion injury (IRI) of the lung. METHODS: An isolated perfused rat lung model was used. The rats were allocated into four groups: the no ischemia group; the ischemia-1 minimum alveolar concentration (MAC) iso group (ventilation with air and 1.38% isoflurane); the Ischemia-3MAC iso group (ventilation with air and 4.2% isoflurane); and the Ischemia-no treatment group (ventilation with only air). Lungs were subjected to 50 min of ischemia at 37 degrees C. Physiological lung functions were measured after reperfusion in experiment one. Mitochondrial control ratio (RCR), cytochrome-c release from mitochondria, and caspase activities just after warm ischemia were measured in experiment two. RESULTS: Pulmonary functions in the Ischemia-1MAC iso group were significantly greater than those in the Ischemia-no treatment group for experiment one. There were no dose-dependent effects between 1MAC and 3MAC isoflurane. In experiment two, RCR in the Ischemia-1MAC iso group was significantly greater than that in the Ischemia-no treatment group. Cytochrome-c release and caspase-9 activity in the Ischemia-1MAC iso group were significantly decreased compared to those in the Ischemia-no treatment group. CONCLUSIONS: Isoflurane inhalation attenuates warm IRI with the protection of mitochondria. Our results suggest that isoflurane inhalation after circulatory arrest can be a simple and effective method to protect the lung against warm ischemia.

Administration, Inhalation↗

PubMed2006

Influence of inflated lung pressure on lung mechanical properties during cold storage in rats.

The degree of lung inflation pressure during cold storage has a deep connection with lung functions after reperfusion. However, the change of the lung mechanical properties during cold storage at the different lung inflation pressure is unknown. We investigated the change of the mechanical properties both at the organ and the tissue level under different inflated lung pressure soon after the cold storage. In group I, the lungs were not preserved. In group II, the lungs were preserved in deflated condition. In groups III and IV, the lungs were inflated with room air at pressures of 14 and 25 cm H2O. After 24-hour storage, the input impedance (Z) was measured by a computer-controlled small animal ventilator (n = 8 each group). All data were analyzed using a homogeneous linear model, which includes airway resistance (R(aw)), tissue elastance (H), and tissue damping (G). Hysteresivity (eta) was calculated as G/H. After Z measurement, the tissue elasticity (Eqs) obtained from the quasi-static stress-strain curve was compared. We also analyzed the biochemical changes of surfactant in bronchoalveolar lavage (BAL) fluid. R(aw )was significantly lower in groups III and IV than in group I (p < 0.01). Hysteresivity (eta) was significantly lower in group IV than in groups I and III (p < 0.05). Eqs was significantly higher in groups III and IV than in groups I and II (p < 0.01). The total protein level in the BAL fluid of the preserved groups was significantly higher compared with group I (p < 0.01). We conclude that hyperinflated storage would deteriorate lung tissue mechanical properties.

Acclimatization↗

PubMed2006

Invited commentary.

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Carcinoma, Non-Small-Cell Lung↗

PubMed2006

Limited surgery and radiofrequency ablation for recurrent lung cancer.

A 72-year-old man who had been diagnosed with second recurrent lung cancer was referred for consideration of a surgical resection. He had undergone a right upper lobectomy with bronchoplasty for the primary lung cancer and stereotactic radiation therapy for the first recurrent tumor. Owing to the comorbid diseases, video-assisted wedge resection and radiofrequency ablation were performed for the second recurrent tumor. The postoperative course was uneventful and the patient was discharged home without complaints. Eighteen months after surgery, he is alive without recurrence. These procedures are minimally invasive and may decrease the local recurrence of lung cancer in properly selected patients.

Aged↗

PubMed2006

Protective effect of a nebulized beta2-adrenoreceptor agonist in warm ischemic-reperfused rat lungs.

BACKGROUND: It seems inevitable that non-beating-heart donors will be utilized to resolve the shortage of donors for clinical lung transplantation. The control of warm ischemia-reperfusion injury is crucial in manipulating non-beating-heart donors. We hypothesized that nebulization of a beta2-adrenoreceptor agonist, salmeterol xinafoate (SLM), during warm ischemia would increase lung tissue cyclic adenosine monophosphate (cAMP) levels, resulting in lung protection. METHODS: Two studies were conducted. The first investigated the effect of SLM nebulization during ischemia on pulmonary ischemia-reperfusion injury, using an isolated rat lung-perfusion model. The heart-lung block was excised with cannulation of the pulmonary artery and vein, exposed to 55 minutes of ischemia at 37 degrees C, and subsequently reperfused for 60 minutes. Several parameters were measured during reperfusion. In the second study, to measure changes in lung tissue cAMP levels during warm ischemia with or without SLM nebulization, rat lungs were harvested and exposed to 60 minutes of warm ischemia with ventilation. RESULTS: Salmeterol xinafoate nebulization significantly decreased the pulmonary shunt fraction, airway resistance, and pulmonary vascular resistance. It also inhibited pulmonary edema throughout the reperfusion period. Lung tissue cAMP was effectively maintained by SLM nebulization at the end of reperfusion. Myeloperoxidase activity in the lungs was decreased significantly by SLM nebulization. Lung tissue cAMP levels decreased during the 60 minutes of warm ischemia, but increased with SLM nebulization (p < 0.01). CONCLUSIONS: Our results confirmed that SLM nebulization during warm ischemia maintained lung tissue cAMP levels, resulting in the alleviation of pulmonary warm ischemia-reperfusion injury.

Adenosine Triphosphate↗

PubMed2005

Early onset of ganciclovir-resistant cytomegalovirus infection in a lung-transplant recipient.

Ganciclovir resistance in cytomegalovirus (CMV) is an increasing problem in lung-transplant recipients with adverse clinical outcomes. We experienced the successful treatment of ganciclovir-resistant CMV infection in a lung-transplant recipient still receiving CMV prophylaxis. A 24-year-old woman with lymphangioleiomyomatosis underwent a living-donor lobar lung transplantation. She was a primary CMV mismatch (D+/R-) patient. She recovered from her postoperative complications, and was about to be discharged. However, she suffered ganciclovir-resistant CMV infection during prophylactic therapy. She was successfully treated with foscarnet, and is now alive without recurrence 18 months after surgery.

Adult↗

PubMed2005

Surgery for pulmonary nodules in breast cancer patients.

BACKGROUND: The nature of pulmonary nodules that appeared in patients who had received surgery for breast cancer, as well as the role of surgery for such pulmonary nodules, remains unclear. METHODS: A total of 52 consecutive patients who underwent surgery for pulmonary nodules between 1992 and 2001 after curative operation for breast cancer were reviewed. RESULTS: The pathologic diagnoses of pulmonary nodules were pulmonary metastases of breast cancer in 39 patients, primary lung cancer in 6, and other diagnoses in 7 (tuberculosis and hamartoma in 2 each; sclerosing hemangioma, organizing pneumonia, and paragohimiasis in 1 each). The incidence of multiple pulmonary nodules was significantly higher in metastatic breast cancer patients (64.1%), but 33.3% of primary lung cancer patients and 28.6% of other histology patients had multiple pulmonary nodules. The average disease-free interval from the initial mastectomy was significantly shorter in metastatic breast cancer patients (66.8 months), but disease-free intervals were longer than 5 years in 41.0% of metastatic breast cancer patients. The 5-year survival rate after pulmonary metastectomy of metastatic breast cancer patients was 30.8%, which was not better than those documented in metastatic breast cancer patients treated with modern chemotherapy. There was no significant difference in postmetastectomy survival according to the number or sites of pulmonary metastases or the disease-free interval. CONCLUSIONS: Pulmonary metastectomy may not be the primary therapeutic option in metastatic breast cancer patients, and patients should be treated principally with chemotherapy. As pulmonary nodules that appear in breast cancer patients are not always pulmonary metastases, the pathologic diagnosis should be confirmed, and surgery is an option for the pathologic confirmation.

Adult↗

PubMed2005

Posttransplant lymphoproliferative disorder in a lung transplant recipient.

The authors describe a case of posttransplant lymphoproliferative disorder (PTLD) in a 38-year-old Japanese male patient who had undergone bilateral lung transplantation. Chest CT performed on day 109 revealed multiple lung nodules measuring approximately 1cm in the left lower lobe. Despite administration of anti-fungal agents, follow-up CT performed on day 138 showed bilateral lung nodules increased in size and number. Transcutaneous lung biopsy was performed, yielding a diagnosis of polymorphic PTLD positive for Epstein-Barr virus (EBV)-encoded RNA (EBER) and CD20. Treatment with rituximab was successful, resulting in decreased size and number of lung nodules. FDG-PET showed no increased metabolic activity in the residual nodules. In this case, CT and FDG-PET were useful for initial diagnosis and evaluation of treatment response. To the best of our knowledge, this is the first report of PTLD in a lung transplant recipient in Japan documented in the English literature.

Adult↗

PubMed2005

Importance of a comprehensive geriatric assessment in prediction of complications following thoracic surgery in elderly patients.

BACKGROUND: The prevalence of comorbidities and functional impairment among elderly patients may enhance the risk of operation-related complications, but the importance of these conditions in elderly patients undergoing thoracic surgery remains unclear. METHODS: One hundred twenty patients >/= 60 years of age who underwent thoracic surgery were registered prospectively and examined. A comprehensive geriatric assessment (CGA) that evaluated such diverse areas as functional status (ie, performance status and activities of daily living [ADLs] using the Barthel index), comorbidity, nutrition (ie, body mass index, arm-muscle circumference, albumin level, transferrin level, lymphocyte count, and cholinesterase level), and cognitive function (ie, mini-mental state examination [MMSE] and negative emotions for operation) was performed in the 2 weeks before patients underwent the operation. RESULTS: The diseases of the 120 patients were as follows: lung cancer, 85 patients; mediastinal tumor, 14 patients; bullas, 12 patients; and other diseases, 9 patients. Postoperative complications developed in 20 patients (16.7%). The patients with dependence for performing the ADLs, and dementia were more likely to develop postoperative complications (p = 0.041, and p = 0.0065, respectively). The patients who experienced longer operation times (ie, >/= 300 min; p = 0.018) were more likely to have complications. The incidence of prolonged air leak in the patients with malnutrition increased seven-fold (p = 0.045) and that of postoperative infectious diseases in those patients with obesity increased 24-fold (p = 0.0013), while all patients who developed delirium had low scores in the MMSE preoperatively (p = 0.0003). Using multiple logistic regression, the best model was obtained with a combination of MMSE (p = 0.031) and the Barthel index (p = 0.04). When the operation variables were added to this model, the operation time had the strongest effect (p = 0.016). CONCLUSIONS: Dependence for the performance of ADLs and impaired cognitive conditions are important predictors of postoperative complications, especially when the operation time is long. CGA is necessary in addition to the conventional cardiopulmonary functional assessment in elderly patients.

Activities of Daily Living↗

PubMed2004

Ultrasonographic evaluation of small nodules in the peripheral lung during video-assisted thoracic surgery (VATS).

OBJECTIVE: We examined the possibility of intraoperative ultrasonography during video-assisted thoracic surgery (VATS) to localize and make a qualitative diagnosis of small peripheral pulmonary nodules. METHODS: Ultrasonography during VATS and conventional thoractomy was performed on 25 and 18 nodules, respectively, all which were localized in the peripheral lung, were less than 30 mm in diameter and for which there was no definitive diagnosis. RESULTS: All 25 nodules, including 10 invisible but palpable and three both invisible and non-palpable, could be localized by ultrasonography during VATS. If nodules were located less than 15 mm from the pleural surface, ultrasonography during VATS could detect nodules 10 mm or less in diameter. The rate of malignant tumors among 11 of 12 pulmonary nodules (91.6%) showing both heterogeneous and ill-defined patterns was significantly higher than 6 of 16 nodules (37.5%) showing both homogeneous and well-defined patterns on ultrasonography. CONCLUSIONS: Our study suggested that ultrasonography during VATS is useful for the detection of peripheral pulmonary nodules, even when they are not identified on video images or palpation, and may enable a differential diagnosis between malignant and non-malignant lesions.

Adult↗

PubMed2004

[A case of sarcoidosis with superior vena cava syndrome diagnosed by mediastinoscopy].

A bilateral hilar lymphadenopathy on the chest radiograph of a 30-year-old man was pointed out in a medical examination. Four months later, he was admitted to our hospital because of exacerbation of a bilateral hilar lymphadenopathy on the chest radiograph with high fever. Physical examination revealed a marked swelling of the face and upper arms as well as a dilated jugular vein. The fever, which was his chief complaint, responded to antibiotic therapy. A CT scan of the chest confirmed the presence of bilateral mediastinal lymphadenopathy and hilar lymphadenopathy, which caused pulmonary artery and superior vena cava stenosis. A superior vena cavagram demonstrated narrowing of the vessel. Mediastinoscopy was performed for definite diagnosis. Pathologic examination of the specimen revealed noncaseating epithelioid cell granuloma consistent with sarcoidosis. He was asymptomatic. Pulmonary function and arterial blood gas studies yielded almost normal results. A roentgenographic stage of intrathoracic change was Stage I. On the basis of these findings, he was observed carefully without systemic corticosteroid therapy. One month later, the swelling of his face and upper arms was improved, and the pulmonary functions and arterial blood gases remained almost normal. Only seven cases of sarcoidosis causing superior vena cava syndrome have been reported. This is the first case reported in Japan.

Adult↗

PubMed2004

[Role of surgical treatment in atypical Mycobacterium avium infection of the lung].

Mycobacterium avium complex (MAC) disease has recently become an increasingly significant problem. MAC is frequently difficult to treat because of its drug resistance. Therefore surgical treatment still plays an important role in the treatment of this disease. Lobectomy has mainly been performed, and the postoperative complication rate is relatively high (up to 32%). The rate of relapse after surgical treatment is reported to be satisfactorily low (less than 20%). Early pulmonary resection is beneficial in patients whose disease is still localized and who can tolerate resection surgery.

Humans↗

PubMed2003

Glycine ameliorates lung reperfusion injury after cold preservation in an ex vivo rat lung model.

BACKGROUND: The role of glycine has not been investigated in lung ischemia-reperfusion injury after cold preservation. Furthermore, the role of apoptosis after reperfusion following cold preservation has not been fully understood. METHODS: Lewis rats were divided into three groups (n=6 each). In the GLY(-) and GLY(+) groups, isolated lungs were preserved for 15 hr at 4 degrees C after a pulmonary artery (PA) flush using our previously developed preservation solution (ET-K; extracellular-type trehalose containing Kyoto), with or without the addition of glycine (5 mM). In the Fresh group, isolated lungs were reperfused immediately after a PA flush with ET-K. They were reperfused for 60 min with an ex vivo perfusion model. Pulmonary function, oxidative stress, apoptosis, and tumor necrosis factor (TNF)-alpha expression were assessed after reperfusion. RESULTS: Shunt fraction and peak inspiratory pressure after reperfusion in the GLY(-) group were significantly higher than those in the GLY(+) and Fresh groups. Oxidative damage and apoptosis in the alveolar epithelial cells of the GLY(-) group, assessed by immunohistochemical staining and quantification of 8-hydroxy-2'-deoxyguanosine and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling method, were significantly higher than those of the GLY(+) and Fresh groups. There were correlations among shunt fraction, oxidative damage, and apoptosis. There was no expression of TNF-alpha messenger RNA in all groups evaluated by the reverse transcription-polymerase chain reaction. CONCLUSIONS: Glycine attenuates ischemia/reperfusion injury after cold preservation by reducing oxidative damage and suppressing apoptosis independent of TNF-alpha in this model. The suppression of apoptosis might ameliorate lung function after reperfusion.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed2003

[A case of primary lung cancer with initial symptoms due to orbital metastases].

We encountered a case of lung cancer in which symptoms due to orbital metastasis were recognized. A 55-year-old man presented with a chief complaint of double vision. Orbital MR image demonstrated a right intraorbital mass with bone destruction, which resulted in oculomotor nerve palsy and optic nerve disturbance. Chest CT scan showed a 4 cm mass in the right S6, which was diagnosed on biopsy as a poorly differentiated adenocarcinoma. A whole-body scintigram revealed multiple bone metastases: the right orbital wall, the lower cervical spine, the left knee joint, and so on. Based on the clinical findings, we believed that the orbital tumor was a metastasis from the lung. Systemic chemotherapy and irradiation of the right orbital tumor and the left knee joint were performed. Though a favorable response was achieved in ocular movement, the patient died 3 months after initial treatment because of progression of the primary lesion. Including this case, seventeen reported cases in which lung cancer metastasized to the orbit in Japan were also reviewed.

Adenocarcinoma↗

PubMed2002

Effect of adenosine triphosphate-sensitive potassium channel openers on lung preservation.

ATP-sensitive potassium channel (KATP) openers have been proven to be involved in ischemic preconditioning, which protects ischemic tissue. However, the effect of KATP openers on ischemia-reperfusion injury of the lungs remains unknown. We investigated whether a KATP opener, pinacidil, can attenuate ischemia-reperfusion injury using an ex vivo rat lung model. Heart-lung blocks were flushed and preserved with phosphate-buffered saline (control group) or with one of the solutions containing pinacidil (pinacidil group) or pinacidil + glibenclamide (a KATP blocker) (glibenclamide group). The control and glibenclamide groups showed significantly higher values with respect to shunt fraction, pulmonary arterial pressure, and peak inspiratory pressure than the pinacidil group. The concentrations of total adenine nucleotides and ATP in the lung after reperfusion became significantly lower in the control and glibenclamide groups than in the fresh group. Lipid peroxidation of the lungs increased significantly in the control and glibenclamide groups after reperfusion. State 3 mitochondrial respiration and State 3/4 ratios of mitochondrial respiration were significantly decreased in the lungs of the control and glibenclamide groups. These findings suggested that KATP openers would maintain the mitochondrial respiratory function during lung preservation, prevent lipid peroxidation after reperfusion, and attenuate ischemia-reperfusion injury.

Adenosine Triphosphate↗