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Biomedical subjects

Y Ashino

Publications and source records attributed to Y Ashino.

53 records · Page 3Linked to original sources
PubMed1994

[Transverse sinus thrombosis in a patient with colon and rectal double cancers: a case report].

We report a case of transverse sinus thrombosis accompanied by colon and rectal double cancers. A 48-year-old male transferred to our department from the division of surgery due to deterioration manifested by headache after colectomy and low anterior resection of the rectum. There was bilateral papilledema and right upper homonymous hemianopsia. On admission all the laboratory data were within normal range. CT showed a left temporal mass lesion of heterogeneous density, which was suspected as being intratumorous hematoma in a metastasis. MRI revealed a left transverse sinus thrombosis. The left transverse and sigmoid sinuses were not opacified, but angiography showed that the occipital and marginal sinuses seemed to be markedly developed. Evacuation of the subcortical hematoma was carried out. Histologically, it was a mixed hematoma in acute and chronic stages without any carcinoma component or vascular malformation. Postoperative course was uneventful, and the patient was returned to the division of surgery in order to follow up the cancer 2 weeks after operation. Angiography 4 months after operation showed almost no recanalization in the left transverse sinus. Further, development of the collateral flow and the double occipital sinus was opacified. Because the coagulation system is often activated by the presence of cancer, it is important to distinguish intracerebral hemorrhage due to sinus thrombosis from intratumorous hemorrhage within a metastatic tumor.

Adenocarcinoma↗
PubMed1994

[A case of lung cancer combined with ocular myopathy and idiopathic thrombocytopenic purpura which was presumed to be caused by heart catheterization].

A 61-year-old patient was admitted to our hospital because of a chest abnormal shadow. He was suffered from ocular myopathy for more than 4 years. A lab data on the admission showed only a slight thrombocytopenia. After the unilateral pulmonary arterial occlusion test for the preoperative evaluation of thoracotomy, the hemorrhagic tendency was appeared. A detailed examination proved idiopathic thrombocytopenic purpura which was presumed to be caused by the heart catheterization. We employed high-dose intravenous gamma-globulin infusion and concentrated platelet transfusion for 5 days for preventing hemorrhagic complications during the thoracotomy. The partial resection was undergone for the left upper lobe tumor, which was proved as large cell carcinoma. The postoperative hemorrhage was well controlled. We conclude that the high-dose intravenous gamma-globulin infusion and/or concentrated platelets transfusion should be positively employed for the patients with even slight thrombocytopenic purpura.

Carcinoma, Non-Small-Cell Lung↗
PubMed1993

Stimulation of pulmonary intravascular macrophages increases microvascular permeability in awake sheep.

The purpose of this study is to determine if stimulation of pulmonary intravascular macrophages (PIMs) increase microvascular permeability in sheep. We infused latex microbeads, 1 micron in diameter, for 1 hr continuously and analysed lung hemodynamic and lymph-dynamic changes. More than 70% of latex microbeads in the lung were assigned to PIMs, and caught in their phagosomes as determined by morphological examination. This implies that infused latex microbeads predominantly stimulate PIMs. Pulmonary arterial pressure increased during the infusion period, and returned to baseline after the infusion period. Lung lymph flow increased and remained high while the lymph to plasma protein ratio ultimately increased above baseline. This implies that infusion of latex microbeads increases pulmonary microvascular permeability. The increase in lung lymph protein clearance was blocked completely by pretreatment with indomethacin, but not with a thromboxane synthetase inhibitor (OKY-046). These data indicate that the increase in microvascular permeability is mediated by an arachidonic acid cyclooxygenase metabolites but not by thromboxane. We conclude that PIMs can act as an initiator to increase pulmonary microvascular permeability by releasing arachidonic acid cyclooxygenase metabolites through their stimulation with latex beads.

Animals↗
PubMed1993

[Hydraulic conductivity of visceral pleura in dogs].

We measured the hydraulic conductivity of the visceral pleura in seven mongrel dogs in situ. The left chest was opened at the seventh intercostal space. A hemispherical capsule, filled with physiological saline, was attached to the visceral pleura of the left lower lobe by the negative pressure in the plate, using a vacuum pump. Transpleural fluid flow (V) was measured at different intracapsular pressures (delta P). The hydraulic conductivity was calculated from the relation between fluid flow and intracapsular pressure, i.e., the slope of the linear regression line. The hydraulic conductivity was 1.49 +/- 0.68 (mean +/- SD) nL.min-1 x cmH2O-2. Our values were smaller than those of former reports obtained in vivo. It is suggested that the dynamics mechanisms of plural effusion may be clarified by studies using our method.

Animals↗
PubMed1993

[Extension of functional limitation for surgery of lung cancer by unilateral pulmonary arterial occlusion test].

We performed unilateral pulmonary arterial occlusion test to determine the indication for lung resection functionally, and investigated 32 cases whose total pulmonary vascular resistance was over 700 dyne.sec.cm-5/M2. Thirteen out of 32 cases underwent surgery. There was no difference in lung function tests between surgical and non-surgical cases. Nine out of 12 cases whose pulmonary vascular resistance was less than 800 dyne by unilateral pulmonary arterial occlusion test underwent surgery, and none of these cases died within 3 months after surgery. In non-surgical cases, two were aged patients and one had chronic renal failure. Four out of 20 cases whose total pulmonary vascular resistance was over 800 dyne underwent surgery. Two cases that underwent surgery died within 3 months after surgery. These results suggest that the functional limitation of lung resection can be extended from 700 dyne.sec.cm-5/M2 to 800 dyne.sec.cm-5/M2 total pulmonary vascular resistance by application of unilateral pulmonary arterial occlusion test.

Aged↗
PubMed1993

[Estimation of filtration variables in isolated rat lungs for evaluation of pulmonary microvascular permeability].

In order to evaluate the microvascular permeability of donor lungs, we calculated the filtration variables; K (reflection coefficient), simultaneously. For the calculation of filtration variables, the isolated rat lungs were kept in zone three conditions (pulmonary arterial pressure > pulmonary venous pressure > alveolar pressure). We used Krebs-Henseleit solution (K-H) with 6% bovine serum albumin for the perfusate, and maintained perfusion using a constant pressure circuit system. The pulmonary venous and alveolar pressures were maintained at 2.5 and 2.0 cmH2O, respectively, and pulmonary arterial pressure was set so that change in lung weight occurred. We increased both pulmonary arterial and venous pressures by 3 cmH2O simultaneously, and obtained the initial filtration rate. Then we diluted the perfusate with K-H to about half concentration, and obtained the initial filtration rate. We obtained values of filtration variables of K=4.55 mg.min-1.cm H2O-1.g-1], Ppmv=0.59 cmH2O, and sigma =0.617. These values agree with values from previous reports. Since these three filtration variables are interrelated, this method for simultaneous measurement is more accurate than independent measurements. The chief advantages of this method are that it does not require direct measurement of interstitial pressure or collection of lymph fluid, and all variables are obtained simultaneously. Using this method, the vascular permeability of isolated rat lungs, can be estimated.

Animals↗
PubMed1992

[Surgery for the patients whose total pulmonary vascular resistance was over 700 dyne during unilateral pulmonary artery occlusion test].

To determine the indication for surgery from the point of pulmonary function, we have performed the unilateral pulmonary artery occlusion test in lung cancer patients. In these patients, we gave a surgery in 13 cases whose total pulmonary vascular resistance were over 700 dyne.sec.cm-5/M2 per body surface area. The pulmonary hemodynamics before and during pulmonary artery occlusion were 549 +/- 82 and 798 +/- 78 dyne.sec.cm-5/M2 in total vascular resistance, 18.7 +/- 3.8 and 27.2 +/- 4.3 cmHg in mean pulmonary arterial pressure and 2.69 +/- 0.36 and 2.73 +/- 4.3 L/min/M2 in cardiac index respectively. In 7 cases out of 13, we performed selective pulmonary artery occlusion test. In pulmonary function test, 10 cases had a chronic obstructive diseases, 2 cases had a disturbance of diffusion and one case has a contractive disease. We gave a lobectomy in 12 cases and completion pneumonectomy in one case. Two of lobectomy cases died in the early phase: 42 and 72 days after surgery due to pulmonary complications. One of these cases needed an additional completion pneumonectomy because of bronchial fistel. Surgical complications were seen in 12 cases. These 13 cases used to be recognized that they have no indication of surgery because of low pulmonary function, however it revealed that we can give a lobectomy through a high intensive care after surgery.

Adenocarcinoma↗
PubMed1992

[Radioaerosol inhalation and perfusion imaging studies in immediate postoperative phase after lobectomy].

In order to determine the changes in pulmonary ventilation-perfusion imaging after lobectomies, we examined 11 patients using radioaerosol inhalation and perfusion scintigraphies, before and after the operations. We employed 99mTc-labeled albumin aerosol generated by a jet nebulizer for the inhalation imaging, and 99mTc-labeled macroaggregated albumin for the perfusion imaging, respectively. Prior to the operations, there were no (major) defects of imagings on the lung fields. Immediately after the operations, however, we could not detect any abnormal findings on chest roentgenograms, we found detects of imagings on the lung fields in either inhalation or perfusion scintigraphy whose area were mismatching. It took more than 3 weeks for these defects of imagings to disappear. In conclusion, these findings suggest that postoperative hypoxemia might be occurred by these mismatchings.

Administration, Inhalation↗
PubMed1991

[Intra-arterial infusion chemotherapy for locally advanced breast cancer using implantable reservoir connected with catheter inserted in recurrent radial artery].

Intra-arterial infusion chemotherapy through a catheter incubated at the recurrent radial artery and connected to an implantable reservoir was performed in eight patients with supraclavicular lymph node metastasis including four locally advanced recurrent breast cancers and two inflammatory breast cancer. Clinical response in breast cancer patients was 1 CR, 3 PR, 1 NC, and 1 PD. There was no complication related with catheter insertion. Therefore from the aspect of quality of life, this system was considered useful for treatment of advanced breast cancer, especially locally advanced recurrent breast cancer.

Adult↗
PubMed1991

[Evaluation of cardio-pulmonary function for lobectomy under the condition of selective pulmonary arterial occlusion test (SPAO)].

We performed selective pulmonary arterial occlusion test (SPAO) and unilateral pulmonary arterial occlusion test (UPAO) in 30 patients with lung cancer who would be undertaken right lower lobectomy or middle and lower lobectomy, and evaluated the preoperative cardio-pulmonary function. The lung hemodynamics during SPAO were different from those during UPAO. This indicates that SPAO evaluated reserve capacity of vascular bed in the right upper lobe which would be remained at the surgery. Moreover, the ratio of total pulmonary vascular resistance during SPAO to that of before SPAO was not differed in two groups, one was a group with and the other was a group without impaired reserve capacity of vascular bed in the contralateral lung. This suggests that reserve capacity of pulmonary vascular bed including right upper lobe would be well compensated even in the patients with highly impaired capacity in the contralateral lung. Based on these findings, we performed lung resections in 9 patients, who were judged contraindications for lung resection by the results of UPAO, and no patient suffered postoperative cardio-pulmonary complications. Total pulmonary vascular resistance immediately after the right middle and lower lobectomy were equal to those during SPAO. Thus we conclude that SPAO is very useful technique for evaluating cardiopulmonary function after right lower lobectomy or middle and lower lobectomy, and that it would be possible to extend the boundaries of safety for lung resection based on evaluation of cardio-pulmonary function by SPAO.

Aged↗
PubMed1991

[Lung function after lobectomy in chronic pulmonary emphysema].

We compared the prediction of postoperative pulmonary function in two groups: chronic pulmonary emphysema (CPE) group (n = 30) and normal control group (n = 41). These patients had a lobectomy because of lung cancer. We measured pulmonary function test (FVC, EFV1, TLC, FRC, RV, DLco), and pulmonary perfusion scan before and after surgery. We found correlation between the predicted and measured postoperative values very close in control group. Whereas, in CPE group, these correlations were very low especially in FVC and FEV1. We also calculated the pulmonary function on the operated and the non-operated sides. The correlation were very high without FEV1 in control group and all the measured values did not correlate to the predicted values. On the non-operated side, the correlations were high in both control and CPE groups. From these results we can conclude that it is difficult to predict the postoperative pulmonary function in the case of chronic pulmonary emphysema.

Chronic Disease↗
PubMed1990

[Activated pulmonary intravascular macrophages increase pulmonary microvascular permeability in sheep].

Pulmonary intravascular macrophages (PIMs) reside in the alveolar capillaries of sheep lung. However, the role of PIMs activation in the mechanism of increasing pulmonary microvascular permeability is not clear. We determined, using awake sheep with chronic lung lymph fistulas, the effects of intraarterial infusion of latex beads emulsion (1 microns in diameter) on lung lymph-dynamics. Sheep were divided into 3 groups; control, low dose latex and high dose latex groups. In control group, their lymph-dynamics were stable during the experimental period. In low dose latex group (5.46 x 10(9) beads/kg), lung lymph flow increased during the infusion period, but lung lymph protein clearance did not change. In high dose latex group (5.46 x 10(10) beads/kg), lung lymph flow began to increase during the infusion period and remained high, and lung lymph protein clearance increased significantly during and after the infusion of latex beads emulsion. The latex beads mainly distributed to lungs, and 70% of the beads were caught by PIMs in their phagosomes. These findings suggest that the activation of PIMs through their phagocytic uptake of circulating microparticles increases pulmonary microvascular permeability.

Animals↗
PubMed1989

[A case of hemangioma of the heart].

A-74-year old woman who had suffered from anterior chest pain and palpitation was admitted to our hospital. The chest X-ray photograph showed that the heart was enlarged mildly. We found that the tumor lay in the mediastinum by the echocardiograph and was enhanced at the aortic phase of the radioisotope angiography. In order to obtain the histological specimen, she underwent exploratory thoracotomy. The tumor was diagnosed as a cavernous hemangioma. She has been asymptomatic over 1-year period. The RI angiography seemed to be useful to diagnose the hemangioma of the heart.

Aged↗
PubMed1989

[Possible involvement of vascular endothelium-derived relaxing factor induced by platelet-activating factor (PAF) on human pulmonary artery after contraction in vitro].

We studied the effects of platelet-activating factor (PAF) on human pulmonary vascular smooth muscle in vitro. 10(-6) M PAF elicited slight contractions in 2 of 7 endothelium-denuded arterial strips, but did not elicit distinct contractions or relaxations in the other strips. After incubation with PAF at 10(-7) M, the contractions of pulmonary vascular smooth muscle induced by histamine and prostaglandin F2 alpha were significantly decreased. Preincubation of 10(-3) M indomethacin did not affect the inhibitory effects of PAF, but these disappeared with removal of endothelium. These results suggest that the inhibitory effects of PAF on human pulmonary vascular smooth muscle contractions may appear not through the cyclooxygenase products but the endothelium-derived relaxing factor.

Female↗
PubMed1989

[Pulmonary hemodynamics during mild exercise in COPD].

The effects of mild exercise on pulmonary hemodynamics and ventilatory responses in COPD were studied. Six patients with FEV1% less than 70% received 20 watt exercise tests by cycle ergometers for 5 minutes. Changes in hemodynamics and ventilation were observed before and during exercise. Nine patients with an FEV1% of more than 70% also received exercise tests as controls. There were no different in changes in respiratory frequency, tidal volume and minute ventilation between control and COPD group. However, the mean pulmonary arterial pressure were higher in the COPD group than in the control group before exercise. Moreover increments of mean pulmonary arterial pressure by exercise were also greater in COPD group. It was concluded that hemodynamics in COPD are much more influenced by mild exercise than in healthy subjects.

Adult↗
PubMed1989

[Pulmonary fibrosis after endotoxin-induced permeability edema].

To know the pathogenesis of the lung fibrosis after ARDS, we investigated the role of PMN-elastase after endotoxin-induced pulmonary edema in awake sheep with chronic lung lymph fistulas. The permeability of the pulmonary circulation increased 2 hours after endotoxin injection. Four hours after endotoxin injection, WBC migrated to the lung interstitium and the number of WBC in BALF increased. Endotoxin increased PMN-elastase in plasma and lymph whereas the level of alpha-1-protease inhibitor (alpha-1-PI) did not change. The activity of alpha-1-PI measured by trypsin inhibitory capacity was zero in the exudative phase. The level of PMN-elastase in lymph was significantly higher 1 week after endotoxin injection than baseline levels. Histologically, pulmonary fibrosis developed 1 week after endotoxin injection. These results suggest that inflammatory mediators released from PMN play an important part in progress to the fibrotic phase after ARDS.

Animals↗