Search PubMed⌕ Search

Biomedical subjects

Y Otani

Publications and source records attributed to Y Otani.

At least 109 records · Page 6Linked to original sources
PubMed1997

Arterial embolization as preoperative treatment for pulmonary aspergillosis with hemoptysis.

Pulmonary aspergillosis associated with old tuberculosis is generally resistant to treatment. Thus, if patients are treated only with conservative therapy, their condition continues to deteriorate due to repetitive hemoptysis, and may even become critical. Surgical treatment is required for these patients; however, it is extremely difficult to resect the lesion due to severe adhesions to the chest wall and vascular proliferation surrounding the lesion. We performed preoperative arterial embolization, achieving good results in three patients with hemoptysis caused by pulmonary aspergillosis. The feeding arteries were embolized using microcoils and/or gelatin sponges, and a lobectomy was safely carried out in all patients. We concluded that preoperative arterial embolization is a safe and effective technique to prevent massive hemorrhage occurring at the time of surgery.

Aged↗
PubMed1997

Surgical management of gastric leiomyosarcoma: evaluation of the propriety of laparoscopic wedge resection.

Laparoscopic surgery has been applied to malignant gastric tumors. To evaluate the propriety of laparoscopic wedge resection for gastric leiomyosarcoma it is necessary to question whether lymph node dissection is necessary for the surgical management of gastric leiomyosarcoma. A retrospective study on open surgery cases of gastric leiomyosarcoma was performed to address this issue. The clinical records of 28 patients with gastric leiomyosarcoma who had had surgery were examined. The patients who underwent open surgery were divided into a systematic lymph node dissection (SLND) group (n = 9) and a nondissection (non-D) group (n = 19). No patient had lymph node metastasis at the time of operation or recurrence, and statistical analysis showed no difference between the SLND and non-D groups in terms of survival rates. These data suggest that SLND might not be necessary for the surgical management of gastric leiomyosarcoma and that laparoscopic wedge resection of the stomach can be considered a first-line treatment for gastric leiomyosarcoma.

Adult↗
PubMed1997

Expression of matrix metalloproteinase-1 mRNA related to eosinophilia and interleukin-5 gene expression in head and neck tumour tissue.

In situ hybridization (ISH) of the expression of matrix metalloproteinase-1 (MMP-1) in areas of local invasion of head and neck tumours was performed. Expression of MMP-1 mRNA was found in stromal inflammatory cells adjacent to the tumour nests, apparently in eosinophils. MMP-1 mRNA expression was seen only in cases with moderate or greater stromal eosinophilia. MMP-1 mRNA was detected in benign papilloma and verrucous carcinoma. In squamous cell carcinomas, expression of the gene was detected only in well-differentiated cases. Expression of MMP-1 mRNA was not related to the grade of malignancy, and appeared in stromal eosinophils, suggesting to us that it is involved in a remodelling process in the reaction of the host to tumour invasion. ISH examination of the expression of interleukin-5 (IL-5), the activating factor for eosinophils, was also performed. In the tumour, its expression was consistent with the location of eosinophils, as with MMP-1 mRNA, suggesting an autocrine mechanism.

Adult↗
PubMed1997

Suppressed production of nitric oxide as a cause of irregular constriction of gastric venules induced by thermal injury in rats.

Microcirculatory disturbance is a crucial step in development of gastric mucosal lesions. In this study we investigated the influence of nitric oxide (NO) on the irregular constriction of gastric venules observed in rats subjected to thermal injury. Male Wistar rats were anesthetized and a 30% full skin thickness dorsal burn was inflicted. Microvascular images in the submucosal layer and basal region of the gastric mucosa were obtained through an intravital microscope. Distribution of constitutive-type nitric oxide synthase (cNOS) was observed by the immunofluorescence method. Venule walls were basically smooth in the control group (no injury), whereas irregular constrictions tended to be observed in the 5-h group (5 h after thermal injury). Venule diameter was significantly smaller in the 5-h group. In the control group, cNOS-associated fluorescence was found on the venule endothelium, whereas it was almost negligible after thermal injury. A NO donor, 3-morpholinosydnonimine hydrochloride, simultaneously diminished the thermal injury-associated venule constriction and irregularity of venule walls. Therefore, the present study suggests that venule constriction, which is observed 5 h after thermal injury, is related to decreased NO production by endothelial cNOS and is a cause of irregularity of the venule walls.

Animals↗
PubMed1997

Matrix metalloproteinase gene expression in chronic gastric ulcer: a potential role of eosinophils in perforation.

Gene expression of matrix degrading enzymes was investigated in surgical specimens of perforated gastric ulcers. In these ulcers, the inflammatory cells infiltrating into the granulation tissue were granulocytes, particularly eosinophils. The extracellular matrix of the stomach wall consists mainly of collagen types I and III, which are selectively degraded by matrix metalloproteinase-1 (MMP-1). MMP-1 mRNA was detected in the cytoplasm of infiltrating cells, suggesting that eosinophils play an important role in ulcer recurrence and in perforation of the stomach wall. The degree of eosinophil infiltration into an ulcer base may be a useful marker for the risk of perforation. Patients showing this marker may benefit from a prophylactic therapy for preventing severe complications. The control of MMP gene expression represents a potential strategy for the treatment of recurrent gastric ulcer.

Adult↗
PubMed1997

Expression of interstitial collagenase (matrix metalloproteinase-1) in gastric cancers.

The expression of matrix metalloproteinase-1 (MMP-1) gene and the presence of MMP-1 protein in gastric cancer were examined by in situ hybridization and immunohistochemistry. Expression of the interstitial collagenase (MMP-1) gene was detected within the stroma of the neoplastic glands, and infiltration of eosinophils was observed to be associated with regions of MMP-1 gene expression. The degree of eosinophilic infiltration correlated with the level of MMP-1 mRNA expression. Immunostaining showed localization of MMP-1 protein in the stromal cells, and additionally in the neoplastic glands. These findings indicate that the stromal cells may play an important role in the expression of MMP-1, and suggest a pathophysiological role for MMP-1 in the invasion and metastasis of gastric cancer.

Adenocarcinoma↗
PubMed1997

Left-sided approach to renal cell carcinoma tumor thrombus extending into suprahepatic inferior vena cava by resection of the left caudate lobe.

A new operative approach to resecting tumor thrombus originating from a right renal cell carcinoma extending into the suprahepatic inferior vena cava (IVC) is reported. Complete local control of the IVC must be obtained above and below the tumor thrombus to remove it under direct vision. The caudate lobe of the liver was resected to expose the retrohepatic IVC and open the lesser omentum. The subhepatic IVC was encircled just below the confluence of the hepatic veins. Caval tumor thrombus was removed en bloc, including the right kidney, by use of the total hepatic vascular exclusion technique (THVE) and IVC exclusion. The retrohepatic IVC was clamped just below the confluence of the hepatic veins once the thrombus was removed, and the suprahepatic IVC clamp was then released and the THVE was terminated. The sequential clamping from the suprahepatic IVC to the retrohepatic IVC below the confluence of the hepatic veins shortened the THVE time.

Carcinoma, Renal Cell↗
PubMed1997

[Laparoscopic surgery for early gastric cancer--its advantage and pitfall].

We have successfully treated 50 patients with early gastric cancer by using two different laparoscopic procedures since March 1992. which are laparoscopic wedge resection of the stomach using a lesion-lifting method (n = 33) and laparoscopic intragastric mucosal resection (n = 17). The indication is as follows; (A) mucosal cancer, (B) < 25 mm, if the lesion is protruded type, (C) < 15 mm and Ul(-), if the lesion is depressive type. The advantages of these methods are; 1) minimally invasiveness. 2) sufficient surgical margin, 3) feasibility of detailed histology, 4) feasibility of perigastric lymph node dissection. In contrast, there are several problems to be solved, which are; 1) preoperative diagnostic accuracy of the depth of cancer invasion, 2) possibility of reoperation because of sm invasion or lymphatic or venous invasion in final histology, 3) possibility of postoperative stenosis after laparoscopic intragastric mucosal resection for the lesion near the cardia, 4) incidence of metachronous multiple gastric cancer.

Adult↗
PubMed1997

Malfunctioning Starr-Edwards mitral valve 21 years after installation.

Two cases of malfunctioning Starr-Edwards cloth-covered mitral valve prostheses requiring reoperation are presented. Both cases underwent successful surgical repair 21 years after the valve replacement. The causes were a disturbance of the poppet during the opening movement due to excessive tissue ingrowth and a paravalvular leak associated with a tear of the valve seat. Replacement of the Starr-Edwards valve prosthesis more than 20 years after the initial installation has not been reported.

Female↗
PubMed1997

[Clinical criteria of chemosensitivity test].

Chemosensitivity test is useful in evaluating the appropriate cancer chemotherapy for solid tumors which are less sensitive to conventionally available antitumor agents. Most of assays used in clinics are in vitro assay, in which the cutoff concentration and contact time should be determined to mimic the clinical response of the chemosensitivity test. Since the antitumor effect of most of antitumor agents depends on their concentration x contact time, and the contact time will be determined according to the assay, the cutoff concentration will be calculated from the cumulative efficacy curve or 50% inhibitory concentration and in vivo response of human tumor xenografts in nude mouse. The clinical result obtained from chemosensitivity test was discussed.

Animals↗
PubMed1997

[Jejunal pouch interposition after total gastrectomy].

The results and procedures of interposed jejunal pouch after total gastrectomy for gastric cancer are reported. Basic requirements of reconstruction after total gastrectomy are 1) formation of a food reservoir, 2) maintenance of duodenal continuity, 3) avoidance of reflux esophagitis, 4) gradual emptying of reservoir into the small intestine. Since 1950's, several procedures of gastric substitutes have been reported. But they were not widely performed. Because scientific evaluation of the value of gastric substitutes was difficult and the operative procedures were time consuming and complicated. With an increasing ratio of early gastric cancer in 1990's, the importance of post-operative QOL, such as food intake and body weight maintenance, in patients after total gastrectomy has been recognized. Our procedure is a double lumen jejunal pouch distal to a interposed jejunum. The length of interposed jejunum is 20 cm and that of pouch is 10 cm. Using surgical staplers, this procedure is safe and simple. Jejunal pouch interposition leads to a satisfactory symptomatic and nutritional result in gastrectomized patients.

Gastrectomy↗
PubMed1997

Availability of nasal mask BiPAP systems for the treatment of respiratory failure after cardiovascular surgery.

BACKGROUND: The availability of nasal mask bi-level positive airway pressure (BiPAP) support in managing respiratory failure following cardiovascular surgery was studied. MATERIALS AND METHODS: BiPAP support was used for eight patients requiring postoperative prolonged respiratory support of 72 hours or longer. Their mean age was 65 years of age and the mean periods of postoperative endotracheal intubation was 12+/-5 days. BiPAP support was removed within 48 hours in six out of eight patients. Reintubation of an endotracheal tube was not necessary in all eight patients after the BiPAP treatment. RESULTS: The respiratory rates during the BiPAP management remained unchanged. The values of the respiratory index significantly (p<0.01) improved after BiPAP management (1.5+/-0.2 --> 0.9+/-0.2). A-aDO2 and Qs/Qt decreased (p<0.1) after the BiPAP management. There were no significant differences in central venous pressure and circulatory states during BiPAP support. CONCLUSIONS: In conclusions, BiPAP support is a noninvasive management technique for postoperative respiratory failure and may also prevent prolonged endotracheal intubation.

Aged↗
PubMed1996

Antitumour activity of cis-diamminedichloroplatinum (II) against human tumour xenografts depends on its area under the curve in nude mice.

A pharmacodynamic analysis of cis-diamminedichloroplatinum(II) (DDP) was conducted using two human gastric cancer xenografts, SC-1-NU and MKN-45, and one human breast cancer xenograft, MX-1, grown serially in BALB/c nu/nu mice. DDP was administered intraperitoneally (i.p.) at a total dose of 5, 10, or 20 mg/kg in a schedule of q7d x 3 or (qd x 5) x 3. DDP was also administered i.p. to BALB/c +/? mice, whose plasma was used for the assay of total and free platinum by the atomic absorption method. A total dose of 20 mg/kg DDP seemed to be the maximum tolerated dose that was effective on MX-1 and SC-1-NU. When the totally administered doses were equivalent, the antitumor effects of the q7d x 3 and (qd x 5) x 3 schedules were similar to each other. The antitumor activity of DDP against MKN-45 was dependent on the total administered dose as well as the area under the curve of free and total platinum in the plasma. Side effects were significantly reduced using a schedule of (qd x 5) x 3 in terms of body and spleen weight loss when a total of 10 or 20 mg of DDP per kg was administered. These results suggest that DDP would be useful when administered using a daily schedule for obtaining the same antitumor activity as that of bolus injection but with reduced adverse effects.

Animals↗
PubMed1996

Pharmacokinetics of cis-diamminedichloroplatinum (II) given as low-dose and high-dose infusions.

A pharmacokinetic analysis of cis-diamminedichloroplatinum (II) (DDP) was conducted comparing low-dose daily bolus infusions, and high-dose drip infusions. Eight patients with gastric cancer were treated with low-dose daily bolus infusions of DDP to a total daily dose of 75 mg/m2 bid for 5 days. Four patients with esophageal cancer and one patient with gastric cancer were treated with high-dose drip infusions of DDP to a total daily dose of 70-80 mg/m2. Side effects were assessed in all the patients, and the platinum concentration in plasma was determined by an atomic absorption method. The peak plasma concentration (Cmax) and area under the curve (AUC) were calculated in four cases of the low-dose therapy, and three cases of the high-dose therapy. The side effects of DDP were evaluated according to the World Health Organization (WHO) grading, paying particular attention to nausea/vomiting, appetite loss, renal toxicity, and bone marrow suppression. The incidence of nausea/vomiting and appetite loss was significantly reduced with low-dose daily bolus infusions when compared to the high-dose drip infusions. Bone marrow toxicity and renal toxicity were similar with both administration methods, although hydration was required for the high-dose drip infusions to prevent renal toxicity. The peak plasma concentration (Cmax) of total and free platinum, and the area under the curve (AUC) of total platinum, were similar with both administration methods, while the AUC of free platinum was higher with the low-dose daily bolus infusions compared to the high-dose drip infusions. The time when the concentration of total platinum was > 1 microgram per ml (holding time) was significantly longer with the high-dose drip infusions than with the low-dose daily bolus infusions. The present study suggests that low-dose daily bolus infusions of DDP would be useful in reducing gastrointestinal toxicity, without reducing the area under the curve which is important for antitumor activity.

Adult↗
PubMed1996

A new biological glue from gelatin and poly (L-glutamic acid).

This study describes the potentiality of hydrogels composed of gelatin and poly(L-glutamic acid) (PLGA) as a biological glue for soft tissues and compares its effectiveness with that of a conventional fibrin glue. Water-soluble carbodiimides (WSC) were used to crosslink the aqueous mixture of gelatin and PLGA. The mixed aqueous solution of gelatin and PLGA set to a hydrogel by use of WSC as rapidly as BOLHEAL fibrin glue. An addition of PLGA to gelatin aqueous solution reduced not only its gelation time but also the WSC concentration necessary for hydrogel formation. The cured hydrogel exhibited firm adhesion to the mouse skin and other soft tissues with a higher bonding strength than BOLHEAL fibrin glue. Cohesive failure in the hydrogel was observed when the gel-tissue bond was broken, in contrast to BOLHEAL fibrin glue. The bonding strength of the gelatin-PLGA hydrogel became higher with the increasing PLGA concentration. The inflammatory reaction around the gelatin-PLGA hydrogel subcutaneously implanted in mice was mild, and the hydrogel was gradually absorbed with time in vivo. A toxicity test demonstrated that the concentration of WSC necessary as a biological glue was low enough not to induce its toxicity.

Adhesives↗