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Biomedical subjects

Y Otani

Publications and source records attributed to Y Otani.

At least 145 records · Page 8Linked to original sources

Intratracheal stent intubation under extracorporeal lung assist.

An artificial stent was intubated using extracorporeal lung assist (ECLA) in two patients with inoperable tracheal stenosis. In a patient with an endotracheal tumor, an airway obstruction due to a partial stent collapse was overcome by an immediate ECLA perfusion. In another patient with chronic inflammatory tracheal stenosis, a repetitive balloon dilation of the trachea could be safely performed utilizing ECLA perfusion. Preventive femoral cannulation, employing the assistance of an ECLA circuit, is thus considered to be a safe and effective procedure for the treatment of inoperable tracheal stenosis.

Adult↗

Active oxygen species in formation of acute gastric mucosal lesions induced by thermal injury in rats.

Active oxygen species generated by circulating leukocytes and released from the gastric mucosa were measured in the process of acute gastric mucosal lesion formation after thermal injury in rats. Alterations of luminol-dependent chemiluminescence activities generated by leukocytes obtained from the gastric vein and the inferior vena cava were approximately same. A decrease in chemiluminescence activity 15 min after thermal injury and a significant increase in chemiluminescence activity 5 hr after thermal injury were observed in leukocytes from both veins. From 15 min to 12 hr after thermal injury, luciferin-dependent chemiluminescence activities were significantly higher than that of the control group. Oral administration of rebamipide resulted in decreased mucosal lesion formation. Rebamipide, an antiulcer agent that protects the mucosa from damage in various animal models decreased chemiluminescence activities only released from the gastric mucosa but not from circulating leukocytes. These results suggest that two different pathways of active oxygen species formation may exist in the pathogenesis of acute gastric mucosal lesions after thermal injury.

Acute Disease↗

Influence of chronic liver damage on regeneration of the organ in rats.

To investigate the influence of chronic hepatic damage on liver regeneration, a 70% hepatectomy was carried out in male BDE rats in which chronic hepatic damage had been induced by i.m. injection of 0.1 ml CCl4/100 g b. w. twice a week for 4 weeks. After resection, we examined adenine nucleotide concentration in the remaining liver tissues, also body weight and wet and dry weight of the liver. The total adenine nucleotide concentration fell 6 h after resection from 2.89 +/- 0.22 mumol/g to 2.03 +/- 0.15 mumol/g and then recovered on the 3rd postoperative day. However, control animals showed lowest values 3 h after resection, and had already begun to recover at 6 h. Energy charges fell 3 h after liver both groups to the lowest values, but recovery was slower in the animals with chronic liver damage. These observations suggest that in animals with hepatic damage regeneration is delayed in the initial post-resection period. However, 5 days after resection the wet and dry weights of the liver were completely normalized and there was no difference between the two groups, i.e., 5 days after 70% liver resection we could not find any delayed regeneration tendency in animals with chronic liver damage.

Adenine Nucleotides↗

Inhibitory effects of intravenous lansoprazole on gastric acid hypersecretion in patients with postoperative stress.

The inhibitory effects of intravenous lansoprazole on gastric acid hypersecretion caused by stress after surgical invasion were studied in patients who underwent surgery under general anesthesia for gastrointestinal diseases. Patients in this study received either 15 mg or 30 mg of lansoprazole by slow intravenous injection twice daily for 3 days (six injections). The total number of patients studied was 82, with 41 patients in each group. Intragastric pH was measured every 8 h after the start of administration, and the inhibitory effects of intravenous lansoprazole on postoperative gastric acid secretion were evaluated using four grades: excellent, good, fair, and poor. In the 15-mg group, 65.8% (25 of 38 patients) were classified as good or excellent, and in the 30-mg group, 75.7% (28 of 37 patients) were good or excellent. No adverse effects directly attributable to the administration of lansoprazole were observed.

2-Pyridinylmethylsulfinylbenzimidazoles↗

[Surgical treatment of metastatic lung tumor from colorectal cancer].

We have experienced thirty-one operations of metastatic lung tumors from colorectal cancer. Various factors affecting prognosis are studied based on 5-year survival in this report. Overall 5-year survival rate was 32%. Statistical significance was present in the relationship between the prognosis and both maximum diameter of lesions and the disease free intervals (DFI) after surgery for metastatic lesions. Though not significant, sex, stage of primary lesion, nodal involvement, surgical procedure, postoperative serum CEA were likely affecting factors on the prognosis. In contrast, there were no relationship between the prognosis and following factors: age, location of the metastatic lesion, DFI after the operation for primary lesion and chemotherapy. Although pulmonary metastasis is essentially an index of the advanced state of malignant diseases leading to poor prognosis, long-term survivors were encountered in our series of surgical treatments for pulmonary metastases from colorectal cancers. It was concluded to be important to make efforts to extend the indication for surgical treatment, since the appropriate selection of patients revealed to give excellent results from our experience of colorectal cancer. In order to improve the prognosis, early detection of pulmonary metastases is quite important, since the incidence of nodal involvement proved to be higher in lesions with larger diameter resulting in inferior survivals from the present study. In addition, low incidence of nodal involvement in small-sized lesion may support possible applicability of thoracoscopic surgery in the excision of metastatic tumors locating at peripheral lesion.

Adult↗

Active oxygen species generation by circulating leukocytes and gastric submucosal microcirculatory disturbances in the early period after thermal injury.

The purpose of the present study was to determine the pattern of microcirculatory disturbance to investigate the causes of gastric mucosal blood flow depression in the early period after thermal injury. Male Wistar rats were anesthetized and a 30% full skin-thickness dorsal burn was inflicted. Active oxygen species (AOS) generated by circulating leukocytes were measured by chemiluminescence. Contraction of arterioles and venules was observed by intravital microscopy, and rolling or sticking of leukocytes in venules was counted using fluorescence microscopy. AOS generation by circulating leukocytes was diminished and arteriolar contraction and increases in rolling or sticking leukocytes in venules were observed 15 min after thermal injury. Decreased AOS generation by circulating leukocytes, contractions of arterioles, and increased rolling or sticking of leukocytes in venules was observed in the early period after thermal injury. Arteriolar contraction may explain decreases in mucosal blood flow. Moreover, decreased AOS generation by circulating leukocytes does not obviate the potential participation of leukocytes in microcirculatory disturbances, because rolling or sticking leukocytes were increased significantly 15 min after thermal injury.

Animals↗

Gene expression of interstitial collagenase (matrix metalloproteinase 1) in gastrointestinal tract cancers.

Collagenolytic proteinases play an important pathological role in the invasion and metastasis of cancer cells. However, little is known about the role of interstitial collagenase (matrix metalloproteinase-1; MMP-1) in this process. To investigate the expression of the MMP-1 gene in cancer tissues, an in situ hybridization study was carried out in gastrointestinal tract cancers (one esophageal cancer, five gastric cancers, and four colorectal cancers), using a 35S-labeled MMP-1 cDNA probe. The MMP-1 gene was expressed in the stromal cells of fibrous tissue around cancer nests, especially at the margin of invasion and/or within the cancer nest; however, no definite expression within cancer cells was observed. Expression of the MMP-1 gene in the stromal cells was more common in well differentiated gastric adenocarcinoma than in poorly differentiated adenocarcinomas. These findings indicate that expression of the MMP-1 gene is greater in stromal cells that are closely associated with cancer cells, suggesting a pathophysiological role of MMP-1 in the invasion and metastasis of cancer cells.

Adenocarcinoma↗

Frequency and operative correction of aortic insufficiency associated with ventricular septal defect.

Frequency and surgical results of aortic cusp prolapse and aortic regurgitation (AR) associated with ventricular septal defect (VSD) were studied. One hundred thirty-six consecutive patients with type I and II VSD according to Kirklin and associates' classification were divided into two groups; group A included 50 patients with type Ia VSD without the conal muscular rim, and group B included 86 patients with type Ib VSD with the conal muscular rim, or with type II VSD. Aortic cusp prolapse was detected in 74% of group A patients and 29% of group B patients. The aortic cusp prolapse correlated negatively with preoperative left-to-right shunt ratio, mean pulmonary artery pressure, and pulmonary-to-systemic pressure ratio in both groups. In group B patients, the smaller the VSD, the higher the frequency of aortic cusp prolapse, especially when less than 4 mm. Aortic regurgitation was observed in 44% of group A patients and 24% of group B patients. All 20 patients with first grade AR underwent VSD closure, 11 with second or third grade AR underwent VSD closure plus valvuloplasty, and 1 with third grade AR underwent aortic valve replacement. Postoperative persistent AR occurred in 8 out of 32 patients, and correlated positively (p < 0.01) with the preoperative grade of AR and the number of plication stitches in both groups.

Adolescent↗

Postnatal reference growth curves for very low birth weight infants.

To construct standard growth curves for Japanese infants of very low birth weight (VLBW) with birth weights of 500-1499 g, we reviewed longitudinal data provided by 54 neonatal intensive care units in Japan. A total of 382 surviving singleton infants, appropriate for gestational age infants, and who were free of neurological sequelae at more than 2.5 years of age, were enrolled. Growth curves, including body weight, head circumference and body length were generated for four ranges of birth weight: 500-749 g, 750-999 g, 1000-1249 g, and 1250-1499 g. When compared with previously published growth data from western countries, Japanese infants of VLBW showed greater weight loss, regained birth weight more slowly, and exhibited smaller average gains in weight, head circumference, and body length. The growth curves reported in western countries may not be useful as reference standards of early postnatal growth in Japan. The new growth curves are a more accurate reflection of current in-hospital growth trends in Japan.

Asian People↗

[Effect of prophylactic intra-arterial infusion of anticancer drugs on post hepatic resection for hepatic metastasis of colorectal cancer].

Prophylactic intra-arterial infusion of anticancer drug on post hepatic resection for hepatic metastasis of colorectal carcinoma were performed 8 cases. In our cases consisted of 8 patients of mean age of 54.3 years (male 3 cases and female 5 cases, synchronous metastasis 4 cases and metachronous 4 cases). All patients were received intra-arterial bolus injection of MMC (4-8 mg/body) at day 1 and continuous infusion of 5-FU (250-750 mg/body) for 7 days on admission. After discharged, patients were received bolus injection of 5-FU (250-750 mg/body) for once a week. Side effect of this treatment was not appeared and all of them obtained very good QOL. There were no recurrence sign of residual liver and this procedure was very useful method for post hepatic resection for hepatic metastasis of colorectal cancer.

Adult↗

[Surgical treatment of needles in intracardiac cavity and chest wall--a case report and the review of cases removed under open-heart surgery in Japan].

A 36-year-old woman under the treatment for neurosis stuck five sewing needles into her left anterior chest wall for the purpose of suicide. She was hospitalized with complaints of anterior chest pain and low-grade fever. Chest roentgenogram and computed tomogram showed two needles in the cardiac cavity and three needles in the chest wall. Following extraction of three needles in the chest wall, we removed two needles from the left and the right ventricular cavities under extracorporeal circulation. Preoperative and intraoperative two-dimensional echocardiography was useful for confirming the location of needles.

Adult↗

[The transverse submammary skin incision for median sternotomy].

Median sternotomy is the incision of choice to allow access to the anterior mediastinum, heart or both lungs. The vertical skin incision is cosmetically unsatisfactory for many female patients. The transverse submammary skin incision with dissection of a flap including the subcutaneous tissue and breasts allow exposure of the sternum for a median sternotomy. Seventy patients with the transverse submammary skin incision was compared with 56 patients with the vertical skin incision in the point of the cosmetic aspect and satisfaction of patients. The transverse submammary skin incision needed a longer wound size and took a longer time for cardiopulmonary bypass, but there were no difficulties in cannulating the ascending aorta for cardiopulmonary bypass. The exposure of the mediastinum and the cosmetic result were excellent. The complications associated with this incision are insignificant if close attention is paid to details.

Adolescent↗

[Surgical repair of an extreme type of tetralogy of Fallot using valved extracardiac conduit].

Three patients with an extreme type of tetralogy of Fallot underwent corrective surgery using the valved extracardiac conduit for reconstruction of the main pulmonary arteries. The conduit consisted of bicuspid valve which was made of heterogeneous pericardium of 18 or 20 mm in diameter. The conduit was sutured to the pulmonary artery followed by an end-to-end anastomosis between the conduit and a Dacron tube which was sutured to the right ventricular outflow tract. Postoperative echocardiography showed little pulmonary regurgitation. Postoperative courses of all the patients have been uneventful.

Blood Vessel Prosthesis Implantation↗

Complete disappearance of metastatic abdominal tumors from gastric cancer after treatment with irsogladine maleate.

A 60-year-old woman with gastric cancer had undergone partial gastrectomy in September 1989. Pathological examination revealed a poorly differentiated adenocarcinoma of pT3pN3pM0 (not resected for cure), stage IV. Postoperative adjuvant therapy comprised 1-(tetrahydro-2-furanyl)-5-fluorouracil plus uracil and OK-432. On 11 August 1990, two forefinger-tip-sized tumors were palpated beneath the operation scar. They increase in size, the superior tumor reaching 4x3 cm, the inferior tumor 5x3 cm on 5 September. Then, on 17 September, the inferior tumor was resected but the superior tumor remained; the histological type was poorly differentiated adenocarcinoma. After the operation, from 20 September, she was given 4 mg irsogladine maleate orally every day. On 8 October, there was no increase in the size of the superior tumor. By 29 October, the superior tumor had disappeared and no further tumor appeared thereafter; the patient showed no sign of relapse.

Abdominal Neoplasms↗

Cloning and sequence analysis of cDNA encoding Rhizopus niveus lipase.

Complementary DNA encoding Rhizopus niveus lipase (RNL) was isolated from the R. niveus IF04759 cDNA library using a synthetic oligonucleotide corresponding to the amino acid sequence of the enzyme. A clone, which had an insert of 1.0 kilobase pairs, was found to contain the coding region of the enzyme. The lipase gene was expressed in Escherichia coli as a lacZ fusion protein. The mature RNL consisted of 297 amino acid residues with a molecular mass of 32 kDa. The RNL sequence showed significant overall homology to Rhizomucor miehei lipase and the putative active site residues were strictly conserved.

Amino Acid Sequence↗

[Clinical evaluation of operative and non-operative treatment in hepatocellular carcinoma with main portal vein tumor thrombus].

It has been well recognized that results of treatment in hepatocellular carcinoma with main portal vein tumor thrombus (Vp 3 HCC) are very poor. But we tried aggressive transcatheter treatment (one shot or continuous hepatic arterial infusion, TAE) and hepatectomy with postoperative TAE in 52 cases by Vp3 HCC in recent 10 years. Analysis of the results disclosed that PR or CR cases were observed only in the series of continuous hepatic arterial infusion therapy. And cumulative survival rate was the best in the series of hepatectomy (50% survival interval is 18 months). We concluded that hepatectomy and resection of the tumor thrombus with postoperative TAE is the best treatment in Vp3 HCC.

Antineoplastic Combined Chemotherapy Protocols↗