Biomedical subjects

Y Tabuchi

Publications and source records attributed to Y Tabuchi.

At least 19 recordsLinked to original sources

PubMed2001

Cibenzoline, an ATP-sensitive K(+) channel blocker, binds to the K(+)-binding site from the cytoplasmic side of gastric H(+),K(+)-ATPase.

1. Cibenzoline, (+/-)-2-(2,2-diphenylcyclopropyl-2-imidazoline succinate, has been clinically used as one of the Class I type antiarrhythmic agents and also reported to block ATP-sensitive K(+) channels in excised membranes from heart and pancreatic beta cells. In the present study, we investigated if this drug inhibited gastric H(+),K(+)-ATPase activity in vitro. 2. Cibenzoline inhibited H(+),K(+)-ATPase activity of permeabilized leaky hog gastric vesicles in a concentration-dependent manner (IC(50): 201 microM), whereas no effect was shown on Na(+),K(+)-ATPase activity of dog kidney (IC(50): >1000 microM). Similarly, cibenzoline inhibited H(+),K(+)-ATPase activity of HEK-293 cells (human embryonic kidney cell line) co-transfected with rabbit gastric H(+),K(+)-ATPase alpha- and beta-subunit cDNAs (IC(50): 183 microM). 3. In leaky gastric vesicles, inhibition of H(+),K(+)-ATPase activity by cibenzoline was attenuated by the addition of K(+) (0.5 - 5 mM) in a concentration-dependent manner. The Lineweaver-Burk plot of the H(+),K(+)-ATPase activity shows that cibenzoline increases K(m) value for K(+) without affecting V(max), indicating that this drug inhibits H(+),K(+)-ATPase activity competitively with respect to K(+). 4. The inhibitory effect of H(+),K(+)-ATPase activity by cibenzoline with normal tight gastric vesicles did not significantly differ from that with permeabilized leaky gastric vesicles, indicating that this drug reacted to the ATPase from the cytoplasmic side of the membrane. 5. These findings suggest that cibenzoline is an inhibitor of gastric H(+),K(+)-ATPase with a novel inhibition mechanism, which inhibits gastric H(+),K(+)-ATPase by binding its K(+)-recognition site from the cytoplasmic side.

Adenosine Triphosphate↗

PubMed2001

Characterization of the mouse TFF1 (pS2) gene promoter region.

Trefoil peptides (TFFs) with a unique trefoil domain(s) are presumed to function in protection and repair of the gastrointestinal epithelial layer. Three peptide family members are differently distributed in the mouse gastrointestinal tract: TFF1/pS2 specifically in stomach, TFF2/SP mainly in stomach, pancreas and duodenum, and TFF3/ITF in intestine. We cloned and sequenced the mouse TFF1 gene 5'-upstream region by means of the genomic walking procedure. The cloned region was ligated to the luciferase reporter gene and then introduced into mouse gastric surface mucous GSM10 cells which express TFF1 and TFF2. The minimum promoter was located in the region containing the TATA-box between -39 and the transcriptional start site. Further upstream regions stimulated (-2192-- -1630bp, -641-- -243bp, -137-- -39bp) and inhibited (-1630-- -641bp, -243-- -137 bp) luciferase gene expression. These regions as well as short segments conserved in the mouse and human 5'-upstream sequences may be important for modulation of the mRNA level of the TFF1 gene.

Animals↗

PubMed2001

Characterization and application of a gastric surface mucous cell line GSM06 established from temperature-sensitive simian virus 40 large T-antigen transgenic mice.

It has been indicated that transgenic mouse harboring a temperature-sensitive simian virus 40 large T-antigen gene is useful for establishing cell lines from tissues that have proved difficult to culture in vitro. The gastric surface mucous cell line GSM06 was established from a primary culture of gastric fundic mucosal cells of the transgenic mice. GSM06 cells showed temperature-sensitive growth in culture and expressed large T-antigen at a permissive temperature (33 degrees C) but not at a nonpermissive temperature (39 degrees C). At 39 degrees C, the cells produced periodic acid-Schiff positive glycoconjugates that formed a mucous sheet like the gastric surface mucosa in the stomach. Insulin markedly increased the production of glycoconjugates. In addition, proprotein-processing endoprotease furin suppression retarded cell growth, but accelerated cell differentiation. An air-liquid interface promoted the differentiation of GSM06 cells in a reconstruction culture with nitrocellulose membrane and collagen gel. The gastric surface mucous cell line GSM06 with unique characteristics, therefore, should be useful as an in vitro model of the gastric mucosa for physiological and pharmacological investigations. Moreover, experiments using immortalized cells established in vitro and having specific functions may offer an alternative to experiments using living animals and thereby offer a solution to this ethical issue.

Animals↗

PubMed2001

[The influence of age on hemodynamics and the dose requirements of propofol and buprenorphine in total intravenous anesthesia].

A retrospective study was performed to determine the influence of age on hemodynamics and awakening time in total intravenous anesthesia (TIVA) with propofol and buprenorphine for spinal surgery. Twenty patients (26-79 yr) were studied and allocated into following four groups by age: 26-49 yr, 50-59 yr, 60-69 yr, and elderly 70-79 yr. All patients were premedicated with midazolam (2.5-5 mg) i.m. Anesthesia was induced (60-180 ml.h-1) and maintained (20-60 ml.h-1) with propofol infusion with 40% oxygen in air, added with vecuronium and one single dose of buprenorphine (0.08-0.2 mg; 1.37-2.63 micrograms.kg-1) before incision. Mean arterial pressure was stable and did not differ in four groups. Heart rate was decreased (P < 0.01) in the elderly group compared with the group younger than 50 yr. Bradycardia (below 50 beat.min-1) occurred in 60% of the elderly group. An adequate dose of buprenorphine (microgram) was proposed as: 208 - 1.8 x age (yr) + 0.3 x weight (kg) (r = 0.90, P < 0.01). The induction and maintenance rates (ml.h-1) of propofol were decreased with age and increased with weight (P < 0.05). However, the maintenance dose of propofol (3.9-8.5 mg.kg-1.h-1) did not correlate with age. Awakening time was prolonged (P < 0.05) in the elderly group (17.0 +/- 7.2 min) as compared with the group of younger than 50 yr (8.0 +/- 3.9 min). The three patients requiring postoperative analgesics were younger than 60 yr. This study suggests that we should reduce the dose of buprenorphine with age in TIVA using propofol. About 50% of the dose given to the patient younger than 50 yr was considered adequate in the elderly group.

Adult↗

PubMed2001

Optimal duration of oral adjuvant chemotherapy with Carmofur in the colorectal cancer patients: the Kansai Carmofur Study Group trial III.

A multi-institutional study was performed to evaluate the appropriate duration of oral administration of Carmofur (1-hexylcarbamoyl-5-fluorouracil, HCFU), a 5-fluorouracil (5-FU) derivative, for postoperative adjuvant chemotherapy in patients with colorectal cancer undergoing curative operation. Patients were divided into two: i) short duration group receiving 6 months of HCFU administration and ii) long duration group receiving 1 year of the administration, using a centralized registration system. Among 364 patients entered in this study, 293 evaluable cases were analyzed to investigate the appropriate duration of adjuvant oral chemotherapy. No statistical differences were found in the cumulative 5-year disease-free or survival rates between the groups. However, the actual duration of oral HCFU administration differed in the patients of short and long duration groups from the protocol. Namely, more than 70% of the patients received a different duration of oral adjuvant chemotherapy in each of the groups. Therefore, apart from this division of two groups, correlation between the actual duration of oral HCFU administration and the prognosis was examined in these patients. As a result, it was suggested that oral adjuvant chemotherapy with HCFU would be effective in colon cancer patients when the duration of administration exceeded 330 days. In rectal cancer patients, however, adjuvant chemotherapy with HCFU alone was considered to be not sufficient to affect the prognosis.

Administration, Oral↗

PubMed2001

[The influence of age on hemodynamics and the dose requirements of propofol and buprenorphine in total intravenous anesthesia combined with continuous epidural anesthesia].

A retrospective study was performed to determine the influence of age on hemodynamics and awakening time in total intravenous anesthesia (TIVA) using propofol and buprenorphine combined with continuous epidural anesthesia for abdominal surgery. Thirty-five patients (36-87 yr) were allocated to the following five groups by age: 36-49 yr, 50-59 yr, 60-69 yr, 70-79 yr and 80-87 yr. All patients were premedicated with midazolam i.m. Anesthesia was maintained with propofol infusion with 40% oxygen in air, intravenous buprenorphine plus vecuronium and continuous epidural anesthesia using 2% mepivacaine. After extubation, the epidural bolus dose (buprenorphine 0.1-0.2 mg with droperidol 1.25-2.5 mg) and epidural infusion (buprenorphine 17 micrograms.h-1 with droperidol 0.1 mg.h-1) were administered. Intraoperative heart rate (HR) and mean arterial pressure (MAP) decreased but remained within 30% of preanesthetic level. HR did not differ in five groups, although MAP decreased significantly in patients above 50 yr of age. The doses of midazolam (1-5 mg), propofol (2.7-7.4 mg.kg-1.h-1) and buprenorphine (40-200 micrograms) decreased with age (P < 0.01), while the maintenance doses of mepivacaine (40-140 mg.h-1) and vecuronium (0.03-0.09 mg.kg-1.h-1) showed no significant decrease. Awakening time was not significantly prolonged with age (r = 0.27, P = 0.12). Two patients in each group required analgesics within 20 hours. Neither nausea, respiratory depression nor awareness was found. We suggest that the combination of TIVA and continuous epidural anesthesia would be useful to maintain stable hemodynamic state and to obtain early recovery time, especially in the elderly.

Adult↗

PubMed2000

Appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ: report of a case.

Appendiceal intussusception is an uncommon pathologic condition; however, villous adenoma of the appendix is a distinctly rare entity. We report herein a case of appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ. A 67-year-old man was admitted to our hospital with a 1-year history of lower abdominal pain for investigation. Barium enema showed a filling defect with an irregular surface in the cecum, and colonoscopy revealed a cecal tumor with a granular surface. Pathological examination of biopsy samples revealed tubulovillous adenoma with well-differentiated adenocarcinoma, and a diagnosis of cecal cancer in tubulovillous adenoma was made. Surgery was performed and the resected specimen was found to contain a tumor arising from the appendix. The tumor was 5.5 x 4.5 cm in size in the cecal cavity, and the appendix had invaginated into the cecum at its base. The cut surface of the appendix showed the villous tumor filling the appendiceal lumen and projecting into the cecal cavity. Microscopic examination revealed well-differentiated adenocarcinoma in tubulovillous adenoma. To the best of our knowledge, this is the first report of appendiceal intussusception caused by tubulovillous adenoma with carcinoma of the appendix.

Adenocarcinoma↗

PubMed2000

Deletion polymorphism of angiotensin-converting enzyme gene is associated with postprandial hyperglycaemia in individuals undergoing general check-up.

1. Deletion polymorphism, DD, of the angiotensin-converting enzyme (ACE) gene is reported to be related to cardiovascular disease, which is frequently based on insulin resistance. 2. To clarify the relationship between the ACE genotype DD and plasma glucose increases after an oral glucose load, we performed 75 g oral glucose tolerance test (OGTT) in 301 nondiabetic men (age range 30-60 years) undergoing general check-up. 3. Insertion/deletion (I/D) polymorphism of the ACE gene was explored using a polymerase chain reaction. The frequency of the II, ID and DD genotypes was 0.43, 0.43 and 0.14, respectively. 4. There were no differences in baseline clinical characteristics between subjects with each ACE genotype. 5. The mean (+/- SEM) plasma glucose level at 60 min of the OGTT was significantly higher in subjects with the DD genotype (170.8 +/- 6.9 mg/dL) than in subjects with either the II or ID genotype (mean value for two groups 156.6 +/- 2.7 mg/dL; P < 0.05). Moreover, the mean percentage change of plasma glucose after 60 min of the OGTT, a marker of plasma glucose increase, was significantly higher in individuals with the DD genotype than in individuals with either the II or ID genotypes. 6. In contrast, the mean fasting plasma glucose level, the plasma glucose level at 120 min, the glucose response area and the fasting insulin level were not different between individuals with the DD genotype and individuals with other genotypes. 7. In conclusion, subjects with the DD genotype showed transiently higher levels of plasma glucose after an oral glucose load than subjects with other genotypes. Further studies are required to determine whether the association between ACE genotype and postprandial hyperglycaemia influences the incidence of cardiovascular disease and diabetes mellitus.

Adult↗

PubMed2000

Telemedicine for evaluation of brain function by a metacomputer.

A method of evaluating brain function using the metacomputer concept of the Globus system combined with a message-passing interface is described. The proposed method has the ability to exploit various geographically distributed resources and parallel computing linked to a high-technology medical instrumentation system, magnetoencephalography, to analyze the functional state of the brain. It is envisaged that the method will lead to the realization of an efficient telemedicine system for health care.

Brain↗

PubMed2000

Establishment and characterization of a colonic epithelial cell line MCE301 from transgenic mice harboring temperature-sensitive simian virus 40 large T-antigen gene.

We produced an immortalized colonic epithelial cell line, MCE301, using fetal mice transgenic for the temperature-sensitive simian virus 40 large T-antigen gene. MCE301 cells showed epithelial-like morphology and maintained tight connections with neighboring cells. The cells grew at a permissive temperature (33 degrees C), but the growth of the cells was significantly prevented at the nonpermissive temperature (39 degrees C). The cells expressed large T-antigen at 33 degrees C but not at 39 degrees C. MCE301 cells were not transformed, as judged by the absence of anchorage-independent growth in soft agar gel and lack of tumor formation in nude mice. Electron microscopic studies showed that the cells formed microvilli-like structures on the cell surface and junctional complexes such as tight junctions and desmosomes between the cells. The cells expressed cytosketal (acidic cytokeratins and actin), basement membrane (laminin and collagen type IV) and junctional complex proteins (ZO-1 and desmoplakin I + II), as judged by specific antibodies. Fetal bovine serum, epidermal growth factor, insulin-like growth factor and insulin significantly increased the cell growth at 33 degrees C. Moreover, MCE301 cells expressed colonic mucin Muc2 mRNA as demonstrated by reverse transcriptase-polymerase chain reaction, indicating that the cells originate from mucus-secreting cells. Alkaline phosphatase, a brush border-associated enzyme, was detected in the cells. Sodium butyrate (2 mM), an inducer of cellular differentiation, markedly elevated alkaline phosphatase activity. Thus, the present mouse colonic epithelial cell line MCE301 possessing these unique characteristics should provide a useful in vitro model of colonic epithelium.

Alkaline Phosphatase↗

PubMed2000

Significance of lysine/glycine cluster structure in gastric H+,K+-ATPase.

Gastric H+,K+-ATPase consists of alpha- and beta-subunits. The catalytic alpha-subunit contains a very unique structure consisting of lysine and glycine clusters, KKK(or KKKK)AG(G/R)GGGK-(K/R)K, in the amino-terminal cytoplasmic region. This structure is well conserved in all gastric H+,K+-ATPases from different animal species, and was postulated to be the site controlling the access of cations (or proton) to its binding site. In this report, we studied the role of this unique structure by expressing several H+,K+-ATPase mutants of the alpha-subunit together with the wild-type beta-subunit in HEK-293 cells. Even after replacing all the positively-charged amino acid residues (six lysines and one arginine) in the cluster with alanine or removing all the glycine residues in the cluster, the mutants preserved the H+,K+-ATPase activity, and showed similar affinity for ATP and K+ as well as similar pH profiles as those of wild-type H+,K+-ATPase, indicating that the cluster is not indispensable for H+,K+-ATPase activity and not directly involved in determination of the affinity for cation (proton).

Adenosine Triphosphate↗

PubMed2000

[Perioperative management for hemicolectomy using propofol infusion in an elderly patient with a mechanical heart valve prosthesis].

An 81-year-old female (145 cm, 39 kg) with a mechanical heart valve prosthesis underwent right hemicolectomy for cecal cancer under total intravenous anesthesia. She had received anticoagulation therapy [international normalized ratio (INR) 4.3] with warfarin for two years before surgery due to replaced aortic valve and atrial fibrillation. Three days before surgery warfarin was switched to heparin infusion (400 U.h-1) continued until 3 hours before the surgery. The activated partial thromboplastin time (APTT) was maintained above 1.5 times of the control (45 sec). Before induction of anesthesia, the activated clotting time (ACT) was 166 seconds. Following propofol infusion (50 ml.h-1; 38 mg) and vecuronium, anesthesia was maintained with propofol infusion (5.9 mg.kg-1.h-1), buprenorphine i.v. (0.08 mg) and appropriate doses of vecuronium. The total dose of propofol used was 950 mg. Heparin infusion (80 U.h-1) was restarted at the onset of surgery. Intraoperative ACT levels were between 148 and 156 seconds. However, at the end of surgery, APTT was prolonged (60.7 sec). Heparin infusion was reduced to 40 U.h-1 and APTT became normal 3 hours after the surgery. On the 4th postoperative day, heparin infusion was returned to 400 U.h-1 (APTT 32-38 sec). Two days after warfarin restoration on the 15th postoperative day, heparin was discontinued (INR 2.1-2.5). The thromboembolism and bleeding tendency did not occur. This case suggests that despite the suspected bleeding tendency via platelet inhibition under propofol infusion, the reduced heparin infusion can be continued with close coagulation monitoring.

Aged↗

PubMed2000

[A comparison of fentanyl and buprenorphine in total intravenous anesthesia using propofol during spinal surgery].

A retrospective study was performed to compare the hemodynamic effect and postoperative pain relief of fentanyl (Group F, n = 11) and buprenorphine (Group B, n = 11) in total intravenous anesthesia (TIVA) using propofol during spinal surgery. All patients were premedicated with midazolam (3-5 mg) i.m. Anesthesia was maintained with propofol infusion, and increments of fentanyl or single dose of buprenorphine with 40% oxygen in air. Total doses of fentanyl and buprenorphine were 7.6 +/- 1.0 micrograms.kg-1 and 2.0 +/- 0.4 micrograms.kg-1, respectively. Maintenance doses of propofol (Group F: 5.5 +/- 0.8 mg.kg-1.h-1, Group B: 5.9 +/- 1.1 mg.kg-1.h-1) and vecuronium were not significantly different. Mean arterial pressures from 2 hours after incision to the end of surgery were elevated significantly in Group F than in Group B. Recovery time (Group F 12.5 +/- 6.1 min vs Group B 11.8 +/- 6.1 min) and extubation time (Group F 19.5 +/- 10.3 min vs Group B 15.0 +/- 7.0 min) were not different. At the end of anesthesia, seven patients in Group F and one patient in Group B (P < 0.01) complained of severe pain. All patients in Group F, and only two in Group B (P < 0.02) received analgesics within 20 hours. Neither nausea nor respiratory depression was found in both groups. This study suggests that buprenorphine would provide a more stable hemodynamic state and better postoperative pain relief than fentanyl in TIVA using propofol.

Adjuvants, Anesthesia↗

PubMed1999

Expression of nm23-H1 in colorectal cancer: no association with metastases, histological stage, or survival.

The correlations of nm23-H1 expression in primary cancer lesions with the already confirmed 14 prognostic variables and survival were examined in 52 advanced colorectal cancer patients, because the clinical roles of nm23-H1 expression in the cancer lesions remain controversial. An immunohistochemical expression of nm23-H1 was found in 23 lesions (positive group) but not found in 29 lesions (negative group). No significant difference between the positive and negative groups was found according to 12 clinicopathological variables including vascular invasion, lymph node and liver metastases, and histological stage. The carcinoembryonic antigen levels (21.5+/-33.4 ng/ml) of the draining venous blood and argyrophilic nucleolar organizer regions score (3.35+/-1.36 per nucleus) of the cancer cells in the positive group were not significantly diffeent from those (34.1+/-102.9 ng/ml and 3.32+/-1.00 per nucleus, respectively) in the negative group. In addition, no significant difference was found in the survival curves or the 5-year survival rates of the positive and negative groups. From these results, it may be concluded that the nm23-H1 expression was not associated with the aforementioned prognostic variables and the prognosis of advanced colorectal cancer patients.

Aged↗

PubMed1999

Clinicopathologic variables affecting survival of distal colorectal cancer patients with macroscopic invasion into the adjacent organs.

A total of 506 distal colorectal cancer patients were classified into two groups, to clarify the variables affecting survival of the patients with macroscopic invasion into the adjacent organs: 47 cases showed invasion (invasive group) while the other did not show invasion (noninvasive group). Differences between the invasive and noninvasive groups were found in eight variables; female, large tumor size, gross types 3 and 4, moderately or poorly differentiated adenocarcinomas and signet-ring cell or mucinous carcinomas, deep cancer invasion, lymphatic invasion, peritoneal and liver metastases, and curability B-C were found significantly more frequently in the invasive group. The survival curve of the former was significantly (P < 0.05) lower than that of the latter. However, no significant difference was found between the survival curves of the patients with curability A (no residual tumors) in both groups. A multivariate analysis in the invasive groups revealed six variables to be significantly related to a good prognosis including a young age, females, a location above the peritoneal reflection, well differentiated adenocarcinoma, negative lymphatic invasion, and curability A. Surgery with curability A should be performed to improve the survival in distal colorectal cancer patients with macroscopic invasion into the adjacent organs.

Adenocarcinoma↗

PubMed1999

Cucumber cotyledon lipoxygenase during postgerminative growth. Its expression and action on lipid bodies.

In cucumber (Cucumis sativus), high lipoxygenase-1 (LOX-1) activity has been detected in the soluble fraction prepared from cotyledons of germinating seeds, and the involvement of this enzyme in lipid turnover has been suggested (K. Matsui, M. Irie, T. Kajiwara, A. Hatanaka [1992] Plant Sci 85: 23-32; I. Fuessner, C. Wasternack, H. Kindl, H. Kühn [1995] Proc Natl Acad Sci USA 92: 11849-11853). In this study we have investigated the expression of the gene lox-1, corresponding to the LOX-1 enzyme. LOX-1 expression is highly coordinated with that of a typical glyoxysomal enzyme, isocitrate lyase, during the postgerminative stage of cotyledon development. In contrast, although icl transcripts accumulated in tissue during in vitro senescence, no accumulation of lox-1 mRNA could be observed, suggesting that lox-1 plays a specialized role in fat mobilization. LOX-1 is also known to be a major lipid body protein. The partial peptide sequences of purified LOX-1 and lipid body LOX-1 entirely coincided with that deduced from the lox-1 cDNA sequence. The data strongly suggest that LOX-1 and lipid body LOX-1 are derived from a single gene and that LOX-1 can exist both in the cytosol and on the lipid bodies. We constructed an in vitro oxygenation system to address the mechanism of this dual localization and to investigate the action of LOX-1 on lipids in the lipid bodies. LOX-1 cannot act on the lipids in intact lipid bodies, although degradation of lipid body proteins, either during seedling growth or by treatment with trypsin, allows lipid bodies to become susceptible to LOX-1. We discuss the role of LOX-1 in fat mobilization and its mechanism of action.

Amino Acid Sequence↗

PubMed1999

Synthesis of phenoxyacetic acid derivatives as highly potent antagonists of gastrin/cholecystokinin-B receptors. III.

In order to improve the biological characteristics of DA-3934 (5), a novel gastrin/cholecystokinin (CCK)-B receptor antagonist, phenoxyacetic acid derivatives replacing the N-methyl-N-phenylcarbamoylmethyl moiety of 5 with various alkyl chains have been synthesized and their biological activity evaluated. The relationship between the structure of these compounds and their human gastrin receptor binding affinity showed that there should be the optimal size among the various N-alkyl chains. Also a significant increase in the receptor binding affinity was achieved by several compounds. Among those compounds, 2-[3-[3- [N-cyclohexylmethyl-N-[2-(N-methyl- N-phenylcarbamoylmethoxy)phenyl]carbamoylmethyl]ureido]pheny l]acetic acid (22c) and (+/-)-2-[3-[3-[N-[2-(N-methyl-N- phenylcarbamoylmethoxy)phenyl]-N-(3-methylpentyl)carbamoy lmethyl]ureido] phenyl]acetic acid (22h) exhibited high affinity for human gastrin receptors and were also more potent inhibitors in a pentagastrin-induced gastric acid secretion model than the parent compound, 5. The ED50 values of these compounds when administered intraduodenally to rats were 0.12 and 0.63 mg/kg, respectively.

Acetates↗

PubMed1999

[Anesthetic management of patients with malignant pleural effusion undergoing hyperthermic perfusion under thoracoscopy].

Nine patients with malignant pleural effusion due to lung cancer had been scheduled for hyperthermic treatment with warmed distilled water (40 degrees C) under thoracoscopy. This treatment aims to produce adhesion of the lungs to reduce pleural effusion. To evaluate the risk of general anesthesia for patients with lung cancer at the end stage, we examined the problems of perioperative management. Seven out of nine patients were classified into ASA physical status > or = III and seven patients into Hugh Jones > or = III Shapiro's score was > or = 5 in four patients. The average %VC was 60 +/- 16 and % FEV1.0 was 41 +/- 18% (means +/- SE). A double lumen endotracheal tube was inserted and anesthesia was maintained with inhalational anesthetics. In two cases, one-lung ventilation could not be maintained because of severe hypoxemia during hyperthermic perfusion. Hypertension occurred in three cases and hypotension in one by direct heat stimulation of the cardiopulmonary system. Although their preoperative risk was poor, there were no major complications and the quality of life was improved. We stress that careful anesthetic management is important for avoiding hypoxemia and hemodynamic instability during this treatment.

Aged↗