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ABSTRACT: OBJECTIVES: Absorbable mesh and fibrin glue applied to prevent alveolar air leakage contribute to reducing the length of chest tube drainage, length of hospitalization and the rate of pulmonary complications. This study investigated the feasibility of omitting chest tube drainage in selected patients undergoing thoracoscopic major lung resection. METHODS: Intraoperative air leakages were sealed with fibrin glue and absorbable mesh in patients undergoing thoracoscopic major lung resection. The chest tube was removed just after tracheal extubation if no air leakages were detected in a suction-induced air leakage test, which is an original technique to confirm pneumostasis. Patients with bleeding tendency or extensive thoracic adhesions were excluded. RESULTS: Chest tube drainage was omitted in 29 (58%) of 50 eligible patients and was used in 21 (42%) on the basis of suction-induced air leakage test results. Male gender and compromised pulmonary function were significantly associated with the failure to omit chest tube drainage (both, P < 0.05). Regardless of omitting the chest tube drainage, there were no adverse events during hospitalization, such as subcutaneous emphysema, pneumothorax, pleural effusion or haemothorax, requiring subsequent drainage. Furthermore, there was no prolonged air leakage in any patients: The mean length of chest tube drainage was only 0.9 days. Omitting the chest tube drainage was associated with reduced pain on the day of the operation (P = 0.046). CONCLUSIONS: The refined strategy for pneumostasis allowed the omission of chest tube drainage in the majority of patients undergoing thoracoscopic major lung resection without increasing the risk of adverse events, which may contribute to a fast-track surgery.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 01/2013; · 2.40 Impact Factor
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ABSTRACT: BACKGROUND: Extensive studies have attempted to clarify the contribution of bone marrow-derived cells to the regeneration of various organs, but not the lungs. We evaluated the role of bone marrow-derived cells in compensatory regenerative lung growth. METHODS: We induced regenerative lung growth by left pneumonectomy in adult C57BL/6 mice. To evaluate the role of bone marrow-derived cells in lung regenerative growth, green fluorescent protein (GFP)-positive, bone marrow-transplanted chimeric mice underwent inhibition of stromal-cell-derived factor (SDF)-1α/CXCR4 signaling by 7-d continuous administration of a CXCR4 antagonist after pneumonectomy. RESULTS: Left pneumonectomy resulted in a significant increase in lung dry weight, as well as an increase in lung volume, without enlargement of the alveolar air space. We observed GFP-positive cells 2.1-fold more frequently in the lungs of pneumonectomized mice versus sham-operated mice by immunohistochemistry (P = 0.001), although only a proportion of these accumulated cells possessed a pneumocyte-like appearance. Pneumonectomy induced a 1.4-fold increase in the SDF-1α level in the remaining lung at 7 d compared with sham-operated mice (P < 0.05), although pneumonectomy was not accompanied by histopathological lung injury. Blockade of SDF-1α/CXCR4 signaling resulted in a significant reduction in the accumulation of GFP-positive cells in the remaining lung at 7 d and prevented regenerative lung growth, as shown by a 10% reduction in lung dry weight at 14 d compared with control pneumonectomized mice (P < 0.05). CONCLUSIONS: Bone marrow-derived cells have a significant role in compensatory regenerative lung growth in an adult mouse model. Further evaluation to clarify molecular interactions between bone marrow-derived cells and pneumocytes should prove fruitful.
Journal of Surgical Research 12/2012; · 2.25 Impact Factor
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ABSTRACT: Background The aim of the present study was to determine the prevalence of anatomical transposition of the remaining right middle lobe after right upper lobectomy and the effect of this transposition on postoperative global pulmonary function.Methods We correlated the postoperative pulmonary anatomical change with the functional change in patients undergoing right upper lobectomy for lung cancer. To estimate the regional pulmonary function, we measured the regional volume of the lung using normal lung attenuation values (-600 to -910 Hounsfield units), known as the functional lung volume, by computed tomography. The position of the middle lobe was objectively evaluated using volume-rendering three-dimensional computed tomography lung models. Intraoperatively, middle lobes were not fixed with the lower lobes.Results Postoperatively, the middle lobe remained attached to the anterobasal segment in 24 patients, whereas it migrated cranially in the remaining 26 patients. The functional volume of the middle lobe changed by various degrees postoperatively (range: 9 to 171% of preoperative values, mean: 96 ± 34%), and this change was significantly associated with the global pulmonary function (R = 0.5, p = 0.01). However, there were no significant differences between patients with and without middle lobe migration with respect to the postoperative functional volume of the middle lobe, the postoperative functional volume of the total lung, and global pulmonary function.Conclusion Right middle lobe transposition after upper lobectomy is not associated with the deterioration of pulmonary function, but unexpected deflation of the right middle lobe is. Strategies for preventing middle lobe deflation should be explored in the clinical setting.
The Thoracic and Cardiovascular Surgeon 10/2012; · 0.88 Impact Factor
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ABSTRACT: Three port complete video-assisted thoracic surgery( 3-port cVATS) is our standard approach for primary lung cancers. The video image for the assistant is inverted, and the access ports are inserted at the best location decided by preoperative simulation surgery. Using this approach, the forceps of the operator are never interfered by the forceps of the assistant. We present 3-port cVATS applied to the mediastinal diseases difficult to be done via hybrid VATS mainly under direct vision. 1)The superior mediastinal tumor extending above the thoracic inlet. 2)The posterior mediastinal tumor extending to the other side behind the left atrium. 3)Surgical removal of non-traumatic mediastinal hematoma without capsule resection. 4)Simple thymectomy for the small anterior mediastinal tumor. We could carry through every operation via 3-port cVATS from one side of the chest. This is our minute report of 3-port cVATS applied to the mediastinal diseases.
Kyobu geka. The Japanese journal of thoracic surgery 10/2012; 65(11):950-4.
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ABSTRACT: Little has been described regarding the technical details, diagnostic accuracy, and probable complications of thoracoscopic cutting needle biopsy, which seems to be preferable to transthoracic needle biopsy for patients scheduled to undergo surgery for suspected lung cancer.
This study was a retrospective analysis of a prospective database of patients who underwent surgical biopsy for suspected lung cancer (n = 176). Sixty-two patients underwent thoracoscopic cutting needle biopsy, which was performed via thoracoport using a 16 gauge coaxial cutting needle; the remaining 114 patients underwent excisional biopsy, followed by curative intent surgery.
The sensitivity and specificity of diagnosing lung cancer by thoracoscopic needle biopsy were 57/59 (96.6%) and 1/3 (33.3%), respectively. One false-negative result and one undiagnostic result occurred, but both lesions were correctly re-diagnosed by backup excisional biopsy during the same operation. When analysis was restricted to patients with lung lesions predominantly presenting with ground glass opacity, the sensitivity and specificity were 13/14 (92.9%) and 1/1 (100%), respectively. The sensitivity, specificity, and accuracy of diagnosing lung cancer by surgical biopsy in all patients were 164/165 (99.4%), 9/11 (81.8%), and 173/176 (98.3%), respectively. Pleural recurrence was identified in one patient after thoracoscopic needle biopsy whose pleural lavage cytology, performed before biopsy, was negative.
Thoracoscopic cutting needle biopsy can be effectively applied to patients with an indeterminate lung tumor, especially those patients with lesions possessing ground glass opacity. However, further evaluation is necessary to confirm the risk of pleural dissemination induced by this procedure.
Surgical Endoscopy 05/2012; 26(7):1865-70. · 4.01 Impact Factor
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ABSTRACT: We report a case of complete resection of lung cancer involving the thoracic aorta, after induction chemoradiotherapy in a 55-year-old man. The chemoradiotherapy, which consisted of two courses of platinum-based chemotherapy with concurrent radiation to a total of 40 Gy, resulted in a partial response. Left upper lobectomy with combined resection and reconstruction of the distal arch aorta and left subclavian artery was performed under cardiopulmonary bypass. The patient was given two courses of platinum-based adjuvant chemotherapy, and there has been no sign of recurrence in the 34 months since his operation.
General Thoracic and Cardiovascular Surgery 05/2012; 60(6):363-6.
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ABSTRACT: ObjectiveTo clarify the difference of 18F-FDG uptake kinetics between FDG-avid metastatic lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) and
FDG-avid benign LNs associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter
for differentiation.
MethodsThe subjects were 134 FDG-avid metastatic LNs in 67 patients with NSCLC and 62 FDG-avid benign LNs in 61 patients with various
lung disorders including NSCLC. PET/CT scan was performed at 2 time points (at 60min and at 120min) after intravenous injection
of 4.4MBq/kg 18F-FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%ΔSUVmax)
were measured at each FDG-avid LN. The optimal parameter for differentiation was determined by the receiver-operating characteristic
analysis.
ResultsDelayed SUVmax was increased compared with early SUVmax in 114 (85.0%) FDG-avid metastatic LNs and 42 (67.7%) FDG-avid benign
LNs, with significant higher delayed SUVmax than early values (7.0±5.0 vs. 5.9±3.4; P<0.0001, and 3.0±1.3 vs. 2.8±1.0; P<0.05, respectively). Early and delayed SUVmax and %ΔSUVmax in metastatic LNs were significantly higher than those in benign
LNs (P<0.0001). The optimal parameter for the differentiation was the combined use of early SUVmax>3.0 or delayed SUVmax>4.0,
yielding sensitivity of 88.8%, specificity of 80.6%, accuracy of 86.2%, negative predictive value of 76.9%, and positive predictive
value of 90.6%. It provided better results than the use of early SUVmax>3.0 alone (P=0.019) or the optimal parameter for %ΔSUVmax (>5%) (P=0.012). However, 12 (19.3%) benign LNs were indistinguishable from metastatic LNs.
ConclusionsAlthough dual-time point PET/CT scan enhances the difference of FDG uptake between FDG-avid metastatic and benign LNs and
improves the differentiation when compared with a single scan, biopsy procedure may be still required for accurate assessment
of LN status in patients with NSCLC and possible etiologies showing intensive FDG uptake in benign LNs.
Annals of Nuclear Medicine 04/2012; 23(6):523-531. · 1.50 Impact Factor
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ABSTRACT: We previously reported that the combined use of absorbable mesh and fibrin glue is superior to the use of fibrin glue alone to stop intraoperative air leaks. However, concern remains about whether mesh-based pneumostasis can induce the recurrence of air leaks after chest tube removal.
We reviewed our prospective database of selected patients (n = 206) who underwent video-assisted major lung resection for cancer. Exclusion criteria included simultaneous combined resection, induction radiotherapy, entire intrathoracic adhesion, or a history of prior ipsilateral thoracotomy. We sealed any intraoperative air leaks with absorbable mesh and fibrin glue and then carried out prophylactic chest-tube drainage for 1 day.
Intraoperative air leaks were detected in 133 (65%) patients. Overall, air leaks were not detected postoperatively in 186 (91%) patients, allowing chest tube removal on the day after the operation. The mean length of time for chest tube drainage was 1.2 days. A prolonged air leak (>7 days) was observed in one (0.5%) patient, and this leak resolved by itself. After chest tube removal, an air leak recurred in six (2.9%) patients during the 30 day follow-up period, necessitating chest tube reinsertion. Although the recurrence was observed more frequently after segmentectomy than after lobectomy (p = 0.04), the recurrence was not observed more frequently in patients who had an intraoperative air leak than in patients who did not (p = 0.3).
Early removal of the chest tube after pneumostasis with absorbable mesh is verified in selected patients who underwent video-assisted major lung resection for cancer. However, further attempts should be made to prevent air leaks after anatomical segmentectomy.
World Journal of Surgery 03/2012; 36(7):1603-7. · 2.36 Impact Factor
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ABSTRACT: Delayed wound healing is a serious clinical problem in patients after surgery. A recent study has demonstrated that bone marrow-derived c-kit-positive (c-kit(+)) cells play important roles in repairing and regenerating various tissues and organs. To examine the hypothesis that surgical injury induces the mobilization and recruitment of c-kit+ cells to accelerate wound healing. Mice were subjected to a left pneumonectomy. The mobilization of c-kit+ cells was monitored after surgery. Using green fluorescent protein (GFP(+)) bone marrow-transplanted chimera mice, we investigated further whether the mobilized c-kit+ cells were recruited to effect wound healing in a skin puncture model. The group with left pneumonectomies increased the c-kit(+) and CD34(+) stem cells in peripheral blood 24 h after surgery. At 3 days after surgery, the skin wound size was observed to be significantly smaller, and the number of bone marrow-derived GFP(+) cells and GFP(+)/c-kit+ cells in the wound tissue was significantly greater in mice that had received pneumonectomies, as compared with those that had received a sham operation. Furthermore, some of these GFP(+) cells were positively expressed specific markers of macrophages (F4/80), endothelial cells (CD31), and myofibroblasts (αSMA). The administration of AMD3100, an antagonist of a stromal-cell derived factor (SDF)-1/CXCR4 signaling pathway, reduced the number of GFP(+) cells in wound tissue and completely negated the accelerated wound healing. Surgical injury induces the mobilization and recruitment of c-kit+ cells to contribute to wound healing. Regulating c-kit+ cells may provide a new approach that accelerates wound healing after surgery.
PLoS ONE 01/2012; 7(11):e48052. · 4.09 Impact Factor
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ABSTRACT: To identify the optimum follow-up period for pure ground-glass nodules (GGN) measuring less than 15 mm in diameter, and to evaluate whether the initial HRCT findings can be used as predictors for the progression of pure GGN.
A total of 150 pure GGNs present in 111 patients were evaluated. The series of HRCT images for each GGN at the time of the initial detection, 2 years after detection, and at the final follow-up were evaluated. The HRCT findings of GGN were compared between the "increasing nodule" and "non-increasing nodule" groups.
Most (87.3%) pure GGN did not increase whereas some nodules (12.7%) eventually increased after long-term follow-up (mean 66.0 ± 25.0 months). Six (31.6%) out of the 19 increasing nodules were regarded as stable at the 2 year follow-up examination. Some morphological findings on initial HRCT, including a size greater than 10 mm (p = 0.001), lobulated margins (p = 0.015), and a bubble-like appearance (p = 0.002), were significantly associated with the growth of pure GGNs.
More than 2 years of follow-up are necessary to detect the growth of pure GGNs. Some characteristic findings indicated a high likelihood of future growth of the GGN.
Japanese journal of radiology 12/2011; 30(3):206-17. · 0.65 Impact Factor
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ABSTRACT: A 62-year-old woman was referred to our hospital for further investigation of slow-growing gastrointestinal submucosal tumors (SMTs) and multiple lung nodules. Esophageal SMTs had been identified 6 years earlier, following which lung tumors and gastric SMTs had subsequently developed. Despite repeated endoscopic biopsies, these SMTs could not be diagnosed definitively. Moreover, we were unable to detect any serological abnormalities or radiologic findings such as lymph node swelling. Thoracoscopic excision of a lung nodule led to the definitive diagnosis of mucosaassociated lymphoid tissue (MALT) lymphoma. Cytological findings of aspiration biopsy specimens from the esophagus and stomach were compatible with that of the lung nodule. To our knowledge, this is the first case report of esophageal MALT lymphoma with lung and gastric involvement. We discuss this extremely rare disease with reference to the relevant literature.
General Thoracic and Cardiovascular Surgery 12/2011; 59(12):826-30.
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ABSTRACT: Bronchial kink is caused by upward displacement of the remaining lower lobe of the lung after upper lobectomy, which can cause an intractable cough or shortness of breath. However, bronchial kink is often overlooked because of the difficulty in the simultaneous diagnosis of bronchial curvature and narrowing.
Screening for bronchial kink with three-dimensional computed tomography (CT)-based bronchography was done on 50 patients who had undergone hemilateral upper lobectomy for cancer. Bronchial kink was confirmed if there was airway angulation and resultant stenosis exceeding 80%. We compared postoperative changes in spirometry-based ventilatory capacity with CT-based functional lung volume (FLV) in patients with and without bronchial kink.
Bronchial kink was confirmed in 21 patients (42%). Postoperative FLV and ventilatory capacity were significantly greater in patients without than in those with bronchial kink (p<0.05 for both measures). Postoperative FLV and ventilatory capacity were also significantly greater than the estimated postoperative values for both measures in patients without bronchial kink (both, p<0.05), representing favorable compensatory adaptation of the remaining lung, whereas this was not the case in patients with bronchial kink (both, p>0.1). Patients with bronchial kink complained more often than those without bronchial kink of an intractable cough and shortness of breath (76% vs 21%, respectively, p<0.01).
Bronchial kink after upper lobectomy is a common and functionally unfavorable condition that can exacerbate postoperative shortness of breath. Computed tomography-based bronchography is a useful tool in screening for bronchial kink. Strategies for preventing bronchial kink should be explored in the clinical setting.
The Annals of thoracic surgery 11/2011; 93(1):259-65. · 3.74 Impact Factor
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ABSTRACT: To estimate the probability that a lung cancer arising in a segment has safety anatomical margin for segmentectomy by using a computed-tomography (CT)-based simulation technique.
We measured the volume of each segment by dividing a three-dimensional lung model into a segment model. We also measured the volume of particular portions of each segment that were located away from the intersegmental plane by a predefined distance according to a virtual tumor size of 1, 2, or 3 cm. The probability that a lung cancer arising in the segment has safety anatomical margin for segmentectomy (chance to accept segmentectomy) was expressed as the ratio of this particular portion to the entire segment.
There was significant variability in segment size (smallest, the right medial-basal; largest, the left apicoposterior segment). The chance to accept segmentectomy depended on the segment size and the virtual tumor size; however, irrespective of segment size, there was only a small chance to accept segmentectomy in the bilateral lateral-basal and left anterior segments. Overall, the chance to accept segmentectomy for virtual tumors of 1, 2, and 3 cm in diameter was 33%, 24%, and 18%, respectively. Bisegmentectomy provided 49% chance in resecting virtual tumors that were 2 cm in diameter.
The chance to accept segmentectomy differed greatly in individual segments; it was minimal if a segment was small or located between neighboring segments. Bisegmentectomy can increase the chance to accept segmentectomy. In addition to these results, our method is useful in identifying tumors having eligibility for segmentectomy.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2011; 41(2):341-5. · 2.40 Impact Factor
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ABSTRACT: Major lung resection may induce expansion of the remaining lung, accompanied by some gain in the function of this lung; however, the impact of the site of resection on this compensatory response remains unclear.
We measured computed tomography-based functional lung volume, representing normal lung attenuation (-600 to -910 Hounsfield units), and spirometry-based lung function (forced expiratory volume in 1 second) preoperatively and 6 months postoperatively in patients with lung cancer and compared them between patients undergoing upper lobectomy (n = 34) and patients undergoing lower lobectomy (n = 26).
We removed 17% ± 4% of the functional lung volume by upper lobectomy and 27% ± 5% by lower lobectomy (P < .001). Postoperatively, the residual lung expanded by various degrees, accompanied by a proportionate gain in the residual lung function (R = 0.6, P < .001). This anatomic and functional compensation of the residual lung was more remarkable after lower lobectomy than after upper lobectomy (P <.05). Consequently, the percentage loss of the functional lung volume after upper lobectomy (10% ± 10%) did not differ significantly from that after lower lobectomy (9% ± 12%, P = .6). Likewise, the percentage loss of lung function after upper lobectomy (12% ± 16%) did not differ significantly from that after lower lobectomy (14% ± 17%, P = .6).
Although the lower lobectomy implies greater resection than the upper lobectomy, lung function after lower lobectomy was not inferior to that after upper lobectomy because the compensatory response appeared more robust after lower lobectomy.
The Journal of thoracic and cardiovascular surgery 06/2011; 142(4):762-7. · 3.41 Impact Factor
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Yoshihiro Takemoto,
Tao-Sheng Li,
Masayuki Kubo,
Mako Ohshima, Kazuhiro Ueda,
Eijirou Harada,
Tadahiko Enoki,
Mariko Okamoto,
Yoichi Mizukami,
Tomoaki Murata,
Kimikazu Hamano
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ABSTRACT: Although operative injury is thought generally to worsen the prognosis of cancer patients, the relevant mechanisms are not yet understood fully. We tested the hypothesis that operative injury induces mobilization and recruitment of bone marrow stem cells, thereby enhancing angiogenesis and accelerating tumor growth.
Mice were subjected to an open gastrotomy, and naïve mice were used as controls. The mobilization of bone marrow stem cells was monitored after operation. Using an established tumor model in green fluorescent protein (GFP)(+) bone marrow-transplanted chimera mice, we investigated further whether the mobilized stem cells affected tumor growth.
Compared with the control, gastrotomy increased the populations of CD34(+) cells (6.9 ± 4.5 % vs 3.3 ± 0.4%, P < .05) and CD34(+)/Flk-1(+) cells (0.08 ± 0.02% vs 0.05 ± 0.01%, P < .05) in peripheral blood 12 h after operation. Twelve days after operation, the tumor volume almost doubled in mice after gastrotomy compared with control (580 ± 106 mm(3) vs 299 ± 162 mm(3), P < .05). A histologic analysis of tumor tissue revealed that the microvessel density and number of proliferating cells were significantly greater, but those of apoptotic cells were significantly less, in mice after gastrotomy as compared with control. Furthermore, the number of GFP(+) cells found in tumor tissue was significantly greater in mice that underwent gastrotomy than in controls. Some of the stained GFP(+) cells were positive for CD34 and had been incorporated into microvessels. Administration of AMD3100, which is an antagonist of stromal-cell-derived factor (SDF)-1/CXCR4 signaling pathway, inhibited the recruitment of GFP(+) cells and negated completely the acceleration in tumor growth after operation (345 ± 172 mm(3), P < .05).
Operative injury may induce the mobilization and recruitment of bone marrow stem cells, thereby enhancing angiogenesis and accelerating tumor growth. Inhibition of the SDF-1/CXCR4 signals may represent a new therapeutic strategy for preventing acceleration of tumor growth after operation.
Surgery 06/2011; 149(6):792-800. · 3.10 Impact Factor
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ABSTRACT: We recently introduced a technique of sutureless, mesh-based pneumostasis for preventing alveolar air leaks after lung resection. To verify the clinical usefulness of this technique, we examined if it can contribute to preserving gas exchange capacity and promoting postoperative rehabilitation.
We prospectively collected perioperative data, including arterial oxygen saturation on postoperative day (POD) 1 and the length of postoperative rehabilitation in 100 patients undergoing elective, video-assisted major lung resection for cancer. Before April, 2006, intraoperative air leaks were sealed with the conventional method (control group), and thereafter, with bioabsorbable mesh and glue, without suturing, (treated group). To reduce the bias in comparison of the nonrandomized control group, we paired the treated group with the control group using the nearest available matching method on the estimated propensity score.
Thirty-five patients in the control group were matched to 35 patients in the treated group based on the estimated propensity score. The length of both chest tube drainage and postoperative rehabilitation were significantly shorter in the treated group than in the control group (median, 1 versus 1 d, P = 0.03; 2 versus 3 d, P = 0.01, respectively). The arterial oxygen saturation on POD 1 was significantly higher in the treated group than in the control group (median, 94.0 versus 92.5 %, P = 0.03).
Mesh-based pneumostasis during video-assisted major lung resection enabled early chest tube removal, preserved postoperative oxygenation capacity, and promoted postoperative rehabilitation, which may facilitate fast-track surgery for patients undergoing video-assisted major lung resection for cancer.
Journal of Surgical Research 05/2011; 167(2):e71-5. · 2.25 Impact Factor
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ABSTRACT: Bone marrow stem cells from diabetes mellitus patients exhibit functional impairment, but the relative molecular mechanisms responsible for this impairment are poorly understood. We investigated the mechanisms responsible for diabetes-related functional impairment of bone marrow stem cells by extensively screening the expression levels of inflammatory factors, cell cycle regulating molecules, extracellular matrix molecules and adhesion molecules. Bone marrow cells were collected from type 2 diabetic (db/db) and healthy control (db/m+) mice, and c-kit+ stem cells were purified (purity>85%) for experiments. Compared with the healthy control mice, diabetic mice had significantly fewer c-kit+ stem cells, and these cells had a lower potency of endothelial differentiation; however, the production of the angiogenic growth factor VEGF did not differ between groups. A pathway-focused array showed that the c-kit+ stem cells from diabetic mice had up-regulated expression levels of many inflammatory factors, including Tlr4, Cxcl9, Il9, Tgfb1, Il4, and Tnfsf5, but no obvious change in the expression levels of cell cycle molecules. Interestingly, diabetes-related alterations of the extracellular matrix and adhesion molecules were varied; Pecam, Mmp10, Lamc1, Itgb7, Mmp9, and Timp4 were up-regulated, but Col11a1, Fn1, Admts2, and Itgav were down-regulated. Some of these changes were also confirmed at the protein level by flow cytometry analysis. In conclusion, c-kit+ bone marrow stem cells from diabetic mice exhibited an extensive enhancement of inflammatory factors and disorders of the extracellular matrix and adhesion molecules. Further intervention studies are required to determine the precise role of each molecule in the diabetes-related functional impairment of c-kit+ bone marrow stem cells.
PLoS ONE 01/2011; 6(10):e25543. · 4.09 Impact Factor
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The Journal of thoracic and cardiovascular surgery 11/2010; 141(5):1323-5. · 3.41 Impact Factor
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ABSTRACT: Lung segmentectomy reduces the extent of resection required for lobectomy, but its resulting clinical benefits remain controversial.
Forty patients who underwent segmentectomy for stage I lung cancer over a 5-year period were matched to 40 patients who underwent lobectomy, using nearest available matching method with the estimated propensity score. We compared the functional volume of the ipsilateral lung to be resected, the ipsilateral lung to be preserved and the contralateral lung before, and 6 months after the operation, between the groups. Functional lung volume was defined as the lung volume representing normal attenuation (-600 to -910 Hounsfield units (HUs)) on computed tomography. We also compared the volumetric parameters to the spirometric parameters in 42 other patients, who underwent major lung resection for stage I lung cancer.
We removed 11.6% of the functional lung volume by segmentectomy and 24.5% by lobectomy (P<0.001). However, the loss of the functional lung volume after segmentectomy was only 8.3% and that after lobectomy was 9.2%: this difference was not significant (P=0.7). Both the ipsilateral residual lung and the contralateral lung increased in functional volume more extensively after lobectomy than after segmentectomy. Increased postoperative functional lung volume was significantly correlated with improvement in postoperative pulmonary function (R=0.6, P<0.001).
Although lung segmentectomy can reduce the extent of lung resection, it may not contribute to preserving postoperative functional lung volume because lobectomy promotes postoperative expansion of the bilateral residual lung, which compensates postoperative pulmonary functional loss to a greater extent than segmentectomy.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 02/2010; 37(6):1433-7. · 2.40 Impact Factor
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ABSTRACT: We performed proteomic differential display analysis of human malignant pleural mesothelioma (MPM) cell lines and a human pleural mesothelial cell line by using 2-DE and LC-MS/MS. The human MPM cell lines were NCI-H28, NCI-H2052 and NCI-H2452, and the human pleural mesothelial cell line was MeT-5A. Between MeT-5A and NCI-H2052, we found 38 protein spots whose expression levels were different, from the results of 2-DE; 28 protein spots appeared higher, and 10 other protein spots lower in NCI-H2052 than in MeT-5A. These spots were analyzed by LC-MS/MS analysis and identified by a peptide sequence tag. However, from the results of 2-DE of the other cell lines, there was only one consistently upregulated protein, astrocytic phosphoprotein PEA-15, in all three MPM cell lines. Western blotting using specific antibodies against PEA-15 confirmed the elevated expression level of PEA-15 in all three MPM cell lines compared with MeT-5A cells and normal pleura tissues from patients. PEA-15 was knocked down in NCI-H2052 cells, and the proliferation of PEA-15-silenced NCI-H2052 cells was suppressed 7–15% compared with negative control cells. These results suggest that PEA-15 expression is likely to be associated with the tumorigenesis of MPM.
Proteomics 09/2009; 9(22):5078 - 5089. · 4.43 Impact Factor
