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ABSTRACT: Researchers are investigating the use of cadaveric lungs to make up for the shortage of donors. However, no method to enable accurate evaluation of cadaveric lung viability has been established. We designed the present study to evaluate the viability of cadaveric lung tissue using near-infrared spectroscopy (NIRS). Male Lewis rats were anesthetized, mechanically ventilated, and subjected to a left thoracotomy. After cardiac arrest induced by an injection of sodium pentobarbital, we continued mechanical ventilation using oxygen (Group 1, n = 16) or nitrogen (Group 2, n = 20). Using NIRS, we monitored the redox state of cytochrome aa3 at intervals of 20 minutes for a period of 5 hours. We harvested the lung tissues of each group at 2 and 5 hours post-mortem and performed pathologic examination. The reduced cytochrome aa3 in Group 2 increased from 2 hours post-mortem. We observed no significant changes in Group 1. We found and scored the formation of hyaline membranes, intra-alveolar edema, edema around bronchioles and small vessels, and congestion in the cadaveric lungs. In Group 1, histologic findings were mild to moderate. In Group 2, findings were moderate at 2 hours post-mortem but became much more severe at 5 hours post-mortem. The measurement of reduced cytochrome aa3 using NIRS may reflect the histologic condition of cadaveric lung tissue. We expect that this evaluation method will be advantageous for lung transplantation in the future.
The Journal of Heart and Lung Transplantation 02/2001; 20(1):80-9. · 4.33 Impact Factor
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Transplantation Proceedings 12/2000; 32(7):2437-8. · 1.00 Impact Factor
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ABSTRACT: We investigated the feasibility and validity of near-infrared (NIR) spectroscopy for evaluation of acute lung injury (ALI). In an in vitro model simulating the spectrophotometric characteristics of the lung, NIR spectroscopy could precisely detect changes in water volume, suggesting its ability to assess the extent of pulmonary edema caused by ALI. The different grades of ALI were induced in rats by administering oleic acid and varying the pulmonary ventilation conditions, and NIR spectroscopy was employed to determine lung water content and hemoglobin (Hb) oxygenation of the lungs. NIR spectroscopy detected increased water content even in histologically mild ALI. The changes in lung water content measured by NIR spectroscopy were significantly correlated with gravimetric lung water content (r = 0.877, p < 0.0001). Deoxy-Hb measured by NIR spectroscopy consistently reflected the histological changes in the lungs, and the deoxy-Hb levels correlated with changes in SaO2 (r = -0.798, p < 0.0001). These findings demonstrate that NIR spectroscopy can evaluate lung water content and Hb oxygenation quantitatively, and may be a useful tool for assessing pathological status in ALI.
American Journal of Respiratory and Critical Care Medicine 07/1999; 160(1):317-23. · 11.08 Impact Factor
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Y Miyata,
H Ohdan,
T Noriyuki,
S Shintaku,
S Shibata,
H Yamamoto,
X H Fan,
Y Fudaba, S Yoshioka,
T Asahara,
Y Fukuda,
K Dohi
Transplantation Proceedings 01/1999; 30(8):4163-5. · 1.00 Impact Factor
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Transplantation Proceedings 12/1998; 30(7):3374-6. · 1.00 Impact Factor
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Transplantation Proceedings 12/1998; 30(7):3361-3. · 1.00 Impact Factor
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Transplantation Proceedings 12/1998; 30(7):3869-70. · 1.00 Impact Factor
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Transplantation Proceedings 12/1998; 30(7):3867-8. · 1.00 Impact Factor
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T Asahara,
K Katayama,
T Itamoto,
Y Okamoto,
H Nakahara, S Yoshioka,
E Ono,
K Dohi,
M Kitamoto,
T Nakanishi,
K Moriwaki,
K Shiroyama,
O Yuge
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ABSTRACT: Thoracoscopic microwave coagulation therapy (MCT) is a new therapeutic approach for hepatocellular carcinoma (HCC) in segments VII and VIII, which allows minimal access to the tumor and complete tumor ablation. In this study, four patients with HCC in segments VII and VIII underwent thoracoscopic MCT as a less invasive therapeutic option due to advanced liver cirrhosis and/or severe complications. Tumor sizes ranged from 15 to 30 mm in diameter and the tumors were well differentiated in 2 patients, moderately in one and poorly in one patient. Microwave irradiation was performed at an 80 W output with a 60-sec duration via a thoracoscopic route and the total duration ranged from 4 to 24 min (mean: 17 min). Patients recovered rapidly to preoperative conditions and no mortality was occurred. Complications were observed in one patient, including pleural effusion and fever elevation, but were cured conservatively. Postoperative computed tomography (CT) showed complete tumor ablation with a cancer-free margin, which is thought to be equivalent to a limited hepatic resection. This preliminary study suggests that thoracoscopic MCT might be a new, less invasive option providing a cure for HCC in segments VII and VIII in patients with advanced liver cirrhosis and severe complications.
Hiroshima journal of medical sciences 10/1998; 47(3):125-31.
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Y Miyata,
H Ohdan,
T Noriyuki,
S Shintaku,
S Shibata,
H Yamamoto,
Y Fudaba,
X H Fan,
H Tashiro, S Yoshioka,
T Asahara,
Y Fukuda,
K Dohi
Transplantation Proceedings 09/1998; 30(5):2484-5. · 1.00 Impact Factor
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ABSTRACT: In spite of the progress in allogeneic microchimerism research, few reports have dealt with the biologic relevance of xenogeneic microchimerism after organ xenotransplantation. These experiments were designed to analyze the development of xenogeneic microchimerism and its relationship to graft outcome in hamster-to-rat lung xenotransplantation.
Golden Syrian hamsters were the donors and Lewis rats the recipients of xenogeneic lung transplantation. Animals were divided into three groups: group 1 were untreated; group 2 received cyclophosphamide (10 mg/kg/day for 6 days) and a short course of FK506 (2 mg/kg/day for 8 days); and group 3 were treated with cyclophosphamide and a long course of FK506 (2 mg/kg/day for 8 days, 1 mg/kg/day for 23 days, and then 0.5 mg/kg/day continuously). Xenogeneic microchimerisms were evaluated by use of polymerase chain reaction with primers specific for the hamster hypoxanthine phosphoribosyl-transferase gene.
The median graft survival times for groups 1, 2, and 3 were 3 days (n = 6), 22 days (n = 7), and 96.5 days (n = 6), respectively. In groups 1 and 2, the incidence of microchimerisms declined in parallel with the progression of rejection. In group 3, it changed dynamically, initially declining, then progressively increasing and finally disappearing.
In the short-term graft survivors, xenogeneic microchimerism in the peripheral blood was closely related to graft outcome. However, it showed dynamic changes and finally disappeared in long-term graft survivors, and the incidence of microchimerism at a single time point did not reflect the donor-recipient immunologic status.
The Journal of Heart and Lung Transplantation 04/1998; 17(3):233-40. · 4.33 Impact Factor
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ABSTRACT: After resection of a non-invasive thymoma, two metastatic lung tumors were found in the left upper lobe and the left lower lobe. There were differences in tumor doubling time (TDT) and invasion between the metastatic tumor in the lower lobe and the one in the upper lobe. The TDTs of the tumors were 834.1 days and 328.3 days, and the tumor of the left lower lobe invaded the left lateral basal segmental bronchus (B9). The differences in the two tumors were determined by pathological findings and nuclear DNA pattern. Pathologically, the resected thymoma and both of the metastatic tumors were mixed type, which consisted of epithelial cells and lymphocytes. But by epithelium form, the resected thymoma and the tumor in the lower lobe were classified as cortex type, and only the slow growing tumor in the upper lobe contained a spindle-cell component. The DNA pattern of the resected thymoma was aneuploid and the two metastatic tumors were diploid. As this case is very interesting clinically and pathologically, we reported it.
[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 01/1998; 45(12):1998-2002.
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Y Miyata,
H Ohdan,
T Noriyuki,
S Shintaku,
S Shibata,
H Yamamoto, S Yoshioka,
T Asahara,
Y Fukuda,
A Kimura,
K Dohi
Transplantation Proceedings 01/1998; 29(8):3505-7. · 1.00 Impact Factor
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ABSTRACT: To quantify changes in tissue oxygenation of pathologic lungs, we applied a novel method using near-infrared spectroscopy (NIRs). In in vitro experiments, we assayed the effect of photon scattering on the absorption spectra of an in vitro system simulating structures of lung, which consists of test tube containing air in hematocrit tubes and red blood cell suspension with various predetermined hemoglobin concentrations. It was determined that photon scattering of the tissue containing air did not affect the absorption in the NIR region. In in vivo experiments, we tested the applicability of the NIRs technique in rat lungs under the following conditions: (1) hypoxic loading; (2) administration of an inhibitor (NaCN) of the mitochondrial respiratory chain; (3) hemorrhagic shock. We found that: (1) Changes in hemoglobin oxygenation state in the lung measured by NIRs depended on inspired oxygen concentrations; (2) NaCN-induced reduction of cytochrome oxidase a,a3 in the lung was observed; and (3) Total hemoglobin levels in the lung decreased after bleeding. Changes in the hemoglobin oxygenation state and cytochrome oxidase redox state in the lung were determined using the least-square-curve fitting for NIR absorption spectra. Our NIRs technique was capable of assessing the hemoglobin oxygenation and cytochrome oxidase redox state in the lung.
American Journal of Respiratory and Critical Care Medicine 12/1997; 156(5):1656-61. · 11.08 Impact Factor
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Nippon Geka Gakkai zasshi 11/1997; 98(10):894.
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H Yahata,
K Sugino,
T Takiguchi, S Yoshioka,
H Tanji,
K Shinozaki,
K Uchida,
T Okimoto,
S Marubayashi,
T Asahara,
N Takeichi,
Y Fukuda,
K Dohi
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ABSTRACT: We performed transhiatal subtotal esophagectomy under laparoscopic guidance to reduce the invasiveness of subtotal esophagectomy while preserving dissectional accuracy. In six cases of advanced thoracic esophageal cancer with distant metastasis, we used a special type of handpiece of ultrasonic surgical aspirator (CUSA) for laparoscopic surgery to dissect the esophagus from surrounding tissues and to isolate vessels entering it while viewing with the video monitor. Hemostasis of isolated vessels was effected by clips or electrocoagulation. There was no massive bleeding from the mediastinum during the operation, nor was there postoperative bleeding or infection. All patients regained normal swallowing ability and were discharged. Transhiatal esophagectomy under laparoscopic guidance is considered a safe, less invasive operative treatment for patients who are suffering from advanced thoracic esophageal cancer.
Surgical Laparoscopy Endoscopy & Percutaneous Techniques 03/1997; 7(1):13-6.
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Transplantation Proceedings 31(1-2):178-9. · 1.00 Impact Factor
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Transplantation Proceedings 31(1-2):694-5. · 1.00 Impact Factor