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Microbial exudates including siderophore, which changes chemical species of actinides and lanthanides. We have investigated effects of desferrioxamine B (DFOB; one of the siderophores) and siderophore-like organic molecules (SLOM) on the adsorption of lanthanides by microbial cells, aluminium oxide (Al 2 O 3 ), and manganese (Mn) oxides. When DFOB was present, the distribution coefficients of cerium (Ce) were measured to be lower than those of neighboring elements of lanthanum (La) and praseodymium (Pr) (Negative anomaly of Ce adsorption). Even though initial oxidation state of Ce in the solution was III, that was changed to IV after the addition of DFOB, indicating that Ce(III) was oxidized by forming complex with DFOB. When lanthanides were adsorbed by biogenic Mn(IV) oxides, negative anomaly of Ce adsorption was observed in the sorption in alkaline solution. Ce(III) was oxidized to forme the complexes of Ce(IV) with SLOM in the solution. These results show that siderophore possesses high performance of oxidation of Ce(III) to Ce(IV) during association, affectiong the adsorption behavior of Ce. After Fukushima accident, radioactive Cs accumulation by Eleutherococcus sciadophylloides (Koshiabura) caused by the dissolution of Fe from soil around the roots, that was dominated by siderophore releasing microorganisms (SB). These SBs may enhance dissolution of iron (Fe) and uranium (U) phases in the nuclear fuel debris formed in the nuclear reactors in Fukushima Daiichi nuclear power plant. Thus, in the interaction between microorganisms and radionuclides, SLOMs discharged by microorganisms are deeply involved in the chemical state change of radionuclides.

A newly recognized distinctive fibrous soft tissue lesion called "calcifying fibrous pseudotumor" (CFPT) was recently described in the soft tissue of the extremities, trunk, scrotum, groin, neck, or axilla. But CFPT orgining from the pleura is rare. A 44-year-old woman was admitted to our hospital for an investigation of a chest radiographic abnormality. The complete resection was performed through mini-thoracotomy utilizing video assisted thoracoscopic surgery. Microscopically, the lesion was mostly composing dense collagenous tissue and scattered calcifications. The postoperative course was uneventful and no recurrence is observed 18 months after operation. We report succsessful surgical treatment for multiple CFPTs.

A 66-year-old man was diagnosed as having prostate cancer (T2aN0M0) and neoadjuvant hormone therapy was started from 17 February 1995. During observation, superficial bladder cancer was incidentally found and the first transurethral resection was carried out on 21 June 1995. Radical prostatectomy was performed on 8 May 1996. Thereafter, bladder cancer demonstrated repeated recurrence. At the time of the third recurrence, malignant trasformation was recognized as TCC G3 T2 or more invasive, and radical cystectomy with ileal conduit was performed on 12 May 2004 when the patient was 74 years old. From the perspective of double cancer, the frequency of diagnosing localized prostate cancer with superficial bladder cancer is expected to increase because PSA screening is being increasingly performed recently. Because of the possibility of malignant transformation in patients with superficial bladder cancer, in cases of coincident of cancers, it remains controversial which treatment should be selected for the previously diagnosed prostate cancer. Here, we report the clinical course and discuss this issue to some extent.

A 76-year-old man was admitted because of dry cough and dyspnea two weeks after VATS lobectomy for lung cancer. Chest radiographs and computed tomography showed interstitial shadows in the only operative lung side. Although antibiotic drugs were given because we believed it to be postoperative pneumonia, abnormal shadows on chest radiographs increased. A bronchoalveolar lavage fluid (BALF) study performed on the 21" day after operation showed that the proportions of eosinophils, basophils and mast cells had increased, and the CD4/CD8 ratio was 4.42. The drug lymphocyte stimulation test for loxoprofen sodium was positive. Based on the clinical course, laboratory data and BALF study, we arrived at a diagnosis of drug-induced pneumonia caused by loxoprofen sodium. Treatment with corticosteroid resulted in marked improvement of the chest radiographs and clinical findings. Drug-induced pneumonia usually occurs bilaterally, but it occurred only on the operative side in this case. Although rare, it is important to recognize that unilateral drug-induced pneumonia is one of the differential diagnose of postoperative pneumonia.

The purpose of this study was to evaluate the effectiveness and safety of combination chemotherapy with docetaxel (TXT) and nedaplatin (CDGP) for patients with oral squamous cell carcinomas. Eight patients were enrolled in this study (4 men and 4 women, with a mean age of 61.7 years). TXT and CDGP were administered at a dose of 60 mg/m(2) and 70 mg/m(2) by drip infusion for 120 minutes, respectively. Three patients received one more administration 4 weeks after the first one. The locoregional response was evaluated 4 weeks after the final administration of TXT and CDGP. As a result, the locoregional response rate after 1 course was 62.5% including 25.0% of complete response (CR). The response rate after 2 courses was 100.0% with 66.7% of CR. According to Oboshi and Shimosato's classification, histological evaluation of surgical specimens revealed that four cases were Grade IIa, two cases Grade IIb, and two cases Grade IV. The severe adverse events were neutropenia and leukopenia, which were effectively managed with granulocyte colony-stimulating factor (G-CSF). No other severe side effects were recognized. The present study suggested that the combination chemotherapy with TXT and CDGP would be an effective and safe regimen in neo-adjuvant chemotherapy for oral squamous cell carcinomas.

The micro-tourniquet method is designed as a substitute and/or supporting technique for obliterating aneurysms that are difficult to operate on using the conventional clipping technique. This method is useful for squeezing the aneurysm neck and making a detour around the neck to spare the branching vessels. These micro-tourniquet instruments are a ligature with both ends attached to a ligature guide, a guide holder, a silastic sheath, and a hemostatic clip or a small aneurysm clip set. The ligature is a 20cm long GORE-TEX suture CV-3, and is attached on both ends to a ligature guide. These ligature guides are made of 7mm wire, and are malleable enough to be bent intentionally during surgery. However, they are also rigid enough to be used as a micro dissector. The silastic sheath is made of a 20G infusion needle, and is cut to a length of 2cm. After branching vessels and perforators are dissected and spared with the aid of the ligature guide, the ligature is passed around the aneurysm neck, both ends of the ligature are passed through the sheath, the aneurysm neck is squeezed, and a clip is applied as a stopper on the ligatures adjacent to the distal end of the sheath. By gently displacing the distal end of the sheath, a conventional aneurysm clip is applied on the aneurysm neck just distal or proximal to the ligature on the neck. Then, the ligature is removed. Two demonstrable cases are presented and the usefulness of the micro-tourniquet method is discussed.

We used a new combination chemotherapy with nedaplatin (CDGP) and 5-fluorouracil (5-FU) in eleven fresh patients with oral squamous cell carcinomas. 5-FU was administered at a dose of 1,000 mg/body by continuous infusion for 24 hours on days 1 to 5. CDGP was administered at a dose of 80 or 100 mg/m2 by drip infusion for 120 minutes on day 5. The response rates of total (1- or 2-course) and 2-course group were 54. 5% and 83.3%, respectively. Adverse drug reactions were limited to two cases of grade 3 toxicity with anorexia. The combination chemotherapy with 5-FU and CDGP in place of cisplatin and 5-FU seemed to play an important role as neo-adjuvant chemotherapy for oral squamous cell carcinomas.

Objective: Among 1,967 patients who underwent corrective surgery for pectus excavatum in our department between January 1980 and December 2001, 33 patients diagnosed as having Marfan syndrome were evaluated. We evaluated the clinical problems and outcome of the 33 patients., Results: The outcome of corrective surgery for pectus excavatum in the 26 patients who underwent a single technique surgery was generally good. Pectus excavatum was complicated by a total of 25 cases of cardiovascular disorder in 14 of 33 (42%) patients. Six patients underwent corrective surgery for pectus excavatum and cardiovascular disorders simultaneously. Three patients also had disorders of lung, which included spontaneous pneumothorax in 2 patients and progressive emphysematous cyst in 1 patient. The 2 patients with spontaneous pneumothorax underwent resection of bullae together with corrective surgery of pectus excavatum, while the patient with progressive emphysematous cyst underwent resection of bullae in a separate surgery after correction of pectus excavatum. Cardiovascular disorders were aggravated in 6 of the 20 patients who could be follow up. A total of 4 (20%) patients died long after surgery., Conclusions: We corrected pectus excavatum in 33 patients with Marfan syndrome, and obtained favorable outcomes. The postsurgical outcome depends on progression of lesions of the heart and large vessels, and it is essential to monitor such lesions carefully.

A 47-year-old man was referred to our clinic with abnormal chest radiographs. He was free of symptoms, but his chest CT demonstrated transient migrating infiltrates. Peripheral blood revealed eosinophilia and eosinophilic pneumonia was suspected. However, the bronchoalveolar lavage fluid showed no increase in eosinophils. Later, the patient's pleural effusion did contain eosinophils. His total IgE level was continuously elevated despite the absence of allergic disease, and so parasitic infection was suspected. Ouchterlony's double diffusion test after absorption of Paragonimus westermanii antigen was positive for Paragonimus miyazakii antigen. The ELISA values of both serum sample and pleural effusion were increased. As the ELISA value of the pleural effusion was higher than the serum one, we realised that pleural effusion was caused by Paragonimus miyazakii. Treatment with praziquantel for 3 days resulted in disappearance of the abnormal chest radiographic findings, and a reduced blood eosinophil level, IgE level and ELISA titre for Paragonimus miyazakii. We concluded that ELISA was useful in the diagnosis and assessment for treatment in Paragonimus miyazakii infections although there was no clearly relevant history.

We encountered two cases of thymoma accompanied by pure red cell aplasia and demonstrating clonal rearrangement of the T-cell receptor beta-chain gene (TCR-beta) in lymphocytes. Patient 1 was a 55-year-old man and Patient 2 was a 43-year-old woman. Both had severe anemia and mediastinal tumors. Bone marrow aspiration was performed and pure red cell aplasia diagnosed. Thymoma was the presumptive diagnosis for the mediastinal tumors, and extended thymectomy was performed. The post-operative diagnosis was invasive thymoma (spindle-cell type) in Patient 1 and non-invasive thymoma (mixed lympho-epithelial type) in Patient 2. The cell compositions (%) obtained with T-cell surface marker analysis were as follows: [table: see text] Southern blot analysis disclosed clonal rearrangement of TCR-beta genes in thymoma thymocytes from both patients.

The resistance of tumor cells to chemotherapeutic drugs is a major obstacle to successful cancer chemotherapy. Expression of the MDR 1 gene, which encodes for a transmembrane efflux pump (P-glycoprotein), leads to decreased intracellular accumulation and resistance to a variety of anticancer drugs. Recently, one mutant p 53 form was shown to stimulate the MDR 1 gene promoter in vitro, whereas wild-type p 53 repressed this activity. We examined the relationship between p 53 gene mutation and MDR 1 gene expression in specimens from non-small cell lung cancer patients. Tumor samples were obtained from 21 patients during surgery. Mutations of exon 5 through exon 8 of the p 53 gene were detected by the polymerase chain reaction single strand conformation polymorphism method. MDR 1 expression was semi-quantified by the reverse transcriptase polymerase chain reaction method. We identified p 53 gene mutation in samples from 7 patients. MDR 1 gene expression was observed in samples from 20 patients. The expressivity of the MDR 1 gene tended to be higher in patients with adenocarcinoma. No significant relationship between p 53 mutation and MDR 1 expressivity was observed in our study.

We deduced the three dimensional structures of transmembrane regions in human beta adrenoceptors by computer simulating using the 2D electron density maps of bacteriorhodopsin and frog rhodopsin as templates. The deduced membrane-spanning helical regions, their arrangements and axes to the membrane plain were different between two models. Typical beta adrenergic antagonist, propranolol, and long-lasting beta antagonist, bopindolol, were docked in these models. The receptor-antagonist interactions were different between both models, in which the 3, 4, 5 and 6th transmembrane domains might participate in the antagonists-binding in both models, however, the amino acid residues in the domains contributing to the binding might be different between models. Propranolol and bopindolol have high affinity to beta 1 and beta 2 subtypes, but low affinity to beta 3 subtype. The simulated receptor-antagonist relationships could account, in part, for the selectivity of the antagonists to the beta subtypes.

Five patients (4 men and one woman) aged 48-82 years who were suffering from superior vena cava (SVC) syndrome had Wallstent implanted percutaneously to relieve the obstruction. After stent placement, all cases received anticoagulant therapy with heparin. However one transient stent thrombosis occurred, stent placement resulted in complete relief of all patients. Wallstent placement could be an extremely useful treatment for SVC syndrome and should be the treatment of choice in all cases where SVC obstruction occurs or recurs, following chemotherapy or radiotherapy.

A case of pulmonary eosinophilic granuloma that underwent spontaneous remission is presented. A 23-year old man presented with dry cough and fever. Chest X-ray film revealed diffuse reticulo-nodular infiltrates in the middle and upper lung fields. Chest CT and HRCT showed multiple cystic lesions with thick walls and small nodules predominantly in the inner zone. Based on radiographic findings, pulmonary eosinophilic granuloma was suspected. Bronchoalveolar lavage cell data showed lymphocyte and eosinophil alveolitis with no increase of CD 1 lymphocytes. The symptoms and radiographic findings improved markedly within 4 months after the onset of symptoms without treatment and upon cessation of smoking. Chest CT and HRCT showed that the cystic walls were thinner and that the small nodules had decreased. Thoracoscopic lung biopsy revealed granulomatous lesions consisting of CD 1 and S-100 protein positive histiocytes with infiltration of eosinophils and fibrous lesions. Pulmonary eosinophilic granuloma was diagnosed. There has been no recurrence for 1 year.

Surgical management of patients with concomitant resectable lung lesions and critical cardiac disease is controversial. We report a case of concomitant pulmonary and cardiac surgery via a left thoracotomy. A 67-year-old male was admitted to our hospital complaining of recurrent bloody sputum and an abnormal shadow on chest X-ray. Chest CT and MRI showed a tumor in the left lower lobe (S10), with invasion of the diaphragm. A diagnosis of squamous cell carcinoma was obtained by transbronchial lung biopsy. The patient had a history of angina pectoris, and stress testing was positive. Coronary angiography showed 90% stenosis at segment 5, suggesting a risk of perioperative or postoperative myocardial infarction. This necessitated simultaneous surgical treatment for lung cancer and ischemic heart disease. A lobectomy of the left lower lung was performed, followed by coronary artery bypass grafting (CABG), using the great saphenous vein. The postoperative course was uneventful except for the occurrence of cholecystitis. Lung cancer and ischemic heart disease can be safely treated simultaneously via a single incision, with and benefit for selected patients.

The non-selective beta-blocker bopindolol, which was developed as a pro-drug, possessed 50-60 times more potent long-acting hypotensive effects on the blood pressure than those of atenolol or propranolol. Because this drug has only a mild partial agonist activity, it did not cause the rapid decrease in heart rate observed with atenolol or propranolol or the increase in heart rate induced by pindolol. These hypotensive effects are due to beta 1-antagonistic effects, not effects on beta 2- or beta 3-adrenoceptors. In addition to these effects, benefits of this drug include the following: slow dissociation rate from beta-adrenoceptors in tissues, high affinity to 5-HT1A subtypes, less clinical effects on lipid metabolism and the inhibition of renin release. It is possible that this drug possesses different pharmacological characteristics from other beta-blockers.

We examined local effects of basic fibroblast growth factor (bFGF) on early bronchial revascularization following bronchial anastomosis. The left main bronchi of mongrel dogs (8-15 kg) were cut and sutured following peripheral radical hilar stripping. The anastomotic sites were wrapped with a pericardial fat tissue pedicle, including branches of the internal thoracic artery and vein (8 dogs group A). One ml of bFGF (Biomedical Tecnologies Inc.) dissolved in 1 ml of fibrin glue (final concentration of 20 ng/ml for a total dose of 100 ng, pH 7.15-7.5) was applied to the anastomotic sites in order to deliver the bFGF gradually and selectively (12 dogs group B). At various timepoints, changes in bronchial mucosal blood flow were measured using a laser Doppler flowmeter and left internal thoracic artery (LITA) blood flow, using an implanted electromagnetic flowmeter. On the 7th postoperative day, silicone rubber was injected into the left subclavian artery, and the revascularization pattern from branches of the LITA to the bronchus was examined histologically. Specimens were labeled as (-) when the neogenic vessels were only observed outside the bronchial wall, (1+) when observed inside the bronchial wall but not in the mucosa, and (2+) when clearly observed in the mucosa. Blood flow in the bronchial mucosa was measured as the left/right ratio. For group A, the averages immediately after operation, and on the 3rd and on the 7th postoperative days, were 0.35 +/- 0.10, 0.46 +/- 0.04, and 0.70 +/- 0.14 respectively; while, for group B, they were 0.27 +/- 0.09, 0.78 +/- 0.15, and 0.90 +/- 0.15, respectively (p < 0.01). Our results show that blood flow in the LITA increased more in group B than in group A (average 2.7 +/- 1.8 ml/min in group A, vs. 4.7 +/- 2.9 ml/min in group B). Furthermore, the pathologic findings of neovascularization were (-) in 3 cases and (1+) in 2 cases in group A, while group B showed (1+) neovascularization in 1 case and (2+) in 4 cases. These results clearly demonstrate increased revascularization in the bFGF treatment group B. We conclude that local application of bFGF is effective in stimulating early bronchial revascularization.

A 66-year-old male was admitted to our hospital because of a chronic traumatic aneurysm of the thoracic aorta caused by a traffic accident 5 years earlier. Although he had been treated successfully by patch closure under extracorporeal circulation, chylothorax gradually manifested 9 days after the operation. The fact that our conservative treatment resulted in complete recovery from chylothorax, strongly suggested that progress of nutriology was a contributing factor.

Screening of neuroblastoma is commonly performed on 6-month-old infants; therefore, its discovery in children younger than that age is extremely rare. However, a 4-month-old boy with pectus excavatum was found to also have mediastinal neuroblastoma after close examination. This 7 kg child had no apparent symptoms, yet revealed an egg-sized shadow along the right atrium in the chest X-ray film, and along the right side of the vertebrae on CT. Due to the increase in the size of the tumor after two months of observation, we suspected malignant neurogenic tumor and performed a thoracotomy. With a right posterolateral thoracotomy we removed the dark-brown, elastic tumor measuring 6 x 4 x 3 cm and located along the right side of the vertebrae from III through VIII ribs. The origin was the thoracic sympathicus and the pathological diagnosis of the tumor was neuroblastoma with rosset formation. After conducting a post-operative chemotherapy (Jame's protocol), no evidence of recurrence was observed at 33 months after surgical treatment. We summarized the previously reported seven surgically treated cases of Stage I mediastinal neuroblastoma at less than 12 months of age. Among the 2500 pectus excavatum surgeries that have been held at our department, non has been found to have mediastinal neuroblastoma.

Inducing pulmonary edema in rat, air bubbles the diameter of which was about 0.3 mm were continuously infused into the right atrium through a catheter at the rate of 2.8 ml/kg/hr during 0.5, 1 and 2 hours, under controlled ventilation (tidal volume of 9 ml/kg and respiratory rate of 80/min) with 1% halothane in room air. Saline or Dilazep hydrochloride solution was simultaneously infused into the right atrium via another catheter. Pulmonary edema was evaluated by the measurement of the ratio of extravascular water weight of lung (g) to blood-free dry lung weight (g) (EVWW) using the gravimetric method and with histologic studies using the rapid freezing method. In control rats, which were sacrificed immediately after induction of anesthesia, the EVWW was 3.114 +/- 0.121 g/g blood-free dry lung (mean +/- 1 S.D. n = 8). In baseline experiments (2 hours ventilation and saline infusion without air embolization), the EVWW was 3.291 +/- 0.081 (n = 4). In air embolization groups with 2 hours saline infusion, EVWW were 3.756 +/- 0.170 (n = 4), 3.722 +/- 0.170 (n = 4) and 3.731 +/- 0.245 (n = 5) in 0.5, 1 and 2 hours infusion groups, respectively. Regardless of emboli infusion time perivascular cuffs and peribronchial cuffs were revealed in the 2 hour saline infusion groups. In the experiment in which the animals were sacrificed immediately after one hour infusion of air bubbles, there was no evidence of pulmonary edema and the EVWW of 3.060 +/- 0.092 (n = 4) in this group control and baseline were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Of 1192 lung resections in patients with bronchogenic carcinoma since 1952, the early post-operative mortality averaged 3.9%, whereas during the last ten years, it was 2.6% of 730 lung resections, including 159 (22%) pneumonectomies, 76 (10%) bilobectomies, 492 (67%) single lobectomies and 3 (0.4%) partial lung resections. In the latter, 352 (48.2%) and 75 (10%) had airway obstructive failure of FEV1.0 less than 70% and 55%, respectively, and, 56 (7.7%) and 9 (1%) represented preoperative hypoxia of PaO2 less than 70 torr and 60 torr, respectively. The ratios of pneumonectomies in these, being similar to those with better lung functions, the perioperative mortality was also similar. Our previously reported indices preoperatively to prove ability to withstand curative lung resections, being supported by these data, we attempted in a certain limited group of patients, extendingly to clear patients with critically poor predicted pulmonary vascular reserve pf 710-930 dyne . cm-5 . sec/m2 for lung resections, resulting in six elevenths of over one year survival. One must extend benefit of lung resection to patients with coexistence of bronchogenic carcinoma and respiratory disorder apparently severe enough to preclude resection surgery by critical assessment of the predicted pulmonary vascular reserve after lung resection.

Transrectal longitudinal ultrasonography of the prostate was done for 20 patients with prostatic diseases, 12 with benign prostatic hypertrophy, 6 with bladder neck contracture, and 2 with chronic prostatitis. The intravesical protrusion of the prostate and the opening of the bladder neck, which can be easily recognized by this method, were discussed in relation to dysuria, using subjective symptoms, residual urine, and uroflowmetry (peak flow rate) as parameters. The former was slightly correlated to dysuria, and the latter was definitely correlated to dysuria.