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Biomedical subjects

A Kitami

Publications and source records attributed to A Kitami.

At least 19 recordsLinked to original sources
PubMed2005

[Aneurysmal bone cyst arising in the rib; report of a case].

We experienced with a relatively rare case of an aneurysmal bone cyst (ABC) arising in the left rib. A 34-year-old female, had experienced chest discomfort on the left anterior side and pain for 1 year. A chest X-ray suggested a left chest wall tumor involving the ribs. Computed tomography (CT), magnetic resonance imaging (MRI) and a bone scintigram revealed an expansive tumor of the anterior portion of the left 4th rib involving the 3rd and 5th rib with "blow out appearance" and "fluid-fluid level". Wide excision of the tumor and adjacent muscle tissue was performed with an antero-axillary incision. Chest wall reconstruction was performed with prolene mesh (140 x 90 mm). The resected specimen showed an encapsulated bony mass (75 x 60 x 35 mm) with multiple blood-filled spaces. Histopathological diagnosis was an ABC originating in the left 4th rib. She has been doing well with no evidence of recurrence 12 months postoperatively.

Adult↗
PubMed2005

[Completion pneumonectomy 9 years after middle lobectomy for adenocarcinoma].

Completion pneumonectomy (CP) is a difficult operation in which the surgeon must use techniques such as intrapericardial ligation of the pulmonary vessels. We report herein a case of CP for a patient with recurrent lung cancer. A 63-year-old man was admitted to our hospital for evaluation of abnormal shadows in the right lung field in October 2002. Right middle lobectomy with mediastinal lymph node dissection had been performed in February 1993. Computed tomography (CT) revealed a hilar mass in the right upper lobe the day after admission. Bronchofiberscopic cytology revealed squamous cell carcinoma. Right completion pneumonectomy was performed on suspicion of metachronous multiple lung cancers 4 days later. Histopathologically, resected specimens represented adenosquamous carcinoma similar to the prior lesion from the middle lobe, and examination revealed that the tumor represented a recurrence following middle lobectomy. The patient remains well as of 19 months postoperatively.

Adenocarcinoma↗
PubMed2004

[Esophageal gastrointestinal stromal tumor surrounding the middle esophagus with dysphagia for 8 years; report of a case].

In September 2002, a 24-year-old woman complaining dysphagia with an abnormal shadow in a chest X-ray was admitted to our hospital. Endoscopic ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) showed a hypo-echoic, low-density mass surrounding the middle esophagus. Bronchofiberscopy and gastrofiberscopy showed compression from the outside of bronchus and esophagus. No ulcer formation was found. Transbronchial aspiration biopsy and esophageal biopsy showed no malignancy. After 14 cm thoractomy, extirpation of the tumor was performed. The solid tumor was 10.5 x 3.0 x 2.5 cm in dimension, and the cut surface of the tumor was light yellow. Immunohistochemically, the tumor cells were positive for c-kit, SMA, CD34, and S-100. Histopathologically, the tumor was diagnosed as gastrointestinal stromal tumor (GIST), combined smooth muscle-neural type. A postoperative upper gastrointestinal tract barium study showed no stenosis. She is doing well without evidence of tumor recurrence at 12 months postoperatively. Although GIST is the most common mensenchymal tumor of the human gastrointestinal tract, this case is reported because the GIST arising from the middle esophagus is very rare.

Adult↗
PubMed2001

Chemotherapy of thymic carcinoma: analysis of seven cases and review of the literature.

BACKGROUND: Thymic carcinoma has a dismal prognosis compared with thymoma, because most of such tumors have locoregional invasion when diagnosed. Thus the important step in the management of thymic carcinoma is the introduction of systemic chemotherapy. However, as thymic carcinoma is a rare neoplasm, treatment with chemotherapy has not been studied systematically. METHODS: We analyzed seven cases of primary thymic carcinoma, treated with various chemotherapy regimens in our hospital from 1990 to 1999, and carried out a literature review of case reports of thymic carcinoma successfully treated with chemotherapy. RESULTS: All four cases who received modified ADOC therapy obtained partial responses. Other chemotherapeutic regimens (CHOP-E, PVB) were not effective. CONCLUSION: Based on the results of this study and the literature review, we feel that a positive response is obtainable with chemotherapy for thymic carcinoma. Modified ADOC therapy showed consistent efficacy in thymic carcinoma in this study.

Adult↗
PubMed2001

Video-assisted thoracoscopic sterilization for exacerbation of chronic empyema thoracis.

STUDY OBJECTIVE: To investigate the efficacy of video-assisted thoracoscopic sterilization to treat patients with exacerbation of chronic empyema thoracis. DESIGN: Case reports and literature review. SETTING: Academic department of surgery. PATIENTS: Two elderly, debilitated patients with worsening, chronic empyema thoracis as diagnosed by radiographs, CT, and thoracentesis. Both patients had a history of therapeutic pneumothorax for tuberculosis without bronchopleural fistulas. INTERVENTIONS: Video-assisted thoracoscopic sterilization of the thoracic cavity. MEASUREMENTS AND RESULTS: There was no recurrence of empyema during a 6-year follow-up period for one patient and a 2.5-year follow-up period for the other patient. CONCLUSIONS: Video-assisted thoracoscopic sterilization is a minimally invasive useful treatment for elderly or debilitated patients with exacerbation of chronic empyema thoracis.

Aged↗
PubMed2001

[Endoscopic transthoracic sympathectomy (ETS) with a fine 2-mm thoracoscope in palmar hyperhidrosis].

Endoscopic transthoracic sympathectomy (ETS) is an efficient, safe, minimally invasive procedure, and requires only a short period of hospitalization. We performed bilateral ETS using a thoracoscope 2 mm in diameter. We performed 120 ETS for the treatment of palmar hyperhidrosis from August 1997 to April 2000. The patient was placed in the semi-sitting position under general anesthesia, one-lung ventilation being used; the operation was performed with 2-mm two-puncture method. The sympathetic chain could be observed through parietal pleura riding on the costovertebral junctions. A 2-mm Kirschner wire was employed as an electrode, and the second and third thoracic sympathetic chains were electro cauterized. A thoracic drain was not used. The needling sites were only 2 mm in size and could be fixed without suture. For the patient, a small scar of this size means virtually no scar. The operative times were from 11 min to 81 min in bilateral ETS. Immediately and dramatic decrease in the sweat excretion in the palms was noted in all patients. The 95% patients were highly satisfied with the results. The commonest side effects were compensatory sweating. This procedure is recommended as the method of choice for the surgical treatments of palmar hyperhidrosis.

Adolescent↗
PubMed2000

Angiosarcoma of the chest wall.

A 50-year-old man sustaining bilateral chest wall angiosarcomas at intervals of several months underwent lesion resection. Angiosarcoma is so rare that we found no case in the literature who had undergone bilateral chest wall surgery for such tumors. His second tumor was thought to be metastatic rather than primary. Despite the 2 surgeries, irradiation, and chemotherapy, however, his prognosis was grave, as in other reports on angiosarcoma.

Hemangiosarcoma↗
PubMed2000

Tiny thymic carcinoma completely surrounded by thymic tissue. The possibility of de novo carcinoma.

We report a case of a 61-year-old man with a tiny thymic carcinoma completely surrounded by thymic tissue. First, a thoracoscopic resection of about two-thirds of the right inferior part of the thymus containing the tumor was performed to obtain the histological diagnosis. Frozen-section diagnosis at operation revealed a thymic carcinoma. Therefore we performed a median sternotomy and resected the remnant of the thymus. A tiny thymic carcinoma completely surrounded by thymic tissue is extremely rare. In this case, as the tumor was tiny and there was a homogeneous mass without a thymoma-like component, we concluded that this tumor was de novo.

Carcinoma↗
PubMed2000

Coronary artery bypass grafting in dialysis patients.

OBJECTIVE: In dialysis patients, there are two issues to consider, water-electrolyte control and a bypass technique for a calcified aorta. We used continuous hemofiltration for water-electrolyte control and an off-pump bypass with arterial grafting for a calcified aorta. METHODS: We performed coronary artery bypass grafting with extracorporeal circulation in 9 cases and without extracorporeal circulation (off-pump bypass) in 3 cases. In 6 cases, the operation was urgent, and in 6 cases the operation was elective. RESULTS: An average of 3.2 grafts/pt, (the arterial graft: 1.3 grafts/pt) was performed in the pump cases. In the off-pump bypass cases we used arterial grafting only (1.7 grafts/pt). We had 1 early death (sudden death) and 1 hospital death (SLE encephalopathy). One late death due to cerebral bleeding occurred at 2 years later. We used continuous hemofiltration for 2 to 11 days (average 3.9 days) in the pump cases. The off-pump cases could be controlled by conventional hemodialysis. CONCLUSION: Continuous hemofiltration was very easily set up with less interference to the hemodynamics. Using an arterial graft with off-pump bypass, an aortic no-touch technique and water control with conventional hemodialysis were possible.

Adult↗
PubMed2000

Sleeve lobectomy of the middle lobe for hilar lung cancer with accompanying cardiomyopathy and actinomycosis.

The indication for sleeve lobectomy of the middle lobe is limited, because the frequency of cancer occupying both the middle lobe and its bifurcation is low and the more commonly used middle and lower lobectomy is an alternate procedure. However, if a patient has accompanying cardiopulmonary restriction, lung preservation is paramount. We present a patient with hilar lung cancer (TisN0M0) associated with progressive cardiomyopathy, who underwent sleeve lobectomy of the middle lobe; the cancer took a favorable course.

Actinomycosis↗
PubMed2000

[Thymic carcinoma successfully treated by a combination of intra-arterial infusion chemotherapy and surgery].

A 47-year-old man with thymic carcinoma that had invaded the inner pericardium and adhered to the superior vena cava and right atrium at first operation was treated with intra-arterial infusion chemotherapy (nedaplatin and adriamycin) through the internal thoracic artery. After 2 courses of modified ADOC therapy (nedaplatin, adriamycin, vincristine, and cyclophosphamide), chest computed tomographic (CT) scans revealed a 47% reduction in tumor size. No adverse effects due to the anticancer drugs were observed. Resection of the tumor included part of the upper lobe of the right lung and pericardium. Examination of resected tumor tissue specimens revealed viable cancer cells and extensive fibrosis. The diagnosis was thymic anaplastic carcinoma. We concluded that intra-arterial selective infusion chemotherapy utilizing an ADOC regimen can be of value as a treatment for thymic carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

[A case of typical carcinoid accompanied with left atrium myxoma].

A 78-year-old female was admitted to Shizuoka red cross hospital because of an abnormal shadow at the right upper lung field on chest X-ray film. A left atrium myxoma was detected at chest CT scan after admission. Though the lung tumor was well defined and hilar and mediastinal lymph nodes were not swollen at CT scan, the tumor was suspected a small cell carcinoma at the result of trans-bronchoscopic biopsy. Firstly we performed removal of the left atrium myxoma, and two months later, we performed thoracotomy and partial resection of the right upper lobe. The lung tumor was finally diagnosed as a typical carcinoid. We have followed the patient for about 32 months after the operation and there is no evidence of tumor recurrence.

Aged↗
PubMed1999

[Emergency coronary artery bypass grafting in dialysis patients].

Emergency coronary artery bypass surgery was performed in nineteen patients including five chronic hemodialysis patients. In fourteen patients (non-dialysis patients), ten patients required preoperative IABP and four required PCPS for cardiogenic shock. Four patients died (29%); three from LOS and one from sudden death. Most of them (3/4) were preoperative cardiogenic shock. In other five patients (dialysis patients), four patients had conventional CABG, while one received off-pump bypass surgery for calcified aorta and brain complication. All five patients received arterial in situ conduit and continuous hemofiltration in the early postoperative period for controlling water and electrolyte. Two patients died (40%); one from arrhythmia and one from deterioration of original disease (SLE encephalopathy) but no one died from LOS. These methods of surgical modification and perioperative management for chronic hemodialysis patients are considered very useful.

Aged↗
PubMed1998

Endoscopic transthoracic sympathectomy with a fine (2-mm) thoracoscope in palmar hyperhidrosis: a case report.

Endoscopic transthoracic sympathectomy (ETS) is a minimally invasive method, causing only small injuries and few complications, and requires only a short period of hospitalization. Therefore, this method has been applied to patients with palmar hyperhidrosis to whom the conventional transthoracic sympathectomy, which is much more invasive, or thoracic sympathetic blockade, which often causes complications, cannot be applied. Conventional thoracoscopes, such as a resectoscope 8 mm in diameter for urological operations, or a thoracoscope 5 mm in diameter, were usually used for this purpose, but they cause operative injuries. We performed ETS using a thoracoscope 2 mm in diameter (MiniSite 2 mm 0 degrees, USSC171303). Its visual field and handling were not inferior to those of conventional thoracoscopes, and the operative injuries were only 2 mm in size. For the patient, a small scar of this size means virtually no scar.

Adolescent↗
PubMed1998

Primary seminoma in the middle mediastinum: case report in a 69-year-old male.

Primary mediastinal seminoma is an uncommon tumor usually located in the anterior mediastinum. The majority of cases occur in young males. We report here an extremely rare case of a 69-year-old male with primary seminoma in the middle mediastinum. The patient had no complaints, but an abnormal shadow was seen in a routine chest X-ray. We performed a tumorectomy in the middle mediastinum, a thymectomy and an orchidectomy and added postoperative chemotherapy. It seems that the tumor was not associated with the thymus, so we believe the tumor did not stem from the embryonic thymus. Our case demonstrated that mediastinal seminoma does not always occur in the anterior mediastinum of young males. Although this case is rare, seminoma should be included among the possible diagnoses of a middle mediastinal mass.

Aged↗
PubMed1998

Effective treatment of thymic carcinoma with operation and combination chemotherapy against acute monocyte leukemia: case report and review of the literature.

Thymic carcinoma associated with acute monocyte leukemia (AMoL) and a history of choriocarcinoma was diagnosed in a 58-year-old female. We found no other such case in a literature search. She was first treated with DCMP therapy: daunorubicin, cytosine arabinoside, 6MP-riboside, and prednisolone against AMoL. After induction chemotherapy, complete AMoL remission was attained. Chest CT scan after chemotherapy revealed regression of the mediastinal tumor. Resection of the tumor included the left upper lobe of the lung, phrenic nerve and pericardium. Pathological diagnosis showed poorly or moderately differentiated squamous cell carcinoma. Although the patient died of pneumonia during chemotherapy for relapsed AMoL, chest X-ray and CT revealed no recurrence of the mediastinal tumor after the original operation. Judging from this case and other successful cases of chemotherapy, we feel that intensive chemotherapy may be a beneficial strategy against thymic carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗