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K Usuda

Publications and source records attributed to K Usuda.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Assessment of nucleolar organizer regions (Ag-NORs) in primary lung cancer--correlation between Ag-NORs and tumor doubling time].

A total of 86 resected cases with primary lung cancer were examined on relationships between argyrophil nucleolar organizer regions (Ag-NORs) and other prognostic factors and correlation between Ag-NORs and tumor doubling time (DT). Survival rates were compared between patients with low Ag-NOR counts and patients with high Ag-NOR counts. 1) After logarithmic conversion of mean Ag-NOR counts in lung cancer, a small skewness (0.00486) and a small kurtosis (-0.7859) showed a normal distribution. Mean Ag-NOR counts was found to have a log-normal distribution. 2) There was a significantly inverse correlation between mean Ag-NOR counts and DT (correlation coefficient -0.705, p < 0.001). By plotting log (DT) on X axis and log (Ag-NORs) on Y axis, a formula representing a linear correlation was obtained: Y = 1.17-0.312 X, correlation coefficient -0.886. 3) The five-year survival rate (35%) of 46 patients with mean Ag-NOR counts which were more than or equal to 3.0 significantly lower than that (74%) of 40 patients with mean Ag-NOR counts of less than 3.0.

Adult↗
PubMed1994

[A case of lung cancer with axillary nodal involvement].

A 57-year-old man with lung cancer was reported. Primary tumor was located at left S1+2, and directly invaded to chest wall (from 1st. rib to 4th rib). Hypercalcemia and delirium were observed. Whole body examination showed that no distant metastasis except for nodal swelling of left axillary region. Left upper lobectomy combined with chest wall resection was performed. Hilar, mediastinal and axillary nodes were also dissected. Histological examination revealed that nodal involvement was not present at neither hilar or mediastinal region, but was present in axillary node. It was thought that lymphatic extension had occurred from trough chest wall to axillary nodes but not through mediastinal rout. So systematic dissection of locally invaded region as well as hilar and mediastinal region was recommended in each cases.

Axilla↗
PubMed1994

[Incidence of nodal involvement of #12u nodes (lymph nodes around the upper lobe bronchus) in cases with right middle lobe, right lower lobe, and left lower lobe carcinoma].

#12u nodes are peribronchial lymph nodes around the upper lobe bronchus which should not be routinely dissected in cases with middle lobe carcinoma or lower lobe carcinoma. In this paper, #12u were examined histologically in 152 lung cancer cases. As a results, 14 of 152 (9.2%) had nodal diseases in #12 nodes. #12u nodes were involved in 3 of 30 N1 diseases (10%), and in 11 of 35 N2 diseases (31.4%). There was a case which had no nodal involvement except for #12u node. And in three cases, we found only one nodal metastasis except for #12u nodes. If we did not dissect #12u nodes, these cases will be relapse in near future. Thus, for curative operation, #12u nodes should be dissected as a standard operation.

Carcinoma, Non-Small-Cell Lung↗
PubMed1993

Cytochrome P-450 55A1 (P-450dNIR) acts as nitric oxide reductase employing NADH as the direct electron donor.

Cytochrome P-450dNIR (P-450dNIR), involved in the fungal denitrification by Fusarium oxysporum, was purified to homogeneity. The cytochrome P-450 (P-450) exhibited a potent nitric oxide (NO) reductase activity to form nitrous oxide (N2O) employing NADH but not NADPH as the sole effective electron donor. The apparent maximum turnover rate against NO was estimated as high as 31,500 min-1. The stoichiometry of the reaction between NO:NADH:N2O was 2:1:1. The reaction required neither an artificial electron-carrying mediator nor other proteinaceous components. An anaerobic incubation of ferric P-450dNIR.NO complex, but not of free ferric P-450dNIR, resulted in rapid reduction of the P-450, indicating that P-450dNIR.NO complex was reduced directly by NADH. Spectral changes during catalytic turnover indicated that decomposition of the ferrous P-450.NO complex might be rate-limiting. The reaction was not inhibited by carbon monoxide at all, suggesting that the free ferrous P-450 is not formed during turnover. On the basis of these results a possible reaction mechanism was considered. The present results demonstrated not only the unique reaction catalyzed by P-450, but also the first P-450-dependent reaction where the electron transport from NAD(P)H to P-450 is not supported by other components. Now that the physiological function of P-450 55A1 (P-450dNIR) has been found, we propose to alter the trivial name to P-450nor.

Chromatography, DEAE-Cellulose↗
PubMed1993

Clinicopathological analysis of 19 cases of isolated carcinoma in situ of the bronchus.

Nineteen cases of isolated squamous cell carcinoma in situ (CIS) of the bronchus were described clinicopathologically from among 149 male heavy smokers with roentgenographically occult lung cancer discovered mainly by mass screening performed from 1982 to 1991. All 19 patients had positive sputum cytology tests and negative chest x-ray films and underwent lobectomy (except one who had segmentectomy because of poor lung function). Prior to operation, localization was accomplished by one to eight bronchoscopies using repetitive brush cytology and biopsy. Five cases were bronchoscopically invisible. Polypoid protuberance was noted in three cases, micronodular swelling in three, thickening of spur in five, and mucosal granularity in three. Histology by serial block sectioning showed that there was no nodal involvement in any cases; the maximum length or diameter was 12 mm. Thirteen tumors were < or = 4 mm, four of which were confined to the spur where they occurred. Follow-up data showed a favorable prognosis. Segmentectomy or sleeve resection of bronchus without mediastinal lymph node dissection may be adequate for CIS.

Aged↗
PubMed1993

Lesions preceding squamous cell carcinoma of the bronchus and multicentricity of canceration--serial slicing of minute lung cancers smaller than 1 mm.

A total of ten minute squamous cell carcinomas smaller than 1 mm were found in surgical lung specimens from 108 patients who had roentgenographically occult lung cancer. These minute lesions were detected by submitting, in all the 108 specimens, the whole bronchial tree to 2-mm-thick sequential transverse slicing which was then followed by microscopic examination of each slice on an H-E stained section. When a focus of minute carcinoma was found, the slice was further serially sectioned to study whether there were such carcinoma-related lesions as dysplasia or other atypical changes of epithelia, and when there were, the spatial relation of these with the carcinoma. It was demonstrated that all the minute carcinomas were closely associated with either dysplasia or what we call "basal cells with marked atypia", cells with markedly enlarged nuclei arranged in linear fashion on the basement membrane. The contiguity of these changes with minute carcinoma strongly suggested that they are lesions preceding overt carcinoma. Also, there were some minute foci of carcinoma, which, though not involving the entire epithelial thickness, proved to have already begun microinvasion.

Aged↗
PubMed1993

Relation between bronchoscopic findings and tumor size of roentgenographically occult bronchogenic squamous cell carcinoma.

A total of 105 lesions in 98 patients with roentgenographically occult bronchogenic squamous cell carcinoma were examined. The relationship of bronchoscopic findings to the depth of invasion into the bronchial wall and the length of longitudinal extension along the bronchus was documented. From viewpoints of the degree of difficulty of bronchoscopic detection and with reference to the height of the lesions, the bronchoscopic findings were classified into three categories: remarkable, minute, and hidden. Of the 105 lesions, 55 (52%) were remarkable, 27 (26%) were minute, and the remaining 23 (22%) were hidden. Of the 23 hidden lesions, 12 were within and 11 were beyond the range of endoscopic visibility. The maximal depth of bronchial invasion (mean +/- standard error) was 3.07 +/- 0.40 mm in the category designated remarkable and 1.62 +/- 0.47 mm in the category designated minute. The depth was 0.93 +/- 0.36 mm in the hidden lesions within the range of endoscopic visibility and 0.78 +/- 0.21 mm in the hidden lesions beyond the range of endoscopic visibility. The maximal length of longitudinal extension along the bronchus was 19.6 +/- 1.5 mm in the remarkable lesions, 9.9 +/- 1.4 mm in the minute lesions, 5.5 +/- 1.0 mm in the hidden lesions within the range of endoscopic visibility, and 8.6 +/- 2.1 mm in the hidden lesions beyond the range of endoscopic visibility. It is useful for predicting the depth of invasion to classify bronchoscopic findings into these three categories for the study of roentgenographically occult bronchogenic squamous cell carcinomas.

Aged↗
PubMed1993

[Resected roentgenographically occult bronchogenic squamous cell carcinoma tumor size, survival and recurrence].

The relationship between tumor size and nodal involvement of resected roentgenographically occult squamous cell carcinoma in 127 cases was documented. Survival and recurrent patterns were analyzed. Intrabronchial invasion was observed in 103 cases and extrabronchial invasion in 24 cases. One hundred and nineteen cases (94%) had N0 diseases, six (5%) N1 diseases and two (2%) N2 diseases. One hundred and one cases were in early stage and 26 in non-early stage. Nodal involvement was observed in two (2%) of the 103 cases with intrabronchial invasion and in six (25%) of the 24 cases with extrabronchial invasion. Nodal involvement was noted in none (0%) of 55 cases in whom longitudinal extension of tumors was within 10mm, but was noted in four (9%) of 46 cases in whom it was 11 to 20mm and in four (15%) of 26 cases in whom it was 21 to 55mm. Death from primary lung cancer occurred in three (12%) of the non-early cases, but in none (0%) of the early cases. Death from multiple metachronous lung cancer occurred in one (4%) of the non-early cases and in three (3%) of the early cases. Nodal and extrabronchial involvement reduced survival. Recurrence often involved hilar, mediastinal, supraclavicular nodes, and surgical margin of bronchus.

Aged↗
PubMed1993

[Bilateral ectopic ureteroceles: a case report].

The twelfth case of bilateral ectopic ureteroceles in Japan is reported. A two-month-old girl was referred to our clinic because of urinary tract infection. Two large intravesical cystic lesions communicating to the dilated upper urinary tracts, which were compatible with bilateral ectopic ureteroceles were detected. Histological findings of the upper moieties of the duplex kidney showed dysplasia on the left side, and immaturity on the right side. Left heminephrectomy was performed, and a pyeloureterostomy was applied on the right side after placement of nephrostomy for 6 months. The ureteroceles collapsed satisfactorily to void smoothly. The patient has not been in trouble for more than thirty months postoperatively. Indications for preservation of the upper segment and ureterocelectomy in small infants are discussed.

Anastomosis, Surgical↗
PubMed1992

Cytologic assessment of peroperative pleural effusion and prognosis in lung cancer patients who underwent resection.

Twenty-five of 108 lung cancer patients who underwent resection had cytologically positive pleural effusions. The rate at which cancer cells were detected was not related to the amount of the effusion. Almost one third of patients with cancer cells in effusion were alive at the end of the third postoperative year, provided that the pleura itself was free of metastasis at the time of operation. Correlation of the cytologically positive rate of pleural effusion (Y) with the degree of pleural metastasis (X1), the degree of pleural involvement (X2), or the degree of nodal involvement (X3) was analyzed using the Hayashi's quantification method type I. The multiple correlation coefficient was 0.843. Partial correlation coefficients of X1, X2, and X3 were 0.733, 0.446, and 0.653, respectively. Pleural metastasis had the strongest effect on the cytologically positive rate of pleural effusion.

Adult↗
PubMed1992

An improved method of bronchial stump closure for prevention of bronchopleural fistula in pulmonary resection.

We performed 880 pulmonary resections from January 1982 to June 1988 using Sweet's procedure for closure of the bronchial stump, in which 39 patients (4.4%) developed bronchial fistulas. Bronchoscopic studies showed that bronchopleural fistulas were located mainly at the corner of the stump. This indicates that the corner is the point with the highest tension when Sweet's procedure is employed. In some cases, stumps were injured by suture materials, resulting in bronchopleural fistulas. Since July 1988, bronchial stumps have been closed by using two pairs of teflon pledgets with additional interrupted sutures. From July 1988 to April 1990, 288 patients were treated by this new method, and only one of them developed bronchopleural fistula. This new method prevents injury of the stump by suture material and reduces the tension at the bronchial stump for a long time. Thus, pulmonary resections can be safely employed even after anti-cancer chemotherapy and/or radiation therapy.

Bronchi↗
PubMed1992

Results of surgical treatment for roentgenographically occult bronchogenic squamous cell carcinoma.

Ninety-four patients with roentgenographically occult bronchogenic squamous cell carcinoma had surgical resection. Fifty-three reported having no symptoms. In 83 carcinoma was detected by cytologic examination of the sputum during lung cancer screening. The carcinomas were located in segmental bronchi (34 cases), subsegmental bronchi (19 cases), divisional bronchi (17 cases), and subsubsegmental or more peripheral bronchi (15 cases). The number of cases classified by TNM staging were 16 Tis N0 M0, 72 T1 N0 M0, 4 T1 N1 M0, and 2 T2 N1 M0. Extrabronchial invasion of the resected carcinoma was observed in 17 lesions (16 cases). Five of six patients with lymph node metastasis in the resected specimens had carcinoma with extrabronchial invasion. Multiple primary lung cancers were observed in nine patients at the time of operation and in seven subsequently. Four of seven patients with subsequent primary lung cancer had surgical resection, and no recurrence was observed after the second operation. There were two deaths from lung cancer: One was caused by subsequent primary lung cancer and the other by mediastinal lymph node metastasis. In the 75 patients with intrabronchial cancer invasion and without lymph node metastasis who had complete resection, there was no local recurrence or metastasis of cancer. The 5-year survivals were 80.4% (death from all causes) and 93.5% (death from lung cancer). Although subsequent primary lung cancer is troublesome, operation is a reliable treatment for occult bronchogenic squamous cell carcinoma.

Bronchoscopy↗
PubMed1992

[Re-evaluation with abridged life tables of the prognosis of lung cancer patients who underwent surgical therapy].

Some lung cancer patients after surgical treatment die as a result of pneumonia or cardiac failure without recurrence of lung cancer months or years after surgery because many such patients are aged or have decreased lung function. Surgical treatment may be partly to blame for these deaths. In this article, to evaluate the contribution of surgical treatment to deaths resulting from other disease, we calculate predicted survival rates using abridged life tables and compute relative survival rates. From 1952 to 1985, a total of 1289 lung cancer patients underwent surgical resection of lung cancer in our department. We calculated some kind of survival rates according to age, stage, and operative procedure. Each case was classified according to age (5-year periods), year of operation (5-year periods), and sex. The 5-year survival rate indicated by the abridged life tables in each class was regarded as the 5-year predicted survival rate of the case. The mean of 5-year predicted survival rates of all cases in a group was regarded as being the 5-year predicted survival rate of the group. The ratio (actual survival rate of the group/predicted survival rate of the group) was also calculated. The ratio of the patients who had stage O, I, or II diseases tended to decrease according to age. This fact supposed that the number of deaths resulting from other diseases with no recurrence of lung cancer in which surgical treatment contributed to death increased in the elderly. In the other hand, this tendency did not exist in the patients who had stage IIIA diseases.

Adolescent↗
PubMed1992

[Experience of Nd-YAG laser treatment in roentogenographically occult bronchogenic squamous cell carcinoma].

Out of 201 patients with roentogenographically occult bronchogenic squamous cell carcinoma, 165 lesions underwent surgical operations, while 41 lesions underwent non-invasive therapy. The 5-year survival rate including all causes of death, was significantly higher in the surgical operation group than that in the non-invasive therapy group (83% vs 43%). Among 14 cases who received Nd-YAG laser treatment, one case died but 4 cases are alive bearing cancer. Since time span of follow-up period is short, it is hard to say that the prognosis of the Nd-YAG laser therapy in fair. Nd-YAG laser treatments were effective for cancers which did not invade beyond bronchial cartilage. From the bronchoscopic examinations and studies with resected lungs, we suggest that Nd-YAG laser treatments may be effective when cancer is extended within 10 mm wide and has only a slight findings in bronchoscopy.

Aged↗
PubMed1991

[Surgical treatment of pathological stage III and IV lung cancer less than 3 cm in diameter].

We analyzed stage III and IV lung cancer with tumor size smaller than 3.0 cm. The percentage of adenocarcinoma among the patients with stage III A lung cancer was high. In survival rate, there was no observable difference between the patients with tumor size smaller than 3.0 cm and the patients with tumor size larger than 3.1 cm. But the ratio of the people who had a long survival was high in the latter group. Among the stage IV patients, the pm 1 group with N0 or N1 had a good prognosis (52%, 50% at 5 years).

Adenocarcinoma↗
PubMed1991

[T4 advanced lung cancer: results of surgical treatment and indications of surgical resection].

A total of 1,289 patients with primary lung cancer were surgically treated at our hospital from January 1953 to December 1985. Surgical treatment for T4 lung cancer was studied in 93 patients who had pulmonary resections. The relationships between histologic type, stage, method of resection, curability, nodal involvement, pleural involvement, site of invasion, pleural metastasis, pleural effusion, combination therapy, and the survival rate were analyzed. The survival rate of 93 patients with T4 lung cancer was 17% at 3 years and 7% at 5 years. Three-year survival rate of 39 patients with adenocarcinoma, 34 patients with squamous cell carcinoma, and 9 patients with large cell carcinoma was 7%, 23%, and 14%, respectively. Two-year survival rate of 6 patients with small cell carcinoma was 17%. Four-year survival rate of 14 patients who had complete resection was 33%. On the other hand, four-year survival rate of 77 patients who had incomplete resection was 7%. Three-year survival rate of 6 patients with N0 disease, and 19 patients with N1 disease, 46 patients with N2 disease, and 22 patients with NX disease was 40%, 39%, 0%, and 15%, respectively. Two patients, who had partial resection of the left atrium because carcinoma made an invasion upon it, had survived more than 5 years. All patients with esophageal invasion or tracheal invasion had died within a year. Indications of surgical resection for patients with T4 lung cancer should be limited to patients with N0 and N1 disease. Radical pulmonary resection can be performed in patients who are expected to have complete resection.

Adult↗