PubMed Health⌕ Search

Biomedical subjects

M Kamiyoshihara

Publications and source records attributed to M Kamiyoshihara.

At least 19 recordsLinked to original sources
PubMed2006

[Surgical fixation of the ribs for flail chest injuries].

The record of 20 patients presenting with flail chest injury from 1998 to 2005 was reviewed to determine surgical indication and timing. There were 4 groups with each indication as followed: 1) 8 patients with surgical indication for injury regions other than fractured ribs, 2) 5 without improvement of flail chest after internal pneumatic stabilization for more than 10 days, 3) 4 performed surgical fixation positively for flail chest with respiratory failure, 4) 3 with strong deformation of the thorax without respiratory failure. Eight patients (40%) required artificial respiration for more than 6 days after surgical stabilization. The reasons of prolonged artificial respiration included unconsciousness in 4 patients, pneumonia in 2, and others in 2. In the group consisting of 8 patients taking more than 6 days to be extubated after surgical fixation, the injury severity score (ISS) was significantly higher (p = 0.006) than that of the other group. In patients with no improvement of flail chest after internal pneumatic stabilization for more than 10 days, surgical fixation reduces the period of internal pneumatic stabilization and the risk of pneumonia. For the elderly who can develop complications easily, early indication of surgical fixation should be considered. In patients with unconsciousness or ISS > or = 25, the extubation delays frequently after surgical fixations.

Adult↗
PubMed2005

[Perioperative management for lung cancer with interstitial pneumonia].

The purpose of this study was to review perioperative managements from the clinical features and the postoperative course of lung cancer patients with interstitial pneumonia (IP). Twenty-two patients with IP were divided into 2 groups: the acute exacerbation (AE) group (6 patients) and the non-acute exacerbation (NAE) group (16 patients). There was no significant difference in the patient background between the 2 groups. In hematological examination, KL-6 levels were significantly higher in the AE group than in the NAE group. There was no significant difference in the respiratory function tests in the both groups, and the heart rate after 2 flights test was significantly higher in the AE group than in the NAE group. There was no significant difference in operation-related factors, tumor-related factors and the postoperative course in the both groups. No postoperative death occurred in our 22 patients probably due to adequate treatments of IP which was managed by our detailed manual. Long-term follow-up for lung cancer patients with IP undergoing surgical intervention is needed to prevent AE.

Aged↗
PubMed2005

[Surgical resection of T3 and T4 lung cancer].

Lung cancer invading neighboring anatomical structures such as the chest wall, pericardium, diaphragm, and left atrium are categorized as T3 or T4, which is regarded as locally advanced lung cancer. The purpose of this study was to evaluate results of surgical treatment of T3-4N0-2M0 non-small cell lung cancer according to involved organs. From 1981 to April 2005, 148 patients with lung cancer invading neighboring organs were surgically treated in our hospital. The 5-year survival was 41.4% in all cases. According to 5-year survival of clinical characteristics, the chest wall (parietal pleura) group (45.5%) had a significantly better prognosis compared with the left atrium (0%, p = 0.03) and diaphragm (0%, p = 0.04) groups. T3N0 (50.3%), IIB (55.4%), IIIA (44.6%), and complete resection groups (49.0%) showed a significantly better prognosis compared with T3N2 (27.9%, p = 0.01), III B (0%, p < 0.0001), and incomplete resection groups (13.9%, p < 0.0001), respectively. These results indicate that the prognosis of patients with N2 disease or incomplete resection remains poor in regardless with the type of involved organs.

Adult↗
PubMed2004

[The clinicopathological features of peripheral small-sized (2 cm or less) squamous cell carcinoma of the lung].

Recently the diagnosis of peripheral small-sized lung cancers has increased with the development of computed tomography. The vast majority of them are adenocarcinoma, whereas squamous cell carcinoma is rare. From 1981 to 2002, 1,054 patients underwent pulmonary resection for primary lung cancer in National Nishigunma Hospital. Among of them, 17 patients with peripheral small-sized (2 cm or less) squamous cell carcinoma underwent lobectomy and systemic nodal dissection were retrospectively reviewed. These were 15 men and 2 women, with a mean age of 68 years (range, 56-75). Regarding the pathologic stage, 15 patients were classified in stage IA, 1 in IIA, and 1 in IIIA. Among of them, only 1 patient with n 2 disease died of cancer at 17 months after surgery. Overall 5-year and 10-year survival rates of this disease were 84.4% and 73.8%, respectively. Based on the present data, we conclude that mediastinal nodal dissection would be unnecessary in the patients with peripheral small-sized squamous cell carcinoma of the lung.

Adenocarcinoma↗
PubMed2004

[Duodenal metastasis from squamous cell carcinoma of the lung; report of a case].

Metastatic carcinoma from primary lung cancer is usually recognized in the brain, adrenal glands, and bone. It is uncommon in the digestive system, particularly in the duodenum. We report a 63-year-old man who had undergone a left lower lobectomy for lung cancer. Anemia (Hb 6.9 g/dl) had been observed 2 months after surgery for primary lung cancer. Gastroduodenoscopy showed duodenal metastasis, and further examination demonstrated adrenal metastasis. Palliative treatment was selected and the patient died 5 months after surgery.

Carcinoma, Squamous Cell↗
PubMed2003

[Mediastinal mature teratoma perforating into the lung with elevated serum carbohydrate antigen 19-9 (CA19-9) levels; report of a case].

A 17-year-old woman was suddenly seized with anterior chest pain and admitted to our hospital. Chest X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass shadow in the left middle lung field associated with the left pleural effusion and high serum carbohydrate antigen 19-9 (CA 19-9) levels (58.5 U/ml). We performed a total resection of the tumor with adherent parts of the left lung. The tumor was 6.5 x 3. 8 x 2.9 cm in size, and was made up of soft tissues, fluid and cystic components. The histological diagnosis was a mature cystic teratoma with perforation into the lung, which contained pancreatic tissues, hepatic cells, bronchial epithelium, serous glands and so on. The levels of fluid amylase and CA 19-9 were high. We report mediastinal mature teratoma perforating into the lung and discuss the mechanism of perforation.

Adolescent↗
PubMed2002

[Clinical study of synchronous multiple primary lung cancers; problems in diagnosis and treatment].

We evaluated retrospectively 33 patients with synchronous multiple primary lung cancers. These were 20 men and 13 women, with a mean age of 67 years (range, 51-79 years). In 27 cases, the tumors were located in the ipsilateral lung, and in 6 cases, they were in the bilateral lung. In patients with synchronous multiple primary lung cancers, combinations of adenocarcinoma and adenocarcinoma (12 cases, 36.4%), adenocarcinoma and others (6 cases, 18.2%) were most commonly observed histologically. Lobectomy was performed in 18, bi-lobectomy in 3, pneumonectomy in 4, lobectomy with partial resection in 6, and lobectomy with laser therapy or irradiation in 2 patients. Overall 5-year survival rate of this disease was 78.3%. Eight patients died within 1 year after surgical resection, and 2 of them died of treatment-related accident. Although optimal treatment of choice for synchronous multiple primary lung cancers remains an unresolved problem, we think that careful planning of the treatment for this disease including selection of surgical methods is much important.

Aged↗
PubMed2002

[Congenital tracheoesophageal fistula; report of an adult case].

We experienced an adult case of congenital tracheoesophageal fistula which was successfully treated by surgical intervention. A 69-year-old female was admitted with complaint of coughing and fever. The patient previously had had several episodes of pneumonia. Esophagography and thoracic CT demonstrated a tracheoesophageal fistula in the upper of the thoracic esophagus. Following the resection of the fistula, the trachea was closed with one layer suture and the esophagus was closed with two layer sutures. A pedicled fifth intercostal muscle was interposed between the tracheal and esophageal suture lines. There was mild inflammatory change in surrounding tissues of the fistula. Pathological examination revealed that the fistula was covered with the squamous epithelium, and had the muscularis mucosa. Her postoperative course was uneventful.

Aged↗
PubMed2002

Clinical significance of the preoperative serum-soluble intercellular adhesion molecule-1 in non-small cell lung cancer.

BACKGROUND: The serum-soluble intercellular adhesion molecule-1 (sICAM-1) is reported to correlate with both the metastatic potential and a poor prognosis. We analyzed the sICAM-1 concentrations and investigated whether or not the serum levels of these adhesion molecules in the peripheral venous blood could help predict the clinical staging in patients with NSCLC. METHODS: From January to December 1999, 66 patients (79.5%) underwent either a lobectomy or a pneumonectomy with a mediastinal lymph node dissection at the National Sanatorium Nishi-Gunma Hospital. RESULTS: The sICAM-1 concentration in the NSCLC patients was a mean value of 212.0+/-106.6 ng/ml. In contrast, the concentration of sICAM-1 in 20 healthy controls was a mean value of 117.9+/-64.1 ng/ml. In patients with NSCLC, the sICAM-1 concentrations were significantly higher than in the normal control group (p=0.002). In addition, the difference in the serum concentrations was significant between the patients with T1 and T2 disease (p=0.042), and N0 and N2 patients (p=0.042). No significant differences were observed in aging, smoking history, histological type, or pathological staging. CONCLUSIONS: The sICAM-1 concentrations in lung cancer patients are thus suggested to play a role in staging, and may also serve as a useful indicator of advanced disease.

Adenocarcinoma↗
PubMed2001

Extralobar pulmonary sequestration in the posterior mediastinum.

Extralobar pulmonary sequestration was incidentally detected in a 65-year-old man. Preoperatively, the lesion presented as a posterior mediastinal mass. At operation the mass was found to be attached to the paravertebral region at the level of the seventh thoracic vertebra by a feeding artery originating from the descending aorta. Only two cases of extralobar pulmonary sequestration in the posterior mediastinum have been previously reported.

Aged↗
PubMed2001

Mediastinal lymph node evaluation by computed tomographic scan in lung cancer.

BACKGROUND: Computed tomography (CT) has been widely used for preoperative mediastinal lymph node evaluation in lung cancer. But its accuracy has remained controversial. We studied the predictability of N-staging by CT scan. METHODS: From 1981 to 1996, 546 patients had preoperative CT scan and underwent a surgical resection with mediastinal lymph node dissection for primary pulmonary adenocarcinoma and squamous cell carcinoma. Nodes larger than 1.0 cm at short axis were considered abnormal. The discrepancy between clinical and pathologic findings in N factor was analyzed. RESULTS: Sensitivity (ST), specificity (SP) and accuracy (AC) were 33.0%, 90.4% and 78.9%, respectively. No statistically significant difference in the results is detected for individual years or types of scanning device. There were statistically significant differences as follows: ST and SP by histologic type, SP by gender, SP and AC by tumor size, SP by Brinkman index, ST by tumor location, and AC by serum CEA value. CONCLUSIONS: We should pay attention to false positive nodes in heavy smokers (or males), and positive nodes in adenocarcinoma, tumor larger than 3 cm or rising of serum CEA value, regardless of negative lymph node on CT scan.

Adenocarcinoma↗
PubMed2001

[Mediastinal lymph node carcinoma without apparent primary lesion: report of case].

A 62-year-old man with dyspnea had an enlarged lymph node, 6.5 cm in size in the left hilum, but no primary carcinoma could be found. The patient underwent lymph node dissection under video-assisted thoracoscopic surgery, and the histological diagnosis was undifferentiated carcinoma. No primary lesion has been identified even in postoperative survey. The postoperative course was uneventful with no evidence of recurrence eight months after the operation.

Carcinoma↗
PubMed2001

[Complete transection of the left main bronchus due to a blunt chest trauma: report of a case].

A 62-year-old man was injured in a traffic accident. A chest roentgenogram showed pneumothorax, hemothorax, subcutaneous and mediastinal emphysema, multiple rib fractures, and a shift of the trachea to the right. Bilateral thorax drainage was performed, and air leakage from a left chest tube was observed. A chest computed tomogram demonstrated stenosis and deformation of the left main bronchus. Bronchofiberscopy revealed complete obstruction of the left main bronchus by the left main pulmonary artery. An emergency thoracotomy revealed complete transection of the left main bronchus and laceration. End-to-end anastomosis of the left main bronchus was performed with interrupted 4-0 PDS II suture. The patient was discharged at the 33rd hospital day.

Accidents, Traffic↗
PubMed2001

Sudden death due to rupture of an omental metastatic tumor arising from cardiac angiosarcoma. A case report.

A 32-year-old man underwent surgical excision of a malignant hemangioendothelioma of the heart and received multidisciplinary treatment. Thirty-three months later, he underwent a second surgical treatment for a recurrent tumor of the posterior chest wall of the right thorax. Five months after this surgery (thirty-eight months after the initial surgery), a second recurrent tumor in the right thorax developed. Although radiotherapy and recombinant interleukin-2 were administered, anemia of unknown origin (hemoglobin 6.7 g/dl) developed. The patient died of sudden shock due to a rupture of an omental metastatic tumor. The patient survived for 41 months after the first surgical resection. We present this case because it is the first reported case of sudden death due to bleeding from an omental metastatic tumor, and because our patient was the second-longest survivor after surgical treatment for cardiac angiosarcoma.

Adult↗
PubMed2001

Cerebral arterial air embolism following CT-guided lung needle marking. Report of a case.

We report a case of survival following a temporary cerebral air embolism, which occurred immediately after CT guided lung needle marking. A 24-year-old man was referred to our hospital for resection of a pulmonary nodule. To localize the tumor, lung needle marking under CT guidance was performed. Almost immediately, the patient experienced symptoms of cerebral arterial air embolism. The following day, the symptoms diminished, and a brain CT showed no abnormal lesions. A video-assisted thoracoscopic wedge resection was performed as scheduled, the patient's postoperative course was uneventful, and he was discharged in relatively good condition.

Adult↗
PubMed2001

[Pulmonary embolism following lung resection: a case report and review of the Japanese literature].

A 73-year-old male was admitted to our hospital with an abnormal shadow on a chest X-ray film. Chest CT demonstrated that a tumor shadow measuring 23 x 22 mm in size with pleural retraction was located in the right lower lobe. Transbronchial lung biopsy yielded a diagnosis of primary pulmonary adenocarcinoma. We performed a right lower lobectomy with mediastinal lymph node dissection. The patient suddenly complained of a syncope attack, tachycardia, hypotension, and hypoxemia 2 days after surgery. A perfusion lung scintigram with Tc-99 m macroaggregated albumin demonstrated localized defects at both the left lower lobe and a part of the left upper lobe. Thrombolytic and anticoagulation therapy with urokinase and heparin were immediately started. A postoperative lung scintigram 14 days after the onset of pulmonary thromboembolism showed normal filling of the left lung. The patient was discharged on the 37th postoperative day, and he has been followed up with anticoagulation therapy.

Acute Disease↗
PubMed2000

The clinicopathological significance of preoperative serum-soluble interleukin-2 receptor concentrations in operable non-small-cell lung cancer patients.

BACKGROUND: Serum-soluble interleukin-2 receptor (IL-2R) concentrations have been found to be elevated in cancer patients. However, the importance of this finding in patients with non-small-cell lung cancer (NSCLC) has not been previously established. METHODS: Preoperative serum-soluble IL-2R concentrations were determined in 65 consecutive patients with operable NSCLC. The correlation of preoperative serum-soluble IL-2R concentrations with various clinicopathological features of this cancer was evaluated to clarify the clinical significance of this parameter. RESULTS: Although serum-soluble IL-2R concentrations were not significantly higher in operable NSCLC patients than in normal controls (P = .1180), serum-soluble IL-2R concentrations were significantly higher in patients with stage IIIB or IV disease than in normal controls (P = .0001). The presence of intrapulmonary metastasis was the only clinicopathological feature that was significantly correlated to serum-soluble IL-2R concentration (P = .0004). The sensitivity of serum-soluble IL-2R concentration in identifying the presence of intrapulmonary metastasis was 87.5%; specificity was 75%. CONCLUSIONS: Elevated preoperative serum-soluble IL-2R concentrations in patients with operable NSCLC reflect the occurrence of intrapulmonary metastasis. Preoperative examination of serum-soluble IL-2R concentrations may be valuable in the detection of the intrapulmonary metastasis preoperatively.

Aged↗