Biomedical subjects

M Kamiyoshihara

Publications and source records attributed to M Kamiyoshihara.

At least 37 records · Page 2Linked to original sources

PubMed2000

Comparison of two automatic staplers for closing the bronchial stump after pulmonary resection.

The incidence of complications following pulmonary resection using an automatic stapler was studied in 348 consecutive patients. A parallel-jaw stapler with two staple lines was used in group A (133 males, 101 females, mean age 66 years) between 1990 and 1995, and a hinged-jaw stapler with three staple lines in group B (70 males, 44 females, mean age 67 years) in 1995-1997. The incidence of bronchopleural fistula was 0.4% (1 patient) in group A and nil in group B. The incidence of intraoperative air leak requiring interrupted suture closure was 4.7% (11 patients) in group A and nil in group B (p < 0.05). Postoperative bronchopleural fistula did not develop in any of the cases, and there was no mortality. For management of the bronchial stump after pulmonary resection, the newer device firing three rows of staples is superior to the two-row device.

Adult↗

PubMed2000

Sclerosant therapy for delayed cardiac tampo-nade after coronary artery bypass grafting.

A 56-year-old Japanese male with delayed cardiac tamponade which occurred 13 months after coronary artery bypass grafting (CABG) is presented. The patient was admitted to our hospital suffering from dypnea due to cardiac tamponade. Pericardiocentesis yielded a viscous bloody fluid. The patient recovered after continuous drainage followed by an intra-pericardial administration of minocycline hydrochloride. Sclerosant therapy is considered to be a treatment of choice for delayed cardiac tamponade following CABG.

Cardiac Tamponade↗

PubMed2000

[Hyperbaric oxygen as an adjunctive treatment for descending necrotizing mediastinitis: report of a case].

We report a case of 59-year-old man of descending necrotizing mediastinitis (DNM) secondary to peritonsillar abscess. A 59-year-old man with diabetes mellitus was admitted to a local hospital because of cervical swelling related to a peritonsillar abscess. Despite administration of antibiotics, swelling of the neck, dysphagia and dyspnea deteriorated. Therefore he was urgently undergone a tracheotomy and transferred to our hospital by an ambulance. The surgery consisted with neck and anterior mediastinal drainage through neck and cervical collar incision. Culture of drainage fluid showed clostridium difficile. On postoperative day 5, we started hyperbaric oxygen therapy (HBOT). After lavage and HBOT, the patient improved by degrees, and discharged on postoperative day 82. DNM is a rare but serious complication of otopharyngeal and deep neck infection that spreads down to the mediastinum through the cervical-facial planes. Its mortality rate remains high even with aggressive surgical drainage and appropriate antibiotics. Our patient was successfully treated with urgent surgical drainage, antibiotics and HBOT. HBOT might be of great value as an adjunctive management to control this fatal infection.

Anti-Bacterial Agents↗

PubMed2000

[Pulmonary cryptococcosis diagnosed by video-assisted thoracoscopic surgery with CT-guided localization: report of a case].

We report a case of pulmonary cryptococcosis diagnosed by video-assisted thoracoscopic surgery (VATS) with CT-guided localization. A 61-year-old man was admitted to our hospital for the precise diagnosis of a solitary mass in the left upper lung. Because the mass was too small to be detected under VATS, we tried CT-guided localization for surgery. One day before VATS, we placed a marking device besides the lesions after percutaneous puncture. We used a Naruke point marker as a marking device. After this procedure, the wedge resection was performed. The pathological diagnosis was cryptococcosis of the lung. The identification of small lesions in the lung has frequently been detected by helical and thin slice CT. Therefore, CT-guided localization procedure may be the most reliable technique to employ before surgery.

Biopsy↗

PubMed2000

Long-term results after pulmonary resection in elderly patients with non-small cell lung cancer.

BACKGROUND: The number of elder by patients with lung cancer is expected to increase. But, there was no report that 10 years completely passed in surgically treated elderly patients (E-pts). This study assesses late results of surgery. METHODS: From 1981 to 1987, 160 patients with non-small cell lung cancer underwent lobectomy or pneumonectomy with mediastinal lymph node dissection. Of these, 37 (23%) were 70 years of age or older. The outcome of this group was compared with that of 123 non-elderly patients (NE-pts). RESULTS: There were no significant differences in the background between E-pts and NE-pts. Five- and 10-year survivals in the E-pts were 35.1%, and 24.3%, respectively. In outcome more than 5 years from operation, E-pts had a significantly poorer prognosis than NE-pts (p=0.04) by any causes of death, but a similar prognosis by primary death. E-pts died of nontumor-related death significantly more than NE-pts (p=0.6). CONCLUSIONS: This study showed that E-pts could consummate their lives completely. Additionally, when long-term prognosis of the postoperative E-pts was discussed, we should contemplate that E-pts had more deaths from nontumor-related causes.

Adolescent↗

PubMed2000

[Surgical treatment of bronchial carcinoid: report of seven cases].

Seven patients with pulmonary carcinoid including three with typical carcinoid and four with atypical carcinoid were reported. There were 3 males and 4 females, with an age range of 37 to 80 years. All patients with typical carcinoid had pathological stage I. Of the patients with atypical carcinoid, one patient had stage I, two stage IIIA and one stage IIIB. All but two patients underwent lobectomy and mediastinal lymph node dissection. Bronchoplastic operation or right pneumonectomy were performed in the two patients. All but one patient underwent absolute or relative curative operation. Only one patient died on the 4th postoperative day. One patient with atypical carcinoid died of cancer recurrence 4 years after surgery. One patient died of breast cancer. One patient underwent surgery for metachronous multiple lung cancer, and he is doing well without recurrence. In conclusion, a limited operation is thought to be acceptable only in patients with typical carcinoid in a peripheral lesion without lymph node metastasis. Lobectomy and mediastinal lymph node dissection is necessary for the atypical carcinoid case.

Adult↗

PubMed2000

[Evaluation of TNM classification for lung carcinoma with satellite nodules in the same lobe as the primary].

We conducted a validation of the treatment of satellite nodules in the UICC TNM classification of 1997. Over the past 17 years (1981 to 1997), 29 patients underwent complete pulmonary resection for primary lung cancer accompanied by satellite nodules in the same lobe as the primary. All these patients were categorized as stage IIIB according to the current staging system. The five-year survival rate of all patients was 40% and the figure was unduly better for stage IIIB patients. The three-year survival rate of 20 patients having lymphatic involvement were 18%, but those of 9 patients without it was 89%. Outcome was significantly influenced on their presence or absence of lymph node metastases. The current staging system for patients with satellite lesions in the same lobe appears to be unacceptable because they provide the different influences on prognosis and selecting treatment modality according to the N status.

Adult↗

PubMed2000

Management of ipsilateral intrapulmonary metastases in the new TNM system for non-small cell lung cancer.

BACKGROUND: Recently, the Union Internationale Contre le Cancer and American Joint Committee on Cancer reclassified not only TNM staging but also ipsilateral intrapulmonary metastases (PM) as T4 in a same lobe or M1 in different lobes. To determine whether the new PM staging is appropriate, we studied the prognosis of PM. METHODS: From January 1981 to October 1997, we performed a lobectomy or pneumonectomy with mediastinal lymph node dissection, and had 42 patients with PM. We analyzed the postoperative prognosis of the patients with ipsilateral PM compared with the same stage group without PM (the non-PM). RESULTS: In the previous classification of PM (the old PM), 2 patients were categorized as stage IIA, 9 as IIB, 17 as IIIA, and 14 as IIIB. After reclassification (the new PM), 37 patients were categorized as stage IIIB, and 5 as IV. The old PM stage IIIA group had a significantly poor prognosis compared with the non-PM stage IIIA. However, the prognosis of the new PM group was compatible with that of the non-PM. None of the other staging group had a significant difference in the prognosis. CONCLUSIONS: The management of PM in the new TNM system for non-small cell lung cancer is appropriate.

Adenocarcinoma↗

PubMed1999

Fibromyxoma of the rib: report of a case.

We present herein the case of a 36-year-old man with fibromyxoma of the rib. At the age of 33 years, an abnormal shadow of the chest was found on a radiographic examination, subsequent to which the mass grew slowly into the intrathorax, and he was referred to our hospital. An X-ray film and computed tomography scan on admission showed an extrapleural mass, 7 x 5 cm in diameter, in the left sixth rib with no evidence of destruction, cortical expansion, or rupture. The patient underwent peripheral osteotomy of the sixth rib, which was resected with a 3-cm margin around the mass. Microscopically, a diagnosis of fibromyxoma was confirmed. To the best of our knowledge, this is the first reported case of fibromyxoma originating in a rib.

Adult↗

PubMed1999

Pulmonary small cell carcinoma associated with sarcoid reactions: report of a case.

A 45-year-old male was admitted to our hospital for investigation of a nodular shadow in segment 5 of the right lung on a chest computed tomogram. A right middle lobectomy with mediastinal lymph node dissection was performed under a diagnosis of lung cancer, and histologic examination confirmed small cell carcinoma. There were sarcoid reactions in the resected lymph nodes and the lung parenchyma, but no signs of systemic sarcoidosis were evident. Sarcoid reactions are rarely observed in the regional lymph nodes draining malignant tumors. Moreover, while they are most common in squamous cell carcinoma of the lung, they extremely rare in small cell carcinoma. To our knowledge, this is only the third report of this unusual entity in the English and Japanese literature.

Carcinoma, Small Cell↗

PubMed1999

Basaloid carcinoma of the thymus.

A 58-year-old man was found to have a basaloid carcinoma of the thymus, initially detected as an abnormal shadow on chest radiograph. The patient underwent resection followed by radiotherapy, and has survived 25 months without recurrence. Although this rare tumor may be related to multilocular thymic cyst, its pathogenesis is obscure. We discuss clinicopathologic features of our case and others.

Carcinoma, Transitional Cell↗

PubMed1999

Primary pulmonary collision tumor including squamous cell carcinoma and T-cell lymphoma.

We report a very rare occurrence of a primary collision tumor in the lung consisting of squamous cell carcinoma and T-cell lymphoma. A squamous cell carcinoma was diagnosed histologically following a transbronchial lung biopsy in a 71-year-old woman, but the other component was diagnosed histologically and immunohistochemically only on examination of the resection specimen. The malignant lymphoma was stained by the monoclonal antibody UCHL-1 (anti-D45RO) against T-lymphocytes but was not stained by the L26 (anti-CD20) antibody against B-lymphocytes. Immunostaining for CD3 was positive, confirming a T-cell lineage. Despite systemic chemotherapy, the patient died 7 months after operation, from progression of the lymphoma. Our case, which illustrates interesting attributes of collision tumors, consisted of an ordinary squamous cell carcinoma and a rare T-cell lymphoma arising in the lung, with the latter part of the combination dictating subsequent treatment and outcome.

Aged↗

PubMed1999

Does an incomplete interlobar fissure influence survival or recurrence in resected non-small-cell lung cancer?

OBJECTIVE: There have been various reports on prognostic factors in non-small-cell lung cancer (NSCLC) under a complete resection, but an incomplete interlobar fissure has not been discussed yet. We attempted to clarify whether this influences survival or recurrence. PATIENTS AND METHODS: From 1981 to 1994, 239 patients (43%) who had a single lobectomy with mediastinal lymph node dissection were pathologically diagnosed as stage IA/IB or IIA/IIB (excluding T3N0M0). These patients were divided in two groups: patients with a complete interlobar fissure group (group L); and patients with an incomplete one (group NL). Postoperative survivals and cancer-free periods were retrospectively assessed. Patients' characteristics had no statistical difference between groups L and NL by N category. RESULTS: The 5-year survival was 77.0% in group L-N0, 79.3% in group NL-N0, 48.7% in group L-N1, and 66.2% in group NL-N1. No statistical difference was found between groups L-N0 and NL-N0, L-N1 and NL-N1, L-T1N0 and NL-T1N0, L-T1N1 and NL-T1N1, L-T2N0 and NL-T2N0, and L-T2N1 and NL-T2N1. The 5-year-relapse-free survival was 81.2% in group L-N0, 85.4% in group NL-N0, 69.4% in group L-N1, and 72.2% in group NL-N1. No statistical difference was found between groups L-N0 and NL-N0, L-N1 and NL-N1, L-T1N0 and NL-T1N0, L-T1N1 and NL-T1N1, L-T2N0 and NL-T2N0, and L-T2N1 and NL-T2N1. There was no statistical difference in recurrent sites between groups L-N0 and NL-N0, and L-N1 and NL-N1. CONCLUSION: We conclude that the incomplete interlobar fissure does not influence the prognosis of resected stage I or II NSCLC (excluding T3N0M0).

Adult↗

PubMed1999

Carbon dioxide insufflation aids video-assisted thoracic surgery in a young child.

A 3-year-old girl with pectus excavatum successfully underwent exploration using video-assisted thoracic surgery. A complete pericardial defect was identified. The lung was kept totally collapsed during the procedure using low-flow (1 L/min), low-pressure (7 mmHg) carbon dioxide insufflation. This technique is expected to be a safe adjunct to thoracoscopic procedures in infants and small children.

Carbon Dioxide↗

PubMed1999

Management of malignant pericardial effusion resulting from recurrent cancer with local instillation of aclarubicin hydrochloride.

To determine the efficacy of aclarubicin hydrochloride in local control of malignant pericardial effusion, the authors carried out a trial of pericardial drainage with local administration of this agent in five patients, whose effusions had produced cardiac tamponade. All patients were women, and their primary cancers, all initially treated surgically, had arisen in the breast (two patients), or lung (three patients). Mean patient age was 54.2 years (range, 43-62). In four patients, improvement permitted removal of the drainage catheter. Two patients (40%) had a complete remission of the malignant pericardial effusion. The other three patients were difficult to evaluate because nonpericardial metastases limited their survival. All patients, however, showed disappearance of malignant cells from the pericardial sac with no cytopathologically demonstrable recurrence. In our few patients, intrapericardial aclarubicin appeared to be highly effective against malignant pericardial effusion.

Aclarubicin↗

PubMed1999

[Intrapulmonary lymph node detected as a small coin lesion: a case report and a review of the Japanese literature].

Intrapulmonary lymph node (IPLN) is commonly identified to the level of fourth-order bronchi and is seldom recognized on a plain chest roentgenogram. We experienced a case of intrapulmonary lymph node, and presented a review of the Japanese literature. A 52-year-old female without a smoking history was discovered to have a coin lesion in a mass screening chest roentgenogram. A Chest CT scan showed a small peripheral nodule in segment 9 of the left lung. Malignancy could not be ruled out and an exploratory thoracotomy was performed, and the definite diagnosis was IPLN. We have encountered more frequent detection of small peripheral pulmonary nodules because of increasing availability of chest CT scans. Although reports of IPLN are rare, it should be considered as one of differential diagnoses for benign or malignant pulmonary nodules.

Female↗

PubMed1999

[Retroperitoneal lipoma through the foramen of Bochdalek detected as a mass of chest roentgenogram: report of a case].

Retroperitoneal lipomas are relatively uncommon. They are generally asymptomatic tumors. We experienced a 70-year-old man who had retroperitoneal lipoma detected as a mass of chest roentgenogram. Transcutaneous needle biopsy yielded a diagnosis of lipoma. We performed surgical resection because the tumor was growing. The complete resection of the tumor was done uneventfully. The pathological diagnosis of the tumor was benign mature lipoma. The sagittal view of the chest MRI gave precise and useful anatomical informations. This tumor was considered to originate from the retroperitoneal fatty tissue at the subdiaphragmatic region and to extend into the posterior mediastinum though the foramen of Bochdalek. We present herein this case because of a unique growing form, which is the first report in the Japanese literature to our knowledge.

Aged↗

PubMed1998

Resection of pulmonary metastases in six patients with disease-free interval greater than 10 years.

BACKGROUND: The relationship between disease-free interval (DFI) and prognosis has been discussed; however, there is little information on long-term DFI. In this study, we surveyed the cases of pulmonary metastases with DFI greater than 10 years. METHODS: Between January 1980 and December 1995, we saw 6 patients with DFI greater than 10 years. All the patients had a histopathologic diagnosis of pulmonary metastases based on surgical resection, and the patients' characteristics and clinical course were reviewed. RESULTS: The median age was 63 years. Primary sites were breast in 2 patients, and one case each of skin, colon, thyroid, and bladder. The numbers of metastases were one in 4 patients and two in 2 patients. The median DFI was 134 months (range, 127 to 235 months). The median tumor-doubling time was 227 days (range, 80 to 815 days). All the patients underwent a lobectomy. Three patients with metastases from the bladder, colon, and breast died of recurrence. One patient with metastasis from the thyroid died of heart failure. Two patients with metastases from breast and skin cancer survived for more than 3 years. CONCLUSIONS: Early death occurred regardless of the long DFI, suggesting that intensive follow-up is mandatory for patients with DFI greater than 10 years.

Adenocarcinoma↗