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Biomedical subjects

O Kawashima

Publications and source records attributed to O Kawashima.

72 records · Page 4Linked to original sources
PubMed1995

Intratracheal stent intubation under extracorporeal lung assist.

An artificial stent was intubated using extracorporeal lung assist (ECLA) in two patients with inoperable tracheal stenosis. In a patient with an endotracheal tumor, an airway obstruction due to a partial stent collapse was overcome by an immediate ECLA perfusion. In another patient with chronic inflammatory tracheal stenosis, a repetitive balloon dilation of the trachea could be safely performed utilizing ECLA perfusion. Preventive femoral cannulation, employing the assistance of an ECLA circuit, is thus considered to be a safe and effective procedure for the treatment of inoperable tracheal stenosis.

Adult↗
PubMed1995

[Myasthenia gravis: an analysis of patients with postoperative crisis after thymectomy].

Five patients with myasthenia gravis whose condition declined during the postoperative unstable period were studied. The Osserman's type, age at the time of onset, duration of illness, sex, age at the time of surgery, preoperative steroid therapy, thymoma and acetyl choline receptor antibody titers were compared with those of 21 patients (control) with myasthenia gravis who had an uneventful postoperative course. In comparison, the study group's Osserman's type was slight, age at the time of onset was older (p < 0.05) and duration of illness was shorter (p < 0.05). There was no significant difference between the groups in sex, age at the time of surgery, thymoma and acetyl choline receptor antibody titers. None of them had preoperative steroid therapy. Intensive postoperative management and careful follow-up at the postoperative unstable period are necessary particularly for patients who have slight Osserman's type, old age at the time of onset, short duration of illness and no preoperative steroid therapy.

Adolescent↗
PubMed1995

Pulmonary epithelioid hemangioendothelioma: a case report.

A 45-year-old woman whose x-ray film revealed multiple widespread bilateral small nodules was diagnosed as having pulmonary tuberculosis or metastatic pulmonary cancer. A conclusive histological diagnosis of pulmonary epithelioid hemangioendothelioma (PEH) was made following an open-lung biopsy. PEH is a progressive disease that probably originates from an endothelial cell. However, there is still no effective therapeutic modality for PEH. The postoperative course of our patient has been uneventful with no evidence of tumor growth for four and a half years after initial x-ray detection of the lesions.

Biopsy↗
PubMed1994

An autopsy case of pseudosarcoma of the common bile duct.

An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to our hospital; he was examined by abdominal ultrasonography (US), revealing biliary calculus, dilatation of the common bile duct, and choledocholithiasis, considered to be the possible cause of the obstructive jaundice. Endoscopic retrograde biliary drainage (ERBD) and cholangioscopy were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complications of the liver, infection, and disseminated intravascular coagulation (DIC). An autopsy study revealed tumor cells with extreme pleomorphic changes, growing diffusely, very like sarcoma. Further examination revealed epithelioid arrangements in the metastatic lymph node. Twelve kinds of immunohistochemical examination showed a positive reaction, reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japanese literature, only 1 case was reported, in 1990, to involve the common bile duct. We therefore report the present case of pseudosarcoma of the common bile duct.

Aged↗
PubMed1994

[Surgical repair of an extreme type of tetralogy of Fallot using valved extracardiac conduit].

Three patients with an extreme type of tetralogy of Fallot underwent corrective surgery using the valved extracardiac conduit for reconstruction of the main pulmonary arteries. The conduit consisted of bicuspid valve which was made of heterogeneous pericardium of 18 or 20 mm in diameter. The conduit was sutured to the pulmonary artery followed by an end-to-end anastomosis between the conduit and a Dacron tube which was sutured to the right ventricular outflow tract. Postoperative echocardiography showed little pulmonary regurgitation. Postoperative courses of all the patients have been uneventful.

Blood Vessel Prosthesis Implantation↗
PubMed1994

[Thoracotomy for patients with bronchial asthma].

We discussed the perioperative management in three patients with bronchial asthma who underwent thoracotomy. The management was as follows: 1. theophylline and steroid agents were preoperatively given till wheezing disappeared, 2. just before surgery, theophylline or beta-stimulator and steroid agents were given, 3. during surgery, aminophylline and steroid agents were given and bronchodilative anesthetics were inhaled, 4. steroid agents were postoperatively applied sufficiently so that signs due to bronchial asthma don't appear. Preoperative respiratory conditions improved with disappearance or decrease of wheezing, and resection of giant bulla and lobectomies with radical mediastinal lymph node dissection were safely possible with no evidence of the side effects due to steroid administration. The perioperative sufficient suppression of airway-tract hyperactivity is very important for thoracotomy in patients with bronchial asthma.

Adult↗
PubMed1993

Abnormalities of ADP/ATP carrier protein in J-2-N cardiomyopathic hamsters.

ADP/ATP carrier protein (AAC) is located in the mitochondrial inner membrane and has an important function in mitochondrial energy supply. This protein transports ATP to the cytoplasm and counter transports ADP into the mitochondria. J-2-N cardiomyopathic hamsters were investigated to determine the AAC content in cardiac mitochondria. After recording an electrocardiogram and collecting blood, the cardiac mitochondria were isolated. The mitochondrial membranes were labelled with eosin-5-maleimide (EMA) and separated on SDS polyacrylamide gels. The position of the AAC component was identified by exposing the gel under UV light, and the AAC content was determined by densitometry after staining with Coomassie blue. The AAC content ratio was significantly decreased in both 10-week-old and 1-year survived J-2-N hamsters when compared to control Golden hamster. Among 10-week-old J-2-N hamsters, the decrease in the AAC content ratio was more marked for the animals with more severe myocardial damage. The H(+)-ATPase activities of mitochondrial membrane were higher in 10-week-old J-2-N hamsters than in control hamsters. These results suggest that the decrease of AAC in J-2-N hamster plays an important role in the pathogenesis of cardiomyopathy in J-2-N hamsters.

Animals↗
PubMed1990

Malignant mesenchymoma of the larynx.

A case report of a primary laryngeal malignant mesenchymoma, a very rare head and neck and even rarer laryngeal lesion, is reported. In this case, an 85-year-old man, who had undergone several panendoscopies and biopsies that were non-diagnostic, subsequently succumbed to pulmonary metastases and died from respiratory failure. At autopsy, tumour cells were demonstrated to constitute both bone and striated muscle cell types. As the tumour cells differentiated into two types of specialized cells from one type of embryonal tissue, the diagnosis of malignant mesenchymoma was established.

Aged↗
PubMedDate not supplied

PEEP therapy for patients with pleurotomy during coronary artery bypass grafting.

Severe pulmonary oxygenation impairment resulting from peripheral lung atelectasis occurred in some patients with pleurotomy during the harvest of the internal mammary artery graft followed by coronary artery bypass grafting (CABG). We studied the efficacy of intraoperative positive end-expiratory airway pressure (PEEP) therapy for the prevention of postoperative pulmonary oxygenation impairment. A total of 66 patients with solitary CABG procedure were included in this study. The pleural cavity was intraoperatively opened in 44 patients and not opened in 22. PEEP therapy was not used in any patient before May 1996 (referred to herein as the former period) and was used more recently in eight patients with pleurotopmy (referred to herein as the latter period). PEEP was initiated immediately after pleurotomy during the harvest of the internal mammary artery graft. Without PEEP therapy, values of PaO2, A-aDO2, and respiratory index (RI) were worse in patients with pleurotomy than in those without pleurotomy. Meanwhile, there were no major differences in these values between patients with or without pleurotomy after the induction of PEEP therapy. Respiratory insufficiency (A-aDO2 > 400 mmHg and RI > 1.5) was detected in six patients with pleurotomy in the former period. Three of these six patients required over 1 week of long-term mechanical respiratory support. No respiratory insufficiency occurred in patients of the latter period. In conclusion, PEEP therapy, which is initiated just after pleurotomy, may prevent oxygen impairment and pulmonary atelectasis after extracorporeal circulation (ECC) and is recommended for patients with pleurotomy, especially for patients with preoperative low respiratory function.

Aged↗
PubMedDate not supplied

The surgical treatment of metastatic tumors in the lung: is lobectomy with mediastinal lymph node dissection suitable treatment?

From January 1981 through October 1995, a total of 28 patients underwent surgery for metastatic lung tumors in our institute. A retrospective review and survival analysis of these patients are reported. There were 12 males and 16 females, with the mean age of 57 years. Of them, 20 patients had solitary lesions. Pulmonary metastasis was from the colon in 8 patients, from the breast in 5, from the stomach and the uterus in each 3, from the bladder, the rectum and the soft tissue in each 2, and from the kidney, the ovarium and the thyroid in each 1. A lobectomy was performed in 22 patients, 17 of whom were accompanied with mediastinal lymph node dissection (R2a). Partial resection without lymph node dissection was performed in 6 patients (R0). Overall 5-year survival was 24.7%. Four-year or over survivor were 4 patients who underwent a lobectomy with R2a. The patients undergoing lobectomy had a significantly better prognosis compared with patients with partial resection (p<0. 05). The patients with R2a had significantly less local recurrence than patients with R1 or R0 (p<0.05). We conclude that lobectomy with R2a is suitable treatment for metastatic lung cancer.

Adult↗
PubMedDate not supplied

Low-grade malignant tumors of the lung: is lymph node dissection necessary?

Low-grade malignant tumors (LGMT) of the lung were surgically treated in our institute between 1981 and 1997. Both the characteristics and prognosis were examined. We studied 10 cases with LGMT of the lung, male to female ratio 1:1, age range 15 to 71 years, mean 55 years, 6 central and 4 peripheral. Five patients had lobectomy, 3 had sleeve lobectomy and 2 had bilobectomy. Pathologically, 5 samples were typical carcinoid, 3 were mucoepidermoid carcinoma and 2 were adenoid cystic carcinoma. None of the patients had lymph node metastasis. Nine patients were stage I and one stage IIIA. Seven patients underwent absolutely curative resection; 2, relatively non-curative resection; 1, non-curative resection. In preoperative examination, only 4 patients was diagnosed correctly and the others were misdiagnosed. Mean survival time was 167.5 months. One patient died from causes other than the primary cancer and the others are surviving (range 2-173 months). The LGMT group was significantly younger and had a significantly better prognosis compared with the control group (p=0.02). Mediastinal lymph node dissection is suggested to be omitted. However, further accumulation of cases is necessary regarding to the omission of lymph node dissection.

Adolescent↗
PubMedDate not supplied

A clinicopathologic study of the resected cases of adenosquamous carcinoma of the lung.

Ten cases of surgically resected adenosquamous carcinoma of the lung were studied clinicopathologically, and their outcome was compared with that of adenocarcinomas and squamous cell carcinomas of the lung. The frequency rate of adenosquamous carcinoma was 1.5% of 668 primary lung cancers resected in our hospital. The survival curves of patients with adenosquamous carcinomas, adenocarcinomas, and squamous cell carcinomas indicated that the outcome of adenosquamous carcinoma was statistically poorer than that of adenocarcinoma (p=0. 01), and tended to be poorer than that of squamous cell carcinoma (p=0.051). The amount of adenocarcinoma component did not affect the survival rate. Five-year survival was not obtained in this series. Although our series is small, this study suggests that adenosquamous carcinoma of the lung is an aggressive tumor with poor prognosis.

Adenocarcinoma↗
PubMedDate not supplied

Results of tracheobronchoplasty for bronchogenic carcinoma.

Tracheobronchial reconstruction is a safe and effective procedure for patients with the neoplasms of low grade malignancy and bronchogenic carcinoma. We present herein a series of 18 cases that had tracheobronchial reconstruction, and discuss a postoperative complication and prognosis. From 1981 to 1997, 18 patients (2.8%) of 647 cases had tracheobronchial reconstruction with mediastinal lymph node dissection. The average age of the 13 males and 5 females, was 61 (range 51-72) years. We analyzed clinical features, postoperative complication and prognosis. Seventeen patients underwent sleeve lobectomy and one lobectomy with carinal reconstruction (Barkley's montage type). There were 13 squamous cell carcinomas, and one each of adenocarcinoma, typical carcinoid, adenoid cystic carcinoma, mucoepidermoid carcinoma and undifferentiated carcinoma. Stage was IA in 3, stage IB in 6, stage IIB in 3, stage IIIA in 5, and stage IIIB in 1 patient. Curative resection was achieved in 11 patients and non-curative resection in 7 patient who had radiotherapy. Six patients (33.3%) had postoperative complications. Five-year survival and mean survival time were 92.3% and 126 months, respectively. Tracheoplasty group had significantly better prognosis than pneumonectomy group or lobectomy group (p<0.01). This study suggests that tracheobronchoplasty is a more useful procedure than pneumonectomy for lung cancer.

Adenocarcinoma↗
PubMedDate not supplied

Early stage primary pulmonary lymphoma.

Because of the rarity of its occurrence, there is no established treatment for early stage primary pulmonary lymphoma. We retrospectively examined five patients with early stage primary pulmonary lymphoma to elucidate the optimal treatment for this unusual disease. All patients underwent complete resection with regional lymph node dissection. Lymphatic and blood vessel invasion were pathologically detected in all cases. All four patients with postoperative chemotherapy are alive without recurrence. One patient who did not undergo chemotherapy had an extrapulmonary recurrence 21 months after operation. The combined therapy of complete resection and postoperative chemotherapy may be the treatment of choice for this unusual disease.

Aged↗
PubMedDate not supplied

Sarcoid reactions in primary pulmonary carcinoma: report of seven cases.

In a consecutive series of 326 patients with primary lung cancer, sarcoid reactions were observed in the regional lymph node or resected lung in 7 patients (2.2%). The average age of the 7 patients, 4 males and 3 females, was 54 years, range 45-70. All the patients underwent lobectomy. The sites in which sarcoid reactions were found were the regional lymph node (N) in 3 patients, the lung parenchyma (L) in 2, N and L in 1, and the tumor stroma in 1. The histologic types were adenocarcinoma in 4 patients, squamous cell carcinoma in 2, and small cell carcinoma in 1. Two patients died of recurrence and myocardial infarction, and five patients are alive, range 5-64 months. The patients with lung cancer complicating sarcoid reactions were significantly younger than the control group (p<0.01), and not significant in prognosis. We conclude that the complication of sarcoid reactions do not influence the prognosis, but that the sarcoid reactions may be a local reaction or resistance to cancer cells.

Adenocarcinoma↗