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Biomedical subjects

T Goya

Publications and source records attributed to T Goya.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Resection of chondrosarcoma of anterior chest wall with pleural dissemination].

A 52-year-old woman admitted with difficulty of breathing and had an anterior chest wall tumor. Primary lesion of the chest wall tumor invading the inferior one third of sternum, right third to sixth ribs, a part of the right middle lobe, the pericardium and a part of the diaphragma and small nodules on the parietal pleura were resected, and a diagnosis of chondrosarcoma of the right fifth or sixth rib and pleural dissemination of the tumor was established. The defect of pericardium was repaired with artificial dura mater and the defect of bony chest wall was repaired with a double layer of Marlex mesh. Although the resection was palliative because of pleural dissemination, she is now working as a housewife without difficulty of breathing.

Chondrosarcoma↗
PubMed1990

[Completion pneumonectomy--a review of 29 cases].

From 1962 through 1988, a total of 29 consecutive patients had completion pneumonectomy (CP). Indications for initial pulmonary resection were primary lung cancer in 27 patients, metastatic lung tumor in 1, and mediastinal tumor with pulmonary invasion in 1. Indications for CP were lung cancer (including local recurrence, pulmonary metastasis from the first lung cancer, and second primary lung cancer) in 21 patients, complications after initial operations in 7, and pulmonary arterial injury during second operation in 1. Severe adhesion of the residual lung and the hilar structures made operative procedures extremely difficult. Injury of pulmonary arteries occurred in 6 patients. Especially, in cases the left upper lobe had been resected previously, deviation of the lower lobe and hilar adhesion lead to operative difficulty. Post-CP bronchial fistula occurred more frequently in what the bronchi had been dissected at more peripheral level than main bronchus, because of some severe hilar adhesions. Operative mortality was 13.8% (9.5% for second lung cancer, 28.5% for post-operative complication). Five-year survival for patients with lung cancer was 32.9% according to the Kaplan-Meier method. We conclude that the indications for CP are clinically resectable lung cancer and bronchial stenosis with residual pulmonary organic changes following bronhoplastic procedure. Postoperative bronchofistulae should be managed by other operative procedure.

Adenocarcinoma↗
PubMed1990

Resection of tracheal carina for lung cancer. Procedure, complications, and mortality.

We studied 20 patients with lung cancer that invaded the tracheal carina who were operated on during a recent 12-year period. Fifteen patients underwent sleeve pneumonectomy, two had pneumonectomy, one had lobectomy with wedge resection of the carina, and two patients had sleeve resection of the carina followed by reconstruction of the carina. There were two patients with postsurgical stage IIIA lung cancer, 15 with stage IIIB, and three with stage IV disease that involved intrapulmonary metastases. However, the operations of 13 patients were curative resections in which the surgical margin was negative for disease. Sleeve pneumonectomy was performed only in the last 3 years of the study period, after we had confirmed the safety and good results of bronchoplastic surgery by our experience of 100 cases of sleeve lobectomy. Hence, the period of follow-up in this group is too short to assess long-term survival. Eleven patients are alive, three died within 1 month after operation (15%), three died in the hospital beyond 1 month after the operation, and three died after discharge from hospital. Nine of the 11 surviving patients have no evidence of disease 1 month to 2 1/2 years after the operation, but two are alive with supraclavicular lymph node metastases. The 1-year and 2-year survival rates for 17 cases (excluding the three operative deaths) were both 59% by the Kaplan-Meier method. Two different methods were used to adjust the difference of calibers of the trachea and the bronchus. The first method involved the shift of the edge of the cartilagonous portion of the bronchus against the edge of the cartilaginous portion of the trachea and the other involved cutting the tracheal wall as a wedge-shaped piece to shorten the diameter of the tracheal caliber. To prevent complications after resection of the tracheal carina in 11 recent cases with sleeve pneumonectomy, anastomoses were protected by a pedicle fat flap nourished by internal thoracic artery and vein. No postoperative complications of anastomoses developed in any of these cases.

Adult↗
PubMed1990

[Surgical resection of metastatic neoplasms of the lung].

Pulmonary resection for metastatic disease in 341 patients resulted in a cumulative survival rate of 36.6% at 5 years and 26.6% at 10 years with an operative mortality of 0.9%. 5-year survival rate was 44.3% in colorectal carcinoma (n = 85), 36.2% in cervical cancer of uterus (n = 35), 40.6% in renal cell carcinoma (n = 32), 50.3% in breast cancer (n = 23), 50.0% in testicular cancer (n = 16), 17.9% in osteosarcoma (n = 33), 34.1% in soft part sarcoma (n = 38). The patients with resected metastatic pulmonary lesions from colorectal and renal cancer showed a good 5-year survival, and then the survival decreased gradually. On the other hand, the survival for testicular and breast cancer, osteosarcoma and soft part sarcoma decreased rapidly in the first 2 to 3 years, but a plateau was reached. Each primary malignancy should be analyzed individually because of the differences of their biologic behaviors. Significant factors influencing survival were (1) patients selection for pulmonary resection, (2) the biologic growth rate of each primary malignancies, and (3) effectiveness of chemotherapy for primary malignancies. Presumably, a good 5-year survival rate after thoracotomy would be a reflection of a length bias, caused by the biologic behavior of the metastatic pulmonary disease. The true benefit for the surgical approaches to metastatic neoplasm of the lung are still controversial.

Breast Neoplasms↗
PubMed1989

Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up.

Pulmonary resection of metastatic lesions from colorectal cancer was performed in 62 patients, and their cumulative 5-year and 10-year survival rates were 42% and 22%, respectively. The overall median survival was 24 months. The survival curve decrease even after 5 years after pulmonary resection; four of 13 patients who survived more than 5 years subsequently died of metastatic disease and only two patients survived more than 10 years. The number and size of the pulmonary metastases were significantly correlated with postthoracotomy survival. Solitary metastases less than 3.0 cm in diameter were good indicators of favorable postthoracotomy survival. There were no significant differences in survival based on Dukes' classification or location of the primary lesion. Sex, age, disease-free interval between the primary tumor and appearance of metastasis, and extent of pulmonary resection had no influence on survival. It is impossible to say from our experience that surgical resection of pulmonary metastases increased the cure rate. Presumably a good 5-year survival rate after thoracotomy would be a reflection of a length bias caused by the biologic behavior of the metastatic pulmonary lesions.

Colonic Neoplasms↗
PubMed1989

Pleural lavage cytology immediately after thoracotomy as a prognostic factor for patients with lung cancer.

Pleural lavage cytology was examined in 230 lung cancer patients just after opening the chest. There were 16 cases (7.0%) of positive pleural lavage cytology, and the results of pleural lavage cytology were related to the presence of pleural involvement by cancer, microscopical pleural dissemination and lymphatic permeation of the cancer cells. If the cancer involves the pleura or lymphatics of the submesothelial layer, being covered with visceral mesothelium, positive cytology may still be obtained. Pleural lavage cytology at opening of the chest seems to be available as a premonitory indicator for exfoliation and dissemination into the pleural cavity or subpleural lymphatic extension of cancer cells, and it was suggested that positive pleural lavage cytology has an influence on postoperative survival.

Humans↗
PubMed1989

[Stage IV renal cell carcinoma producing alpha-fetoprotein treated with multimodal treatment. A case report].

A 63 year old man, having right renal cell carcinoma which was found after initial symptoms of left supraclavicular tumor and gross hematuria, is presented. The points to note with this case are; (1) An unusual production of alpha-fetoprotein (AFP), (2) Being discovered at a very advanced stage and that the disease progressed rapidly (at initial presentation the patient had lymph nodes metastases from the paraaorta, mediastinum to the left supraclavicular region. Later the patient had a recurrent tumor in the left supraclavicular area and multiple cutaneous metastases), (3) Various modalities of treatment were given (right nephrectomy, abdominal lymph nodes dissection, resection of the supraclavicular and mediastinal lymph nodes metastases, hyperthermia combined with irradiation for the recurrent tumor in the supraclavicular region and systemically adoptive immunotherapy with tumor infiltrating lymphocytes). During this treatment course, the drift of serum AFP showed a good correlation. The possibility of AFP as a tumor marker of renal cell carcinoma in selected cases was presented and the suitability of the treatments performed to this patient was discussed.

Carcinoma, Renal Cell↗
PubMed1989

Ultrasonography of benign gastric ulcers. Characteristic features and sequential follow-ups.

Ultrasonography was performed for 15 patients with gastric ulcers, after tap water ingestion using 5-MHz and/or 7.5-MHz transducers. Sonographic signs of gastric ulcer were classified as gastric wall edema associated with ulcer crater (six cases) and gastric wall edema only (nine cases). The latter nine included two cases of perforation of gastric ulcers that were depicted as gastric wall edema associated with fluid collection. Ultrasonography proved useful for detecting benign ulcerations and can be used to supplement follow-up examinations, but it cannot replace endoscopy and contrast radiography.

Adult↗
PubMed1989

[Brain metastases from carcinomas of the digestive organs--a comparative study with those from pulmonary carcinomas].

During the past 11 years, we have experienced 7 cases of a metastatic brain tumor with the primary lesion in the digestive organs. Their clinical courses were retrospectively compared with those of 19 cases with a brain metastases from pulmonary carcinomas. Leptomeningeal carcinomatosis was found in 2 patients of the former group but none in the latter. Six out of 7 brain metastases in the former group were found to have averaged 13 months before their appearance after the diagnosis of the primary lesion. In contrast, 14 out of 19 patients in the latter group had an onset with symptoms of a brain metastasis. The average survival after intracranial surgery on the metastatic tumor was 174 days for the former group and 268 days for the latter. The prognosis of a brain metastasis from a carcinoma of the digestive organ appears to be extremely probable.

Adult↗
PubMed1989

[Preoperative evaluation of digital subtraction pulmonary angiography in primary lung cancer].

The preoperative evaluation of the resectability for primary lung cancer was studied by using digital subtraction pulmonary angiography (DSA-PAG). Thirty operative cases with primary lung cancer performed DSA-PAG as preoperative test at random for 3 years from June 1985 were subjected in this study. The apparatus used is DSA device (Angiotoron) of a product of Siemens Co., Ltd. The findings obtained by DSA-PAG were retrospectively studied according to the surgical findings, operative modes and postoperative histopathological findings. Moreover, at the same time, usefulness of DSA-PAG was evaluated comparing its findings with preoperative enhanced CT interpretation. The useful findings were obtained in 10 cases of 30 cases (33%). Its contents were 2 cases with invasion of the left atrium, 2 cases with invasion of superior and inferior pulmonary vein, 5 cases with invasion of truncus pulmonary artery and 1 case with interlobar invasion. The findings in all cases were superior to those obtained by the enhanced CT. The decision of operative modes confirming invasion of tumor or metastatic lymph node is one of the important aims of the preoperative test. DSA-PAG can be carried out simply and safely on out-patient basis, additionally, favorable result can be especially obtained in invasion lesions of blood vessels of hilus regions. From the result, informations of regions unknown by preoperative CT were accurately obtained. As a rule, DSA-PAG should be performed by the preoperative routine test of primary lung cancer.

Adenocarcinoma↗
PubMed1989

An esophagobronchopleural fistula successfully treated by a surgical procedure combined with conservative therapy after resection for lung cancer.

The patient was a 43-year-old woman, who had undergone a right middle and lower lobectomy for adenocarcinoma of the lung. An esophagobronchopleural fistula developed two months after the operation. It was treated by a combined procedure consisting of pedicle flap closure of the fistula and thoracoplasty. The esophagobronchopleural fistula recurred two days later, however, and another pedicle flap closure with fenestration of the chest wall were performed in a third operation. A bronchopleural fistula then recurred, after which it was treated by conservative therapy including intravenous hyperalimentation, frequent dressing changes and systemic administration of appropriate antibiotics. It closed spontaneously 23 days after surgery, in spite of this being a very rare but serious complication very difficult to treat and cure. From our experience with this particular case, we recommend, for treating esophagobronchopleural fistulas, proper drainage, antibiotic therapy, intravenous hyperalimentation and packing of the empyema space, together with closure of the fistula using a muscle or pleural flap.

Adenocarcinoma↗
PubMed1989

Electrocardiogram studies on cancer patients treated with OK-432, a streptococcal preparation with potent biological response modifier activities.

The present study was performed to see if OK-432, a useful anticancer agent with potent biological response modifier activities, induces effects on heart due to its nature as a streptococcal preparation. Examination of electrocardiograms of cancer patients treated with a variety of doses and routes of OK-432 has revealed that none of 266 patients examined showed any significant change in electrocardiograms (ECGs) after OK-432 treatments, regardless of their pretreatment heart conditions (normal or abnormal ECGs). Furthermore, these patients did not develop any detectable antibodies against heart muscle, either in serum or deposited on heart tissue. Experimentally, antibodies reactive with human heart tissue became detectable in the sera of rabbits immunized with streptococci in complete Freund's adjuvant, confirming the previous reports. However, the repeated injections of OK-432 without the adjuvant did not induce any detectable antibodies. These results indicate that OK-432 can be used for treating cancer patients with little fear of possible side effects on the heart.

Adult↗
PubMed1989

[Surgical treatment in pulmonary metastases of colorectal cancer].

From 1962 to 1987, 72 patients with primary colorectal cancer underwent surgical treatment for pulmonary metastases. The overall cumulative 5 year survival rate was 41.3%. But the cumulative 1 year survival rate of patients with incomplete resection was 20.0%. Reduction surgery should not be employed. Twenty-nine of 66 patients with complete resection have recurred. The most of first manifested recurrences were in the lung and within 18 months after thoracotomy. This tendency was remarkable in patients with multiple pulmonary metastases and all recurrences of them were within 18 months and 80% were multiple in bilateral lung. Almost all multiple pulmonary metastases seemed to be only one manifestation of generalized metastatic disease. So indication of surgical treatment for them should be cautious. Type of pulmonary resection had no influence on post-thoracotomy survival rate. But in patients with partial resection, 7 recurrences at surgical margin and one recurrence on regional lymph nodes were doubted. Four metastatic lesions less than 3cm in maximum diameter had metastases to the regional lymph nodes. To resect more curatively, lobectomy and systemic lymphadenectomy should be recommended as the standard operation for pulmonary metastases of colorectal cancer.

Adult↗
PubMed1989

[A case report of fibromuscular dysplasia presenting symptoms like moyamoya disease: "string of beads" appearance of the pericallosal artery].

We report a case of fibromuscular dysplasia (FMD) presenting a transient ischemic attack (TIA) like Moyamoya disease. The patient, a 16-year-old woman, had recurrent attacks of right hemiparesis induced by hyperventilation. Neurological examinations revealed no abnormality. Angiography showed severe stenosis of both anterior cerebral arteries at the proximal portion with "string of beads" appearance in the left pericallosal artery, and tubular stenosis of the left internal carotid artery at the level of the second cervical vertebra. Renal artery stenosis was not seen. A cerebral-blood-flow (CBF) study with 133Xe SPECT showed marked reduction of CBF in the left cerebral hemisphere at times of hyperventilation. Extracranial-intracranial bypass surgery was performed and histological examination of the superficial temporal artery (STA) revealed intimal fibroplasia which was compatible with FMD. Postoperative angiography showed good filling of the middle cerebral arteries from the STA. The patient has had no recurrence of TIA for a year since the operation. CBF study showed mild low CBF in the region of the left anterior cerebral arterial circulation at hyperventilation. There is no report of intracranial FMD presenting an ischemic symptom induced by hyperventilation. Clinical diagnosis of Moyamoya disease should be made carefully when extracranial vascular lesion accompanies it.

Adolescent↗
PubMed1988

The importance of surgery to non-small cell carcinoma of lung with mediastinal lymph node metastasis.

In the past 25 years, 1,654 patients with non-small cell cancer underwent resection at National Cancer Center Hospital, Tokyo. A comparative study has been made of 5-year survival of patients who had pulmonary resection with and without mediastinal lymph node dissection. There were 426 patients (25.8% of the total) with N2 M0 disease. Of these, 345 underwent pulmonary resection with mediastinal lymph node dissection. The 5-year survival in this group was 15.9% (T1 N2 M0, 30.0%; T2 N2 M0, 14.5%; and T3 N2 M0, 12.9%). In the remaining 81 patients, who did not have mediastinal lymph node dissection, 5-year survival was 6.7%. Of the 426 patients with N2 M0 disease, 242 were select patients who underwent a curative operation with an overall 5-year survival of 19.2%. Sixty-six of them had squamous cell carcinoma and a 5-year survival of 30.8%; 153 had adenocarcinoma and a survival of 16.0%; 14 had large cell carcinoma and a survival of 12.8%; and 9 had adenosquamous cell carcinoma, and none survived 5 years. To improve the end results, it is important to perform as many curative operations with mediastinal lymph node dissection as possible. Histological cell type and tumor status must be taken into consideration.

Adult↗
PubMed1988

[The role of surgery in the management of patients with small cell lung cancer].

Fifty-seven patients with small cell lung cancer were operated on at the National Cancer Center Hospital, Tokyo, between 1962 and 1986. Twenty-seven patients had oat cell type and thirty had intermediate cell type. The five-year survival rate of patients who were treated before 1979 (the first term) was only 11%, whereas the rate for patients treated after 1980 (the latter term) was 53%. No patient with oat cell type small cell lung cancer, treated in the first term, survived for three years after the operation. However, four patients with oat cell type lung cancer, treated in the latter term, survived for five years or more after surgery. The five-year survival rate of the patients with oat cell type lung cancer, who were treated after 1980, was 64%. The five-year survival rates for patients with intermediate cell type were 20% in the first term and 41% in the latter term. We have introduced CT and echography for the preoperative evaluation of patients and also perioperative intensive chemotherapy. Improvement of preoperative evaluation and intensive chemotherapy have yielded good results.

Adult↗