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Biomedical subjects

T Motohara

Publications and source records attributed to T Motohara.

At least 19 recordsLinked to original sources

Portal venous tumor thrombus associated with hepatic metastasis of renal cell carcinoma: case report.

We report a case of liver metastasis of renal cell carcinoma with portal venous tumor thrombus. Abdominal computed tomographic images showed a large hepatic mass that enhanced slightly during arterial phase. Multiple hypoattenuating lesions were seen in the intrahepatic portal venous branches and were traced directly from the mass. The histologic specimen confirmed metastatic liver tumor of renal cell carcinoma with portal venous tumor thrombus.

Adult↗

Severe aplastic anemia associated with thymic carcinoma and partial recovery of hematopoiesis after thymectomy.

Aplastic anemia has been a rare complication of thymic tumors documented in only a few cases. We now report that a previously healthy, 72-year-old woman had a well-differentiated squamous cell thymic carcinoma and severe aplastic anemia, as detected on a simultaneous basis. After extirpation of the thymic carcinoma, hematological recovery was achieved. While cyclosporine (CyA), prednisolone (PSL), and methenolone improved hematological data even more, a partial and stable remission has been sustained for 22 months. The patient's serum prior to the surgery had a suppressive effect on the formation of colonies of erythroid and nonerythroid colonies, as determined using the patient's bone marrow cells and compared with the patient's serum after the surgery and normal AB serum. This case report concerns a patient in whom we observed simultaneous occurrence of a thymic tumor and a sever marrow aplasia for which we describe our therapeutic approach.

Aged↗

Augmentation of the pharmacological action of corydalis tuber by saussurea root in isolated mouse ileum.

To understand the meaning of blending crude drugs in Chinese medicinal prescriptions, the influence of Saussurea root on the pharmacological action of Corydalis tuber was examined. Saussurea root increased the depression of acetylcholine-induced contraction caused by the hot water extract solution of Corydalis tuber in mouse ileum at low dosage, which showed no direct influence on acetylcholine. Dehydrocostuslactone in Saussurea root was characterized as the component having increasing activity and the relationship between the concentration of acetylcholine and the variation in the contraction depressed by Corydalis tuber alone or a mixture of the Corydalis tuber and dehydrocostuslactone was investigated for clarification of the mode of action.

Acetylcholine↗

[Surgery for intrathoracic recurrence of non-small cell lung cancer].

In this study, we defined a solitary lung nodle in the same histology which could be traced its' origin from carcinoma in situ or was found over than two years' follow up as a second primary lung cancer. These cases were excluded. Eighteen cases underwent second surgery for intrathoracic recurrence. Fourteen cases were male and four cases were female. Their ages ranged from 23 to 75 (average 59.6) years. The histology were adenocarcinoma in 9 cases, squamouscarcinoma in 7, adenosquamous carcinoma in 1, large cell carcinoma in 1. The initial surgical procedures were lobectomy in 17, partial resection in 1. The initial stage were I in 13, II in 2, IIIA in 1. Pulmonary recurrence were found in 10, bronchial stump recurrence were found in 4, pulmonary hilus lymph node recurrence were found in 2, mediastinal lymph node recurrence were found in 2, pulmonary stump recurrence was found in 1. The second surgical procedures were completion pneumonectomy in 7, completion lobectomy in 1, lobectomy with segmentectomy in 1, segmentectomy or partial resection in 7, mediastinal dissection in 2. The overall 5-year survival rate of the patients with recurrence after reoperation was 31.8%. An aggressive surgical approach for recurrent lung cancer should be recommended.

Adult↗

Case of retroperitoneal dedifferentiated mixed-type liposarcoma: comparison of proliferative activity in specimens from four operations.

In a case of retroperitoneal dedifferentiated mixed-type liposarcoma, a dedifferentiated component was observed in the so-called mixed-type liposarcoma consisting of well-differentiated and myxoid components. The proliferative activity was compared among the different components of the tumor by immunohistochemical study using the proliferating cell nuclear antigen (PCNA) and MIB-1 monoclonal antibodies. The dedifferentiated component showed higher positivity than the well-differentiated and myxoid components, and tumor progression was most advanced in the dedifferentiated component. In the chronological examination of each component, the labeling indices of PCNA and MIB-1 were significantly higher at the third recurrence than in the primary lesion in all types, indicating that the proliferative activity of the tumor cells increased gradually. Considering the surgical treatment of liposarcoma, an extended resection encompassing normal adjacent tissues is required in cases containing the dedifferentiated component in comparison to the cases containing only well-differentiated or myxoid components.

Antibodies, Monoclonal↗

A case of pseudosarcoma associated with type 3 squamous cell carcinoma of the esophagus: report of a case.

A case of a primary esophageal pseudosarcoma associated with an independent type 3 tumor is described herein. A 60-year-old male presented with dysphagia and chest discomfort. A clinical evaluation revealed a type 3 tumor in the middle of the esophagus, which was diagnosed after a biopsy to be squamous cell carcinoma (SCC). A subsequent gross examination of the subtotally removed esophagus revealed a polypoid tumor adjacent to the type 3 tumor. Histologically, the polypoid mass was composed of SCC and mesenchymal components without a transitional zone. The tumor was thus classified as a pseudosarcoma of the esophagus, and was unique in that this appeared to have developed independently from the SCC.

Carcinoma, Squamous Cell↗

Ga-67 tumor scan in malignant diffuse mesothelioma--comparison with CT and pathological findings.

Malignant diffuse mesothelioma is characterized by more difficult diagnosis and worse prognosis than other pleural tumors. In the Department of Thoracic Surgery, Hyogo Medical Center for Adults, 11 patients underwent panpleuropneumonectomy for this disease between January, 1988 and March, 1993. In 7 of these cases, Ga-67 scans were obtained before the operation. To clarify the factors affecting Ga-67 uptake in the pleural tumor, we compared Ga-67 uptake on the involved side of the thorax with CT and the pathological findings of the tumor. Regarding the use of Ga-67 scan imaging for the diagnosis of this disease, a number of related findings must be considered, such as an encircled wide Ga-67 uptake in the thickened pleural involvement and a diffuse slight Ga-67 uptake on the affected side with very slight involvement of the pleura. When the involved pleural thickness was over 6 mm, a definite correlation was found between the degree of Ga-67 uptake and the macroscopic thickness of mesothelioma in resected specimens. Thickness of the pleura on CT images demonstrates the real tumor thickness in the case of thickened involvement but in the case of thin involvement the real thickness of active mesothelioma could not be identified. No definite correlation was found between the degree of Ga-67 uptake and the histological type, or among microscopic findings, such as the extent of tumor parenchyma, interstitial volume and tumor vascularity. Our results suggest that the Ga-67 scan is very useful for revealing the extent of pleural involvement, especially when this involvement is more than 6 mm thick.

Adult↗

[A case report on surgery for chylothorax after anterior spinal fusion: usefulness and effectiveness of intraoperative milk administration and postoperative OK-432 administration].

A 75-year-old man of chylothorax after anterior spinal fusion successfully underwent thoracoabdominal operation in order to ligate chyloleakage. Not only preoperative milk intake but also intraoperative administration of milk through nasogastric tube was useful for identification of the site of leakage. OK-432 was administered through locally placed and chest tube after operation, after which residual chyloleakage was stopped. lntraoperative administration of milk through nasogastric tube was useful and OK-432 injection through topical and chest tube may be effective, these should be recommended for management of chylothorax.

Aged↗

[A successful case report on intralesional OK-432 therapy for cystic mediastinal lymphangiomas].

A 42-years-old female was referred to the university hospital because of cystic lesions of the right superior mediastinum. Drainage tube was found at right supraclavicular fossa with prolonged lymphatic discharge. We diagnosed this case as a benign cystic lymphangiomas with CT scan and CT scan with cystography and chemical analysis of the contents of the cyst. Intralesional OK-432 therapy for cystic mediastinal lymphangioma was performed. OK-432 was administered through intralesionally placed drainage tube. Excellent result was obtained. A few weeks later, residual lymphatic discharge through drainage tube became stopped. No expansion of the mediastinal cyst was found after drainage tube removal. Intralesional OK-432 therapy for cystic mediastinal lymphangioma was very effective and useful, it should be recommended for the management of the first choice of therapeutic method for cystic mediastinal lymphangioma because of no neurological deficit after this treatment.

Adult↗

[Surgical analysis for metastatic lung tumor from renal cell carcinoma].

Metastatic lung tumor from renal cell carcinoma were studied in 29 cases. Eighteen patients were treated surgically, 11 were treated non-surgically. The overall 5-year survival rate with the patients of pulmonary resection was 53.5%, and that with those of conservative therapy was 0%, and this difference is statistically significant (p < 0.05). There was no significant difference in any characteristics such as sex, age, stage, grade, disease free interval, metastatic pattern and combination with or without interferon therapy. There was no significant difference in surgically treated patients with pulmonary metastasis in terms of any factors such as age, sex, stage, grade, disease free interval, pulmonary metastasis pattern, metastatic number, surgical procedure, combination with or without interferon therapy statistically. Analysis for the surgically treated patients with pulmonary metastasis from renal cell carcinoma shows no significant difference in prognosis with any characteristics. This result shows efficacy of surgery even if for the patients with synchronous bilateral multiple pulmonary metastasis from renal cell carcinoma.

Adult↗

Perineural invasion by ductal adenocarcinoma of the pancreas.

BACKGROUND AND OBJECTIVES: The correlation between various levels of perineural invasion by pancreatic carcinoma and the patient's prognosis has never been cleared. The authors carried out a histopathologic study of resected pancreatic carcinoma to elucidate the significance of a new histologic finding concerning perineural invasion, which we designated "intrapancreatic, extratumoral perineural invasion (nex)," and also to determine its predictive value for prognoses of patients after surgical removal of the tumor. METHODS: We investigated 90 patients with pancreatic adenocarcinoma who had undergone pancreatic resection. The prognoses of all patients were explored, and correlations between survival and pathologic factors were statistically examined for neural invasion. RESULTS: Nex was found in more than 50% of resected pancreases. A statistically significant association was found between the presence of nex and the grade of intrapancreatic neural invasion or the presence of extra-pancreatic neural plexus invasion. Nex was also found to be associated with patient survival after removal of the tumor. CONCLUSIONS: Nex appears to be an element predicting pancreatic cancer infiltration to the extrapancreatic nerve plexus and also to be a factor influencing postoperative survival of patients with pancreatic carcinoma.

Adult↗

Surgical salvage of failed esophageal reconstruction attempted with gastric pedicle.

Use of the gastric pedicle is an established method for esophageal reconstruction. However, fistula or necrosis of the pedicle occasionally occur due to vascular insufficiency or the severity of the surgery. During the past 4 years, the authors encountered six patients with necrosis of the gastric pedicle, who required reconstruction of circumferential defects of the cervical and thoracic esophagus. In such secondary reconstructive cases, primary closure of the wound is very difficult because the surrounding soft tissue becomes fibrous from infectious and fistulous complications of the first operation. Free jejunal transfers were utilized for restoring continuity of the alimentary tract, a platysma myocutaneous and pectoral fasciocutaneous flap for covering the intestinal anastomoses, and a mesenteric flap connected with the jejunal graft for covering the remaining skin defects in these cases. In follow-up periods from 3 to 21 months, satisfactory results were obtained in all but one patient. Five patients could eat a normal diet without difficulty. This reconstructive method is advocated as safe and well-tolerated physiologically in the salvage of necrosis of the gastric pedicle.

Aged↗

Reconstruction following total laryngopharyngoesophagectomy and extensive resection of the superior mediastinum.

Our experience with four patients who underwent immediate reconstruction following total laryngopharyngoesophagectomy and extensive resection of the superior mediastinum is presented. The reconstructive procedures included free jejunal graft or microvascularly augmented gastric pedicle for esophageal reconstruction, pectoral fasciocutaneous or myocutaneous flap for tracheal reconstruction, and mesenteric flap connected with jejunal graft omental flap, or pectoral flap for protection of the great vessels and obliteration of the dead space in the cervical and superior mediastinal region. The reconstructive procedures were successful, and no pharyngocutaneous fistula, mediastinitis, or great vessel rupture was noted in any patient. There was one patient who developed lung edema and liver dysfunction postoperatively. Combinations of reconstructive procedures using well-vascularized soft tissues can be expected to provide well-tolerated reconstruction following extensive cervical and superior mediastinal resection.

Aged↗

[Balloon-occluded ethanol ablation therapy: (BEAT) for hepatocellular carcinoma].

To obtain simultaneous embolization of feeding arteries and portal veins in the hepatocellular carcinoma, we performed a new treatment, balloon occluded ethanol ablation therapy (BEAT), in 7 patients. A Balloon catheter was inserted into the hepatic vein draining the tumor bearing segment of the liver. During occlusion of the hepatic vein by balloon catheter, an absolute ethanol-Lipiodol emulsion was injected through a microcatheter or a microballoon catheter placed in the feeding artery. There were no major side effects. Histological examination of the specimen taken from one case showed complete necrosis of the tumor and accumulation of Lipiodol within the portal veins of the surrounding tissue.

Aged↗

[Surgical analysis for lung cancer in patients younger than 40 years].

Sixteen cases of primary lung cancer in patients younger than 40 years old had been operated on at the department. There were 8 males and 8 females and the male-to-female ratio was 1:1 that was closer than the ratio in elder patients over 40 years. Histologic types were adenocarcinoma in 7 cases, squamous carcinoma in 5 cases, carcinoid in 2 cases, and small cell carcinoma in 2 cases. In younger patients, adenocarcinomas, small cell carcinomas, and carcinoids were more commonly found than squamous cell carcinomas. Patients in stage I, II, and IIIA and those undergoing a curative resection were predominant in cases without any symptoms preoperatively. The 5-year survival rate of the 16 patients younger than 40 years was 42.9%, that was not significantly different from that of elder patients over 40 years old. This relatively better prognosis might be owing to a fact that operated patients were dominantly composed of asymptomatic patients. In younger patients who have good physical status and respiratory function compared with elder patients, aggressive surgical diagnosis followed by resection, if the definitive diagnosis of malignancy is established may contribute to the improvement of prognosis for patients who was suspected of having malignancy.

Adenocarcinoma↗

Value of intraoperative intrathoracic ultrasonography during video-assisted thoracoscopic pulmonary resection.

Recent advances in endoscopic surgical equipment, video monitoring, and endoscopic surgical techniques have expanded the application of thoracoscopic surgery to pulmonary resection. One of the major limitations of this technique is the difficulty in identifying invisible pulmonary nodules in which manual palpation is not possible. To resolve this problem, we employed intraoperative intrathoracic ultrasonography during video-assisted thoracoscopic pulmonary resection. We conclude that intraoperative ultrasonography during thoracoscopic pulmonary resection is useful to identify pulmonary nodules, except inflammatory lesions.

Adult↗

[Thoracoscopic surgery, current indication and technique].

Thoracoscopy has become an important tool in the diagnosis and management of intrathoracic disease. The development of endoscopic suturing techniques and stapling devices for abdominal surgery dramatically expanded the potential of thoracoscopic surgery. Between 1993 and 1994, 43 patients underwent thoracoscopic surgery. Lung resection were performed on 23 patients for pulmonary nodules and on 9 patients for diagnosis of interstitial lung disease. Extirpation were performed on 2 patients for mediastinal tumor. A procedure done thoracoscopically is far less invasive and the postoperative pain and its consequences are drastically reduced. As endoscopic instrumentation develops, newer operations will become technically feasible. We think that indications for thoracoscopic surgery will expand in developing these techniques in the future, if thoracoscopic surgery is safer and more efficient.

Adult↗