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Biomedical subjects

T Naruke

Publications and source records attributed to T Naruke.

At least 73 records · Page 4Linked to original sources
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

[A case of tracheal stenosis following surgery of esophageal cancer].

A case of 54-year-old man with tracheal stenosis following surgery for thoracic esophageal cancer was reported. It was considered that the stenosis had occurred due to the tracheal ischemia after esophagectomy and lymph node dissection. Importance of preservation of tracheal blood supply was again noticed. On tracheal reconstruction, application of pedicled pleural flap was recognized to be useful in order to repair the leakage from membranous portion that could not be closed by suture.

Anastomosis, Surgical↗
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↗
PubMed1988

Solitary mast cell tumor of the lung.

An extremely rare solitary mast cell tumor of the lung was studied histologically, immunohistochemically, and ultrastructurally. The histologic features of the tumor included nodular growth of well-differentiated mast cells and clear cells with no granules. The current case is the third case of a solitary mast cell tumor (granuloma) of the lung in the literature. Clinicopathologic features of this tumor are compared with the other two cases reported previously in the international literature, and the nature of the clear cells is discussed.

Antigens, Neoplasm↗
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

Close correlation between restriction fragment length polymorphism of the L-MYC gene and metastasis of human lung cancer to the lymph nodes and other organs.

Restriction length fragment polymorphism of the L-MYC gene was examined in DNAs from lung cancer tissues and normal tissues of 51 Japanese patients with lung cancer. In individual patients, no difference was seen between the restriction length fragments of the two alleles of L-MYC [6-kilobase (kb) and 10-kb fragments in EcoRI digests] in lung cancer tissues and normal tissues. But a striking correlation was found between the restriction length fragment polymorphism pattern of L-MYC and the extent of metastasis, particularly to the lymph nodes at the time of surgery: Patients with only the L band (10 kb) had few lymph node metastatic lesions, whereas patients with either the S band (6 kb) or the S and L bands almost always had lymph node metastatic lesion. A similar correlation was found between the presence of the S band and metastases to other organs. This correlation was particularly marked in cases of adenocarcinoma. These results indicate a clear genetic influence on metastases and a consequent poor prognosis for certain patients of lung cancer; L-MYC restriction length fragment polymorphism is thus shown to be a useful marker for predicting the metastatic potential of human lung cancer.

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↗
PubMed1988

Prognosis and survival in resected lung carcinoma based on the new international staging system.

A new TNM staging system was proposed and the previous system has been revised recently. To evaluate the new TNM staging system for lung cancer, we analyzed records of 1737 patients who underwent pulmonary resection at the National Cancer Center Hospital, Tokyo. With regard to clinical stages, three patients had occult carcinoma; 821 patients had stage I disease; 248 patients, stage II; 465 patients, stage IIIA; 82 patients, stage IIIB; and 118 patients, stage IV. The 5-year survival rates for the respective stages were 50.1% for stage I, 31.2% for stage II, 20.2% for stage IIIA, 5.1% for stage IIIB, and 7.9% for stage IV. In terms of postoperative stages, four patients were classified in stage 0, 536 in stage I, 221 in stage II, 559 in stage IIIA, 159 in stage IIIB, and 258 in stage IV. The 5-year survival rates were as follows: stage I, 65.0%; stage II, 42.9%; stage IIIA, 22.2%; stage IIIB, 5.6%; and stage IV, 7.5%. In both the clinical stage and the postoperative stage, there were significant prognostic differences between stage I and stage II, stage II and stage IIIA, and stage IIIA and stage IIIB, but there was no significant difference in 5-year survival rates between stage IIIB and stage IV.

Adenocarcinoma↗
PubMed1988

[Prognostic factors in lung cancer].

For 1,886 cases, out of total 1,982 lung cancer cases, which had been admitted to and undergone resection at National Cancer Center Hospital during the period between May, 1962 and December, 1987, excluding cases of multiple primaries and low grade malignancies, prognostic factors have been reviewed and examined. Prognosis does not depend on only one factor, but many complicated factors, however, 5 year survival rate was very good for stage I and stage II cases, for which curative resection could have been performed. There have been difference histologically in prognoses between cases of squamous cell carcinoma, adenocarcinoma, large cell carcinoma and small cell carcinoma, but prognoses of stage I and II cases were good in the group, for which curative resection was possible. Prognostic factors of lung cancer cases can be epitomized by staging of the disease and histological type and it is evident from the review on these cases that early detection, early treatment and indication of curative resection should be pursued as much as possible.

Adult↗
PubMed1987

[Clinical and basic studies on the treatment of cancer metastasis].

Lung resection for metastatic lung tumors from cancers of other organs has shown a significant curative success rate among affected patients. Hepatectomy also shows promise as a good curative approach for patients with liver metastasis from cancers of various abdominal organs. Descriptive data and their analysis of metastases by Bross and Viadana indicate a cascade spreading process. The fact that key-sites such as the lung and/or liver which, for some time, have proved a stumbling block to the generalization of cancers by metastases, has led to the success of therapy for metastasis in the clinical field. Chemotherapy as an adjuvant therapy to surgery for key-site metastatic foci is anticipated to raise future cure rates.

Humans↗
PubMed1986

Papillary adenoma of type 2 pneumocytes.

A case of papillary adenoma of type 2 pneumocytes is reported. A 57-year-old man had an unusual coin lesion in the periphery of the right lung without any symptoms. When detected in a mass survey examination, it was approximately 1.5 cm in diameter, well circumscribed, and located in S4, involving the sixth-order bronchus of B4. Light-microscopic examination revealed cuboidal tumor cells arranged in a papillary pattern. Ultrastructurally, the cells had characteristic osmiophilic lamellar bodies. By immunoperoxidase staining, the tumor cells were shown to have intracytoplasmic surfactant apoproteins. The postoperative course was uneventful, and there is no evidence of disease 8 years later.

Cystadenoma↗