[Mucoepidermoid carcinoma].
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Carcinoma, Mucoepidermoid↗
Biomedical subjects
T Souma
Publications and source records attributed to T Souma.
[How extensive should lymph node dissection be done for the surgery of the left lung cancer?].
Mediastinal lymph node dissection for cancer of the left lung is more difficult than for cancer of the right lung because of the presence of aorta. Location and frequency of lymph node metastasis were examined for 231 left lung cancer patients who underwent pulmonary resection and mediastinal lymph node dissection, and survival rate of them was evaluated. Subaortic (# 5), paraaortic (#6), subcarinal (#7), tracheobronchial (#4) lymph nodes were the most frequently involved N 2 nodes. 5-year survival rate of the patients who had #4, #5, #6, #7, #8 or #9 lymph node metastasis was 20.7%. #4, #5, #6, #7, #8 and #9 should be dissected for the surgery of the left lung cancer.
Carcinoma, Non-Small-Cell Lung↗
Thoracoscopic stapled bullectomy supported by suturing.
In 1985, a thoracoscopic technique for closing bullae with hemostatic clips was developed. However, the method was limited, and therefore clinical application was small. A linear endoscopic stapler (Endo-GIA) was developed in 1990. The advent of the Endo-GIA nearly made thoracoscopic treatment of spontaneous pneumothorax practicable, and ended the use of clipping. In addition, a new operative technique was developed, the 3-cm minithoracotomy bullectomy for the treatment of spontaneous pneumothorax. This technique has now become obsolete. The current method is that of a thoracoscopic stapled bullectomy using the Endo-GIA, supported by suturing. The recurrence rate was 2.7% (1/37) using this method. The one recurrence occurred in a case where no bullae were observed during the operation. Our findings suggest that thoracoscopic stapled bullectomy supported by suturing is a practicable treatment of spontaneous pneumothorax. An economical use of the endoscopic stapler and complementary suturing may be less expensive than using a laser. Pleurodesis should be performed in the patients in whom no distinct bullae are discovered thoracoscopically.
Humans↗
[A case report of pulmonary metastasis of malignant fibrous histiocytoma (MFH) accompanied by mediastinal lymph node metastasis].
Mediastinal lymph node metastasis associated with pulmonary metastasis is rarely seen in soft tissue sarcoma. A case is presented in which investigation of primary lung cancer (cT2N2M0) in a 78-year-old woman with a history of MFH of the left thigh revealed pulmonary metastasis of MFH accompanied by paratracheal (#2) and anterior mediastinal (#3a) lymph node metastases.
Aged↗
[Results of surgery for pT4 lung cancer].
During 1977 and 1991, 54 patients with lung cancer underwent surgery at Niigata University Hospital and were diagnosed with pathological T4. The survival rate of these pT4 patients was 32.5% at 3 years and 24.4% at 5 years. There was no significant difference between the survival rates of those with squamous cell carcinoma and those with adenocarcinoma. 5-year survival rate of 20 patients with N0 disease and 23 patients with N2 disease was 43.0% and 13.0%, respectively (p < 0.05). 5-year survival rate of 21 patients with organ invasion alone, 21 with dissemination or malignant effusion alone, and 12 with organ invasion plus dissemination or malignant effusion was 22.5%, 28.6% and 0%, respectively; there was no significant differences between these rates. Seven patients survived over 5 years; however, there were no obvious common factors. An aggressive surgical approach is indicated for T4 lung cancer, not only in patients with N0 disease but also in those with organ invasion alone or small amounts of malignant effusion alone.
Adult↗
[Recurrent thymic carcinoid tumor--report of a case and review of the literature].
A case is presented of a 48-year-old male patient with thymic carcinoid tumor who was operated on twice and followed for 12 years. The original tumor was removed in 1979, and a recurrent tumor was removed 4 years later. Multiple metastases to the lungs, pleura and lymph nodes of the neck were found in 1988; chemotherapy (BAPP) and radiation therapy were not effective, and there was subsequent subcutaneous invasion of the anterior chest. We also discuss the 153 cases of thymic carcinoid tumor reported in the Japanese literature in the Niigata Carcinoid Registry.
Carcinoid Tumor↗
[Invasive thymoma involving the liver: a case report of transdiaphragmatic extension].
A 38-year-old woman had an invasive thymoma which disseminated into the thoracic cavity and infiltrated the lateral liver surface. Such transdiaphragmatic extension by an invasive thymoma is rare, however, routine abdominal CT should be performed in invasive thymoma cases to avoid underestimating the extent of disease.
Adult↗
[Surgical management of desmoid tumors of the chest wall: a case report and review of literature].
A 45-year-old man without special predispositions showed a chest wall tumor with tenderness. A needle biopsy revealed a desmoid tumor which had invaded the muscles. A wide resection from the second to fifth rib was carried out and 4 years have passed without recurrence. A resection, at least 3 cm away from the lesion, is necessary for desmoid tumors which seem to have clear margins.
Fibroma↗
[Surgical management of multiple rib fractures: a case report of rib stapler].
A 66-year-old woman with multiple rib fractures was successfully treated with the use of Rib Staplers (Judet's struts made of titanium). Rib Staplers are effective for the stabilization of fractured ribs even if fracture lines are oblique.
Aged↗
[Laser vaporization for tracheobronchial lesions using a double intubation technique under general anesthesia].
A method for simple and safe management of laser vaporization is described. Following intubation with a thin endobronchial tube which is removed from a twin-lumen tube, a thick endotracheal tube for a bronchial fiberscope is intubated. This double intubation technique provides for a safe and long operation without danger of vapor inhalation.
Anesthesia, General↗
[Surgical therapy of HCG-producing mediastinal tumor accompanied with intrapulmonary metastasis].
The patient is a 31-year-old man who was suffering from hyperthyroidism and left hemothorax. His serum HCG level was extremely elevated and chest X-ray showed a mass shadow of anterior mediastinum and bilateral multiple intrapulmonary metastasis. Our clinical diagnosis was primary HCG-producing germ cell carcinoma of mediastinum and immediately administered CDDP and VP-16. Chemotherapy was effective and tumor extirpation was carried out for mediastinum and lungs by median sternotomy. All of the resected specimen showed no cancer cells and 4 years have passed with no evidence of recurrence. Aggressive surgical approach is indicated for mediastinal germ cell carcinoma accompanied with intrapulmonary metastasis when chemotherapy is effective.
Adult↗
[Surgical treatment of advanced (p-stage III.IV) lung cancer less than 2.0 cm in size].
We treated surgically 567 patients with primary lung cancer from June 1975 to December 1989. There were nine patients with advanced (p-stage III.IV) lung cancer less than 2.0 cm in size. The five year survival rate was 50.8%. The histological diagnosis was adenocarcinoma in 6, squamous cell carcinoma in 3. A curative resection was performed in seven of nine patients. Six patients had one level metastasis of mediastinal lymph node. Three patients in whom relative curative resection was performed at surgery later developed regional recurrence. However, distant metastasis was not evident in all but one of nine patients. In conclusion surgical resection is considered to be significant in patients with advanced (p-stage III.IV) lung cancer less than 2.0 cm in size.
Adenocarcinoma↗
[Subdural hematoma following surgery of an aneurysm of the diverticulum of the ductus arteriosus with partial cardiopulmonary bypass].
The patient was a 72-year-old man, who had an aneurysm of the descending thoracic aorta with left recurrent laryngeal nerve palsy identified by preoperative examination. Thoracotomy revealed an aneurysm of a diverticulum of the ductus arteriosus measuring 2.7 X 3.4 cm. The aneurysm was excised under partial cardiopulmonary bypass and the defect of the aortic wall was repaired with a Dacron patch. Two days after surgery, he developed mild deterioration of consciousness and right hemiparesis. An acute subdural hematoma which covered the left frontal, parietal, and temporal lobes was found by CT examination. Craniotomy was performed 16 days after the previous surgery, and 100 g of hematoma was removed. Following craniotomy, complete recovery of cerebral function was observed. This appears to be a valuable report of a patient who developed acute subdural hematoma following surgery of aneurysms of the descending thoracic aorta with partial cardiopulmonary bypass.
Aged↗
[Successful mitral valve replacement for infective endocarditis in pregnancy].
A 27 weeks' pregnant women exhibited infective endocarditis due to alpha-streptococcus. As echocardiography showed vegetations on both mitral leaflets, cesarean section was performed at 35 weeks' gestation and a healthy male infant weighing 2,430 g was delivered. Antibiotic therapy was continued for fever after the cesarean section but macrohematuria and Osler's nodes developed. Emergency mitral valve replacement was performed successfully despite the presence of active infective endocarditis. She was discharged after completion of a 10-week course of antibiotic therapy.
Adult↗
[Significance of fiberoptic bronchoscopy after pulmonary resection of lung cancer for early detection in second lung cancer].
By the end of 1988, seventy five cases after pulmonary resection for lung cancer and one case after pulmonary resection for basal cell hyperplasia were examined with fiberoptic bronchoscopy as postoperative follow up. Endobronchial tumor was detected in 14 cases. In seven cases, endobronchial tumor was located at site far from the surgical bronchial anastomosis. These tumors were suspected as second lung cancer as long as examined by fiberoptic bronchoscopy. Histological type of all of these was squamous cell carcinoma. Re-operations were performed in five cases and two of them were early lung cancer. In 6 cases (13.6%) among 44 cases examined with fiberoptic bronchoscopy after pulmonary resection for central type squamous cell carcinoma, second lung cancer was detected. In the case of central type squamous cell carcinoma, usually the tumor appears to be of same histological type and at same location. Among those cases those who smoke heavily should be separated as high risk group. If this group is followed with fiberoptic bronchoscopy or sputum cytological examination, it is more possible to detect second lung cancer at an early stage.
Bronchoscopy↗
[Pulmonary complication after resection of lung cancer--difficulty in expectoration and cough dynamics].
From January 1975 to December 1986, 415 patients were operated for primary lung cancer. Postoperative pulmonary complications were observed in 83 patients and among them 48 patients (57.8%) suffered from difficulty in expectoration. Postoperative expectoration mostly depends on the ability of coughing. To evaluate cough dynamics, expiratory flow-rate and volume at voluntary maximal cough were measured. The more expiratory flow rate and volume a cough has, the more effective it is for expectoration. In those patients with decreased FEV1.0, or respiratory muscle weakness because of emaciation and aging, or severe pain in the wound, the cough dynamics was decreased. By cleaning retained secretions in the respiratory tract, postoperative pulmonary complications would be prevented. However in cases where the decrease in postoperative cough dynamics is predictable, application of limited resection should be considered as well.
Aged↗
[A case report of graft-versus-host reaction after aortocoronary bypass--a clinicopathological study].
An immunologically normal 70-year-old male developed fever and disturbance of consciousness after aortocoronary bypass; this was followed by diarrhea, systemic erythroderma and granulocytopenia. He died as a result of sepsis and acute renal failure. The skin biopsy showed basel vacuolar degeneration, epidermal eosinophilic necrosis and invasion of T-lymphocytes. The autopsy showed necrotic small interlobular bile ducts, severely hypoplastic bone marrow and widespread necrosis of lymphoid tissue. Based on these clinicopathological findings, we made a diagnosis of graft-versus host reaction after transfusion.
Aged↗
The distribution and surface ultrastructure of airway epithelial cells in the rat lung: a scanning electron microscopic study.
The fine structure and distribution of the epithelial cells of the airway in the rat were studied continuously from the trachea to terminal bronchioles by scanning electron microscopy (SEM). The airway could be divided into three different regions according to cell population: 1) the trachea and extrapulmonary bronchi; 2) intrapulmonary bronchi (larger than 500 microns in caliber); and 3) bronchioles (smaller than 500 microns in caliber). From their surface structures, the epithelial cells could be classified into ciliated and non-ciliated cells, the latter including brush cells, Clara cells and other non-ciliated (secretory) cells. 1. Ciliated cells. The cilia are longer, thicker and more numerous in the trachea; they decrease in length, thickness and number toward the periphery. 2. Brush cells. They possess thin microvilli (0.2 micron in thickness) in the trachea and extrapulmonary bronchi, with a rounded end. In the bronchioles they possess thick microvilli (0.3 micron in thickness) abruptly ending in a right angle edge. The brush cells are distributed sparsely but rather uniformly, and apt to be grouped in two or more cells. 3. Clara cells. Their apical cytoplasm shows a domed or papillary swelling and possesses a few microvilli. The Clara cells are distributed in the bronchioles and can already be found some distance proximal to the bronchial furcations into bronchioles. 4. Other non-ciliated (secretory) cells. Their apical cytoplasm seems to contain secretory granules immediately beneath the cell surface. They often gather in groups in the trachea and extrapulmonary bronchi, tending to form large areas corresponding to sites supported by tracheal or bronchial cartilage. There were found several orifices in tracheal or bronchial glands whose long axes paralleled the tracheal or bronchial axes. Dome-shaped elevations sometimes appear near the branching points of the intrapulmonary bronchi. There were regarded as bronchus-associated lymphoid tissue (BALT).
Animals↗