Biomedical subjects

T Yamanda

Publications and source records attributed to T Yamanda.

34 records · Page 2Linked to original sources

PubMed1998

Effects of lung volume reduction surgery on exercise pulmonary hemodynamics in severe emphysema.

STUDY OBJECTIVES: To clarify the effects of lung volume reduction surgery (LVRS) on pulmonary hemodynamics in severe emphysema and to evaluate the role of pulmonary circulation in the increased exercise performance after LVRS. DESIGN: In eight male patients with severe emphysema, we measured pulmonary artery (Ppa) and occlusion (Pop) pressures and cardiac output through a Swan-Ganz thermodilution catheter, and we calculated cardiac index (CI), pulmonary vascular resistance index, and driving pressure. The study was performed at rest and during exercise using a supine bicycle ergometer at 25 W, under room air and O2 inhalation. Exercise performance was expressed as endurance time in minutes. Pulmonary function tests were performed. The patients underwent an identical study before and 6 months after LVRS. RESULTS: The patients' exercise performance was significantly increased after LVRS (5.9+/-1.8 min) compared with that before LVRS (3.6+/-0.9 min). LVRS resulted in a significant increase in FEV1 and a significant decrease in residual volume. Before LVRS, Ppa was increased both at rest and during exercise. LVRS did not change rest or exercise Ppa. LVRS significantly decreased Pop during exercise from 24+/-10 mm Hg to 18+/-7 mm Hg. CI at rest and during exercise were significantly increased after LVRS. O2 administration significantly decreased Ppa during exercise both before and after LVRS. CONCLUSIONS: These findings suggest that LVRS does not improve pulmonary hypertension at rest or during exercise in patients with severe emphysema and that elevated Pop during exercise before LVRS is probably related to lung mechanic abnormalities.

Aged↗

PubMed1998

[Feasibility of limited surgery for small peripheral lung cancer].

We investigated the pathologic factors of small (< or = 20 mm in diameter) peripheral non-small-cell lung cancer lesions and postoperative course of the patients with these lesions to evaluate feasibility of limited surgery for small peripheral lung cancer. From 1982 to 1997, 114 patients underwent resection for small (< or = 20 mm in diameter) peripheral non-small-cell lung cancer. The histologic type was adenocarcinoma in 92 and squamous cell carcinoma in 22. Lobectomy was performed in 111, pneumonectomy in two and segmentectomy in one patient. The systematic mediastinal dissection was carried out in all patients. In 33 patients with tumors 12 mm in diameter or smaller, there were no one with lymph-node metastasis or pulmonary metastasis. Likewise, all patients were survived without relapse. In conclusion, curative resection may be possible without mediastinal dissection or with lesser lung resection (segmentectomy or partial resection), when the tumor diameter is less than 10 mm, for small peripheral non-small-cell lung cancer.

Adenocarcinoma↗

PubMed1998

[Mechanism of short-term improvement in exercise tolerance after lung volume reduction surgery for severe emphysema].

To investigate the mechanism of short-term improvement in exercise tolerance after lung volume reduction surgery (LVRS) for severe emphysema, we performed six-minute walk tests and pulmonary-function tests, and studied their correlation before and 3-to-5 months after LVRS in 7 patients with severe emphysema who underwent bilateral lung reduction via median sternotomy. Results of the tests showed a 59% increase in the 1-second forced expiratory volume (FEV1), a 25% reduction in the functional residual capacity (FRC), a 49% increase in the maximum voluntary ventilation (MVV), and a 20% increase in the distance walked in 6 minutes (6 MD). The degree of improvement in 6 MD correlated significantly with the degree of improvement in FEV1 (r = 0.97, p < 0.01), in FRC (r = 0.86, p < 0.05), and in MVV (r = 0.87, p < 0.05), and did not correlate with the degree of improvement in pulmonary gas exchange. These results support the hypothesis that an increase in lung elastic recoil after targeted emphysematous resection reduces airflow limitation, and thus leads to a short-term improvement in exercise tolerance after LVRS.

Aged↗

PubMed1998

[An evaluation of pathologic T3 lung cancer].

A total of 35 pT3 patients of lung cancer underwent pulmonary resection from 1983 to 1997 in our department. The overall five-year survival rate of the 35 cases was 35.8%. There was no significant difference between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. A superior outcome was observed for cases of curative resection compared with that of non-curative resection. Five-year survival rates of 19 patients with N0 disease, 16 patients with N1 or N2 disease were 46.6% and 22.2% respectively (p < 0.05). There was no significant differences among the survival rates according to the site of tumor invasion. We concluded that the long-term survival of patients with pathologic T3 disease critically depended on the lymph node state and completeness of resection.

Adenocarcinoma↗

PubMed1998

[Catamenial pneumothorax under video-assisted thoracoscopic surgery: a case report].

A 46-year-old woman complained four times of chest pains due to repeated right pneumothorax. This was improved by the right thoracic drainage each time. She was diagnosed as having catamenial pneumothorax from the fact that each episode of pneumothorax began with the first day of her menstrual cycle. She was admitted to our hospital in Jan. 1996 and operated on by the obliteration of pleuro-peritoneal fistulas on right diaphragm under video-assisted thoracoscopic surgery (VATS). No other abnormal lesions were found in the right pleural cavity and right lung. In this case, the pathophysiological mechanisms of pneumothorax might have been caused by the air influx from the peritoneal cavity to the right pleural cavity through the fistulas on the right diaphragm. VATS is minimally invasive surgery and very useful for the treatment of pleuro-peritoneal fistulas on the diaphragm. It should be emphasized that hormonal therapy is necessary after VATS of catamenial pneumothorax.

Endoscopy↗

PubMed1997

Immunohistochemical studies of vascular volume and proliferative activity in squamous cell carcinoma of the esophagus.

For immunohistochemical investigation and clarification of the relationship between the vascular volume in esophageal carcinoma and the proliferative activity of its tumor cells, we examined surgical specimens of squamous cell carcinoma (SCC) of the esophagus from 15 patients. The vascular volume was evaluated by immunostaining for platelet-endothelial cell adhesion molecule-1 with monoclonal antibody JC70, and the proliferative activity of the carcinoma cells was evaluated by immunostaining for proliferating cell nuclear antigen (PCNA) with antibody 19A2. The ratio of the vascular area to the tumor area and the labeling index (LI) for PCNA in the carcinoma cells was then calculated. The antibody JC70 was useful for immunohistochemically detecting blood microvessels in esophageal carcinoma. The vascular volume, expressed as the ratio mentioned above, was higher in well- and moderately differentiated SCCs than in poorly differentiated SCC (P < 0.01), and the PCNA LI did not depend on the degree of differentiation. However, there was a significantly inverse relationship between the ratio of the vascular area to that of carcinoma and the PCNA LI of the carcinoma cells (P < 0.01). These findings show that angiogenesis is greater in esophageal carcinomas with little proliferative activity.

Aged↗

PubMed1997

Factors affecting the radiologic appearance of peripheral bronchogenic carcinomas.

The use of high-resolution computed tomography and magnetic resonance imaging have allowed the detailed description of morphologic findings associated with lung cancer. In particular, the desmoplastic response of lung tissue to tumor growth has not been adequately described. This article reviews roentgenologic and pathologic correlations of primary lung carcinomas. An irregular or indistinct tumor margin may be caused by tumor infiltration, an irregular desmoplastic response to the tumor growth, or irregular contraction in the central portion of the tumor. Solid tumor growth, on the other hand, may be associated with a well-defined tumor margin, with or without displacement of adjacent anatomical structures.

Adenocarcinoma↗

PubMed1997

[A case of mature teratoma perforated into the pericardial cavity].

A case of a 35-year-old woman with mature teratoma which was perforated into the pericardial cavity, was reported. She was admitted to our hospital for surgical treatment of anterior mediastinal tumor. On her 6th hospital day, she had high fever. A chest X-ray and UCG showed cardiomegaly and pericardial effusion. We diagnosed her as perforated teratoma into the pericardial cavity and the emergent operation was performed. The tumor adheeded to pericardium and a large quality of bloody effusion was found in the pericardial cavity. The tumor was removed with pericardium immediately. In this case, the mechanism of perforation was thought to be caused by infection and massive fluid influx into the cyst.

Adult↗

PubMed1996

[Postoperative early complication of primary lung cancer].

We analyzed postoperative early complications of primary lung cancer in 321 cases during 1982 to 1993 in our hospital, and assessed the prevention and the treatment against these complications. In order of frequency the complications are, paroxymal supraventricular tachcarida (10.6%), atelectasis due to sputum (6.9%), pulmonary fistula for more than seven days (4.7%), hoarseness of voice due to recurrent nerve palsy (4.0%), chylothorax (2.5%), gastrointestinal tract complications (2.2%), reoperation due to massive bleeding (1.2%), wound dehiscence (0.9%), bronchial fistula (0.6%), rupture of ascending aorta (0.3%) and myocardial infarction (0.3%). The two cases of bronchial fistula after pneumonectomy, and one of myocardial infarction after lobectomy through the median approach died of early complications. The operative indication for primary lung cancer is extended to the patients with higher age and lower pulmonary function; so we should be careful for the pre and postoperative prevention and the rapid and appropriate treatment against these postoperative early complications.

Adult↗

PubMed1995

[Complete disruption of the trachea due to blunt neck trauma--a case report].

A complete disruption of the cervical trachea due to blunt trauma is relatively rare. Because of dislocation of the disrupted trachea and/or bleeding into airway, this is a mostly fatal accident. This article reports the author's experience with the successful surgical treatment of the complete disruption of the cervical trachea. A 60-year-old man suffered from a cervical blunt trauma by traffic accident and referred to our hospital. He had a dyspnea and severe subcutaneous emphysema around neck and anterior chest wall. Urgent fiberoptic bronchoscopy (FOB) revealed a complete disruption of the cervical trachea. After intubation under guide of FOB, he underwent an end to end anastomosis of the disrupted trachea from cervical approach. Tracheostomy was performed two months later, because of his bilateral recurrent nerve paralysis. The patient is alive and well 25 months after surgery. It should be emphasized that early diagnosis and adequate management are important to save patients with complete disruption of the trachea due to blunt trauma.

Accidents, Traffic↗

PubMed1995

[Immunohistochemical expression of sialyl-Lewis antigens in lung cancer].

We investigated the immunohistochemical expression of three carbohydrate antigens, sialyl-Lewisa, sialyl-Lewisx and sialyl-Lewisx-i, in human lung cancer tissues using monoclonal antibodies, 2D3, SNH3 and FH6, respectively, and compared the expression rate of these three antigens with clinical and pathologic findings. The expression rate of all the three antigens in adenocarcinoma was higher than that in squamous cell carcinoma and that of sialyl-Lewisx was highest in adenocarcinoma. Sialyl-Lewisx antigen was expressed in all cases of positive nodal metastasis or postoperative distant metastasis in adenocarcinoma. In squamous cell carcinoma, however, there was no relationship between the expression rate of sialyl-Lewisx antigen and nodal or distant metastasis. These results suggest that expression of sialyl-Lewisx antigen in adenocarcinoma of the lung may be correlated with nodal or distant metastasis.

Adenocarcinoma↗

PubMed1995

Management of chylothorax after pulmonary resection.

BACKGROUND: Conservative management with intrapleural drainage and total parenteral nutrition (TPN) has been the first choice of treatment for postoperative chylothorax. With this approach, however, it usually takes several weeks for the chylothorax to resolve and it is sometimes unsuccessful. In this study, we reviewed seven patients who had chylothorax develop after pulmonary resection for primary carcinoma of the lung. STUDY DESIGN: The patients were treated according to a "one-week trial" that consisted of one week of observation with intrapleural drainage and maximum parenteral nutritional support followed by operative intervention if the effect of the conservative therapy was not adequate. When the chylous leak was decreased to less than 100 mL/day or less than 15 percent of the maximum daily drainage volume after the "one-week trial," the conservative management was continued for two more weeks. After observation for three weeks, oral intake was begun and a final evaluation of the treatment was made. RESULTS: One patient did not consent to the "one-week trial" and underwent operative treatment on the third postoperative day. Two patients had chylous leaks less than 100 mL/day or less than 15 percent of the maximum daily chylous leak after one week observation. Conservative management with TPN was continued in these patients for two more weeks and operation was performed in one on the 20th day and in the other on the 22nd postoperative day. The remaining four patients underwent operative treatment on the seventh or eighth postoperative day. All of the operations for chylothorax were successful, and chest tubes were removed promptly. These results show that operative management of chylothorax was reliable and safe. The "one-week trial," however, offered few advantages in determining the therapeutic strategy for postoperative chylothorax.

Adult↗

PubMed1993

Proliferative activity of human thyroid tumors evaluated by proliferating cell nuclear antigen/cyclin immunohistochemical studies.

BACKGROUND: To clarify the proliferative activity of human thyroid tumors, the labeling index of various thyroid tumors was evaluated by proliferating cell nuclear antigen (PCNA)/cyclin immunostaining. METHODS: Surgically removed thyroid carcinoma, adenoma, adenomatous goiter, normal thyroid, and breast carcinoma were used for the study. Small pieces of tissue from the surgical materials were fixed in Methacarn solution (methanol-chloroform-acetic acid = 6:3:1) (Wako junyaku Co., Osaka, Japan) and embedded in paraffin. Sections were stained with PCNA/cyclin monoclonal antibody. RESULTS: The reaction product for PCNA/cyclin was observed mainly on nuclei. The ratio of the PCNA/cyclin-positive nuclei to the total number of nuclei was compared among the tumors. Ratios of PCNA/cyclin-positive nuclei were 4.9% in well-differentiated papillary carcinoma of the thyroid, 4.6% in poorly differentiated papillary carcinoma of the thyroid, 3.6% in thyroid follicular carcinoma, 1.9% in adenomatous goiter, 2.0% in thyroid follicular adenoma, and 0.6% in normal thyroid tissues. CONCLUSIONS: It was shown in this study that the ratio of PCNA/cyclin-positive nuclei reflects the relative clinical behavior of thyroid tumors.

Adenocarcinoma↗

PubMed1993

Aberrant retrotracheal goiter: report of a case.

A case of intrathoracic retrotracheal goiter in a 40-year-old woman is herein described. A computed tomographic scan, magnetic resonance imaging and endoscopical ultrasonography all confirmed the existence of a retrotracheal encapsulated lesion, which was suspected to be aberrant mediastinal goiter. Radioiodine scintigraphy, however, demonstrated little uptake in the mass. A large (7 x 6 x 4 cm), encapsulated adenomatous goiter was then easily removed via a right thoracic approach.

Adult↗

PubMed1992

Adjuvant radiotherapy after complete resection of thymoma.

Seventy patients were studied after undergoing complete resection of thymoma to determine the effect of postoperative adjuvant mediastinal radiotherapy on prognosis, with regard to clinical stage, histological type, and pleural factor. Pleural factor was defined as follows: p0, no adhesion to the mediastinal pleura; p1, fibrous adhesion to the mediastinal pleura without microscopic invasion; and p2, microscopic invasion of the mediastinal pleura. Recurrence of thymoma after complete resection was observed in 13 patients, 12 (92%) with pleural dissemination, 6 (46%) with local recurrence, and 2 (15%) with distant metastasis (types of recurrence are overlapping). In stage I and stage II p0 patients, no recurrence was observed, regardless of mediastinal radiotherapy. Whereas mediastinal irradiation completely prevented recurrence in stage II p1 patients, 4 (36.4%) nonirradiated stage II p1 patients experienced recurrence. In stage II p2 patients, 75% had pleural dissemination even after radiotherapy. A high incidence of recurrence was also observed in stage III, nonirradiated (25%) and irradiated (30%) patients. The results suggest that mediastinal irradiation for stage I and II p0 patients is not always necessary, and that therapy for stage II p1 is essential and also expected to decrease the recurrence rate. On the other hand, in stage II p2 and stage III thymomas, mediastinal irradiation is not sufficient to prevent pleural recurrence even after complete resection. Our classification based on pleural factor is useful for better selection of appropriate postoperative treatment for thymoma patients.

Adolescent↗

PubMed1992

[Results of patients in stage I and II primary lung cancer with curative resection].

We analyzed 91 patients who had curative resection from 1982 to 1989 for stage I and II primary lung cancer. The 5-year survival rates were 71.4% for stage I and 44.7% for stage II. The 5-year survival rates were 86.6% for T 1 N 0 M 0, 47.3% for T 2 N 0 M 0, 56.3% for T 1 N 1 M 0, and 37.9% for T 2 N 1 M 0. There was no cancer death in patients with squamous cell carcinoma of T 1 N 0 M 0. For stage I, tumor diameter was significant factor to influence survival. Although there was a statistically significant difference between stage I and II in patients with adenocarcinoma, there was no significant difference in those with squamous cell carcinoma. Chemotherapy had no significant improvement in survival for stage I and II lung cancer.

Adenocarcinoma↗