Haigan
Online ISSN : 1348-9992
Print ISSN : 0386-9628
ISSN-L : 0386-9628
Volume 33, Issue 1
Displaying 1-18 of 18 articles from this issue
  • Makoto Nonaka, Mitsutaka Kadokura, Noboru Tanio, Shigeru Yamamoto, Tos ...
    1993 Volume 33 Issue 1 Pages 1-8
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Twenty cases of exploratory thoracotomy for pulmonary nodules were observed during the period from January, 1986 to December, 1990. Fourteen cases were males and 6 were females. The average age was 51. Lesions were found by mass surveys in 10 of the patients, during the treatment of other diseases in 5 patients and by subjective respiratory symptoms in 5 patients. In the preoperative non-definitive clinical diagnosis, benign tumors were found in 10 cases and malignant in 10. Enucleation was performed for most benign tumors, while lobectomies were performed for malignant tumors. Pathological examination of resected specimens showed that among the 20 cases, there were 9 primary adenocarcinomas of the lung and 1 metastatic adenocarcinoma of the lung, 5 tuberculomas, 2 hamartomas, 2 plasma cell granulomas and 1 benign clear cell tumor. Three cases that were thought to be clinically malignant but turned out to be pathologically benign were all tuberculomas. It was concluded that thoracoscopy or exploratory thoracotomy is an effective method for cases of lung nodular shadows in which a definitive diagnosis cannot be reached.
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  • Takaaki Konishi, Teruo Matsui, Yoshito Matsubara, Satoru Sawai, Hisao ...
    1993 Volume 33 Issue 1 Pages 9-17
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    From 1976 to 1991, 173 patients with stage IIIA non-small cell lung cancer underwent pulmonary resection. Of these, absolutely curative resection was performed on 3 patients, relatively curative resection on 103, relatively non-curative resection on 41 and absolutely non-curative resection on 26 patients. The 5-year survival rates were 36.1% for the 103 relatively curative resection patients, 23.3% for the 41 relatively non-curative resection patients, and 0% for the 26 absolutely non-curative resection patients. The patients undergoing relatively curative resection showed significantly longer survival than the patients undergoing relatively non-curative or absolutely non-curative resection. For each level of operative curativity, the outcome was evaluated in relation to whether post-operative chemotherapy and/or radiotherapy were employed, but no significant differences were found. The relatively curative and relatively non-curative resection patients were separated into pT1-2N2, pT3N0-1 and pT3N2 subgroups. The outcome was not affected by the use or non-use of postoperative adjuvant therapy in all subgroups. However, there were many cases with distant metastasis in the pT1-2N2 subgroup and many cases with local recurrence in the pT3N0-1 subgroup. It is surmized that postoperative genaral therapy is effective for pN2 cases, while local therapy is useful for pT3 cases.
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  • Kunihiro Matsuda, Hideki Takahashi, Kuniaki Seyama, Toshihiro Nukiwa
    1993 Volume 33 Issue 1 Pages 19-28
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Single-strand conformation polymorphism (SSCP) analysis was applied to detect mutations of p53 gene in 32 patients with primary lung cancer. cDNA was synthesized from total RNA of primary or metastatic tissues of lung cancer using oligo (dT) primer and reverse transcriptase.35S-labelled partial cDNA with various lengths (200-400bp) were amplified from evolutionary conserved regions of p53 gene by polymerase chain reaction (PCR) using pairs of p53 specific primers and [α-35S] dCTP. After denaturing by formamide, the amplified products were electrophorezed on nondenaturing polyacrylamide gel, and electrophoretic mobilities were compared. Among 32 specimens, 23 were found to have different electrophoretic mobilities compared with normal specimens. Ten out of 23 cases were subjected to further analysis of nucleotide sequencing. Point mutations were found at amino acid residues 151 (Pro→Ser), 234 (Tyr→His, 2 cases), 245 (Gly→Ala), 248 (Arg→Leu), 249 (Arg→Met), 266 (Gly→Arg), 273 (Arg→Leu, 2 cases) and 283 (Arg→Pro). In SSCP analysis, no heterozygosity of abnormal or normal bands was found in any case, suggesting that combination of point mutation and deletion of another allele is the main mechanism of loss of p53 function in primary lung cancer. When SSCP analysis was performed using PCR fragments of 200-400bp length, detectability of p53 point mutations by SSCP analysis seemed to depend on neither length of the PCR fragments nor position of point mutations on each PCR fragment. PCRSSCP analysis is useful for screening of a large number of clinical specimens in the study of p53 gene analysis.
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  • Kazumi Shiojima, Kazushige Hayakawa, Yuko Nakayama, Yoshihiro Saito, O ...
    1993 Volume 33 Issue 1 Pages 29-35
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    From 1976 to 1985, 402 patients with primary lung cancer were treated with radiotherapy at our hospital. There were 75 female patients who formed the basis of our analysis. Comparing the characteristics of female and male patients, the predominant characteristics of the female patients were as follows 1) larger proportion of the patients with adenocarcinoma, 2) higher percentage of stage N patients, 3) lower average age, 4) better performance status (PS), 5) lower frequency of lethal complications, and 6) higher frequency of more than two admissions. The prognosis of female patients was better than that of males. The favorable characteristics of female patients for prognosis, were lower average age, better PS, and lower frequency of lethal complications. A higher frequency of admission to hospital might be a favorable characteristics for female patients to extend survivail in patients with recurrence disease.
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  • Kouzo Yamada, Yuji Mori, Akira Suzuki
    1993 Volume 33 Issue 1 Pages 37-42
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Computed tomography (CT) has now assumed a major role in the evaluation of the mediastinal lymph nodes. However several potential problems exist in the use of CT for the evaluation of mediastinal lymph nodal metastases from lung cancer; CT criteria for nodal involvement by tumor rely on nodal size. Accurate methods of measuring the size of lymph nodes have yet been established.
    We investigated the size of 40 mediastinal nodes which were measured on CT by 20 independent blind observers. The mean standard deviation of nodal size was 2.9 mm (range: 1.2-8.5mm). The mean standard deviation of nodal size using the shortest dimension as indicator was smaller than that of nodal size using the largest dimension (p<0.01). Neither the site of mediastinal lymph node or the use of contrast enhanced CT images had any significant difference in the standard deviation of nodal size. However the use of contrast enhanced CT images slightly inproved the accuracy of measurement of nodal size than by the plain CT images.
    In conclusion, we need to adopt the using shortest dimension of lymph nodes as an indicator and contrast enhanced CT images for diagnosis of mediastinal lymph node metastases to improve diagnostic accuracy.
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  • Chiaki Wada, Kazuhumi Imanaka, Takahisa Hashimura, Kazuyuki Yonezawa, ...
    1993 Volume 33 Issue 1 Pages 43-49
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Some lung cancer patients evaluated as complete response (CR) after radiotherapy combined with chemotherapy may suffer from local recurrence during follow-up, with poor prognosis. This might be caused by the inaccurate evaluation of the therapeutic effect and the estimation of local recurrence. 246 patients who received radiotherapy combined with chemotherapy for primary lung cancer at our department from 1983 to 1987 included 15 CR patients, composed of 5 patients treated for small cell lung cancer (SCLC) and 10 patients treated for non-SCLC. The therapeutic effects were re-evaluated by CT, provided that the 3 cases on whom CT was not performed on the day of reevaluation were excluded from the study. This re-evaluation revealed that 4 cases of SCLC should have been classified as partial response (PR) cases. Tumor regrowth was observed in the irradiated field in all these cases. In conclusion, strict evaluation of the therapeutic effect on lung cancer is extremely important for determining response rate and prognosis.
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  • Yasuhiko Ohta, Yoshio Endo, Mika Noguchi, Motohiro Tanaka, Makoto Oda, ...
    1993 Volume 33 Issue 1 Pages 51-59
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    In order to develop an assay which is highly sensitive and quantitative, specific detection of a segment of human β-globin gene in metastasized human tumor cells in nude mice was performed by the polymerase chain reaction (PCR) technique and analyzed by Southern blotting. In this series, we used human fibrosarcoma HT-1080 cells. The results showed that lung metastasis could be detected as positive amplified PCR fragments from 1 week after tumor inoculation in the experimental metastatic model system. On the other hand, both lung and lymph node metastasis could be detected from 5 weeks after tumor inoculation in the spontaneous metastatic model system. In addition, by this method, therapeutic effects on lung metastasis of human tumor in nude mice could be detected within 2 weeks after tumor inoculation. This method will be useful for the elucidation of the mechanism of metastasis or invasion of human tumor cells in experimental animals and should contribute to the development of new chemotherapeutic methods for metastasis.
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  • Koji Sensaki, Hideo Masuda, Keiichi Kikuchi, Keigo Takagi, Katsuichi K ...
    1993 Volume 33 Issue 1 Pages 61-69
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Postoperative changes in cellular and humoral immunity were examined in 39 cases of primary lung cancer patients, and the effect of the granulocyte protease inhibitor, ulinastatin, was studied. Subjects were divided into two groups at random; 19 patients were given 300, 000 units of ulinastatin in the operative day and next four days. The other 20 patients were not given it. The following parameters were examined; white blood cell count, NK cell activity, T cell, B cell, immunoglobulin, plasma elastase. Left deviation of neutrophils, decrease of NK cell activity and T cell, B cell count were seen significantly in the control group. However these changes were inhibited in the ulinastatin group at POD 0 and POD 1. These results suggests that the administration of ulinastatin improves the defense mechanism in the postsurgical state.
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  • Kozo Sueyoshi, Isamu Narabayashi, Ryuichiro Namba, Yasunobu Nakata, Yo ...
    1993 Volume 33 Issue 1 Pages 71-77
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    67Ga scintigraphy is frequently used to screen pulmonary malignant tumors. We recently re-evaluated the diagnostic significance of 67Ga scintigraphy by comparing 67Ga scintigraphy (planar image) and chest CT in assessing the T and N factors of tumors. The study included 13 cases of squamous cell carcinoma and 15 cases of adenocarcinoma. In all cases, the diagnosis was histologically verified by surgery. The analysis revealed that 67Ga scintigraphy better demonstrated the T factor and stage of squamous cell carcinoma than in adenocarcinoma. The true positive rate of N factor did not significantly differ between chest CT (60% for squamous cell carcinoma and 86% for adenocarcinoma) and 67Ga scintigraphy (67% and 88%, respectively).67Ga scintigraphy is considered to be a useful preoperative examination for non-small cell lung cancer, because it provides additional information for preoperative evaluation concerning surgical indications if it is applied to selected cases with sufficient knowledge about limitations concerning its imaging abilities.
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  • Kohichi Yamazaki, Shosaku Abe, Hironori Takekawa, Noriaki Sukoh, Naomi ...
    1993 Volume 33 Issue 1 Pages 79-85
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    The clinical pictures of 75 cases with primary lung cancer who died at Hokkaido University from 1984 to 1989 were analyzed and studied with respect to respiratory failure. A total of 46 cases (61.4%, 53 times) suffered respiratory failure. Respiratory infection, tumor growth, pleural effusion and interstitial pneumonitis due to chemotherapy or radiation therapy were the 4 main causes of respiratory failure, and other causes such as DIC or SVC syndrome were associated with respiratory failure. However, 11 cases (20.8%) recovered from respiratory failure, and it was demonstrated by analysis of recovering cases that the recovery rate was better when the cause was respiratory infection or interstitial pneumonitis, when there was only one cause, when PaO2 at the time of respiratory failure was more than 50 Torr, and when general condition, especially the consciousness level, was good. A significantly better survival period from the first respiratory failure was observed in patients who showed recovery (162±110 days) than those who did not show recovery (29±42days). These results suggested that aggresive management should be done when indicated in cases of lung cancer with respiratory failure.
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  • Masao Kinoshita, Shin Fujita, Harubumi Katoh, Setsuo Hirohashi
    1993 Volume 33 Issue 1 Pages 87-94
    Published: February 20, 1993
    Released on J-STAGE: September 13, 2011
    JOURNAL FREE ACCESS
    The monoclonal antibody NCC-Lu-226 was established by fusing murine myeloma cells with splenocytes obtained from a BALB/c, nu/nu mouse immunized with human lung large cell carcinoma cell line C-Lu-65 using ‘rejection method’. Immunoprecipitation analysis of the antigen expressed on C-Lu-65 showed that the antigen was a single 130 kD cell surface protein under reducing and non-reducing conditions. The tissue distribution and expression of the antigen were examined using immunohistochemical method in human normal tissues and 142 cases of human lung cancer tissues. In normal tissues, the antigen was strongly expressed in basal side of stratified squamous epithelia, in basal layer of skin, tongue and esophagus. In human lung cancer tissues, the antigen was most strongly expressed in squamous cell carcinomas compared with adenocarcinomas, large cell carcinomas and small cell carcinomas. The expression rates of the antigen were 35 of 39 (90%) cases in squamous cell carcinomas, 21 of 61 (34%) cases in adenocarcinomas, 4 of 25 (16%) cases in large cell carcinomas and 0 of 17 (0%) cases of small cell carcinomas. The expression of the antigen was stronger on the peripheral basement membrane side of the cancer nest adjacent to the surrounding stromal tissue than in the intercellular layer among the cancer nests. According to the analysis of molecular weight and immunohistochemical study, the antigen was different from similar antigens reported up to the present. The monoclonal antibody NCC-Lu-226 may be useful not only for diagnosis and treatment of squamous cell carcinomas but also for studying the fundamental mechanisms of invasion and metastasis.
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  • Fumio Imamura, Harumichi Ikegami, Shinsuke Tamura, Tomiya Masuno, Hide ...
    1993 Volume 33 Issue 1 Pages 95-100
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    A phase I trial was conducted to study the effect of a prolonged administration of oral etoposide for SCLC. Each of 18 patients entered into this study was either previously treated by standard intensive chemotherapy or could not tolerate it. A modified Fibonacci schedule was used for dose escalation. Sixteen patients were eligible and evaluable. At 50mg/m2/day, 67% and 33% of patients developed neutropenia and anemia of grade 3 or 4, respectively. Moreover, other toxicities were minimal. Therefore, oral etoposide 50mg/m2 for 21 consecutive days was the maximum tolerated dose and myelosuppression was the dose-limiting toxic factor. Pharmacological analysis showed that the mean plasma concentration of etoposide was above 1μg/ml, which was the possible minimal effective concentration, by oral administration of 50mg/body/day and above. The accumulation of etoposide was not observed.
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  • Shinsuke Aida, Yuji Kimura, Hisamasa Akabane, Hirotaro Miura
    1993 Volume 33 Issue 1 Pages 101-107
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    A total of 79 non-operative autopsy cases of pulmonary adenocarcinoma were classified according to the cytological subtypes of Shimosato et al. (1982) to examine the correlation to survival period and frequency of metastasis. 1) The bronchial surface cell type with little or no mucus showed the longest survival period. The mean survival period was long even in stage N. Pulmonary metastasis was relatively frequent. 2) Frequency of pulmonary metastasis was highest in the goblet cell type, but the mean survival period was as long as that of the bronchial surface cell type. 3) Both lymph node metastasis and pleuritis carcinomatosa were most frequently observed in cases of the bronchial gland cell type, and the survival period was the shortest among all subtypes. 4) The Clara cell type showed relatively frequent pleuritis carcinomatosa and the prognosis was relatively poor, but the survival period of individual case was distributed over a very wide range. 5) Cases which were difficult to classify (undetermined type) showed frequent pleuritis carcinomatosa, lymph node metastases, intrapulmonary metastases and short survival.
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  • Akira Tanaka, Yuji Tohda, Takahiro Yamamoto, Yasuo Tsuya, Yukio Nagasa ...
    1993 Volume 33 Issue 1 Pages 109-113
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    A 73-year-old man was admitted to Kinki University Hospital because of mediastinal tumor. He had a history of surgical removal of mediastinal tumor ten years ago at a local hospital. At that time the histological diagnosis was schwannoma. Percutaneous needle biopsy was performed, but histological diagnosis was not determined. We diagnosed his illness as anterior mediastinal tumor according to the radiological findings. Tumorectomy was performed and the histological diagnosis was malignant pleural mesothelioma.
    We re-examined the histology of the mediastinal tumor in the first operation and found the same histological findings as that of the present operation. Malignant pleural mesothelioma is relatively rare, especially when found in the mediastinum. It was difficult to differentiate with the mediastinal tumor in this case.
    Cases of malignant pleural mesothelioma with long-term survival of more than ten years are also rare. There have been two other similar cases reported in Japan.
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  • Masatake Suzuki, Masumi Kurashige, Shinya Kusachi, Minoru Kurita, Kuni ...
    1993 Volume 33 Issue 1 Pages 115-120
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
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    Three resected cases of squamous cell carcinoma of the lung in chromate workers are reported. Case 1 was a 48-year-old male, and his chief complaints were cough and bloody sputum. This case was diagnosed by sputum cytology and bronchoscopy, and left lower lobectomy was performed. Case 2 was a 52-year-old male, whose complaints were continual cough and perforation of his nasal septum. In this case, lung carcinoma was detected in the left lower lobe bronchus and left pneumonectomy was performed. Case 3 was a 65-year-old male, whose only complaint was cough. This case was diagnosed based on evidence from sputum cytology and bronchoscopic biopsy, and right lowe lobectomy was performed. All three cases had histories of chromate exposure for periods of from 24 to 35 years. All cases were heavy smokers and their Brinkmann index ranged from 720 to 1380. At periodic routine examinations in their company, there were neither specific chest symptoms of lung cancer nor abnormal findings on plain roentgenograms. However, all three cases were diagnosed by bronchoscopic biopsy. In this occupational cancer, the problem of treatment was very difficult because of the possibility of synchronous and metachronous multiple recurrence. It was considered that periodic examinations including sputum cytology and bronchoscopy were very important for early detection of this occupational lung cancer in workers engaged in chromate manufacture.
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  • Toshiyuki Katoh, Akemi Shimauchi, Jou Shindoh, Michiaki Horiba, Michih ...
    1993 Volume 33 Issue 1 Pages 121-128
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
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    Granular cell tumor, the histological origin of which is considered to be myogenic or neurocytegenic, is usually benign and is found in various organs but is rare in the trachea, bronchus, and lung. A case of primary bronchial granular cell tumor in a 53-year-old male with bronchial asthma was detected. He complained of pharyngeal discomfort. Fiberoptic bronchoscopy revealed a whitish elevated lesion at the orifice of the left basal bronchus which had a smooth surface and was partially nodular. Biopsy revealed characteristic pathological findings of granular cell tumor, including numerous eosinophilic granules in the cytoplasm of tumor cells that were positive for PAS stain and S-100 protein. This tumor was diagnosed as primary granular cell tumor of the bronchus. Our case is the 22nd case of granular cell tumor located in the trachea, bronchus or lung reported in Japan. Though granular cell tumor is often surgically resected, we are following up our case carefully as most of them are benign and grow slowly.
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  • Wataru Chiba, Satoru Sawai, Takaaki Konishi, Hisao Ishida, Yoshito Mat ...
    1993 Volume 33 Issue 1 Pages 129-135
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
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    A 16-year-old boy had an anterior mediastinal tumor, which was resected in our hospital. The weight of the tumor was 205g, and it was diagnosed as Hodgkin's disease of the nodular sclerosis type. We performed gene analysis of the tumor in regard to the immunoglobulin heavy chain gene, light chain κ gene, λ gene, T-cell receptor βgene, and bcl-2 gene. We did not find any rearrangement bands for any of those genes. These results indicate that the origin of Hodgkin's disease is neither T-cell nor B-cell. The results of immunohistochemical staining were as follows. S-100 protein was positive, CD1a was positive, Ki-1 (CD 30) was positive, L26 (pan B-cell) was negative, UCHL-1 (pan T-cell) was negative, CD15 was negative, and CD68 was negative, for Hodgkin cells or Reed-Sternberg cells. These results, similar to those for the gene analysis, showed that the origin of Hodgkin's disease is neither T-cell nor B-cell. We suggest that the positive staining for S-100 protein and CD1a indicate that the Reed-Sternberg cells or Hodgkin cells are derived from interdigitating cells (T-zone histiocytes).
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  • 1993 Volume 33 Issue 1 Pages 136-150
    Published: February 20, 1993
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
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