All issues
Volume 43, Issue 6
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
Shinichiro Miyoshi2003 Volume 43 Issue 6 Pages 675-685
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe 30-day operative mortality was 1.3% among 7099 patients, who underwent thoracotomy for lung cancer in 1994 in Japan. Since the most frequent cause of death was pulmonary complications, I reviewed studies in the literature reporting preoperative cardiopulmonary function tests used to predict postoperative pulmonary complications. In the 1950s to 1970s, many studies using spirography were done and FEV1 or MVV, which shows obstructive pulmonary function disorders, were reported to be useful. During the same period, the unilateral pulmonary artery occlusion test was developed and pneumonectomy criteria were established. In the 1970s to 1980s, postoperative pulmonary function was predicted using pulmonary ventilation or perfusion scintigraphy or numbers of segments or subsegments. High correlations between predicted and measured postoperative pulmonary functions were demonstrated. Predicted postoperative FEV1 was extremely useful for predicting postoperative pulmonary morbidity, but not mortality. In the 1980s, a new method measuring VO2 during exercise testing was applied to preoperative evaluation and V02max and empirical anaerobic threshold were reported to predict both postoperative mortality and survivable morbidity. These findings suggest that cardiopulmonary rehabilitation should be attempted to prevent post-thoracotomy pulmonary morbidity and mortality.View full abstractDownload PDF (1729K) -
Satoshi Shiono, Kanji Nagai, Mitsuyo Nishimura, Junji Yoshida, Kazuya ...2003 Volume 43 Issue 6 Pages 687-690
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. The purpose of this study was to determine pleural dissemination predictors based on preoperative clinical and radiological findings. Methods. Among 1469 primary lung cancer patients who underwent thoracotomy at our institution from July 1992 through November 2001, 48 (3%) had pleural dissemination. Preoperative chest computed tomography (CT) scans, serum CEA levels, patient characteristics, tumor histology, and surgical findings were reviewed. Results. Pleural dissemination was found significantly more frequently among patients of female gender, adenocarcinoma histology, c N1/2 fmdings and CEA level above 10ng/ml. All dissemination patients had CT/surgical fndings suggestive of pleural invasion. Conclusion. Negative CT findings of visceral pleura invasion was the negative predictor of pleural dissemination in lung cancer patients.View full abstractDownload PDF (554K) -
Ryoji Kawano, Ryuta Fukai, Toshiya Yokota, Shingo Ikeda, Enjo Hata2003 Volume 43 Issue 6 Pages 691-697
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. To find out the optimal surgical treatment in primary lung cancer patients with intrapulmonary metastasis (pm), we evaluated the various clinicopathological factorsof the patients who received complete surgical resection with a lymphadenectomy. Methods. Thirty-four patients withintrapulmonary metastasis were classified into 26 pm patients within the same lobe as the primary tumor (pm 1) and8 patients within another lobe to that containing the primary tumor (pm 2). Results. The overall survival of pm patients was 44.4% at 5-years. The 5-year survival rate of pm 1 was 54.8%, but that of pm 2 was 0%. The 5-year disease-free survival (5-DFS) rate of all patients showed 28.9%. The 5-DFS of pm 1 was 33.3%, and the 2-DFS that of pm 2 was 14.3%. Theanalysis of outcome of the 5-year survival rate of pm 1 patients based on clinicopathological factors (tumor histology, number of pm, vessel invasion, T factor apart from pm factor, and N factor) showed that the nodal involvement is the most influential factor. The 5-year survival rate of the N-positive group (N1: 2 cases, N2: 9 cases, N3: 4 cases) was 38.9% and that of the N-negative group was 74.1%. A statistical significant difference between the two groups was identified (p=0.005). The 5-DFS of the N-negative group was 66.7%, and 3-DFS of N positive group was 3.7%(p=0.0002). Postoperative recurrence was identified in 17 (62.9%) of 27 pm 1 patients, and the most recurrence site was the lung. The recurrence rate based on the N factor was 4 (33.3%) of 12 patients without nodal involvement and 13 (86.6%) of 17 patients with nodal involvement. Conclusion. pm 1 patients without lymph node metastasis appeared to be the most appropriate candidates for the surgical procedure. Even if completely curative resection of pm 1 patients with lymph node metastasis seemed to have been achieved, there was a high rate of tumor recurrence. Therefore, surgical treatment of pm 1 patients with nodal involvement was suggested to be less effective for the local control of tumor.View full abstractDownload PDF (886K) -
Hiroyuki Sakurai, Kenji Suzuki, Shun-ichi Watanabe, Hisao Asamura, Ryo ...2003 Volume 43 Issue 6 Pages 699-703
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. In this retrospective study, we investigated the feasibility of subsequent pulmonary resection after pneumonectomy. Methods. Between 1987 and 2002, 383 patients underwent pneumonectomy at our hospital. Four (1%) of these patients underwent subsequent pulmonary resection in the contralateral lung. The clinicopathological records were reviewed with regard to tumor histology, pathological stage, preoperative and postoperative pulmonary function, the interval between subsequent pulmonary resection and pneumonectomy, mode of contralateral pulmonary resection, complications, mode of recurrence, and outcome. Results. Histology of the tumor treated by pneumonectomy was adenocarcinoma in 2 patients, squamous cell carcinoma in 1, and adenoid cystic carcinoma in 1. The postsurgical stage in patients who had undergone pneumonectomy was stage IA in 1 patient, stage IIB in 2, and stage IV in 1. Subsequent pulmonary resection was performed 7 to 53 months (mean, 25.5 months) after pneumonectomy. All patients had subsequent tumors arising in the periphery of the lung and underwent partial lung resection. Complications occurred in 2 patients, in both of whom the complications were respiratory-related. One of them died of respiratory failure postoperatively. Two patients had recurrent disease: one patient had recurrent tumor in the trachea and received radiotherapy and stent insertion, and is alive at 78 months with recurrence, while the other patient died from cancer recurrence after 63 months. Conclusion. Subsequent resection after pneumonectomy is regarded as the treatment of choice if the tumor is located in the periphery of the lung and can be curable by partial resection.View full abstractDownload PDF (1620K) -
Analysis Based on a Conventional Treadmill TestHiroaki Harada, Wataru Nishio, Morihito Okada, Toshihiko Sakamoto, Kaz ...2003 Volume 43 Issue 6 Pages 705-710
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSObjective. Since 1992, we have performed limited resection-extended segmentectomy-for patients suspected of having peripheral lung tumors less than 2cm on chest roentgenograms and with no evidence of metastasis through routine examinations. We already reported that the outcome of extended segmentectomy is comparable to that of lobectomy, and the postoperative functional loss of extended segmentectomy is small. However, controversy about the postoperative functional advantage of limited surgery over standard lobectomy for lung cancer still continues. The aim of this study was to evaluate the extent of reduction of maximal oxygen consumption after extended segmentectomy compared with lobectomy. Patients and Methods. An exercise test was performed preoperatively and two months after surgery to compare the effects of the procedure in 46 patients who underwent extended segmentectomy and 156 who underwent lobectomy. Results. Patients who were treated by extended segmentectomy retained 87.2±0.2% of their preoperative VO2max/BW, whereas the lobectomy group retained only 78.8±0.1%(p<0.0001). Also in the analysis for each lobe, the extended segmentectomy group retained significantly better exercise tolerance than the lobectomy group. Conclusions. At several months after surgery, better exercise tolerance was retained in patients who had undergone extended segmentectomy than those who had undergone lobectomy.View full abstractDownload PDF (668K) -
Hirohiko Akiyama, Daisuke Okada, Yutaka Enomoto, Hitoshi Nishimura2003 Volume 43 Issue 6 Pages 711-714
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. According to previous reports, partial anomalous pulmonary venous connection (PAPVC) found during a lobectomy for lung cancer patient is rare. Case. A 76-year-old woman was found to have an abnormal shadow on chest X-ray film and was admitted to our hospital diagnosed as adenocarcinoma of the lung and pulmonary tuberculosis. The preoperative clinical findings did not suggest a vascular shunt and we carried out right upper lobectomy and mediastinal node dissection. Intraoperatively, the anomalous pulmonary vein was seen to drain into the azygos vein from the right upper lung lobe and lateral part of the middle lung lobe. We were able to perform right upper lobectomy and mediastinal node dissection in safety, and the postoperative course was uneventful. The postoperative pulmonary angiography revealed that neither atrial septal defect (ASD) nor contralateral anomalous pulmonary vein was present. Conclusion. Although PAPVC found during a lobectomy for lung cancer is rare, we should keep in mind the possibility of variations of pulmonary vessel distribution before, during and after pulmonary surgery for safe perioperative managementView full abstractDownload PDF (2705K) -
Tomoyasu Uno, Hirofumi Mochizuki, Tsuneto Okada, Hirohisa Yoshizawa, E ...2003 Volume 43 Issue 6 Pages 715-719
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Elevated serum amylase associated with lung cancer is a rare phenomenon. Case. A 76-year-old man was admitted to our hospital complaining of abdominal and back pain. Chest X-ray film showed abnormal shadow in bilateral lung fields and laboratory data revealed elevated level of serum amylase. Neither the pancreas nor the salivary gland had any clinical involvement. Cytology by transbronchial curettage revealed adenocarcinoma, and the cancer cells stained positively for salivary amylase immunohistochemically. Chemotherapy was ineffective, he died three months after diagnosis. Postmortem examination revealed moderately differentiated adenocarcinoma with partial papillary and tubular structures. Positive immunostaining for salivary amylase in cytoplasm of the tumor cells was reconfirmed. Conclusion. Amylase-producing lung cancer should be considered as a differential diagnosis in cases of elevated level of serum amylase.View full abstractDownload PDF (2575K) -
Shinji Kanemitsu, Motoshi Takao, Iwao Hioki, Isao Yada, Hiroki Yasui2003 Volume 43 Issue 6 Pages 721-724
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Extramedullary plasmacytomas are rare neoplasms among plasma cell tumors and occur mainly in the upper respiratory tract or oral cavity. Such tumors limited to the mediastinum are extremely rare. Case. A 65-year-old man consulted our hospital due to a mediastinal tumor revealed on chest X-rays and computed tomography (CT). Bronchoscopic needle biopsy failed to enable a definitive diagnosis. The mediastinal tumor was completely resected. The completely encapsulated tumor was 40×45 mm. Neither trachea nor the great vessels were involved. Histopathological findings revealed plasmacytoma producing a monoclonal IgG kappa component and positive for Cyclin D1 on immunohistochemical staining. At 8 months after surgery, the patient remains well, and there is no evidence of recurrence or development of multiple myeloma. Conclusion. Solitary extramedullary plasmacytoma occurring in the mediastinum is extremely rare. In this paper, we report a surgically treated case of extramedullary plasmacytoma occurring in the mediastinum.View full abstractDownload PDF (2720K) -
Jin Sakamoto, Toshihiro Okamoto, Hiroshi Mizuno2003 Volume 43 Issue 6 Pages 725-728
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Although the incidence of metastasis of renal cell carcinoma to the lungs is high, there have been few reports of delayed lung metastasis occurring more than 10 years after nephrectomy. Case. A 63-year-old man had undergone right nephrectomy because of renal cell carcinoma when he was 50 years old. Thirteen years after, multiple lesions of the bilateral pleurae and lungs appeared on chest X-ray films and CT scans. The seven metastatic lesions were resected completely. The examination of resected tissues revealed renal cell carcinoma. Conclusion. This case was worth reporting, because lung metastasis rarely occurred a long time after nephrectomy for renal cell carcinoma.View full abstractDownload PDF (2855K) -
Akira Nagashima, Masayuki Kawasaki, Hiroshi Wataya, Takashi Yoshimatsu ...2003 Volume 43 Issue 6 Pages 729-733
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Benign metastasizing leiomyoma (BML) is a rare clinical entity that has been described in several previous reports, and most documents do not make mention of long-term consequences. Case. We present a case of BML in a 39-year-old woman followed up for a long time after diagnosis. She had undergone a total abdominal hysterectomy without oophorectomy for uterine myoma at age 37. Two years later, her chest roentgenogram showed multiple nodular shadows in the lung field. A thoracoscopic lung biopsy revealed leiomyomatous tumors that were pathologically similar to the uterine leiomyoma removed previously, and the tumors were eventually diagnosed as BML. In spite of medical castration using GnRH agonist (buserelin acetate) for six months after surgery, the residual lung tumors showed slight increased in size. After that, she received no further treatment for five years, and chest CT showed slight increase in size and number of the lung tumors. Then, six courses of GnRH agonist (leuprorelin acetate) were administered, and obtained decrease in the size of the tumors. Six years and 5 months after diagnosis and with no further therapy, the patient remains asymptomatic with very slowly growing lung tumors. Conclusion. Medical castration using GnRH agonist appears to be the treatment of choice in the pre-menopausal patient with BML.View full abstractDownload PDF (4841K) -
Hiromasa Morikawa, Takashi Hirai, Akira Yamanaka, Fumio Konishi2003 Volume 43 Issue 6 Pages 735-738
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Lung cancer in young patients under 40 years of age is rare. Juvenile cases account for about 3% of all lung cancer patients. We experienced a case of lung cancer in a woman 18 years old. Case. An 18-year-old woman was admitted to our hospital for examination of an abnormal shadow on chest X-ray. Although diagnosis could not be confirmed by transbronchial biopsy, lung cancer was suspected by CT scan (1.5×1.2cm shadow in the right upper lobe). As intraoperative histologic examination through thoracotomy revealed lung cancer, right upper lobectomy was performed. Resected specimens showed well differentiated papillary adenocarcinoma. The pathological stage was IA. The patient is alive without any sign of recurrence 12 months after the operation. Conclusion. Detailed examination including open lung biopsy must be kept in mind even in young patients.View full abstractDownload PDF (1919K) -
Shigeki Sawada, Shigeharu Moriyama, Youichi Watanabe, Masatoshi Kubo, ...2003 Volume 43 Issue 6 Pages 739-744
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Primary pulmonary collision tumor is relatively rare. We report three cases of primary pulmonary collision cancer. Case. Case 1 was a 67-year-old man in whom an abnormal shadow, a tumor 2cm in diameter in the right S10, was found on a chest X-ray film and bronchofiberscopic cytology showed squamous cell carcinoma of the lung. Right lower lobectomy was performed and the pathologic diagnosis showed collision cancer of adenocarcinoma and squamous cell carcinoma. Case 2 was a 77-year-old man. His chest X-ray film and CT showed a tumor in the right S6. Right lower lobectomy was performed and pathologic diagnosis showed collision cancer of adenocarcinoma and squamous cell carcinoma. Case 3 was a 75-year-old woman in whom chest X-ray film and CT showed a tumor 2.7cm in diameter in the right S2. Biopsy via bronchofiberscopy showed squamous cell carcinoma. After right upper lobectomy, pathologic diagnosis showed collision cancer of adenocarcinoma and squamous cell carcinoma. Conclusion. These three cases were all collision tumors involving adenocarcinoma and squamous cell carcinoma which is the most common combination in lung cancer.View full abstractDownload PDF (4513K) -
Hirokazu Taniguchi, Hitoshi Abo, Hideki Miyazawa, Hirofumi Noto, Sabur ...2003 Volume 43 Issue 6 Pages 745-749
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSBackground. Epitheloid hemangioendothelioma is a rare tumor which originates from hemangioendothelial cells. We report a case of epitheloid hemangioendothelioma involving the lung and liver. Case. A 29-year-old man was admitted to our hospital, because of multiple small nodular shadows on a chest radiograph and CT taken at a regular medical examination. Open lung biopsy yielded a diagnosis of epitheloid hemangioendothelioma of the lung. His abdominal CT showed some small nodular shadows in the liver, which were diagnosed as the same epitheloid hemangioendothelioma by laparoscopic biopsy. He was followed with no treatment for the tumors, and six years later, he was admitted to our hospital because of epigastralgia. The lung lesions were slightly enlarged compared to six years previously, but the liver lesions had significantly enlarged and the left branch of the portal vein was occluded by compression or invasion of the tumor. Transcatheter arterial embolization was done, but showed no effect. Then, he suffered from jaundice due to the enlarged liver tumors. Six years and eight months after the first admission, he died. Conclusion. This rare case of epitheloid hemangioendothelioma involving the lung and liver was unique in terms of the enlargementof the liver lesions.View full abstractDownload PDF (4222K) -
2003 Volume 43 Issue 6 Pages 750-774
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (5190K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2003 Volume 43 Issue 6 Pages 780-784
Published: October 20, 2003
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (579K)
- |<
- <
- 1
- >
- >|