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Volume 45, Issue 1
February
Displaying 1-13 of 13 articles from this issue
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ORIGINAL ARTICLE
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Akira Nagashima, Hidehiko Shimokawa, Mitsuhiro Takenoyama, Kosei Yasum ...2005 Volume 45 Issue 1 Pages 1-4
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSObjective. We assessed the outcome of surgical treatment for non-small cell lung cancer with interlobar pleural invasion to an adjacent lobe, and elucidated whether or not such lung cancer cases should be categorized as T2. Furthermore, the optimal operative method for treating the adjacent invaded lobe was discussed. Patients and Methods. Forty non-small cell lung cancer patients with invasion beyond the interlobar pleura and categorized as pT2 (the ILp3pT2 group) were studied. The outcomes of the patients without interlobar pleural invasion and categorized as pT2 (the ILp0-2pT2 group), and those categorized as pT3 (the pT3 group) were compared. Results. The 5-year survival rates for the ILp3pT2 group, the ILp0-2pT2 group and the pT3 group were 56.4%, 51.2%, and 33.4%, respectively. The survival of the ILp3pT2 group was significantly better than that of the pT3 group (p=0.013) and similar to that of the ILp0-2pT2 group (p=0.415). The type of operative procedure selected for the treatment of the adjacent lobe invaded by cancer did not significantly influence survival. The locoregional recurrence rate did not substantially differ between the ILp3pT2 group, who underwent a partial resection to treat the adjacent lobe invaded by cancer, and the ILp0-2pT2 group. Conclusion. Our findings indicate that it is appropriate to categorize interlobar pleural invasion to the adjacent lobe as T2 and the optimal operative procedure is considered to be a partial resection of the adjacent invaded lobe.View full abstractDownload PDF (53K) -
Kazuro Sugi, Kouji Kitada, Eisuke Matsuda, Katsutoshi Hirazawa, Toshit ...2005 Volume 45 Issue 1 Pages 5-11
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSObjective. The objective of this study was to analyze the current treatment of clinical stage I and II lung cancer in the elderly, with emphasis on surgical treatment, and propose topics for clinical research. Methods. The subjects were 206 patients with clinical stage I and II non-small cell lung cancer treated at the author's hospital from August 1996 to July 2003. The patients were divided into an elderly group (≥75 years old) and a non-elderly group (<75 years old). Results. There were 54 elderly patients (26.2%) and 152 non-elderly patients (73.8%). Surgery was performed on 72.2% of the elderly group and 77.6% of the non-elderly group, with no difference between the two groups. Preoperative complications occurred in 25.6% of the elderly group versus 14.4% of the non-elderly group. In the elderly group, less invasive approaches such as video-assisted thoracic surgery and muscle-sparing thoracotomy were used more often (P=0.036), but the main procedure was lobectomy. Postoperative complications occurred in 14.8% of the elderly group, and were significantly more common than in the non-elderly group (5.3%, P=0.024). Postoperative complications occurred in 25.0% in the elderly patients without preoperative complications. Postoperative complications occurred mainly in the patients who underwent standard thoracotomy and lobectomy. The 3-year postoperative survival rate was 74.4±10.8% in the elderly group and 87.0±4.2% in the non-elderly group, showing no significant difference (P=0.711). Conclusion. Less invasive approaches and limited surgery can reduce postoperative complications and yield satisfactory prognosis in elderly patients with clinical stage I and stage II lung cancer.View full abstractDownload PDF (72K) -
Jun Ogata, Koichi Takayama, Jian Ni, Naoko Inoshima, Junji Uchino, Aki ...2005 Volume 45 Issue 1 Pages 13-18
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSObjective. In this experiment, we investigated the effects of overexpressed IκBα on human lung cancer cell line H460 proliferation in vitro and in vivo. Methods. The IκBα gene was transferred by recombinant adenovirus, AdIκBα. Cell growth suppression was evaluated by MTS assay in vitro and tumor growth suppression was evaluated by direct measurement of tumor size established on nude mice. Results. The results suggested that the infection of AdIκBα blocked NFκB activity in H460 cells and significantly inhibited cell proliferation by inducing apoptosis, which was confirmed by increased activity of caspase 3 in transfected cells. An in vivo study showed the tumor incidence to be significantly lower in mice implanted with H460 cells infected with AdIκBα than those with control virus (P=0.012). For established H460 tumor, the intratumoral injection of AdIκBα also inhibited the tumor growth significantly. Immunohistochemical staining of treated tumor showed the suppressed VEGF expression. Conclusion. Overexpressed IκBα inhibited tumorigenesis significantly partly due to antiangiogenesis through the suppression of VEGF production.View full abstractDownload PDF (72K)
CASE REPORT
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Miyuki Kitahara, Isao Ogawa, Satoshi Yodonawa, Akira FujiwaraArticle type: Others
Subject area: Others
2005 Volume 45 Issue 1 Pages 19-23
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. It has been reported that emphysematous bullae is a risk factor of lung cancer. We report a case of microscopic lung cancer and AAH incidentally detected after giant bullae resection. Case. A 32-year-old man. was referred to our hospital for diagnosis of bilateral giant bullae on chest X-ray films taken in a health examination at his company. He was kept under observation because he had no symptoms. Three years before, right giant bullae resection was performed because of the appearance of respiratory symptom and enlargement of the right bullae. Five lung specimens were offered, two of the bullae showed localized tumors on the inner surface, measuring 1.0×1.0 mm and 1.5×3.0 mm in size. Histologically, the tumors were diagnosed as microscopic adenocarcinoma consisting of papillary proliferation. Also, normal lung material of the same specimen contained a tumor, measuring 5.0×3.0 mm in size, diagnosed as atypical adenomatous hyperplasia (AAH) histologically. Additionl operation has not been perfomed and he has beenfollowed. Conclusions. We should recognize that patients who have pulmonary bullae belong to the high risk group of lung cancer, and we need follow them up regularly. Also, we should keep in mind the existence of microscopic lung cancer detected after bullae resection accidentally. Histologically we should diagnose very carefully.View full abstractDownload PDF (158K) -
Takuya Samukawa, Kouji Uozumi, Yoichiro Higashi, Masatada Soejima, Hir ...2005 Volume 45 Issue 1 Pages 25-30
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. The incidence of primary pulmonary lymphomas is only 0.34%, and peripheral T-cell lymphoma is very rare. Moreover, there is no literature recording its appearance in a Human T lymphotropic virus type 1 (HTLV-1) carrier. Case. A 65-year old man with dry cough, fever, and chills was admitted with multiple pulmonary nodules and pleural effusion. High lymphocyte count and elevated adenosine deaminase (ADA) were found in the pleural effusion. Antitubercular therapy yielded no clinical or radiologic improvement. The patient was transferred to our hospital where lymphoma was confirmed from positive rearrangement of the TCR-β gene in cells in the pleural effusion. The patient was positive for HTLV-1 antibody, but did not have monoclonal integration of the pro-virus HTLV-1 in cells in the pleural effusion. Conclusion. This was the first case of an HTLV-1 carrier presenting with primary pulmonary T cell lymphoma.View full abstractDownload PDF (121K) -
Hiromichi Itoh, Tatsuo Yamamoto, Yukihisa Saida, Shigemi Ishikawa, Mas ...2005 Volume 45 Issue 1 Pages 31-36
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. As HRCT (high resolution computed tomography) has become increased commonly used, it has become apparent that GGA (ground-glass attenuation) is present in a variety of lung diseases. We report a case of unilateral lung edema represented as GGA in an opposite lung field after treatment of pulmonary adenocarcinoma. Case. A 70-year-old man with uncontrolled diabetes was admitted because of an abnormal shadow discovered during a routine chest X-ray in June 2003. In 1994, he underwent a left lower lobectomy and post-operative mediastinal radiation for pulmonary adenocarcinoma (p-Stage IIIA). Chest CT on admission demonstrated widespread GGA in the right hilar lesion of the middle and lower lobes. Detailed examinations including TBLB, bacterial culture and a serological test could not confirm bronchioloalveolar carcinoma, interstitial pneumonia, viral pneumonia or alveolar proteinosis. The patient increased his weight by 5 kg and ultrasound examination showed dilatation of the inferior vena cava and a congestive liver. The GGA disappeared one month after the administration of furosemide. Conclusion. The clinical course, HRCT and pathological findings suggested that lung edema caused by volume overload affected as localized unilateral GGA in the chest CT. The decrease in pulmonary vessel beds due to surgical resection, obstruction of lymphatic circulation after mediastinal radiation, and increased permeability of microvessels associated with diabetes are supposed to be linked to lung edema. Localized lung edema should be considered as a possible cause of GGA after lung cancer treatment.View full abstractDownload PDF (138K) -
Norihiko Funaguchi, Toshiyuki Sawa, Takashi Ishiguro, Tsutomu Yoshida, ...2005 Volume 45 Issue 1 Pages 37-40
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. Paraneoplastic neurological syndrome (PNS) is known as an immunological disease accompany in malignant diseases. Small cell lung cancer (SCLC) is one of the most important causes of PNS. We report a case of SCLC with Lambert-Eaton myasthenic syndrome (LEMS) and paraneoplastic cerebellar degeneration (PCD). Case. A 62-year-old man was admitted to our hospital because of difficulty in standing and walking. A complete medical examination led to a diagnosis of SCLC with LEMS and PCD. Four courses of chemotherapy (carboplatin + etoposide) and concurrent radiotherapy with a total dose of 45 Gy were performed and resulted in a complete response. Marked improvement of his muscle weakness enabled ambulation. However cerebellar ataxia persisted after therapy. Conclusion. Marked improvement of LEMS was achieved, however PCD symptoms persisted in spite of the treatment of SCLC.View full abstractDownload PDF (97K) -
Sounosuke Tanaka, Hiromi Egawa, Akiko Mito, Yoshiro Tachiyama2005 Volume 45 Issue 1 Pages 41-46
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. Primary germ cell tumor cases of the mediastinum are rare. We report a case of primary mixed-type germ cell tumor of the mediastinum associated with choriocarcinoma. Case. A 31-year-old man was referred to our hospital due to pleural fluid accumulation. CT examination showed a huge tumor in the anterior mediastinum. After percutaneous needle biopsy and evaluation of tumor markers we made a diagnosis of primary germ cell tumor of the mediastinum with metastasis to the lung. Three courses of cisplatin-based chemotherapy were given, but no sufficient therapeutic results were obtained. With metastasis to the whole body, he died four months after the initiation of therapy. Autopsy revealed primary mixed-type germ cell tumor consisting of immature teratoma and choriocarcinoma. Conclusion. Among primary germ cell tumors of the mediastinum, choriocarcinoma is especially rare, and its poor prognosis requires the development of an effective therapeutic method.View full abstractDownload PDF (615K) -
Motohisa Kuwahara, Kitaroh Futami, Sumitaka Arima, Hideo Toyoshima, Ak ...2005 Volume 45 Issue 1 Pages 47-50
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBackground. Pulmonary lymphoma in young patients under 40 years of age without immunological deficiency is rare. Case. A 27-year-old woman was admitted to our hospital with bilateral multiple pulmonary opacities on a chest radiograph. Computed tomography revealed an irregular marginal nodular shadow 2.8 cm in diameter in right S4 with spiculation and multiple alveolar opacities in left S1+2, S4, S10 and right S2. The tumors in the left lung were resected thoracoscopically, and were well defined and white in color. Pathologically, the specimens were diagnosed as extranodal marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue. The patient rejected immediate treatment and chose to be followed up until tumor progression was confirmed. Conclusion. We encountered a rare case of primary multiple pulmonary lymphomas of bronchus-associated lymphoid tissue in a young person.View full abstractDownload PDF (124K)
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Hideaki Otsuji2005 Volume 45 Issue 1 Pages 51-54
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSWe must analyze four structures on chest CT: as the tracheobronchial tree, pulmonary artery, pulmonary vein and interlobar fissures. We can find enumeration of anatomical figures in various textbooks, but can seldom find how to analyze the anatomical structures. Inexperienced readers are usually unable to give anatomical nomenclature correctly on their own even after reading textbooks. I showed 3D movies using a PC to demonstrate the analytical process of examining pulmonary structures revealed by multislice CT, and presented an outline of key slices for pulmonary analysis.View full abstractDownload PDF (60K) -
Kouzo Yamada2005 Volume 45 Issue 1 Pages 55-61
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSClinical symptoms of primary lung cancer are frequently unobserved in not only the early stages but also relatively advanced stages of the disease. Primary lung cancer is often first revealed by a mass screening or imaging diagnosis of the chest region because of another other diseases. The chest computed tomography (CT) diagnosis is considered to play a great role in the diagnosis of lung cancer. With the recent introduction of FDG-PET and the newest MRI in the diagnosis of lung cancer, attempts have begun to be made to apply these techniques to the qualitative diagnosis of lung cancer. In actual clinical practice, however, the chest CT still plays a major role in not only screening but also qualitative diagnosis. With the spread of lung cancer screening using chest CT, many small pulmonary lesions have been detected. The role of the qualitative diagnosis based on high resolution CT images is becoming increasingly important. This paper describes the qualitative diagnosis and stage diagnosis using chest CT in the diagnosis of lung cancer by comparing CT findings with pathological findings.View full abstractDownload PDF (213K) -
Yoshiharu Ohno, Munenobu Nogami, Takanori Higashino, Sumiaki Matsumoto ...2005 Volume 45 Issue 1 Pages 63-73
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSRecent advances in computed tomography (CT) and magnetic resonance (MR) imaging such as the multidetector-row CT system, the parallel imaging technique, new sequences and software provide new reconstructed CT images and new MR imaging for diagnosis of TNM staging and assessment of pulmonary function. In this review, we describe recent advances in MR imaging of lung cancer, focusing on (1) characterization of solitary pulmonary nodules and differentiation of subtypes of adenocarcinoma; (2) assessment of T-, N-, M-stage, and (3) pulmonary functional MR imaging.View full abstractDownload PDF (287K) -
Hiroto Takahashi2005 Volume 45 Issue 1 Pages 75-78
Published: 2005
Released on J-STAGE: May 12, 2006
JOURNAL OPEN ACCESSBasic aspects of bronchoscopy. This paper explains the anesthesia and insertion method of forceps with 180 degrees angulation to B1+2a+b. Recent topic in bronchoscopy. This paper explains the insertion method of forceps to B1+2a+b by P-260 and the endotracheal inversion method by XBF-260F. Applications of ultrasonography for respiratory disease. Ultrasonography shows prominent local resolution, and a functional diagnosis is possible by observation of blood flow. We applied this method to the diagnosis of lung cancer, and we discuss mainly trans-tracheal endoscopic ultrasonography (TUS), trans-esophageal endoscopic ultrasonography guided fine needle aspiration biopsy (EUS-FNAB), body surface ultrasonography and perioperative ultrasonography.View full abstractDownload PDF (119K)
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