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Publications (21)3.39 Total impact

  • H Hiyoshi, H Iwanami, E Tsuboi, H Kato
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    ABSTRACT: This patient, a 53-year-old man, has underwent operation on the diagnosis of esophageal cancer 2 years ago. An abnormal shadow was detected in the left lung field and he was admitted to our hospital for further examination. On the suspicion of metastatic lung tumor by transbronchial brushing cytology, partial resection of the left lower lobe was performed. Histologically the tumor was of carcinomatous (squamous cell carcinoma and adenocarcinoma) and sarcomatous (fibrosarcoma and chondrosarcoma) elements, so the patient was diagnosed as "true" pulmonary carcinosarcoma. True pulmonary carcinosarcoma is one of the very rarest neoplasms of the lung.
    Kyobu geka. The Japanese journal of thoracic surgery 06/2004; 57(5):360-3.
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    ABSTRACT: Four cases of primary lung carcinoma (two squamous cell carcinomas and two adenocarcinomas) were performed right middle lobectomy combination with the reconstruction of upper pulmonary vein to remain the upper lobe. Lung carcinomas were in the right lobe and infiltrated to lower margin of upper pulmonary vein in all cases. After resection of the right middle lobe and an affected portion of upper pulmonary vein, the defect of the upper pulmonary vein was replaced with auto-pericardial graft in three cases, and the other one was closed by continuous suture of 5-0 plorene. Pathological classification of these four cases was stage IB in one patient, stage IIB in two and stage IV in one. All patients died from 6 to 53 months after operation (average: 31 months). Metastasis to distant organs was confirmed in all cases, so the prognosis of them was generally poor. Reconstruction of pulmonary vein may be feasible to avoid over resection of other lobes, because pulmonary function can be preserve as well as in the bronchoplasty.
    Kyobu geka. The Japanese journal of thoracic surgery 02/1999; 52(1):30-4.
  • The Journal of The Japanese Association for Chest Surgery. 01/1999; 13(2):136-139.
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    ABSTRACT: This patient, a 52-year-old male, underwent subtotal thyroidectomy on the diagnosis of medullary carcinoma of the thyroid gland in 1980 and postoperative course was uneventful. Since November 1990 he had a persistent diarrhea for 6 months and was admitted to the hospital for the further examination on June 1991. The serum CEA and calcitonine level was very high and chest CT scan findings showed the swelling of right neck and mediastinal lymph nodes. Dissection of the lymph nodes was performed by anterior approach which was gained through a proximal median sternotomy extended into the anterior fourth intercostal space as well as to the base of the neck on the right side. On the pathological examination it was metastasis of medullary carcinoma of the thyroid gland. And 50 months later after second operation he had a persistent diarrhea once again. Left neck and mediastinal lymph node metastasis was detected by chest CT with high serum CEA and calcitonine level. Similarly resection was performed by the same anterior approach on the left side. Irrespective of the extended resection he was free of severe complication; he is still alive 10 months after the third operation without any evidence of recurrence and his current performance status is very good.
    Kyobu geka. The Japanese journal of thoracic surgery 01/1998; 50(13):1133-5.
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    ABSTRACT: Twenty-four cases of primary lung cancer with dissemination or malignant effusion of pleura detected preoperatively or intraoperatively were surgically treated at our hospital. Mean survival time (MST) and two-year survival rate (2 YSR) were analyzed on their resected cases and non-resected cases with similar lesion. MST and 2 YSR of 19 cases with lobectomy, 5 cases with pneumonectomy including pleuropneumonectomy and 15 cases with no surgical procedure were 2.77 +/- 0.60 years, 53.4%, 1.51 +/- 0.50 years, 26.7% and 0.99 +/- 0.15 years, 6.7%. MST and 2 YSR of 13 cases with lymph node dissection under R 1 and 6 cases over R 2 on lobectomy group were 1.99 +/- 0.38 years, 37.5% and 5.66 +/- 1.71 years, 66.7%. These findings suggested that lobectomy with lymph node dissection of R 2 over may be a beneficial treatment of lung cancer with dissemination or malignant effusion of pleura.
    Kyobu geka. The Japanese journal of thoracic surgery 03/1997; 50(2):120-2.
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    ABSTRACT: This patient, a 53-year-old male, has had back pain and an abnormal shadow was detected in the right lung field on December 1989. He was admitted to the hospital for the further examination. On the diagnosis of lung cancer with high serum CEA level operation was performed on February 1990. As a results of pathological examination, histological type was adenocarcinoma and pathological stage was pT3N0M0 stage IIIA. After operation the serum CEA level was decreased immediately but it was gradually increased once again. And then 14 months later right adrenal metastasis was detected by abdominal CT with high serum CEA level and resection was performed. Similarly a solitary lymph node metastasis located in abdomen was detected and resected with high serum CEA level 28 months after second operation. In this case detection and resection of the metastatic lesion was managed effectively by serum CEA level. The patient had a good operative course and is alive 76 months after first operation without any evidence or recurrence.
    Kyobu geka. The Japanese journal of thoracic surgery 10/1996; 49(10):873-5.
  • The Journal of The Japanese Association for Chest Surgery. 01/1996; 10(7):743-747.
  • The Journal of The Japanese Association for Chest Surgery. 01/1996; 10(6):690-693.
  • The Journal of The Japanese Association for Chest Surgery. 01/1996; 10(6):721-724.
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    ABSTRACT: Bronchoscopic findings from the main to segmental bronchi were compared with the histopathological findings in 185 resected cases of lung cancer, in order to determine which bronchoscopic features are associated with lung cancer invading the subepithelium or submucosa from beyond the bronchial wall. Carcinoma invaded the subepithelium or submucosa from beyond the bronchial wall in 43 cases (22.9%) out of the total of 185 cases. Bronchoscopic findings were evaluated in these 43 cases, and were summarized as follows: (1) The bronchoscopic findings in cases of subepithelial invasion consisted of vascular engorgement, bleeding, subepithelial tumor, and emphasized longitudinal relief; (2) irregularity of the mucosa was observed in cases of epithelial or muscular invasion; (3) indistinct bronchial cartilage was observed in cases of invasion proximal to the extramuscular layer; (4) accentuated irregular folds were observed in cases of invasion of the extramuscular or cartilage layers; and (5) edema and redness were not specific for malignancy. In addition, the occurrence of mediastinal lymph node metastasis was higher in cases of invasion to main or lobar bronchi. This result indicates that recognition of invasion of the subepithelium or submucosa of the central bronchus may be helpful in indicating the probability of mediastinal lymph node metastasis. Accordingly, there may be specific bronchoscopic findings which correlate with invasion of the bronchial subepithelium or submucosa. Accurate recognition of these findings may be useful in determining appropriate biopsy sites and may provide more information concerning selection of therapeutic strategy.
    Lung Cancer 04/1995; 12(1-2):35-44. · 3.39 Impact Factor
  • The Journal of The Japanese Association for Chest Surgery. 01/1994; 8(2):169-173.
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    ABSTRACT: This case is a 30-year-old male who was indicated abnormal shadow in the left upper lung field by chest X-ray film. The aortography was carried out because pulmonary sequestration was suspected by chest CT-scan etc. From the result, rare pulmonary sequestration in the left upper lung field was diagnosed because patterns with inflow of an abnormal artery from descending aorta into the left upper lung field and perfusion of it into the upper pulmonary vein were observed. The wedge resection was performed. The specimen was slightly hard on the whole, and many cartilages or multiple nodules were observed on the cut surface. Histopathologically, normal pulmonary structure was disappeared, and hyperplasia of the lymphatic nodule was remarkably observed in the interstitium, and cystic wall was covered by ciliated cylindrical epithelium.
    Kyobu geka. The Japanese journal of thoracic surgery 08/1993; 46(7):614-7.
  • The Journal of The Japanese Association for Chest Surgery. 01/1993; 7(5):603-607.
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    ABSTRACT: We reported a successful pleuro-venous shunt operation (Pl-V shunt) for a patient of liver cirrhosis with secondary hydrothorax. A 78-year-old female was admitted to our hospital because of severe dyspnea and palpitation. Chest x-ray film revealed right sided massive pleural effusion. Over several weeks the chest tube drainaged about 1,500 ml of transudative fluid per day. We performed Pl-V shunting and pleural effusion subsequently decreased in amount and dyspnea disappeared. This Pl-V shunting is thought to be useful for such a patient with massive pleural effusion which failed to respond to medical therapy.
    Kyobu geka. The Japanese journal of thoracic surgery 01/1993; 45(13):1205-8.
  • The Journal of The Japanese Association for Chest Surgery. 01/1993; 7(2):192-198.
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    ABSTRACT: We reported a successfully treated case of empyema with a large tracheal fistula which had developed after a radical operation of esophageal cancer (reconstructed with stomach). This 59-year-old male was treated by the method of fixation and plombage with major pectoral muscle flap and thoracoplasty, because we could not use the omentum that were frequently used nowadays for closure of the fistula. The size of the tracheal fistula was a large as the main bronchus bronchoscopically. Postoperative care were the following, the endotracheal tube was inserted from the tracheal stoma to the left main bronchus and 9 days left hemi-ventilation was performed. Continuous suction was performed at the same time from the right main bronchus in order to prevent secretion and blood pour into the left lung. Bronchoscopical examination done 28 postoperative day, the small fistula remained the tip of the muscle flap. But 72 postoperative day, the surface of the fixed muscle flap was replaced by normal bronchial mucomembrane and tracheal fistula was obliterated. Major pectoral muscle could be used as local flap to obliterate empyema cavity associated with tracheal fistula. We believe that utilizing an muscle flap for those who had undergone abdominal operation like our case is a valuable method.
    [Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 09/1992; 40(8):1254-60.
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    ABSTRACT: We applied an endoscopic Nd-YAG laser therapy for an early hilar lung cancer complicated with hemophilia A in a patient of 62-year-old male. Abnormality was pointed out by means of sputum cytology. But, no shadow of tumor was observed by chest x-ray films and computed tomogram. By a bronchoscopy, a mild irregular mucomembrane and stenosis without tumor were exhibited. By means of cytological diagnosis of an abrasive-washing specimen of that region, the presence of squamous cell carcinoma was proved. Also, he was diagnosed as factor VIII deficient hemophilia A. So we performed him a laser therapy in place of the operation and with an intrabronchial arterial infusion. After the laser treatment, the conditions progressed better without any recurrence but about one and a half years later, an intrapulmonary metastasis occurred. Then, radiation and chemotherapy have been applied and at present, the patient is in a good state although under the tumor-bearing condition.
    Kyobu geka. The Japanese journal of thoracic surgery 02/1992; 45(1):84-8.
  • The Journal of The Japanese Association for Chest Surgery. 01/1992; 6(7):798-803.
  • Y Shinohara, H Iwanami, E Tsuboi
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    ABSTRACT: We surgeons have always encountered difficulty in localizing small pulmonary nodules, measuring less than 5 mm in diameter, through palpation during operation. In order to solve such a problem, we devised a new method of localizing small pulmonary nodules by applying a technique of CT-guided needle biopsy; namely, metallic spring coil is implanted through a 16 G eraster needle, the tip of which has been placed near the lesion. Our method not only secures the resection of entire lesions, but reduces an amount of lung resection through a small incision (mini-thoracotomy) as well. Furthermore, this method is also thought to be useful for open lung biopsy of pulmonary nodules, measuring less than 1 cm in diameter, in saving time and reducing an amount of lung tissue collection. In case of cystic lesion which is thought to be difficult to palpate on operation, this method can also be useful for its resection.
    Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica 07/1990; 50(6):674-6.
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    ABSTRACT: Of 200 lung cancer lesions resected in our hospital, there were 15 cases (7.5%) with middle lobe origin. The histological types were adenocarcinoma in 13 patients (4 patients with alveolar cell carcinoma), squamous cell carcinoma in one and large cell carcinoma in one. These patients were classified into two groups according to the type of operation they received and each group was evaluated. Group I (resection of the middle lobe) included 8 patients. Each one of Stage IIIB and Stage IV received the operation to improve their symptoms. The six patients of Stage I received only middle lobectomy as absolute curable cases. Group II (resection of the middle and lower lobes) included 7 patients, who had preoperative diagnosis of stage III. Two of them were postoperatively found to be cases of Stage I and Stage II. Although it was still short-term, the follow-up evaluation proved that these patients survived without local recurrence and distant metastasis, except for two with pleural dissemination and one with cerebral metastasis, who had received lobectomy as palliative operation. No difference was observed between the two groups receiving different types of operation.
    Kyobu geka. The Japanese journal of thoracic surgery 04/1990; 43(3):211-4.