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ABSTRACT: To understand the mechanism of exertional dyspnea, we postulated that, despite hyperoxia during exercise, patients with idiopathic pulmonary fibrosis (IPF) might not regulate exertional acidosis by ventilatory compensation to stop exercise. The exercise responses during 30% O(2) or compressed air (CA) were examined in 13 patients with IPF. The Pa(O2), Pa(CO2), and H(CO3-) levels were higher during exercise with hyperoxia than with CA. At peak exercise, hyperoxia reduced the plasma lactate level. The dyspnea - ratio (%) of the ΔV˙o(2) (peak minus resting oxygen uptake) curve reached a break point that occurred at a similar exercise point with hyperoxia and CA, preceded by a break point in the breathing frequency-ratio of the ΔV˙o(2). Accordingly, the dyspnea score and pH each reached similar levels with hyperoxia and CA to stop exercise. Regardless of breathing CA or 30% O(2), IPF patients did not regulate exertional acidosis by ventilatory compensation to stop exercise, resulting in reaching a specific pH.
Respiratory Physiology & Neurobiology 12/2012; · 2.24 Impact Factor
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ABSTRACT: Background: The features of pulmonary disease caused by rapidly growing mycobacteria (RGM) have not been sufficiently documented. Objectives: To establish these features, we retrospectively evaluated 44 patients. Methods: We screened respiratory isolates at the National Toneyama Hospital (Osaka, Japan) between 2003 and 2007. Diagnosis was based on the latest guidelines of the American Thoracic Society. The patients were classified into 3 types according to their radiographic findings: fibrocavitary, nodular bronchiectatic and unclassified variant. Results: We obtained 1,348 nontuberculous mycobacteria respiratory isolates from 1,187 patients, including 119 RGM isolates from 100 patients. Forty-four of these 100 patients were definitively diagnosed with respiratory disease due to RGM. The most common pathogen was Mycobacteriumabscessus, which accounted for 65.9% of cases, followed by Mycobacterium fortuitum at 20.5%. There was a statistically significant difference in smoking history between patients infected with these 4 RGM species (excluding those with an unknown smoking history; p = 0.039). The overall evaluation of radiographic findings revealed 18.2% as fibrocavitary, 43.2% as nodular bronchiectatic and 38.6% as unclassified variants in these 44 patients. There was a significant difference in radiographic findings between the 4 RGM species (p = 0.002). There was also a significant difference in radiographic findings between M. abscessus and M. fortuitum infected patients (p = 0.022). Conclusions: Patients with M. abscessus seem to have less of a smoking history and more frequent nodular bronchiectatic radiographic patterns than patients with M. fortuitum. In contrast, fibrocavitary patterns might be more frequent with M. fortuitum infection.
Respiration 08/2012; · 2.26 Impact Factor
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Satoshi Kohmo,
Takashi Kijima, Masahide Mori,
Toshiyuki Minami,
Yoshinobu Namba,
Yukihiro Yano,
Tsutomu Yoneda,
Yoshito Takeda,
Seigo Kitada,
Toshihiko Yamaguchi,
Isao Tachibana,
Soichiro Yokota
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ABSTRACT: Although a chemokine CXCL12 is implicated in some infectious diseases, especially those in which T cell-mediated immunity plays critical roles, the relevance of CXCL12 to tuberculosis has never been elucidated. To determine the clinical efficacy of CXCL12 as a diagnostic marker for tuberculous (TB) pleurisy, we measured CXCL12 concentration in pleural fluid and serum from patients with various etiologies. Of 60 patients with pleural fluid, the median age of TB patients was 52 which was significantly lower than 71 of non-TB patients (P < 0.01). CXCL12 level in TB effusion (4456 ± 1013 pg/mL, n = 15) was significantly higher than non-TB effusion (2851 ± 1229 pg/mL, n = 45) (P < 0.01). On the other hand, serum CXCL12 level showed no significant differences among TB pleurisy, non-TB pleurisy, and normal healthy subjects. The sensitivity and specificity of CXCL12 in pleural fluid for the diagnosis of TB pleurisy was 60.0% and 93.2% (cut-off value = 4600 pg/mL), respectively. Area under the receiver operating characteristic (ROC) curve (AUC) for CXCL12 was 0.84. As the source of CXCL12, pleural mesothelium, endothelium of pulmonary vessels, bronchial epithelium, multinucleated giant epithelioid cells, and macrophages were positive for CXCL12 staining. Increased CXCL12 level in pleural fluid could be an informative diagnostic marker for differentiating TB pleurisy from other etiologies.
Tuberculosis (Edinburgh, Scotland) 01/2012; 92(3):248-52. · 2.54 Impact Factor
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Internal Medicine 01/2012; 51(19):2841-2. · 0.94 Impact Factor
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ABSTRACT: Smoking has been determined as a cause of chronic obstructive pulmonary disease (COPD) in most patients. Smoking cessation should be stressed above everything else for COPD patients under all conditions. A smoking habit is determined not as a preference but as a dependency on tobacco; therefore, smoking cessation is difficult solely based on one's motivation. Smoking cessation therapy is employed with cessation aids. Now, we can use nicotine-containing gum, patches, and the nicotine-receptor partial agonist varenicline. First, nicotine from tobacco is replaced with a nicotin patch, or a nicotine-free condition is induced by varenicline. Subsequently, the drugs are gradually reduced. In Japan, smoking cessation therapy is covered by public health insurance as definite requirements.
Nippon rinsho. Japanese journal of clinical medicine 10/2011; 69(10):1831-5.
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ABSTRACT: A 63-year-old male smoker with left chest pain was admitted for examination of an abnormal chest shadow. A chest computed tomography (CT) scan revealed a tumor in S6 of the left lung, and left pleural effusion. Histological examination by CT-guided needle biopsy revealed a proliferation of spindle-shaped tumor cells with sarcomatous features. Immunohistochemical staining confirmed the tumor cells to be of epidermal origin, indicating a diagnosis of sarcomatoid carcinoma of the lung. No distant metastases were found, and his disease was judged to be clinical stage IV (T3N2M1a). He received 5 courses of systemic chemotherapy consisting of carboplatin, paclitaxel and bevacizumab, and the tumor shrank. Systemic chemotherapy is generally ineffective for sarcomatoid carcinoma of the lung. However, in the present case this chemotherapy was effective with the addition of bevacizumab.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2011; 49(4):304-8.
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Masahide Mori,
Kazutaka Izawa,
Takeya Fujikawa,
Takeshi Uenami,
Teppei Sugano,
Sin-ichi Kagami,
Yoshinobu Namba,
Yukihiro Yano,
Tsutomu Yoneda,
Seigo Kitada,
Hiromi Kimura,
Toshihiko Yamaguchi,
Soichiro Yokota,
Ryoji Maekura
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ABSTRACT: A 49-year-old-woman was diagnosed with tuberculosis of the left humerus. She had received treatment, including rifampicin, for tuberculosis 17 years previously. Treatment was begun with isoniazid, rifampicin, ethambutol, and pyrazinamide, but these were discontinued because of mild neutropenia and thrombocytopenia 2 weeks posttreatment. Rifampicin and ethambutol were readministered after a 4-day interruption; however, generalized purpura appeared several hours later. By the next day, her platelet count was reduced from 160 × 10(3) to 3 × 10(3)/μl. The patient improved rapidly after platelet transfusion and steroid treatment. Readministration of drugs other than rifampicin did not induce thrombocytopenia; therefore, thrombocytopenia was likely due to rifampicin.
Journal of Infection and Chemotherapy 04/2011; 17(2):288-90. · 1.80 Impact Factor
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Satoshi Kohmo,
Takashi Kijima,
Yasushi Otani, Masahide Mori,
Toshiyuki Minami,
Ryo Takahashi,
Izumi Nagatomo,
Yoshito Takeda,
Hiroshi Kida,
Sho Goya,
Mitsuhiro Yoshida,
Toru Kumagai,
Isao Tachibana,
Soichiro Yokota,
Ichiro Kawase
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ABSTRACT: Small cell lung cancer (SCLC) is an aggressive malignancy with extremely high mortality due to the appearance of widespread metastases early in its clinical course and rapid acquisition of chemoresistance after initial therapy. A theory of cell adhesion-mediated drug resistance is thought to be a principal mechanism in which extracellular matrix proteins provide a survival advantage against cytotoxic drug-induced apoptosis. We found that the tetraspanin family member CD9 was expressed preferentially in SCLC tumors and metastases from three of seven relapsed patients, whereas chemonaïve primary tumors from 16 patients were CD9 negative with only one exception. Additionally, CD9 was highly expressed on SCLC cell lines rendered resistant to cisplatin or etoposide, and was upregulated in parental chemosensitive cells within 48 hours after exposure to either of these compounds. CD9-expressing chemoresistant SCLC cells adhered more tightly to fibronectin via β1 integrin, but they were less motile than the respective chemosensitive parental lines. Notably, treatment of the chemoresistant cells with chemokine CXCL12 downregulated CD9 and transiently restored motility. Moreover, selective targeting of CD9 by treatment with specific monoclonal antibody ALB6 or a small interfering RNA triggered apoptosis in the chemoresistant cells. Taken together, our findings implicate CD9 in the cell adhesion-mediated drug resistance mechanism, highlighting CD9 as an attractive therapeutic target to improve therapeutic outcomes in SCLC.
Cancer Research 10/2010; 70(20):8025-35. · 7.86 Impact Factor
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ABSTRACT: The objective of this phase II study was to evaluate the efficacy and safety of carboplatin and weekly paclitaxel in previously untreated patients with unresectable non-small cell lung cancer. In addition, the clinical pathway intensified the management of chemotherapy including the assessment of efficacy, safety and implementation of treatment and patient education. Patients received paclitaxel at a dose of 70 mg/m(2) on days 1, 8 and 15 and carboplatin (area under the curve of 6) on day 1 and every 28th day thereafter. Fifty-eight patients were enrolled. A median of 3 cycles (range 1-6) were administered. Twenty-eight cases showed objective responses (48.2%), including 2 complete (3.4%) and 26 partial responses (44.8%; 95% confidence interval 35.4-61.1). The median survival time was 663 days, and the 1-year survival rate was 59.9%. Nineteen patients (32.8%) had grade 3, and 4 patients (6.9%) had grade 4 neutropenia. Nine patients (15.5%) experienced > or =3 grade nonhematological toxicities. There were no treatment-related deaths due to this study. Carboplatin and weekly paclitaxel combination chemotherapy might be an alternative treatment selection in patients with unresectable non-small cell lung cancer.
Chemotherapy 02/2010; 56(1):39-45. · 1.82 Impact Factor
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Atsushi Ogata, Masahide Mori,
Shoji Hashimoto,
Yukihiro Yano,
Takeya Fujikawa,
Mari Kawai,
Yusuke Kuwahara,
Toru Hirano,
Junsuke Arimitsu,
Keisuke Hagihara,
Yoshihito Shima,
Masashi Narazaki,
Souichirou Yokota,
Tadamitsu Kishimoto,
Ichiro Kawase,
Toshio Tanaka
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ABSTRACT: Interferon gamma (IFN-gamma) production is a critical step of antituberculosis (anti-TB) immune response. The purpose of this study was to determine the influences of biologics, including the interleukin (IL)-6 receptor-inhibitor tocilizumab (TCZ), and tumor necrosis factor (TNF) antagonists infliximab (INF) and etanercept (ETA), on Mycobacterium tuberculosis (MTB) antigen-induced IFN-gamma production. MTB antigen (ESAT-6 and CFP-10)-induced IFN-gamma-releasing assay was performed with or without addition of biologics (TCZ, ETA, and INF) using whole blood from patients with active TB. ETA and INF inhibited IFN-gamma production in a dose-dependent manner. In whole blood from TB patients, ESAT-6 stimulated significant production of IFN-gamma (1.30 +/- 1.95 IU/ml), and TCZ did not inhibit IFN-gamma production (1.56 +/- 1.88 IU/ml). IFN-gamma production by ESAT-6 was inhibited by ETA and INF (0.98 +/- 1.74, 0.75 +/- 1.66 IU/ml, respectively). CFP-10 stimulated significant production of IFN-gamma (1.46 +/- 1.60 IU/ml), and TCZ did not inhibit IFN-gamma production (1.51 +/- 1.77 IU/ml). IFN-gamma production by CFP-10 was inhibited by ETA and INF (0.91 +/- 0.99, 0.72 +/- 0.88 IU/ml, respectively). TCD did not inhibit MTB antigen-induced IFN-gamma production. As IFN-gamma production is important in antimycobacterial host defenses, the minimal influence of TCZ on IFN-gamma-releasing assay suggests a low risk of latent TB infection reactivation during tocilizumab therapy.
Modern Rheumatology 11/2009; 20(2):130-3. · 1.58 Impact Factor
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Yusuke Oji,
Yayoi Kitamura,
Eriko Kamino,
Aiko Kitano,
Noriyoshi Sawabata,
Masayoshi Inoue, Masahide Mori,
Shin-ichi Nakatsuka,
Nao Sakaguchi,
Kaori Miyazaki, [......],
Naoki Hosen,
Akihiro Tsuboi,
Riichiro Nezu,
Hajime Maeda,
Yoshihiro Oka,
Ichiro Kawase,
Katsuyuki Aozasa,
Meinoshin Okumura,
Shinichiro Miyoshi,
Haruo Sugiyama
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ABSTRACT: There are urgent needs to develop methods for early detection of nonsmall cell lung cancer (NSCLC) because of its increasing incidence and poor prognosis. Here, we analyzed the production of IgG antibody (WT1 Ab) against WT1 (Wilms' tumor gene) protein that was overexpressed in the majority of NSCLC. Enzyme-linked immuno-sorbent assay showed that WT1 Ab was produced in all of 91 NSCLC patients and 70 healthy individuals and that WT1 Ab titers were significantly higher in NSCLC patients compared with healthy individuals. When the cut-off level of WT1 Ab titers were fixed at mean + 3SD of those in healthy individuals, 26.4% of NSCLC patients had WT1 Ab titers over the cut-off level, and positive rates of WT1 Ab at each clinical stage were 25.0, 30.8 and 38.4% in stage I, II and III NSCLC, respectively. When WT1 Ab was combined with CEA or CYFRA for detection of NSCLC, positive detection rates increased from 25.0 to 34.1 and 31.8%, respectively, in stage I and from 38.4 to 69.2 and 46.1%, respectively, in stage III, but not changed in stage II. Western blot analysis showed that dominant subclass of WT1 Ab was Th1-type IgG2. Interestingly, elevation of WT1 Ab titers was significantly associated with longer disease-free survival in patients with stages I-III NSCLC. These results showed that WT1 Ab could be a useful marker for early detection of NSCLC and its prognostic prediction. These results also suggested that WT1-specific immune responses played an important role in anti-cancer immunity in NSCLC.
International Journal of Cancer 03/2009; 125(2):381-7. · 5.44 Impact Factor
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ABSTRACT: A 58-year-old man presented with a nodule in the right lung. Initially, the chest CT showed a ground-glass shadow. However, the shadow had become a solid nodule one month later. Histological examination revealed it was an inflammatory pseudotumor of the lung and subsequent surgery showed it to be an organizing pneumonia type. This disease is rare and in most cases is considered to be slow growing. Chest CT findings in the early stages have not been reported previously. Therefore, the present case is noteworthy in that we could confirm the CT findings in the early stages of this disease with rapid growth.
Internal Medicine 02/2009; 48(15):1279-82. · 0.94 Impact Factor
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Megumi Fukai, Masahide Mori,
Yoshinobu Namba,
Kenji Fushitani,
Yukie Nakazawa,
Yukihiro Yano,
Manabu Niinaka,
Hiromi Kimura,
Nobuyuki Naka,
Tatsuya Okada,
Masaru Nakagawa,
Soichiro Yokota
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ABSTRACT: A 61-year-old woman who had never smoked was given a diagnosis of adenocarcinoma of the lung with multiple pulmonary metastases. Systemic chemotherapy consisting of carboplatin and paclitaxel was not effective, thereafter daily oral administration of gefitinib was initiated. Six days later, bilateral pneumothorax was found. The extent of the pneumothorax was slight and she recovered without drainage within about one month although treatment of gefitinib was restarted. Gefitinib was effective for lung cancer in this case. Bilateral pneumothorax is a rare complication of chemotherapy for lung cancer. Only 3 such cases under treatment with gefitinib were reported in Japan.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 07/2008; 46(6):483-7.
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Masahide Mori,
Takeo Iwasaki,
Yukie Nakazawa,
Yoshinobu Namba,
Manabu Niinaka,
Yukihiro Yano,
Seigo Kitada,
Hiromi Kimura,
Nobuyuki Naka,
Tatsuya Okada,
Masaru Nakagawa,
Ryoji Maekura,
Soichiro Yokota
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ABSTRACT: A 70-year-old Japanese man was re-admitted because of relapse of adenocarcinoma of the lung. He received daily administration of gefitinib as second-line chemotherapy. He was given a diagnosis of drug-induced lung disease due to gefitinib on day 6 because of hypoxemia and ground glass opacities in the bilateral lung fields. There was no response to corticosteroid pulse therapy. Continuous administration of sivelestat was intravenously added from day 9. Although mechanical ventilation was required for 10 days, lung infiltrates and hypoxia gradually improved. Sivelestat and corcicosteroid was apparently effective in this case and may be useful treatment for drug-induced lung disease due to gefitinib.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2008; 46(3):232-6.
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Takeo Iwasaki, Masahide Mori,
Seigo Kitada,
Kenji Fushitani,
Masaharu Motone,
Yoshinobu Namba,
Kenji Yosimura,
Manabu Niinaka,
Mari Miki,
Keisuke Miki,
Nobuyuki Naka,
Toru Hiraga,
Masami Ito,
Soichiro Yokota,
Ryoji Maekura
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ABSTRACT: On routine physical checkup, a 27-year-old man with productive cough was found to have multiple nodules with cavitation in the bilateral lung fields and mediastinal and hilar lymph adenopathy on chest X-ray film and CT scan. Serum levels of angiotensin converting enzyme and lysozyme were high. Tuberculin reaction was negative. Non-caseous epitheloid granulomas were confirmed in the bronchial wall specimens obtained by trans-bronchial biopsy. The number of lymphocytes and the CD4/CD8 ratio of lymphocytes in bronchoalveolar lavage fluid was increased. Therefore, pulmonary sarcoidosis was diagnosed, and the lung nodules with cavitation were considered due to sarcoidosis. The walls of the cavitations gradually thinned and had almost completely vanished after 6 months of careful observation without steroid therapy.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 02/2007; 45(1):59-64.
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ABSTRACT: A 42-year-old man had swelling in the right side of the neck, cough and chest pain. On admission, an abnormal shadow was detected in the right upper lung field and squamous cell carcinoma of the lung with superior vena cava (SVC) syndrome was diagnosed. Concurrent radiotherapy and systemic chemotherapy consisting of cisplatin and vinorelbine induced a partial response. At 15 months after diagnosis, he was re-admitted because of bilateral pleural effusion and facial edema due to relapse of SVC syndrome. Examination of the milky right pleural effusion revealed chylothorax (959mg/dl of beta-lipoprotein and 675mg/dl of triglyceride). The right effusion was finally controlled by pleurodesis with OK-432. Non-traumatic chylothorax is a rare complication of lung cancer.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 11/2006; 44(10):706-10.
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Tsutomu Yoneda,
Toru Kumagai,
Izumi Nagatomo,
Mitsugi Furukawa,
Hiroyuki Yamane,
Shigenori Hoshino, Masahide Mori,
Yoshito Takeda,
Takeshi Horai,
Sumiyuki Nishida,
Dai Watanabe,
Takashi Kijima,
Mitsuhiro Yoshida,
Tadashi Osaki,
Isao Tachibana,
Mark I Greene,
Ichiro Kawase
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ABSTRACT: EGFR is involved in the density-dependent inhibition of cell growth, while coexpression of EGFR with erbB2 can render normal cells transformed. In this study, we have examined the effect of a species of p185 that contains the transmembrane domain and the extracellular domain of p185(c-neu), on growth properties of a human malignant mesothelioma cell line that coexpresses EGFR and erbB2. The ectodomain form of p185(c-neu) enhanced density-dependent inhibition of cell growth and we found that p21 induction appeared to be responsible for this inhibitory effect. Previously, the extracellular domain species was shown to suppress the transforming abilities of EGFR and p185(c-neu/erbB2) in a dominant-negative manner. The ability of this subdomain to affect tumor growth is significant, as it reduced in vivo tumor growth. Unexpectedly, we found that the domain did not abrogate all of EGFR functions. We noted that EGFR-induced density-dependent inhibition of cell growth was retained. Tyrosine kinase inhibitors of EGFR did not cause density-dependent inhibition of cell growth of malignant mesothelioma cells. Therefore, simultaneously inhibiting the malignant phenotype and inducing density-dependent inhibition of cell growth in malignant mesothelioma cells by the extracellular domain of p185(c-neu) may represent an important therapeutic advance.
DNA and Cell Biology 10/2006; 25(9):530-40. · 2.07 Impact Factor
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Yoshinobu Namba,
Seigo Kitada, Masahide Mori,
Takeo Iwasaki,
Masaharu Motone,
Manabu Niinaka,
Kenji Yoshimura,
Mari Miki,
Keisuke Miki,
Nobuyuki Naka,
Toru Hiraga,
Ryoji Maekura,
Masami Ito
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ABSTRACT: A 33-year-old man had a high fever and was given Cefcapene and Oseltamivir without a definite diagnosis of influenza. Three days later an abnormal chest shadow was pointed out. Chest CT revealed ground-glass opacities and air-space consolidation in bilateral lung fields. Although he was given antibiotics, lung infiltrates increased and his symptoms worsened. Therefore, he was transferred to our hospital. Corticosteroid pulse-therapy resulted in prompt improvement of chest infiltrates and his symptoms. The drug-induced lymphocyte stimulating test results indicated 170% of oseltamivir and 150% of cefcapene. Considering the clinical course and laboratory data, this was probably drug-induced lung injury caused by oseltamivir.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 06/2006; 44(5):410-4.
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Takeo Iwasaki,
Tatsuya Okada,
Yoshinobu Namba,
Manabu Niinaka,
Yoshito Takeda,
Hiromi Kimura,
Yoshinobu Naka, Masahide Mori,
Masaru Nakagawa,
Soichiro Yokota,
Masami Ito
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ABSTRACT: A 68-year-old man suffered right facial palsy and left deafness, however, his condition was considered to be idiopathic and he was followed. Three months later, bloody sputum and hoarseness caused him to be admitted to our hospital. An abnormal shadow was detected in the right upper lung field and adenocarcinoma of the lung with multiple brain metastases was diagnosed. He underwent gamma-knife radiosurgery for the brain lesions and subsequent systemic chemotherapy consisting of combined carboplatin and paclitaxel, which were not effective. Subsequently various neurological symptoms appeared, such as muscle weakness of the extremities, dizziness, and gait disturbance. Adenocarcinoma cells confirmed in the cerebrospinal fluid were similar to those in the obtained by transbronchial curetting. Whole-brain irradiation was performed, however, the neurological symptoms worsened and he died. Leptomeningeal carcinomatosis is difficult to diagnose while the patient is alive. It is thought that cranial neuropathy due to leptomeningeal carcinomatosis is a rare form of onset for lung cancer.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 12/2005; 43(11):664-7.
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Masahide Mori,
Masaru Nakagawa,
Takeya Fujikawa,
Takeo Iwasaki,
Tomoko Kawamura,
Yoshinobu Namba,
Manabu Niinaka,
Yoshito Takeda,
Hiromi Kimura,
Nobuyuki Naka,
Tatsuya Okada,
Toshihiko Yamaguchi,
Soichiro Yokota,
Masami Ito
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ABSTRACT: A 41-year-old man with productive cough was admitted to our hospital. His chest roentgenogram showed multiple small nodules in the bilateral lung fields. The nodules were revealed as intrapulmonary metastases of the adenocarcinoma of the lung. Systemic chemotherapy with paclitaxel and carboplatin was not effective, and continuous oral gefitinib therapy was initiated. Twenty-one days later, spontaneous pneumothorax was found in the left lung, and four days after that, in the right lung as well. The extent of the pneumothorax was slight; therefore, he recovered without drainage within several days. Spontaneous pneumothorax, especially bilateral pneumothorax, is a rare complication of chemotherapy for lung cancer.
Internal Medicine 09/2005; 44(8):862-4. · 0.94 Impact Factor
