Fumihiro Tanaka

University of Occupational and Environmental Health, Kitakyūshū, Fukuoka, Japan

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Publications (262)764.74 Total impact

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    Soichi Oka · Hidetaka Uramoto · Sohsuke Yamada · Fumihiro Tanaka
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    ABSTRACT: We herein describe a rare case of a sclerosing mediastinitis without IgG4-related disease. This case was clearly excluded from IgG4-related disease, because this patient's serum IgG4 level was not elevated. Specifically, this patient's serum IgG4 level was 7.9mg/dl (4.8-105). A 61-year-old Japanese female presented at our hospital due to an abnormal chest X-ray that showed a growing shadow in the mediastinum. Chest computed tomography (CT) showed an 80×75×75mm tumor, which located in the anterior mediastinum. This large tumor surrounded the thoracic aorta, left brachiocephalic vein and superior vena cava. It was difficult to obtain a definitive diagnosis. We tried to perform three biopsies, and eventually performed a partial resection of the tumor. This case did not fit the criteria for IgG4-related disease, and it was therefore unclear whether steroid therapy should be used for this case. We will continue to carefully follow up this patient's residual lesion, and there have been no changes in the lesion at present. Sclerosing mediastinitis and IgG4-related disease should be included in the differential diagnosis of patients presenting with a mediastinal tumor. However, sclerosing mediastinitis is difficult to diagnose, and it is important to obtain a sufficient amount of tissue to ensure an accurate diagnosis. Copyright © 2015 Z. Published by Elsevier Ltd.. All rights reserved.
    International Journal of Surgery Case Reports 12/2015; 10. DOI:10.1016/j.ijscr.2015.03.013
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    ABSTRACT: Intrapericardial vessel management is one of the necessary techniques for respiratory surgeons. We collected cases that had undergone intrapericardial vessel management for lung cancer, and herein discuss the practical performance and safety of this treatment method. We identified 23 (5.6%) of 413 patients who had undergone lung cancer surgery during the 30-month period from January 2011 to June 2013 at our institution. Twenty cases had large sized tumors near the hilum. Three cases demonstrated severe adhesion in the intrathoracic region due to a previous operation. The lung cancer staging was stage ⅠA in 1 case, stage ⅠB in 4 cases, stage ⅡB in 5 cases, stage ⅢA in 11 cases, stage ⅢB in 1 case, and stage Ⅳ in 1 case. We performed lobectomy in 11 cases, bilobectomy in 6 cases, and pneumonectomy in 6 cases. The average operation time was 366 minutes (137-965). Post operative complications were observed in five cases, including two cases of air-leakage and three cases of arrhythmia. All cases were able to walk on foot at discharge. It is important to clearly understand intrapericardial anatomy in order to carry out successful intrapericadial vessel management.
    Journal of UOEH 09/2015; 37(3):191-4. DOI:10.7888/juoeh.37.191
  • Cancer Research 08/2015; 75(15 Supplement):380-380. DOI:10.1158/1538-7445.AM2015-380 · 9.33 Impact Factor
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    ABSTRACT: We herein report a very rare case of adenoid cystic carcinoma of the peripheral lungs. A 77-year-old female visited a family physician for aortitis syndrome, diabetes mellitus and hyperlipidemia. A follow-up chest computed tomography scan for aortitis syndrome revealed a nodule in the middle lobe of the right lung. Although a transbronchial lung biopsy was attempted, a definitive diagnosis could not be made. Because the possibility of lung malignancy could not be ruled out, thoracoscopic wedge resection of the middle lobe was performed. The intraoperative pathological diagnosis revealed carcinoma of the lungs and we performed middle lobectomy under complete video-assisted thoracoscopic surgery. A histopathological examination demonstrated an adenoid cystic carcinoma with a characteristic cribriform structure.
    Journal of UOEH 06/2015; 37(2):121-5. DOI:10.7888/juoeh.37.121
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    ABSTRACT: A 65-year-old Japanese woman was introduced to our hospital for an examination of multiple pulmonary cystic lesions and a pulmonary nodule in the left lower lobe. She had a smoking history of 25 pack-years, and her two younger brothers had suffered from pneumothorax; one of them additionally had lung cancer with pulmonary multiple cystic lesions. A surgical biopsy specimen obtained from her left lower lobe revealed adenocarcinoma surrounded by a single epithelial layer that was covered with collagen fibers. The pathological features were compatible with the findings of the cystic lesions in the patients with Birt-Hogg-Dubé syndrome (BHDS). A diagnosis of BHDS was eventually made according to the detection of a folliculin gene mutation. This is the first report of a possible familial case of BHDS complicated with primary lung cancer. We herein reviewed the previously reported cases of BHDS with lung cancer and other tumors and discussed a potential mechanism of tumorigenesis and carcinogenesis in the lung in the patients with BHDS. Copyright © 2015. Published by Elsevier Ltd.
    Respiratory medicine 05/2015; 109(7). DOI:10.1016/j.rmed.2015.05.005 · 3.09 Impact Factor
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    ABSTRACT: Lung cancer is responsible for most cancer-related deaths. There are two broad types of lung tumors, usually classified as small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Current clinicopathological staging systems provide the advantage of standardized criteria for assessing tumor stage, and a relationship between advancing tumor stage and poor prognosis has been established for NSCLC. However, these staging systems have not led to clear criteria for selection of therapy for individual patients with NSCLC. The concept of therapy based on anatomical location, as used in staging systems, is poorly associated with the cancer stem cell (CSC) characteristics of individual tumor tissues. CSCs may have self-renewal and multipotent differentiation abilities and be responsible for tumor initiation, progression, and metastasis; they are highly resistant to chemoradiotherapy. Therefore, research into CSCs will provide the basis for developing of novel diagnostic and therapeutic strategies. We review aldehyde dehydrogenase isoform 1 (ALDH1), CD133, CD44 and CD166 as CSC markers, as weel as the Wnt/β-catenin pathway, KRAS, and the embryonic stem cell (ESC) signature.
    05/2015; 4. DOI:10.1016/j.pmu.2015.03.007
  • Fumihiro Tanaka · Kazue Yoneda
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    ABSTRACT: Non-small cell lung cancer (NSCLC) accounts for 80-90 % of cases of primary lung cancer. Although surgery is recommended as the primary treatment for early-stage NSCLC, the prognosis is unsatisfactory even when complete resection is achieved. Recent clinical trials have shown that postoperative adjuvant chemotherapy with cytotoxic agents, namely uracil-tegafur (UFT) for stage IA (>2 cm in diameter)-IB patients or cisplatin-based regimens for stage II-IIIA patients, improves the prognosis, and adjuvant chemotherapy is recommended as the "standard treatment of care." However, adjuvant chemotherapy provides only a modest 5-year survival benefit of 4 % and may sometimes be fatal. To improve the risk-benefit balance of adjuvant chemotherapy, targeting agents such as antibodies against vascular endothelial growth factor (VEGF) and tyrosine-kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) are being evaluated in ongoing adjuvant trials. Another promising approach may be the individualization of adjuvant chemotherapy based on biomarkers that may predict the prognosis or benefits associated with adjuvant chemotherapy. The current status and future perspectives of adjuvant chemotherapy for NSCLC are reviewed and discussed.
    Surgery Today 04/2015; DOI:10.1007/s00595-015-1174-7 · 1.53 Impact Factor
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    ABSTRACT: We herein present the pathological findings of a bulla covered using an absorbable polyglycolic acid sheet applied with fibrin glue. These findings indicated that the membrane of the bulla was reinforced. Covering the bulla with an absorbable polyglycolic acid sheet (Neoveil, Gunze Ltd, Kyoto, Japan) and applying fibrin glue was effective to prevent the recurrence of the pneumothorax. Moreover, this report is the first case report showing the pathological findings of a bulla which was covered with an absorbable polyglycolic acid sheet and fibrin glue.
    General Thoracic and Cardiovascular Surgery 04/2015; DOI:10.1007/s11748-015-0545-8
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    ABSTRACT: Diaphragmatic eventration, defined as permanent elevation of the diaphragm without defects, is a rare anomaly in adults. Trauma, neoplasms, infection, and degenerative disease are the most common causes of this condition, whereas idiopathic eventration of the diaphragm is relatively infrequent. We herein present the rare case of an 85-year-old female with idiopathic eventration of the bilateral diaphragm. The patient demonstrated a rapidly progressive course with dyspnea; therefore, thoracoscopic surgery of the unilateral diaphragm was performed. She subsequently withdrew from home oxygen therapy, which had introduced preoperatively, and exhibited a significant improvement in her pulmonary function for one year after the operation. Various approaches for diaphragmatic plication have been reported, including open (transthoracic or transabdominal) and minimally invasive methods, such as thoracoscopic or laparoscopic plication. We consider thoracoscopic plication to be an effective minimally invasive method, although single-lung ventilation is required. We experienced a case in which thoracoscopic plication of the unilateral diaphragm resulted in adequate objective improvements in the pulmonary function in a patient with idiopathic eventration of the bilateral diaphragm. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
    International Journal of Surgery Case Reports 04/2015; 8. DOI:10.1016/j.ijscr.2015.04.001
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    ABSTRACT: The Japanese Association for Thoracic and Cardiovascular Surgery has conducted annual surveys of thoracic surgery throughout Japan. The purpose of this study was to examine the 30-day mortality and hospital mortality after chest surgery per year to confirm the surgical outcomes of modern medical care in the area of respiratory surgery. The mean of the 30-day mortality/hospital mortality over a period of 16 years for the patients with lung cancer, metastatic pulmonary tumors, mediastinal tumors, inflammatory pulmonary disease, empyema, and spontaneous pneumothorax was 0.60/1.20, 0.26/0.41, 0.26/0.45, 0.32/0.50, 1.77/4.15, and 0.07/0.10, respectively. Undergoing thoracic surgery is therefore relatively safe in Japan. The death rates associated with lung cancer and mediastinal tumors have gradually decreased owing to therapeutic improvements in recent years. However, this tendency was not true of empyema. The 30-day mortality/hospital mortality rates for empyema were particularly high. These data suggest that the rates for empyema might have reached the limit for the current surgical techniques, and that there might be room for improvement by developing new techniques or management strategies. These data from the nationwide surveys can be useful for surgeons, because they can provide a better understanding of the present problems, as well as future prospects.
    General Thoracic and Cardiovascular Surgery 02/2015; 63(5). DOI:10.1007/s11748-015-0524-0
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    ABSTRACT: EML4-ALK lung cancer accounts for approximately 3%–7% of non-small cell lung cancer cases. To investigate the molecular mechanism underlying tumor progression and targeted drug sensitivity/resistance in EML4-ALK lung cancer, clinically relevant animal models are indispensable. In this study, we found that the lung adenocarcinoma cell line A925L expresses an EML4-ALK gene fusion (variant 5a, E2:A20) and is sensitive to the ALK inhibitors crizotinib and alectinib. We further established highly tumorigenic A925LPE3 cells, which also have the EML4-ALK gene fusion (variant 5a) and are sensitive to ALK inhibitors. By using A925LPE3 cells with luciferase gene transfection, we established in vivo imaging models for pleural carcinomatosis, bone metastasis, and brain metastasis, all of which are significant clinical concerns of advanced EML4-ALK lung cancer. Interestingly, crizotinib caused tumors to shrink in the pleural carcinomatosis model, but not in bone and brain metastasis models, while alectinib showed remarkable efficacy in all three models, indicative of the clinical efficacy of these ALK inhibitors. Our in vivo imaging models of multiple organ sites may provide useful resources to analyze further the pathogenesis of EML4-ALK lung cancer and its response and resistance to ALK inhibitors in various organ microenvironments.This article is protected by copyright. All rights reserved.
    Cancer Science 01/2015; 106(3). DOI:10.1111/cas.12600 · 3.52 Impact Factor
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    Hidehiko Shimokawa · Tomoko So · Hidetaka Uramoto · Fumihiro Tanaka
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    ABSTRACT: A total of 437 primary lung cancer patients underwent curative surgery from 2006 to 2010. Twenty-two patients (5.0%) had collagen disease. Sixteen (72.7%) patients had rheumatism, 3 (13.7%) patients had systemic sclerosis, 2 (9.1%) had systemic lupus erythematosus, and 1 (4.5%) had adult Still's disease. Sixteen (72.7%) patients were pathological stage IA, 4 (18.2%) were stage IB, and 2 (9.1%) were IIIA. Eighteen (81.8%) patients had adenocarcinoma, 2 (9.1%) had squamous cell carcinoma, 1 (4.5%) had large cell neuro-endocrine carcinoma, and 1 (4.5%) had pleomorphic carcinoma. Sixteen (72.7%) patients underwent lobectomy, 2 (9.1%) patients received segmentectomy, and 4 (18.2%) patients underwent partial resection. Only postoperative pneumothorax occurred after surgery as a complication, and there was no significant difference between patients with and without collagen disease (P=0.539). The only significant difference was in preoperative interstitial pneumonitis (P=0.001). Therefore, we were able to perform surgery with the careful observation of patients with collagen disease.
    The Journal of the Japanese Associtation for Chest Surgery 01/2015; 29(1):2-5. DOI:10.2995/jacsurg.29.2
  • The Journal of the Japanese Associtation for Chest Surgery 01/2015; 29(5):582-586. DOI:10.2995/jacsurg.29.582
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    ABSTRACT: We report a resected case of advanced right lung cancer invading the entrance of the right upper bronchus, with inflammatory stenosis of the middle bronchus in a 74-year-old man. We performed right upper and middle sleeve lobectomy. Computed tomography revealed a mass of 52×37 mm invading the ascending pulmonary artery. Transbronchial lung biopsy was performed, but a preoperative diagnosis was not obtained. A bronchofiber could not be passed through the middle bronchus because of the severe inflammatory stenosis. The preoperative diagnosis was lung cancer, and the clinical stage was T2bN0M0, IIA. We performed right upper and middle sleeve lobectomy and combined resection of the azygos arch. We anastomosed the right main bronchus and peripheral part of the intermedius, and then covered it with a pedicled pericardial fat pad. We resected the pulmonary ligament to reduce the tension of anastomosis. The pathological diagnosis was small cell lung cancer, and the final stage was T3N1M0, IIIA. Four courses of adjuvant chemotherapy (CDDP/CPT-11) were administered. No recurrence has occurred to date.
    The Journal of the Japanese Associtation for Chest Surgery 01/2015; 29(4):491-494. DOI:10.2995/jacsurg.29.491
  • Radiotherapy and Oncology 12/2014; 111:S15-S16. DOI:10.1016/S0167-8140(15)30804-5 · 4.36 Impact Factor
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    ABSTRACT: We herein describe a rare case of a pulmonary arteriovenous fistula (PAVF). The patient was a 20-year-old asymptomatic female, admitted to our hospital because of an abnormal shadow in the right lung field on chest X-rays. Chest computed tomography (CT) revealed two nodules with well-defined margins in the right upper and lower lobes. Contrast-enhanced three-dimensional CT (3D-CT) revealed two enhanced solitary lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively. Based on these findings, we made a preoperative diagnosis of PAVF. We performed partial pulmonary resection of the right upper and lower lobes by video-assisted thoracoscopic surgery (VATS). The histopathological findings revealed small and medium-sized vascular channels composed of arteries with mild and irregularly thickened muscle walls and juxtaposed or seemingly anastomosing dilated veins. Based on these findings, a diagnosis of PAVF was confirmed. The patient had an uneventful postoperative course. A PAVF is often associated with various complications, and pregnancy could be a risk factor for these complications because of the increase in the shunt fraction. Females with known PAVF should be maximally treated prior to becoming pregnant as complications of PAVF during pregnancy can have devastating consequences. Therefore, we thought that treatment should be recommended in this case in the event she might later choose to become pregnant. Surgical resection using VATS for a limited number of ipsilateral isolated pulmonary arteriovenous fistulae is recommended due to its safety, low recurrence and low mortality rate. Copyright © 2015. Published by Elsevier Ltd.
    International Journal of Surgery Case Reports 12/2014; 7C:54-57. DOI:10.1016/j.ijscr.2014.12.006
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    ABSTRACT: While hypervascular lesions in the lung are known to mimic pulmonary arteriovenous malformation (PAVM), here we report a rare case of lung granuloma mimicking PAVM, on which video-assisted thoracic surgery (VATS) was performed. A 76-year-old woman without any symptom was admitted to our hospital because of abnormal shadow in the left lung field on chest X-ray. A 20mm×14mm nodule with well-defined margins and smooth contours in the left upper segment was detected in her chest computed tomography (CT). Contrast-enhanced three-dimensional CT (3D-CT) revealed an enhanced solitary lung nodule, which was connected with linear structures suggestive of feeding artery and drainage vein. Thus, we made a preoperative diagnosis of PAVM by performing partial pulmonary resection by VATS. Intraoperatively, elastic hard nodule was palpable in the left upper segment and bruit was not convincing. Histopathological findings revealed multiple foci of coagulative necrosis surrounded by epithelioid cell granuloma containing Langhans-type multinucleated giant cells, involving the medium-sized blood vessels in the pulmonary parenchyma. Abnormal vascular structures, such as PAVM were not convincing. Based on these findings, a diagnosis of left lung granuloma was made. Preoperatively, it was difficult to distinguish the left lung granuloma from PAVM, because hypervascular lesion, such as inflammatory changes can present as strongly enhanced nodules after injection of contrast material. Surgical approach seems appropriate, not only for the purpose of diagnosis, but also for the safety in treatment of a PAVM. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
    International Journal of Surgery Case Reports 12/2014; 6C:154-156. DOI:10.1016/j.ijscr.2014.10.049
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    ABSTRACT: Regulatory T-cells (Tregs) have a pivotal role not only in abrogating autoimmune disease, but also in tumor immune escape. The purpose of the present study was to evaluate the clinical significance of the relative expression of forkhead/winged helix transcription factor (FOXP3) and micrometastasis in the regional lymph nodes (RLNs) of patients with stage I non-small cell lung cancer (NSCLC). The RLNs in 131 patients who underwent complete surgical resection for stage I NSCLC were collected at the time of surgery. The relative expression levels of FOXP3 and cytokeratin 19 (CK19) in RLNs were determined by quantitative RT-PCR. The pathological stage was diagnosed as stage IA in 97 patients (74.0%) and stage IB in 34 patients (26.0%). The relative expression levels of FOXP3 and CK19 in the RLNs were 0.062±0.0083% and 0.025±0.056%, respectively. The relative expression of FOXP3 tended to increase with increasing relative expression of CK19. The five-year overall survival rate of the patients with low expression of FOXP3 was better (90.3%) than that of patients with high expression (79.3%) (p=0.0419). A multivariate analysis using the significant variables (gender, age, histology and FOXP3 expression) showed that the FOXP3 expression in RLNs was a significant independent prognostic factor. The expression of CK19 tended to be positively correlated with the expression of FOXP3. High expression of FOXP3 in RLNs was a significant unfavorable prognostic factor in patients with stage I NSCLC. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 12/2014; 34(12):7185-90. · 1.83 Impact Factor
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    ABSTRACT: Video-assisted thoracic surgery (VATS) has become popular in the field of chest surgery. Recently, there has been a gradual reduction in the number of surgeons in Japan, which thus increases concerns regarding a potential shortage in the number of surgeons in the future. In this study, we evaluated the efficacy of using a surgical simulator with an endoscopic simulator to provide practical training for 245 medical students. Three different tests were performed with a one-week interval between each test, and the task completion time between the 1st and 2nd training sessions was then analyzed. A reduction in the time required to perform the tasks was observed. In addition, 95% of the subjects had a positive opinion regarding the application of the device for practical training, while 85% reported an increased interest in surgery. No significant relationships were observed between the task completion time and the degree of proficiency in performing the task or between the results of students choosing to become surgeons and those not choosing to become surgeons in the future according to a follow-up study. The students who later decided to become surgeons tended to express a positive opinion on the questionnaire compared with the non-departmental staff. As a result, providing student education using a training simulator for endoscopic surgery is therefore considered to have a beneficial effect in increasing the number of medical school students who later decide to become surgeons.
    Kyobu geka. The Japanese journal of thoracic surgery 11/2014; 67(12):1047-50.
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    ABSTRACT: Erratum to: Gen Thorac Cardiovasc Surg (2014) 62:734-764 DOI 10.1007/s11748-014-0464-0The following errors appeared in the above-cited article.In 2012 Final report, (A) Cardiovascular surgery section, on the seventh line in the third paragraph, “14,944 cases in thoracic aortic aneurysm” should read “15,058 cases in thoracic aortic aneurysm”.Also in (A) Cardiovascular surgery section, the title for Table 3, “Thoracic aortic aneurysm (total; 14,944)” should read “Thoracic aortic aneurysm (total; 15,058)”. (1) “Dissection (total; 6,266”) should read (1) “Dissection (total; 6,380”). Additionally, some column totals were incorrect. The corrected table is given below.In (B) General thoracic surgery section, Table 22, on the eighth line of the table body, “Cardinal reconstruction” should read “Carinal reconstruction”.
    General Thoracic and Cardiovascular Surgery 10/2014; 63(2). DOI:10.1007/s11748-014-0464-0

Publication Stats

3k Citations
764.74 Total Impact Points


  • 2011–2015
    • University of Occupational and Environmental Health
      • School of Medicine
      Kitakyūshū, Fukuoka, Japan
    • Okayama University
      Okayama, Okayama, Japan
  • 2006–2013
    • Hyogo College of Medicine
      • • Department of Thoracic Surgery
      • • Department of Internal Medicine
      • • Department of Cardiovascular Surgery
      Nishinomiya, Hyōgo, Japan
  • 2009
    • Hyogo Cancer Center
      Akasi, Hyōgo, Japan
  • 1995–2009
    • Kyoto University
      • Department of Thoracic Surgery
      Kioto, Kyōto, Japan
  • 2005
    • Tokyo University of Science
      Edo, Tōkyō, Japan
  • 2003–2004
    • University of Texas MD Anderson Cancer Center
      • Department of Thoracic Cardiovascular Surgery
      Houston, Texas, United States