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C Konaka

Publications and source records attributed to C Konaka.

At least 37 records · Page 2Linked to original sources
PubMed1998

Peripheral non-small cell lung cancers 2.0 cm or less in diameter: proposed criteria for limited pulmonary resection based upon clinicopathological presentation.

Clinical features of peripheral non-small cell lung cancer 2.0 cm or less were retrospectively analyzed. Nodal status and prognosis in relation to tumor diameter and histologic type were investigated in 171 consecutive patients with peripheral clinical T1N0M0 non-small cell lung carcinomas 2 cm or less in diameter and who had undergone surgical resection between 1976 and 1997. Of the 171 patients, 136 had adenocarcinoma, 27 had squamous cell carcinoma, four had large cell carcinoma, three had carcinoid and one had adeno-squamous carcinoma. There was no statistically significant difference in the incidence of stage I cases between adenocarcinoma and squamous cell carcinoma. Lymph node involvement was recognized in 30 (17.5%) patients: ten (5.8%) at N1 nodes and 20 (11.7%) at N2 nodes. Lymph node metastasis was significantly more common in tumors 1.5-2.0 cm in diameter (22%) than in those 1.5 cm or less in diameter (14.0%, P = 0.0490). There was no lymph node metastasis in tumors 1.0 cm or less in diameter. The 5-year survival rates cases with or without lymph node involvement were 63.3 and 75.3%, respectively, showing significant difference (P = 0.0338). The result of the present study suggested that systematic mediastinal and hilar lymph node dissection is necessary even for cases with tumor diameter less than 2 cm. However, if the tumor is within 1.0 cm in diameter, mediastinal lymph node dissection might be dispensable; therefore, these cases are good candidates for video-assisted lobectomy.

Adult↗
PubMed1997

Relationship between TA01 and TA02 polypeptides associated with lung adenocarcinoma and histocytological features.

TA01 (molecular weight 35.0 kDa, isoelectric point 5.45) and TA02 (molecular weight 35.0 kDa, isoelectric point 5.29) polypeptides were detected using two-dimensional polyacrylamide gel electrophoresis (2-DE). A previous study has shown that these polypeptides are distributed in primary adenocarcinomas and some large-cell carcinomas of the lung. However, various expression levels of TA01 and TA02 polypeptides were demonstrated in adenocarcinoma, while large-cell carcinoma expressed low levels. To evaluate the relationship between the expression of TA01 and TA02 polypeptides and the histocytological features of primary adenocarcinoma of the lung, these two polypeptides were analysed by 2-DE combined with a non-enzymatic sample preparation technique, and their expression levels were compared with the histocytological features of primary lung adenocarcinoma. Out of 57 primary lung adenocarcinoma cases, 46 cases (80.7%) and 52 cases (91.2%) expressed TA01 and TA02 polypeptides respectively. Furthermore, the expression levels of TA01 and TA02 polypeptides correlated with the degree of cellular atypia, structural atypia and histocytological differentiation of primary lung adenocarcinoma. On the other hand, these two polypeptides were not detected in adenocarcinoma of the lung, metastatic from the colon and mammary glands. High expression of TA01 and TA02 polypeptides reflected the differentiation of primary adenocarcinoma in the lung. These two polypeptides are valuable in determining the histocytological differentiation of primary lung adenocarcinoma as well as in distinguishing between primary and metastatic adenocarcinoma of the lung.

Adenocarcinoma↗
PubMed1997

[Photodynamic therapy for bronchogenic carcinoma].

Laser endoscopic surgery has now achieved a status as effective therapeutic modality for lung cancer. Especially increasing attention has been focused on photodynamic therapy (PDT) using Photofrin and excimer dye laser. PDT obtained government approval in October 1994 and finally obtained national insurance reimbursement status in April 1996. Over the past decade, 248 patients (296 lesions) with central type lung cancers have been treated in our hospital. Overall complete remission was obtained in 42.5% of the 125 lesions, partial remission in 56.8% and no remission was obtained in 1.0%. Indications of PDT are follows, 1. Early stage lung cancer as a curative purpose: among 104 early stage lesions CR was obtained in 87 (83.7%) and 61 cases were disease free at 2 to 178 months. 2. Advanced lesions for opening of bronchi: overall, "effective" opening of bronchi was achieved in 61 out of 81 lesions (75%) for the PDT group, as opposed to 143 of 177 (81%) for the Nd-YAG laser therapy group. 3. Preoperative laser irradiation for the propose of increasing operability and reducing the extent of resection area: the initial purpose of PDT, i.e., either reduction of extent of resection of conversion of inoperable disease to operable status, was achieved in 21 out of 21 patients treated. 4. Multiple primary lung cancer. The success from clinical trials using PDT for treatment of cancers offers encouragement for its future use. More stable, definitive and more successful results will be obtained if new dyes which distribute more equally in the tumor tissue and deeper tissue penetration by longer wavelength beams are used.

Aged↗
PubMed1997

[A resected case of intralobar pulmonary sequestration with increased serum tumor markers, CA19-9, CA125 and NCC-ST-439].

A 39-year old female was found to have intralobar pulmonary sequestration with a high serum level of the tumor markers, CA19-9, CA125 and NCC-ST-439. The lesion was located in the left S10 and an aberrant artery from the aorta was noted. After partial resection of the left lower lobe, serum levels of the tumor markers (CA19-9 2418U/ml, CA125 50.3U/ml, NCC-ST-439 13.0U/ml) gradually returned to normal. The half-life of serum CA19-9 was about 7 days. Immunohistochemical analysis revealed that CA19-9 was being produced in the bronchial epithelium of the sequestered lung. Increased serum levels of CA19-9 may be helpful in diagnosing pulmonary sequestration.

Adult↗
PubMed1996

Evaluation of a new solution containing trehalose for twenty-hour canine lung preservation.

We examined the efficacy of two new preservation solutions containing trehalose--an extracellular type (ET-K) of solution and an intracellular type (IT-K) of solution--in relation to that of Euro-Collins (EC) solution in 20-h canine lung preservation. Canine lungs were flushed with one of the three solutions (n = 5 for each solution) after pretreatment with PGE1 (20 micrograms/kg) and were stored for 20 h at 4 degrees C. The left lungs were transplanted and evaluated to 6 h post transplant. In the ET-K group, the arterial oxygen tension after reperfusion was significantly higher than in the IT-K and EC groups. The pulmonary vascular resistance, wet/dry weight ratio, and histological evaluation of each transplanted lung in the ET-K group were also better than in the IT-K and EC groups. This indicates that ET-K solution is useful for 20-h preservation of canine lung grafts.

Analysis of Variance↗
PubMed1996

Primary lung cancer of the middle lobe. Is its prognosis poor?

The right middle lobe is unique because it is surrounded by two other lobes and the pericardium, and it is the smallest lobe. The proper surgical treatment and prognosis for cancer of the right middle lobe has not been definitively established. In order to clarify its prognosis and the best operative technique, 31 surgically treated patients with lung cancer of the right middle lobe were studied clinically and pathologically. The outcome of surgical treatment of the right middle lobe cancer was compared with other locations in the lung. The 5-year survival rate of this group was 51.5%, with a median survival time of 82.3 months. For resectable cases, the outcome for carcinomas of the middle lobe was no worse than for other locations. However the rate of exploratory thoracotomy was highest for the right middle lobe. All five patients with lobectomies are alive and disease free at 26.4-151.4 months. The 5-year survival rate of 23 bilobectomies was 40.0%, with a median survival time of 48.4 months. The difference between lobectomy and bilobectomy cases was statistically significant (P < 0.025). When the tumor was limited to the completely separated middle lobe without dissemination, pulmonary or mediastinal lymph node metastasis, lobectomy was sufficient for curative treatment.

Female↗
PubMed1996

Photodynamic therapy with a diode laser for implanted fibrosarcoma in mice employing mono-L-aspartyl chlorin E6.

The authors performed photodynamic therapy (PDT), avoiding any hyperthermic effects, using a newly developed diode laser and photosensitizer, mono-L-aspartyl chlorin e6 (NPe6), of Meth-A fibrosarcoma implanted in mice and achieved tumor therapeutic benefit. The photodynamic light treatment was performed 5 h following the photosensitizer administration. With 5.0 mg/kg NPe6 and light doses of 50, 100, 150 and 200 J/cm2, the tumor cure rates were 20, 50, 70 and 90%, respectively. With 100 J/cm2 laser exposure and NPe6 doses of 1.25, 2.5, 5.0, 7.5 and 10.0 mg/kg, the tumor cure rates were 0, 20, 50, 70 and 90%, respectively. A charge-coupled device (CCD) camera system was employed to measure the NPe6 fluorescence intensity correlating with the residual amount of the photosensitizer at deferent depth from the tumor surface. The ratios of the NPe6 fluorescence intensity at 3 mm from the tumor surface following 50, 100, 150 and 200 J/cm2 laser exposure to no laser exposure were 0.73, 0.36, 0.22 and 0.16, respectively. With samples sectioned at 1 mm depth, after 50 J/cm2 and the same photosensitizer dose (5 mg/kg) this ratio was 0.19. These results suggest that a certain increase in the tumor tissue level of NPe6 and a certain increase of laser light dose reaching deeper layer of tumor caused an increase in percent cure. In addition, the effectiveness of PDT depends on the total laser dose reaching deeper layers of tumors. Furthermore, the effectiveness of PDT tends to correlate with the amount of NPe6 photobleaching by PDT.

Animals↗
PubMed1996

[Photodynamic therapy for multiple primary lung cancer].

In recent years, multiple primary lung cancers have been reported with greater frequency, partly as a result of technologic advances in the detection of lung cancer and therapeutic achievements in its management. As for the treatment of multiple primary lung cancer, operative excision is usually difficult for all lesions due to problems of pulmonary function. PDT is a good therapeutic modality in the treatment of multiple primary lung cancer, especially central type lung cancer, for preservation of lung function. Since 1980, 27 patients of multiple primary lung cancers have been treated with PDT at Tokyo Medical College. Fourteen of these 27 patients were synchronous with the rest, metachronous. Seven of 27 patients with multiple tumors had early-stage lesions and were treated with endoscopic PDT alone. In other 20 cases, PDT was used to treat accessible early-stage foci although operative excision was required for advanced lesions. Mean survival after PDT, alone or in combination with surgery, was 52 months (range, 5 to 162 months) and 16 patients remain alive to date. PDT is useful in extending the therapeutic options for, and improving the prognosis of patients with, multiple primary bronchogenic carcinomas.

Adenocarcinoma↗
PubMed1996

[Photodynamic therapy for early stage lung cancer].

Since 1980, 225 patients with lung cancers have been treated with photodynamic therapy (PDT) at Tokyo Medical College. These were 212 males and 13 females, and the median age was 65.2 years (range 36 to 85). Clinical stages were 72 early stage, 33 stage I, 11 stage II, 84 stage III and 25 stage IV. In 72 cases (91 lesions) of early stage lung cancers, complete remissions were obtained in 75 cases (82.4%) and partial remission in 16 cases. Mean survival after PDT was 52 months and 53 cases were disease free in 5 to 176 months. PDT is useful in the treatment for early stage lung cancer.

Adult↗
PubMed1996

[Laser photodynamic therapy for central-type lung cancer].

Laser endoscopic surgery is recognized as an effective treatment for lung cancer. Attention has increasingly been focused on photodynamic therapy (PDT) with dihermatoporphyrin ethers. The Japanese government approved the use of this therapy in October 1995, and reimbursement through the national health insurance system began in April 1996. Over the past decade, 140 patients (283 lesions) with central type lung cancers have been treated at our hospital. Overall complete remission was obtained in 39.6% of 112 lesions, partial remission in 59.4% and no remission in 1.0% The indications for PDT are as follows: 1. Early stage lung cancer curative; among 95 early stage lesions complete remission was obtained in 79 (83.2%), and 71 patients were disease free at 3 to 176 months. 2. Advanced lesions opening of bronchi; overall, "effective" opening of bronchi was achieved in 61 of 81 lesions (75%), in the PDT group, and in 143 of 177 (81%) in the Nd-YAG laser therapy groups. 3. Preoperative laser irradiation to increase operability and reduce the extent of operation; the extent of resectin was reduced, or inoperable lesions were made operable in 21 of 24 patients treated. 4. Multiple primary lung cancer. The success of clinical trials of PDT for treatment of lung cancers bodes well for its future use. More stable, definitive, and successful treatment will become possible with the use of new dyes that distribute more evenly in tumor tissue, and with the deeper tissue penetration made possible by longer-wavelength beams.

Adenocarcinoma↗
PubMed1995

Photofrin photosensitization. Correlation of Photofrin:erythrocyte binding processes with photolysis.

Unilamellar suspensions of dimyristoylphosphatidylcholine (DMPC) can be utilized to remove Photofrin from the erythrocyte. This enables correlation of the Photofrin membrane-binding processes with Photofrin-sensitized photolysis. The observed rates of erythrocyte biding as well as the observed rates of removal of PHotofrin from the erythrocyte membrane suggest the existence of two Photofrin species that differ in their rates of exchange between the erythrocyte and buffer phases. Selective depletion and readdition of these Photofrin species to the erythrocyte membrane permits evaluation of their separate and joint photolytic efficiencies. These rapidly and slowly exchanging membrane-bound Photofrin species are separately much less efficient photosensitizers than the two species together. The two Photofrin species exhibit essentially identical fluorescence emission spectra in the presence of DMPC. Nevertheless, models consistent with the results involve partitioning by chemically distinct Photofrin components or partitioning of chemically similar Photofrin components into distinct membrane environments, or a combination of these.

Dihematoporphyrin Ether↗
PubMed1995

Use of high-resolution cytometry in predicting the biologic behavior of T1 adenocarcinoma of the lung.

Touch preparations from 60 cases of T1 adenocarcinoma were analyzed using a high-resolution, automated image cytometer. These cases were divided according to pathologic stage: stage I, 31; stage II, 3; stage III, 19; and stage IV, 7. For each nucleus 57 features were analyzed, and using a linear combination of three texture features describing the DNA distribution in the cell nucleus (TARL, ODMAX and FAREA1), aggressive cancer cells belonging to stage III/IV could be identified. The best discrimination between the stages was achieved when the frequency of aggressive cancer cells was 48%; the correct classification rate was 77%. Using this criterion, 22 of 27 patients (81%) who died of cancer within five years after surgery were correctly predicted. These results suggest that high-resolution cytometry may be of value in predicting the biologic behavior of adenocarcinoma cases, especially in stage I/II.

Adenocarcinoma↗
PubMed1995

[Resection of recurrent lung cancer].

The resected recurrent lung cancer cases were evaluated retrospectively. Out of 1,060 cases who received an operation due to primary lung cancer, 21 (1.8%) had recurrent lung cancer which were resected subsequently. Stage I adenocarcinoma cases were found to be most frequent at the first operation (76%). Out of 21 cases, 7 received completion pneumonectomy, 5 had lobectomy and 8 had limited operation, respectively. The 5-year survival rate after the second operation was 36.6% in all the cases. There was no statistical difference in survival rate between the lobectomy group (including completion pneumonectomy) and the limited operation group. There was statistical difference in survival rate between cases who received a second operation in a time span of 2 or more years after the first operation and the cases who received it in less than 2 years. Good prognosis can be expected after the resection of recurrent lung cancer, but further analysis would be required in evaluation of respiratory function as well as biological malignancy of the tumor.

Adenocarcinoma↗
PubMed1995

[Reevaluation of preneoplastic lung lesions in lung carcinoma? In bronchial carcinoma?].

Since the genetic model for colorectal carcinogenesis was presented by Fearon and Vogelstein, carcinogenesis has been thought to occur based on the accumulation of gene-mutations. In this context, preneoplastic lesions may be morphological phenotypes of different steps during multistep carcinogenesis. Historically, autopsy findings reported by Auerbach and cytological findings by Nasiell and Saccomanno support the idea that bronchial squamous metaplasia (BSM) with atypia is a preneoplastic lesion in large bronchi. Thereafter, the de novo theory became prevalent, because BSM was almost never shown to appear immediately adjacent to tiny bronchial neoplasias on examinations of resected lung materials. However, advanced molecular biological analysis shows that BSM with various grades of atypia has been found to correlate with cellular and genetic alterations (e.g., hyperproliferation, genomic instability, deletion of 3p and p53 tumor-suppressor gene etc.). These findings suggested that BSM with atypia might be a preneoplastic lesion of bronchial squamous cell carcinoma. Recently, it was shown that similar kinds of sequential genetic changes occurred in atypical adenomatous hyperplasia (AAH). It was also suggested that AAH might be a preneoplastic lesion of adenocarcinoma in peripheral regions of the lung. Based on these ideas, chemopreventive effects on BSM of folate and vitamin B12 were evaluated. The therapeutic efficacy of these vitamins was assessed in terms of grades of histopathological atypia. Vitamins were administered (B12, 750 micrograms/day and folate 10 mg/day) to 24 persons in whom bronchoscopic biopsy had revealed BSM but no malignancy. Controls consisted of 20 subjects who received no medication. Evaluation of a second biopsy performed 12 months later showed a decrease in atypia score from 1.7 to 0.4 in the treatment group but no significant change (1.4, 1.2) in the controls. At present, reevaluation of the concept of preneoplastic lesions is extremely important from the stand-point of reduction of lung cancer mortality. It is necessary to establish the criteria and therapeutic strategy for lung preneoplastic lesions.

Bronchial Neoplasms↗
PubMed1994

Recurrence at the bronchial stump after resection of lung cancer.

OBJECTIVE: Recurrence at the bronchial stump frequently is difficult to diagnose before the disease progresses. Patients with recurrence at the bronchial stump after surgical treatment were studied to clarify characteristics. SUMMARY BACKGROUND DATA: Reports on this type of recurrence are few. METHODS: Between January 1979 and December 1988, 625 primary lung cancers were resected. Fourteen patients (2.2%), in whom recurrence occurred at the bronchial stump, were studied pathologically and clinically. RESULTS: Eight tumors (57.1%) were squamous cell carcinomas, five (35.7%) were adenocarcinomas, and one (7.1%) was small cell carcinoma. Pathologically, six tumors (42.9%) were stage I, four (28.6%) were stage II, two (14.3%) were stage IIIA, and two (14.3%) were stage IV. Eight patients had bloody sputum at recurrence; two cases were asymptomatic. Submucosal tumors were observed bronchoscopically at recurrence in 11 patients. Considering lymphadenopathy on chest x-ray, the submucosal type recurrence may have been direct invasion from metastatic lymph nodes. The periods from the operation to the recurrence were 7 to 102 months (mean 28.8 months). In 8 of 14 patients, recurrence was observed within 24 months. All but one patient died within 24 months of recurrence detection. CONCLUSIONS: Long survival could be expected only if there were no metastases in the mediastinal lymph nodes. If the tumors were detected earlier, it was possible to cure the tumors by intensive therapy, even in submucosal type recurrence. Regular bronchoscopic examination is needed to diagnose the recurrence at the bronchial stump as early as possible.

Adenocarcinoma↗
PubMed1994

Photodynamic therapy using a diode laser with mono-L-aspartyl chlorin e6 for implanted fibrosarcoma in mice.

We have developed a new high-power red (664 nm) laser diode system for photodynamic therapy (PDT) with mono-L-aspartyl chlorin e6 (NPe6). Meth-A fibrosarcoma cells (1 x 10(6)) were implanted subcutaneously in the right hind leg of 4-week-old BALB/c female mice. One week later, diode laser irradiation was applied 5 h after the intravenous administration of NPe6 to each tumor-bearing mouse. In the first study, the time course of intratumor temperature increase during PDT was measured by using a 23-guage thermocouple hypodermic needle at a depth of 2 mm from the tumor surface. In the second study, 6 groups of 10 to 17 tumor-bearing mice were treated with the diode laser 5 h after intravenous administration of NPe6 at the dose of 1.25, 2.5, 5.0 or 7.5 mg/kg i.v. per mouse. Total photoirradiation ranged from 0 to 150 J/cm2 and the dose rate was adjusted to 100 mW/cm2. Percentages of cures were determined from numbers of mice apparently disease-free 50 days after treatment. The results showed that this diode laser is effective in PDT of implanted fibrosarcoma after NPe6 administration. It also confirmed that the therapeutic effects of PDT were not due to hyperthermia. Moreover, the diode laser beam was demonstrated by CCD technology to be uniform in intensity throughout the photoirradiated field.

Animals↗