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H Asamura

Publications and source records attributed to H Asamura.

At least 37 records · Page 2Linked to original sources
PubMed2000

Application of short tandem repeat of genomic DNA and mitochondrial DNA for identification of mixed-up tissue specimens.

Deoxyribonucleic acid (DNA) typing methods, short tandem repeat of genomic DNA and mitochondrial DNA with the use of polymerase chain reaction amplification, were applied to formalin-fixed, paraffin-embedded tissues submitted for diagnosis, to identify and sort out mixed-up tissue specimens. These techniques were found to be reliable, reproducible and specific for personal identification, and thus to eliminate the need for further examinations and to prevent unnecessary surgery.

Aged↗
PubMed2000

Lung carcinoma with polypoid growth in the main pulmonary artery: report of two cases.

Invasion into the lumen of the main pulmonary artery is an uncommon mode of extension in lung carcinoma and its prognostic significance remains unclear. We describe here two resected cases of lung carcinoma that showed such a rare tumor spread. Although a preoperative evaluation, such as angiography or perfusion scan of the lung, had shown a significant decrease in circulation, we could not diagnose the intraluminal tumor growth preoperatively. Pneumonectomy was finally needed to perform a curative operation. The tumors were centrally located and showed polypoid growth in the main pulmonary artery. Postoperative pathological examination revealed the tumors to be adenosquamous carcinoma of the lung in both cases. No intrapulmonary metastases were detected. One patient is doing well with no signs of recurrence after a follow-up period of 10 years. Although intra-arterial polypoid growth of lung carcinoma is extremely rare, such tumor extension should be considered preoperatively to perform a curative surgical resection, especially when the tumor is centrally located. While arterial invasion is generally an ominous prognostic factor, curative surgical resection would offer a good prognosis, even for lung carcinoma invading the main pulmonary arterial trunk.

Aged↗
PubMed2000

Robotic surgery.

Explore the source record for details and available documents.

General Surgery↗
PubMed2000

Hemangioma of the rib: a case report.

A case of hemangioma of the left seventh rib is presented. In January 1999, a 59-year-old woman presented with an enlarged costal mass which had been followed up for 4 years. Preoperative examination suggested chondrosarcoma because of tumor growth beyond the disrupted bony cortex. She underwent resection of the left seventh rib along with the sixth and seventh intercostal muscles and reconstruction of the chest wall defect. The pathological diagnosis of the lesion was hemangioma. She was discharged after an uneventful postoperative course. There has been no evidence of recurrence after a 14-month follow-up. Tumor growth beyond the disrupted bony cortex was a characteristic feature by both imagery and pathological examination in this case. This case represents a difficulty of a preoperative definite diagnosis of the chest wall tumors by imagery alone.

Bone Neoplasms↗
PubMed1999

Clinical features and management of bronchogenic cysts: report of 17 cases.

Between 1966 and 1996, 17 patients, comprising 1 child and 16 adults, underwent surgical treatment for bronchogenic cysts at the National Cancer Center Hospital. The bronchogenic cysts were located in the mediastinum in 11 patients and in the pulmonary parenchyma in 6. Of the 17 patients, 5 (29.4%) manifested symptoms, being more frequently seen in those with intrapulmonary cysts than in those with mediastinal cysts. Chest radiographs were ineffective for accurate preoperative diagnosis, but accurate diagnosis was possible with 69.2% of computed tomography (CT) scans and 100% of magnetic resonance imaging (MRI) scans. MRI also proved very useful for qualitatively diagnosing the mediastinal tumors as cystic or solid. Surgery was performed through a thoracotomy in 14 patients and by video-assisted thoracic surgery (VATS) in 3 patients, achieving complete resection in 16 patients. In one patient, a mediastinal bronchogenic cyst was excised by VATS and incompletely resected because of tight adhesion to the membranous part of the trachea; however, no late complication or recurrence developed after the residual cystic wall had been ablated by electrocautery. VATS, which is an easy procedure to perform with only minimal surgical invasion, may be indicated for bronchogenic cysts if patients who undergo incomplete resection can be followed up carefully. Recent advances in imaging techniques have made it unnecessary to perform surgical excision for diagnostic confirmation, but we recommend surgery for most patients to relieve symptoms and prevent complications.

Adolescent↗
PubMed1999

Lobe-specific extent of systematic lymph node dissection for non-small cell lung carcinomas according to a retrospective study of metastasis and prognosis.

BACKGROUND: Complete lymphadenectomy of the mediastinum is advised for patients with lung cancer to provide prognostic information and possible survival benefit. The proper extent of dissection should be further defined. METHOD: The lymphatic metastatic patterns according to the primary site and prognoses were retrospectively analyzed in 166 patients with non-small cell carcinoma who underwent at least lobectomy with hilar and mediastinal lymphadenectomy. All patients had histologically proven mediastinal metastasis (pN2). RESULTS: Among 54 right upper lobe tumors the most common site of metastasis was the lower pretracheal station (74%), whereas metastases to the subcarinal station were seen only in 13%. Among 8 patients with right middle lobe tumors and 41 patients with right lower lobe tumors, both superior mediastinal and subcarinal stations were involved. The 34 left upper segment tumors metastasized to the aorticopulmonary window most commonly (71%) and to the subcarina only in 12% of cases. Inversely, the 10 left lingular tumors metastasized to the subcarina most commonly (50%) and to the aorticopulmonary window only in 20% of cases. Among 44 left lower lobe tumors the subcarinal station was most common for metastasis (58%), with infrequent metastases to the aorticopulmonary window. The 5-year survival for all 166 patients was 35%. Patients with single-station and single-node metastases had a significantly better prognosis than those with more extensive metastases. Right lower lobe tumors with superior mediastinal metastasis carried a particularly poor 5-year survival of only 4.1%. COMMENT: Subcarinal lymphadenectomy is not always necessary for tumors of the right upper lobe and left upper segment. For tumors of other lobes both superior mediastinal dissection and subcarinal dissection are advised. However, superior mediastinal metastasis should be recognized as an indicator of poor prognosis in tumors of both lower lobes.

Adult↗
PubMed1999

Lymph node sampling in lung cancer: how should it be done?

OBJECTIVES: Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is expected to improve local control. We investigate the most effective method of lymph node dissection or sampling. METHODS: A retrospectrive study was carried out on 1815 patients who underwent systematic lymph node dissection and complete resection. The lymphatic route of metastatis from each lobe was investigated by examining which nodes had the most likelihood of metastasis, or to find out which is the sentinel lymph node in the case of small sized tumor, suitable for the video assisted thoracic surgery (VATS) approach. RESULTS: At N2 level, distribution of major metastases from each lobe are as follows: right upper lobe tumor, #3 - 12.3% (80/648) and/or #4 - 8% (52/648); right middle lobe tumor, #3 and/or #7 - 16.4% (13/79); right lower lobe tumor, #7 - 13.7% (52/380); left upper lobe tumor, #5 - 12.3% (60/489) and/or #6 - 6.7% (33/489); and left lower lobe tumor, #7 - 11.9% (26/219). Small sized tumor requires lymph node sampling upon staging, and the lymph node most likely to become the first metastasis, i.e. sentinel node, are as follows: regardless of the location of tumor, #12, #11, and/or #10 in N1 level, which means dissection or sampling within these locations of lymph nodes are prerequisite. In N2 level, #3 and/or #4 in right upper lobe tumor, #3 and/or #7 in right middle lobe tumor, #7 in right lower lobe tumor, #5 and/or #6 in left upper lobe tumor, and, #7 in left lower lobe tumor. CONCLUSIONS: In clinical T1NO lung cancer, sentinel lymph node sampling should be done first, if the nodes are negative, complete mediastinal lymph node dissection might be omitted. On the other hand, if the sentinel nodes are positive for pathology, complete medistinal lymph node dissection is required for curative resection.

Adenocarcinoma↗
PubMed1999

The judgment of a gunshot wound with severe post-mortem changes.

This is a report on an autopsy case that revealed a gunshot wound to the back of the head. On examination of the external surface, an entrance and exit wound could not be found in the head region because of the severe post-mortem changes and the atypical entrance wound position and direction of the bullet tract; X-rays taken before the internal examination were effective in this case. In this case, the direction of the bullet tract was supposed to be similar to that of the suboccipital puncture.

Journal Article↗
PubMed1999

D1S80 subtyping by PCR-RFLP: new nomenclature and further characterization.

In a previous study, we screened out sequence variations within alleles at the D1S80 locus of a Japanese population using PCR-RFLP with EcoRII as a restriction enzyme. In the present study, through analyzing the alleles in a Chinese population, we were able to demonstrate four new electrophoretic band patterns that were complementary to the Japanese data. After summarizing the band patterns and sequencing results of these two populations, we established a new nomenclature for the PCR-RFLP band patterns, closely relating them to their corresponding sequences so that the new types could be designated easily and accurately. After PCR-RFLP subtyping, nineteen alleles in the Chinese population were revealed to have a total of thirty-seven subtypes. The discrimination power of this locus in the Chinese population was elevated from 0.974 to 0.988, and the Hardy-Weinberg equilibrium in this population showed no deviation when checked. Two samples typed as homozygotes 24/24 and 30/30 were identified to be actually heterozygous according to their band patterns. The result was supported by the sequencing analysis of the two samples in which overlapping of eight and eleven repeat units, respectively, were revealed. The heterozygosity was thus elevated from 0.85 to 0.87. The present study proved that PCR-RFLP was an effective method for subtyping D1S80 alleles in the Chinese.

Journal Article↗
PubMed1999

Thoracoscopic procedures for intrathoracic diseases: the present status.

Thoracoscopic operations, alternatively termed as video-assisted thoracic surgery (VATS), are replacing the variety of surgical procedures which have been otherwise performed by open thoracotomy. The minimally invasive nature of the procedure, reduced postoperative pain, shortened hospital stay, and reduced cost, are the potential advantages of VATS. While these merits are being proven, the limits to this technique are also getting clearer. In fact, VATS has already become a standard treatment of choice in several diseases, such as bullectomy for spontaneous pneumothorax and biopsy for indeterminate nodule and diffuse interstitial lung disease, while others, such as major video-assisted lung resection for lung carcinoma and resection of metastatic lung tumour, await further evaluation of their roles in terms of oncological and technical aspects. Three issues that currently need to be addressed as the present role of thoracoscopy evolves are instrumentation, economics, indication, and end results in certain procedures.

Contraindications↗
PubMed1999

Histopathologic prognostic factors in resected adenocarcinomas: is nuclear DNA content prognostic?

BACKGROUND: The pathobiological characteristics of lung adenocarcinoma are still unclear. To identify the factors that may affect the survival of patients undergoing pulmonary resections for adenocarcinoma of the lung, univariate and multivariate analyses were performed for 17 variables of the host, histopathology, nuclear DNA content (NDC), and morphometry of nucleus (nuclear area [NA]) of tumor cells. METHODS: Seventy-two consecutive patients who underwent resection at the National Cancer Center in Tokyo were studied. They consisted of 45 men and 27 women with an average age of 61.7 years (range, 27 to 83 years). For these patients, NDC and NA were prospectively measured by cytofluorometry and morphometry, respectively. For univariate analysis, 17 factors were studied, including age, sex, TNM stage, diameter of the tumor, pleural involvement, degree of differentiation, scar grade, nuclear atypia, mitotic index, histogram pattern of NDC, mean NDC, number of aneuploid stem cell lines, and mean and SD of NA. A multivariate analysis was performed with Cox's regression model for 16 variables. RESULTS: In the univariate analysis, 12 factors were significantly related to postoperative survival, including TNM stage, diameter, pleural involvement, nuclear atypia, mitotic index, mean NA, mean NDC, number of aneuploid stem cell lines, and the DNA histogram pattern. In the multivariate analysis, M, T, and the histogram pattern of NDC were significantly associated with survival while N showed a strong, but not significant, association. CONCLUSIONS: Multivariate analysis of histopathologic prognostic factors indicated that the TNM stage, as well as each component independently, still provided the greatest prognostic value in resected adenocarcinomas of the lung. Among other factors, only NDC significantly affected survival. The importance of NDC measurement should be stressed for predicting the survival after surgical resection more accurately and for selecting patients with a higher risk of recurrence.

Adenocarcinoma↗
PubMed1999

Early complications. Cardiac complications.

Cardiopulmonary complications developing after pneumonectomy are described. Arrhythmias are seen in about 25% of patients undergoing pneumonectomy, and supraventricular tachyarrhythmias are common. To date, the efficacy of medical prophylaxis has not yet been defined. Postpneumonectomy heart failure shares a common cause with postpneumonectomy edema. Cardiac herniation with subsequent torsion is a rare but fatal complication after pneumonectomy. Early recognition and prophylaxis are always crucial.

Anti-Arrhythmia Agents↗
PubMed1998

Surgical resection of pulmonary metastases from gastric cancer.

BACKGROUND AND OBJECTIVES: There are no reports concerning surgical treatment on pulmonary metastases from gastric cancer. The aims of this study were to characterize patients with pulmonary metastasis from gastric cancer and to determine the efficacy of surgical therapy. METHODS: Between 1977 and 1993, 3,076 patients underwent curative resection for gastric cancer. Among them, four patients (0.1%) with pulmonary metastases from gastric cancer underwent pulmonary resection. RESULTS: All four patients had advanced gastric cancers involving regional lymph nodes far from the primary gastric lesion. The median tumor-free interval after the initial gastrectomy was 32.0 months (range: 19-48 months). All patients underwent a lobectomy for a solitary pulmonary lesion. Although transthoracic fine-needle aspiration cytology revealed adenocarcinoma in all cases, none of them were definitely diagnosed as metastasis from gastric cancer preoperatively. The diagnosis was obtained after pulmonary resection. All patients received postoperative chemotherapy or radiotherapy, or both. However, they all subsequently developed systematic metastases. The time interval to recurrence after pulmonary resection ranged from 6 to 36 months and they were all dead at a median follow-up of 24.3 months after the pulmonary resection. CONCLUSIONS: An aggressive surgical approach was not warranted in patients with isolated resectable pulmonary metastases from gastric cancer. However, the possibility of surgical treatment could not be eliminated because surgery is the only diagnostic method for a solitary pulmonary nodule when there is some doubt about the diagnosis of primary or secondary lung cancer in patients with gastric cancer.

Adenocarcinoma↗
PubMed1998

Lobe-specific intercostal strategy in video-assisted lobectomy.

When performing video-assisted lobectomy for lung diseases, the incisional strategy for the minithoracotomy and two trocar ports is crucial for successful completion of the procedure. Our strategy is primarily determined according to three principles: The hilar bronchovascular structures should be easily accessible; the minithoracotomy should be readily convertible to a standard open thoracotomy; and the wounds should create only limited damage. To enable a quick conversion, the minithoracotomy incision must be placed on the scheduled posterolateral thoracotomy line regardless of its location. The entire procedure is best managed when the minithoracotomy is placed anteriorly on the inframammary line in the fourth intercostal space for upper and middle lobectomies and posteriorly over the auscultation triangle in the fifth intercostal space for lower lobectomies. Two trocars are used for thoracoscopy and retraction. The sequence of each operative step should be determined by the lobe to be resected. This lobe-specific incisional and operative strategy based on anatomical considerations not only facilitates the safe dissection of the hilum but also enables a rapid conversion to a standard posterolateral thoracotomy.

Adult↗