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J Shimizu

Publications and source records attributed to J Shimizu.

313 records · Page 18Linked to original sources
PubMedDate not supplied

Primary mediastinal germ cell tumor in a middle-aged woman: case report and literature review.

Although primary mediastinal germ cell tumors are found much more frequently among young males than among other people, we recently encountered a middle-aged woman with the disease. The patient was a 59-year-old woman who complained mainly of anterior chest pain. Chest CT scans revealed a nonhomogeneous mass measuring 7 x 7 cm in the anterior mediastinal area, accompanied by signs suggestive of mediastinal invasion of the tumor. Reduction surgery was performed. The pathologic diagnosis was mediastinal dysgerminoma. The patient received postoperative radiochemotherapy but died due to liver metastasis 11 months after surgery.

Combined Modality Therapy↗
PubMedDate not supplied

Gluteal abscess caused by perforating rectal cancer: case report and review of the literature.

An unusual case is described in which an abscess developed remote from a carcinoma of the rectum. A 52-year-old Japanese man developed a gluteal abscess six months after radiation therapy for unresectable carcinoma of the rectum. This case is presented with a review of the literature. Perforating carcinoma of the colon and rectum with abscess formation is best treated by preliminary total diversion colostomy and local drainage of the abscess. However, the mortality rate is still high.

Abscess↗
PubMedDate not supplied

Role of the liver in alloimmune response following inoculation of donor spleen cells.

The liver is thought to be an immunologically privileged organ in the response to inoculated antigens. We previously demonstrated that it is possible to localize inoculated antigens to the liver alone or only to extrahepatic tissue using orthotopic syngeneic liver transplantation (OSLT). In this study, we analyzed more detailed mechanisms of the anti-alloimmune response in the liver. DA rat spleen cells were systemically injected into WS rats (donor spleen cell inoculation, DSI). In the sensitized liver-grafted (SLG) group, after DSI, liver grafts were retrieved from sensitized WS rats, then transplanted into naive WS rats. In the sensitized liver-removed (SLR) group, after DSI, WS rats were totally hepatectomized and given livers transplanted from naive WS rats. All the rats were challenged with heterotopic heart grafts 10 days after DSI. Mean heart graft survival in the control, DSI, SLG, and SLR groups were 11.6+/-1.6, 10.7+/-2.4, 4.4+/-1.0, and 24.6+/-6.3 days, respectively. Accelerated rejection in the SLG group as well as graft prolongation in the SLR group disappeared when OSLT was performed 2 days after DSI or later. Irradiation of DA splenocytes before inoculation did not alter graft survival in SLG. However, pretreatment with gadolinium chloride prior to DSI attenuated the antidonor response in the SLG group. In conclusion, a vigorous antidonor response occurred in the liver after systemic inoculation of spleen cells. It peaked I day after DSI and disappeared rapidly. Kupffer cells seemed to play an important role in this phenomenon.

Animals↗
PubMedDate not supplied

Small giant cell carcinoma of the lung diagnosed preoperatively by transthoracic aspiration cytology. A case report.

Giant cell carcinoma (GCC) of the lung is considered an aggressive form of lung cancer. Most patients with GCC have large tumors with widespread metastases on hospital admission. We describe a small GCC in the lower lobe of the right lung. Preoperative aspiration cytology showed numerous bizarre, giant epithelial cells, highly suggestive of GCC. The resected tumor measured 1.2 x 1.0 x 0.7 cm in diameter, with an ill-defined margin. Histologically the tumor was composed of pleomorphic mononucleate or multinucleate giant cells without adenocarcinoma or squamous cell differentiation. The tumor cells were loosely organized and noncohesive or free in the alveolar space. The histology was interpreted as GCC of the lung. The clinicopathologic features of giant cell carcinoma are discussed.

Biopsy, Needle↗
PubMedDate not supplied

Evaluation of the clamshell incision for bilateral pulmonary metastases.

To treat bilateral pulmonary metastases during a single operation, simultaneous bilateral thoracotomy via median sternotomy is usually employed. With this approach, however, it is sometimes difficult to access lesions located on the dorsal side of the left lower lobe. We have explored the use of clamshell incisions for such difficult cases. From 1990 to 1995, we studied the use of clamshell incisions in 14 patients with bilateral pulmonary metastases. The average duration of surgery was 212 minutes, the average volume of intraoperative blood loss was 477 ml, and the average number of metastatic lesions extirpated was 23. The endotracheal tube could be removed immediately after the operation in 12 patients, while the remaining 2 patients, who underwent an extensive operation, needed 3 and 4 days of intubation. The arterial blood gas analysis on the first postoperative day for the former 12 patients was as follows: the average value of PaCO2 was 44.4 mmHg, and the average value of PaO2 was 140.4 mmHg (FiO2 = 0.4). None of the patients experienced severe pain or respiratory distress that impaired their daily activities due to continuous epidural anesthesia following surgery. The length of time from surgery to discharge was relatively short, averaging 22 days. We have not encountered any sternal override in our patients. Although we cannot ignore the biological behaviour of primary tumors when selecting a surgical approach, the clamshell incision seems to provide a useful means of thoracotomy when treating bilateral pulmonary metastases. We intend to use this approach in future, taking into careful consideration the indication of each individual case.

Adolescent↗
PubMedDate not supplied

Clinicopathologic study of mucoepidermoid carcinoma of the lung.

BACKGROUND: Mucoepidermoid carcinoma is a relatively uncommon form of lung cancer and has generally been viewed as a low grade malignant tumor. The present study was undertaken to establish a clinicopathological characterization of patients with this cancer who were treated surgically at Kanazawa University Hospital. METHODS: Between 1973 and 1975, 10 patients with mucoepidermoid carcinoma were surgically treated in our department. RESULTS: The 10-year survival rate after surgery for the central type of carcinoma was 67%, while the 4-year survival rate for the peripheral type was 25%. When the survival rates were analyzed in terms of Conlan's grades, grade 1 cases had a 10-year survival rate of 80%, while the 4-year survival rate for grade 2 and 3 cases was 20%. The four patients who survived 5 years or more following surgery all had a grade 1 central type tumor. CONCLUSIONS: These results suggest that mucoepidermoid carcinoma of the lung should not be viewed uniformly as a low grade malignant tumor, but that this tumor can sometimes be highly malignant with a poor prognosis. Since this tumor is often difficult to distinguish from adenosquamous carcinoma, and because accurate distinction between these two types of tumor seems to be essential for establishing a prognosis, there is an urgent need for a valid pathological method for differential diagnosis of mucoepidermoid carcinoma.

Adult↗