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Biomedical subjects

K Suemasu

Publications and source records attributed to K Suemasu.

At least 55 records · Page 3Linked to original sources

Daily and long-term balloon dilation via minitracheostomy in cicatric bronchial stenosis.

We developed balloon dilation for bronchial stenosis via minitracheostomy. The balloon catheter was introduced via minitracheostomy into the stenotic bronchus. The balloon was inflated 4 hours per day. We conducted this procedure for a tuberculous cicatric stenosis of the left lower lobe bronchus. The bronchus was sufficiently dilated after eight applications. Compared with conventional balloon dilation via the mouth, the patient had less discomfort and could undergo treatment for a longer time and more frequently.

Adult↗

De-epithelialization for esophageal cyst by video-assisted thoracoscopic surgery monitored by esophagoscopy.

In a 26-year-old male a congenital esophageal cyst was de-epithelialized using electro-cauterization via video-assisted thoracoscopic surgery (VATS) together with esophagoscopy. As the cyst adhered firmly to the esophageal muscle layer and mucosa, partial excision of the cyst and burning up of the cystic mucosa by electro-cauterization was performed to prevent esophageal mucosal perforation and postoperative esophageal dysmotility. Intraoperative video esophagoscopic monitoring enabled esophageal mucosal perforation to be avoided. Postoperative barium esophagography revealed good esophageal motility, and the patient showed no symptoms of esophageal dysmotility. We conclude that de-epithelialization for congenital esophageal cysts using VATS together with esophagoscopy is a minimally damaging and reasonable curative procedure without postoperative complications.

Adult↗

Random nuclear p53 overexpression pattern in tamoxifen-mediated endometrial carcinoma.

In a previous paper, we suggested that tamoxifen (TAM)-mediated endometrial carcinogenesis may not involve estrogenic pathways because of random estrogen receptor positivity among endometrial carcinomas with and without TAM treatment for breast cancer. DNA adduct formation (reported in rat liver and human endometrium) was considered to be a more plausible mechanism for TAM-mediated carcinogenesis. To examine the reported correlation between DNA adduct formation and p53, the present study examined p53 expression in the endometrial carcinomas reported in the previous study. Seven endometrial adenocarcinomas associated with long-term TAM treatment for breast carcinoma and 4 carcinomas without TAM treatment but with history of breast carcinoma were immunohistochemically investigated for nuclear p53 expression. The bcl-2 product was also examined. Diffuse and intense nuclear reactivity for p53 protein was present in only one TAM-related case. Essentially, no differences were observed in the bcl-2 staining patterns of TAM-treated and -untreated patients with cancer. Thus, p53 overexpression in endometrial carcinomas occurring in patients with breast cancer seems to be not specific for TAM-treated patients, and, if DNA adduct formation has any role in this type of endometrial carcinogenesis, it may not be related preferentially to p53 gene alteration. Further studies are needed to understand the precise mechanism(s) of the endometrial carcinogenesis.

Adult↗

Influence of drinking green tea on breast cancer malignancy among Japanese patients.

Inhibitory effects of green tea on carcinogenesis have been investigated in numerous laboratory studies using (-)-epigallocatechin gallate (EGCG) or crude green tea extract, and there is also some epidemiologic evidence. Further, EGCG has been reported to inhibit the growth of cancer cells, lung metastasis in an animal model, and urokinase activity. In this study, we first examined the association between consumption of green tea prior to clinical cancer onset and various clinical parameters assessed at surgery among 472 patients with stage I, II, and III breast cancer. We found that increased consumption of green tea was closely associated with decreased numbers of axillary lymph node metastases among premenopausal patients with stage I and II breast cancer and with increased expression of progesterone receptor (PgR) and estrogen receptor (ER) among postmenopausal ones. Since these are potential prognostic factors, we then investigated the prognosis of breast cancer with special reference to consumption of green tea, in a follow-up study of these patients. We found that increased consumption of green tea was correlated with decreased recurrence of stage I and II breast cancer (P < 0.05 for crude disease-free survival); the recurrence rate was 16.7 or 24.3% among those consuming > or = 5 cups or < or = 4 cups per day, respectively, in a seven-year follow-up of stage I and II breast cancer, and the relative risk of recurrence was 0.564 (95% confidence interval, 0.350-0.911) after adjustment for other lifestyle factors. However, no improvement in prognosis was observed in stage III breast cancer. Our results indicate that increased consumption of green tea prior to clinical cancer onset is significantly associated with improved prognosis of stage I and II breast cancer, and this association may be related to a modifying effect of green tea on the clinical characteristics of the cancer.

Adult↗

Lung adenocarcinomas diagnosed by open lung or thoracoscopic vs bronchoscopic biopsy.

STUDY OBJECTIVES: To examine the characteristics of peripheral lung adenocarcinomas diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. DESIGN: We used retrospective analysis to compare tumor stage, pleural involvement, central tumor fibrosis, and the number of bronchi or vessels involved with tumors of small peripheral lung adenocarcinomas diagnosed by bronchoscopic biopsy. PATIENTS: Subjects had lung adenocarcinomas diagnosed by open lung or VATS (n=22) and those diagnosed by bronchoscopic biopsy (n=22), which were matched by tumor size. RESULTS: The T1N0M0 tumor was notably more frequent in the open lung or VATS group (77.3%) than in the bronchoscopic biopsy group (36.4%) (p<0.01). Tumors invading beyond the pleural surface were less frequent in the open lung or VATS group (4.5%) than in the bronchoscopic biopsy group (40.9%) (p<0.01). The grade of in-tumor central fibrosis--a malignancy factor and the cause of bronchi or vessel involvement with tumors-was significantly lower in the open lung or VATS group than in the bronchoscopic biopsy group (p<0.01). The number of bronchi or vessels involved with tumors was significantly fewer in the open lung or VATS group than in the bronchoscopic biopsy group (p<0.001). CONCLUSIONS: (1) Lung adenocarcinomas diagnosed by open lung or VATS biopsy were more frequently T1N0M0 than those diagnosed by bronchoscopic biopsy, which was caused by low grade of central tumor fibrosis rather than small tumor size. (2) They were infrequently diagnosed by bronchoscopic biopsy because few bronchi were involved by tumors due to the low grade of central tumor fibrosis. (3) Small pulmonary nodules not diagnosable by bronchoscopic biopsy should be diagnosed aggressively using VATS biopsy to detect early-stage lung cancer.

Adenocarcinoma↗

[Usefulness of marking with colored collagen to localize small pulmonary nodules for thoracoscopic biopsy].

We examined the usefulness of marking with colored collagen to localize small pulmonary nodules (less than 10 mm in diameter) for thoracoscopy. Before using colored collagen, 2 of 6 lesions (33%) could be localized. It was possible to localize 14 of 15 lesions (93%) for thoracoscopy after marking with colored collagen, a percentage that is significantly higher than localization without such marking (P < 0.01). Thus, marking using colored collagen is useful to localize pulmonary nodules less than 10 mm in diameter for thoracoscopy.

Collagen↗

[A case of pulmonary epithelioid hemangioendothelioma diagnosed by video-assisted thoracoscopic biopsy].

A regular annual physical checkup for a 46-year-old man revealed multiple small nodules, which were less than 1 cm in diameter, in both lungs. Metastatic lung tumors were suspected, but no primary lesion was found in the general examination. Video-assisted thoracoscopic surgery (VATS) diagnosed multiple pulmonary epithelioid hemangioendothelioma (PEH), so no treatment was performed. Careful follow-up showed no significant change during 10 months. VATS is thus a certain, noninvasive procedure for the diagnosis of PEH.

Biopsy↗

[A 13-year-old male with a funnel chest treated by sternal elevation].

A 13-year-old male with a funnel chest was treated by sternal elevation method. Reconstruction was performed by resection of rib cartilage, wedge osteotomy of the anterior site of the sternum, sternal elevation by placement of a titanium A-0 plate under the sternum, and fixation of the wedge osteotomy site by a titanium plate. After surgery, the chest wall deformity was improved remarkably without complication. Although the A-0 plate was removed 19 months after surgery due to a break in the plate, cosmetic and functional results are now excellent 28 months after surgery.

Adolescent↗

Fibromatosis of the Breast: A Case Report.

Fibromatosis develops in many anatomic sites, but it rarely arises as a primary lesion in the breast. This lesion is locally invasive and frequently recurs after a local excision, but it has no potential for distant metastasis. In this report, we present a case of mammary fibromatosis which was closely similar to carcinoma in clinical, mammographic and ultrasonographic findings, thus leading us to breast conserving surgery. Despite being a rare disease, fibromatosis should be included in the differential diagnosis of younger patients (the age of the present case was 51, and the mean ages of patients with fibromatosis ranges from 37 to 49) with abnormal changes on physical examinations and imaging studies.

Journal Article↗

Prognostic factors and prognostic staging system for small cell lung cancer.

This study was performed to assess the prognostic factors and the predictors of long-term (3-year) survival in patients with small cell carcinoma of the lung, accrued in one randomized trial, and to define patient subgroups showing significantly different survivals using recursive partitioning and amalgamation analysis. A total of 300 patients with small cell carcinoma of the lung were entered into a randomized study comparing cyclophosphamide, adriamycin and vincristine (CAV), cisplatin and etoposide (PE) and alternating treatments of CAV and PE. Of these, 286 patients were analysed for the present study of prognostic factors. Multivariate analysis showed that poor performance status (2-3) (P = 0.0001), extensive disease (P = 0.0015) and abnormally elevated serum lactate dehydrogenase (P = 0.0001) and alkaline phosphatase (P = 0.0013) were independently adverse pretreatment prognostic factors. Of limited disease patients, performance status (P = 0.029) and white blood cell count (P = 0.044) had a significant influence on the probability of 3-year disease-free survival. Using recursive partitioning and amalgamation analysis, three classes of similar prognosis were identified: the most favorable class was defined by knowledge of lactate dehydrogenase (normal), performance status (0-1) and serum sodium levels (normal) with median survival time of 16.0 months, and the class with the poorest prognosis was defined by knowledge of lactate dehydrogenase (elevated) and performance status (2-3) (median survival time 6.6 months). The intermediate class had a median survival time of 9.4 months. In conclusion, this subclassification system will be used for the design, implementation and interpretation of clinical studies as well as decision-making in individual patients.

Adult↗

Opening of infectious giant bulla with use of video-assisted thoracoscopic surgery.

In 5 cases, an infectious giant bulla was opened with the use of video-assisted thoracoscopic surgery (VATS). Because all bullae adhered to the thoracic wall and were noncommunicating with the airway, they were opened without complete resection, leaving their inside walls at the lung and lateral walls on the thoracic wall. The expansion of remnant lung was excellent, and postoperative air leakage did not occur in any case. The postoperative vital capacity and FEV1 improved significantly over the preoperative condition (p<0.01). Because the bronchial communication of bulla is frequently obliterated after infection within the bulla, opening of a bulla is curative and simpler, more effective, and less invasive than complete resection.

Adult↗

[Analysis of small lung nodules diagnosed by open lung or thoracoscopic biopsy].

We examined clinicopathologic findings in 86 cases with peripheral lung nodules less than 30 mm in size diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. Biopsies were conducted because of the new appearance or enlargement of nodules as evidenced in a comparison with retrospective chest films in 47 patients, X-ray findings of malignancy suspicion without retrospective films in 13, enlargement of nodules after the administration of antituberculosis agents in 9, and a past history of malignancy in 17. Mean tumor size was 18.1 mm in primary lung cancer (n = 29), 16.2 mm in metastatic lung cancer (n = 13), 16.3 mm in tuberculosis (n = 18), 15.3 mm in nonspecific inflammation (n = 12), 16.7 mm in benign lung tumors (n = 7), 7.5 mm in intrapulmonary lymph node (n = 2), and 19.4 mm in others (n = 5). Among primary lung cancers with a clear N-factor, the percentage of T1N0M0 cancers was up to 72%. No significant difference was observed in either of the reasons for these biopsies and the size of nodules among diseases. To detect early lung cancer and increase the rate of cure, small pulmonary nodules that could be hardly diagnosed using bronchoscopic or needle aspiration biopsy should be diagnosed positively using VATS biopsy.

Adult↗

Fine Needle Aspiration Cytology of Argyrophilic Mucinous Carcinoma of the Male Breast.

The results of fine needle aspiration (FNA) cytology of case of argyrophilic mucinous carcinoma of the male breast is presented. The smear obtained from the tumor showed many loose clusters of atypical cells with abundant granular cytoplasm in the mucous background. Most tumor cells showed a plasmacytoid appearance with eccentric nuclei. Numerous fine granules and a few large droplets were found in the cytoplasm. The characteristic light microscopic feature of this lesion was organoid nest formation of tumor cells in mucous lakes. The Grimelius method revealed numerous argyrophilic granules in the cytoplasm and immunohistochemistry showed a positive reaction for chromogranin A. Thus, this tumor revealed the cytomorphologic characteristics of mucinous as well as argyrophilic carcinoma, simultaneously.

Journal Article↗

Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography.

PURPOSE: To compare low-dose spiral computed tomography (CT) with radiography of the chest for the screening and detection of small peripheral lung cancers in a high-risk population. MATERIALS AND METHODS: Posteroanterior and lateral radiographs and low-dose spiral CT scans were obtained twice a year from September 1993 to April 1995 in 1,369 individuals (a total of 3,457 examinations) who were at high risk for lung cancer. Low-dose spiral CT parameters were 120 kvP, 50 mA, 10-mm collimation, and 2:1 pitch. RESULTS: Peripheral lung cancer was detected in 15 of 3,457 examinations (0.3%). Among the 15 cases, the results of chest radiography were negative in 11 (73%), and the tumors were detected only at low-dose spiral CT. The detection rates of low-dose spiral CT and chest radiography were 0.43% (15 of 3,457 examinations), respectively. Fourteen (93%) of the 15 (exclusion of one pulmonary lung cancer) tumors were stage I. CONCLUSION: Low-dose spiral CT was superior to chest radiography in the screening and detection of peripheral lung cancer in high-risk individuals. Further large-scale studies are warranted, however, to clarify the efficacy and cost-effectiveness of low-dose spiral CT in a randomized, controlled population.

Adult↗