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Biomedical subjects

K Yoshiya

Publications and source records attributed to K Yoshiya.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Intracavity suction and drainage in a patient with giant bulla accompanied by pneumoconiosis and emphysema: a case report].

A 74-year-old man with giant bulla accompanied by pneumoconiosis and emphysema was treated by intracavity suction and drainage procedure using chemical irritant and fibrin glue. About one month later, the bulla disappeared and the patient symptomatically improved on discharge from hospital. Intracavity suction and drainage is safe and effective treatment of emphysematous bulla in patients considered to be a bad risk for formal thoracotomy.

Aged↗
PubMed1995

[Four cases of hemolytic uremic syndrome (HUS) associated with serotype O165 verotoxin producing Escherichia coli (VTEC) identified by LPS-solid phase enzyme-linked immunosorbent assay (ELISA)].

Enzyme-linked immunosorbent assay using LPS derived from newly recognized serotype O165 verotoxin producing Escherichia coli (VTEC) could identify 4 cases of hemolytic uremic syndrome (HUS) associated with O165 VTEC. All 4 cases showed a typical clinical course seen in VTEC-associated HUS. We screened 33 cases of HUS whose pathogen was not identified by culture of serodiagnosis. The O165 serotype was not thought to be important not only as a VTEC but also as an enteropathogenic E. coli. However, the prevalence, 4 cases, was as high as of O111 serotype, which is the second major serotype of VTEC in Japan. We have to be careful for this serotype when we look for the pathogen of the patients with hemorrhagic colitis or with HUS.

Bacterial Toxins↗
PubMed1995

[Thoracoscopic partial lung resection using staplers and polyglycolic acid (PGA) felts in an 85-year-old patient].

An 85-year-old man was admitted to our hospital with complaints of dyspnea and palpitations. His chest roentgenogram and CT scan showed emphysematous lung and a right pneumothorax with bulla. In cases of emphysematous lung disease, it is well-known that postoperative pulmonary leakage tend to be prolonged, and that control of such leakage is often difficult. A felt-like bioabsorbable prosthesis (polyglycolic acid sheet: NEOVEIL) was used for partial lung resection under thoracoscopic guidance. On each side of the stapler, PGA strips (1 cm wide x 3.5 cm long) were fixed with absorbable sutures. We found that it was difficult to cut with the stapler knife and that the second staple line could not easily cut across the first. However, there was no postoperative air-leakage and his postoperative course was uneventful.

Aged↗
PubMed1995

[Thoracoscopic treatment of a giant bulla: a case report].

A 38-year-old man was admitted to our hospital because of left giant bulla and pneumothorax. His chest X-rays and CT scan showed giant bulla of the left upper lobe and left pneumothorax. We performed bullectomy using the ENDOPATH ENDO LINEAR CUTTER 60 mm and 35 mm disporsable surgical stapler under thoracoscopic guidance. Clipping with end-clips and fibrin glue were effective for miner air leakage. There were no complications such as prolonged air leakage or incomplete lung re-expansion. His post operative couse was uneventful and he was discharged from the hospital on the 11th post operative day. When performed along with mini-thoracotomy, thoracoscopic operation is useful in treating patients with giant bulla.

Adult↗
PubMed1995

[Reoperation for recurrent or second primary lung cancer].

From 1975 to July 1994, twenty patients underwent second or third pulmonary resections for 7 recurrent lung cancers and 14 second primary lung cancers. The initial surgical procedures were lobectomy in 18, pneumonectomy in 1 and bilateral segmentectomy in 1. The procedures at the second operation were completion pneumonectomy in 4, ipsilateral wedge resection in 3, contralateral lobectomy in 1, contralateral segmentectomy in 4, contralateral wedge resection in 7 and resection of left main bronchus in 1. At the third operation, wedge resection was done in one 28 months after completion pneumonectomy. There was no operative death following second and third operations. Five-year survival rate following second operation in 20 patients was 32.3%, and it was 28.6% for patients with recurrent lung cancers, and 31.2% for multiple primary lung cancers. In conclusion, an aggressive surgical approach for reappearing lung tumor should be performed. At the reoperation, wedge resection for recurrent lung cancers, completion pneumonectomy for ipsilateral primary lung cancers and segmentectomy for contralateral primary lung cancers should be chosen for the standard surgical procedure.

Adenocarcinoma↗
PubMed1995

[Completion pneumonectomy for local recurrence of lung cancer].

Completion pneumonectomy refers to an operation intended to remove what is left of a lung partially resected during a previous operation. The procedure is seldom indicated and the risk of operative mortality and morbidity is higher than standard pneumonectomy. Four patients underwent completion pneumonectomy for recurrence of lung cancer. The first patient had metastatic lesion of hilar lymph nodes more than five years after surgery. The second one had received preoperative radiation therapy and the third had very poor pulmonary function. The last one had underwent pulmonary resections twice during twelve years. Each case was relatively uncommon and gave the difficult surgical problem, but all patients survived the operation and are doing well at present.

Adenocarcinoma↗
PubMed1994

[Renal ablation by transcatheter renal arterial embolization in the treatment of benign renal disease].

Renal ablation by transcatheter renal arterial embolization (TAE) was performed in 10 patients with benign renal disease (hydronephrosis n = 6; renovascular hypertension n = 3; nephrotic syndrome n = 1). Each affected kidney had little or no renal function. Six patients with hydronephrosis were treated with TAE using absolute ethanol alone in three patients and the combination of absolute ethanol and gelatin sponge in the other three. Each patient was followed by sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. In four of the six patients, the embolized kidney had no urine, and there was very little urine in the remaining two. The size of the embolized kidney was markedly decreased on CT. The three patients with renovascular hypertension were pre-studied by selective and renal vein sampling for PRA, and the kidney excreting higher renin was embolized by TAE with absolute ethanol. Blood pressure has become manageable without antihypertensive drug in two patients and with a reduced amount of drug in one. The patient with nephrotic syndrome had end stage renal failure and showed significant protein excretion. To prevent further protein loss, both kidneys were embolized with stainless steel coils. Urine output was significantly decreased, and consequently, hypoalbuminemia improved. All patients tolerated the procedure well, and there were no significant complications. Renal ablation by TAE may be an alternative to surgical treatment in selected patients with benign renal disease, particularly in patients with contraindications to surgery and in the elderly. Absolute ethanol and gelatin sponge seem safe and effective for TAE in patients with hydronephrosis and renovascular hypertension. For hydronephrosis, we recommend combining TAE with sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. Though we successfully applied steel coil for the patient with nephrotic syndrome, absolute ethanol may be equally effective.

Adult↗
PubMed1994

[How extensive should lymph node dissection be done for the surgery of the left lung cancer?].

Mediastinal lymph node dissection for cancer of the left lung is more difficult than for cancer of the right lung because of the presence of aorta. Location and frequency of lymph node metastasis were examined for 231 left lung cancer patients who underwent pulmonary resection and mediastinal lymph node dissection, and survival rate of them was evaluated. Subaortic (# 5), paraaortic (#6), subcarinal (#7), tracheobronchial (#4) lymph nodes were the most frequently involved N 2 nodes. 5-year survival rate of the patients who had #4, #5, #6, #7, #8 or #9 lymph node metastasis was 20.7%. #4, #5, #6, #7, #8 and #9 should be dissected for the surgery of the left lung cancer.

Carcinoma, Non-Small-Cell Lung↗
PubMed1993

Incomplete interlobar fissures: bronchovascular analysis with CT.

Thin-section computed tomographic scans of both lungs in 154 patients, including seven cadavers, with lung cancer (n = 37), diffuse (n = 32) or inflammatory (n = 30) lung disease, other proved or suspected disease (n = 23), or healthy lungs (n = 32) were analyzed to determine the frequency of incomplete interlobar fissure (IIF). An IIF was defined as a discontinuous linear shadow that remained in contact with the chest wall. An IIF was found in 128 of 154 right lungs (83.1%) and 77 of 154 left lungs (50.0%). Some bronchovascular structures crossed or passed through two contiguous lobes in the fused area. The most common bronchovascular structure associated with an IIF was a pulmonary vein; this association was found in 87 right lungs (56.5%) and 20 left lungs (13.0%). An IIF was traversed by a pulmonary artery in only seven right lungs and 13 left lungs or by a bronchus in only three lungs. It is concluded that recognition of an IIF might improve understanding of the spread of pulmonary disease.

Bronchi↗
PubMed1993

[A five-year survivor of small cell lung carcinoma stage IIIB treated with surgical resection and an adjuvant chemoradiotherapy--a case report].

A 56-year-old woman was admitted to our hospital with the complaint of cough. She had a rt. supraclavicular lymph node swelling, and her chest X-ray showed masses at the rt. hilum and the mediastinum. On bronchofiberscopy, a tumor was detected at the orifice of the lt. B3b, and the biopsy revealed small cell lung cancer (SCLC). With the peroperative diagnosis of stage IIIB SCLC, a neoadjuvant chemotherapy followed by surgical resection was performed. Because of the presence of malignant cells in the pericardial effusion, the operation turned out to be an absolutely non-curative one. As the recurrence of mediastinal lymph node swelling occurred after the surgery, an intensive chemoradiotherapy was performed successfully. Then the patient has been free from disease for five years. This case indicates the possibility that some of SCLC patients can be long-term survivors by the treatment of an appropriate adjuvant therapy combined with radical resection, even if the clinical stage is advanced. Therefore an extended operative indication for SCLC should be considered.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[A case of quadricuspid aortic valve associated with mitral regurgitation].

A case of a 60-year-old man associated with quadricuspid aortic valve and mitral regurgitation is reported. The aortic valve consisted of three larger cusps and a small accessory cusp situated between the right and the non-coronary cusps. The aortic regurgitation resulted from malcoaptation of the four cusps and the mitral regurgitation resulted from annulus dilatation and thickening of the anterior leaflet. The surgical treatment was performed successfully by the aortic and mitral valve replacements with St. Jude Medical valves. The patient is doing well fifteen months postoperatively. Sixteen Japanese cases of quadricuspid aortic valve which were corrected surgically are reviewed.

Aortic Valve↗
PubMed1993

[Results of surgery for pT4 lung cancer].

During 1977 and 1991, 54 patients with lung cancer underwent surgery at Niigata University Hospital and were diagnosed with pathological T4. The survival rate of these pT4 patients was 32.5% at 3 years and 24.4% at 5 years. There was no significant difference between the survival rates of those with squamous cell carcinoma and those with adenocarcinoma. 5-year survival rate of 20 patients with N0 disease and 23 patients with N2 disease was 43.0% and 13.0%, respectively (p < 0.05). 5-year survival rate of 21 patients with organ invasion alone, 21 with dissemination or malignant effusion alone, and 12 with organ invasion plus dissemination or malignant effusion was 22.5%, 28.6% and 0%, respectively; there was no significant differences between these rates. Seven patients survived over 5 years; however, there were no obvious common factors. An aggressive surgical approach is indicated for T4 lung cancer, not only in patients with N0 disease but also in those with organ invasion alone or small amounts of malignant effusion alone.

Adult↗
PubMed1992

[A case of Marfan's syndrome that required emergency Bentall's operation due to acute dissecting aortic aneurysm (DeBakey type II) following surgery of abdominal aortic aneurysm].

Graft replacement was performed in a 29-year-old man for an abdominal aortic aneurysm associated with Marfan's syndrome. Since the dissecting aortic aneurysm (DeBakey type II) accompanied by disruption of the right coronary artery developed 74 days after operation, the emergency Bentall's operation was successfully carried out with bypassing of the right coronary artery using a saphenous vein graft. Fifteen Japanese cases operated on for abdominal aortic aneurysm associated with Marfan's syndrome are reviewed, and the problems concerning surgery of abdominal aortic aneurysm and Bentall's operation are discussed.

Acute Disease↗
PubMed1992

[Surgical management of desmoid tumors of the chest wall: a case report and review of literature].

A 45-year-old man without special predispositions showed a chest wall tumor with tenderness. A needle biopsy revealed a desmoid tumor which had invaded the muscles. A wide resection from the second to fifth rib was carried out and 4 years have passed without recurrence. A resection, at least 3 cm away from the lesion, is necessary for desmoid tumors which seem to have clear margins.

Fibroma↗