Biomedical subjects

M Kikui

Publications and source records attributed to M Kikui.

At least 19 recordsLinked to original sources

PubMed2000

Reproducibility of diagnosis and its influence on the distribution of lung cancer by histologic type in Osaka, Japan.

The histologic types of lung cancer cases diagnosed in 1979-1980 (n=799) and 1987 (n=587) were independently reviewed by two pathologists in order to investigate the reproducibility of the diagnosis of the histologic type when the WHO classification (1981) was used. The specimens from 354 surgical cases and biopsy or cytology specimens from 1032 non-surgical cases were reviewed. The inter-observer agreement was 87.9% (kappa=0.79) for surgical cases and 81.4% (kappa=0.72) for non-surgical cases. When compared to the original diagnosis, the agreement was 86.8% (kappa=0.78) for surgical and 86.4% (kappa=0.79) for non-surgical cases in 1979-1980 and the agreement was 92.8% (kappa=0.87) for surgical and 89.1% (kappa=0.83) for non-surgical cases in 1987. By histologic type, no difference in the agreement was observed except for large cell carcinoma. The distribution of histologic types after the review differed only slightly (less than 6%) from the original distribution. This suggests that in Osaka, Japan, the diagnosis based on the WHO classification (1981) had only a limited influence on the distribution of histologic types, and is not a major reason for the changing trends in lung cancer incidence by histologic type.

Diagnosis, Differential↗

PubMed2000

Prognostic significance of hTERT expression in non-small cell lung cancer.

To investigate the prognostic role of hTERT expression in non-small cell lung cancer (NSCLC), we examined the expression of hTERT mRNA in tumor specimens from 68 patients with NSCLC using RT-PCR. The expression of hTERT was detected in 34 (50%) of 68 cancer tissues. There were no correlations between hTERT status and any common clinical features except age. Patients with hTERT expression had shorter survival than those without hTERT expression. Multivariate analysis showed that hTERT expression was an independent negative prognostic factor. These results suggest that expression of hTERT may be an independent prognostic factor for NSCLC patients.

Aged↗

PubMed1997

Transcutaneous needle biopsy of the lung.

PURPOSE: To evaluate the usefulness of transcutaneous needle biopsy (TCNB). MATERIAL AND METHODS: From May 1988 to December 1994, we performed TCNB under fluoroscopic control in 408 patients with mass lesions of the peripheral lung. The Surecut needle (1.5 mm) was selected mainly because of its ability to obtain specimens large enough for histological examination. Of the 408 patients, 286 had had previous bronchofiberscopic examinations but no definite diagnosis had been reached. RESULTS: A definite diagnosis was obtained by TCNB in 305 (74.7%) of 408 cases (251 malignant neoplasms, 54 benign lesions). In malignant neoplasms, the pathological diagnosis based on cytology and histology together was more reliable than that based on cytology alone. Although the complications of this procedure (such as pneumothorax) were within the range of acceptability, care should be taken to avoid air embolism and the seeding of cancer cells along the needle tract. CONCLUSION: TCNB with the Surecut needle is a useful procedure with relatively low risk.

Biopsy, Needle↗

PubMed1997

p21 expression as a predictor for favorable prognosis in squamous cell carcinoma of the lung.

Although p21 WAF1/Cip1 expression has been detected immunohistochemically in non-small cell lung cancer (NSCLC), the associations between p21 expression and clinical characteristics are unknown. To determine the association between p21 expression and clinical features, p21 expression was immunohistochemically analyzed in paraffin-embedded tumor samples from 137 patients with curatively resected NSCLC. p21 expression, indicating normal p21 function, was detected in 48 (35.0%) of the 137 patients with curatively resected NSCLC and was detected more frequently in patients with stage I or II disease (40.2%) than in those with stage IIIA disease (22.5%; P = 0.0483). There was no difference in the positive rate between squamous cell carcinoma [SCC; 15 of 48 (31.3%)] and adenocarcinoma [30 of 77 (39.0%)]. For SCC, patients with tumors expressing p21 survived longer than did those with tumors negative for p21 expression; however, the corresponding survival time was not significant for adenocarcinoma. On the other hand, p53 expression, detected in 58 (42.3%) of these patients, did not act as any predictor for prognosis in either SCC or adenocarcinoma. Our findings suggest that the presence of p21 expression is associated with favorable prognosis in SCC and may be useful in obtaining candidates for adjuvant therapies from among patients with SCC.

Adenocarcinoma↗

PubMed1996

Histologic changes in small cell lung carcinoma after treatment.

BACKGROUND: Small cell lung carcinoma (SCLC) has been divided into three subtypes: pure SCLC, mixed small cell/large cell carcinoma (mixed SC/LC), and combined SCLC. Patients with mixed SC/LC show a worse prognosis than those with pure SCLC. METHODS: Persistence of histologic subtype in SCLC in the primary sites during the course of treatment or in the different organs at autopsy was examined. For this purpose, biopsy or cytologic specimens before chemotherapy, and autopsy specimens from 175 patients with SCLC were reviewed. They included 147 (84%) men and 28 (16%) women with an age range of 29-83 (median, 65) years. RESULTS: The frequency of mixed SC/LC in the primary sites was statistically higher in autopsy (14.3%) than that in biopsy or cytology specimens (8.6%) (P < 0.05). At autopsy, involved organs were categorized into two groups according to frequency of appearance of mixed SC/LC, i.e., a higher frequency group, including the liver (31 of 85; 36.4%), adrenal gland (15 of 56; 26.8%), brain (6 of 9; 66.7%), and extrathoracic lymph nodes (17 of 59; 28.8%) and a lower frequency group, including the lung (metastatic sites) (12 of 102; 11.8%), pleura (8 of 74; 10.8%), and intrathoracic lymph nodes (12 of 94; 12.8%). The difference in frequency between these two groups was statistically significant (P < 0.05). CONCLUSIONS: These findings suggest that primary pure SCLC can progress to mixed SC/LC with an increased potential for distant metastasis.

Adult↗

PubMed1996

Idiopathic bronchiolitis obliterans organizing pneumonia (idiopathic BOOP) in childhood.

Idiopathic bronchiolitis obliterans organizing pneumonia (idiopathic BOOP) is a clinicopathological entity of unknown origin first described by Epler and colleagues in 1985. We report our findings from a study of two Japanese boys aged 12 and 13 years with idiopathic BOOP. The patients showed no respiratory symptoms nor signs of infection. There was no history of exposure to noxious agents or medications in either case. Laboratory data, including hematological, biochemical, and immunological tests, were normal, and pulmonary function tests showed only a slight nonprogressive decrease from normal predicted values in vital capacity and diffusing capacity. Serial radiographs in both cases showed migration of patchy infiltrates. Fiberoptic bronchoscopy was performed for evaluation of eosinophilic pneumonia, but the bronchoalveolar lavage (BAL) revealed no increase in eosinophils and a decrease in CD4/CD8 ratio in the BAL fluid. Histopathological findings of transbronchial lung biopsy (TBLB) specimens were compatible with a diagnosis of BOOP. As neither case has shown clinical abnormalities apart from migratory patchy infiltrates on chest radiographs, both patients have been observed without drug therapy for 3-4 years.

Adolescent↗

PubMed1995

[Pulmonary complications in patients with rheumatoid arthritis].

Pulmonary manifestations of rheumatoid arthritis were studied in 26 patients. Pulmonary complications could be divided into four subgroups: Interstitial pneumonia/Pulmonary fibrosis (n = 18), Bronchiolitis Obliterans Organizing Pneumonia (n = 4), Bronchiolitis Obliterans (n = 2), and Pleuritis/Pericarditis (n = 1). Analysis of cells in broncho-alveolar lavage fluid (BALF) revealed abnormally high percentages of lymphocytes in one-half of the patients and abnormally high percentages of neutrophils in one-third of the patients. The percent of BALF cells that were neutrophils was higher with higher chest radiograph grades. Analysis of soluble constituents of BALF indicated local production of IgG in two cases, but IgM-rheumatic factor was not detected. In 18 of 26 patients corticosteroid or immunosuppressive drugs were needed, and most of the patients responded to the therapy and had good outcomes. The conditions of 6 patients with interstitial pneumonia/pulmonary fibrosis deteriorated and 4 patients died of progressive respiratory failure. The subclassification of rheumatoid lung was useful for predicting its outcome.

Aged↗

PubMed1994

Postinflammatory bronchiectatic cavity observed by fibreoptic bronchoscopy.

A 55 year old female, complaining of bloody sputum and fever, was referred to our institution. The chest roentgenogram on admission revealed a large thin-walled cavitary shadow in the right upper lobe. We could clearly observe the inner surface of the postinflammatory bronchiectatic cavity in the right B3 bronchus by fibreoptic bronchoscopy. This is the first case in which interesting bronchoscopic findings of a bronchiectatic cavity could be directly observed.

Bronchi↗

PubMed1994

[A case of subcutaneous sarcoid nodules induced by interferon-alpha].

A 57-year-old woman came to our hospital complaining of multiple subcutaneous nodules that developed while she received corticosteroid therapy for pulmonary sarcoidosis. She was treated with interferon-alpha (IFN-alpha) at another hospital for C-type chronic hepatitis and she noticed these nodules with tenderness two months after treatment began. A biopsy specimen of the nodule revealed subcutaneous sarcoid granuloma. Her abnormally high serum-ACE value and subcutaneous nodules resolved after the dose of IFN-alpha was gradually reduced. IFN therapy should be used with care in cases of sarcoidosis in which IFN-gamma and T-lymphocytes are mainly involved.

Female↗

PubMed1994

[Hypersensitivity pneumonitis--histopathology of summer-type hypersensitivity pneumonitis].

Summer-type hypersensitivity pneumonitis(SHP) first reported by T. OCHI, et al. (1978), as a new type hypersensitivity pneumonitis(HP) with features of initiation during summer and anti-Cryptococcus antibody positive sera, has been recognized as "a unique disease in Japan", a most common type of HP in Japan, and now also known as anti-Trichosporon cutaneum antibody-positive SHP. This report was mainly concerned with the histopathology of SHP, thus far diagnosed in our hospital. Of the cases in our hospital, 62 consecutive biopsied cases (3 cases of open lung biopsy and 59 cases of transbronchial lung biopsy) without steroid institution before lung biopsy have been reviewed and revealed granulomatous interstitial pneumonitis in the bronchiolo-alveolar region, like various types of HP. Alveolitis (61 of 62 cases; 98.4%), sarcoid-like granuloma (50 of 62; 80.6%) and Masson's body (36 of 62; 58.1%) are main features, and could be named "triad" features. Concerning histopathological findings related with the period of lung biopsy after onset of clinical episodes as HP, alveolitis has been present regardless of period, and fibrinous exudate present in the early period and not in a case at 4 months. Sarcoid-like granuloma and Masson's body have appeared firstly at one-month cases. After this period sarcoid-like granuloma have been present in nearly all cases, but Masson's body has been not present in 10-month case with gradual decrease after 2 months, when all 2-month cases had it. In summary, for histopathological diagnosis of HP, the "triad" features and the time of lung biopsy done are keys, taking into consideration histopathological differential diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolitis, Extrinsic Allergic↗

PubMed1993

[Open lung biopsy in an 11 year old boy with %FVC 11%].

Anesthesia was administered to an 11 year old boy with %FVC 11%. The patient had dyspnea and severe constrictive pulmonary disorder with an almost normal chest radiograph. Open lung biopsy was performed and the patient was weaned in the first postoperative morning without any problem. Pulmonary fibrosis was caused by anti-cancer drugs given in his infancy. He died of cardiorespiratory failure 14 months postoperatively.

Biopsy↗

PubMed1993

[A case of spontaneous remission of paragonimiasis miyazakii].

A 52-year-old man was admitted with fever and chest pain. Chest X-ray showed a soft infiltration in the right lung and bilateral pleural effusions. A strong tuberculin reaction was elicited. Significant laboratory findings included eosinophilia (37% in peripheral blood and 78% in pleural fluid) and elevated IgE levels (577 IU/ml in sera and 6700 IU/ml in pleural fluid). Adenosine deaminase activity in the pleural fluid was high. No helminth eggs were detected after repeated examination of the pleural fluid and sputum. No definitive diagnosis was made. Three months of chemotherapy with INH and rifampicin resulted in little improvement. Corticosteroid was then administered orally under a tentative diagnosis of idiopathic eosinophilic pleurisy, which proved to be a successful treatment and resulted in a marked reduction of pleural fluid volume. Two years after discharge, the patient's chest X-ray was normal and laboratory findings were normal including the eosinophil count and IgE level. The pleural fluid obtained at the first admission and kept frozen was subjected to immunological analysis for anti-parasite antibody activity. The pleural fluid showed an unexpectedly high titer of antibody activity (x6400 dilution) against Paragonimus miyazakii antigen assayed by double diffusion Ouchterlony method. Examination of the sera obtained from the patient two years after discharge, however, revealed no detectable antibody activity against the parasite antigens assayed either by Ouchterlony or ELISA method. We concluded from the clinical as well as laboratory findings that the patient had recovered from Paragonimiasis miyazakii without specific intervention for the disease.

Antibodies, Helminth↗

PubMed1993

[A case of multiple broncholithiasis caused by mucus retention].

The patient was a 57-year-old male with long-standing bronchiectasis who developed severe respiratory failure and died in 1991. Autopsy revealed multiple broncholithiasis in both lungs, but no calcified lymph nodes in the hilar region. Since histological examination of the broncholiths showed only stratified structures but no tissue structure, most likely cause was considered to be calcification of mucus in the bronchi. Analysis of the stone components revealed 78% calcium and 22% protein. This patient represents a case of multiple broncholithiasis caused by mucus retention, which is thought to be very rare.

Adult↗

PubMed1991

Intraoperative pleural lavage cytology in lung cancer patients.

Cytology of intraoperative pleural lavage was examined in 164 lung cancer patients who underwent pulmonary resections. None of the patients had any pleural effusion or dissemination. Cytology was performed three times: (1) at thoracotomy, (2) immediately after resection, and (3) after washing the pleural cavity with 5,000 mL of physiological saline solution just before closure of the chest wall. Twenty-three patients (14%) had more than one positive cytological finding. The frequency of positive cytological findings was significantly correlated with pathological T classification, pleural status, and pathological stage. The positive lavage group had a significantly higher recurrence rate than the negative lavage group in patients with stage I or stage II cancer. Four patients in the positive lavage group (17.4%) had recurrence in pleura or pericardium whereas only 1 patient in the negative lavage group (0.7%) had a recurrence in pericardium. The positive cytological finding of pleural lavage has more important meaning as a prognostic factor in stage I and stage II and indicates a greater possibility of recurrence in pleura or pericardium, but further examinations to evaluate the viability of detected malignant cells are required so that the positive cytological findings of pleural lavage can be regarded as subclinical pleural dissemination.

Adenocarcinoma↗

PubMed1991

Sensitivity and specificity of lung cancer screening in Osaka, Japan.

Sensitivity and specificity were evaluated for lung cancer screening conducted at 8 municipalities in Osaka Prefecture during 1981-1985. As a screening policy, all attendants were examined by miniature chest X-ray, and the high-risk group, defined as those who smoked cigarettes or had bloody sputum, were also examined by 3-day pooled sputum cytology. A total of 33,599 screening tests for 19,028 people who were 40 years old or more at the time of screening were conducted, resulting in 33,490 miniature chest X-ray examinations for 18,992 people and 11,420 sputum cytologies for 7,070 people. As a result, 43 lung cancer cases were detected. All test-negatives were followed by means of record linkage with the files of the Osaka Cancer Registry up to the end of 1986. There were 24 cases who were diagnosed as having lung cancer without having given a positive screening result in 1981-1986. Assuming the preclinical detectable phase of lung cancer to be one year uniformly, the sensitivity and specificity for the lung cancer screening were estimated to be 71.6% and 95.3%, respectively. The feasibility of increasing the sensitivity is discussed.

Adult↗

PubMed1991

Lymphoproliferative diseases of the lung in Japan: review of thirty-six patients with an immunohistochemical study.

Thirty-six cases of primary lymphoproliferative disease of the lung, collected from hospitals in Japan, have been reviewed. Histologically they were divided into three groups: definite lymphoma (DL) showing monomorphous proliferation of medium to large cells (17 cases), small lymphoid cell proliferation (SLP) frequently containing lymphoid follicles (11 cases), and pseudolymphoma showing lymphoid follicular hyperplasia (LFH) (six cases) or mixed diffuse infiltration of small lymphocytes and macrophages (two cases). In some DL cases, lymphoid follicles were present in or near the tumors. Pulmonary lesions in SLP and LFH patients were frequently detected at their medical checkups. Immunohistochemistry revealed that proliferating cells in 15 out of 17 DL and all SLP cases were B cells with restricted expression of the immunoglobulin light chain, all lambda type, in three DL and four SLP cases. From morphologic and immunologic findings, 10 SLP cases were diagnosed as intermediate lymphocytic lymphoma (ILL) and one as being of lymphoplasmacytic type. Two DL cases with convoluted nuclei proved from immunohistochemistry to be of T-cell type, showing a much lower frequency of T-cell type than that found in the USA (approximately 50%).

Antigens, Differentiation↗

PubMed1991

Pleomorphic adenoma in the periphery of the lung. Report of a case and review of the literature.

A pleomorphic adenoma of the lung recurred after 9 years. The primary tumor consisted mainly of cartilaginous and fibrous elements with a small area of epithelial cell nests, whereas the second one possessed epithelial cell nests with cartilaginous stroma. Immunohistochemical studies showed that both tumors had neoplastic cells with immunoreactive S100, keratin, actin, vimentin, and glial fibrillary acid protein-positive cytoplasm. The primary tumor, which was resected from the periphery of the lung, was not connected with the trachea or the bronchus macroscopically. To our knowledge, the literature contains only six reports of pleomorphic adenoma in the lung.

Adenoma↗

PubMed1990

[Study on local recurrence of squamous cell carcinoma of the lung on hilar lesion].

The study population consisted of 62 patients with squamous cell carcinoma of the lung on hilar lesion who underwent curative or relative curative resection during the seven year period between January, 1980 and December, 1986. We studied the correlation between local recurrence and the distance from the surgical margin of the trachea or bronchus to the tumor. 1) As the classification of the T and N factors increased, the incidence of local recurrence became higher. 2) In order to prevent local relapse, we need to completely resect the hilar and mediastinal lymph nodes, and we must maintain a distance of 16 mm or more between the surgical margin of the trachea or bronchus and the tumor.

Carcinoma, Squamous Cell↗