Biomedical subjects

S Morinaga

Publications and source records attributed to S Morinaga.

At least 73 records · Page 4Linked to original sources

PubMed1997

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↗

PubMed1997

Histamine poisoning after ingestion of spoiled raw tuna in a patient taking isoniazid.

An 83-year-old woman taking isoniazid (INH) suddenly developed a headache, palpitations, and skin eruptions with itching while eating raw tuna. The symptoms were compatible with those of histamine intoxication. When given fresh raw tuna to eat, no such reactions were evoked in this patient. The episode was speculated to be due to two conditions; eating spoiled raw tuna and at the same time being on a course of INH, a potent histaminase inhibitor. We should therefore be aware of the possible adverse effects due to the interactions between drugs and foods.

Aged↗

PubMed1997

Long survival after extrapleural pneumonectomy for pleural malignant mesothelioma with metastasis to infradiaphragmatic lymph node.

A woman who at the age of 47 years underwent extrapleural pneumonectomy for malignant pleural mesothelioma with metastasis to an infradiaphragmatic lymph node is alive and well 63 months later. Because such metastasis is readily caused by lymphatic tumour-cell permeation from the diaphragm and parietal pleura, the infradiaphragmatic nodes should be dissected at extrapleural pneumonectomy for malignant pleural mesothelioma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[A case of mediastinal ganglioneuroma in an elderly patient].

A 64-year-old woman was found to have a posterior mediastinal mass. X-ray findings revealed a neurogenic tumor, i.e., a schwannoma or neurofibroma. Postoperative pathological examination of the resected tumor showed it to be a ganglioneuroma an extremely rare occurrence, given the fact that the mediastinal ganglioneuroma tends to be diagnosed in adolescents and young adults.

Female↗

PubMed1997

[Long-term survival after multimodal therapy for lung cancer with pleural dissemination].

A 56-year-old man with peripheral T1N0M0 lung cancer underwent thoracotomy. Pleural dissemination was recognized intraoperatively. We performed wedge resection of the lung including the primary tumor, and applied hypotonic cisplatin treatment. We followed this up postoperatively with chemotherapy combined with cisplatin and irinotecan. One year later, a recurrent tumor occurred at the resected end of the lung, so we conducted stereotactic radiosurgery on the recurrent lung lesion, resulting in complete eradication. One year later, no relapse of cancer was observed. We conclude that implementing hypotonic cisplatin treatment in pleural dissemination of lung cancer followed by stereotactic radiosurgery on any recurrent tumor in the peripheral lung was effective for the present case.

Adenocarcinoma↗

PubMed1996

Primary hepatocellular carcinoma and hepatoid adenocarcinoma of the stomach with liver metastasis: an unusual association.

Alpha-fetoprotein (AFP)-producing hepatoid adenocarcinoma of the stomach is a rare and recently discovered entity. We report an unusual combination of hepatocellular carcinoma and hepatoid adenocarcinoma of the stomach with multiple liver metastases. The patient, a 62-year-old Japanese man, was clinically diagnosed as having hepatocellular carcinoma because of the presence of liver tumors, a markedly elevated serum AFP level, and a positive hepatitis C virus (HCV) antibody titer. Autopsy revealed multiple tumors in the liver; one was a primary hepatocellular carcinoma without metastasis, and the others were metastases from latent hepatoid adenocarcinoma of the stomach. In the hepatocellular carcinoma, bile production was observed although the tumor was immunohistochemically negative for AFP. On the other hand, both the primary gastric and metastatic liver hepatoid adenocarcinomas were positive for AFP. Therefore, hepatoid adenocarcinoma of the stomach was responsible for the excessive production of AFP and was the cause of death.

Adenocarcinoma↗

PubMed1996

[Exacerbation of idiopathic interstitial pneumonia after lobectomy for lung cancer].

A 51-year-old man was found to have cancer in the left lung during treatment for idiopathic interstitial pneumonia. He underwent a left upper lobectomy because pulmonary function was judged to be adequate and because the interstitial pneumonia was not severe. After the operation, acute exacerbation of interstitial pneumonia occurred, and respiratory failure developed. Immediate steroid therapy alleviated his condition. Acute exacerbations of idiopathic interstitial pneumonia after pulmonary resection are usually fatal, and cases such as this are very rare.

Disease Progression↗

PubMed1996

[A case of bronchogenic carcinoma associated with pulmonary infarction which showed a tumorous shadow].

The patient was 69-year-old male with bronchogenic carcinoma associated with another abnormal shadow in the same left lower lobe. Its shadow was considered whether obstructive pneumonia or intrapulmonary metastasis before thoracotomy. Pathological examination revealed that this lesion was pulmonary infarction. It may be rare that bronchogenic carcinoma is associated with pulmonary infarction showing tumorous shadow. The staging and operative indication of lung cancer should be carefully determined which associate with abnormal shadow on the same lung field.

Aged↗

PubMed1996

[A case of carcinomatous peritonitis for which combination therapy of 5-FU, leucovorin and cisplatin was effective].

This case report describes a case of carcinomatous peritonitis which showed a good response to the combination therapy of 5-FU, leucovorin and cisplatin. A 55-year-old man was admitted with complaints of meteorism due to ascites fluid. Ascitic examination showed a high concentration of CEA and CA19-9, and adenocarcinoma cells. Laboratory and radiological examination did not reveal the origin of the carcinoma, and laparotomy suggested an appendiceal origin. The combination chemotherapy with 5-FU, leucovorin and cisplatin was conducted for a total of 11 courses for 2 years with good QOL until his death. This therapy was suggested to be useful for inoperable carcinomatous peritonitis.

Adenocarcinoma↗

PubMed1996

[Squamous cell carcinoma of the lung associated with palmo-plantar hyperkeratosis].

Palmo-plantar hyperkeratosis (PPH) is a diffuse keratoderma of the palms and soles that has been reported to be associated with internal malignancies such as lung and esophageal carcinomas. When PPH is associated with malignancy the prognosis is poor. The present patient was a 48-year-old man with PPH who suffered from squamous cell carcinoma of the lung. The pathological stage was T4N2M1 and the patient died of recurrent tumor 17 months after surgery. Because the prognosis of lung carcinoma associated with PPH is poor, patients with these conditions should undergo frequent medical examinations, which should include chest radiography and cytologic examination of sputum.

Carcinoma, Squamous Cell↗

PubMed1996

Yolk sac tumor of the liver combined with hepatocellular carcinoma.

Hepatic yolk sac tumor is extremely rare, and only nine cases have been reported previously to our knowledge. We report the occurrence of a tumor combining hepatocellular carcinoma and yolk sac tumor. The clinical, pathologic, and immunohistochemical findings are presented. The patient was a 62-year-old Japanese man who died of hepatic failure and uncontrolled ascites. On autopsy, a large hepatic tumor was observed, which microscopically was composed of hepatocellular carcinoma and yolk sac tumor. The two components were intermingled, and transition zones were evident. Immunohistochemically, both components were positive for alpha-fetoprotein, but only the yolk sac tumor component was positive for carcinoembryonic antigen, epithelial membrane antigen, stage specific embryonic antigen-1, placental alkaline phosphatase, and keratin. To our knowledge, this is the first reported case of hepatic yolk sac tumor associated with hepatocellular carcinoma. The present tumor is best considered a variant of hepatocellular carcinoma showing yolk sac differentiation, and it provides another explanation for the histogenesis of extragonadal yolk sac tumor.

Carcinoma, Hepatocellular↗

PubMed1996

[Use of an expandable metallic stent in patients with superior vena cava syndrome--comparison of angiographic findings and autopsy findings].

To evaluate the usefulness of expandable metallic stens (EMS) in patients with superior vena cava (SVC) syndrome, we compared venographic findings obtained before EMS insertion with findings at autopsy. Stents were inserted into the SVC in 10 patients. An autopsy was done in 7 of the 10 patients. At autopsy, the lumen of the SVC was patent in 4 patients; in those 4 patients venography before EMS insertion showed that the SVC was obstructed by extramural compression. These results suggest that extramural compression without direct invasion of the tumor is the best indication for insertion of an EMS. At autopsy, the lumen of the SVC was obstructed by direct invasion of a tumor in 2 patients; in those 2 patients venography showed wall irregularity and lumen narrowing caused by tumor invasion. However, in those 1 patients SVC syndrome either did not recur or recurred in only a mild form after EMS insertion. The results in these 2 patients suggest that if collateral circulation does not develop, insertion of an EMS is indicated also in patients in whom the SVC is obstructed by direct invasion of a tumor. In the remaining patient, the lumen of the SVC was found at autopsy to be obstructed by a thrombus. SVC syndrome developed in this patient 430 days after EMS insertion. In 1 of the 7 patients, an EMS was inserted into the left innominate vein and also into the SVC. Venography before EMS insertion showed that the vein was obstructed by extramural compression without direct invasion of the tumor, but the EMS was found at autopsy to be completely obstructed by a thrombus. This suggests that insertion of an EMS into the left innominate vein is not indicated this vein is easily obstructed by thrombi because of its anatomical location.

Adult↗

PubMed1996

[Detection of PEBP2 beta/MYH11 fusion mRNA in acute myelomonocytic leukemia without marrow eosinophilia].

We present a 15-year-old woman with acute myelomonocytic leukemia without marrow eosinophilia, M4 in the FAB classification. She was admitted to our hospital with nausea and headaches. Upon admission, the leukocyte count was 284,000/microliters with 95% leukemic cells. The bone marrow aspirate was hypercellular with 74.8% blasts and 0.2% eosinophils. Leukemic cells were positive for myeloperoxidase and esterase staining. Initially, the karyotype of the bone marrow cells on admission was considered to be normal. However, the PEBP2 beta/MYH11 fusion transcript was detected in the bone marrow mononuclear cells by using the reverse transcriptase-polymerase chain reaction (RT-PCR). Reevaluation of karyotypes showed a t(16;16) (p13;q22) in the bone marrow cells. After achieving complete remission, she was treated with low-dose etoposide. Chromosome analysis showed a normal karyotype and no amplified chimeric transcripts were observed. This case indicates that the molecular analysis of PEBP2 beta and MYH11 genes is a useful tool to detect inv (16) and t(16;16) which were often difficult to find, and that leukemic cells from some cases of M4 without marrow eosinophilia have these chromosome abnormalities.

Adolescent↗

PubMed1996

[Recurrence of a stage I thymoma after resection].

A 61-year-old man had a non-invasive thymoma. The tumor recurred in the aortocaval groove 6 months after thymothymectomy. The second tumor was a non-invasive, lymphocytic thymoma with polygonal cells, and was similar to the first one. The tumor may have been a multicentric thymoma, with malignant cells remaining in thymic tissue behind the brachiocephalic veins. To resect thymomas, extended thymectomy should be done to prevent recurrence from the remaining thymic tissue. CT scans should be obtained for long-term follow up after surgery, to detect any recurrence in its early stage.

Follow-Up Studies↗

PubMed1996

[Lymphomatoid granulomatosis of the brain with multiple lesions on MRI].

A 28-year-old man was admitted to our hospital, because of double vision, memory disturbance and dysarthria. These symptoms developed in November, 1994. His mental activity was gradually decreased and he became apathetic. A physical examination on admission was unremarkable. There were no lymphadenopathy, hepatosplenomegaly or skin rash. Neurological examination revealed disorientation, decreased mental activity and left gaze-evoked nystagmus. Neuropsychological tests demonstrated impairment of recent memory and performance but frontal lobe functions were maintained. Laboratory data showed hyponatremia, elevation of antinuclear antibodies and IgG-antibodies to Epstein-Barr virus capsid antigen and Epstein-Barr virus nuclear antigen. A brain MRI revealed multiple lesions in the cerebral subcortex, cerebellum and brainstem. These lesions showed high signal intensity on T2-weighted images and enhanced high signal intensity on T1-weighted images using Gd-DTPA injection. A cystic mass was seen between bilateral lateral ventricles and contacted with the fornix and thalamus. Lymphomatoid granulomatosis was diagnosed by an open brain biopsy, which showed diffuse infiltration of small lymphocytes, histiocytes and plasma cells, especially around the small vessels. Epithelioid granuloma or necrosis was not seen. An immunohistochemical study showed that nearly all lymphocytes were MT-1 positive T lymphocytes. The patient was treated by whole brain irradiation (30Gy) and pulse therapy of methylprednisolone. Multiple lesions in the brain responded to these modalities with complete resolution of the lesions and clinical improvement. In this case, impressive multiple and cystic lesions seen on brain MRI disappeared by whole brain irradiation and steroid. Since etiologies of multiple lesions on MRI includes many possibilities, histological diagnostic methods should be performed to obtain a definitive diagnosis. This is the first case of lymphomatoid granulomatosis that showed multiple and cystic lesions on brain MRI in Japan.

Adult↗

PubMed1995

Expanding intrathoracic hemorrhagic lesion penetrating the thoracic wall: a rare complication of chronic tuberculous pleurisy.

The patient was a 72-year-old woman with an expanding intrathoracic hemorrhagic lesion penetrated beyond the thoracic wall and was associated with chronic tuberculous pleurisy. Enhanced computed tomography revealed an extravasation of contrast medium into the lesion. The intrathoracic lesion and its penetrating lesion of the thoracic wall were resected. Microscopic examination revealed a hematoma with papillary structures lined with vascular endothelial cells, simulating organizing thrombus. An expanding intrathoracic hemorrhagic lesion is an extreme type of chronic tuberculous pleurisy, and can cause intrathoracic compression as the lesion increases in size.

Aged↗

PubMed1995

Protein 1 (Clara cell protein) serum levels in healthy subjects and patients with bacterial pneumonia.

Serum levels of protein 1 (P1), a Clara cell secretory protein, were studied in 942 healthy subjects in relation to sex, age, and smoking habits and in 117 patients with bacterial pneumonia in relation to prognosis. P1 values in bacterial pneumonia patients at disease onset were compared with those in 234 healthy control subjects matched by sex and age. P1 values in healthy males were highest in those 30 to 39 yr of age and highest in healthy females > or = 70 yr of age but lowest in those 30 to 49 yr of age. P1 values in healthy males were significantly higher than those in females in the 30- to 39-yr age group (p < 0.05). Male smokers showed higher P1 values than nonsmokers, but without a significant difference. P1 values in patients with pneumonia were significantly lower than in control subjects (p < 0.0001). P1 values were significantly lower in patients treated with a respirator than in in patients treated without a respirator (p < 0.05). In 59 patients, whose P1 values could be followed up until the outcome of pneumonia, all 37 recovered patients showed significantly increased P1 values after recovery (p < 0.001), and all 22 who died of their illness showed significantly decreased P1 values just before death (p < 0.01). We thus conclude that P1 serum levels were significantly affected by sex and by the degree of seriousness in bacterial pneumonia.

Adolescent↗

PubMed1995

Protein 1 (Clara cell protein) serum levels in lung cancer patients receiving chemotherapy.

As many antineoplastic drugs can cause injury to alveolar pneumocytes, Clara cells (nonciliated, nonmucous epithelial cells of the bronchioles) may also be damaged by such drugs. Protein 1 (P1) is an alpha-microprotein secreted by Clara cells. The effect of antineoplastic drugs on Clara cells is examined by the measurement of serum levels of P1 in patients with lung cancer receiving chemotherapy. Serum levels of P1 were studied in 36 patients with lung cancer, before chemotherapy and 5-7, 10-12 and 14-18 days after chemotherapy. One hundred and eight healthy subjects, matched by sex and age, acted as controls. There was no significant difference in P1 serum levels between patients with lung cancer and healthy controls. P1 serum levels decreased significantly 5-7 and 10-12 days after chemotherapy, recovering thereafter. We conclude that P1 serum levels do not differ between lung cancer patients and healthy controls, and that antineoplastic drugs inhibit the synthesis or secretion of P1 by Clara cells in the early period after the administration of medication.

Aged↗