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T Yasumitsu

Publications and source records attributed to T Yasumitsu.

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

[Prediction and the results of postoperative performance status in patients with giant bulla--prospective study of 47 patients].

The discriminant function (Z) for predicting postoperative performance status in patients with giant bulla was addressed in our previous paper. In the present study, patients with dyspnea were classified into Group 1 or Group 2 based on preoperative function, Group 1 showing continuous improvement in dyspnea and Group 2 unchanged or worsened condition after bullectomy. Of the 47 patients in this study, 28 had dyspnea of grade 2 or more, 19 revealing no symptoms prebullectomy. The group predictions for the 28 patients were compared with the postoperative status in dyspnea for over four years following surgery. The predicted grouping in 26 of the 28 (93%) agreed with the postoperative status but in two it did not: one was familial bullous emphysema the other had repeated episodes of pneumonia, both of which were predicted for Group 1. All 19 patients without preoperative dyspnea were studied their symptoms and lung functions before and after bullectomy. After surgery, none showed dyspnea and significant changes of functions. As to preoperative pulmonary function, patients with FEV1.0% of more than 60% and delta N2 of less than 2% were improved, the prediction agreeing with the actual results. Fourteen patients with FEV1.0% of less than 55% showed high delta N2. When delta N2 exceeded 3.5%, deterioration of dyspnea was observed following surgery. Bullectomy is indicated in patients with low pulmonary function, by preoperative FEV1.0% and delta N2.

Adult↗
PubMed1994

Mediastinal ultrasonography for the assessment of mediastinal lymph node metastases in lung cancer patients.

Using an ultrasonic probe inserted into the mediastinum during cervical mediastinoscopy, mediastinal ultrasonography (USM) was performed on 63 patients with lung cancer. The patients with a small peripheral mass of less than 2 cm in diameter, according to the chest X-ray results, and with mediastinal lymph nodes smaller than 1 cm in their short axes as determined by computed tomography (CT), were excluded from this study. An analysis of the areas under the receiver operating characteristic curves derived from CT and USM showed that USM was superior (P = 0.043) to CT in terms of the diagnosis for mediastinal lymph node metastases, when the short axis dimension of mediastinal lymph nodes was employed for the diagnosis of metastases. The reason for this is that 97% of the mediastinal lymph nodes imaged by USM were located vertically along the body axis of the patient, and hence USM imaged the true short axis of the node in many cases. Our results indicate that USM is useful for performing a safe biopsy of lymph nodes during mediastinoscopy as well as for obtaining a clear imaging of the subcarinal nodes, which are inaccessible by normal cervical mediastinoscopy.

Adult↗
PubMed1994

Case-control study for lung cancer and cigarette smoking in Osaka, Japan: comparison with the results from Western Europe.

In order to clarify the relation between cigarette smoking and lung cancer, a case-control study was conducted. The case series consisted of 1,376 lung cancer patients (1,082 males and 294 females) who were newly diagnosed and admitted to eight hospitals in Osaka during 1986-88. Smoking histories were compared with those of 2,230 controls (1,141 males and 1,089 females) admitted to the same hospitals during the same period without established smoking-related diseases. Odds ratios of current smoker versus nonsmoker were 18.1, 1.9, 21.4, and 3.8 for squamous, adeno, small, and large cell carcinoma, respectively, for males, and 9.7, 1.3, 12.1, 3.7, respectively, for females. Compared to the results from previous studies in Japan, the magnitude of the odds ratios for squamous and small cell carcinoma is approaching the level of Western Europe in the late 1970s. Population attributable risk of exsmokers has also been increasing to the level of Western Europe. Among male current smokers, smoking intensity, such as number of cigarettes per day or fraction smoked per cigarette, seemed to have a slightly greater influence on squamous cell carcinoma than adenocarcinoma, while factors associated with the spread of cigarette smoke, such as inhalation, seemed to have greater influence on adenocarcinoma. The difference in the distribution of these smoking characteristics between Japan and Western Europe could not fully explain the difference in lung cancer incidence and distribution of histologic types between the two areas.

Adenocarcinoma↗
PubMed1994

[Lung resection for lung carcinoma with idiopathic interstitial pneumonia].

Of 12 patients who underwent lung resections for lung cancer with idiopathic interstitial pneumonia (IIP), eight patients survived and four patients died due to acute exacerbation of IIP after the operation. The preoperative values for percent forced vital capacity, predicted postoperative percent vital capacity, percent one-second forced expiratory volume index and serum level of C-reactive protein were significantly different between the group of patients who survived and that of having died. Three days after the operation, the percentage of lymphocytes among leukocytes and serum level of lactate dehydrogenase in the two groups were both significantly different. These findings showed that the operative strategy for patients with lung cancer and IIP needs specifically careful consideration for operative procedure, and preoperative serum levels of C-reactive protein and postoperative lactate dehydrogenase and the percentage of lymphocytes in leukocytes would be useful in evaluation of the severity of IIP.

Adenocarcinoma↗
PubMed1994

Preoperative histologic diagnosis of chest wall invasion by lung cancer using ultrasonically guided biopsy.

Before operation, we evaluated the usefulness of ultrasonically guided needle biopsy to detect histologically invasion of the chest wall by tumor in patients with lung cancer. Ultrasonically guided needle biopsy, computed tomography, and ultrasonography were done in 29 patients with lung cancer. In all of them, chest wall invasion was histologically confirmed by thoracotomy. As for the diagnosis of chest wall invasion, sensitivity, specificity, and accuracy of ultrasonically guided needle biopsy diagnosis were 61.5%, 100%, and 82.8%, respectively; for diagnosis by computed tomographic scan these figures were 69.2%, 75.0%, and 72.4%, respectively; and for diagnosis by ultrasonography they were 76.9%, 68.8%, and 72.4%, respectively. We had no false-positive cases in the ultrasonically guided needle biopsy assessment and no fatal complications or implantation metastases. Our results indicate that ultrasonically guided needle biopsy is safe and useful for preoperative histologic diagnosis of chest wall invasion in cases in which combined chest wall resection is being considered in patients with lung cancer.

Aged↗
PubMed1993

Lung cancer incidence rate for male ex-smokers according to age at cessation of smoking.

Lung cancer incidence rate after the cessation of smoking was assessed for male ex-smokers according to the age at cessation, using the results from a case-control study for ex-smoker versus continuing smoker, and the lung cancer incidence rate function for continuing smoker estimated from Japan Vital Statistics and the "Six-prefectural Cohort Study" in Japan. This hospital-based case-control study consisted of 776 lung cancer cases (553 current smokers and 223 ex-smokers) and 772 controls (490 current smokers and 282 ex-smokers) who started smoking at ages 18-22. The odds ratio of developing lung cancer for ex-smokers compared to continuing smokers according to years since the cessation of smoking was estimated for four age groups (55-64, 60-69, 65-74 and 70-79). Given that the number of years since cessation of smoking is the same, reduction of the odds ratio appeared to be greater for the younger age group than for the older age group, reflecting the shorter period of exposure for the younger age group. Lung cancer incidence rate (per 100,000) was assumed to be expressed by the following function; 1.7 x 10(-5) x (age -24.3) for continuing smokers and 0.15 x 10(-5) x (age) for nonsmokers. Lung cancer incidence rate among ex-smokers according to years since cessation was then estimated to be the above function multiplied by the odds ratio from the case-control study for each age group. In contrast to the greater reduction of the odds ratio among younger ex-smokers, reduction of the incidence rate, in terms of rate difference, was considerably greater for older ex-smokers due to a high incidence rate of lung cancer for older continuing smokers. This indicates that the absolute magnitude of reduction of the lung cancer incidence rate after cessation of smoking is greater for older ex-smokers, although the relative magnitude of reduction is greater for younger ex-smokers.

Age Factors↗
PubMed1992

Prediction of postoperative performance status in patients with giant bulla.

To predict the postoperative improvement in performance status after bullectomy, preoperative pulmonary function and dyspneic grade were evaluated in 20 patients with giant bulla. The patients were divided into two groups, based on postoperative performance status: group 1 consisted of 15 patients with improved status after surgery; and group 2 of five patients with worsened status after temporary improvement. To determine correlation with the groups, preoperative functional measurements such as %VC, FEV1%, MMF, PEFR, RV/TLC, delta N2, LCI, and PNCD were then analyzed by the multivariate statistic method; results of delta N2 and FEV1% showed significant correlation with the groups. Prediction of the groups based on the two measurements agreed with the actual results except in one patient. These results show that postoperative improvement in performance status of patients with giant bulla can be predicted on the basis of preoperative pulmonary function.

Adult↗
PubMed1992

[Thymic carcinoid tumor--report of 3 operative cases].

Three cases of thymic carcinoid were surgically treated in our hospital. All 3 cases belonged to stage IVb (Masaoka's classification) because of anterior lymph nodes metastasis. A 44-year-old male patient died of multiple metastasis of bone and liver in 94 months after the operation. A 45-year-old female patient who had undergone operation 4 years ago, was re-operated on for recurrent carcinoid tumor but complete resection of the tumor could not be performed because of the tumorous invasion to superior vena cava, pericardium and costal bone. After the operation she has been treated by radiotherapy and any re-growth of the tumor has never been detected for 1 year. Another 50-year-old male patient who had been operated and treated by chemo-radiotherapy for thymic carcinoid before 50 months was diagnosed as recurrent tumor at left interpectoral lymph node. Radiotherapy is now preparing for this patient. 160 cases of thymic carcinoid reports in Japan were reviewed. 37 cases were stage IVb and 36 cases had supraclavicular or mediastinal lymph nodes metastasis. Those cases which had been underwent complete resection followed by radiotherapy seemed to have better prognosis. We conclude that patients of thymic carcinoid should be treated with complete resection including supraclavicular and mediastinal lymph nodes dissection, followed by radiotherapy.

Adult↗
PubMed1992

[Intra-bullous ventilation of giant bulla: does slow ventilation space on multi-breath nitrogen washout test mean that giant bulla is present?].

Intra-bullous ventilation and uneven ventilation in patients with giant bulla were studied by the multi-breath nitrogen washout and 133Xe washout tests. Fourteen patients underwent the nitrogen washout test before and after bullectomy; 2 of them also underwent the 133Xe washout test before surgery. After bullectomy, pulmonary nitrogen clearance delay and alveolar dilution rate (ADR) of slow ventilation space improved significantly (p less than 0.01) from 202.5% to 51.5%, and from 0.98 to 0.95, respectively. The dilution rate of 133Xe in the bullous region, based on the 133Xe clearance curve, showed the same values as the nitrogen washout test. Therefore, we considered that bullous ventilation could be estimated by the ADR of the nitrogen washout test and that uneven ventilation resulted from the ADR difference between the giant bulla and the nonbullous lung. When the nonbullous lung region was emphysematous, however, it was impossible to estimate the intra-bullous ventilation from the nitrogen washout test.

Adolescent↗
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

Lung cancer risk among exsmokers.

Lung cancer risk among exsmokers according to years since cessation of smoking was assessed by means of a case-control study. The case series consisted of 1,052 lung cancer patients who were newly diagnosed and admitted to eight hospitals in Osaka in 1986-88. Smoking histories were compared with those of 1,111 controls admitted to the same hospitals during the same period without any diagnosis of smoking-related disease. The odds ratio of lung cancer for exsmokers compared to current smokers was estimated to be 0.90, 0.50, 0.51, 0.59, 0.48 and 0.29, for 1-4, 5-9, 10-14, 15-19, 20-24 and greater than or equal to 25 years after cessation of smoking, respectively. Risk reduction appeared to be greater for those who smoked less than the 1200 cigarette index, compared to those who smoked more. In classification according to histologic type, small cell and large cell carcinoma showed a rapid decrease compared to adenocarcinoma, while squamous cell carcinoma showed an intermediate pattern. Quantitative estimates for reduction of lung cancer risk among exsmokers can be used for projecting lung cancer incidence in the future, by assuming future trends of smoking prevalence, as well as for health education among individual smokers.

Aged↗
PubMed1991

[A case of benign pulmonary metastasis from ovarian immature teratoma].

A thirty one-year-old female underwent resection for pulmonary metastatic tumor from immature ovarian teratoma (G-II). Resected specimens from the lung revealed no malignant findings in the cystic teratoma (G-0). We speculated this finding might be due to retroconversion of ovarian immature teratoma. Retroconversion of ovarian immature teratoma is rarely reported and no report was found which dealt with pulmonary metastatic lesion histologically.

Adult↗
PubMed1990

Bestatin in resected lung cancer. A randomized clinical trial.

A randomized study with and without bestatin, a new biological response modifier, was conducted in order to evaluate its survival effect on resected lung cancer. A total of 153 patients (72 with squamous cell carcinoma, 66 with adenocarcinoma, and 15 with other types of cancer) were evaluated. Among the patients with squamous cell carcinoma, the bestatin-treated group had significantly prolonged survival compared to the control group. No significant difference between the two groups was seen in adenocarcinoma.

Adenocarcinoma↗
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↗
PubMed1990

[Three cases of occult thyroid cancer with mediastinal lymph node metastasis manifesting as a mediastinal cyst].

We experienced three cases (one 38-year-old male, 58-year-old and 67-year-old females) whose resected mediastinal cysts proved to be metastatic lymph nodes from occult thyroid cancer. Primary lesions in thyroid gland were detected by echography in all three cases though they were detected in one case out of two by CT, in one out of three by 201T1 scintigraphy, in two out of three by 123I scintigraphy. After these examinations on thyroid gland, operations (one lobectomy, one hemithyroidectomy, one total thyroidectomy) were performed. Primary lesions in thyroid gland were all papillary carcinomas, and ranged 4 x 3 mm to 12 x 10 mm in size. Multiple foci were found in two cases, many intrathyroidal metastases in one case, cervical lymph node metastases in two cases. In cases of mediastinal cyst, thyroid gland should be examined by echography paying attention to the mediastinal lymph node metastasis from occult thyroid cancer. When occult thyroid cancer with mediastinal lymph node metastasis is diagnosed, total thyroidectomy followed by 131I radiation therapy is recommended as the treatment for a primary lesion, because of multiple foci in thyroid gland and intrathyroidal metastases.

Adult↗
PubMed1989

[The discussion of the need of mediastinal lymph node dissection in the surgical treatment of lung cancer].

The need of lymph node dissection in the case of operative lung cancer with negative mediastinoscopy was discussed. As a preliminary study, the N-number obtained from the mediastinoscopy and that of postoperative examination was compared. The rate of agreement of N-number was as high as 96%. Secondary, 183 cases of lung cancer with squamous-or adenocarcinoma pathologically T-1 or 2. N-0 and P-0 or 1 were picked up and examined. In those cases, the result of 3 years survival rate was 80% in the cases of absolute curative operation and 60% in that of relative non-curative cases, and 5 years survival rate was 70% and 52% respectively, and the cases of absolute curative operation was statistically excellent than that of another group. However, the background of the two groups was different to some degree on account of the advancement of the cancer and the age of the patients. Therefore, the randomized study as for the lymph node dissection in the cases of negative mediastinoscopy was finally performed. In the 30 cases of squamous cell carcinoma where dissection was carried out in 13 cases and not done in 17 cases, the result of 3 years survival was 84% (dissecting group) and 89% (non-dissecting group), and 5 years survival was 73% and 63% respectively. In 23 cases of adenocarcinoma (13; dissecting, 10; non-dissecting), the result of 3 years survival was 100%, 63% and that of 5 years survival rate was 100%, 63% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗