Biomedical subjects
Publications and source records attributed to Y Hayata.
A 68-year-old man who had had cough and sputum for ten months was referred to our hospital because sputum cytologic findings were suggestive of lung cancer. Fiberoptic bronchoscopy and biopsy revealed mucosal neuroma of the bronchi. There were no signs suggesting pheochromocytoma or medullary thyroid carcinoma. To our knowledge, this is the first case of solitary mucosal neuroma of the bronchi to be reported.
The clinical efficacy of photodynamic therapy (PDT) was evaluated in cases of early-stage lung cancer. Haematoporphyrin derivative was used as a photosensitizer and an argon dye laser and excimer dye laser were used as the light sources. A total of 199 lesions in 165 patients with lung cancer were treated by PDT. Forty-five lesions in 40 patients, which had been detected only by sputum cytology, were endoscopically suggestive of early-stage lung cancer. All patients showed normal chest X-ray findings. Thirty lesions in 26 patients were treated by PDT only, with or without other conservative treatment because of poor pulmonary function or for other reasons. All lesions initially showed complete remission. Recurrences were seen in three cases. Nine patients died of unrelated causes and one patient died after a recurrence. The other 16 patients are alive and apparently free of the disease. Fifteen lesions were treated surgically after PDT because the effectiveness of PDT was uncertain. Among these, five lesions showed complete remission histologically. Three of the PDT-only patients have now survived for more than five years. The longest surviving patient has gone eight years without apparent recurrence.
We performed several basic studies concerning lung cancer and their results were applied clinically. One was the establishment of cultured lung cancer cell strains and they were employed for sensitivity tests of anticancer agents and to study histogenesis of oat cell carcinoma and monoclonal antibody. Another study was the experimental induction of lung cancer in dogs. We succeeded in inducing canine central type lung cancer. Using epithelial cells from the various stages recognized in the carcinogenetic process. We measured DNA distribution and nuclear protein amounts, and we indicated the relationship between the carcinogenetic process and DNA pattern. Among 2,633 lung cancer cases 1,072 were resected. The 5-year survival of the latest 384 resected cases was 80.3% in stage I. The reasons for this relatively high survival rate is probably because of increased numbers of early stage central type lung cancer due to increasing sputum cytology surveys. Adjuvant therapy was performed using nocardia rubra cell wall skeleton and/or chemotherapy with CDDP. However, significantly better results were not obtained. The surgical results were discussed in 425 cases aged 70 years and over. The therapeutic results and indications of photodynamic therapy in early stage central type lung cancer were presented.
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The usual surgical treatment for fungus ball type pulmonary aspergillosis is lobectomy, but in cases of aspergillosis located in a post-lobectomy space a second lobectomy is difficult because of the accompanying inflammatory process. A 53-year-old male underwent left upper lobectomy for pulmonary tuberculosis eight years ago. Six year postoperatively, he developed fungus ball type aspergillosis in the post-lobectomy space with bronchopleural fistula and recurrent hemoptysis. We performed an omental pedicle flap plombage via the post-sternal route to resect the pleural cavity fungus ball. The post operative course was uneventful and clinically the bronchopleural fistula was closed.
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A murine monoclonal antibody designated 1G12 has been produced by immunizing mice with A549 human lung adenocarcinoma. Using radiolabeled monoclonal antibody 1G12, a sensitive radioimmunoassay to detect 1G12 antigen has been developed. The antigen was detected on the surface of peripheral blood mononuclear cells (PBMC). A study was performed to examine the frequency of distribution of this antigen on the surface of PBMC from healthy donors and patients with cancer. An antigen level of above 30 units per 1 x 10(6) PBMC was considered positive. None of 41 healthy donors (0%) and 16 of 96 patients (16.7%) with benign diseases of the lung, ovary, and uterus were positive. In contrast, 27 of 41 patients (65.8%) with lung cancer, 14 of 18 patients (77.8%) with ovarian cancer, and 16 of 27 patients (59.2%) with uterine cervical cancer had elevated levels of 1G12 antigen. When patients were grouped by stages of cancer, PBMC from patients in relatively early stages (stages I and II) also gave positive results, i.e., 9 of 17 patients (59.2%) with lung cancer, 6 of 10 patients (60%) with ovarian cancer, and 11 of 22 patients (50%) with uterine cervical cancer of these stages were positive. These results suggest that the detection of 1G12 antigen on PBMC of patients may be useful for early diagnosis of cancers.
We reported a dumbbell type tumor of the posterior mediastinum. The patient was an asymptomatic 40-year-old male. An abnormal shadow in the right lower lung field was pointed out in a mass survey. We recognized a dumbbell type tumor in the posterior mediastinum by chest CT and MRI. The tumor invaded the intervertebral canal through the spinal foramen. It was most clearly seen by MRI myelography. Operation was performed with the patient in a prone position and with an L-shaped skin incision of the back and 11th intracostal thoracotomy and Th11 laminectomy. The dumbbell type tumor was completely removed by this operation. The pathological diagnosis was Schwannoma. The post operative course was good. The one-stage operation is useful for dumbbell type tumors of the posterior mediastinum.
Endoscopic Nd-YAG laser treatment and adjuvant therapy were performed in 44 cases with metastatic lesions of airway. The best results were obtained in 31 cases (93.9%) out of 33 cases complaining of ventilatory disturbance in which endoscopic Nd-YAG laser treatment was indicated as an emergency procedure. In most of these cases with metastatic lesions of airway consisted of respiratory tract invasion from mediastinal lymph nodes in cases of esophageal cancer or lung cancer. In these cases, after laser treatment for ventilatory disturbance, the patients condition improved to the extent that adjuvant therapy could be performed. Adjuvant therapy was performed in 38 cases, there were 7 cases treated surgically (resection of the metastatic lesions of airway in 3 cases, tracheal tube stent operation in 4 cases 0, 28 radiotherapy in 28 cases (Linac irradiation in 24 cases, 60Co intraluminal irradiation of the trachea in 4 cases 0, and 32 cases were treated with chemotherapy. Tracheal tube stent operation was useful for maintenance of the tracheal lumen following laser treatment, and 60Co intraluminal irradiation was effective for the residual intratracheal tumor. The 1-year survival rate of 44 cases with metastatic lesions of airway was 42% and the 2-year survival rate was 22%, so this result suggested endoscopic Nd-YAG laser treatment and adjuvant therapy for metastatic lesions of airway was useful to prolong survival time. However the main value of this modality is for the rapid relief of severe ventilatory disturbance due to obstructive airway lesions.
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Nuclear DNA content in individual, morphologically identified tumor cells from 33 squamous lung carcinomas, 20 small cell lung carcinomas, and 10 bronchiolo-alveolar carcinomas were analyzed by means of cytophotometry on Feulgen-stained histologic and cytologic specimens. Twenty-eight of the squamous cell carcinomas and 17 of the small cell carcinomas had high and scattered DNA values, indicative of high malignancy potentials. None of the bronchiolo-alveolar carcinomas showed such high DNA values. These results are in line with clinical experience that squamous cell and small cell carcinoma are associated with rapid progression and death in patients, whereas bronchiolo-alveolar carcinomas have a more indolent course.
A monoclonal antibody, NCC-LU-165 (IgM, k), was obtained by somatic cell hybridization between mouse myeloma cells (P3-X63-Ag8-U1) and spleen cells of an immunocompetent mouse (BALB/c, nu/+) immunized with sera of immunodeficient athymic mice (BALB/c, nu/nu) bearing human giant cell lung cancer xenografts (Lu65). Immunohistochemically, the antibody was reactive with most nonsmall cell carcinoma of the lung. It also reacted with adenocarcinoma of the stomach, colon, pancreas and breast. Antigens were detected in sera of athymic mice bearing human lung cancer xenografts and in cell-free conditioned media of Lu65 cells by a sandwich enzyme immunoassay. This immunization method may be useful to raise monoclonal antibodies that detect circulating tumor-associated antigen.