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Biomedical subjects

Y Monden

Publications and source records attributed to Y Monden.

At least 181 records · Page 10Linked to original sources
PubMed1988

Thymoma: results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients.

A series of 141 patients with thymoma was studied with regard to the way in which complete resection followed by postoperative radiation therapy influenced prognosis according to the stage and histologic type of thymoma. Postoperative radiation therapy (30 Gy in 3 weeks to 50 Gy in 6 weeks) was performed in 73.1% of the patients. Thirty-five of 48 patients with thymoma invading the surrounding tissues (stage III) underwent complete resection, with survival rates of 100% at 5 years and 94.7% at 10 and 15 years. The prognosis in these patients was comparable with those in 45 patients with no invasion (stage I) and in 33 patients with capsular invasion (stage III), all of whom underwent complete resection. Complete resection was done in 18 of 26 patients with epithelial cell thymoma, and there were no deaths by tumor until 15 years after the operation. There were no statistically significant differences in the survival rates of patients undergoing complete resection according to cell type (33 of 36 patients with lymphocyte predominant type and 61 of 77 patients with mixed cell type). The survival rate in six patients with epithelial cell type who underwent subtotal resection was not significantly different from that of 12 patients who underwent biopsy alone. Our findings indicate that complete resection of thymoma followed by postoperative radiation therapy results in a "benign" postoperative course, regardless of the stage and histologic type. Therefore, an aggressive surgical approach, such as resection of the superior vena caval system followed by reconstruction with a ringed polytetrafluoroethylene graft and/or complete pleuropneumonectomy, is justified for advanced thymoma, although the long-term results of such extended operations are still unclear.

Adolescent↗
PubMed1988

[Breast cancer detected by mass screening using physical examination alone].

In Tokushima prefecture, mass screening for breast cancer has been conducted using physical examination alone since 1970. Breast cancer was detected in 108 of 141,116 screened women up until 1986. The detection rate was 0.08% among total examinees, 0.12% among initial examinees, and 0.04% among subsequent examinees. Patients with breast cancer were divided into three groups. Group I consisted of 70 patients whose cancers were detected by initial screening examination. Group II consisted of 38 patients whose cancers were discovered by subsequent periodic screenings. Group III included "interval" patients, whose cancers were found in the interval within 2 years between a negative screening examination and the next screening; 19 patients were classified into this group. Serving as controls were 615 breast cancer patients who visited our outpatient clinic, independently of the screening program, during the same period as that of the mass screening. Of the 108 patients in Groups I and II, 51 patients (47%) had noticed a lump in the breast themselves by the time of the mass screening. The stage classification and nodal involvement showed significant differences between the mass screening group and the control group, but no significant differences among the three groups. The Group III cases (interval cases) were detected at an early stage, but some of these cases included patients with fast-growing tumors. When compared with cumulative survival curves according to age-matched case-control study, there was no significant difference between the patients whose tumors were detected in the mass screening and the controls.

Ambulatory Care↗
PubMed1988

[A case of advanced breast cancer successfully treated with combined tamoxifen and epitiostanol].

A patient with stage IV advanced breast cancer with multiple metastasis (bones of the whole body, lungs) were treated by ovariectomy, administration of an non-steroidal antiestrogen (tamoxifen) and mild chemotherapeutic drugs, with favorable results. After four years, however, the patient had a relapse of the cancer. A steroidal antiestrogen (epitiostanol) was then administered with satisfactory results. When a breast cancer relapse occurs in patients once treated successfully with endocrinotherapy, a different form of endocrinotherapy should be tried. There is a possibility that the mechanism of action of Epitiostanol, which is regarded as a steroidal antiestrogen, is different from that of tamoxifen in which an estrogen receptor (ER) system is included.

Androstanols↗
PubMed1987

Importance of biologic status to the postoperative prognosis of patients with stage III nonsmall cell lung cancer.

The prognosis of patients with stage III nonsmall cell lung cancer was studied, with special attention to their biologic status prior to lung resection. The biologic status was estimated from the neutrophil/lymphocyte ratio in the peripheral blood, serum albumin level, and erythrocyte sedimentation rate. Among 46 patients who underwent potentially curative operations, 31 cases of biologic status A or B (more than two parameters normal) revealed 37.6% of a 5-year survival rate, whereas there was no 5-year survivor in 15 cases of biologic status C or D (more than two parameters abnormal). Of the 5-year survival rate in T3N0 disease of biologic status A or B, the 60% surviving (of 10 cases) was in marked contrast to the same stage disease of biologic status C or D where only 1 patient (of 10 cases) was still surviving at more than 30 months. In 30 patients with T3N0, T3N1, and T2N2 diseases of biologic status A or B, where long-term survivors were derived, the 5-year survival rate in 30 patients of biologic status A or B was 36.6% in contrast to no long-term survivor in the same stage diseases of biologic status C or D (n = 25). We conclude that surgical results in stage III nonsmall cell lung cancer will be beneficial in patients of biologic status A or B, but nonbeneficial in patients with the same stage of biologic status C or D.

Adult↗
PubMed1987

Breast cancer detected by mass screening using physical examination alone.

In Tokushima prefecture, mass screening for breast cancer has been conducted using physical examination alone since 1970. Breast cancer was detected in 116 of 111,571 screened women up until 1984. The detection rate was 0.08 per cent in total examinees, 0.13 per cent in initial examinees, and 0.04 per cent in subsequent examinees. The patients with breast cancer were divided into three groups, i.e., 62 cases detected at initial screening, 28 cases detected at subsequent screenings, and 26 interval cancer cases. 510 patients with breast cancer in the outpatient clinic were serving as controls. The stage classification and nodal involvement were significantly different between the mass screening group and the control group, but not significantly different among the three groups. The interval cases were detected at an early stage. The survival rates were not significantly different between the three groups and the control group. Efforts should be doubled to educate women about the proper method of breast self-examination in order to promote the early detection of breast cancer.

Adult↗
PubMed1987

Exercise tolerance test in lung cancer patients: the relationship between exercise capacity and postthoracotomy hospital mortality.

To evaluate the significance of the blood lactate threshold as a predictor of postthoracotomy hospital mortality resulting from pulmonary complications, a 3-minute incremental exercise test was administered to 33 lung cancer patients who underwent thoracotomy between October, 1981, and May, 1984. The oxygen consumption/body surface area at an arterial lactate level of 20 mg/dl (VO2/BSA at La-20) was adopted as the blood lactate threshold. Age and pulmonary function parameters such as forced expiratory volume in one second (FEV1)/body surface area (BSA), FEV1/forced vital capacity, diffusing capacity for the carbon monoxide/lung volume, and maximum ventilatory volume/BSA revealed significant differences between patients with postthoracotomy pulmonary complications and those without such complications. However, there was no difference in pulmonary function test results between the surviving and deceased patients. In contrast, although VO2/BSA at La-20 did not differ between the patients with and without pulmonary complications, it differed significantly between the surviving and deceased patients. We concluded that postthoracotomy pulmonary complications depended on the severity of preoperatively associated pulmonary function disorders and that the blood lactate threshold expressed by VO2/BSA at La-20 was an important indicator of the risk of hospital mortality.

Aged↗
PubMed1987

An evaluation of operative outcome in patients with funnel chest diagnosed by means of the computed tomogram.

A questionnaire survey of 66 patients with funnel chest who underwent corrective surgical procedures by the sternal elevation method, with or without the application of metal strut, demonstrated that the operative result was good in 60.6% and fair in 39.4%. None of the patients rated the result as unsatisfactory. A computed tomogram of the chest wall was performed to study the depression (b/c), asymmetry (b'/b), and flatness (a/b) of the chest wall, where a was the maximum transverse distance of the chest wall, b and b' were the maximum distance from the anterior to the posterior chest wall at the left and right sides (b greater than b'), and c was the perpendicular distance from the point of the anterior chest wall at its greatest deformity to the level of the anterior tip of the spine. In patients with a good result, b/c and b'/b were well corrected, while in patients with a fair postoperative result, they were still significantly different from those in subjects with normal chest walls. Moreover, 85.7% of the patients (6/7) with b/c over 3.0 before operation had a fair postoperative result. The degree of a/b was not corrected in patients with either good or fair postoperative results. We conclude that an operative approach to lengthen ribs would be necessary to improve the degree of a/b, that in patients with severely depressed funnel chest, expressed as a b/c value over 3.0 by computed tomography, a transient support with struts should be applied, and finally, that a more careful approach for correction of asymmetry should be undertaken to improve the operative results.

Adolescent↗
PubMed1987

[A clinical study of lobular carcinoma of the breast].

In a review of 549 cases of breast cancer in the last 16 years, 7 cases with lobular carcinoma have been studied. All of the patients appeared well and were without recurrence. Two cases had been lobular carcinomas in situ, one of which had arisen in a small fibroadenoma associated with malignant phyllodes tumor in the opposite breast, and the other had shown multicentric foci of a lobular neoplasm. The remaining 5 cases had been invasive lobular carcinomas. The incidence of lobular carcinoma represented 1.3% (7/549) of all primary breast carcinomas, and had been increasing chronologically. Estrogen and progesterone receptors were positive in 5 eligible cases.

Adult↗
PubMed1987

[Carcinoma of the esophagogastric junction with extension to the cervical esophagus].

A 51-year-old woman with adenocarcinoma of the esophagogastric junction (E-G J), which spread from the E-G J to the cervical esophagus, is reported. Only two cases of carcinoma in the E-G J with the extension of the tumor to the upper or middle portion of the intrathoracic esophagus have been reported in the Japanese literature in the past two decades and there have been no previous reports of E-G J carcinoma with extension to the cervical esophagus. At first, the invasion to the esophagus in our case was thought to be continuous. Histological examination, however, revealed that the tumor in the esophagus was discontinuous in some portions and that the lymph vessels were remarkably invaded. These findings suggested that the extension of the tumor to the esophagus was lymphogenous metastasis.

Adenocarcinoma↗
PubMed1987

[Prognostic value of hormone receptor in breast cancer].

The relationship of hormone receptor and postoperative prognosis was investigated in 166 patients with breast cancer who underwent curative operation and postoperative adjuvant chemotherapy. The endocrine therapy was performed only for the patients with recurrent disease. The content of estrogen receptor (ER) and progesterone receptor (PgR) were measured by binding assay using gel-filtration method. ER-positive cases accounted for 56% of 166 patients and PgR-positive ones for 36% of 124. The relapse free interval was not different between the ER-positive group and ER-negative one, but the survival curve after relapse was significantly different between the both groups. There was no significant difference in the relapse free interval and the survival curve after relapse between PgR-positive group and PgR-negative one. These results suggest that the ER is a good predictor as to the response to endocrine therapy given for recurrent disease, but not as to early recurrence.

Breast Neoplasms↗