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  • 1
    ISSN: 1436-2813
    Keywords: pulmonary blastoma ; p53 ; single-strand conformation polymorphism ; cytology ; preoperative diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 30-year-old woman was admitted to our hospital for investigation of an abnormal shadow in the right pulmonary hilus on a chest X-ray film. A percutaneous needle biopsy was performed, which revealed pulmonary blastoma. A right upper lobectomy was performed and the pathological stage was confirmed to be IIIa (T3N0M0). An analysis of preoperative cytological specimens showed that epithelial tumor cells with thin cytoplasm were either tubular or papillary, while some mesenchymal tumor cells with elliptic and spindle-shaped nuclei were also found in the necrotic background. Thus, pulmonary blastoma should be considered when a two-cell pattern consisting of both epithelial and mesenchymal components is observed. DNA analysis was performed on previously identified areas of the epithelial or sarcomatous components, using a microdissection method. An analysis of the p53 gene by the single-strand conformation polymorphysm method showed an abnormal band with shifted mobility of exon 8 in only the sarcomatous component.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: Nd:YAG laser surgery ; bronchofiberscopy ; tracheal stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 47 patients with malignant and benign lesions in the trachea and carina were used to demonstrate the effectiveness of endoscopic Nd:YAG laser surgery. The histology consisted of 37 malignant and 10 benign lesions, and 23 of the patients had severe symptoms with laser surgery being performed as a lifesaving emergency. Endoscopic Nd:YAG laser treatment was able to dilate the tracheal calibers from, 2.6±0.9 mm to 6.1±1.4 mm in the emergency cases with a remarkable effect and brought relief from wheezing and dyspnea, with an objective improvement of more than 25 per cent in peak expiratory flow rate being demonstrated. Furthermore, the tracheal diameters were able to be dilated from about 7 mm to 10 mm in the non-emergency cases. A remarkable effect was achieved in patients with intraluminal or mixed types of tumors among both the emergency and non-emergency cases. The survival rates of the emergency patients in whom a remarkable effect was achieved were definitely better than those in whom only fair or poor effects were achieved and, in the non-emergency cases, similar results were demonstrated. In conclusion, the application of endoscopic Nd:YAG laser surgery to tracheal stenotic diseases has an instantaneous and definite effect on luminal dilatation and shows significance as a lifesaving procedure. Moreover, the resultant improvement in the patients' general condition could make it possible for them to undergo other combined therapy and prolong their life span. Endoscopic Nd:YAG laser surgery is thus considered to be a very effective and established procedure for the treatment of tracheal stenotic lesions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: Key Words: pulmonary blastoma ; p53 ; single-strand conformation polymorphism ; cytology ; preoperative diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1436-2813
    Keywords: transfer factor ; lung cancer ; adenocarcinoma ; adjuvant therapy ; immunotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 102 patients were studied in a randomized controlled trial to evaluate the clinical effect of transfer factor (TF) for primary resected adenocarcinoma of the lung. The TF and Control groups consisted of 50 and 52 randomly chosen patients, respectively. However, 6 and 5 patients were excluded from both groups for various reasons, therefore the total of cases eligible for evaluation were 44 and 47 in the TF and Control groups, respectively. The clinical features of both groups were similar. The survival of the TF group was significantly better than that of Controls in Stage I cases (p〈0.05), however, there was no significant difference in patients in Stages II, III and IV. Significant differences were found between the TF and Control groups in curative resection cases (p〈0.05), however, no significant difference was seen in either the relatively curative resection or noncurative resection groups. TF seems to inhibit postoperative recurrence and appears to be an effective postoperative adjuvant immunotherapeutic for primary resected adenocarcinoma of the lung, especially at the relatively early stages.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: myasthenia gravis ; thymectomy ; prednisolone therapy ; anti-ChE preparation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Administration of anti-cholinesterase before operation and high doses of prednisolone after the operation are commonly prescribed in cases of thymectomy for the treatment of myasthenia gravis. Our policy is to carry out an extended thymectomy combined with pre- and post-operative administration of prednisolone on alternate days. Our method was used in the treatment of 50 patients with generalized myasthenia gravis, from January 1979 to December 1984. The results were examined in conjunction with the necessity for preoperative administration of an anti-cholinesterase preparation and also with factors influencing the follow-up result and postoperative process. This method made it feasible to perform surgery under conditions of stabilization of clinical symptoms and satisfactory postoperative management. A postoperative period of unstable symptoms could thus be avoided. The palliation rate at one year after the operation was 96 per cent, while the remission rate at 5 years after the operation was 70 per cent. The preoperative supplement of anti-cholinesterase and preoperative per cent forced vital capacity were considered to be predictive factors concerning the necessity of artificial respiration.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: germ cell tumor ; mediastinum ; superior vena cava ; surgery ; chemotherapy ; artificial graft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of primary mediastinal germ cell tumor, which was radically treated with reconstruction of the superior vena cava (SVC) after neoadjuvant chemotherapy, is reported herein. This tumor, accompanied with SVC syndrome, was initially unresectably advanced and chemotherapy, using cis-dichlorodiamine-platinum, vindesine and bleomycin, was administered, resulting in a partial response with a 65 per cent tumor regression. The serum human chorionic gonadotropin, which originally had a high value, became reduced in parallel with the tumor regression to within the normal range. Complete tumor resection with reconstruction of the SVC using an expanded polytetrafluoroethylene (EPTFE) graft was successfully performed. The patient has now returned to productive employment and the graft is patent without any clinical symptoms of recurrence, 15 months post-operatively. Neoadjuvant chemotherapy is considered to be vitally important for the treatment of germ cell tumors originating in the anterior mediastinum and an EPTFE graft with external ring support seems to be acceptable as an artificial substitute for SVC replacement.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1436-2813
    Keywords: lung allo-transplantation ; immunosuppression ; lung rejection ; cytotoxic activity to donor skin fibroblasts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The immunosuppressive effect of FK506 (FK) in comparison to cyclosporine A (CsA) on lung graft rejection was demonstrated using 24 mongrel dogs with left lung allotransplanatation. The cytotoxic activity of peripheral blood mononuclear cells was evaluated using donor skin fibroblasts. In eight dogs not given immunosuppression, the grafted lungs lost aeration 5–10 days postoperatively, and histologic findings revealed grade II rejection and cytotoxic activity elevated to between 10.7 and 60.5%, being an average of 31.2% at an effector/target (E/T) ratio of 50. Of 12 dogs treated with FK, none demonstrated a cytotoxic activity of 10% or more at an E/T ratio of 50. Moreover, histologic examinations of the specimens obtained by open chest biopy revealed no signs of rejection during the first 10 postoperative days of FK administration, except in one dog showing grade I rejection from the FK 0.05 mg/kg group. A dose study of the duration until the onset of graft rejection and the elevation of cytotoxic activity after the termination of FK administration revealed approximately 1–2 weeks in the FK 0.05 mg/kg group, 3–4 weeks in the 0.1 mg/kg group, and later in the 0.4 mg/kg and 2.0 mg/kg groups. However, severe body weight loss was seen in the 0.4 mg/kg and 2.0 mg/kg groups postoperatively, without recovery even after the termination of FK. In fact, two dogs died of pneumonia possibly derived from general emaciation. These results suggest the optimal concentration of FK in canine lung allo-transplantation to be 0.1 mg/kg intramuscularly.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-2813
    Keywords: bronchofiberscopy ; Nd:YAG laser surgery ; lung cancers ; tracheal malignancies ; tracheal stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of endoscopic Nd:YAG laser surgery were studied in 36 patients with unresectable advanced primary and metastatic malignancies in the trachea with special reference to the factors influencing long-term survival. Overall effectiveness of YAG laser treatment was demonstrated in 34 of the 36 patients (94 per cent), while the overall 1, 3 and 5 year survival rates after the first laser treatment were 25 per cent, 13 per cent and 13 per cent, respectively. Neither histologic type nor the severity of clinical symptoms before laser treatment showed any significant influence on the survival curves, however, endoscopic findings of stenosis, the effect of laser treatment and irradiated longitudinal length were all significantly correlated with the survival curves. In other words, endoscopically protruding type tumors with a longitudinal length of irradiation of 3.0 cm or less, and good responses not only to laser treatment but also to other combined modalities are favorable factors for achieving long-term survival in patients with tracheobronchial malignancies undergoing endoscopic Nd:YAG laser treatment. Endoscopic Nd:YAG laser surgery is considered to be a promising part of the multi-modality treatment for unresectable advanced primary and metastatic malignancies of the trachea.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1436-2813
    Keywords: liposarcoma ; mediastinum ; thymus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein the case of a 77-year-old woman who was admitted to our hospital for further evaluation of an abnormal shadow in the right upper mediastinum that had been revealed by a routine chest X-ray. Computed tomography (CT) and magnetic resonance imaging (MRI) scans confirmed the presence of a thymic tumor, but did not show any evidence of invasion into the central vessels or adjacent structures. Thus, an extended thymectomy with resection of the tumor was performed. Microscopically, normal thymic tissue was found among the tumor cells, and a pathological diagnosis of well-differentiated liposarcoma was established. From the operative and microscopic findings, it is apparent that the tumor was related to the thymus. Postoperative irradiation of 60 Gy was delivered to the operative site and the patient has remained free of disease for 29 months since the operation.
    Type of Medium: Electronic Resource
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