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Yamaguchi M, Yoshino I, Suemitsu R, Osoegawa A, Kameyama T, Tagawa T, Fukuyama S, Maehara Y. Elective Video-Assisted Thoracoscopic Lung Biopsy for Interstitial Lung Disease. Asian Cardiovasc Thorac Ann 2016; 12:65-8. [PMID: 14977746 DOI: 10.1177/021849230401200116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lung biopsy is often required for the definitive subtype classification of interstitial lung disease. The video-assisted thoracoscopic approach has been advocated as an alternative to standard open lung biopsy because it is less invasive; however, whether it makes a positive contribution to treatment strategy remains contentious. We investigated the safety and efficacy of the video-assisted approach in a retrospective review of 30 consecutive patients who underwent the procedure in an elective setting after being diagnosed with interstitial lung disease by chest radiography and computed tomography. The mean age of the patients was 56.7 years. The preoperative vital capacity and forced expiratory volume in 1 second were 80.0% and 83.6%, respectively. There was no operative mortality, but 2 cases of respiratory failure and 1 of prolonged air leak occurred. The diagnostic yield was 100%, and treatment was changed in 57% of the cases as a result of the histological diagnosis. The rate of treatment change was higher for patients with nonspecific interstitial pneumonia than for those with idiopathic pulmonary fibrosis. We conclude that video-assisted biopsy is effective in the subtyping of interstitial lung disease and is a safe procedure when performed electively at the early stage of the disease.
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Affiliation(s)
- Masafumi Yamaguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Fukuoka, Japan.
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Suemitsu R, Takeo S, Hamatake M, Furuya K, Uesugi N. A case of diffused malignant pleural mesothelioma forming small multiple disseminations with intraoperatively suspicious carcinoid tumors. Ann Thorac Cardiovasc Surg 2011; 17:290-2. [PMID: 21697793 DOI: 10.5761/atcs.cr.09.01416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 03/15/2010] [Indexed: 11/16/2022] Open
Abstract
A 65-year-old male, having symptoms suggestive of pulmonary malignant tumor, underwent video-assisted thoracic surgery (VATS). Surgery revealed a solid tumor originating from the thoracic wall, with many small solid tumors in the thoracic wall and diaphragm near the tumor. The intraoperative observation of a frozen section typed the tumor as carcinoid; however, hematoxylin-eosin staining and immunohistological findings provided the definitive diagnosis of diffused, malignant pleural mesothelioma (MPM).
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Fukuoka, Japan.
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Suemitsu R, Tokito T, Ichiki M, Takeo S, Momosaki S, Furuya K. Complication of bovine pericardial buttress: pulmonary pseudotumor. Asian Cardiovasc Thorac Ann 2011; 19:64-5. [PMID: 21357322 DOI: 10.1177/0218492310390053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 38-year-old man reported progressive back pain 4 years after undergoing partial resection of the lung for spontaneous pneumothorax, using staples buttressed with bovine pericardium. Chest computed tomography detected a mass near the staple line. Resection of the mass was performed successfully and the pain was relieved. The excised material was identified as an inflammatory pulmonary pseudotumor caused by the buttressing material.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
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Suemitsu R, Takeo S, Yamaguchi M, Hamatake M. A Complication of Thoracic Surgery: A Late-onset Chylomediastinum Resulting from a Left Upper Lobectomy and Lymph Node Dissection through a Median Sternotomy. Ann Thorac Cardiovasc Surg 2011; 17:182-4. [DOI: 10.5761/atcs.cr.08.01373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 01/06/2010] [Indexed: 11/16/2022] Open
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Suemitsu R, Takeo S, Kusumoto E, Hamatake M, Ikejiri K, Saitsu H. Results of a pulmonary metastasectomy in patients with colorectal cancer. Surg Today 2010; 41:54-9. [DOI: 10.1007/s00595-009-4244-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Accepted: 08/12/2009] [Indexed: 12/13/2022]
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6
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Suemitsu R, Takeo S, Hamatake M, Morokuma A, Suemori Y, Tanaka H. The results of surgery under general anesthesia in patients with lung cancer. Surg Today 2010; 41:60-6. [PMID: 21191692 DOI: 10.1007/s00595-009-4215-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 09/03/2009] [Indexed: 01/22/2023]
Abstract
PURPOSE There are few reports of surgical complications for underweight patients. This study evaluated the complications associated with lung cancer surgery and anesthesia in underweight patients in a comparison with obese ones. METHODS A single-center retrospective evaluation of perioperative complications was conducted in 756 patients who underwent thoracic surgery under general anesthesia between 1996 and 2006. The body mass index showed that 39 were extremely underweight (<17.2 kg/m(2)), 45 were underweight (17.2-18.4 kg/m(2)), 513 were normal (18.5-24.9 kg/m(2)), and 159 were obese (>24.9 kg/m(2)). RESULTS Extremely underweight patients had the most preoperative thoracic disease such as emphysema, whereas obese patients had the most preoperative cardiovascular disease such as hypertension. The postresection-predicted pulmonary function showed no difference among the four groups. Extremely underweight patients had an increased incidence of intraoperative hypotension and arrhythmia in comparison to underweight patients. On the other hand, obese patients had the majority of intraoperative thoracic complications such as hypoxia. Extremely underweight patients had more postoperative thoracic complications, especially pneumonia and pulmonary air leakage, than other patients. CONCLUSIONS Extremely underweight patients as well as obese patients had a high risk of perioperative complications, especially postoperative thoracic complications. Extremely underweight patients should therefore be carefully observed with regard to respiratory management.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
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Suemitsu R, Takeo S, Uesugi N, Inoue Y, Hamatake M, Ichiki M. A long-term survivor with late-onset-repeated pulmonary metastasis of a PEComa. Ann Thorac Cardiovasc Surg 2010; 16:429-431. [PMID: 21263425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 09/09/2009] [Indexed: 05/30/2023] Open
Abstract
A 59-year-old male underwent a surgical resection of a retroperitoneum tumor in 1990 that was diagnosed as leiomyoblastoma. Thereafter he demonstrated pulmonary metastases followed by a total of 3 pulmonary resections from 1995 to 1997. In 2008, he was incidentally found to have a tumor in the left lower lobe, which was diagnosed as a metastatic perivascular epithelioid cell (PEComa) neoplasm. Retrospectively, a primary tumor and pulmonary metastases were also diagnosed as PEComa. We experienced late-onset repeated pulmonary metastasis of a PEComa.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
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Suemitsu R, Takeo S, Hamatake M, Yamamoto T, Furuya K, Momosaki S. Thyroid cancer with a cystic mediastinal tumor invading the right main bronchus. Ann Thorac Surg 2010; 89:296-8. [PMID: 20103264 DOI: 10.1016/j.athoracsur.2009.02.084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 01/20/2009] [Accepted: 02/26/2009] [Indexed: 10/20/2022]
Abstract
A 55-year-old woman presented with hemosputum. She had noted thyroid swelling and computed tomography was performed by her family physician. The computed tomographic scan revealed a thyroid tumor and a mediastinal cyst connecting to the thyroid tumor. Fiberoptic bronchoscopy showed direct invasion to the right main bronchus. She was preoperatively diagnosed with thyroid cancer combined with a mediastinal tumor and underwent a thyroidectomy and mediastinal tumor resection. These tumors were adherent to the esophagus, trachea, superior vena cava, and azygos vein; however, the mediastinal cyst, despite the fact that it directly invaded the right main bronchus, showed no malignant cells.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
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Yamaguchi M, Takeo S, Suemitsu R, Matsuzawa H, Okazaki H. Video-assisted thoracic surgery for fibropurulent thoracic empyema: a bridge to open thoracic surgery. Ann Thorac Cardiovasc Surg 2009; 15:368-372. [PMID: 20081744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Accepted: 11/17/2008] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Thoracic empyema remains a serious problem. OBJECTIVE We evaluated the feasibility and efficacy of video-assisted thoracic surgery (VATS) for fibropurulent thoracic empyema. PATIENTS AND METHODS Twenty-six consecutive patients with thoracic empyema resistant to medical therapy were treated by VATS from 1997 to 2006. The presence of pleural adhesion was not a contraindication. Patients with destroyed lung, bronchopleural fistula, or excessively thickened pleura were excluded. RESULTS Twenty-two were males and 4 were females with a mean age of 59 years (range 14 to 85). The length of preoperative period was 39.3 +/- 25.3 days, and the length of preoperative treatment was 11.2 +/- 14.3 days. The operating time was 127.6 +/- 45.1 minutes and intraoperative bleeding was 353.8 +/- 438.4 g. Postoperative complications were observed in two cases (8.0%). There were no hospital deaths. Twenty-two cases (84.6%) were cured with a postoperative drainage time of 12.5 +/- 8.2 days. Four cases required an additional operation. However, the VATS procedure was not required to perform additional thoracoplasty using pedicled chest wall muscles. CONCLUSIONS VATS for fibropurulent thoracic empyema is effective and less invasive, and it may be important as a bridge between minimally invasive and conventional open thoracic surgical management.
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Affiliation(s)
- Masafumi Yamaguchi
- Division of General Thoracic Surgery, Respiratory Center and Clinical Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Yamaguchi M, Takeo S, Suemitsu R, Matsuzawa H. Feasibility study for biweekly administration of cisplatin plus gemcitabine as adjuvant-chemotherapy for completely resected non-small cell lung cancer. Cancer Chemother Pharmacol 2009; 66:107-12. [PMID: 19809815 DOI: 10.1007/s00280-009-1139-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Accepted: 09/08/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the feasibility of biweekly administration of cisplatin and gemcitabine as adjuvant chemotherapy for patients with completely resected non-small cell lung cancer (NSCLC). PATIENTS AND METHODS This was a single-arm, single-institutional study. Patients with completely resected NSCLC (p-Stages IB-IIIA) with no previous chemotherapy or radiotherapy were eligible. Simon's optimal two-stage design was applied. Both cisplatin (50 mg/m(2)) and gemcitabine (1,000 mg/m(2)) were given on days 1 and 15, every 28 days. The primary endpoint of this study was the feasibility of this combination in the four cycles of treatment. RESULTS Twenty patients (19 lobectomies and 1 pneumonectomy) were enrolled in this study. Nine (45%) of patients had grade 3/4 neutropenia, and 6 (30%) had grade 3/4 anemia. Severe non-hematologic toxicities were uncommon in this series. No treatment-related death was encountered. Thirteen (65%) patients completed the planned 4 cycles of chemotherapy. The median intensity was 24 (range 21-25) mg/(m(2) week) with an average of 24.0 (21-25) mg/(m(2) week) cisplatin and 483 (range 412-500) mg/(m(2) week) with an average of 481.0 (412-500) mg/(m(2) week) gemcitabine. The median relative dose intensity of cisplatin was 100 (range 25-100) % with an average of 87.4 (25-100) % and that of gemcitabine was 100 (range 25-100) % with an average of 86.8 (25-100) %. CONCLUSION This regimen is feasible in the treatment of patients with completely resected NSCLC. A multicenter phase III trial is warranted to assess the efficacy of this regimen at promoting survival and preventing recurrence.
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Affiliation(s)
- Masafumi Yamaguchi
- Division of General Thoracic Surgery, Respiratory Center and Clinical Institute, National Hospital Organization Kyushu Medical Center, Jigyouhama 1-8-1 Chuou-ku, Fukuoka 810-8563, Japan.
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Suemitsu R, Sakoguchi T, Morikawa K, Yamaguchi M, Tanaka H, Takeo S. Effect of Body Mass Index on Perioperative Complications in Thoracic Surgery. Asian Cardiovasc Thorac Ann 2008; 16:463-7. [DOI: 10.1177/021849230801600607] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity is perceived as a risk factor in general thoracic surgery. We conducted a single-center retrospective evaluation of perioperative complications in 822 patients who underwent thoracic surgery between 2000 and 2005. According to body mass index, 82 were underweight (< 18.5 kg·m−2), 568 were normal (18.5–24.9 kg·m−2), 155 were overweight (25.0–29.9 kg·m−2), and 17 were obese (≥30 kg·m−2). A significant increase in preoperative comorbidity (hypertension and ischemic heart disease) was observed with increasing body mass index. There was no significant difference in operation time or length of stay in the operating room, but extubation time was significantly different among the 4 groups. Of the intraoperative complications, alveolar-arterial oxygen difference increased significantly with increasing obesity, and hypoxia was least common in the normal group. Postoperatively, there was more pulmonary leakage in the underweight group and less pneumonia in the normal group. Both the underweight and the obese are at increased risk of perioperative complications and need to be carefully observed and managed intraoperatively and postoperatively.
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Affiliation(s)
| | - Taro Sakoguchi
- Department of Anesthesiology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center Fukuoka, Japan
| | - Keiko Morikawa
- Department of Anesthesiology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center Fukuoka, Japan
| | | | - Hiroyuki Tanaka
- Department of Anesthesiology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center Fukuoka, Japan
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Suemitsu R, Matsuzawa H, Yamaguchi M, Takeo S. Dumbbell-shaped mediastinal neurogenic tumor forming a string-of-beads structure. J Thorac Cardiovasc Surg 2008; 136:522-3. [PMID: 18692668 DOI: 10.1016/j.jtcvs.2007.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 08/30/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
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Suemitsu R, Yamaguchi M, Takeo S, Ondo K, Ueda H, Yoshino I, Maehara Y. Favorable surgical results for patients with nonsmall cell lung cancer over 80 years old: a multicenter survey. Ann Thorac Cardiovasc Surg 2008; 14:154-160. [PMID: 18577893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 07/13/2007] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Surgery for elderly patients, especially those over 80 years old, with primary lung neoplasms is a relatively common treatment according to the increasing elderly population. We reviewed our experiences to evaluate surgical outcomes in over-80-year-old patients with nonsmall cell lung cancer (NSCLC). PATIENTS AND METHODS We reviewed and analyzed the clinical records of 146 consecutive over-80-year-old patients (Group 1) and 926 control patients (65 years old and younger) (Group 2) with NSCLC who underwent surgical resections from 1981 to 2006. RESULTS The mean ages of Group 1 and Group 2 were 82.6 and 56.2 years old, respectively. The ratio of the clinical and pathological Stage I was higher than the Stages II-IV in Group 1, and that of pathological Stage III was higher in Group 2. Segmental and wedge resection were selected more frequently in Group 1, otherwise, pneumonectomy and lobectomy were selected more frequently in Group 2. The ratio of squamous cell carcinoma was higher in Group 1 than in Group 2. When we divided the time of surgeries into decades, the 1980s, 1990s, and 2000s, the ratio of elder to younger patients was clearly increased according to era: 6.6%, 13.7%, and 18.8%. Furthermore, incomplete operation cases were significantly decreased in the two groups. There was no difference of overall survival in either. When examined for overall survival, except for patients with incomplete resection, there was no significant difference between the two groups. CONCLUSIONS Surgery is the convenient treatment for elderly NSCLC patients, especially, for those who can undergo complete resection.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, and Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Suemitsu R, Fukuyama S, Ondo K, Ueda H. Resection of mediastinal granulocytic sarcoma triggered the rapid progression of acute myeloid leukemia. Ann Thorac Cardiovasc Surg 2008; 14:181-183. [PMID: 18577899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Accepted: 06/15/2007] [Indexed: 05/26/2023] Open
Abstract
Mediastinal granulocytic sarcoma (GS) is a relatively rare disease. We experienced a case of acute myeloid leukemia (AML) that took a rapid turn for the worse after the resection of a mediastinal GS. A healthy 60-year-old man had been in good general health all his life, but was diagnosed with a mediastinal tumor by his family physician and was referred to our department. The patient underwent resection of the mediastinal tumor because thymoma was highly suspected. On postoperative day (POD) 3, the patient suffered a fever as well as an elevated white blood cell (WBC) count and a high C-reactive protein level. His WBC count was 77,240 at its peak on POD 9, at which point the patient was diagnosed with AML by bone marrow aspiration. The immunohistological findings showed the features of leukemia, and GS was diagnosed. Despite chemotherapy, the patient died on POD 28 as a result of rapid disease progression.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan
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Yamaguchi M, Takeo S, Suemitsu R. Feasibility of adjuvant cisplatin and gemcitabine in patients who have undergone complete resection of stage IB-IIIA non-small cell lung cancer (NSCLC): Preliminary report of a feasibility trial in Japanese patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.18503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Suemitsu R, Maruyama R, Nishiyama K, Okamoto T, Wataya H, Seto T, Ichinose Y. Pulmonary typical carcinoid tumor and liver metastasis with hypermetabolism on 18-fluorodeoxyglucose PET: a case report. Ann Thorac Cardiovasc Surg 2008; 14:109-111. [PMID: 18414349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 05/11/2007] [Indexed: 05/26/2023] Open
Abstract
Pulmonary carcinoid tumors are generally hypometabolic on 18-fluorodeoxyglucose (FDG)-positron emission tomography (PET). We experienced a case of pulmonary typical carcinoid that showed rapid growth and high FDG uptake at the primary site and liver metastasis. A 56-year-old man with hemosputum had a medical examination by his family physician. A roentgenogram and computed tomography of the chest showed a solitary solid mass on the right lower lung field. However, he had not been shown an abnormal shadow on a roentgenogram taken 8 months earlier. He had undergone fiber-optic bronchoscopy, but the cytological diagnosis showed no evidence of malignancy. After that, FDG-PET was examined and revealed hot spots in the pulmonary tumor and liver mass. A standard uptake value of this pulmonary tumor was 32.9 mg/mL, and that of the liver mass was almost the same value of pulmonary lesion. He had undergone a right lower lobectomy diagnosed as a typical carcinoid. Thereafter he underwent partial resection of he liver mass, and the histology was metastasis from pulmonary carcinoid. We first reported a typical pulmonary carcinoid that showed high FDG uptake at the primary site and liver metastasis.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Oncology, Kyushu Cancer Center, Fukuoka, Japan
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Suemitsu R, Okamoto T, Maruyama R, Wataya H, Seto T, Ichinose Y. A long-term survivor after aggressive treatment for tracheal adenoid cystic carcinoma: a case report. Ann Thorac Cardiovasc Surg 2007; 13:335-337. [PMID: 17954991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Accepted: 07/02/2007] [Indexed: 05/25/2023] Open
Abstract
A 61-year-old male underwent a tracheal resection and reconstruction with omentopexy for the treatment of tracheal adenoid cystic carcinoma. Postoperatively, he received radiotherapy for a microscopic residual tumor of the tracheal margin. It recurred with pulmonary metastasis and para-esophageal lymph nodal metastasis at 7 years and 10 months after the initial operation. A wedge resection and concurrent chemoradiotherapy were carried out to treat the recurrence, followed by consolidation chemotherapy. Eleven months later, he developed a second recurrence with a right hilar lymph nodal metastasis, and thereafter he also suffered from a left hilar lymph nodal metastasis. As a result, he received concurrent chemoradiotherapy twice over a 3-year period. One year and 2 months later, a new pulmonary metastasis appeared, and a wedge resection was carried out. Although the patient had five instances of recurrence over an 11-year period during his treatment course, he is presently doing well as a result of appropriate local treatments using multiple modalities.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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Suemitsu R, Ondo K, Fukuyama S, Ueda H. Late-period-onset chylothorax after a pulmonary resection for lung cancer: a case report. Ann Thorac Cardiovasc Surg 2007; 13:345-348. [PMID: 17954994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Accepted: 07/02/2007] [Indexed: 05/25/2023] Open
Abstract
A 65-year-old female had been diagnosed with right lung cancer by her family physician, and she was introduced to our Department of Thoracic Surgery at Matsuyama Red Cross Hospital in May 2004. She underwent a right upper lobectomy and wedge resection of S6 with the systematic dissection of her mediastinal lymph nodes. The patient made an uneventful recovery and was discharged on postoperative day 19. However, chylothorax was detected on a chest roentgenogram when she consulted our outpatient clinic again for dyspnea on exertion and chest pain. Chylothorax occurred in postoperative day 34. The patient initially received conservative therapy, but subsequently underwent surgical treatment and fibrin glue intubation when conservative therapy proved to be unsuccessful.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
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Maruyama R, Suemitsu R, Okamoto T, Kojo M, Aoki Y, Wataya H, Eguchi T, Nishiyama K, Seto T, Ichinose Y. Persistent and Aggressive Treatment for Thymic Carcinoma. Oncology 2007; 70:325-9. [PMID: 17164588 DOI: 10.1159/000097944] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 07/03/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study is to retrospectively evaluate the role of several therapies, mainly chemotherapy, for thymic carcinoma (TC). METHODS From July 1973 to July 2005, 25 patients (15 males and 10 females) with histologically proven TC were treated at our department. The median age of the patients was 59 years, with a range of from 30 to 78 years. According to Masaoka's staging system, there was 1 stage I patient, 3 stage II, 7 stage III, 6 stage IVa, and 8 stage IVb patients. The histological subtype was in all cases squamous cell carcinoma, nonkeratinizing type. RESULTS There were 6 complete surgical resections, 1 incomplete resection followed by chemoradiotherapy, 6 with radiotherapy alone, 3 with radiotherapy plus chemotherapy, and 9 with chemotherapy alone as the initial treatment. Eighteen patients were administered second-line therapy. The regimen obtaining the best response rate was doublet chemotherapy consisting of carboplatin (CBDCA) and paclitaxel. The median survival time and survival rate at 5 years for the patients excluding surgical cases with stage I/II disease were 32 months and 31%, respectively. CONCLUSION The doublet of CBDCA and paclitaxel thus appears to be a promising regimen for TC and further investigation in a multi-institutional phase II trial is, therefore, strongly called for.
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Maruyama R, Miyake T, Kojo M, Aoki Y, Suemitsu R, Okamoto T, Wataya H, Ichinose Y. Establishment of a clinical pathway as an effective tool to reduce hospitalization and charges after video-assisted thoracoscopic pulmonary resection. ACTA ACUST UNITED AC 2006; 54:387-90. [PMID: 17037393 DOI: 10.1007/s11748-006-0014-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the effect of establishing a clinical pathway based on the length of hospitalization, hospital charges, and the outcome for video-assisted thoracoscopic pulmonary resection (VATPR). METHODS We retrospectively analyzed consecutive patients who were diagnosed as having primary lung cancer, metastatic lung cancer, or a nodule that was suspected to be malignant and thus was operated on using VATPR during the 1-year period before (n = 105) and after (n = 113) pathway implementation. RESULTS The mean economic cost and total hospital stay before and after pathway implementation were about dollars 14439 and dollars 13093 (US), and 29.4 and 18.6 days, respectively. These figures were significantly lower after pathway implementation than before establishment of the pathway. CONCLUSION A clinical pathway is thus considered useful for reducing the length of total hospital stay and the costs associated with VATPR while maintaining high-quality postoperative care.
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Okamoto T, Maruyama R, Suemitsu R, Aoki Y, Wataya H, Kojo M, Ichinose Y. Prognostic value of the histological subtype in completely resected non-small cell lung cancer. Interact Cardiovasc Thorac Surg 2006; 5:362-6. [PMID: 17670594 DOI: 10.1510/icvts.2005.125989] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Non-small cell lung cancer (NSCLC), which includes several different histological subtypes, is usually treated by the same strategy. However, the biological behavior of each cell type appears to be different. We retrospectively reviewed the clinical records of 1119 consecutive NSCLC patients who underwent a complete resection, in order to investigate whether a histological cell type is a powerful prognostic factor. The overall 5- and 10-year survivals of the patients with adenocarcinoma (AD), squamous cell carcinoma (SQ), large cell carcinoma (LA), and adenosquamous cell carcinoma (AS) were 54.2 and 40.2%, 51.6 and 30.3%, 40.9 and 18.7%, and 35.1 and 30.1%, respectively. The AD patients had a significantly better survival than the non-AD patients in Stage I (P=0.0004), whereas the SQ patients had a better survival than the non-SQ patients in Stage II (P=0.018). A multivariate survival analysis indicated the AD patients to have a significantly better survival than the SQ patients in Stage IA (P=0.04), while the SQ patients had a better survival than the AD patients in Stage II (P=0.03). These above observations suggest that the prognosis after complete resection is different between adenocarcinoma and squamous cell carcinoma in Stage IA and II.
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Affiliation(s)
- Tatsuro Okamoto
- Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka, 811-1395, Japan.
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Wataya H, Asou H, Maruyama R, Okamoto T, Suemitsu R, Ichinose Y. [A case of adenocarcinoma of the lung significantly responding to TS-1 plus cisplatin combination chemotherapy]. Gan To Kagaku Ryoho 2006; 33:501-3. [PMID: 16612161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A 67-year-old man was admitted to our hospital, complaining of productive cough and chest pain. Chest radiograph and computed tomography revealed a huge mass invading the mediastinum, enlargement of right hilar and cardiophrenic lymph nodes and nodules in right lower lobe and left upper lobe. Multiple space occupying regions in the liver were also observed. Cytology for exfoliated sputum revealed adenocarcinoma, so he was diagnosed with advanced lung cancer (clinical stage T 4 N 2 M 1, stage IV). He was enrolled in a clinical phase II study, and received combination chemotherapy with TS-1 and cisplatin. TS-1 was administered on days 1-21. Cisplatin was administered on day 8. Every cycle was repeated every 5 weeks. The patient then received 6 cycles of chemotherapy,and yielded a partial response (87% decrease in size determined by RECIST criteria version 2. 0). Grade 2 leukopenia and neutropenia were observed, and non-hematologic toxicities were also mild. The disease progressed after the end of chemotherapy, and he was given 5 regimens of chemotherapy, including gefitinib. He died of brain metastases. Time to progression of his disease for combination chemotherapy using TS-1 and cisplatin chemotherapy was 240 days. Survival time was 709 days. This combination chemotherapy was effective in the present case, and might prolong survival. We think it is valuable to confirm the efficacy of TS-1 and cisplatin combination chemotherapy.
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Affiliation(s)
- Hiroshi Wataya
- Dept. of Thoracic Oncology, National Kyushu Cancer Center
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Maruyama R, Sakai M, Nakamura T, Suemitsu R, Okamoto T, Wataya H, Nishiyama K, Kamei T, Ichinose Y. Triplet Chemotherapy for Malignant Pericardial Mesothelioma: A Case Report. Jpn J Clin Oncol 2006; 36:245-8. [PMID: 16533802 DOI: 10.1093/jjco/hyl003] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Malignant pericardial mesothelioma (MPM) is a relatively rare neoplasm in Japan, and no standard treatment regimens have been established for this disease. A 47-year-old woman with MPM presenting with cardiac tamponade was treated using four cycles of chemotherapy consisting of cisplatin (CDDP) 40 mg/m2, gemcitabine (GEM) 800 mg/m2 and vinorelbine (VNR) 20 mg/m2 on days 1 and 8 every 4 weeks after pericardial drainage alone. The diagnosis of MPM was confirmed by an immunohistochemical procedure using either positive or negative markers of malignant mesothelioma in addition to conventional cytological examinations using pericardial effusion. The patient experienced no severe non-hematological or hematological toxicities except for grade 3 neutropenia. The patient has returned to her usual activities and has remained well for 24 months after the last chemotherapy without any evidence of disease progression.
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Affiliation(s)
- Riichiroh Maruyama
- Department of Thoracic Oncology, Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
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Abstract
Lung cancer extending beyond 3 cm in diameter without lymph node or distant metastasis is defined as T2. The purpose of this study was to analyze the prognosis based on tumor size for patients with resected T2N0M0 non-small cell lung cancer. The 268 patients who underwent complete resection of a lung tumor > 3 cm in diameter were reviewed retrospectively. They were divided into 3 groups based on tumor size: 3-5 cm, > 5-7 cm, and > 7 cm. There were significant differences in the 5-year survival rates of 61.4%, 47.9%, and 21.9% in each group, respectively. In the two subgroups with tumor sizes 3-4 cm and > 4 cm, the 5-year survival was 63.8% and 48.1%, respectively. Tumors > 4 cm in diameter indicate a poor long-term prognosis.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan.
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Abstract
OBJECTIVE The purpose of this study was to examine the pulmonary metastatic results in patients with orthopedic malignancies. METHODS Forty-three consecutive patients who underwent a resection of a pulmonary metastasis from an orthopedic malignancy in our hospital were retrospectively investigated. The survival following the resection of a pulmonary metastatic tumor was then analyzed using the Kaplan-Meier method. The impact of clinicopathologic variables on the prognosis including gender, patient age, primary tumor type, the number of the pulmonary metastases, the number of metastasectomies, the operation-era, and the disease-free interval was examined by the Logrank test and Cox's proportional hazards model. RESULTS The 5-year overall survivals after a pulmonary metastasectomy were 20.7%. A univariate analysis revealed a significant benefit in the post-metastasectomy survival based on the patients age and the disease-free interval. A multivariate analysis demonstrated patient age to be an independent factor for the prognosis with a hazard ratio of 4.873 (p = 0.0373). When only young (less than 40 years of age) patients were investigated, the histologic type was revealed to be related to the prognosis (p = 0.0004). CONCLUSION Pulmonary metastasis from soft tissue tumors is considered to lead to a poor prognosis for younger patients and a metastasectomy for such patients should be considered as one of the potentially effective treatments.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Thoracic Surgery, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
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Suemitsu R, Yoshino I, Tomiyasu M, Fukuyama S, Okamoto T, Maehara Y. Serum tissue inhibitors of metalloproteinase-1 and -2 in patients with non-small cell lung cancer. Surg Today 2005; 34:896-901. [PMID: 15526122 DOI: 10.1007/s00595-004-2853-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2003] [Accepted: 03/09/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE In view of the increasing number of patients diagnosed with lung cancer every year worldwide, there is an urgent need for an effective screening marker to improve its early detection. METHODS We quantified the level of immunoreactive proteins for the tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 in the sera of 54 patients with non-small cell lung cancer (NSCLC) and 25 healthy control subjects, by using enzyme-linked immunosorbent assays with specific monoclonal antibodies. RESULTS The TIMP-1 level was significantly higher, and the TIMP-2 level was significantly lower in the patients with NSCLC than in the controls. Furthermore, both TIMP-1 and TIMP-2 were significantly higher in patients with squamous cell carcinoma than in those with adenocarcinoma. The TIMP-1 level in patients with stage III/IV disease was significantly higher than that in those with stage I/II disease. The TIMP-1/TIMP-2 ratio was significantly higher in the patients with NSCLC, and the receiver-operating characteristic curves analysis revealed that the TIMP-1/2 ratio, but not TIMP-1 or -2 alone, was a better screening marker for NSCLC than carcinoembryonic antigen (P < 0.0001). Patients with a high TIMP-1 value had significantly shorter disease-free survival (P = 0.0479), but those with a high TIMP-1/2 ratio did not. CONCLUSION The TIMP-1/2 ratio may be a good screening marker of NSCLC; however, it was less effective than TIMP-1 as a prognostic factor.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, 812-8582, Fukuoka, Japan
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Suemitsu R, Yoshino I, Shoji F, Yamaguchi M, Tomita Y, Maehara Y. The effects of pretreatment with donor antigen and immunosuppressive agents on fully allogenic tracheal graft. J Surg Res 2004; 122:8-13. [PMID: 15522308 DOI: 10.1016/j.jss.2004.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Indexed: 11/21/2022]
Abstract
BACKGROUND Obliterative bronchiolitis is a major clinical problem in cases involving a transplanted lung. We examined drug-induced tolerance to a fully allogenic tracheal graft in a murine heterotopic transplantation model. MATERIALS AND METHODS Recipient mice (C57BL/6) were primed iv with 1 x 10(8) splenocytes of donor mice (BALB/c). Day 0 was the day of the splenocyte injection. Cyclophosphamide and Busulfan were injected intraperitoneally on day 2. On day 3, 1 x 10(7) donor bone marrow cells were intravenously injected. On day 28, a donor tracheal graft was implanted into a subcutaneous pocket. Grafts were harvested at 3-week intervals, and the degree of obstruction of the inner cavity, the condition of epithelium, and the viability of chondrocytes were examined. RESULTS All of the isograft controls (BALB/c) and grafts implanted in the T cell-free recipients (BALB/c-nu) showed patent, lined epithelium and viable chondrocytes. All allografts tested showed total luminal occlusion by granulative tissue and inflammatory cells, and the epithelium was totally absent. Five of 11 drug-treated grafts were completely patent, although the epithelium was almost absent and the chondrocytes were substantially destroyed. However, when the chimerism was analyzed by flow cytometry analysis of the recipient T cells, approximately 90% of the donor cells were recognized. CONCLUSIONS Even by this pre-treatment-induced chimerism, a transplanted allogenic trachea was not completely preserved. The present results suggest that a non-allogenic response might have contributed to the rejection.
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Affiliation(s)
- Ryuichi Suemitsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Tomiyasu M, Yoshino I, Suemitsu R, Okamoto T, Sugimachi K. Quantification of macrophage migration inhibitory factor mRNA expression in non-small cell lung cancer tissues and its clinical significance. Clin Cancer Res 2002; 8:3755-60. [PMID: 12473586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
PURPOSE Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine derived from T cells and the pituitary gland. However, several types of solid cancers also secrete MIF, and this factor has been suggested to play an important role in carcinogenesis and the progression of malignancy. In this study, we quantified MIF mRNA expression of non-small cell lung cancer tissues and examined its relationship with clinicopathological factors. EXPERIMENTAL DESIGN MIF mRNAs of both tumor and normal tissues were quantified by a real-time monitoring reverse-transcription PCR in 59 patients with non-small cell lung cancer. The relationship between the grade of MIF expression and clinicopathological factors such as smoking history, cell type, stage, and prognosis was examined to investigate the clinical significance of intratumoral expression of MIF. RESULTS The mean copy number of MIF mRNA per 0.08 micro g of total mRNA in tumor tissues was 144,078.00, whereas that of normal lung tissue was 25,438.46 (P < 0.0001). The amounts of MIF proteins revealed by a Western blot analysis correlated well with those of the corresponding mRNAs. Male patients and heavy smokers showed significantly higher expression of MIF. Patients with squamous cell carcinomas showed a higher expression of MIF mRNA than other subjects. In squamous cell carcinoma patients, higher expression of MIF mRNA was significantly associated with unfavorable prognosis (P = 0.0142). CONCLUSIONS The general intratumoral expression and close relation with smoking suggested that MIF might contribute to tumorigenesis in the lung.
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MESH Headings
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/metabolism
- Carcinoma, Adenosquamous/genetics
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Case-Control Studies
- Female
- Gene Expression Regulation
- Humans
- Lung/metabolism
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Macrophage Migration-Inhibitory Factors/biosynthesis
- Macrophage Migration-Inhibitory Factors/genetics
- Male
- Neoplasm Staging
- Prognosis
- RNA, Messenger/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Smoking/adverse effects
- Survival Rate
- Tumor Cells, Cultured/metabolism
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Affiliation(s)
- Makiko Tomiyasu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Yoshino I, Fukuyama S, Kameyama T, Shikada Y, Yoneya T, Baba H, Tomiyasu M, Suemitsu R, Shoji F, Tachiishi M, Yano A, Sugio K, Mitsutomi T, Ishida T, Yasumoto K. [Departmental review of surgical cases in the last 17 years: Lung neoplasm]. Fukuoka Igaku Zasshi 2002; 93:34-7. [PMID: 11989239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Tomiyasu M, Yoshino I, Suemitsu R, Shoji F, Sugimachi K. An intrapulmonary chondromatous hamartoma penetrating the visceral pleura: report of a case. Ann Thorac Cardiovasc Surg 2002; 8:42-4. [PMID: 11916442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
A 65-year-old woman had been followed up for a hamartoma-like mass in the right upper lobe of the lung since 1995. A follow-up CT scan showed an increase in the size of the lesion and a new lesion next to the old mass, which was highly suspected to be lung cancer. A right upper lobectomy was thus performed in May 2000. The hamartoma penetrated the visceral pleura, and adhered to the mediastinal pleura. Such a growing hamartoma with pleural invasion has so far rarely been previously reported.
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Affiliation(s)
- Makiko Tomiyasu
- Department of Surgery and Science, Division of Pathophysiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka 812-8582, Japan
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Yoshino I, Baba H, Fukuyama S, Kameyama T, Shikada Y, Tomiyasu M, Suemitsu R. A time trend of profile and surgical results in 1123 patients with non-small cell lung cancer. Surgery 2002; 131:S242-8. [PMID: 11821819 DOI: 10.1067/msy.2002.119796] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND A time trend for characteristics and prognoses of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection was investigated. METHODS A series of 1123 consecutive patients with NSCLC who underwent surgical resection from 1975 to 1998 was reviewed with respect to changes in patient profile and surgical outcome among subgroups classified by clinicopathologic factors. RESULTS With time, the proportion of female, elderly (> or =70 years), pathologic stage IA, nonsmoking, and adenocarcinoma patients increased significantly whereas pneumonectomy, incomplete resection, and pathologic stage IIIA patients decreased significantly. Overall survival showed an upward trend with 5-year survival rates of 30.0% in the 1970s, 41.6% in the 1980s, and 50.1% in the 1990s (P <.0001). This tendency was similar in every pathologic stage that was observed. The proportion of female patients with adenocarcinoma that exhibited the most favorable prognosis among subpopulations classified by gender and cell types was significantly higher in the 1990s (28.0%) than in the 1970s (14.0%). Multivariate analysis revealed that female gender, adenocarcinoma, complete resection, and early pathologic stage were independently favorable factors whereas advanced age was an unfavorable factor. CONCLUSIONS The improved survival following surgical resection for NSCLC during the study period was associated with an increasing population of female patients with adenocarcinoma, more detection of early disease, and effective elimination of unresectable cases.
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Affiliation(s)
- Ichiro Yoshino
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yoshino I, Ushijima C, Tomiyasu M, Suemitsu R, Ichinose Y, Sugimachi K. Unique minithoracotomy assisted by videothoracoscopy facilitates a maximal view even with a minimal wound for resection of primary lung cancer. Surg Endosc 2002; 16:148-50. [PMID: 11961626 DOI: 10.1007/s004640080194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2001] [Accepted: 06/01/2001] [Indexed: 11/26/2022]
Abstract
Resection for primary lung cancer with an unique minithoracotomy and use of videothoracoscopy is described. Through an incision of approximately 10 cm at an ausculatory triangle, the 5th intercostal thoracotomy is done following dissection of muscles. At the anterior and posterior portion of the 6th rib, the 6th intercostal vessels and nerve were dissected and the rib was resected. This approach makes feasible opening of a thoracic window without injury to the nerve and removal of the rib. Thoracoscopy is introduced through a midaxillary wound of 2 cm. We report nine patients in whom we achieved resection for primary lung cancer by using this approach. This technique facilitates a standard operation for lung cancer and an almost painless postoperative state.
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Affiliation(s)
- I Yoshino
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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Yamazaki K, Yano T, Kameyama T, Suemitsu R, Yoshino I, Sugio K. Clinical significance of serum TH1/TH2 cytokines in patients with pulmonary adenocarcinoma. Surgery 2002; 131:S236-41. [PMID: 11821818 DOI: 10.1067/msy.2002.119795] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The acquisition of immune reaction in the peripheral blood is expected to play a critical role in the prevention of tumor progression. However, the clinical role of the circulating immune response against human cancer remains unclear. METHODS Serum samples from 68 consecutive patients who underwent resection for pulmonary adenocarcinoma were obtained before the operation. The serum levels of interferon gamma and interleukin 4 were measured and the impact on the clinical features was assessed. According to the predominance of the cytokine levels, the patients were classified into 4 groups: interferon gamma only (T(H)1), interleukin 4 only (T(H)2), both (T(H)0), and neither (T(H)X). RESULTS In the T(H)1 group, 18 of 22 patients (81.8%) were free from lymph node metastasis, whereas 5 of 7 patients (71.4%) in the T(H)2 group had lymph node involvements. As a result, 62 patients underwent complete resection, with 9 of 19 patients (47.3%) in the T(H)1 group having recurrence, but no relapse of the disease appearing in the T(H)2 group during the observation period. The disease-free interval for the T(H)2 group was significantly longer than that for the T(H)1 group (44.2 mo vs 26.1 mo, P =.03). CONCLUSIONS Assessing the serum T(H) profile on the basis of the predominance of the serum interferon gamma or interleukin 4 is important to presume the ongoing responses of T cells against the tumor burden.
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Affiliation(s)
- Koji Yamazaki
- Department of General Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Suemitsu R, Yoshino I, Tomiyasu M, Fukuyama S, Koto H, Sugimachi K. Asymptomatic atresia of the lobar bronchus of the lung: a case report. Ann Thorac Cardiovasc Surg 2001; 7:301-3. [PMID: 11743858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
A 64-year old woman presented with an asymptomatic occlusion of the intermediate bronchus associated with a peripheral mass occupying the entire middle and lower lobes. As malignancy was suspected, inferior bilobectomy was done. There was a complete atelectasis of both lobes, with massive parenchymal necrosis. Pathological examinations suggested a tuberculous granuloma in the bronchus and parenchyma although tuberculous bacilli were not found. This case was unusual as congenital anomaly, and was suspected as bronchial tuberculosis.
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Affiliation(s)
- R Suemitsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka 812-8582, Japan
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Yoshino I, Hashizume M, Shimada M, Tomikawa M, Tomiyasu M, Suemitsu R, Sugimachi K. Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system. J Thorac Cardiovasc Surg 2001; 122:783-5. [PMID: 11581613 DOI: 10.1067/mtc.2001.115231] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- I Yoshino
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Suemitsu R, Horiuchi K, Ohnishi K, Kubota M. High-performance liquid chromatographic determination of alterporriol D and E in fermentation of Alternaria porri (Ellis) Ciferri. J Chromatogr A 1990; 503:282-7. [PMID: 2341518 DOI: 10.1016/s0021-9673(01)81512-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- R Suemitsu
- Department of Applied Chemistry, Faculty of Engineering, Doshisha University, Kyoto, Japan
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Suemitsu R, Horiuchi K, Ohnishi K, Yanagawase S. High-performance liquid chromatographic determination of macrosporin, altersolanol A, alterporriol A, B and C in fermentation of Alternaria porri (Ellis) Ciferri. J Chromatogr A 1988; 454:406-10. [PMID: 3235604 DOI: 10.1016/s0021-9673(00)88639-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- R Suemitsu
- Department of Applied Chemistry, Faculty of Engineering, Doshisha University, Kyoto, Japan
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Suemitsu R, Yamada Y, Sano T, Kitayama M. Analysis of naturally occuring redueced anthraquinones obtained from alternaria porri (ellis) ciferri by high-performance liquid chromatography. J Chromatogr A 1985. [DOI: 10.1016/s0021-9673(01)90674-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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40
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Fujita S, Enomoto Y, Suemitsu R, Fujita Y. [Miscellaneous contributions to the essential oils of the plants from various territories. 28. On the components of the essential oils of Acorus calamus Linn. var. angustatus Bess]. YAKUGAKU ZASSHI 1971; 91:571-4. [PMID: 5105143 DOI: 10.1248/yakushi1947.91.5_571] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Fujita SI, Suemitsu R, Fujita Y. [Miscellaneous contributions to the essential oils of the plants from various territories. XXV. On the components of the essential oils of Acorus gramineus Soland]. YAKUGAKU ZASSHI 1970; 90:1367-71. [PMID: 5530445 DOI: 10.1248/yakushi1947.90.11_1367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Suemitsu R, Fujita S, Yoshimura M, Kondo I. Studies on cow's urine. V. Determination by gas-liquid chromatography of an acidic part obtained from cow's urine (supplement). Bull Chem Soc Jpn 1969; 42:2368. [PMID: 5346839 DOI: 10.1246/bcsj.42.2368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Suemitsu R, Fujita S, Mishima Y, Yoshimura M. Studies on cow's urine. IV. Determination by gas-liquid chromatography of an acidic part obtained from cow's urine. Bull Chem Soc Jpn 1968; 41:1381-5. [PMID: 5716806 DOI: 10.1246/bcsj.41.1381] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
Deoximation of 3,4,6-tri-O-acetyl-2-oximino-α-D-arabino-hexopyranosides to the corresponding 2-ulosides followed by borohydride reduction affords the α-D-glucopyranosides in excellent yields.
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