Showing papers by "Toshio Onitsuka published in 2004"
Journal Article•
TL;DR: Elevated preoperative serum CEA level is a TNM staging independent prognostic factor for patients with adenocarcinoma but not for those with squamous cell carcinoma, although there is a trend toward a correlation between serumCEA level and stage of the diseases.
Abstract: Objectives: Clinical significance of measurement of preoperative serum carcinoembryonic antigen (CEA) level in patients with non-small cell lung cancer was investigated. Methods: Consecutive 271 adenocarcinoma and 112 squamous cell carcinoma patients of nonsmall cell lung cancer referred to our institute were included in this study. There were 214 men and 169 women, ages ranged from 19 to 90 years, with an average of 64.46 years. Curative resection was performed for 220 adenocarcinoma and 93 squamous cell carcinoma patients. Serum level of CEA was measured before staging or resection of cancer. Results: There is a trend toward a correlation between serum CEA level and stage of the diseases, however, serum CEA level was not always related to tumor node metastasis (TNM) status. In patients with adenocarcinoma, survival rate of patients with an elevated serum CEA level was significantly lower than that with a normal serum CEA level. Multivariate analysis showed that prognostic significance of serum CEA level was TNM staging independent in patients with adenocarcinoma. On the other hand, serum CEA level was not related to patients’ survival in patients with squamous cell carcinoma. Conclusions: Elevated preoperative serum CEA level is a TNM staging independent prognostic factor for patients with adenocarcinoma but not for those with squamous cell carcinoma. (Ann Thorac Cardiovasc Surg 2004; 10: 76‐80)
66 citations
Journal Article•
TL;DR: A detection of micrometastasis in lymph nodes could be a useful tool to identify the subpopulation of patients who might have a higher risk of recurrence and distant metastases.
Abstract: Background: Based on the metastatic route in lymph nodes from lung cancer, we investigated micrometastasis in the dissected lymph nodes by genetic analysis of keratin 19 and nm23-H1 (the expression of a tumor-metastatic suppressor gene) and evaluated the postoperative outcomes. Methods: Ten patients operated with lung cancer were 4 males and 6 females, who were stage IA; 2, stage IB; 3, stage IIA; 2, stage IIB; 1, and stage IIIA; 2, respectively. After total RNA extraction from the dissected lymph nodes, the expression of nm23-H1 and keratin 19 messenger ribonucleic acid (mRNA) were analyzed with reverse-transcripted polymerase chain reaction (RT-PCR). Results: The confirmation of micrometastasis in lymph nodes was realized in seven of 10 cases (70%), in their 5-year follow-up term. In three patients there was recurrence (43%, 3/7), and the one of them had died from the mediastinal recurrence. On the expression of nm23-H1 mRNA in lymph nodes, there was no significant difference between the pathologically lymph-node metastasis positive group and the negative one, and between the group with a tumor size over 30 mm and the group with a tumor size under 30 mm, respectively. The expression ratio of nm23-H1 gene was significantly expressed in the group with micrometastasis in lymph nodes (47%, 9/19) as compared to those without micrometastasis (10%, 1/10) (p<0.05). On the all-positive expression of nm23-H1 in the examined lymph nodes (n=4), no patient had recurrence (0%, 0/4). However, in the rest of the six patients without the all-positive expression of nm23-H1 in those lymph nodes (n=6), four patients had recurrence (67%, 4/6). There was no significance between the recurrent ratio in the all-positive expression of nm23-H1 suggesting lower incidence as compared to that in patients without all-positive expression of nm23-H1. Conclusion: A detection of micrometastasis in lymph nodes could be a useful tool to identify the subpopulation of patients who might have a higher risk of recurrence and distant metastases. The nm23-H1 gene might be involved in a suppression role for micrometastasis in lymph nodes through the lymphatic route in lung cancer. (Ann Thorac Cardiovasc Surg 2004; 10: 152‐9)
13 citations
TL;DR: A 73-year-old woman with a history of hypertension and hyperlipidemia presented with a sharp pain ranging from the right shoulder to the upper limb and a chest computed tomography scan revealed an aneurysmal change of the origin of the brachiocephalic artery.
Abstract: A 73-year-old woman with a history of hypertension and hyperlipidemia presented with a sharp pain ranging from the right shoulder to the upper limb. She had suffered a sharp pain at rest accompanied by general fatigue and nausea for about ten months prior to admission. Her white blood cell count was 12,800/microl, and her serum C-reactive protein was 17.5 mg/dl. A chest computed tomography scan revealed an aneurysmal change of the origin of the brachiocephalic artery. Pseudoaneurysm due to infection and aortic dissection was considered as a preoperative diagnosis. A total arch replacement was performed under cardiopulmonary bypass, deep hypothermia, and selective cerebral perfusion. Postoperatively, a bacteriologic culture of the contents of the aneurysm revealed Staphylococcus aureus. Perioperative administration of antibiotics was effective and the postoperative course was uneventful.
2 citations
2 citations
TL;DR: The MSSA (methicillin sensitive Staphylococcus aureus) project, which aims to improve the quality of life for children with learning disabilities, is under way.
Abstract: key words:感 染性心内膜炎,心 室瘤破裂 <要旨> 症例は44歳,女 性. 1985年2月,慢 性糸球体腎炎による慢性腎不全のため血液透析導入. 2002年10月 初旬より 発熱 全身関節痛,右 腰~殿部痛が出現 したため,近 医へ入院 した.高 度の炎症所見があ り,血 液培養検査でMSSA (methicillin sensitive Staphylococcus aureus)を 検出 し,心 エコー検査で僧帽弁後尖に弁石灰化 とともに疣贅を認 め,感 染性心内膜炎と診断 された.当 科へ転入院後のCT検 査で,全 身性に多発性膿瘍を認めた.左 心不全 は増悪 し, 弁尖の疣贅が1.5~2.0cmと 大きかったこと,広 範な塞栓症状があったため, 10月23日,緊 急に僧帽弁置換術を施 行 した.炎 症反応は改善 したが,術 後9日 目に右心室自由壁穿孔による心タンポナーデを発症 し,穿 孔部縫縮術を 施行 した.以 後,全 身状態は改善 していたが,僧 帽弁置換術後51日 目に,再 び心タンポナーデを発症.胸 部CTで 僧帽弁直下の左心室瘤破裂を認め,同 日死亡 した.長 期透析患者で弁石灰化による弁膜症合併時には,感 染性心内 膜炎の発症に注意 を要する.本 症例のように,透 析患者に感染性心室瘤を合併することはまれであ り,若 干の考察 を加え報告する.
TL;DR: The results showed that the combined evaluation of mediastinal nodal involvement with the three procedures might increase underestimation, but decrease overestimation as compared to computed tomography alone.
Abstract: We investigated whether the combined use of computed tomography, thallium-201 single photon emission computed tomography and serum carcinoembryonic antigen level improves preoperative non-invasive mediastinal. 128 consecutive non-small cell lung cancer patients (85 adenocarcinomas, 31 squamous cell carcinomas and 12 others) who underwent a surgical resection were enrolled in this study. The results of the combined procedures were compared with the pathologic findings. Our results showed that the combined evaluation of mediastinal nodal involvement with the three procedures might increase underestimation, but decrease overestimation as compared to computed tomography alone. Thallium-201 single photon emission computed tomography for patients with enlarged nodes at computed tomography showed 81.3% and 100% of positive predictive value in overall and squamous cell carcinoma patients, respectively. The negative predictive value of thallium-201 single photon emission computed tomography for patients without en...