Surgical and Functional Problems in Pulmonary Resection for Lung Cancer

Thirty-four cases of pulmonary cancer have been studied by the methds of spirametry and temporary unilateral pulmonary occlusion with and temporary unilateral pulmonary occlusion with and without exercise. The prognostic significance of cardiopulmonary function for resectional treatment was re-evaluated by thesemans, and the functional indication values, which had been reported previously, were proved valuable. The postoperative pulmonary failure developed in patients with the RV : TLC ratio over 45%. It was emphasized that the relationships among pulmonary arterial presure, diastolic right heart pressure, and cardiac output, were the most important factors in judging how the borderline cases will tolerate surgical intervention. HARVEY\u27S conception was discussed in this regard

A model for investigation of survival of tracheal graft

A method to facilitate circulatory restoration of a long tracheal graft is remained to be developed to apply in reconstruction for an extended tracheal resection. An abdominal tracheal stoma model was devised to simplify the investigation and allow frequent bronchoscopy in conscious animal. In this model, a tracheal graft was wrapped with omentum ; with one end of graft opened and stitched to a round defect created at abdominal wall to make an abdominal tracheal stoma. This model allowed daily bronchoscopy without general anesthesia and negative factors affecting blood supply into omental flap can be excluded to simplify investigation and analysis

Aggressive Node Dissection for Esophageal Cancer

Fifty-eight patients with esophageal cancer were compared by dividing into two groups, the two-field and the three-field lymphadenectomy groups. The modes of node involvement were estimated according to grading of the depth of cancer infiltration. When cancer infiltration extends beyond the submucosal layer, the nodes were extensively involved thoroughout the three fields. Therefore, an extensive lymphadenectomy is mandatory for curative operation and it is the only way to improve the surgical outcome with help of surgical techniques

Carcinoid Tumor Arising from the Cystic Wall of the Lung

A 65-year-old male with carcinoid arising from the cystic wall was reported with some consideration to lung cancer associated with lung cyst. It is emphasized that an increasing mass adjacent lung cystic wall on chest xp should be taken into account as a malignant tumor arising from the cystic wall

Prognosis for recurrence of carcinoma of the esophagus

Surgical outcome for carcinoma of the esophagus is not yet satisfied. The reasons are based on the delay in diagnosis. As a matter of fact a complaint of dysphagia means advanced stage of cancer. In general, such a patient suffers from poor nutritional condition which relates to restriction of oral intake, and this disease frequently affects the aged people. Furthermore, anatomical specificity of the lack of the serosal layer is likely affected by carcinoma outside the wall of the esophagus. And rich lymphatic flow tends to constitute lymphatic metastasis anywhere in the longitudinal direction. In order to improve surgical results for carcinoma of the esophagus an important access to the treatment is to inhibit the growth of recurrent cancer cells effectively. In this series, experience with recurrent carcinoma of the esophagus was clinically analyzed to search for a better management

Surgery for Recurrence of Lung Cancer

Fifteen patients with recurrence after surgery for lung cancer were clinically investigated in terms of the validity and the indication of reoperation. 1) In most of cases with reoperation for recurrence, the disease stage was stage I lung cancer at the time of the initial operation. 2) In five out of the eight patients who underwent node dissection, nodal involvement was positive (62.5%). 3) A longer survivor is predicted in patients with negative node metastasis at the initial and the second operations. 4) Reoperation for recurrence is required for obtaining a longer survivor, if possible. The surgical outcome for lung cancer has been more and more improved. However, a five year survival rate is not satisfactoried with as large as 25 to 35%. It is great concern about the treatment of postoperative recurrence. Recently advances in the adjuvant therapy of chemotherapy and radiation enabled us to make the survival rate longer. In rare cases with localized recurrence, it has become possible to perform a radical excision for recurrence. The purpose of this study is to clarity the feasibility and validity of reoperation on the basis of clinical experience with the 15 patients who underwent re-excision for recurrence

Surgery for Perforating Intestial Behcet\u27s Disease

We reported the surgical experience with perforating intestinal Behcet\u27s diesease in a 36-year-old male and discussed mainly the operation method to avoid recurrence and postoperative complications

A Limited Operation for Breast Cancer

A limited operation for breast cancer is now prevalent in accordance with advances in the adjuvant therapy. Seventy-five per cent of Stage I patients and 25.9% of Stage II were the candidates of the limited operation and the Surgical outcomes were satisfactory as compared with those of standard radical mastectomy. However, preoperative assessment of nodal involvement was not necessarily equivalent to postoperatively comfirmed one. Perioperative histologic examination is required for further preservation of surgical oncologic radicality including determination of the extent of node dissection

Distribution of Mast Cells in Mediastinal Lymph Nodes from Lung Cancer Patients

BACKGROUND: Mast cells have been documented to have several key functions with regards to malignant neoplasms. However, the functional significance of their accumulation is largely unknown. An analysis of the mast cell profile in mediastinal lymph nodes from lung cancer patients is reported here. METHODS: One hundred thirty-four, randomly selected lymph nodes (63 with positive pathological lymph node status) from 39 surgically treated lung cancer patients were examined. All cancer negative nodes were obtained from stage I patients. Mast cells were stained with Alcian blue and safranin O. Metastatic cancer cells were stained using anti-cytokeratin antibody. RESULTS: Immunohistochemical studies with cytokeratin revealed micro metastasis in 9/71 (12.68%) nodes previously diagnosed as histological negative. In tumor-free mediastinal lymph nodes, the mast cell count was significantly higher than in metastatic nodes. In all cases, mast cells were observed primarily in the T-cell area. CONCLUSIONS: An inverse relationship was observed between the number of mast cells and the amount of tumor tissue. The presence of mast cells primarily in the T-cell area implies a relationship between mast cells and the T-cell system. From the present study it is not possible to conclude whether mast cells in lymph nodes are for or against tumor spread

Prolactin alters blood pressure by modulating the activity of endothelial nitric oxide synthase

Prolactin is a hormone secreted by the pituitary gland that controls changes in the breast to enable milk production after the baby is born. In some mothers with pregnancy-related high blood pressure (BP), the concentration of prolactin in the blood is higher than normal, but whether this causes the high BP or is a consequence of it is uncertain. To answer this question, we have generated experimental mice that produce prolactin in the liver when we feed them a substance, indole-3-carbinol (IC3), that is found in broccoli. When fed normal chow, the mice are well, but, when fed IC3, they develop high BP and heart problems. This suggests that pregnant women with abnormally high prolactin levels may need special attention