Bronchial Blood Flow at Anastomosis of Allografts in Relation to Immunosuppresive Drugs

The microflow in the bronchial mucosa was measured by means of electrochemically generated hydrogen on dogs, identifying close producibility of measurement. In general anesthsia, the microflow of tracheal bifurcation was 71.5± 13.23ml/min/100g that of right main bronchus, 65.6±10.84 and that of left main bronchus, 69.0±12.51 respectively. There was no significant difference in microflow between anastomically difeerent sites. Basic diffusion in the bronchial mucosa was estimated as many as 17.0±4.80ml/min/100g. The microflow at bronchial anastomosis in autografts increased on day 3 and hyperdynamic state continued on day 7 to 14. On the other hand, that in allografts treated with cyclosporine A (CyA ) showed increased levels on day 5 although that treated with azathioprine demonstrated lower levels until on day 7, thereafter increased on day 10

Risk Factor for Recurrence of Breast Cancer

The risk factors of recurrence following surgical treatment for patients with breast cancer were clinically evaluated on the basis of a result of clinical analysis. In this study, it is emphasized that special attention should focus on tissue CEA and DNA analysis. In conclusion, clinical uses of tissue positive CEA and aneuploid pattern in analysis of nuclear DNA content in cancer cells are of great value to forecast recurrence

Surgery for Tracheal Stenoses

On the basis of an analysis in the outcome of tracheal surgery, it proved useful for the relief of respiratory distress. As a result, we are confident that surgical management should be mandatory for tracheal stenoses, provided that the patient\u27s general condition is satisfactory with preoperatively meticulous cares. The incidence of occurring the risks of postoperative complications was relatively high in patients with malignant lesion. It seemd preferable to select a wide resection as far from the visible margin of the tumor as possible, in particular, in case of adenoid cystic caricnoma

Paget\u27s Disease of the Female Breast

Eight patients of Paget\u27s disease of the breast operated during 1969 and 1990 were studied. Four patients had Paget\u27s diseases confirmed to the nipple and remaining 4 patients had an associated palpable tumor. Seven patients had invasive intraductal carcinoma and only one had noninfiltrative ductal carcinoma. None of the patients without palpable mass had axillary lymph node metastasis, while three of four patients (75%) with palpable mass in the breast had axillary lymph node metastases. One patient of 4 without palpable mass died of lung cancer 19 years and 8 months after operation. Remaining 3 are alive and well 3 years, 4 years and 16 years following mastectomy. Two of 4 patients with palpable breast mass died of metastasis 6 months and 8 months after surgery. Remaining 2 are alive and well 7 months and 22 years following mastectomy

Recurrent Breast Cancer with Bone Metastasis

Twenty patients with bone metastasis following surgery for recurrent breast cancer were clinically evaluated in analysis of clinicopathologic aspect in comparison with those with metastases in other organ. It is more likely that bone metastasis occurs in younger patients as compared with other organ metastasis. However, there were no certain clinical patterns of patients with bone metastasis including the survival time, as compared with those with other organ metastasis. In this series, ER and PgR failed to measure and to elucidate the effect of hormore therapy because a subject includes parts of patients prior to development of ER and PgR measurement. In conclusion, there were no clinicopathologic features in patients with bone metastasis following surgical treatment of breast cancer except for occurrence in younger patients

Clinical Significance of Combined Resection with Tracheobronchial Trees for Advanced Esophageal Cancers

It was confirmed that combined resection of the trachea and the bronchus is feasible and available for advanced cancer patients on the basis of 9 patients of our clinical experience. However, meticulous postoperative cares are necessary for prevention of fatal outcome of postoperative complicatios. Anatomical drawback of tracheobronchoplastic operation is able to be overcome in combination with the procedure of omentopexy which facilitates neovascularity to the reconstructed trachea and bronchus

Surgery for Advanced Lung Cancer

Twenty-one patients with advanced lung cancer who underwent surgery were clinically reviewed on the basis of clinical experience at the First Department of Surgery, Nagasaki University School of Medicine. The surgical outcome was related to the intensity of surgical insult, which implied the grade of cancer progression. However, aggressive surgery is effective in a palliation of patient\u27s surffering regardless its time duration. It is emphasized that surgeons should be aware of establishment of safety operation and of elimination of the risk of cancer spreading during surgical manipulation to improve surgical outcome for advanced lung cancer

Hypertrophic Pulmonary Osteoarthropathy Associated with Primary Adenocarcinoma of the Lung

Hypertrophic pulmonary osteoarthropathy (HPOA) associated with primary lung cancer is reported in a fifty-four-year-old man. Symptoms of HPOA were makedly improved following lung resection for adenocarcinoma of the lung

Results of Surgical Treatment for Small Cell Lung Cancers

We analyzed the data for patients with small cell lung cancer, especially as regards comparison of the results of surgical treatment before and after the introduction of multimodal chemotherapy treatments. Sixty cases with small cell lung cancer were admitted in our department between January, 1955 and December, 1993. Among them, 38 cases underwent pulmonary resection. To evaluate the efficacy of the multimodal treatment including cisplatin with surgical therapy, patients were devided whether pulmonary resection was performed before 1983 (Group A) or after 1984 (Group B). There were no differences in sex and stage between two groups, but ages and operative proceduress were significantly different (p <0.05). Ages were older in Group B (65.5 years) than in Group A (58.1 years) and operations were lesser in Group B (lobectomy or segmentectomy 87.0 %) than in Group A (pneumonectomy or bilobectomy 53.5 %). The operative mortality rates were 13.3 % (2/15) in Group A and 4.3 % (1/23) n Group B. Survival rate at 3 years of Group A was only 6.7 % and no patients survived more than 4 years. While, survival rates of Group B at 3 and 5 years were 24.2 %. The 5 years survival rate of patients with Stage I and II of Group B was 46.9 % and that of Stage III and IV was 8.5%. It is concluded that surgical resection of limited small cell lung cancer (Stage I and II) with intensive chemotherapy is an efficient therapeutic approach

Intraoperative HFJV support during bronchoplasty

High frequency jet ventilation (HFTV) was experimentally studied to ensure intraoperative respiratory support at tracheo-bronchoplasty. On the condition of driving pressure of 5 to 15 PSI and frequency of 100 to 400 during bronch-plastic procedure, HFJV is of great help to shorter the operation time and to secure the anastomosis. And the arterial Po2 and Pco2, and pulmonary hemodynamics were kept satisfactory in the circumstances of intraoperative respiratory suppor