Toshinori Hashizume

Hepatocyte Growth Factor and c-Met/Hepatocyte Growth Factor Receptor in Pulmonary Adenocarcinomas: An Evaluation of Their Expression as Prognostic Markers

The expression of hepatocyte growth factor (HGF) and its receptor, c-Met, was investigated immunohistologically in tissue specimens of patients with a pulmonary adenocarcinoma. The prognosis was significantly worse in the HGF-positive or c-Met-positive patients than in the negative patients. Multivariate analysis showed that c-Met had a significant effect on the prognosis, whereas HGF did not. Our findings suggest that HGF and c-Met play an important role in tumor progression and that c-Met can be a useful prognostic marker for pulmonary adenocarcinomas.

Tracheal reconstruction by esophageal interposition : an experimental study

The purpose of this study was to assess the possibility of reconstructing a circumferential tracheal defect with autogenous esophagus. In 6 mongrel dogs, a circumferential defect involving seven rings of the cervical trachea was reconstructed by interposing pedicled esophagus. A silicone T tube was used as a stent. The vertical limb of the T tube (usually referred to as the horizontal limb when used in humans) was cut shorter after the cervical wound had healed well, and it eventually was buried subcutaneously. Two dogs died 36 days after operation, and 1 died 28 weeks after operation. In no dog was the cause of death related to the operation or to a respiratory tract complication. Two dogs were put to death 4 weeks and 32 weeks after operation. They were well until then, and all the anastomoses between the trachea and the esophagus had healed fully without formation of granulation tissue. One dog is alive and well 14 months after operation. The vertical limb of the T tube retracted into the subcutaneous space, and there is no open cervical wound. Esophageal interposition might be a feasible technique for tracheal replacement in select groups of patients.

Serum Levels of Vascular Endothelial Growth Factor and Cavity Formation in Active Pulmonary Tuberculosis

Background: In active pulmonary tuberculosis, certain cytokines have been postulated to be related to cavity formation, although the detailed mechanism of cavity formation is not yet known. Objective: We examined the relationship between cavity formation in pulmonary tuberculosis and vascular endothelial growth factor (VEGF), which functions as an angiogenesis factor. Methods: Forty-eight patients with active pulmonary tuberculosis were divided into two groups according to cavity formation as evaluated by chest high-resolution computed tomography. We evaluated serum VEGF levels by enzyme immunoassay. Results: Group A (with cavities) was comprised of 22 patients and group B (without cavities) was comprised of 26 patients. The serum levels of VEGF were significantly higher in group B (58.733 ± 21.612 pg/ml) than those in normal individuals (8.739 ± 3.656 pg/ml) and in group A (13.053 ± 8.670 pg/ml) (Mann-Whitney U test, p = 0.0149 and p = 0.0481, respectively). Serum levels of interleukin-8 and tumor necrosis factor-α were not significantly different between the two groups. Conclusion: These findings suggested that increased serum VEGF levels subdue cavity formation in active pulmonary tuberculosis.

Insulin-like growth factor-II as a prognostic factor in pulmonary adenocarcinoma

We stained resected specimens from 117 patients with pulmonary adenocarcinoma for insulin‐like growth factor‐II (IGF‐II) by the avidin‐biotin‐peroxidase (ABC) method and evaluated the usefulness of IGF‐II as a prognostic factor. The patients were classified into the IGF‐II (+) groups showing staining of 1% or more cancer cells (60 patients) and the IGF‐II (−) groups showing staining of <1% (57 patients). The 5‐year survival rate was 22% in the IGF‐II (+) group and 54% in the IGF‐II (−) group (P < 0.01). Our results suggest the usefulness of IGF‐II stainability as a prognostic factor of pulmonary adenocarcinoma.

Transforming Growth Factor-β Isoforms Expressions in Pulmonary Adenocarcinomas as Prognostic Markers

The transforming growth factor (TGF)-β1, TGF-β2 and TGF-β3 expressions were immunohistologically studied in tissues specimens from 120 patients with a pulmonary adenocarcinoma. The results of a univar

Massive hemoptysis due to Mycobacterium fortuitum infection controlled with bronchial artery embolization - a case report.

We reported a case of first reported pulmonary infection due to Mycobacterium fortuitum (M. fortuitum) with massive hemoptysis, successfully treated by bronchial artery embolization (BAE). A 78-year-old male was admitted to our hospital complaining of massive hemoptysis. A biochemical examination and DNA/DNA hybridization revealed M. fortuitum in the culture of his sputum. He was treated by BAE, and antituberculous agents and levofloxacin. The patient remains well without recurrence more than one and a half years after the admission.

A giant mediastinal liposarcoma weighing 3500 g resected with clam shell approach, a case report with review of literature

Highlights • Mediastinal liposarcoma weighing 3500 g could be resected using calm shell approach.• The present study analyzed 61 surgical cases of mediastinal liposarcoma.• Adjuvant therapy did not significantly suppress the recurrence.• Complete resection is the only means to achieve the favorable outcome.

Intratumoral gene expression of 5-fluorouracil pharmacokinetics-related enzymes in stage I and II non-small cell lung cancer patients treated with uracil-tegafur after surgery: A prospective multi-institutional study in Japan

OBJECTIVES This investigation was conducted to assess the use of the intratumoral mRNA expression levels of nucleic acid-metabolizing enzymes as biomarkers of adjuvant chemotherapy for non-small cell lung cancer (NSCLC) using uracil-tegafur in a multi-institutional prospective study. MATERIALS AND METHODS 236 patients with a completely resected NSCLC (adenocarcinoma and squamous cell carcinoma) of pathological stage IA (maximum tumor diameter of 2 cm or greater), IB, and II tumors were given a dose of 250 mg of uracil-tegafur per square meter of body surface area per day orally for two years after surgery. Intratumoral mRNA levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), and thymidine phosphorylase (TP) genes relative to an internal standard, β-actin, were determined using laser-capture microdissection and fluorescence-based real time PCR detection systems. RESULTS AND CONCLUSION Among 5-FU target enzymes, TS was the only one that showed a significant difference in the level of gene expression between the high and low gene expression groups, for both disease-free survival (DFS) and overall survival (OS), when patients were divided according to median values; 5-year DFS rates in high/low TS gene expression were 60.4% and 72.6%, respectively (p=0.050), 5-year OS rates were 78.1% and 88.6%, respectively (p=0.011). Coxs proportional hazard model indicated that the pathological stage and TS gene expression level were independent values for predicting DFS. The TS gene expression level was shown to be an independent predictive factor for DFS in stage I and II NSCLC patients who were treated with uracil-tegafur following surgery.

Laparoscopic Repair of Bochdalek Hernia Into Contralateral Thoracic Cavity

Introduction: Bochdalek hernias in adults rarely become symptomatic. However, once the abdominal organs become incarcerated in Bochdalek hernia, surgery is required to reduce them from the thoracic cavity. Case Description: We present the case of a 71-year-old woman with continuous chest discomfort and spontaneous epigastralgia. Computed tomography demonstrated that the colon and omentum were herniated into the right thoracic cavity through the posterior mediastinum from a left diaphragm defect. We suspected Bochdalek hernia because upper gastrointestinal series radiography showed that the esophageal hiatus was intact. At first, the hernia was unsuccessfully reduced by colonoscopy. Then laparoscopic repair was performed because the abdominal organs were herniated in the thoracic cavity opposite to the hernial orifice. We succeeded in laparoscopic repair and closure of the orifice by direct suturing and diagnosed this diaphragm hernia as Bochdalek hernia. Discussion: Surgical repair should be performed immediately after diagnosis to prevent strangulation or perforation. To the best of our knowledge, this is the first report of adult Bochdalek hernia in which abdominal organs were herniated into the opposite side of the hernial orifice.

Wegener’s Granulomatosis with Unilateral Renal Atrophy

Wegener’s Granulomatosis with Unilateral Renal Atrophy Yoshiyuki Abe a, Masato Nakamurac, Kuninori Suzukia, Toshinori Hashizume a, Kakuro Takada b, Tetsuri Kondo d, Tadahiko Fujino a, Yoshito Ueyama c aDepartment of Respiratory Diseases and b Department of Urology, National Sanatorium Kanagawa Hospital, Ochiai, Kanagawa, and cDepartment of Pathology and dDepartment of Respiratory Medicine, Bohseidai, Isehara, Kanagawa, Japan