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| 1.
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木下, 敬弘 ; 太田, 安彦 ; 平能, 康充 ; 渡邊, 俊一 ; 小田, 誠 ; 村上, 眞也 ; 渡辺, 洋宇 ; Kinoshita, Takahiro ; Ohta, Yasuhiko ; Hirano, Yasumitsu ; Watanabe, Shun-ichi ; Oda, Makoto ; Murakami, Shinya ; Watanabe, Yoh
概要:
金沢大学医薬保健研究域医学系<br />症例は56歳, 女性.健診にて左下肺野の異常影を指摘された.胸部CTにて肺動静脈瘻が疑われ入院となった.肺動脈造影にて左下葉の動静脈痩は最大径60mm, 流入血管径が8mmと大きいため経皮的カテーテル
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塞栓術 (以下;TAE) は不可能と判断された.また同時に右下葉にも最大径10mmの動静脈瘻を認めたため, これに対してはTAEを施行した.左側の動静脈瘻に対して開胸下に瘻切除術を施行した.<br />A 56-year-woman was admitted to the hospital with an abnormal shadow in the left lower lung field on chest X-ray film. The findings on chest CT examination suggested a pulmonary arteriovenous fistula. Left pulmonary arteriogram showed a large fistula (60 mm) with feeding vessels of 8 mm in diameter in the left lower lobe. It seemed to be impossible to perform embolization because of the size of fistula and its feeding vessels. Right pulmonary arteriogram at the same time revealed a small fistula of 10 mm in diameter in the right lower lobe, which was treated by embolization. The fistula of the left lung was resected on thoracotomy.
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| 2.
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大竹, 由美子 ; 小田, 誠 ; 清水, 淳三 ; 太田, 安彦 ; 林, 義信 ; 川上, 卓久 ; 渡辺, 洋宇 ; 野々村, 昭孝 ; Ohtake, Yumiko ; Oda, Makoto ; Shimizu, Junzo ; Ohta, Yasuhiko ; Hayashi, Yoshinobu ; Kawakami, T. ; Watanabe, Yoh ; Nonomura, Akitaka
概要:
金沢大学医薬保健研究域医学系<br />A 63-year-old male had squamous cell carcinoma in the left upper lobe. CT scan suggested the invasio
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n of the tumor into the vertebral body and the descending aorta. Left pneumonectomy and combined aortic resection under the temporary bypass using Anthron tube was performed. The bypass using Anthron tube provides us no systemic heparinization and the procedure is easy. So the danger of massive bleeding during and after the operation can be decreased and the operative time can also be shortened. This procedure may be a great help for carrying out the operation with combined aortic resection more safely and speedily.
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| 3.
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小田, 誠 ; 金森, 太郎 ; 丸川, 洋平 ; 伊藤, 祥隆 ; 石川, 暢己 ; 田村, 昌也 ; 呉, 哲彦 ; 渡辺, 俊一 ; 太田, 安彦 ; 渡辺, 剛 ; 渡辺, 洋宇 ; Oda, Makoto ; Kanamori, Taro ; Marukawa, Yohei ; Itoh, Y. ; Ishikawa, Y. ; Tamura, Masaya ; Go, Tetsuhiko ; Watanabe, Shun-ichi ; Ohta, Yasuhiko ; Watababe, Go ; Watanabe, Yoh
概要:
金沢大学医薬保健研究域医学系<br />The purpose of this study was to evaluate the results of new TNM staging system for lung cancer in 1
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997, especially T3N0M0, stage IIIA, stage IIIB, and pm. Five-year survival rates of the patients with stage IIIA and stage IIIB were 16% and 18% respectively (NS). Five-year survival rates of patients with T3N1M0, T1N2M0, T2N2M0, and T3N2M0 were 40%, 28%, 15%, and 3%, respectively. The prognosis of T3N2M0 was significantly worse than that of T3N1M0, T1N2M0, and T2N2M0. Five-year survival rates of the patients excluding pm 1 with T4N0M0, T4N1M0, T4N2M0, and T4N3M0 were 21%, 10%, 10%, and 0%, respectively. The prognosis of the patients with T4N0 was significantly better than that of T4N2 and T4N3. In the patients with pm, 5-year survival rates of the patients with pm 1 and pm 2 were 26% and 7%, respectively (p < 0.01). In the patients with pm 1, 5-year survival rates of the patients with N0 + N1 and N1 + N2 were 53% and 16%, respectively (p < 0.01). From our these results, we supported the new TNM system as putting T3N0M0 to stage IIB, putting pm 2 into stage IV. We proposed; 1) chest wall invasion with bone destruction stay in stage IIIA or is T4, 2) T3N1M0 is classified with stage IIB, 3) main stem bronchus invasion is classified with T2, 4) pm 1 is subdivide by N status. Furthermore, stage III seemed to be reasonably subdivided into T1-2N3M0, T4N0-1M0 as stage IIIA and T3-4N2, T1-4N3 as stage IIIB.
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小田, 誠 ; 金森, 太郎 ; 伊藤, 祥隆 ; 石川, 暢己 ; 田村, 昌也 ; 呉, 哲彦 ; 渡辺, 俊一 ; 太田, 安彦 ; 渡辺, 剛 ; 渡辺, 洋宇 ; Oda, Makoto ; Kanamori, Taro ; Itoh, Y. ; Ishikawa, Y. ; Tamura, Masaya ; Go, Tetsuhiko ; Watanabe, Shun-ichi ; Ohta, Yasuhiko ; Watababe, Go ; Watanabe, Yoh
概要:
金沢大学医薬保健研究域医学系<br />The purpose of this study was to evaluate the results of carinal resection for bronchogenic carcinom
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a in our institute. From 1981 to 1999, 24 carinal resection were performed for squamous cell carcinoma (n = 19), adenoid cystic carcinoma (n = 2), small cell carcinoma (n = 1), adenocarcinoma (n = 1), and mucoepidermoid carcinoma (n = 1). Nineteen underwent sleeve pneumonectomy, 2 had carinal resection without lung resection, 2 had carinal resection with right middle and lower lobectomy, and 1 had wedge pneumonectomy. In the patients with sleeve or wedge pneumonectomy, there were 5 operative death and 3 patients had survived for more than 3 years. Two patients with low-grade malignant tumors underwent carinal resection without lung resection and survived more than 10 years. We believe that limited carinal resection for low-grade malignant tumors are safe and valuable procedure. Careful selection of patients with sleeve or wedge pneumonectomy is mandatory.
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滝沢, 昌也 ; 小田, 誠 ; 太田, 安彦 ; 川上, 和之 ; 常塚, 宣男 ; 松本, 勲 ; 田村, 昌也 ; 谷内, 毅 ; 渡辺, 剛 ; 高仲, 強 ; 西嶋, 博司 ; 松井, 修 ; Takizawa, Masaya ; Oda, Makoto ; Ohta, Yasuhiko ; Kawakami, Kazuyuki ; Tsunezuka, Yoshio ; Matsumoto, Isao ; Tamura, Masaya ; Yachi, Tsuyoshi ; Watanabe, Go ; Takanaka, Tsuyoshi ; Nishijima, Hiroshi ; Matsui, Osamu
概要:
金沢大学医薬保健研究域医学系<br />We evaluated the efficacy of perioperative targeting brachytherapy for lung cancer invading the ches
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t wall. Between 1998 and 2003, 7 patients underwent perioperative targeting brachytherapy for lung cancer invading the chest wall. There were 5 male and 2 female patients. The mean age was 63.3 years, with a range of 45 to 77 years. All patients underwent complete resection including the chest wall combined resection. During the operation, plastic afterloading catheters fixed on the Vicryl mesh at interval of 1 cm were placed on the site of chest wall resection. From the third to sixth day after the operation, 15 to 32 Gy of radiation was delivered over 3 or 4 days using a high dose rate remote afterloading system. The area targeted for brachytherapy was determined by a computed tomography (CT) scanner translator with a computer program for radiation planning. The median postoperative hospital stay was 35 days. Local recurrences were observed in 2 patients, but there was no evidence of recurrence in the margin of the resected chest wall. We believe that this short period of treatment and the low side effects enhances the quality of the patients. Prevention of local recurrence was achieved in short term follow-up.
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| 6.
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太田, 安彦 ; 清水, 洋介 ; 加藤, 陽介 ; 松本, 勲 ; 田村, 昌也 ; 小田, 誠 ; 湊, 宏 ; 渡辺, 剛 ; Ohta, Yasuhiko ; Shimizu, Yosuke ; Kato, Yosuke ; Matsumoto, Isao ; Tamura, Masaya ; Oda, Makoto ; Minato, Hiroshi ; Watanabe, Go
概要:
金沢大学医薬保健研究域医学系<br />This retrospective analysis was undertaken to review our results of treatment of lung cancers with i
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nvasion of non-apical and non-vertebral chest wall structures. In summary of our experience, although relatively good prognosis can be expected in N0M0 patients with the histological type of adenocarcinoma by initial operation, distant relapse remains a major problem of the disease. Furthermore, our results are in agreement with the idea that postoperative adjuvant therapy is of little value in patients with complete resection. To ameliorate surgical outcomes, induction treatment should be considered and preoperative staging assessment needs to be strictly done for proper selection of patients with this locally advanced disease. The indication of initial operation needs to be cautiously determined for patients with this disease.
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| 7.
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太田, 安彦 ; Ohta, Yasuhiko
概要:
取得学位 : 博士（医学）, 学位授与番号 : 医博甲第1022号,学位授与年月日：平成4年3月25日,学位授与年：1992
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Watanabe, Yoh ; Oda, Makoto ; Shimizu, Junzo ; Hayashi, Yoshinobu ; Ohta, Yasuhiko ; Iwa, Takashi ; Tonami, Norihisa ; Hisada, Kinichi
概要:
金沢大学医薬保健研究域医学系<br />In a group of 27 patients with early hilar lung cancer, standard sleeve lobectomy was performed in 1
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4 cases, standard lobectomy in 9 cases, and another 4 patients underwent parenchymal-sparing operations (2 had sleeve segmentectomy, 1 had sleeve middle lobectomy, and 1 had left second carinal resection). The changes of conventional pulmonary function tests and regional pulmonary function were compared between patients undergoing sleeve lobectomy and those undergoing parenchymal-sparing surgery. The parameters used for the conventional lung function tests were FVC, %FVC, FEV1.0, and %FEV1.0. For the evaluation of regional pulmonary function, perfusion scans using 99mTc-MAA and ventilation scans using 133Xe were performed. The decrease of FVC in the sleeve lobectomy group (n = 5) was 724 +/- 182.7 ml, whereas that in the parenchymal- sparing surgery group (n = 4) was 367.5 +/- 52.1 ml, a significant difference. Both the FEV1.0 and %FEV1.0 showed no marked changes in both groups between the preoperative and postoperative values. Perfusion and ventilation scans in the parenchymal-sparing group showed a superior result in comparison with sleeve lobectomy group. All the patients undergoing parenchymal-sparing operations survived over the long term. It was thus concluded that parenchymal-sparing surgery can be applied to carefully selected patients with tiny localized cancers.
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| 9.
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Ishikawa, Norihiko ; Sun, You Su ; Nifong, L. Wiley ; Oda, Makoto ; Ohta, Yasuhiko ; Watanabe, Go ; Chitwood Jr., W. Randolph
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金沢大学大学院医学系研究科<br />Introduction: The operator performing minimally invasive surgery is prevented from seeing the whole f
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ield with both eyes by the restricted small thoracotomy incision. To overcome this problem, we developed mirror glasses. Methods: Use of these glasses was evaluated in terms of the time required for threading of sutures with endoscopic forceps. Three surgeon ligated thread a suture five times with and without use of the glasses in the box, and the mean time was calculated for each surgeon. Results: The time required for ligation (mean ± SD) was 24.2 ± 2.9 s with mirror glasses and 27.0 ± 2.5 s without the glasses (p = 0.01). Conclusion: The mirror glasses may be found useful for fine manipulation for minimally invasive surgery. © 2006 Springer Science+Business Media, LLC
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| 10.
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Ishiguro, Takashi ; Kasahara, Kazuo ; Matsumoto, Isao ; Waseda, Ryuichi ; Minato, Hiroshi ; Kimura, Hideharu ; Katayama, Nobuyuki ; Yasui, Masahide ; Ohta, Yasuhiko ; Fujimura, Masaki
概要:
金沢大学医薬保健研究域医学系<br />Primary malignant tumors of the pulmonary arteries occur infrequently. The clinical presentation and
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diagnostic imaging features of the tumor are usually nonspecific and correct diagnosis is often delayed. In this report, we present a case of pulmonary artery sarcoma. MRI and PET-CT were found to be useful for differentiating the tumor from a thromboembolism. © 2007 The Japanese Society of Internal Medicine.
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