Papers - AYABE Takanori
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肺癌の上腕骨移転に対し、化学療法後に切除を行い長期生存中の１例. Reviewed
原 政樹, 松崎泰憲, 清水哲哉, 富田雅樹, 綾部貴典, 鬼塚敏男
Japanese Journal of Lung Cancer 45 ( 7 ) 829 - 832 2005.5
Language：Japanese Publishing type：Research paper (scientific journal)
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Clinical assessment of the thoracic surgical diseases associated with von Recklinghausen's disease
Ayabe T., Matsuzaki Y., Edagawa M., Shimizu T., Hara M., Ninomiya H., Ogata K., Onitsuka T.
Kyobu geka. The Japanese journal of thoracic surgery 58 ( 3 ) 219 - 225 2005.3
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Kyobu geka. The Japanese journal of thoracic surgery
Type I neurofibromatosis (NF-I), also referred to as von Recklinghausen's disease, is an autosomal dominant disease characterized by neurofibromas and abnormal cutaneous pigmentation (café-au-lait spot). We studied retrospectively the 8 cases operated in our hospital between January 1979 to December 2002, which were complicated with von Recklinghausen's disease and a thoracic surgical disease. The patients were 6 males and 2 females and the age from 16 to 70 (the averaged age was 36 +/- 22). The thoracic diseases were consist of mediastinal tumors (n = 7) and esophageal cancer (n = 1). The operative procedures were tumorectomy (n = 6), subtotal esophagectomy (n = 1), and pericardial cystectomy (n = 1). The mediastinal tumors were neurofibroma (n = 3), malignant schawannoma (n = 1), ganglioneurinoma (n = 2), and pericardial cyst (n = 1). Malignant neoplasms were recognized in 2 cases (25%). The postoperative survival was 10 months for malignant schwannoma, and 8 months for esophageal cancer, and the others were alive. For 1 case of neurofibromas, there was observed to be the reoperated one after the postoperative recurrence. von Recklinghausen's disease are apt to be complicated with thoracic surgical neoplasms, it should be required a careful and systemic exploration especially for malignant neoplasms.
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純赤芽球癆と重症筋無力症を合併した胸腺腫. Reviewed
綾部貴典, 松崎泰憲, 枝川正雄, 清水哲哉, 原 政樹, 富田雅樹, 秋山 裕, 鬼塚敏男
胸部外科 58 ( 6 ) 1023 - 1031 2005.2
Language：Japanese Publishing type：Research paper (scientific journal)
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Tomita M., Matsuzaki Y., Shimizu T., Hara M., Ayabe T., Onitsuka T.
Respirology 10 ( 1 ) 31 - 35 2005.1
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Respirology
Objective: Although several previous studies have investigated the prognostic significance of vascular endothelial growth factor (VEGF) expression in non-small cell lung (NSCL) cancer, no previous study has concentrated on NSCL cancer with pathologically abnormal mediastinal nodes (pN2). Methodology: A total of 60 patients with pN2 NSCL cancer who had undergone a complete resection with a systematic mediastinal lymph node dissection were reviewed retrospectively. Immunohistochemical examination, using antibodies against VEGF, was conducted. The prognostic significance of VEGF expression and clinicopathological factors were analysed. Results: The overall 5-year survival rate was 21.7%. With respect to clinicopathological factors, single N2 involvement and skip metastasis were significantly associated with patients' survival. Expression of VEGF was found in 35/60 (58.3%) patients. VEGF expression was not related to the clinicopathological parameters examined. There was no relationship between survival rates and patients positive and negative for VEGF. Multivariate analysis showed that single N2 disease was an independent prognostic factor, while VEGF expression was not. Conclusions: Although VEGF expression might be important for tumour development and maintenance, no prognostic significance of VEGF expression in pN2 NSCL cancer was found.
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Bilateral lower lobectomies for pulmonary mucormycosis
Ayabe T., Matsuzaki Y., Edagawa M., Shimizu T., Hara M., Ninomiya H., Yamashita A., Marutsuka K., Onitsuka T.
Kyobu geka. The Japanese journal of thoracic surgery 57 ( 13 ) 1185 - 1190 2004.12
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Kyobu geka. The Japanese journal of thoracic surgery
Mucormycosis is an extremely rare case of pulmonary mycosis, its prognosis is very poor, and known as an opportunistic infection among immunocompromised hosts accompanied with other primary chronic disease. We report here a case of bilateral lower lobectomies carried out by two-stage operation for pulmonary mucormycosis combined with diabetes mellitus (type I) and severe resistance to an antimycobiotics under biblicographical considerations. A 36-year-old female was diagnosed as a diabetes mellitus (type I), and has been administrated with an insulin injection in 1989 at the age of 22-year-old. The patient was suffered a dry cough in June and the bilateral abnormal shadows were pointed out by the chest X-ray film in November, 2002. By transbronchial lung biopsy, Mucor fungus was confirmed in grannulomatous lung specimen. Intravenous injection of amphotericin B could not be continued due to the unavoidable side-effects from this agent. As the lung mass shadow was enlarged increasing and strongly suggested an abscess, formation in its focus, and then the left lower lobectomy was performed as the first step of surgical treatment and the right lower lobectomy was done on the postoperative forty-fourth day as the second step. The postoperative prognosis was considerably uneventful. After bilateral lower lobectomies, the patient could try a walk and go upstairs with a moderate dyspnea. A possible surgical resection should be conducted for the pulmonary mucormycosis, when the medicinal therapy showed an uneffectiveness and/or an infectious lesion was shown as restricted lesion.
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[Bilateral lower lobectomies for pulmonary mucormycosis].
Ayabe T, Matsuzaki Y, Edagawa M, Shimizu T, Hara M, Ninomiya H, Yamashita A, Marutsuka K, Onitsuka T
Kyobu geka. The Japanese journal of thoracic surgery 57 ( 13 ) 1185 - 90 2004.12
Language：Japanese Publishing type：Research paper (scientific journal)
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Intrapleural hyperthermic perfusion with chemotherapy increases apoptosis in malignant pleuritis
Matsuzaki Y., Edagawa M., Shimizu T., Hara M., Tomita M., Ayabe T., Onitsuka T.
Annals of Thoracic Surgery 78 ( 5 ) 1769 - 1772 2004.11
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Annals of Thoracic Surgery
Background Previously, we reported on the effectiveness of intrapleural hyperthermic perfusion with chemotherapy, a new treatment we developed for patients with malignant pleuritis. The present study analyzes the mechanism of the effectiveness of this therapy by examining the induction ratio of apoptosis among tumor cells following the perfusion treatment. Methods This study included 11 consecutive patients with primary pulmonary adenocarcinoma and accompanying pleural seedlings and pleural effusions containing tumor cells but without distant metastasis. All patients underwent surgical resection of the primary lesion and then received sequential perfusion treatment. Tumor cells collected from the effusion both before and again at 24 hours following the perfusion treatment were subsequently examined using an immunocytochemical stain to determine apoptosis among tumor cells. The percentage of positively stained cells was expressed as the apoptotic index. We compared the survival rate of these 11 patients with the survival rate of a second group of 11 patients with malignant pleuritis who underwent surgical resection of the primary lesion but who did not receive the perfusion treatment (control group). Results The ratio of spontaneous apoptosis of untreated tumor cells was 2.8% ± 2.0%. Following the perfusion, apoptosis among tumor cells was 25.2% ± 4.6%, clearly a significant increase. While the median survival time for patients receiving the perfusion treatment was 20 months, the median survival time for the control group was 6 months. Conclusions In patients with malignant pleuritis, intrapleural hyperthermic perfusion with chemotherapy induced potent apoptosis of tumor cells in the pleural cavity and also improved the survival rate of these patients as compared with patients who did not receive the perfusion treatment. © 2004 by The Society of Thoracic Surgeons.
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Thymothymectomy for the thymoma with pure red cell aplasia; report of a case
Ayabe T., Matsuzaki Y., Edagawa M., Shimizu T., Hara M., Ninomiya H., Onitsuka T.
Kyobu geka. The Japanese journal of thoracic surgery 57 ( 9 ) 905 - 909 2004.8
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Kyobu geka. The Japanese journal of thoracic surgery
We report a case of thymothymectomy for the thymoma with pure red cell aplasia (PRCA). A 31-year-old male with a general fatigue had a severe anemia (hemoglobin 3.1 g/dl) since November 1997. By the bone marrow examination, PRCA was diagnosed and treated with blood transfusion and immunosuppressive drug (cyclosporin: CYA) administration but anemia had not been improved. The chest computed tomography displayed a 3 cm in a diameter of thymoma located in the anterior mediastinum. The extended thymothymectomy had been performed in February 1998, pathological detection disclosed Masaoka classification stage I, type AB was diagnosed due to the World Health Organization (WHO) classification. PRCA had not obtained an immediate remission during the postoperative-early term, while, adjuvant therapy (CYA 300 mg/day) has been continued and it brought a complete remission of PRCA in August 2001 (after the postoperative 3 years and 6 months later). Conclusions: Even though only thymothymectomy for thymoma with PRCA showed no effectiveness for the postoperative-early remission of PRCA, however, the combination of thymectomy and the postoperative adjuvant therapy (CYA) should bring a better outcome, and the continuous follow-up would be required for a long postoperative term.
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Ayabe T., Tomita M., Matsuzaki Y., Ninomiya H., Hara M., Shimizu T., Edagawa M., Onitsuka T., Hamada M.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 10 ( 3 ) 152 - 159 2004.6
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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.
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破裂性腹部大動脈瘤術後に合併した急性腎不全治療の経験. Reviewed
綾部貴典, 福島靖典, 矢野義和, 吉岡 誠, 鬼塚敏男
宮崎県医師会医学会会誌 28 ( 1 ) 63 - 67 2004.5
Language：Japanese Publishing type：Research paper (scientific journal)
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純赤芽球癆を合併した胸腺腫の１例. Reviewed
綾部貴典, 松崎泰憲, 枝川正雄, 清水哲哉, 原 政樹, 二宮浩範, 鬼塚敏男
胸部外科 57 ( 9 ) 905 - 910 2004.5
Language：Japanese Publishing type：Research paper (scientific journal)
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Micrometastasis and expression of nm23 messenger RNA of lymph nodes from lung cancer and the postoperative clinical outcome Reviewed
Takanori Ayabe, Masaki Tomita, Yasunori Matsuzaki, Hironori Ninomiya, Testuya Shimizu, Masao Edagawa, Masaki Hara, Toshio Onitsuka, and Minoru Hamada
Ann Thoracic Cardiovasc Surg 10 152 - 159 2004.4
Language：English Publishing type：Research paper (scientific journal)
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肺ムコール症に対する両側下葉切除. Reviewed
58. 綾部貴典, 松崎泰憲, 枝川正雄, 清水哲哉, 原 政樹, 二宮浩範, 山下 篤, 丸塚浩助, 鬼塚敏男
胸部外科 57 ( 13 ) 1185 - 1190 2004.2
Language：Japanese Publishing type：Research paper (scientific journal)
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"The law of 3": prognostic parameters for resectsd metastatic pulmonary tumors. Reviewed
63. Matsuzaki Y., Shimizu T., Edagawa M., Hara M., Tomita M., Ayabe T., Onitsuka T.
Ann. Thorac. Cardiovasc. Surg., 9(5): 290-294, (2003) 9 ( 5 ) 290 - 294 2003.12
Language：English Publishing type：Research paper (scientific journal)
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慢性膿胸に対する外科的治療法の臨床的検討 - 大網充填法を中心に - . Reviewed
綾部貴典, 吉岡 誠, 福島靖典, 松崎泰憲, 鬼塚敏男
胸部外科 56 ( 12 ) 989 - 996 2003.12
Language：Japanese Publishing type：Research paper (scientific journal)
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"The Law of 3": prognostic parameters for resected metastatic pulmonary tumors.
Matsuzaki Y., Shimizu T., Edagawa M., Hara M., Tomita M., Ayabe T., Onitsuka T.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 9 ( 5 ) 290 - 294 2003.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
Metastatic tumors from various organs are found in pulmonary tissue because of the unique anatomical function of the lungs as a filter for systemic venous return. A retrospective study of the clinical factors used to assess the prognosis of 80 patients who underwent resections of metastatic pulmonary tumors in our surgical department between September 1978 and December 2002 is presented. The overall 5-year survival rate in our study was 31.7%. We demonstrated four significant factors used in predicting the prognosis of patients with resected metastatic pulmonary tumors: diameter of the tumor (</=3.0 cm or >3.0 cm), number of tumors (</=3 or >3), disease-free interval (>/=3 years or <3 years), and ratio of the diameter of the largest tumor to the diameter of the smallest tumor in patients with multiple metastases (</=3 or >3). Based on our results, we have applied the term "the law of 3" to these valuable prognostic factors. Among these parameters, the ratio of the diameter of the largest to the diameter of the smallest tumor may be applicable as a new prognostic parameter for surgery in patients with multiple foci. (Ann Thorac Cardiovasc Surg 2003; 9: 290-4)
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Clinical study on the surgical cases of the ruptured thoracic aortic aneurysm
Ayabe T., Nakamura K., Yano M., Onitsuka T.
Kyobu geka. The Japanese journal of thoracic surgery 56 ( 7 ) 555 - 559 2003.7
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Kyobu geka. The Japanese journal of thoracic surgery
The prognosis of the ruptured thoracic aortic aneurysm is poor. Even if the surgical treatment was performed, the clinical outcome does not sufficiently satisfy us. Between January 1978 to July 1999, 171 cases of thoracic aortic surgery were operated in our department, in which 12 patients were with the ruptured thoracic aortic aneurysm without acute dissection. The aneurysm was located in ascending aorta (2), aortic arch (6), descending aorta (3), and thoracoabdominal aorta (1). The aneurysm was ruptured into thorax (4), pericardium (2), mediastinum (3), lung (2), and esophagus (1). The operative procedure was artificial vascular graft replacement (9), patch closure (2), and aneurysmal interposition (1) [bypass with ascending aorta to abdominal aorta)]. The operations were performed during hypothermic circulatory arrest with antegrade selective cerebral perfusion (6), under total (1) or partial complete extracorporeal circulation (5). The hospital death was 33% (4/12). The causes of death were cerebral complication (2), sepsis (1), and multiple organ failure (1). The 12 patients were divided into 2 groups: group A; 8 cases with alive; group D; 4 cases with hospital death. We compared and analyzed the perioperative factors of these 2 groups. On intraoperative factors, operation time (minute) demonstrated a significant difference (498 +/- 129 in group A v.s. 851 +/- 227 in group D, p < 0.05). No significant difference was observed between the groups on extracorporeal circulation time, aortic clumping time, selective cerebral perfusion time, systemic circulatory arrest time, intraoperative blood loss, and blood transfusion. The postoperative major complication was revealed in 6 cases (50%, 6/12), cerebral infarction (3), sepsis (2), and hoarsness (1). In conclusions, to make an effort to shorten an operative time as possible, and to prevent the postoperative neurological dysfunction under selective cerebral perfusion, those efforts should contribute to a good postoperative outcome for the ruptured thoracic aortic aneurysm.
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心筋梗塞に合併した後心室中隔穿孔に対する急性期Daggett手術の経験. Reviewed
綾部貴典, 福島靖典, 帖佐英一, 吉岡 誠, 鬼塚敏男
宮崎県医師会医学会会誌 27 ( 1 ) 54 - 57 2003.5
Language：Japanese Publishing type：Research paper (scientific journal)
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下腹壁動脈をcomposite graftとして使用したCABG (特集). Reviewed
綾部貴典, 福島靖典, 吉岡 誠, 鬼塚敏男
胸部外科 56 ( 9 ) 731 - 741 2003.5
Language：Japanese Publishing type：Research paper (scientific journal)
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破裂性胸部大動脈瘤手術症例の臨床検討. Reviewed
綾部貴典, 中村都英, 矢野光洋, 鬼塚敏男
胸部外科 56 ( 7 ) 555 - 559 2003.5
Language：Japanese Publishing type：Research paper (scientific journal)