[Outcomes of the Critical Pathway for Cooperative Follow-up on Patients with Postoperative Lung Cancer].

Objectives: We introduced the critical pathway (CP) for follow-up on patients with postoperative lung cancer to the staff of the Hyogo Prefectural Awaji Medical Center and regional medical institutions in Japan, in 2010.

Methods And Results: We raised awareness within our hospital and collaborating medical institutes and trained our staff on the CP before introducing it. From May 2013 through October 2023, lung cancer surgery was performed on 460 patients.

[Solitary Pulmonary Metastasis of Pancreatic Cancer Seven Years after Pancreatoduodenectomy That Needed to Differentiate from Primary Lung Cancer].

The indications for resection of pulmonary metastases of pancreatic cancer are controversial even now. We report a 63-year-old woman who was found a pulmonary nodule in the apical area of the left lung by chest computed tomography (CT) seven years after pancreatoduodenectomy for pancreatic cancer. Since the nodule was located adjacent to the left subclavian artery, we performed surgery for diagnosis and treatment without biopsy.

[Ectopic Cervical Thymoma that was Difficult to Differentiate from Thyroid Tumor:Report of a Case].

We report a case of ectopic cervical thymoma that was difficult to differentiate from thyroid tumor. A 69-year-old woman was referred to our hospital with a tumor on the left side of the neck. Fine-needle aspiration cytology could not establish the diagnosis and the surgery was then performed for diagnosis and treatment.

[Experience with Pleural Metastasis from Hepatocellular Carcinoma;Report of a Case].

A 69-year-old man with a ruptured hepatocellular carcinoma(HC) was treated by hepatic transcatheter embolization (TAE) followed by upper segmentectomy of the liver. He developed postoperative intrahepatic recurrence and was treated with transcatheter arterial chemoembolization (TACE) at 6 months and 12 months postoperatively. Furthermore, chest computed tomography (CT) revealed a nodule suspected to be pleural metastasis 12 months postoperatively.

Successful management of threatened aortic rupture late after rib fracture caused by blunt chest trauma.

A 62-year-old man was crushed in a car accident and diagnosed with a fractured left ninth rib, pulmonary and heart contusion, hemopneumothorax, and descending aortic injury based on a computed tomography scan. He underwent chest tube drainage and was intubated for mechanical ventilation because a bone fragment of the ninth rib threatened to penetrate the descending aorta. On the second posttrauma day, computed tomography showed the bone fragment of the ninth rib approaching the descending aorta.

Pulmonary sequestration with high levels of tumor markers tending to be misdiagnosed as lung cancer.

A 62-year-old man with hemoptysis and an abnormal shadow on chest roentgenogram was diagnosed as having anomalous systemic arterial supply to the normal basal segment of the left lower lobe. The preoperative serum carbohydrate antigen 19-9 and carcinoembryonic antigen levels were 73.8 units/ml and 10.

Functional advantage after radical segmentectomy versus lobectomy for lung cancer.

Background: Although several reports have recently demonstrated that segmentectomy for small-sized N0 lung cancer leads to recurrence and survival rates equivalent to those associated with lobectomy, controversy regarding the postoperative functional advantage in the former over the latter still persists. The purpose of this study was to evaluate the degree of postoperative functional loss in patients undergoing segmentectomy or lobectomy for lung cancer.

Methods: We analyzed patients able to tolerate lobectomy, who underwent radical segmentectomy (n = 38) or lobectomy (n = 45) for non-small-cell lung cancer.

Suppression of laser-induced choroidal neovascularization by oral administration of SA3443 in mice.

The effect of a synthetic cyclic disulfide compound, SA3443, on neovascularization was investigated. In vitro, enzyme-linked immunosorbent assay and RT-PCR demonstrated that SA3443 suppressed the expression of the hypoxia-induced vascular endothelial growth factor (VEGF) at both protein and mRNA levels in ARPE-19 cells. In vivo, the administration of SA3443 to mice with laser-induced choroidal neovascularization (CNV) suppressed the leakage from the lesions and reduced their size.

Technique for using the St. Jude aortic connector in anastomosis with a composite graft of saphenous vein and radial artery.

We presented a technique for using the St. Jude Aortic Connector System in anastomosis with a composite graft of saphenous vein and radial artery. This technique has not been reported in the previous literature.

Complications and outcomes after pulmonary resection for cancer in patients 80 to 89 years of age.

Objective: Patients 80 years or older often present with potentially resectable cases of non-small cell lung cancer. Whether such patients should undergo surgical treatment is becoming increasingly important in this rapidly aging society.

Methods: From April 1997 through March 2004, 40 consecutive patients with non-small cell lung cancer who were 80-88 years of age underwent complete resection of their tumors, as confirmed pathologically.

Primary pulmonary myxoma.

We report a case of a primary pulmonary myxoma. The patient was a 69-year-old previously healthy human. Computed tomographic scan demonstrated a well-circumscribed tumor with a diameter of approximately 13 mm in the right upper lobe.

Resection of chest wall invasion in patients with non-small cell lung cancer.

Objective: The treatment of patients with non-small cell lung cancer invading the parietal pleura or chest wall is still debated. It is unsolved whether the depth of chest wall involvement or the type of resection (extrapleural or en bloc) affects long-term survival.

Methods: design, retrospective analysis; setting, Hyogo Medical Center for Adults, patients: the 97 patients who underwent surgical resection for non-small cell lung cancer involving the parietal pleura or chest wall between 1985 and 1997 were reviewed.

Prediction of morbidity after lung resection with risk factors using treadmill exercise test.

Objective: To predict accurate morbidity after lung resection using treadmill exercise test.

Methods: A total of 130 patients (108 men and 22 women, with mean age 67.1+/-11.

Division of the pulmonary ligament after upper lobectomy is less effective for the obliteration of dead space than leaving it intact.

Purpose: To investigate whether division of the pulmonary ligament after upper lobectomy obliterates dead space.

Methods: Thirty-five patients scheduled to undergo upper lobectomy (23 right, 12 left) were randomly assigned to two groups, according to whether the inferior pulmonary ligament was divided (11 right, 12 left) or preserved (6 right, 6 left). To assess upward movement of the nonoperated lobes, plain chest X-ray films (posterior-anterior) were done at end-inspiration preoperatively and 1 month postoperatively, and the ratio of dead space in the longitudinal axis was measured.

Selective segmental jet injection to distinguish the intersegmental plane using jet ventilation.

We used the selective jet injection method under bronchofiberscopy to distinguish the intersegmental plane. This method can reveal the intersegmental line clearly, quickly and easily with a good operative view even through a miniature utility thoracotomy or a thoracoscope, since only the burdened segment and not the entire lobe is inflated.

Subconjunctival administration of bucillamine suppresses choroidal neovascularization in rat.

Purpose: Bucillamine is an antirheumatic drug with antiangiogenic properties that is currently used in clinical practice. Because bucillamine inhibits the production of VEGF, it is possible that this drug may inhibit choroidal neovascularization (CNV). Thus, the effect of bucillamine on the eyes of rats with experimental CNV was investigated in vivo by subconjunctival injection or oral intake.

Inhibitory effect of bucillamine on laser-induced choroidal neovascularization in rats.

Purpose: We investigated the inhibitory effects of bucillamine on formation of laser-induced choroidal neovascularization (CNV) in a rat model.

Methods: Bucillamine administration (approximately 150 mg/kg/day) was started 1 week before photocoagulation and continued to the end of the study. Control groups received drinking water.

Empyema necessitatis into the retroperitoneal space.

Empyema necessitatis is a rare complication of tuberculous empyema. We present a very rare case of empyema necessitatis into the retroperitoneal space through the diaphragm. The fistula between the thoracic empyema cavity and the retroperitoneal abscess was clearly identified by magnetic resonance imaging.

Mediastinal angioleiomyoma.

We report a case of a mediastinal angioleiomyoma. The patient was a 64-year-old previously healthy man. Computed tomographic scan revealed a well-circumscribed tumor with a diameter of approximately 2 cm in the right anterior mediastinum.

Efficacy of a pedicled pericardial fat pad fixed with fibrin glue on postoperative alveolar air leakage.

The purpose of this randomized trial was to investigate the effect of using a pedicled pericardial fat pad fixed with fibrin glue on postoperative alveolar air leakage. Thirty consecutive patients with lung cancer, who had moderate alveolar air leaks after pulmonary resection, were randomized into two groups: in group A fibrin glue was applied onto the surface of the leaking raw lung and in group B, after applying fibrin glue in the same manner as in group A, a pedicled pericardial fat pad was immediately fixed to the leaking lung surface with fibrin glue. The duration of the postoperative air leakage and chest tube drainage was recorded.