Pulmonary mucosa-associated lymphoid tissue lymphoma forming a reversed halo sign from ground-glass opacity.

The reversed halo sign (RHS) has been associated with various pulmonary diseases. We report a rare case of pulmonary mucosa-associated lymphoid tissue lymphoma forming a RHS from a ground-glass opacity (GGO). A 73-year-old man was followed-up for the GGO on his computed tomography images, which gradually extended peripherally.

Skin marking with computed tomography at functional residual capacity to predict lung nodule site.

Various marking techniques for lung nodules may be complex and can cause serious complications. In this study, we aimed to describe and evaluate the feasibility of CTFRC marking, a novel preoperative skin marking technique guided by computed tomography (CT) at functional residual capacity (FRC). This simple and non-invasive marking technique only requires a preoperative CT scan without any anaesthesia.

Successful treatment of late onset empyema after extrapleural pneumonectomy: A case report.

Treatment of post-extrapleural pneumonectomy empyema (PEPPE) is more difficult than that for post-pneumonectomy empyema for two reasons: first, a large infectious dead space remains after extrapleural pneumonectomy (EPP); and second, defects of the pericardium and diaphragm are reconstructed with artificial materials, which ideally should be removed for treatment of infection. Here, we report the case of a 56-year-old male with PEPPE that occurred long after EPP for mesothelioma. The patient was treated successfully by minimally invasive procedures of irrigation, instillation of urokinase and antibiotics, and surgical debridement without peeling off artificial materials.

Pulmonary vein thrombosis after lobectomy with vein stump closure by ligation.

Objectives Thrombosis in the pulmonary vein stump after a left upper lobectomy is a rare but potentially life-threatening complication, and the pulmonary vein stump length plays an important role here. We assessed the frequency and risk factors for thrombosis in patients undergoing lobectomy with division of the superior pulmonary vein using ligation. Methods We retrospectively reviewed 425 patients with primary lung cancer who underwent lobectomy or bilobectomy in our institution from 2008 to 2016, with contrast-enhanced chest computed tomography within a year after lobectomy.

Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015.

Objectives: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery.

Methods: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015.

[Japanese Board Certified Thoracic Surgeon].

The Japanese Board of General Thoracic Surgery (JBGTS) consisted by Japanese Association of Chest Surgery (JACS) and The Japanese Association of Thoracic Surgery (JATS) has been certified Japanese Board Certified Thoracic Surgeon (JBCTS) since 2004. At present, JBCTS is obtained by being of Certified Surgeon by Japan Surgical Society( JSS), completion of minimum requirement of surgical experience, scientific papers, presentation at medical assembly, learning of postgraduate educational programs, and examination approximate 11 years after graduation of medical school. Thirteen hundreds JBCTS throughout Japan are engaged in operation for 77,000 cases/year, including 38,000 lung cancer patients/year.

Development of an annually updated Japanese national clinical database for chest surgery in 2014.

Objectives: A national clinical database (NCD) adopted an "Internet-based collection" in 2011. An NCD specializing in chest surgery was launched based on the NCD system in 2014. The system was linked to the board certification as the second level in the hierarchy of the specialty of chest surgery and accreditation of educational institutions for chest surgery.

Complications of bronchial stapling in thoracic surgery.

Objective: The use of staplers for thoracic surgery has been widely accepted and regarded as a safe procedure. However, complications of stapling are occasionally experienced. The aim of this retrospective study was to analyze complications of bronchial stapling.

[Clinical characteristics after surgery of non-small cell lung cancer which measures 20 mm or less in diameter].

Today's advances in diagnostic image-technologies often enable us to find small lung cancers. However, we have few definite strategies including how to diagnosis and treat them. In this study, we performed a retrospective analysis of 122 consecutive patients who underwent surgery for non-small cell lung cancer 20 mm or less in diameter to clarify the clinical features of small lung cancer.

[Surgical and bronchoscopic treatment for COPD].

Lung volume reduction surgery (LVRS) has been proved as the safe, effective, and durable treatment which improves life-span, exercise tolerance, QOL, and dyspnea in patients with severe COPD selected appropriately by distribution of emphysema (upper lobe vs non-upper lobe) and exercise capacity(low vs high) through the National Emphysema Treatment Trial (NETT) as well as previous or concurrent reports of clinical studies. However, this procedure has not always been offered to those patients who might benefit from it these years because of significant morbidity and mortality during perioperative period and in part because of misleading in early results of the trial. On the other hand, nonsurgical procedures, such as endobronchial valve to intend collapse of the emphysematous lung, extra-anatomical airway bypass to eliminate excessive residual lung volume, and remodeling of emphysematous lung with biological adhesives or vapor ablation have been proposed as alternative treatments for emphysema recently.

The diaphragm: a hidden but essential organ for the mammal and the human.

The diaphragm is the only organ which only and all mammals have and without which no mammals can live. The human is the only mammal which keeps the diaphragm parallel to the ground even during locomotion. Abdominal breathing mode maximizes the diaphragmatic motion using abdominal muscles, and control precisely exhaled air velocity.

Sudden hemothorax following lobectomy caused by staple.

A 74-year-old female with lung cancer underwent a right lower lobectomy by video-assisted thoracic surgery (VATS), and suddenly developed hemothorax soon after discharge. The bleeding point was an intercostal artery which faced a stump of the right lower vein divided by a stapler. Operative finding suggested that it was caused by an incidental injury of the artery by a staple.

Diaphragmatic elevation of a patient with chronic obstructive pulmonary disease after left upper lobectomy.

Among postoperative pleural space problems after pulmonary resections, it is more difficult and troublesome to manage this space after left upper lobectomy in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective study focusing on the elevation of ipsilateral hemidiaphragm of the 36 patients with or without COPD after left upper lobectomies, by measuring diaphragmatic dome length (DDL) with a plain posteroanterior roentgenogram. They were divided into two groups: group I (forced expiratory volume in 1 s (FEV1) % predicted < 70%, n = 5); and group II (FEV1) % predicted > or = 70%, n = 31).

[A case of hypersensitivity pneumonitis caused by zinc fume].

A 55-year-old man with a 3-year occupational history of welding was admitted for repeated episodes of fever, cough and dyspnea after inhalation of smoke while welding galvanized steel. A computed tomography (CT) showed diffuse centrilobular nodules, panlobular ground-glass opacity and interlobular septal thickening in both lung fields, and he suffered from hypoxemia (PaO2 = 55.3Torr) while breathing room air.

[Intrapulmonary bronchogenic cysts].

Bronchogenic cysts are commonly found in the mediastinum, but occasionally in lung parenchyma. We report 3 patients with intrapulmonary bronchogenic cysts. A female presented back pain and a large cystic lesion with an air-fluid level on chest X-ray and computed tomography (CT).

[Can video-assisted thoracoscopic surgery change the indication of lung resection for patients with lung cancer?].

Video-assisted thoracoscopic surgery (VATS) is associated with reduced pain, postoperative complications, release and responses of proinflammatory cytokines, and better ventilatory function during very early postoperative period after lung resection than standard thoracotomy. Because of the concern of local recurrence with pulmonary wedge resection by thoracotomy, anatomical lobectomy remains the curative procedure for lung cancer. However, same or better prognosis with a lesser resection by extended segmentectomy or wedge resection with VATS in patients with small lung cancer has been recently published.

Position of a chest tube at video-assisted thoracoscopic surgery for spontaneous pneumothorax.

Background: Video-assisted thoracoscopic surgery (VATS) is a good therapeutic option for young patients with primary spontaneous pneumothorax (PSP), but there sometimes exists unexpected prolonged hospital stay due to air leak after the operation.

Objectives: The goal of this retrospective study was to clarify if the position of the chest tube placed at VATS for PSP affected the periods of postoperative hospital stay.

Methods: Seventy-one cases with PSP under age 40 who undertook VATS from January 1994 to February 2001 were examined for several factors.

[Placement of an ultraflex nitinol stent for severe tracheobronchial obstruction in a case of relapsing polychondritis].

A 59-year-old man, who had been treated for bronchial asthma since 2000, was hospitalized with high fever and productive cough in November 2003. Chest radiography on admission showed consolidations in both lower lung fields, and computed tomography demonstrated anteroposterior narrowing of both main bronchi. A physical examination revealed deformity of auricular cartilage and saddle nose, and we diagnosed him relapsing polychondritis (RP).

Pericardial metastasis of myxoid liposarcoma causing cardiac tamponade.

Although myxoid liposarcoma often metastasizes to various organs, cardiac metastasis is rare. We present herein a rare case with pericardial metastasis of myxoid liposarcoma, which expanded the pericardial sac extraordinarily and required an emergency operation because of acute cardiac tamponade. We undertook a review of the English literature regarding liposarcoma.

Rapid occurrence of pulmonary aspergillosis after pulmonary wedge resection.

A 61-year-old man with diabetes mellitus undertook wedge resection of pulmonary tuberculoma in the left upper lobe. He was discharged uneventfully. However, he became febrile with productive cough five weeks after the discharge, and was readmitted.

Successful thoracoscopic debridement of descending necrotizing mediastinitis.

Descending necrotizing mediastinitis results from odontogenic, deep neck infection that spreads along fascial planes into the mediastinum. Although the optimal surgical approach remains controversial, nearly half of the cases require mediastinal debridement by thoracotomy. We report a case of successful thoracoscopic debridement for descending necrotizing mediastinitis due to odontogenic infection that failed to be drained by transcervical approach.