Case of thoracoscopic right upper lobectomy for lung cancer with tracheal bronchus and a pulmonary vein variation

A 58-year-old woman visited our hospital with the chief complaint of an abnormal chest shadow. Chest CT showed an 18-mm ground-glass opacity in the right upper lobe, which became enlarged over time, and lung cancer was suspected. At the same time, a tracheal bronchus originating directly from the trachea was observed. She underwent thoracoscopic right upper lobectomy and mediastinal lymph node dissection. During surgery, in addition to the tracheal bronchus, a pulmonary vein variation was seen running dorsal to the pulmonary artery. Her postoperative course was uneventful. Tracheal bronchus is a rare anomaly, with an incidence of 0.1%-5%. Since tracheal bronchus is often accompanied by pulmonary vessel variations and may be associated with repeated previous infections, care should be taken when performing thoracoscopic lung resection.

Quantitative measurement of hard x-ray spectra for high intensity laser produced plasma

X-ray line spectra ranging from 17 to 77 keV were quantitatively measured with a Laue spectrometer, composed of a cylindrically curved crystal and a detector. Either a visible CCD detector coupled with a CsI phosphor screen or an imaging plate can be chosen, depending on the signal intensities and exposure times. The absolute sensitivity of the spectrometer system was calibrated using pre-characterized laser-produced x-ray sources and radioisotopes. The integrated reflectivity for the crystal is in good agreement with predictions by an open code for x-ray diffraction. The energy transfer efficiency from incident laser beams to hot electrons, as the energy transfer agency for specific x-ray line emissions, is derived as a consequence of this work.

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following carboplatin-paclitaxel administration in a patient with lung cancer

A 60-year-old female underwent right upper lobectomy of the lung and lymph node dissection under a diagnosis of cancer in the upper lobe of the right lung. Pathological examination showed stage IIIA adenocarcinoma with mediastinal lymph node metastasis. One month after the operation, adjuvant chemotherapy with carboplatin (CBDCA) and paclitaxel (PTX) was initiated. Four days after the chemotherapy, hyponatremia progressed, and central nervous system disorder developed. A diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was made. She recovered after fluid intake restriction and electrolyte correction. SIADH was considered to be due to the adverse effects of anticancer drugs. In postoperative adjuvant chemotherapy, attention should be paid to the serum Na level.

Intrapulmonary schwannoma in the right middle lobe: a case report

Herein, we report a patient with a rare disease, intrapulmonary schwannoma. The patient was a 61-year-old woman who had a 20 mm × 18 mm nodule, with a clear boundary and homogeneous content, on the central side of S4 in the right lung on chest CT. On PET with 18- fluorodeoxyglucose scanning, 18-fluorodeoxyglucose accumulations with a maximal standardized uptake value of 2.5 and 3.3 were observed in the early and late phases, respectively, suggesting a malignant tumor. A thoracoscopic right middle lobectomy was performed because the tumor was present in the segmental bronchial region of the middle lobe. Intrapulmonary schwannoma accounts for 0.2% of lung tumor cases, and cases involving patients who have undergone preoperative PET with 18- fluorodeoxyglucose scanning have rarely been reported.

Efficient multi-keV x-ray generation from a high-Z target irradiated with a clean ultra-short laser pulse

Kα line emissions from Mo and Ag plates were experimentally studied using clean, ultrahigh-intensity femtosecond laser pulses. The absolute yields of Kα x-rays at 17 keV from Mo and 22 keV from Ag were measured as a function of the laser pulse contrast ratio and irradiation intensity. Significantly enhanced Kα yields were obtained for both Mo and Ag by employing high contrast ratios and irradiances. Conversion efficiencies of 4.28×10⁻⁵/sr for Mo and 4.84×10⁻⁵/sr for Ag, the highest values obtained to date, were demonstrated with contrast ratios in the range 10⁻¹⁰ to 10⁻¹¹.

Heuristic optimization in penumbral image for high resolution reconstructed image

Penumbral imaging is a technique which uses the fact that spatial information can be recovered from the shadow or penumbra that an unknown source casts through a simple large circular aperture. The size of the penumbral image on the detector can be mathematically determined as its aperture size, object size, and magnification. Conventional reconstruction methods are very sensitive to noise. On the other hand, the heuristic reconstruction method is very tolerant of noise. However, the aperture size influences the accuracy and resolution of the reconstructed image. In this article, we propose the optimization of the aperture size for the neutron penumbral imaging.

A case of G-CSF-producing invasive apical cancer resected following preoperative adjuvant therapy

The patient was a 47-year-old male with the chief complaints of right shoulder pain and fever. A 10-cm mass was found to be present in the right pulmonary apical region on chest X-ray examination. The mass was diagnosed as a G-CSF-producing invasive apical cancer and the patient underwent chemoradiotherapy followed by right upper lobectomy with combined resection of the chest wall, and lymph node dissection. A very small nodule was noted in the right frontal lobe on brain MRI before surgery, and the final diagnosis was pT3N0M1, stage IV lung adenocarcinoma. For the brain metastasis, gamma knife treatment and chemotherapy were performed after surgery, and there was no recurrence during 16 months after surgery. The prognosis for G-CSF-producing lung cancer and invasive apical cancer is poor. This was a rare and difficult case of lung cancer showing both characteristics of lung cancer.

The dominant non-gibberellin-responding dwarf mutant (D8) of maize accumulates native gibberellins

The endogenous gibberellins (GAs) were examined from young vegetative shoots of the dominant mutant, Dwarf-8, a GA-nonresponder, and normal maize; GA(44), GA(17), GA(19), GA(20), GA(29), GA(1), and GA(8), members of the early-13-hydroxylation pathway, were identified from both kinds of shoots by full-scan mass spectra and Kovats retention indices. In addition, we report the identification of 3-epi-GA(1), GA(3), GA(4), GA(5), GA(7), GA(9), GA(12), GA(15), GA(24), GA(34), and GA(53) by using the same criteria. [1,7,12,18-(14)C(4)]GA(53) and -GA(44), [17-(2)H(2)]GA(19), and [17-(13)C,(3)H(2)]GA(20), -GA(29), -GA(1), -GA(8), and -GA(5) were used as internal standards to determine the endogenous levels of these GAs by measurement of isotope dilution, using capillary gas chromatography and selected ion monitoring. Shoots of Dwarf-8 accumulate relatively high levels of GA(20), GA(1), and GA(8). The accumulation of GA(1) appears to be related to gene dosage. Since Dwarf-8 contains the same pattern of GAs as normals (including GA(1) and GA(3)), the genetic control point probably lies after GA(1) (and GA(3)). Thus Dwarf-8 may be a GA receptor mutant or a mutant that controls a product downstream from the binding of the bioactive GA to a receptor.

Mediastinal tuberculous lymphadenitis with intractable fistula to the neck

A 62-year-old female consulted our hospital due to an ulceration on the skin of her neck and a mediastinal tumor. Chest CT scan and MRI revealed a mediastinal tumor-like lesion with direct progression to the neck skin lesion. En bloc resection of the tumor including the neck skin ulcer was performed under a median sternotomy. Mediastinal tuberculous lymphadenitis was diagnosed histologically. This is a case of a very rare type of mediastinal tuberculous lymphadenitis that progressed to the neck with an intractable fistula.

X-ray polarization spectroscopy to study anisotropic velocity distribution of hot electrons produced by an ultra-high-intensity laser

The anisotropy of the hot-electron velocity distribution in ultra-high-intensity laser produced plasma was studied with x-ray polarization spectroscopy using multilayer planar targets including x-ray emission tracer in the middle layer. This measurement serves as a diagnostic for hot-electron transport from the laser-plasma interaction region to the overdense region where drastic changes in the isotropy of the electron velocity distribution are observed. These polarization degrees are consistent with analysis of a three-dimensional polarization spectroscopy model coupled with particle-in-cell simulations. Electron velocity distribution in the underdense region is affected by the electric field of the laser and that in the overdense region becomes wider with increase in the tracer depth. A full-angular spread in the overdense region of 22.4 degrees -2.4+5.4 was obtained from the measured polarization degree.

Percutaneous radiofrequency lung ablation combined with transbronchial saline injection: an experimental study in swine

To evaluate the efficacy of radiofrequency lung ablation with transbronchial saline injection. The bilateral lungs of eight living swine were used. A 13-gauge bone biopsy needle was inserted percutaneously into the lung, and 1 ml of muscle paste was injected to create a tumor mimic. In total, 21 nodules were ablated. In the saline injection group (group A), radiofrequency ablation (RFA) was performed for 11 nodules after transbronchial saline injection under balloon occlusion with a 2-cm active single internally cooled electrode. In the control group (group B), conventional RFA was performed for 10 nodules as a control. The infused saline liquid showed a wedge-shaped and homogeneous distribution surrounding a tumor mimic. All 21 RFAs were successfully completed. The total ablation time was significantly longer (13.4 +/- 2.8 min vs. 8.9 +/- 3.5 min; P = 0.0061) and the tissue impedance was significantly lower in group A compared with group B (73.1 +/- 8.8 Omega vs. 100.6 +/- 16.6 Omega; P = 0.0002). The temperature of the ablated area was not significantly different (69.4 +/- 9.1 degrees C vs. 66.0 +/- 7.9 degrees C; P = 0.4038). There was no significant difference of tumor mimic volume (769 +/- 343 mm(3) vs. 625 +/- 191 mm(3); P = 0.2783). The volume of the coagulated area was significantly larger in group A than in group B (3886 +/- 1247 mm(3) vs. 2375 +/- 1395 mm(3); P = 0.0221). Percutaneous radiofrequency lung ablation combined with transbronchial saline injection can create an extended area of ablation.

Multifocal nodular lymphoid hyperplasia of the lung differently identified by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)

Nodular lymphoid hyperplasia (NLH) is a rare lung disease classified as a non-neoplastic pulmonary lymphoid lesion. It is believed that 36 % of cases present with multifocal lesions, and although there are some reports in which (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) results are positive, the FDG uptakes vary and the imaging findings are very similar to those of lung cancer or malignant lymphoma. We present a case of surgically resected multifocal NLH which was differently identified by chest computed (CT) tomography appearance and FDG-PET findings.

Experimental evidence of impact ignition: 100-fold increase of neutron yield by impactor collision

We performed integrated experiments on impact ignition, in which a portion of a deuterated polystyrene (CD) shell was accelerated to about 600 km/s and was collided with precompressed CD fuel. The kinetic energy of the impactor was efficiently converted into thermal energy generating a temperature of about 1.6 keV. We achieved a two-order-of-magnitude increase in the neutron yield by optimizing the timing of the impact collision, demonstrating the high potential of impact ignition for fusion energy production.

[Analysis of invasive variation according to the different approaches of thoracoscopic resection for lung cancer]

There have been great variations among institutions in the approach of thoracoscopic surgery for lung cancer. However, we could not have found reports regarding the comparison study about operative invasion according to the thoracoscopic approach. We attempted to examine the differences of operative invasion in the various thoracoscopic approaches for lung cancer. We analyzed 158 cases of clinical stage I lung cancer by classifying thoracoscopic surgery into 3 different approaches. Specifically, group A (n=16) had less than 10 cm access with enlarged intercostal space by using rib-spreader, group B (n=84) had 4 to 8 cm access with soft material instrument and group C (n=50) had 2 to 3 cm access with soft material instrument. In each group, 2 or 3 thoracoports were added. Conversion to open thoracotomy were 8 cases. Operation time was significantly long in the conversion group, bleeding was significantly small in group C. Postoperative 48 hours drain discharge showed no differences in 3 groups, however, C-reactive protein (CRP) and creatine phosphokinase (CPK) with times showed significantly low level in group C, and both group A and conversion group were very close. Our results suggested the difference of the surgical invasiveness in thoracoscopic resection for lung cancer under various thoracoscopic approach.

Streaked x-ray backlighting with twin-slit imager for study of density profile and trajectory of low-density foam target filled with deuterium liquid

Low-density plastic foam filled with liquid deuterium is one of the candidates for inertial fusion target. Density profile and trajectory of 527 nm laser-irradiated planer foam-deuterium target in the acceleration phase were observed with streaked side-on x-ray backlighting. An x-ray imager employing twin slits coupled to an x-ray streak camera was used to simultaneously observe three images of the target: self-emission from the target, x-ray backlighter profile, and the backlit target. The experimentally obtained density profile and trajectory were in good agreement with predictions by one-dimensional hydrodynamic simulation code ILESTA-1D.