再発性甲状腺癌のリンパ節転移におけるTc-99m MDPの集積(Tc-99m MDP Accumulation in Lymph Node Metastases of Recurrent Thyroid Cancer)(英語)

金沢医科大学 放射線科原著論文/症例報

Comparison between Prolonged Administration of Oral Etoposide and UFT Combined with Intravenous Cisplatin-based Chemotherapy in Postoperative Non-small Cell Lung Cancer: a Randomized Trial

Oral administration of etoposide or UFT is generally used in outpatient treatment of non-small cell lung cancer (NSCLC) after surgery in Japan. We examined the effectiveness of etoposide and UFT with relation to disease-free survival, overall survival and toxicity in postoperative NSCLC patients. In this study, a total of 50 patients were randomized to receive either, 25mg/day of etoposide, on a 2 week cycle (Group I- 25 cases) or 300mg/day of UFT, continuous administration (Group II-25 cases), after a Mitomycin C, Cisplatin and Vindesine, intravenous (i.v.). Disease-free and overall survival were better in Group II with 20 complete cases than in Group I with 15 complete cases. Furthermore, Group II achieved better disease-free and overall survival rates than Group I with reference to stage IIIA and lymph node metastasis groups. There were no instances of severe toxicity in either group. Results of this study showed that prolonged oral administration of 25mg/day of etoposide is ineffective compared with oral UFT in NSCLC patients after surgical treatment. New randomized clinical trials of 50mg/day of etoposide will be necessary to determine usefulness and toxicity

Clinical Evaluation with Referrence to Operative Specificity on Tracheal and Bronchial Reconstruction

The clinical specificity were evaluated in those 11 cases who underwent tracheal recon - structive surgery and in those 25 cases who underwent bronchial reconstructive surgery respectively. Its prognosis after tracheal reconstruction at the level of intrathoracic region was extremely poor. The operative specificity with regard to tracheal surgery consist of being a poor genera- condition preoperativelly and of having an urgent demand of removal of tracheal stenotic lesion to alleviate respiratory distress . The prognosis after tracheal surgery was commonly poor and was similar to that after emergency operation as a general accep - tance for the reason of unfavorable general condtion . The present study was to define clinical problems in which the salvage after tracheal surgery was entirely difficult. The improvement of the prognosis following tracheal surgery should be found in maximum endeavor for prevention of postoperative complication related to operative death intimately. However, terminal tracheostomy employed for lesions of cervical trachea was one o

The Effect of Surgical Repair for Pectum Excavatum on Cardiopulmonary Function

In five patients with corrective surgery for pectus Excavatum, the effectiveness of surgical repair were evaluated from the results of pulmonary function test as well as the finding on ECG according to follow-up study postoperativelly. Of five patient undergone the corrective surgery which sternoturnover with costalplasty employed in 4, and sternoplasty alone in I, all of them were male and the average age except 3 years of age was 14.8 years ranging from 10 to 21 years. There are no manifestation of clinical syndrome in all 5 cases. However, the fair mental growth demands psychologically the early corrective surgery in young chidren. By follow-up study after surgical correction for pectus excavatum during a period from 3 months to 3 years and 3 months, the finding on EKG of right ventricular overload revealed the improvement within 2 months after surgical correction in contrast the results of pulmonary function test disclosed no marked changes until 2 months following surgery. From the view of cosmetic efficacy of corrective surgery, sternoturnover with or without costalplasty are one of the adovocating operative procedures

An Evaluation of Surgical Problems for Carcinoma of Esophagus in view of Autopsy Findings

By comparison of the findings in operation and those in autopsy, 9 cases of death within 30 days after esophagectomy and dissection of the lymph node for thoracic esophageal cancer were examined mainly on the influence of dissection of the lymph node. In autopsy, remained metastatic lymph node was observed in 4 of them (44,4%). Remained metastatic thoracic lymph node was to the tracheobronchial lymph node group. Metastatic abdominal lymph node was observed in many cases at the operation, but in autopsy remained cancer in this area was not observed. It is proved that remained metastatic lymph node in the abdomen at autopsy is in paraaortic lymph node in high rate. It was examined by the experiment with the dogs that frequency of pulmonary complication will be higher if extended radical mediastinal lymph node dissection is performed. In the experiment, decrease of lung surfactant, rise in pulmonary wedge pressure, trouble in perfusion of pulmonary lymph flow in the experiment by dye solution, and interstitial edema and alveolar edema in the lung in histological examination were observed. As described above, since direct operative death after esophagectomy is related to respiratory complications, treatments for this complications may be able to be improved, if the cause is made clear and pathological treatments are carried out. In order to improve surgical treatments for metastasis to the lymph node of esophageal cancer, these points should be given attention to

Utility and limitations of coherent mapping algorithm utilizing vectors and global propagation patterns in atrial tachycardia

Background: A novel mapping algorithm utilizing vectors and global patterns of propagation (Coherent™, Biosense Webster) has been developed to help identify the mechanism of atrial tachycardia (AT). We aimed to determine the diagnostic accuracy of coherent mapping compared with that of ripple mapping. Methods and results: This study included 41 consecutive patients with 84 ATs (47 reentrant and 37 focal ATs). Two independent electrophysiologists confirmed the diagnoses using coherent mapping before the ripple map-guided ablation. AT termination was achieved in 75 of 84 ATs (89%) at first ablation lesion set. Four of the remaining nine ATs, which were terminated before an index radiofrequency (RF) application, were non-inducible after RF delivery at the first lesion set, whereas the other five ATs were terminated at the second lesion set. Diagnostic agreement between coherent and ripple maps was achieved in 51 of 84 ATs (61%): 28 of the 47 macroreentrant ATs (60%) and 23 of the 37 focal ATs (62%; P = 0.826). In typical macroreentrant ATs, including left atrial roof, perimitral, and cavotricuspid isthmus-dependent ATs, coherent maps achieved diagnostic agreement in 23 of 29 ATs (79%), which was higher than that in other ATs (51%, P = 0.018): 13 of 26 macroreentrant ATs (50%) and 15 of 29 focal ATs (52%, P = 1.000). Conclusion: Ripple map-guided AT ablation achieved a high termination rate in the first lesion set. Coherent mapping yielded a favorable diagnostic accuracy for typical macroreentrant ATs, though its value for diagnosing other ATs was limited