Photodynamic diagnostic ureteroscopy using the VISERA ELITE video system for diagnosis of upper-urinary tract urothelial carcinoma: a prospective cohort pilot study

Background The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system. Methods We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated. Results A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS). Conclusions Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system. Trial registration: The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803-002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205)

Evanescently Coupled Rectangular Microresonators in Silicon-on-Insulator with High Q-Values: Experimental Characterization

We report on evanescently coupled rectangular microresonators with dimensions up to 20 × 10 μm2 in silicon-on-insulator in an add-drop filter configuration. The influence of the geometrical parameters of the device was experimentally characterized and a high Q value of 13,000 was demonstrated as well as the multimode optical resonance characteristics in the drop port. We also show a 95% energy transfer between ports when the device is operated in TM-polarization and determine the full symmetry of the device by using an eight-port configuration, allowing the drop waveguide to be placed on any of its sides, providing a way to filter and route optical signals. We used the FDTD method to analyze the device and e-beam lithography and dry etching techniques for fabrication

Mesothelial cyst derived from chest wall pleura growing after thoracic surgery: a case report

Abstract Background Intrathoracic mesothelial cysts almost always arise in the mediastinum, and extramediastinal mesothelial cysts are extremely rare. Here we describe a case of mesothelial cyst derived from the chest wall pleura growing after thoracic surgery. Case presentation A 63-year-old Japanese woman was referred to our department. She had undergone total hysterectomy for cervical carcinoma and two lung wedge resections for metastatic lung cancer on the upper and lower lobes of her right lung and lower lobe of her left lung. After the thoracic surgery, an intrathoracic chest wall mass was found, which grew gradually. Computed tomography demonstrated a 2.0 × 1.8 cm low-density mass without contrast effect. Magnetic resonance imaging demonstrated a low-intensity mass in T1-weighted imaging and a high-intensity mass in T2-weighted imaging. Thoracoscopic excision of the mass was performed. The cystic mass was thought to be derived from her chest wall and was pathologically diagnosed as mesothelial cyst. Five years after the surgery, she has no evidence of recurrence of the cyst or cervical carcinoma. Conclusions The genesis of extramediastinal mesothelial cysts may be related to inflammation. From this perspective, extramediastinal mesothelial cysts may have different characteristics from pericardial cysts and resemble peritoneal inclusion cysts. Although, extramediastinal mesothelial cysts are not established, their characteristics resemble peritoneal inclusion cysts; therefore, such interesting intrathoracic cysts should be carefully resected considering the risk

Long‐term survival of a patient with lung cancer treated with pembrolizumab after recurrent cardiac tamponade

Abstract A 69‐year‐old man with non‐small cell lung cancer presenting with pericardial effusion and rapid progression of dyspnea achieved long‐term disease stabilization after radiation therapy and immunotherapy. This case shows that pembrolizumab may improve prognosis in advanced lung cancer, even when complicated by cardiac tamponade

Common fever acutely progressing to descending necrotizing mediastinitis treated with thoracoscopic surgery: A case report

Descending necrotizing mediastinitis (DNM) is caused by a cervical or odontogenic infection that spreads downward to the mediastinum through anatomical cervical spaces. Its mortality rate is high, and its early diagnosis is important for successful treatment. Here, we report about a 14-month-old girl with DNM and pyothorax who was admitted to our hospital. She underwent thoracoscopic surgery (TS) for drainage of the mediastinum and was administrated with antibiotics. Her postoperative course was uneventful. Common fever in children, even in those without past history, can acutely progress to DNM with pyothorax. TS was effective in performing mediastinal drainage. Keywords: Descending necrotizing mediastinitis, Thoracoscopic surgery, Pyothora

Bladder stone formation around polyethylene glycol after use of SpaceOAR Hydrogel

Introduction Radiation therapy is used as primary, adjuvant, and salvage therapy for prostate cancer. When using radiation therapy, the SpaceOAR® system is considered easy to use and useful for reducing the irradiated dose and toxicity to the rectum. Although SpaceOAR® system have been reported some adverse event including death. Case presentation A 74‐year‐old male was diagnosed with prostate cancer of clinical stage cT2aN0M0 and intermediate risk by the National Comprehensive Cancer Network guidelines. We inserted the SpaceOAR® Hydrogel before performing intensity‐modulated radiation therapy, as the patient had ulcerative colitis. We did not recognize any complications during or after the procedure, although magnetic resonance imaging revealed hydrogel in the bladder retrospectively. Fourteen months after the procedure, the patient was presented with macrohematuria and we found a bladder stone including hydrogel. Conclusion We report the first case of a bladder stone after use of SpaceOAR® Hydrogel. We must be careful of taking place it