Surgery for older patients with advanced esophageal cancer involving the adjacent organs.

The treatment for thirty three advanced carcinoma of thoracic esophagus with cancer infiltrations to the adjacent organs were clinically analysed. The most affected organs were the aorta, followed by the trachea and bronchus. Clinical features are that two or three organs are affected at the same time and only one organ involvement is rare in frequency. Furthermore, nodal involvement is commonly accompanied and is spreading to the mediastium and abdomen. Surgical outcome of combined resection with involved organs is now unsatisfactory. In contrast, to relieve severe symptoms and to ensure the quality of life, aggressive combined resection is indispensable. It is assumed that further advances in improvement of potent anticancer drugs and surgical techniques may lead to prolonged survival of advanced esophageal cancer patients

Thymectomy for myasthenia gravis

The effect of thymectomy on elimination of a myasthenic symptom was clinically evaluated. The operative approach was primarily extended thymectmy of choice via midsternotomy in all but one of transcervical approaches. Most of them belonged to Osserman II b and II a of the disease type. Thirteen cases were in combination with thymoma and thirty-five were not in combination. Thymectomy yields a 53.8% effectiveness rate for patients with thymoma and a 65.7% for patients without thymoma. There was no defenitive relationship between the operation effectiveness and the suffering duration of time. However, aggravation and no improvement of a clinical sign after thymectomy were observed in patients with a severe or moderate degree of germinal center formation

Intraoperative HFJV support during bronchoplasty

High frequency jet ventilation (HFTV) was experimentally studied to ensure intraoperative respiratory support at tracheo-bronchoplasty. On the condition of driving pressure of 5 to 15 PSI and frequency of 100 to 400 during bronch-plastic procedure, HFJV is of great help to shorter the operation time and to secure the anastomosis. And the arterial Po2 and Pco2, and pulmonary hemodynamics were kept satisfactory in the circumstances of intraoperative respiratory suppor

Lung Preservation Using Cadaver Perfusion

Cadaver perfusion of in vivo lung storage method is evaluated with respect to time course of ischemic damage to lungs subsequently charged with providing total pulmonary function in comparison with survival and histological derangement of a lung. It, however, is limited within 2 hours due to failure of extracorporeal circulation with core cooling to 15°c by which splanchnic pooling causes reduced venous return. However, cadaver perfusion is useful to minimize an ischemic damage to a lung as a method of in vivo preservation

Benefit from omentopexy on bronchial wound healing in performing concurrent esophagectomy

The healing process of bronchial wound was compared among wrapping tissues such as pedicled omentum, pericardium, and parietal pleura in terms of the degrees of revascularization of the bronchial artery interrupted by bronchoplasty itself by microangiography, including the circumstances of performing a procedure of esophagectomy. The development of neovascularity was marked and facilitated by omentopexy. The procedure of wrapping by pedicled pericardium and pleura was not so useful for promoting neovascularity as would be expected, and it was almost the same as non-wrapping one. Meanwhile, recanalization by wrapping with free pleura was delayed. When esophagectomy was combined with bronchoplasty, revascularization was apparently retarded. In conclusion, wound healing at bronchial anastomosis was markedly impaired so that omentopexy was recommended for facilitating wound healing at anastomosis

Update on the GOSAT TANSO–FTS SWIR Level 2 retrieval algorithm

The National Institute for Environmental Studies has provided the column-averaged dry-air mole fraction of carbon dioxide and methane (XCO$_2$ and XCH$_4$) products (L2 products) obtained from the Greenhouse gases Observing SATellite (GOSAT) for more than a decade. Recently, we updated the retrieval algorithm used to produce the new L2 product, V03.00. The main changes from the previous version (V02) of the retrieval algorithm are the treatment of cirrus clouds, the degradation model of the Thermal And Near-infrared Spectrometer for carbon Observation–Fourier Transform Spectrometer (TANSO–FTS), solar irradiance spectra, and gas absorption coefficient tables. The retrieval results from the updated algorithm showed improvements in fitting accuracies in the O$_2$ A, weak CO$_2$, and CH$_4$ bands of TANSO–FTS, although the residuals increase in the strong CO$_2$ band over the ocean. The direct comparison of the new product obtained from the updated (V03) algorithm with the previous version V02.90/91 and the validations using the Total Carbon Column Observing Network revealed that the V03 algorithm increases the amount of data without diminishing the data qualities of XCO$_2$ and XCH$_4$ over land. However, the negative bias of XCO$_2$ is larger than that of the previous version over the ocean, and bias correction is still necessary. Additionally, the V03 algorithm resolves the underestimation of the XCO$_2$ growth rate compared with the in situ measurements over the ocean recently found using V02.90/91 and V02.95/96