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171.
Okui M Kohno M Izumi Y Asakura K Nomori H 《General thoracic and cardiovascular surgery》2011,59(9):632-635
A technique for combined resection of S2
b (horizontal subsegment of the posterior segment) and S3
a (lateral subsegment of the anterior segment) of the right upper lobe of the lung is presented. Although both the S2
b and S3
a should be resected from the interlobar fissure, an approach for the artery and bronchus of S3
a (A3
a and B3
a, respectively) is easier from the ventral side of the hilum rather than from the interlobar fissure, because B3 runs in back of V2 at the interlobar fissure. To resolve this contradiction, we devised a procedure as follows: (1) A2
b and B2
b are cut at the interlobar fissure; (2) A3
a and B3
a are cut from the ventral side of hilum; (3) the peripheral stumps of A3
a and B3
a are transferred to the interlobar fissure; and (4) subsegments of S3
a and S2
b are resected with the peripheral stumps of A2
b, B2
b, A3
a, and B3
a from the side of the interlobar fissure. We believe this procedure makes the combined resection of S2
b and S3
a easy. 相似文献
172.
Sentinel node (SN) identification in patients with lung cancer is useful not only to minimize lymph node dissection, but also
to target the best lymph nodes for intraoperative frozen section during segmentectomy. Since 2000, we have identified the
SN in lung cancer patients using radioisotope (RI). This review presents our data on SN identification, describing the following:
the procedure, using a radioisotope tracer; the flow of Tc-99 tin colloid after the injection; the characteristics of patients
whose SNs could not be identified; ex vivo SN identification; reliability of in vivo SN identification; the algorithm for
reducing mediastinal lymph node dissection; the differences in SN identification between large and small radioisotope particles;
SNs at segmental lymph nodes; SN navigation segmentectomy for clinical stage IA non-small cell lung cancer; and small metastasis
in the SN. 相似文献
173.
Yamauchi Y Izumi Y Nakatsuka S Inoue M Hayashi Y Mukai M Nomori H 《European journal of radiology》2011,79(2):e85-e89
Objective
The diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity (GGO) pulmonary lesions was evaluated.Materials and methods
Out of 90 patients who underwent CT fluoroscopy-guided core needle biopsy of GGO lesions at our institution, the biopsy results and the final diagnoses were retrospectively compared in 67 patients with available data (one lesion per patient). Diagnostic performance was also compared according to the lesion size (≤10 mm (n = 8) versus 11-20 mm (n = 42) versus >20 mm (n = 17)), the percentage of GGO component (50-90% (n = 31) versus >90% (n = 36)), and the length of needle path (≤7 cm (n = 45) versus >7 cm (n = 22)). Finally, all 90 cases were reviewed for complications.Results
The overall sensitivity, specificity, and accuracy were 97%, 100%, and 97%, respectively. The diagnostic sensitivity and accuracy tended to be lower in smaller lesions (≤10 mm; 86 and 88%, 11-20 mm; 97 and 98%, >20 mm; 100 and 100%, respectively, p > 0.05), and in lesions with lower percentage of GGO component (50-90%; 93 and 94%, >90%; 100 and 100%, respectively, p = 0.21), but statistical significances were not reached. The sensitivity and accuracy were not significantly affected by the length of needle path (≤7 cm; 98 and 98%, >7 cm; 95 and 96%, respectively, p = 1.00). Fourteen patients (16%) developed pneumothoraces, and 13 patients (14%) experienced mild hemoptysis, all of which resolved conservatively.Conclusion
The diagnostic performance was satisfactory, and it was considered that the procedure was appropriate for GGO lesions regardless of lesion size, the percentage of GGO component, or the length of needle path. The procedure was also feasible without any major complications. 相似文献174.
Takeoka Y Inaba A Fujitani Y Kosaka S Yamamura R Senzaki H Okamura T Ohta K 《[Rinshō ketsueki] The Japanese journal of clinical hematology》2011,52(11):1777-1781
Intravascular large B-cell lymphoma (IVLBCL) is a rare form of non-Hodgkin's lymphoma characterized by a proliferation of tumor cells within the lumina of small to medium-sized vessels. Because there are few or no concomitant solid lesions, a diagnosis of IVLBCL usually cannot be established by CT or MR imaging. Herein, we describe a case of IVLBCL involving the uterus, in which (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) was useful for diagnosis. A 47-year-old woman was referred to our hospital because of fever and anemia. Laboratory examination demonstrated anemia and thrombocytopenia. Bone marrow aspiration and biopsy showed hemophagocytosis without involvement of lymphoma cells. Random skin biopsy did not demonstrate lymphoma involvement. FDG-PET/CT imaging showed FDG accumulation in the uterus. MR imaging demonstrated uterine leiomyoma only. Based on these findings, uterine endometrial biopsy was performed and histological diagnosis of IVLBCL involving the uterus was established. She received 6 courses of R-CHOP therapy and high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation. At present, she remains in complete remission after 33 months. 相似文献
175.
Yusuke Takahashi Yotaro Izumi Mitsutomo Kohno Eiji Ikeda Hiroaki Nomori 《International journal of medical sciences》2013,10(12):1702-1714
Purpose: Reduction in the level of vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of pulmonary emphysema. To this end, pharmacological VEGF receptor blockade, and the Cre-lox system models have been utilized to study the effects of VEGF depletion in the lung. These models generally reproduce air space enlargement resembling clinical emphysema. Here we report a potentially more readily available model of lung targeted VEGF depletion by airway administration of VEGF small inhibitory RNA oligonucleotides (siRNAs) in mice.Methods: Airway administration of VEGF siRNAs were done in C57BL/6 mice. The lungs were removed for histology and protein analysis 2, and 4 days later. Airspace enlargement was evaluated by lung volume measurement, and histological analyses. VEGF levels were analyzed by western blot and immunohistochemistry.Results: Airway administration of VEGF siRNAs induced transient air space enlargement in the mouse lung morphologically resembling the previously reported models of pulmonary emphysema. VEGF expression was significantly reduced in the lung, particularly in the alveolar septal cells. We also found that in this particular model, sequential airway administration of recombinant VEGF protein attenuated this air space enlargement. Additionally, we found that airway administration of DCI, a combination of dexamethasone, 3''-5''-cyclic adenosine monophosphate, and isobutylmethylxanthine attenuated the air space enlargement in this particular model, at least in part through the recovery of lung VEGF expression.Conclusions: The pathogenesis of pulmonary emphysema is likely to be multifaceted, but the present mouse model may be useful in dissecting the involvement of VEGF in pulmonary emphysema. 相似文献