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Shintani Y.,Osaka University | Funaki S.,Osaka University | Nakagiri T.,Osaka University | Inoue M.,Osaka University | And 4 more authors.
Interactive Cardiovascular and Thoracic Surgery | Year: 2013

OBJECTIVES: Although video-assisted thoracoscopic surgery (VATS) is widely used for the resection of a mediastinal mass, it is converted to an open resection in some patients with a mature teratoma because of dense adhesions. We reviewed cases with a mature teratoma removed by VATS and investigated the indications for that procedure for this tumour. METHODS: We retrospectively investigated 15 patients with a benign mediastinal mature teratoma who underwent a thoracoscopic procedure. RESULTS: The mean tumour diameter was 5.3 cm (range 3.2-8.5). The mean operative time was 188 min (78-430), and intraoperative blood loss was 138 ml (10-450). Thoracoscopic resection was completed in all except 3 patients with larger tumours, which presented the most difficult problems with dissection. Each of those 3 had severe preoperative chest pain and a tumour larger than 5.5 cm. No mortality or postoperative complications were recorded, except for postoperative chylothorax. Tumour recurrence did not develop in any patient during the mean follow-up period of 4.6 years. CONCLUSIONS: For selected patients with a mediastinal teratoma, VATS may be considered standard care, as most are benign. In contrast, an open approach may be more appropriate for patients with a large tumour or preoperative symptoms. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. Source

Morita S.,Shiga University of Medical Science | Takimoto T.,Toyonaka Municipal Hospital | Kawahara K.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Nishi K.,Shiga University of Medical Science
BMJ Case Reports | Year: 2013

Perfluoroallyl chloride (PFAC), a fluorine-containing compound, has very severe toxicity, but this toxicity is not well characterised. We report a fatal case of acute chemical lung injury caused by the inhalation of PFAC. A 39-year-old man, working at a chemical factory, inhaled PFAC gas and died 16 days later of acute lung injury with severe pneumothorax. We present his clinical course together with thoracic CT findings, autopsy and analysis of PFAC in blood and urine samples with gas chromatograph-mass spectrometry. Previously, a fatal case of PFAC was reported in 1981 but PFAC was not identified in any of the patient's samples. In our patient, we identified PFAC in both blood and urine samples. Our toxicological analysis may be used as a reference to detect PFAC toxicity in the future. Our study should be helpful for diagnosing lung injury induced by a highly toxic gas, such as PFAC. Copyright 2013 BMJ Publishing Group. All rights reserved. Source

Shintani Y.,Osaka University | Inoue M.,Osaka University | Funakoshi Y.,National Hospital Organization Toneyama Hospital | Matsumura A.,National Hospital Organization Kinki chuo Chest Medical Center | And 3 more authors.
Anticancer Research | Year: 2011

Background: The enzyme dihydropyrimidine dehydrogenase (DPD) is involved in the metabolism of 5-fluorouracil (5-FU). The aim of this study was to clarify the correlation between the expression of DPD and the efficacy of 5-FU therapy in patients with lung adenocarcinoma (AD). Patients and Methods: We examined surgically resected specimens from 90 stage I to IIIA patients with lung ADs to determine the level of intra-tumoral DPD mRNA. Results: Administration of 5-FU improved the prognosis of patients with low DPD-expressing tumors, whereas it did not do so for patients with high DPD expressing tumors. Patients with low DPD-expressing tumors administered with 5-FU had a significantly better prognosis than those who underwent surgery alone. A Cox proportional hazards regression model revealed that administration of 5-FU was an independent variable to predict prognosis in patients with low DPD-expressing tumors. Conclusion: Quantification of DPD mRNA levels is useful for determining the subgroup of lung AD patients who would benefit most from 5-FU after surgery. Source

Yamaguchi M.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Fujita H.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Bessho Y.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Inoue T.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | And 2 more authors.
European Journal of Radiology | Year: 2011

The purpose of this study was to clarify the relationship between display sizes of high resolution computed tomography (HRCT) images for detecting ground-glass opacity (GGO) and observer performance using a digital contrast-detail (d-CD) phantom. A structure of the d-CD phantom was determined on the basis of the actual images of GGOs and background noises of 22 patients who were diagnosed as GGO by chest HRCT. The d-CD phantom has a 512 × 512 matrix in size and has total of 100 holes: the diameter of these holes increases stepwise from 2 to 20 pixels with 2 pixels interval in a vertical direction and the CT value varies stepwise from 2 to 200 HU in a horizontal direction. The observer performance study was carried out for three different display sizes (30 cm × 30 cm as an enlarged size, 13 cm × 13 cm as an original size, and 7 cm × 7 cm as a reduced size) using a 2-megapixels LCD monitor, and it was analyzed using Friedman and Wilcoxon statistical tests. As a result, the observer performance for the original display and the reduced display sizes was superior to that for the enlarged size (P = 0.006 and 0.037 for the original display and the reduced display sizes, respectively), whereas there was no significant difference between the original display and reduced display sizes (P = 0.77). The d-CD phantom enables a short-term evaluation of observer performance and is useful in analyzing relationship between display size and observer performance. © 2010 Elsevier Ireland Ltd. Source

Yamaguchi M.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Bessho Y.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Inoue T.,Osaka Prefectural Medical Center for Respiratory and Allergic Disease | Asai Y.,Kinki University | And 2 more authors.
Radiological Physics and Technology | Year: 2011

We evaluated the effect of the displayed image sizes on observers' ability to detect nodular ground-glass opacity (n-GGO) on CT and investigated the optimal viewing size for soft-copy reading at CT screening for lung cancer. A total of 46 patients' high-resolution computed tomography (HRCT) images (22 patients with one GGO; 24 without GGO) were displayed on a monochromatic liquid crystal display monitor at a resolution of 1,200 × 1,600. HRCT was presented on the screen with cine-mode display. We compared two viewing sizes (original size, i.e., the image displayed with a zoom factor of 1 in which each pixel value in the image is displayed as one pixel on the display: 13 cm × 13 cm; fit size, i.e., by zooming the captured image until it occupies the entire screen: 30 cm × 30 cm) in terms of radiologists' performance for detecting n-GGO on HRCT and the viewing times required for soft-copy reading decisions. Observer performance was analyzed in terms of the receiver operating characteristic (ROC) curve. A statistically significant improvement was found with the original size in the average area-under-the-ROC curve values for the accuracy of diagnosis and the viewing times compared to the fit size (P < 0.05). The original size with cine-mode display leads to increased lung GGO detection at CT screening for lung cancer, and the reduced time spent performing the diagnosis offers cost savings. © 2010 Japanese Society of Radiological Technology and Japan Society of Medical Physics. Source

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