記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Surgery Today  

Purpose: To develop a comorbidity risk score specifically for lung resection surgeries. Methods: We reviewed the medical records of patients who underwent lung resections for lung cancer, and developed a risk model using data from 2014 to 2017 (training dataset), validated using data from 2018 to 2019 (validation dataset). Forty variables were analyzed, including 35 factors related to the patient’s overall condition and five factors related to surgical techniques and tumor-related factors. The risk model for postoperative complications was developed using an elastic net regularized generalized linear model. The performance of the risk model was evaluated using receiver operating characteristic curves and compared with the Charlson Comorbidity Index (CCI). Results: The rate of postoperative complications was 34.7% in the training dataset and 21.9% in the validation dataset. The final model consisted of 20 variables, including age, surgical-related factors, respiratory function tests, and comorbidities, such as chronic obstructive pulmonary disease, a history of ischemic heart disease, and 12 blood test results. The area under the curve (AUC) for the developed risk model was 0.734, whereas the AUC for the CCI was 0.521 in the validation dataset. Conclusions: The new machine learning model could predict postoperative complications with acceptable accuracy. Clinical registration number: 2020–0375.

DOI： 10.1007/s00595-024-02878-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Molecular Sciences  

Malignant pleural mesothelioma (MPM) develops primarily from asbestos exposures and has a poor prognosis. In this study, The Cancer Genome Atlas was used to perform a comprehensive survival analysis, which identified the CHST4 gene as a potential predictor of favorable overall survival for patients with MPM. An enrichment analysis of favorable prognostic genes, including CHST4, showed immune-related ontological terms, whereas an analysis of unfavorable prognostic genes indicated cell-cycle-related terms. CHST4 mRNA expression in MPM was significantly correlated with Bindea immune-gene signatures. To validate the relationship between CHST4 expression and prognosis, we performed an immunohistochemical analysis of CHST4 protein expression in 23 surgical specimens from surgically treated patients with MPM who achieved macroscopic complete resection. The score calculated from the proportion and intensity staining was used to compare the intensity of CHST4 gene expression, which showed that CHST4 expression was stronger in patients with a better postoperative prognosis. The median overall postoperative survival was 107.8 months in the high-expression-score group and 38.0 months in the low-score group (p = 0.044, log-rank test). Survival after recurrence was also significantly improved by CHST4 expression. These results suggest that CHST4 is useful as a prognostic biomarker in MPM.

DOI： 10.3390/ijms25042270

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Thoracic and Cardiovascular Surgery  

An 82-year-old male patient underwent a left upper lobectomy with anterolateral thoracotomy for lung cancer. Although a complete left-pericardial defect was observed during surgery, the pericardial repair was not performed because the left lower lobe remained and the heart was considered stable. Postoperative pathological examination revealed primary synchronous double-lung squamous-cell carcinoma (pathological stage pT2a(2) N0M0 stage IB). He was discharged without complications on postoperative day 8. Leftward displacement of the heart and left diaphragmatic elevation, suspected of phrenicnerve paralysis, were found in the chest X-ray after discharge. However, the patient’s overall condition remained unaffected at the 5-month postoperative follow-up. To assess the need for pericardial repair, we compared cases of complete pericardial defects observed during lobectomy or pneumonectomy reported in the literature. Only one of 12 cases occurred postoperative death despite pericardial repair, and that case combined pectus excavatum and pericardial defects. Our assessment indicated that pericardial repair might not be necessary, excluding complex cases.

DOI： 10.5761/atcs.cr.24-00041

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JTCVS Techniques  

DOI： 10.1016/j.xjtc.2023.07.026

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Preoperative three-dimensional computed tomography (CT) facilitates accurate identification of aberrant systemic arteries in thoracic surgery for pulmonary sequestration (PS). Furthermore, the boundary between normal and sequestrated lungs can be visualized using the spread of fluorescent indocyanine green (ICG) when performing surgery for PS. This study aimed to determine how to completely visualize anatomical variations, safely treat aberrant arteries, remove only sequestrated lungs, and perform minimally invasive surgery for PS. Seventeen patients underwent lung resection for intralobar PS at our institution between 2009 and 2022. We retrospectively reviewed the surgical outcomes and intraoperative images using ICG to assess the efficacy and feasibility of near-infrared fluorescence imaging. Since 2019, intraoperative near-infrared fluorescence imaging with ICG has been used in six patients, including four females and two males (median age, 56 years), to visualize the boundary between normal and sequestrated lungs. Aberrant arteries were identified using preoperative three-dimensional CT, and the boundary between sequestrated and normal lungs could be clearly delineated intraoperatively using ICG in all cases. The median operative time was 145 min (range, 88–167 min), and the median blood loss was 5 mL (range, 1–191 mL). The overlay mode using near-infrared thoracoscopy, which merges visible light images with fluorescent images, was safer and more useful than conventional thoracoscopy for delineating boundaries with electrocautery. No intraoperative or postoperative complications occurred. The median postoperative hospital stay was 5 days (range, 3–7 days). Intraoperative identification of the boundary between normal and sequestrated lungs using ICG was simple and feasible. We suggested that this technique was effective for lesion resection and normal lung preservation during surgery for intralobar PS.

DOI： 10.21037/jtd-23-892

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Hematology  

Patient-derived xenograft (PDX) mouse models are useful for deepening our understanding of the biology of malignant lymphoma; however, factors associated with the success of the PDX lymphoma model are largely unknown. We retrospectively analyzed the characteristics of 66 xenotransplantations from 65 patients. In all, 43 (65%) specimens were obtained from patients aged > 60 years, and 42 (64%) specimens were obtained at diagnosis. Specimens were obtained from patients with the following diseases: diffuse large B-cell lymphoma (n = 30), intravascular large B-cell lymphoma (n = 12), follicular lymphoma (n = 8), peripheral T-cell lymphoma (n = 7), mantle cell lymphoma (n = 2), and other (n = 7). The specimens were sourced mainly from bone marrow (n = 31, 47%) and extranodal tumors (n = 13, 20%). Engraftment was successful in 33/66 (50%) xenotransplantations. The median age of patients who provided successful specimens was significantly higher than that for unsuccessful specimens (p = 0.013). Specimens with a high proportion of tumor cells in the graft and those obtained from patients with relapsed/refractory disease showed higher tendencies toward successful engraftment. Taken together, these data suggest that tumor cells with a highly malignant potential might have a high likelihood of engraftment.

DOI： 10.1007/s12185-023-03604-z

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担当区分：筆頭著者,　責任著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Extended thymectomy is a procedure to remove the thymus gland and surrounding adipose tissue, while the traditional approach via a median sternotomy, minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) have been adopted. This report described the technique of bilateral approach for extended thymectomy in patients with myasthenia gravis (MG) by robot-assisted thoracoscopic surgery, and also showed the perioperative outcomes and postoperative exacerbation rates of 11 patients. In most patients, score of MG symptom were reduced and levels of anti-acetylcholine receptor antibodies declined postoperatively. In a small number of cases, the safety and efficacy of a RATS bilateral approach for extended thymectomy were confirmed.

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Interdisciplinary cardiovascular and thoracic surgery  

Resection Process Map (RPM) is a surgical simulation system that uses preoperative three-dimensional computed tomography. Unlike the usual static simulation, this system provides surgeons an individualized dynamic deformation of the lung parenchyma and vessels. RPM was first introduced in 2020. Although the intraoperative usefulness of this system has been evaluated experimentally, there have been no reports on its clinical use. Herein, we presented in detail the first experience on RPM during robot-assisted anatomical lung resection in the real clinical setting.

DOI： 10.1093/icvts/ivad059

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Surgical Oncology  

DOI： 10.1245/s10434-022-12844-y

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1245/s10434-022-12860-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JTCVS Techniques  

Objective: Prolonged air leak is the most common complication of thoracic surgery. Intraoperative leak site detection is the first step in decreasing the risk of leak-related postoperative complications. Methods: We retrospectively reviewed the surgical videos of patients who underwent lung resection at our institution. In the training phase, deep learning-based air leak detection software was developed using leak-positive endoscopic images. In the testing phase, a different data set was used to evaluate our proposed application for each predicted box. Results: A total of 110 originally captured and labeled images obtained from 70 surgeries were preprocessed for the training data set. The testing data set contained 64 leak-positive and 45 leak-negative sites. The testing data set was obtained from 93 operations, including 58 patients in whom an air leak was present and 35 patients in whom an air leak was absent. In the testing phase, our software detected leak sites with a sensitivity and specificity of 81.3% and 68.9%, respectively. Conclusions: We have successfully developed a deep learning-based leak site detection application, which can be used in deflated lungs. Although the current version is still a prototype with a limited training data set, it is a novel concept of leak detection based entirely on visual information.

DOI： 10.1016/j.xjtc.2022.06.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Physiology and Functional Imaging  

Background: Postoperative loss of exercise capacity and pulmonary function is a major concern among lung cancer patients. In this study, the time for a stair-climbing to 12-m height was used to investigate whether preoperative chest 3D-computed tomography (CT) could be a useful tool for predicting postoperative variations in exercise capacity and pulmonary function. Methods: Seventy-eight patients undergoing lobectomy for suspected stage I lung cancer were prospectively enroled. Preoperatively, lobe volume and low attenuation volume (LAV) were evaluated using the SYNAPSE VINCENT system. Preoperative data on stair-climbing time, spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) at baseline and 6-month postoperative data were used to evaluate variations in exercise capacity and pulmonary function. Maximal oxygen uptake (VO2t) was evaluated based on the stair-climbing time. Results: Significant differences in the variation of exercise capacity at 6 months postoperatively were found between the groups categorized by target lobe volume and LAV status: The large volume/LAV (+) group had a greater decline in VO2t. Mean loss of VO2t was −6.2%, −1.4%, −1.6% and −0.1% in the large volume/LAV (+), large volume/LAV (−), small volume/LAV (+) and small volume/LAV (−) groups, respectively. The large volume/LAV (−) group had a greater decline in forced expiratory volume in 1 s. The small volume/LAV (+) group showed a reduced decline in the DLCO. Conclusions: Analysis of chest 3D-CT scans is a potential tool for predicting the loss of exercise capacity and pulmonary function after lung lobectomy.

DOI： 10.1111/cpf.12777

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

We report the case of a 20-year-old woman with carinal adenoid cystic carcinoma who underwent left sleeve pneumonectomy in the left lateral decubitus position, during which severe desaturation was encountered. After transecting the left main bronchus, the left lung was selectively intubated and ventilated. However, oxygenation was inadequate. Hence, venoarterial extracorporeal membrane oxygenation (ECMO) was introduced. Initially, Barclay’s procedure was planned to preserve the left lung, but this plan was altered due to the extent of the tumor and unstable ventilation. After the lesion was removed, the trachea and right main bronchus were anastomosed end-to-end. During left pneumonectomy, the right lung was selectively ventilated, but oxygen saturation (SpO2) dropped to <70% despite ECMO. SpO2 improved on additionally ventilating the left lung using another breathing circuit. Temporary right chest closure was performed with ventilation of the left lung across the thoracotomy wound. The patient was turned to the semi-supine position, and tolerated selective right lung ventilation with ECMO. Subsequently, left thoracotomy and pneumonectomy were successfully performed. Careful management is required for desaturation in left sleeve pneumonectomy in the left lateral decubitus position.

DOI： 10.18999/nagjms.84.3.673

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1245/s10434-021-10969-0

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：Progress in Biomedical Optics and Imaging - Proceedings of SPIE  

This paper proposes a super-resolution (SR) method, for performing SR of medical images, training on a newly-built lung clinical CT / micro CT specimen dataset. High-resolution (HR) medical images always come at longer scanning time or heavier patient burden. Thus performing SR of low-resolution (LR) medical images for obtaining HR images is an optional approach. Conventional SR methods are always trained on bicubic downsampled images (LR) / original images (HR) image pairs. However, in medical imaging, LR medical images and HR images are commonly obtained from different imaging devices, causing registration between LR and HR images having low precision and LR-HR image pairs do not match each other perfectly. Since conventional SR methods need perfectly matched LR-HR images, low precision of registration results in conventional SR methods’ unsatisfactory performance in medical imaging. To tackle this problem, we need to propose an SR method considering the modality difference and registration error between HR-LR medical images. In this paper, we propose a coarse-to-fine cascade framework for performing SR of medical images. First, we design a coarse SR network to translate LR medical images into coarse SR images, training on poorly-aligned LR-HR images. Next, we utilize a fully convolutional network (FCN) to perform fine SR (translate coarse SR images to fine SR images). We conducted experiments using a newly-built clinical / micro CT lung specimen dataset. Experimental results illustrated that our method obtained PSNR of 27.30 and SSIM of 0.75, higher than the conventional supervised method of PSNR 19.08 and SSIM 0.63.

DOI： 10.1117/12.2611311

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancer Science  

Epstein-Barr virus-associated lymphoproliferative disease (EBV-LPD) is frequently fatal. Innate immunity plays a key role in protecting against pathogens and cancers. The stimulator of interferon genes (STING) is regarded as a key adaptor protein allowing DNA sensors recognizing exogenous cytosolic DNA to activate the type I interferon signaling cascade. In terms of EBV tumorigenicity, the role of STING remains elusive. Here we showed that treatment with the STING inhibitor, C-176, suppressed EBV-induced transformation in peripheral blood mononuclear cells. In an EBV-LPD mouse model, C-176 treatment also inhibited tumor formation and prolonged survival. Treatment with B cells alone did not affect EBV transformation, but suppression of EBV-induced transformation was observed in the presence of T cells. Even without direct B cell-T cell contact in a transwell system, the inhibitor reduced the transformation activity, indicating that intercellular communication by humoral factors was critical to prevent EBV-induced transformation. These findings suggest that inhibition of STING signaling pathway with C-176 could be a new therapeutic target of EBV-LPD.

DOI： 10.1111/cas.15152

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JTCVS Open  

DOI： 10.1016/j.xjon.2021.09.043

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Cancer  

Background: The aim of this study was to assess the diagnostic utility of metabolic parameters on fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) for predicting lymph node (LN) metastasis in patients with cN2 non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed patients who underwent surgery for cN2 NSCLC between 2007 and 2020. Those who had clinically diagnosed positive hilar and mediastinal LNs by routine CT and PET/CT imaging were investigated. To measure the metabolic parameters of LNs, the data according to maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN-to-primary tumor ratio of SUVmax (LPR) were examined. The diagnosis of each retrieved LN was confirmed based on histopathological examination of surgical tissue specimens. Receiver operating characteristics (ROC) curves with area under the curve (AUC) calculations and multivariate analysis by logistic regression were performed. Results: Forty-five patients with 84 clinically diagnosed positive hilar or mediastinal LNs were enrolled in the present study. Of the 84 LNs, 63 LNs were pathologically proven as positive (75%). The SUVmax, MTV, TLG, and LPR of LN metastasis were significantly higher than those of benign nodes. In the ROC analysis, the AUC value of LPR [AUC, 0.776; 95% confidence interval (CI), 0.640–0.913] was higher than that of LN SUVmax (AUC, 0.753; 95% CI, 0.626–0.880) or LN TLG3.5 (AUC, 0.746; 95% CI, 0.607–0.885). Using the optimal LPR cutoff value of 0.47, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.1, 66.7, 88.3, 58.3, and 79.8%, respectively. Multivariate analysis by logistic regression showed that LPR was an independent predictor for LN metastasis (odds ratio, 6.45; 95% CI, 1.785–23.301; P = 0.004). In the subgroup analysis of adenocarcinoma patients (n = 18; 32 LNs), TLG3.5 was a better predictor (AUC, 0.816; 95% CI, 0.639–0.985) than LPR (AUC, 0.792; 95% CI, 0.599–0.986) or LN SUVmax (AUC, 0.792; 95% CI, 0.625–0.959). Conclusions: Our findings suggest that LPR on FDG-PET is a useful predictor for LN metastasis in patients with cN2 NSCLC. TLG can be a good predictor for LN metastasis in patients with adenocarcinoma.

DOI： 10.1186/s12885-021-08688-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. Methods: Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan–Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. Results: Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41–4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70–2.70). Conclusions: Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.

DOI： 10.1007/s11748-021-01619-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Trials  

Background: One aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents. Methods: This multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording. Discussion: It is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD. Trial registration: UMIN Register 000029851. Registered on January 06, 2018

DOI： 10.1186/s13063-020-04750-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic and Cardiovascular Surgery  

DOI： 10.1016/j.jtcvs.2010.12.080

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Surgical Oncology  

DOI： 10.1245/s10434-020-08337-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, imageguided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and ex vivo lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

DOI： 10.18999/nagjms.82.2.161

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Background: We have developed a surgical navigation system that presents virtual thoracoscopic images using computed tomography (CT) image data, as if you are observing intra-thoracic cavity in synchronization with the real thoracoscopic view. Using this system, we made it possible to simultaneously visualize the ‘area of lung cancer before induction therapy’ and the ‘optimal resection line for obtaining a safe surgical margin’ as a virtual thoracoscopic view. We applied this navigation system in the clinical setting in operations for lung cancer patients with chest wall invasion after induction chemoradiotherapy. Methods: The proposed surgical navigation system consisted of a three-dimensional (3D) positional tracker and a virtual thoracoscopy system. The 3D positional tracker was used to recognize the positional information of the real thoracoscope. The virtual thoracoscopy system generated virtual thoracoscopic views based on CT image data. Combined with these two technologies, patient-to-image registration was performed in two patients, and the results generated a virtual thoracoscopic view that was synchronized with the real thoracoscopic view. Results: The operations were started with video-assisted thoracic surgery (VATS), and the navigation system was activated at the same time. The virtual thoracoscopic view was synchronized with the real thoracoscopic view, which also simultaneously indicated the ‘area of lung cancer before induction therapy’ and the ‘optimal resection lines for obtaining a safe surgical margin’. We marked the optimal lines using an electric scalpel, and then performed lobectomy and chest wall resection with a sufficient surgical margin using these landmarks. Pathological examinations confirmed that the surgical margin was negative. No complications related to the navigation system were encountered during or after the procedures. Conclusions: Using this proposed navigation system, we could obtain a ‘CT-derived virtual intrathoracic 3D view of the patient’ that was aligned with the thoracoscopic view during surgery. The accurate identification of areas of cancer invasion before induction therapy using this system might be a useful for determining optimal surgical resection lines.

DOI： 10.21037/jtd.2019.12.108

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本肺癌学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11748-018-01054-7

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Thoracic Surgery  

Background: Programmed death ligand 1 (PD-L1) is reportedly expressed in various malignancies and is considered a prognostic factor. We attempted to reveal the usefulness of the PD-L1 expression as a prognostic factor in patients with thymoma. Methods: Eighty-one patients with thymoma who underwent surgical resection between 2004 and 2015 were retrospectively reviewed. The PD-L1 expression was evaluated by immunohistochemistry and stratified by the proportion of positive tumor cells. Strong membranous reactivity of the PD-L1 antibody in 1% or more of tumor cells was considered “positive.” The association between the PD-L1 expression and the clinicopathologic features was investigated. Results: The PD-L1 expression was positive in 22 patients (27%) and negative in 59 patients (73%). The PD-L1 positivity was significantly associated with type B2 and B3 thymoma (p < 0.001) and stage III and IV disease (p = 0.048). In addition, PD-L1 positive tumors showed a significantly higher maximum standardized uptake value than PD-L1 negative tumors (p = 0.026). The 5-year disease-free survival rate was 82% in PD-L1 positive patients and 88% in PD-L1 negative patients, showing no significant difference (p = 0.57). Furthermore, PD-L1 positivity was not an independent prognostic factor for the disease-free survival on a Cox proportional hazards analysis (p = 0.59). Conclusions: A strong expression of PD-L1 in thymoma was significantly associated with type B2 and B3 and higher pathologic stages. In addition, PD-L1 positivity was associated with an increased maximum standardized uptake value of the tumor. However, patients with PD-L1 positive thymomas did not show a significantly worse prognosis than patients with PD-L1 negative tumors.

DOI： 10.1016/j.athoracsur.2018.08.037

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Surgery Today  

Purpose: We adopted a bilateral approach to complete robotic extended thymectomy with the excision of the pericardial fat tissue from both sides and analyzed the initial outcomes. Methods: The patient cart was docked first from the left shoulder side. After dissection of the thymus and right pericardial fat tissue, the cart was temporarily rolled out, and the bed was rotated approximately 90° clockwise. The cart was then re-docked from the right-side shoulder, and extended thymectomy was performed via the left-side approach. The outcomes were compared with four cases of unilateral approach performed for mediastinal tumor in the same term. Results: Four patients with myasthenia gravis (two of whom had stage I thymoma) underwent extended thymectomy by the bilateral approach. The mean operative time was 288 min, and the console time was 146 min in the right side and 67 min in the left side. The resected thymus and surrounding adipose tissue were almost symmetrical, in contrast with those obtained via the unilateral approach. No remarkable events were noted. Conclusion: Bilateral extended thymectomy for myasthenia gravis patients was safe and reasonable based on the initial outcomes.

DOI： 10.1007/s00595-017-1567-x

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiology  

Purpose: To investigate the relationship between the postoperative prognosis of patients with part-solid non–small cell lung cancer and the solid component size acquired by using three-dimensional (3D) volumetry software on multidetector computed tomographic (CT) images. Materials and A retrospective study by using preoperative multidetector Methods: CT data with 0.5-mm section thickness, clinical records, and pathologic reports of 96 patients with primary subsolid non–small cell lung cancer (47 men and 49 women; mean age 6 standard deviation, 66 years 6 8) were reviewed. Two radiologists measured the two-dimensional (2D) maximal solid size of each nodule on an axial image (hereafter, 2D MSSA), the 3D maximal solid size on multiplanar reconstructed images (hereafter, 3D MSSMPR), and the 3D solid volume of greater than 0 HU (hereafter, 3D SV0HU) within each nodule. The correlations between the postoperative recurrence and the effects of clinical and pathologic characteristics, 2D MSSA, 3D MSSMPR, and 3D SV0HU as prognostic imaging biomarkers were assessed by using a Cox proportional hazards model. Results: For the prediction of postoperative recurrence, the area under the receiver operating characteristics curve was 0.796 (95% confidence interval: 0.692, 0.900) for 2D MSSA, 0.776 (95% confidence interval: 0.667, 0.886) for 3D MSSMPR, and 0.835 (95% confidence interval: 0.749, 0.922) for 3D SV0HU. The optimal cutoff value for 3D SV0HU for predicting tumor recurrence was 0.54 cm3, with a sensitivity of 0.933 (95% confidence interval: 0.679, 0.998) and a specificity of 0.716 (95% confidence interval: 0.605, 0.811) for the recurrence. Significant predictive factors for disease-free survival were 3D SV0HU greater than or equal to 0.54 cm3 (hazard ratio, 6.61; P = .001) and lymphatic and/or vascular invasion derived from histopathologic analysis (hazard ratio, 2.96; P = .040). Conclusion: The measurement of 3D SV0HU predicted the postoperative prognosis of patients with part-solid lung cancer more accurately than did 2D MSSA and 3D MSSMPR.

DOI： 10.1148/radiol.2018172319

Web of Science

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s10147-017-1219-6

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11748-017-0827-4

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ejcts/ezx124

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objectives: The aim of this study was to investigate the feasibility and safety of our surgical experiences conducted in collaboration with cardiovascular surgeons at our institution. Methods: From May 2002 to December 2015, among 3595 general thoracic surgeries, 75 (2.1%) operations were carried out collaboratively with cardiovascular surgeons at Nagoya University Hospital. We investigated the surgical procedures, manipulated organs, morbidity and mortality, completeness of surgical resection, and prognosis of these 75 cases. Results: The study cohort consisted of 56 males and 19 females, ranging in age from 18 to 79 years (median 60 years). Fifty-eight patients had a malignant disease, and 17 had a benign disease. Out of 75 collaborative surgeries, 53 (71%) were scheduled cases (cardiovascular surgeons’ support was considered to be necessary preoperatively), and 22 (29%) were emergent cases (cardiovascular surgeons’ support was considered to be necessary intraoperatively). No 30- or 90-day mortality was observed. Respiratory failure, defined as the requirement of mechanical ventilation or non-invasive positive pressure ventilation for ≥5 days, was the most common morbidity (n = 14, 18%). Forty-three patients (78%) out of 55 with thoracic neoplasms achieved microscopic complete resection. The resection status of the remaining 12 (22%) was microscopic residual tumor. Conclusion: Collaborative surgeries with cardiovascular surgeons at our institution were feasible. High-quality surgeries with a good balance between safety and completeness of resection are important not only for treatment, but also in terms of education for general thoracic surgeons.

DOI： 10.1007/s11748-017-0800-2

Web of Science

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00268-017-3938-2

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2016.11.067

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.18999/nagjms.79.1.37

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s40792-017-0293-3

Web of Science

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Respiratory Medicine Case Reports  

A previously healthy 73-year-old man was hospitalized with left complicated effusion and a consolidation in the left upper lung. He underwent a chest tube insertion and was treated with clindamycin but the consolidation remained after the treatment. We subsequently performed flexible bronchoscopy but it was impossible to make a diagnosis. Three months later, the consolidation had worsened so we performed another bronchoscopy. Finally, we were able to diagnose the consolidation as pulmonary actinomycosis, and to treat the condition appropriately. Pulmonary actinomycosis is a rare and difficult condition to diagnose. There are many conditions with similar clinical features, such as tuberculosis, fungal infections, lung abscesses, and lung malignancy. Respiratory physicians should consider the possibility of pulmonary actinomycosis when investigating patients with persistent pulmonary infiltrations. Early diagnosis and correct treatment may lead to a good prognosis and prevent unnecessary surgery.

DOI： 10.1016/j.rmcr.2017.04.008

Scopus

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.lungcan.2015.04.011

記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

記述言語：英語  

DOI： 10.3390/cells9041019

PubMed

記述言語：英語  

DOI： 10.21037/jtd.2019.12.108

PubMed

記述言語：英語  

DOI： 10.18999/nagjms.82.1.25

PubMed

記述言語：英語  

DOI： 10.1016/j.ebiom.2020.102632

PubMed

記述言語：英語  

DOI： 10.1007/s10147-020-01624-x

PubMed

記述言語：英語  

DOI： 10.1016/j.jtcvs.2019.12.089

PubMed

記述言語：英語  

DOI： 10.1007/s00595-019-01821-w

PubMed

記述言語：英語  

DOI： 10.1007/s11748-019-01122-6

PubMed

記述言語：日本語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：(NPO)日本肺癌学会  

記述言語：英語  

DOI： 10.1053/j.semtcvs.2019.09.002

PubMed

記述言語：英語  

DOI： 10.21037/jtd.2019.08.48

PubMed

記述言語：英語  

DOI： 10.1007/s00595-019-01822-9

PubMed

記述言語：英語  

DOI： 10.18999/nagjms.81.2.291

PubMed

記述言語：英語  

DOI： 10.1007/s10147-018-1362-8

PubMed

記述言語：英語  

DOI： 10.1016/j.athoracsur.2018.08.037

PubMed

記述言語：英語  

Purpose To investigate the relationship between the postoperative prognosis of patients with part-solid non-small cell lung cancer and the solid component size acquired by using three-dimensional (3D) volumetry software on multidetector computed tomographic (CT) images. Materials and Methods A retrospective study by using preoperative multidetector CT data with 0.5-mm section thickness, clinical records, and pathologic reports of 96 patients with primary subsolid non-small cell lung cancer (47 men and 49 women; mean age ± standard deviation, 66 years ± 8) were reviewed. Two radiologists measured the two-dimensional (2D) maximal solid size of each nodule on an axial image (hereafter, 2D MSSA), the 3D maximal solid size on multiplanar reconstructed images (hereafter, 3D MSSMPR), and the 3D solid volume of greater than 0 HU (hereafter, 3D SV0HU) within each nodule. The correlations between the postoperative recurrence and the effects of clinical and pathologic characteristics, 2D MSSA, 3D MSSMPR, and 3D SV0HU as prognostic imaging biomarkers were assessed by using a Cox proportional hazards model. Results For the prediction of postoperative recurrence, the area under the receiver operating characteristics curve was 0.796 (95% confidence interval: 0.692, 0.900) for 2D MSSA, 0.776 (95% confidence interval: 0.667, 0.886) for 3D MSSMPR, and 0.835 (95% confidence interval: 0.749, 0.922) for 3D SV0HU. The optimal cutoff value for 3D SV0HU for predicting tumor recurrence was 0.54 cm3, with a sensitivity of 0.933 (95% confidence interval: 0.679, 0.998) and a specificity of 0.716 (95% confidence interval: 0.605, 0.811) for the recurrence. Significant predictive factors for disease-free survival were 3D SV0HU greater than or equal to 0.54 cm3 (hazard ratio, 6.61; P = .001) and lymphatic and/or vascular invasion derived from histopathologic analysis (hazard ratio, 2.96; P = .040). Conclusion The measurement of 3D SV0HU predicted the postoperative prognosis of patients with part-solid lung cancer more accurately than did 2D MSSA and 3D MSSMPR. © RSNA, 2018.

DOI： 10.1148/radiol.2018172319

PubMed

記述言語：日本語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：(NPO)日本肺癌学会  

記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）  

DOI： 10.1007/s00595-017-1567-x

PubMed

記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）  

DOI： 10.1007/s11748-017-0800-2

PubMed

記述言語：英語  

DOI： 10.1093/ejcts/ezw178

PubMed

記述言語：英語  

DOI： 10.1186/s40792-016-0151-8

PubMed

記述言語：英語  

DOI： 10.1016/j.athoracsur.2016.03.014

PubMed

記述言語：英語  

DOI： 10.1016/j.athoracsur.2015.11.067

PubMed

記述言語：英語  

DOI： 10.1093/ejcts/ezv389

PubMed

記述言語：英語  

DOI： 10.1007/s11748-015-0564-5

PubMed

記述言語：英語  

DOI： 10.1007/s11748-015-0525-z

PubMed

記述言語：英語  

DOI： 10.1007/s00595-014-0894-4

PubMed

記述言語：英語  

DOI： 10.1111/his.12428

PubMed

記述言語：英語  

DOI： 10.2188/jea.JE20140102

PubMed

記述言語：英語  

DOI： 10.1093/icvts/ivu233

PubMed

記述言語：英語  

DOI： 10.1007/s11748-013-0345-y

PubMed

記述言語：英語  

DOI： 10.1097/JTO.0000000000000020

PubMed

記述言語：英語  

DOI： 10.1093/ejcts/ezs419

PubMed

記述言語：英語  

DOI： 10.1093/ejcts/ezs627

PubMed