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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2007.10.035 Byline: Hiroaki Nomori (a), Takeshi Mori (a), Koei Ikeda (a), Koichi Kawanaka (b), Shinya Shiraishi (b), Kazuhiro Katahira (c), Yasuyuki Yamashita (b) Abbreviations: ADC, apparent diffusion coefficient; CR, contrast ratio; CT, computed tomography; DWI, diffusion-weighted magnetic resonance imaging; FDG, fluorodeoxyglucose; FN, false-negative; FP, false-positive; MRI, magnetic resonance imaging; NSCLC, non-small cell lung cancer; PET, positron emission tomography; STIR, short tau inversion recovery; SUV, standard uptake value; TE, echocardiographic time; TN, true-negative; TP, true-positive; TR, repetition time Abstract: One of the deficiencies of positron emission tomography for N staging in lung cancer is a false-positive result caused by concurrent lymphadenitis. Recently, diffusion-weighted magnetic resonance imaging has been reported to be able to image tumors of body organs. The aim of this study is to examine the usefulness of diffusion-weighted magnetic resonance imaging for N staging of non-small cell lung cancer compared with positron emission tomography-computed tomography. Author Affiliation: (a) Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (b) Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (c) Department of Radiology, Kumamoto Central Hospital, Kumamoto, Japan Article History: Received 9 July 2007; Revised 23 October 2007; Accepted 31 October 2007

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.10.026 Byline: Takeshi Mori (a), Hiroaki Nomori (a), Koei Ikeda (a), Hironori Kobayashi (a), Kazunori Iwatani (a), Toshiaki Kobayashi (b) Abbreviations: FH, follicular hyperplasia; MG, myasthenia gravis Abstract: We sought to examine the distribution of parenchyma, follicles, and lymphocyte subsets in the thymus of patients with myasthenia gravis and to identify determinants of remission after thymectomy. Author Affiliation: (a) Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (b) Department of Assistive Diagnostic Technology, National Cancer Center Hospital, Tokyo, Japan. Article History: Received 6 August 2006; Revised 7 October 2006; Accepted 23 October 2006 Article Note: (footnote) Supported, in part, by a Grant-in-Aid from the Ministry of Health, Labor and Welfare of Japan.

Type IV collagen, a major component of the basement membrane (BM), is composed of six genetically distinct α(IV) chains, α1(IV) to α6(IV). Their genes are paired on three different chromosomes in a head-to-head arrangement. The α5(IV) gene (COL4A5) and the α6(IV) gene (COL4A6) are on chromosome Xq22 and are regulated by a bidirectional promoter. Loss of the α5(IV)/α6(IV) chains in epithelial BM occur in the early stage of cancer invasion. However, the regulatory mechanism of the specific loss of the α5(IV)/α6(IV) chains during cancer cell invasion is still undetermined. In the present study, we examined the expression of the α5(IV)/α6(IV) chains and the methylation profiles of the bidirectional promoter region of COL4A5/COL4A6in colon cancer cell lines and colorectal tumor tissues. The expression of the α5(IV)/α6(IV) chains was down-regulated in colorectal cancer, and the loss of expression of the α5(IV)/α6(IV) chains was associated with the hypermethylation of their promoter region. In conclusion, the hypermethylation of the bidirectional promoter region of COL4A5/COL4A6is one of the events that is responsible for the loss of expression of the α5(IV)/α6(IV) chains and the remodeling of the epithelial BM during cancer cell invasion.

Abstract: We performed extrapleural pneumonectomy (EPP) with combined resection of the diaphragm and pericardium via a lower door open (LDO) thoracotomy to treat right malignant pleural mesothelioma (MPM) in a 57-year-old man. Specifically, we extended the standard posterolateral thoracotomy skin incision along the anterior costal arch, and performed the thoracotomy by cutting into the 6th to 9th costal cartilage. The resulting defect of the diaphragm and pericardium were reconstructed with a reversed latissimus dorsi (LD) muscle flap and a fascia lata graft, respectively. The patient had an uneventful postoperative course without dyspnea or dysfunction of the extremities. The LDO thoracotomy provided a good operative field, especially for the costo- and cardiophrenic angles, allowing a complete resection of the diaphragm to be performed easily. Furthermore, the reversed LD muscle flap and fascia lata graft proved to be ideal autologous materials for reconstruction of both the diaphragm and the pericardium.

Purpose. To identify prognostic factors for metastatic osteosarcoma patients and establish indication for repeat metastasectomy. Methods. Data from 37 patients with pulmonary metastasis from osteosarcoma who underwent metastasectomy in our institute from 1979 to 2013 were retrospectively reviewed. Results. Prognostic factors analyzed were age, sex, maximal diameter of the tumor at first pulmonary metastasectomy, total number of resected pulmonary metastases at first metastasectomy, number of surgeries, and disease free interval. In our analysis, characteristics associated with an increased overall survival were age > 15 years and fewer metastases (≤3). Of the 37 patients, 13 underwent repeat metastasectomy after the first metastasectomy. Of the 7 patients that underwent only two metastasectomies, three remained disease-free. In contrast, all six patients that underwent three or more metastasectomies died of relapse. Patients who had five or less lesions at second metastasectomy showed better survival compared to those who had six or more lesions. Conclusion. Age > 15 years and number of metastases at first metastasectomy were independent prognostic factors. Metastasectomy may provide curative treatment even in cases requiring repeat surgery. The number of metastases at second metastasectomy may be a potential predictor of the need for repeat surgery.