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Background Previously, it has been shown that using a fixed ratio of FEV1/FVC of 0.7 to classify airway obstruction could not predict survival outcomes in lung cancer patients undergoing thoracic surgery. We demonstrated that use of the lower limit of normal (LLN) of FEV1/FVC may allow better risk stratification for postoperative outcomes in patients with chronic obstructive pulmonary disease (COPD) patients. Nevertheless, it remained unclear whether survival outcomes in this population could be predicted by LLN-defined airway obstruction. Objective To evaluate the clinical relevance of LLN-defined airway obstruction to survival outcomes. Methods The clinical relevance of LLN-defined airway obstruction was analyzed and compared in 699 subjects, using Kaplan–Meier curves and the log-rank test. A Cox regression model was used to explore prognostic risk factors. Results One hundred-and-seventy-eight subjects were assigned to the below-LLN group, in which airflow obstruction determined by the FEV1/FVC ratio was below the LLN. Five hundred-and-twenty-one subjects were assigned to the above-LLN group. The below-LLN group had a worse overall survival (OS) and disease-free survival (DFS) than the above-LLN group. The diffusing capacity of the lung for carbon monoxide and the ratio of the inspiratory capacity divided to the total lung capacity were independent risk factors for OS and DFS. Conclusions A standardized assessment of LLN-defined airway obstruction may allow risk stratification for survival likelihood in lung cancer patients who undergo thoracic surgery.

Introduction: The presence of ground glass opacity (GGO) on high-resolution computed tomography (HRCT) is well known to be pathologically closely associated with adenocarcinoma in situ. Recently, measuring the tumor diameter including areas of GGO on HRCT has been reported to possibly overestimate the T status. The purpose of this study was to evaluate the significance of the tumor size measured eliminating the area of GGO on HRCT as a prognostic factor and to propose a refined TNM classification based on modified T descriptors. Methods: Four hundred seventy-five patients with clinical T1a-T2bN0M0 non-small-cell lung cancer underwent surgical resection. All tumors were reclassified based on the diameter measured eliminating the GGO area on HRCT according to the seventh TNM classification of lung cancer. We defined this new classification as modified T descriptors categorizing into five groups: mTis, mT1a, mT1b, mT2a, and mT2b. The overall survival rates of the patients in the current and modified staging groups were evaluated. Results: The 5-year survival rates were 88% and 82% in the patients with T1a and T1b tumors and 90% and 75% in the patients with mT1a and mT1b tumors, respectively. The differences in the survival rate of the patients classified by using mT1a and the other modified T descriptors were more clearly separated statistically than those of the patients classified by using the current T1a and other T descriptors. Conclusion: The modified T descriptors of the tumor size measured eliminating the GGO component on HRCT more clearly classified the prognoses of patients with early lung cancer than did the current T classification.

In this paper, a three-degree-of-freedom model is employed for computer simulation to determine the relationship between the planar and roll motions of a large-size vehicle, so that the roll motion could be eventually predicted to prevent the vehicle from going dynamically unstable. Factors such as the varying center of gravity height and roll steer are also taken into consideration. An experiment is conducted using an actual truck with and without load to investigate its effect on the dynamics of the vehicle.

A primary sternal tumor is rare, and it is difficult to make an accurate diagnosis. We herein report a case of intraosseous schwannoma of the sternum, which was associated with various difficulties in regard to making an accurate preoperative diagnosis. A 38-year-old woman underwent a surgical resection for a sternal tumor. Preoperative radiologic images showed a well-defined, dumbbell-shaped and solid nodule in her sternum. However, a definitive diagnosis could not be obtained before the operation. The pathologic findings of the resected specimen revealed schwannoma, Antoni type A. No recurrence has been observed during her postoperative course.