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Interactions between CXCL12 and its receptors CXCR4 or CXCR7 are involved in tumor growth and metastasis in various types of human cancer. However, CXCL12 expression and its role in lung cancer are not fully elucidated. Here we examined the expression of CXCL12 in 54 lung cancer cell lines consisting of 23 small cell lung cancers (SCLCs) and 31 non-small cell lung cancers (NSCLCs). CXCL12 was overexpressed in lung cancer cell lines compared to non-malignant human bronchial epithelial cell lines (N = 6). CXCL12 expression was positively but weakly correlated with the expression of CXCR4 or CXCR7. We also examined CXCL12 expression in 89 NSCLC specimens and found that CXCL12 expression was significantly higher in tumor specimens from female patients, non-smokers and adenocarcinoma patients. Small interfering RNAs targeting CXCL12 inhibited cellular proliferation, colony formation and migration of CXCL12-overexpressing lung cancer cells; however, this inhibition did not occur in lung cancer cells that lacked CXCL12. Furthermore, the anti-CXCL12 neutralizing antibody mediated inhibitory effects in three lung cancer cell lines that overexpressed CXCL12, but not in two CXCL12 non-expressing lung cancer cell lines nor two non-malignant bronchial epithelial cell lines. The present study demonstrates that: CXCL12 is concomitantly overexpressed with CXCR4 or CXCR7 in lung cancers; CXCL12 is highly expressed in NSCLCs from females, non-smokers and adenocarcinoma patients; and disruption of CXCL12 inhibits the growth and migration of lung cancer cells. Our findings indicate that CXCL12 is required for tumor growth and provide a rationale for the anti-CXCL12 treatment strategy in lung cancer.

Objective A pulmonary segmentectomy is requires the identification of the segmental planes, making it technically more difficult than a lobectomy. Therefore, we present a new method that uses a butterfly needle to distinguish the intersegmental plane under video-assisted thoracoscopic surgery (VATS). Methods From May 2005 to August 2008, 15 patients underwent anatomic segmentectomy using VATS. In this approach, a working port 4 to 7 cm in length was made in the fifth intercostal space. Additional 1.2-cm thoracic ports were made in the seventh intercostal space on the anterior axillary line and the ninth intercostal space on the posterior axillary line. Each segment was selectively isolated, and the targeted bronchovascular pedicle was divided. For the segmentectomy, the lung was deflated, and the pulmonary artery and vein to the involved segment were divided. The segmental bronchus was divided using a stapling device. Using a butterfly needle, oxygen/air (1–2 L) was used to inflate the involved segment, and the involved segment was severed and removed using electrocautery or a stapling device. The raw surface was covered with an absorbable sealing material such as polyglycolic acid to prevent air leaks. Results Using this method, apical segment of the right upper lobe (S1), apical posterior segment of the left upper lobe (S1 + 2), upper division, and posterior segment of the right upper lobe (S2), superior segment of the right or left lower lobe (S6), and basal segmentectomies could be performed with VATS. However, the technique did not work in one patient with severe emphysematous changes, because the plane was not readily identifiable. Conclusions Butterfly-needle video-assisted segmentectomy is a useful technique. Selective segmental inflation allows the intersegmental plane to be identified completely under the surgeon's control, eliminating the need for an anesthesiologist to pass a bronchoscope or insufflate the lung in a particular manner.

Information about the impacts of disasters on health is useful for establishing hazard prediction maps and action plans of disaster management. This study aims at learning effective asthma management from the volcano disaster of Mount Asama eruption in Japan on September 1, 2004. We conducted a cross-sectional study to assess the acute impact of volcanic ash on asthma symptoms and their treatment changes by using a questionnaire completed by 236 adult asthmatic patients and their physicians. In the ashfall over 100g/m2 area, 42.9% of asthma patients suffered exacerbations, PEF decreased, asthma treatments increased, and inhalation of β2 stimulants was used most for exacerbated asthma. Compared to severe asthma patients, mild and moderate asthma patients were most at risk. Severe asthma patients were not affected since most of them knew their asthma status was severe, and did not go outside and kept windows closed. Deteriorated asthma symptoms of wheezing, chest tightness and cough appeared in the ashfall over 100g/m2 area. Ash contained inhalable 10μm diameter particles, and included high concentrations of airway toxic substrates of silica. These data suggest that ashfall over 100 g/m2 is harmful, access to these areas by asthma patients needs to be restricted, and these areas need to improve asthma treatment. In addition, the increase in the proportion of asthma patients with wheeze and cough are diagnostic clues for ash-induced asthma in affected areas, and can be used by doctors to tell whether patients are receiving sufficient asthma treatment.