Pulmonary Function After Lobectomy: Video-Assisted Thoracoscopic Surgery Versus Muscle-Sparing Mini-thoracotomy.

Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars. Pulmonary function tests were performed a week before surgery and 3 months after surgery. There were 14 males and 11 females in VATS lobectomy and 32 males and 30 females in mini-thoracotomy lobectomy. For lobe location (right upper/right lower/left upper/left lower), there were 12/1/8/4 in VATS lobectomy and 16/19/13/14 in mini-thoracotomy lobectomy, respectively. The percent predicted postoperative forced vital capacity (FVC) (postoperative FVC/predicted postoperative FVC × 100) (110 ± 15 %) of VATS lobectomy was significantly higher than that (101 ± 16 %) of mini-thoracotomy lobectomy (P = 0.0124). The percent predicted postoperative forced expiratory volume in 1 s (FEV1) (postoperative FEV1/predicted postoperative FEV1 × 100) (110 ± 15 %) of VATS lobectomy was not significantly higher than that (104 ± 15 %) of mini-thoracotomy lobectomy (P = 0.091). Multiple regression analysis revealed that operative procedure (VATS lobectomy or mini-thoracotomy lobectomy) was the only significant variable contributing to percent predicted postoperative FVC (P = 0.0073) and percent predicted postoperative FEV1 (P = 0.0180). Postoperative FVC after VATS lobectomy is better than after mini-thoracotomy lobectomy.

Excited-State Proton Transfer of Cyanonaphthols in Protic Ionic Liquids: Appearance of a New Fluorescent Species.

Excited-state proton transfer (ESPT) of 5-cyano-2-naphthol (5CN2) and 5,8-dicyano-2-naphthol (DCN2) in three different protic ionic liquids (PILs), triethylammonium trifluoromethanesulfonate ([N222H][CF3SO3]), triethylammonium methanesulfonate ([N222H][CH3SO3]), and triethylammonium trifluoroacetate ([N222H][CF3COO]), was studied by time-resolved fluorescence. In [N222H][CF3SO3], both 5CN2 and DCN2 showed fluorescence only from ROH* (normal form of substituted naphthol in the excited states), indicating that no ESPT occurred in [N222H][CF3SO3]. For 5CN2 in [N222H][CH3SO3], fluorescence bands from ROH* and RO-* (anionic form of substituted naphthol in the excited states) were observed, indicating that 5CN2 could dissociate proton to surrounding solvents and form RO-*. More interestingly, 5CN2 in [N222H][CF3COO] and DCN2 in [N222H][CH3SO3] and [N222H][CF3COO] showed an anomalous fluorescence band around 470 nm (5CN2) or around 520 nm (DCN2) which has not been reported previously. The kinetics of each fluorescent component of 5CN2 and DCN2 was analyzed on the basis of the time profile of fluorescence intensity. Plausible ESPT schemes of 5CN2 and DCN2 were discussed on the basis of the kinetics and the basicity of anion in PILs.

A Suspected Case of an Alveolar Haemorrhage Caused by Dasatinib.

A 39-year-old man treated with dasatinib for chronic myelogenous leukaemia presented to our hospital with haemoptysis, coughing, and dyspnoea. Chest radiography and computed tomography revealed ground-glass opacities and a crazy-paving pattern. Bronchoalveolar lavage was not performed due to serious hypoxemia and bleeding. Significant bleeding from the peripheral bronchi led to a diagnosis of an alveolar haemorrhage. Dasatinib-induced alveolar haemorrhaging was suspected based on the clinical findings. His condition improved immediately after dasatinib withdrawal and initiation of steroid therapy. Reports of alveolar haemorrhaging induced by dasatinib are rare. As such, this is considered an important case.

Diagnostic Performance of Diffusion-Weighted Imaging for Multiple Hilar and Mediastinal Lymph Nodes with FDG Accumulation.

BACKGROUND: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. MATERIALS AND METHODS: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. RESULTS: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value (1.57±0.29x10(-3) mm2/sec) of malignant MHMLN was significantly lower than that (1.99±0.24x10(-3) mm2/sec) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher (10.0±7.34 as compared to 6.38±4.31) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). CONCLUSIONS: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.

Diffusion Weighted Imaging Can Distinguish Benign from Malignant Mediastinal Tumors and Mass Lesions: Comparison with Positron Emission Tomography.

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. It is uncertain whether DWI is more useful than positron emission tomography-computed tomography (PET-CT) for distinguishing benign from malignant mediastinal tumors and mass lesions. MATERIALS AND METHODS: Sixteen malignant mediastinal tumors (thymomas 7, thymic cancers 3, malignant lymphomas 3, malignant germ cell tumors 2, and thymic carcinoid 1) and 12 benign mediastinal tumors or mass lesions were assessed in this study. DWI and PET-CT were performed before biopsy or surgery. RESULTS: The apparent diffusion coefficient (ADC) value (1.51±0.46x10(-3) mm2/sec) of malignant mediastinal tumors was significantly lower than that (2.96±0.86x10(-3) mm2/sec) of benign mediastinal tumors and mass lesions (P<0.0001). Maximum standardized uptake value (SUVmax) (11.30±11.22) of malignant mediastinal tumors was significantly higher than that (2.53±3.92) of benign mediastinal tumors and mass lesions (P=0.0159). Using the optimal cutoff value (OCV) 2.21x10(-3) mm2/sec for ADC and 2.93 for SUVmax, the sensitivity (100%) by DWI was not significantly higher than that (93.8%) by PET-CT for malignant mediastinal tumors. The specificity (83.3%) by DWI was not significantly higher than that (66.7%) for benign mediastinal tumors and mass lesions. The accuracy (92.9%) by DWI was not significantly higher than that (82.1%) by PET-CT for mediastinal tumors and mass lesions. CONCLUSIONS: There was no significant difference between diagnostic capability of DWI and that of PET-CT for distinguishing mediastinal tumors and mass lesions. DWI is useful in distinguishing benign from malignant mediastinal tumors and mass lesions.

Recurrence and metastasis of lung cancer demonstrate decreased diffusion on diffusion-weighted magnetic resonance imaging.

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. METHODS: A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. RESULTS: Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70?10-3 mm2/sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. CONCLUSIONS: DWI is useful for detection of recurrence and metastasis of lung cancer.

Diagnostic performance of diffusion weighted imaging of malignant and benign pulmonary nodules and masses: comparison with positron emission tomography.

BACKGROUND: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. MATERIALS AND METHODS: One hundred- forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. RESULTS: The apparent diffusion coefficient (ADC) value (1.27 ± 0.35 ?10-3 mm2/sec) of malignant pulmonary nodules and masses was significantly lower than that (1.66 ± 0.58 ?10-3 mm2/sec) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUV max: 7.47 ± 6.10) of malignant pulmonary nodules and masses were also significantly higher than that (3.89 ± 4.04) of benign nodules and masses. By using optimal cutoff values for ADC (1.44?10-3 mm2/sec) and for SUV max (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that (65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG- PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. CONCLUSIONS: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.

Relationships between EGFR mutation status of lung cancer and preoperative factors - are they predictive?

BACKGROUND: The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. MATERIALS AND METHODS: One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. RESULTS: There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:3.66±4.53) in positron emission tomography-computed tomography of mutant LC was significantly lower than that (8.26±6.11) of wild-type LC (p<0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p<0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). CONCLUSIONS: Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.

Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy: a randomized trial.

To expand postoperative residual lungs after pulmonary lobectomy, thoracic drainage with two chest tubes has been recommended. Several studies recently demonstrated that postoperative drainage with one chest tube (PD1) was as safe as that with two chest tubes (PD2). However, most of the patients in those studies underwent lobectomy by standard thoracotomy. Although the number of pulmonary lobectomies by video-assisted thoracic surgery (VATS) has been increasing in recent years, there have been no reports that compared PD1 with PD2 after pulmonary lobectomy, including that by VATS. To elucidate whether postoperative management with PD1 is as safe as that with PD2, we conducted a randomized controlled trial. Lung cancer patients who underwent lobectomies with mediastinal nodal dissection in our hospital were assigned to one of two groups: one chest tube placed in PD1 group and two chest tubes placed in PD2 group. A total of 108 patients were registered in the study. There were no significant differences in the age, gender, pathological stage or histological type between two groups. Since the residual lung expansion was good in both groups, there were no patients who needed thoracentesis. There were no significant differences in the number of cases with pleurodesis, the amount/duration of drainage or the pain of the patients between two groups. In conclusion, since PD1 has advantages in saving cost and time and in low risk of transcutaneous infection, PD1 is appropriate after pulmonary lobectomy by VATS and by open thoracotomy.

Differences in the prognostic significance of the SUVmax between patients with resected pulmonary Adenocarcinoma and squamous cell carcinoma.

BACKGROUND: The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. MATERIALS AND METHODS: Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. RESULTS: The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p<0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p<0.01). CONCLUSIONS: SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.

Diffusion-weighted imaging (DWI) signal intensity and distribution represent the amount of cancer cells and their distribution in primary lung cancer.

The aim of this study was to interpret diffusion-weighted imaging (DWI) signals in lung cancers. They were converted into several three-dimensional DWI signals patterns, which represent the degree of DWI signal intensity by height and the degree of distribution by area: flat, low elevation, irregular elevation, single-peak elevation, multiple-peak elevation, and nodular elevation. There were 39 adenocarcinomas and 21 squamous cell carcinomas. Three-dimensional DWI signals decreased significantly in order of cell differentiation. Tumor cellular densities were increased according to the increase in three-dimensional DWI signals. DWI signal intensity and distribution can represent the amount of cancer cells and their distribution in the carcinoma.

Advantages of diffusion-weighted imaging over positron emission tomography-computed tomography in assessment of hilar and mediastinal lymph node in lung cancer.

BACKGROUND: The significance of diffusion-weighted imaging (DWI) is uncertain for the diagnosis of nodal involvement. The purpose of this study was to examine diagnostic capability of DWI compared with PET-CT for nodal involvement of lung cancer. METHODS: A total of 160 lung cancers (114 adenocarcinomas, 36 squamous cell carcinomas, and 10 other cell types) were analyzed in this study. DWI and PET-CT were performed preoperatively. RESULTS: The optimal cutoff values to diagnose metastatic lymph nodes were 1.70 × 10(-3) mm(2)/s for ADC value and 4.45 for SUVmax. DWI correctly diagnosed N staging in 144 carcinomas (90 %) but incorrectly diagnosed N staging in 16 (10 %) [3 (1.9 %) had overstaging, 13 (8.1 %) had understaging]. PET-CT correctly diagnosed N staging in 133 carcinomas (83.1 %) but incorrectly diagnosed N staging in 27 (16.8 %) [4 (2.5 %) had overstaging, 23 (14.4 %) had understaging]. Sensitivity, accuracy, and negative predictive value for N staging by DWI were significantly higher than those by PET-CT. Of the 705 lymph node stations examined, 61 had metastases, and 644 did not. The maximum diameter of metastatic lesions in lymph nodes were 3.0 ± 0.9 mm in 21 lymph node stations not detected by either DWI or PET-CT: 7.2 ± 4.1 mm in 39 detected by DWI, and 11.9 ± 4.1 mm in 24 detected by PET-CT. There were significant differences among them. The sensitivity (63.9 %) for metastatic lymph node stations by DWI was significantly higher than that (39.3 %) by PET-CT. The accuracy (96.2 %) for all lymph node stations by DWI was significantly higher than that (94.3 %) by PET-CT. CONCLUSIONS: DWI has advantages over PET-CT in diagnosing malignant from benign lymph nodes of lung cancers.

Development of specific and quantitative real-time detection PCR and immunoassays for λ3-interferon.

AIM: Single nucleotide polymorphisms (SNP) around interferon (IFN)-λ3 have been associated with the response to pegylated IFN-α treatment for chronic hepatitis C. Specific quantification methods for IFN-λ3 are required to facilitate clinical and basic study. METHODS: Gene-specific primers and probes for IFN-λ1, 2 and 3 were designed for real-time detection PCR (RTD-PCR). Dynamic range and specificity were examined using specific cDNA clones. Total RNA from hematopoietic and hepatocellular carcinoma cell lines was prepared for RTD-PCR. Monoclonal antibodies were developed for the IFN-λ3-specific immunoassays. The immunoassays were assessed by measuring IFN-λ3 in serum and plasma. RESULTS: The RTD-PCR had a broad detection range (10-10(7) copies/assay) with high specificity (∼10(7) -fold specificity). Distinct expression profiles were observed in several cell lines. Hematopoietic cell lines expressed high levels of IFN-λ compared with hepatocellular carcinoma cells, and Sendai virus infection induced strong expression of IFN-λ. The developed chemiluminescence enzyme immunoassays (CLEIA) detected 0.1 pg/mL of IFN-λ3 and showed a wide detection range of 0.1-10 000 pg/mL with little or no cross-reactivity to IFN-λ1 or IFN-λ2. IFN-λ3 could be detected in all the serum and plasma samples by CLEIA, with median concentrations of 0.92 and 0.86 pg/mL, respectively. CONCLUSION: Our newly developed RTD-PCR and CLEIA assays will be valuable tools for investigating the distribution and functions of IFN-λ3, which is predicted to be a marker for predicting outcome of therapy for hepatitis C or other virus diseases.

[Screening for lung cancer: present and future].

A certified method for lung cancer screening in Japan is the combination of chest X-ray and sputum cytology. The chest Xray examination is intended primarily for the detection of peripheral-type lung cancer. Interpretation of the films should be performed by two different physicians, and the films of screenees suspected to have abnormal shadow should be compared to the same screenee's films from previous screening visits. Sputum cytology is conducted for heavy smokers, and is useful for early detection of central lung cancer. The efficacy of this lung cancer screening method has been shown in several case control studies. There are some problems to solve i. e., a low rate of attendance and inadequate quality control. Low-dose thoracic CT screening is performed with an exposure within a single breath hold, and its interpretation can be conducted with films, CRT, or a LCD monitor. Even when taken at low doses, the radiation exposure dose is large compared to a chest X-ray, being about 3-10 times greater than the absorbed dose and 20-40 times greater than the effective dose. Since the radiation dose in a usual clinical condition is much higher, the clinical condition is not recommended for screening. Concerning the efficacy of low-dose CT screening for heavy-smokers, a positive result was reported in June 2011, and further detailed analyses are required. There are still some problems to solve i. e., the management of undiagnosed shadows, harm caused by the screening, quality control, and efficacy in non-smokers.

Electric conductivities of 1:1 electrolytes in high-temperature ethanol along the liquid-vapor coexistence curve. II. Tetraalkylammonium bromides.

The molar electrolyte conductivities of dilute solutions of the tetramethyl, tetraethyl, tetra-n-propyl, and tetra-n-butylammonium bromides were measured in ethanol along the liquid-vapor coexistence curve up to 160 °C. The limiting molar electrolyte conductivities and the molar association constants were obtained from the analysis of the concentration dependence of the conductivity. The ionic friction coefficients were estimated from the electrolyte conductivities. On the basis of the present data together with the literature ones at higher densities (lower temperatures) and comparisons with the continuum dielectric friction theory, the density (temperature) dependence of the translational friction coefficients of the tetraalkylammonium ions were discussed in the range of 0.810 ≥ ρ ≥ 0.634 g cm(-3) (-5 °C ≤ t ≤ 160 °C). The dielectric friction effect was important for the tetramethylammonium ion in the whole range studied. The tetraethylammonium ion showed a relatively small friction coefficient in ambient condition indicating the structure-loosening effect around the ion, while the dielectric friction effect became more important as the density reduces and the temperature raises. For the tetra-n-butylammonium ion, the friction coefficients were determined mainly by the bulky size effect. The tetra-n-propylammonium ion showed an intermediate tendency between the tetraethylammonium and tetra-n-butylammonium ions.

Do Japanese thoracic surgeons think that dissection of the pulmonary ligament is necessary after an upper lobectomy?

It is uncertain whether the dissection of the pulmonary ligament is necessary in patients who undergo an upper lobectomy. A questionnaire was sent to the directors of Thoracic Surgery in 102 hospitals, asking whether dissection of the pulmonary ligament is performed in such patients, and the complications associated with dissecting or preserving the ligament. Seventy-eight directors (76%) returned the questionnaire. The preservation of the ligament is the current practice in 54 hospitals (69%), while 13 hospitals (17%) occasionally dissect, 9 hospitals (11%) regularly dissect, and 2 hospitals (3%) half dissect the ligament. Thirty directors experienced complications which were thought to be associated with dissecting the ligament: bronchial stenosis (21 directors), atelectasis (8), and bronchial obstruction (4). Twenty-six directors described complications thought to be associated with preserving the ligament: the pooling of pleural effusion (19 directors), insufficient expansion of lung (18), atelectasis (8), and empyema (7). Preservation of the ligament may therefore be useful in preventing bronchial stenosis and obstruction, while its dissection may be useful to prevent the pooling of pleural effusion.

Correlation between glucose transporter-1 expression and 18F-fluoro-2-deoxyglucose uptake on positron emission tomography in lung cancer.

PURPOSE: The aim of this study was to determine if glucose transporter-1 (Glut1) expression correlates with (18)F-FDG ((18)F-fluoro-2-deoxyglucose) uptake on positron emission tomography (PET) in lung cancer and to examine the similarities and differences between them. METHODS: A total of 34 patients with resected primary lung cancers were investigated in this study. There were 17 adenocarcinomas, 12 squamous cell carcinomas, and 5 cancers of other cell types. Immunohistochemical Glut1 intensity was categorized into three groups: negative, positive, and strongly positive. Glut1 frequency was defined by the proportion of positive cells among all cancer cells, and it was graded on a semiquantitative scale as 0-100% in 10% increments. The data are expressed as the mean +/- SD. RESULTS: Maximum standardized uptake values (SUVmax) were 4.8 +/- 6.3 in "negative" Glut1 intensity cases, 4.7 +/- 3.1 in "positive" Glut1 intensity cases, and 11.2 +/- 5.2 in "strongly positive" Glut1 intensity cases. Although SUVmax correlated significantly with tumor size (correlation coefficient 0.58, P = 0.00033), Glut1 frequency did not correlate significantly with tumor size (correlation coefficient 0.18, P = 0.301). Cell type and cell differentiation correlated significantly with Glut1 expression and (18)F-FDG uptake. CONCLUSION: Glut1 expression correlates significantly with (18)F-FDG uptake. There are similarities in cell differentiation and cell type between Glut1 expression and (18)F-FDG uptake. (18)F-FDG uptake correlates significantly with tumor size, but Glut1 expression does not.

Electric conductivities of 1:1 electrolytes in high-temperature ethanol along the liquid-vapor coexistence curve. I. NaBr, KBr, and CsBr.

The molar electric conductivities Lambda of NaBr, KBr, and CsBr were measured in liquid ethanol at temperatures from 60 to 220 degrees C along the liquid-vapor coexistence curve. The limiting molar electrolyte conductivities Lambda(o) and the molar association constants K(A) were determined by the analysis of the concentration dependence of Lambda. The friction coefficients zeta for the Na(+), K(+), Cs(+), and Br(-) ions were estimated from Lambda(o) by an assumption that the cationic transference number of KBr is independent of temperature and density. The density dependences of zeta thus obtained together with literature values at higher densities (lower temperatures) were examined. zeta increases with decreasing density at densities above 2.0rho(c), where rho(c)=0.276 g cm(-3) is the critical density. At lower densities, the density dependences of zeta depend on ion. The relative contribution of the nonviscous effect in zeta was estimated by Deltazeta/zeta, where Deltazeta was the difference between zeta and the Stokes friction coefficient. At densities above 2.7rho(c), Deltazeta/zeta slightly decreases with decreasing density except for the Cs(+) ion. At densities below 2.7rho(c), Deltazeta/zeta increases with decreasing density and the density dependence is larger for larger ion. The results at densities above 2.2rho(c) were well explained by the Hubbard-Onsager (HO) dielectric friction theory [J. Hubbard, J. Chem. Phys. 68, 1649 (1978)] based on the sphere-in-continuum model. Below 2.2rho(c), however, experimental Deltazeta/zeta tends to be larger than the prediction of the HO theory. The lower limit density of the validity range of the HO theory is slightly higher in ethanol than in methanol.

Lung cancer screening and its efficacy.

The efficacy of lung cancer screening should not be evaluated by the survival rate of lung cancer patients but by lung cancer mortality in a certain population because the survival rate can be greatly affected by several types of bias. Randomized controlled trials that were conducted during the 1970s and 1980s in Europe and the United States failed to prove the efficacy of lung cancer screening in decreasing the mortality rate; but recently the results of case-control studies in Japan have revealed that undergoing currently available screening decreases the risk of lung cancer deaths by 30%-60%. A system is now being created in Japan whereby the guidelines regarding cancer screening will continue to be updated. The preliminary reports concerning lung cancer screening using thoracic computed tomography revealed that not only the detection rate of lung cancer but also the survival rate of detected lung cancer patients were surprisingly high. However, the presence of some potential bias in these studies cannot be ignored; therefore, it is still unknown whether there is actual efficacy. Several randomized controlled trials are presently in progress overseas, but the interim results were not favorable. A randomized controlled trial should therefore immediately be started in Japan as well.

Curative wedge resection for non-invasive bronchioloalveolar carcinoma.

Pure bronchioloalveolar carcinomas have no stromal, vascular or pleural invasion, and they are candidates for curative wedge resection, although standard operative procedure for lung cancer is a pulmonary lobectomy. Most lung cancers with ground glass opacity (GGO), namely faint homogeneous shadows with sharp margin, are pure bronchioloalveolar carcinomas. This report presents the results of a pilot study on wedge resection with candidate selection by high-resolution computed tomography and positron emission tomography with 18F-fluorodeoxyglucose (FDG). The criteria for wedge resection were; 1) clinically no nodal or distant metastasis, 2) the location of the tumor was peripheral enough to undergo wedge resection, 3) the diameter of the shadow was 8-20 mm, 4) GGO% (diameter of GGO area/diameter of whole tumor) was 80% or over, 5) FDG uptake of the tumor was less than that of the mediastinum, 6) the intraoperative pathological diagnosis was non-invasive bronchioloalveolar carcinoma, and 7) informed consent was obtained. Nine tumors from 8 patients were selected in the study. The maximum diameter of the tumors was 9-18 mm and GGO% was 82-100%. All of nine tumors were treated with a wedge resection under video-assisted thoracic surgery. The postoperative courses were uneventful and no recurrence has been detected after 19-50-month follow-up. The changes in pulmonary function before and after the surgery were minimal. In conclusion, wedge resections were safely performed without any recurrence, and the postoperative pulmonary function was well preserved, suggesting the advantage of wedge resections for non-invasive bronchioloalveolar carcinomas.