[Reconstruction after wide resection of the chest wall: application of plates as rigid prosthetic materials].

Wide resection of the chest wall requires reconstruction with rigid prosthetic material to protect the thoracic organs and to avoid flail chest. We tried to use three kinds of plates for chest wall reconstruction in 4 cases: acrylic plate for 1, ultra-high-molecular-weight polyethylene (UHMWP) plate for 1 and methyl metacrylic resin (MMR) plate for 2. Marlex mesh was utilized to strengthen the rebuilt chest wall sandwiching rigid prosthesis in UHMWP plate and MMR plate. Except for somewhat local accumulation of serous fluid in two cases of acrylic plate and MMR plate, postoperative courses were uneventful in all cases. Acrylic plate which was used for patient with metastatic sternal tumor was easily damaged by heat. UHMWP plate which was used for patient with large benign sternal tumor was expensive and took a long time to make. On the other hand, MMR plates which were used for two patients with malignant lateral chest wall tumor were easy to handle on the spot and not expensive. MMR plate sandwiched by Marlex mesh seems to be more suitable and available for chest wall reconstruction.

[Mass screening for early lung cancer by the Miyagi method].

Mass screening for early detection of lung cancer has been in practice from 1982. Up to 1985, 583,549 persons-years have been screened. Screening was done by examining miniature X-rays taken of the chest for all those tested, and by sputum cytology for those thought to be high-risk, 34,044 persons-years. Heavy smokers over 50 years of age comprised much of the high-risk cases and persons evidencing hemoptysis. In a total of 207 detected cases of lung cancer, 120 cases were found by chest X-ray only, 69 cases were uncovered by sputum cytology only, and 18 cases were discovered by both X-ray and cytology. In one hundred and forty-four cases the cancers were resected and in 69 cases the cancers were determined to be in an early stage.