[Ingenuity for the Uniportal Video-assisted Thoracic Surgery as a Minimally Invasive Procedure].

Uniportal video-assisted thoracic surgery (VATS) is a minimally invasive, wound-reducing approach performed mainly in Europe and Asia. This approach is rapidly gaining popularity in Japan. We performed a technique with layer awareness, grasping and dissection of tissue membrane even in uniport VATS as for open thoracotomy or multiport VATS. Interference is a problem with uniport VATS because surgical instruments are inserted and removed through a small incision of 4 cm or less;there-fore, instrument selection is critical. The use of curved forceps ensures more working space and reduced interference. The incision should be placed between the 4th or 5th intercostal space and should be 3.5 cm in size at our institution. For vascular manipulation, ligation and transection can be used when it is difficult to divide vessels with a stapler. During mediastinal lymph node dissection, a precise view can be achieved with the use of a custom-made spatula. Uniport VATS was performed in 51 cases from January 2019 to June 2022. Although recurrence was observed in two cases, no serious perioperative complications were observed, and the procedures were performed safely.

[Stage â £ HER2-Positive Breast Cancer That Showed Complete Response for Over One Year after Discontinuation of Anti-HER2 Therapy-A Case Report].

A 75-year-old woman with a left breast mass on breast cancer screening was referred to our hospital for detailed evaluation. Further examination revealed left breast cancer with metastases to the left axilla, left parasternal region, left supraclavicular fossa, mediastinum, and left hilar lymph nodes, as well as multiple lung metastases. Histopathological evaluation of a needle biopsy specimen revealed invasive ductal carcinoma(scirrhous type), and she was diagnosed with Stage Ⅳ human epidermal growth factor receptor 2(HER2)-positive breast cancer. Following diagnosis, treatment was initiated with trastuzumab, pertuzumab, and docetaxel; however, she developed hypersensitivity to docetaxel and received only trastuzumab and pertuzumab after the second course. We observed a complete response after 3 courses, and treatment was discontinued after 13 courses. She underwent regular evaluation after treatment discontinuation, and a complete response was maintained for 1 year and 6 months. We conclude that combination therapy comprising trastuzumab and pertuzumab was effective for Stage Ⅳ HER2-positive breast cancer and that a complete response could be maintained even after treatment discontinuation.

Measurement of basic characteristics of scintillation-type radiation survey meters with multi-pixel photon counter.

The basic characteristics of three low-cost radiation survey meters using multi-pixel photon counters (MPPC), the C12137, T-GMK2-S, and iMetry, were measured. The linearity of the dose rate was confirmed over the full range of each instrument. All the survey meters could obtain gamma-ray energy spectra, with an accuracy within ±â€¯30% of the theoretical value. These survey meters are therefore applicable for radiation management.

Evaluation of basic characteristics of a semiconductor detector for personal radiation dose monitoring.

Real-time radiation dose management is important because staff members working in interventional radiology may be exposed to relatively high doses of primary and scattered radiation from the body of a patient. In this study, we investigated the dependence of energy and dose rate of the commercially available semiconductor detector named Pocket Geiger (POKEGA) for personal monitoring in diagnostic X-rays. In the energy-dependence study, a suitable metal filter and the threshold level were examined for energy compensation using a Monte Carlo calculation code. Moreover, the energy dependence of the POKEGA with an optimal metal filter was compared with that of commercially available active personal dosimeters (APDs). With an aluminum filter, the difference of the ratio of the absorbed dose of silicon to that of air was ±7% for a tube voltage of 70-110 kV and a cutoff energy of 23 keV in the calculation. The energy response of the APDs, except the PDM-122B-SHC and the POKEGA, met the required JIS standard from 50 to 110 kV. In the dose rate-dependence study, a high linearity was observed up to 2.2 mGy h-1 using the POKEGA with an aluminum filter.

AN EVALUATION OF THE BASIC CHARACTERISTICS OF A PLASTIC SCINTILLATING FIBRE DETECTOR IN CT RADIATION FIELDS.

The ionisation chamber for computed tomography (CT) is an instrument that is most commonly used to measure the computed tomography dose index. However, it has been reported that the 10 cm effective detection length of the ionisation chamber is insufficient due to the extent of the dose distribution outside the chamber. The purpose of this study was to estimate the basic characteristics of a plastic scintillating fibre (PSF) detector with a long detection length of 50 cm in CT radiation fields. The authors investigated position dependence using diagnostic X-ray equipment and dependencies for energy, dose rate and slice thickness using an X-ray CT system. The PSF detector outputs piled up at a count rate of 10 000 counts ms-1 in dose rate dependence study. With calibration, this detector may be useful as a CT dosemeter with a long detection length except for the measurement at high dose rate.