18F-fluorodeoxyglucose uptake and apparent diffusion coefficient in lung schwannoma.

Intrapulmonary schwannoma is uncommon and preoperative radiological diagnosis is rare. Described is a schwannoma that developed as a pulmonary hilar nodule in a 38-year-old woman. The nodule showed strong (18)F-fluorodeoxyglucose uptake with a maximum standard uptake value of 5.98 on positron emission tomography and had a high apparent diffusion coefficient (2.5 × 10(3) mm(2)/s) on diffusion-weighted magnetic resonance imaging. Combination of these functional imaging techniques warrants further evaluation in radiological diagnosis of intrapulmonary schwannoma.

Intraoperative ultrasonographic localization of pulmonary ground-glass opacities.

OBJECTIVES: Ground-glass opacities are typically difficult to inspect and to palpate during video-assisted thoracic surgery. We therefore examined whether ultrasonographic assessments could localize ground-glass opacities and help to achieve adequate resection margins. METHODS: An intraoperative ultrasonographic procedure was prospectively performed on 44 patients harboring ground-glass opacities of less than 20 mm in diameter to localize these lesions and to achieve adequate margins. We also examined whether there were any complications resulting from the intraoperative ultrasonogram, such as lung injury, heart injury, or arrhythmia. We excluded patients with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure is more difficult to interpret when residual air is present in the lung. RESULTS: A total of 53 ground-glass opacities were successfully identified by intraoperative ultrasonography without any complications. Of the 20 mixed ground-glass opacities that we examined, 15 were found on palpation. However, only 4 (12.1%) of the 33 pure ground-glass opacities could be palpated. In all instances in which complete collapse of the lung was achieved (30/53 of these cases), high-quality echo images were obtained. Additionally, a strong correlation was found between the resection margins measured by ultrasonogram and the margins determined by histologic examination in the resected lung specimens (r(2) = 0.954, P < .001). CONCLUSIONS: Intraoperative ultrasonography can both safely and effectively localize pulmonary ground-glass opacities in a completely deflated lung. This procedure is also useful for the evaluation of surgical margins in a resected lung. Hence, ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of solitary lung ground-glass opacity.

[Re-evaluation of effects of thymectomy on autoimmune myasthenia gravis].

In Japan, thymectomy for the treatment of autoimmune myasthenia gravis (MG) underwent about 300 cases every year. The number of the cases has most 2001 and is decreasing henceforth. Such reduction is considered because a steadfast proof that thymectomy is effective in the treatment of autoimmune MG is not shown. Thymectomy for autoimmune MG is considerably effective for patient with generalized, severe, female patients. The validity of thymectomy for the treatment of autoimmune MG should be confirmed in a randomized, controlled trial targeted on these types of autoimmune MG patients, with standardized surgical approach.

Histamine and serotonin stimulate eotaxin production by a human lung fibroblast cell line.

Histamine and serotonin are important inflammatory mediators in the pathophysiology of asthma, and asthmatic patients have higher plasma histamine and serotonin levels than nonasthmatic control subjects. Eotaxin, a potent eosinophil-specific chemotactic factor, is increased in the lower respiratory tract of allergic patients. Recently, lung fibroblasts have been reported to produce eotaxin and are suggested to be the major cellular source of eotaxin. We postulated that lung fibroblasts might release eotaxin in response to histamine or serotonin. To test this hypothesis, we evaluated the potential of histamine or serotonin to induce the release of eotaxin by the human fetal lung fibroblast cell line, HFL-1. HFL-1 released eotaxin in response to histamine and serotonin in a dose- and time-dependent manner (p < 0.05). Histamine or serotonin treatment of HFL-1 augmented the expression of eotaxin mRNA. Eosinophil chemotactic activity by HFL-1 supernatant fluids was inhibited by anti-human eotaxin-neutralizing antibody. These findings lead to the hypothesis that lung-fibroblast-derived eotaxin may in part be responsible for the eosinophil infiltration observed in allergic disease of the airways.