Topical erythritol combined with L-ascorbyl-2-phosphate inhibits staphylococcal growth and alleviates staphylococcal overgrowth in skin lesions of canine superficial pyoderma.

Erythritol (ERT) and L-ascorbyl-2-phosphate (APS) are bacteriostatic, but their effects on staphylococcal skin infections remain unknown. We aimed to determine whether ERT combined with APS inhibits the growth of staphylococci that are commonly isolated from pyoderma skin lesions in dogs. We investigated the individual and combined effects of ERT and APS on the growth of Staphylococcus pseudintermedius, S. schleiferi, and S. aureus using turbidity assays in vitro. Skin lesions from 10 dogs with superficial pyoderma were topically treated with 5% ERT and 0.1% APS for 28 days, and swabbed skin samples were then analyzed using 16S rRNA amplicon sequencing and quantitative real-time PCR (qPCR). Results showed that ERT inhibited S. pseudintermedius growth regardless of harboring the mecA gene, and APS increased the inhibitory effects of ERT against S. pseudintermedius, S. schleiferi, and S. aureus in vitro. Moreover, combined ERT and APS decreased the prevalence of staphylococci on canine skin lesions at the genus level. The combination slightly increased the α-diversity but did not affect the ß-diversity of the microbiota. The qPCR results revealed that the combination significantly decreased S. pseudintermedius and S. schleiferi in skin lesions. Topical administration of EPS combined with APS can prevent staphylococcal colonization on the surface of mammalian skin. The results of this study may provide an alternative to systemic antibiotics for treating superficial pyoderma on mammalian skin surfaces.

Clinical effects of combined Lactobacillus paracasei and kestose on canine atopic dermatitis.

Probiotics and prebiotics are viable bacteria with beneficial effects on the host and components that selectively act on the beneficial commensal bacteria, respectively. The combined use of probiotics and prebiotics is termed synbiotics. Probiotic intake improves dysbiosis in the intestinal microbiota and can positively affect canine atopic dermatitis (CAD). However, clinical studies on improvements in CAD using synbiotics remain limited. In this study, 15 dogs with CAD who received prednisolone, a synthetic glucocorticoid (GC) used in the treatment of CAD, for more than 90 days were continuously treated with Lactobacillus paracasei M-1 from fermented food as a probiotic, and trisaccharide kestose as a prebiotic, for 90 days to determine their synbiotic effects on CAD. The CAD symptoms were evaluated using the canine atopic dermatitis lesion index (CADLI) and pruritus visual analog scores (PVAS) at 30, 60 and 90 days after synbiotic administration. The total prednisolone use for 90 days pre- and post-administration was also evaluated. Synbiotic administration significantly reduced the CADLI (pre: median, 28.0 [22.0-32.0]; 30 days: median, 20.0 [20.0-28.0]; 60 days: median, 20.0 [10.0-21.0]; 90 days: median, 12.0 [10.0-19.0]) and PVAS (pre: median, 6.0 [5.0-7.0]; 30 days: median, 3.0 [3.0-3.5]; 60 days: median, 3.0 [3.0-3.5]; 90 days: median, 2.0 [2.0-3.5]) scores, and reduced the total prednisone use over 90 days (pre: 112.0 [25-450] mg; post: 80.0 [18.-300.0] mg; p⟨0.001) in the 15 dogs. Thus, the synbiotic activity of L. paracasei M-1 and trisaccharide kestose can improve CAD.

The bacteriostatic effect of erythritol on canine periodontal disease-related bacteria.

Erythritol helps both prevent and improve periodontal disease and is therefore widely used for dental care in humans. However, only a few studies have investigated the effects of erythritol on periodontal disease in animals. We hypothesized that erythritol could be used to prevent and improve periodontal disease also in canines and investigated the effects of erythritol on canine periodontal disease-related pathogenic bacteria using both in vitro and in vivo methods. The effect of erythritol on the proliferation of Porphyromonas gulae, which is reportedly associated with canine periodontal disease, was investigated in vitro. In addition, a 4-week intervention trial using an external gel preparation containing 5% erythritol was performed in canines with mild periodontal disease; changes in the microbiota around periodontal lesions were investigated using next-generation sequencing and bioinformatics analysis. The growth of P. gulae was significantly suppressed by erythritol in vitro. In the intervention study, the Shannon index, an indicator of the species distribution α-diversity, and the occupancy of several canine periodontal disease - related bacteria ( P. gulae, P. cangingivalis) were significantly decreased in periodontal lesions. Based on the results of in vitro and in vivo studies, we conclude that, as in humans, erythritol has bacteriostatic effects against periodontal disease - related bacteria in canines.

COVID-19 transmission in dental and oral/maxillofacial surgical practice during pandemic: questionnaire survey in 51 university hospitals in Japan.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has become a major public health problem. Dental procedures that generate aerosols are considered to impose a high risk of infection; therefore, dental professionals, such as dentists and dental hygienists, may be at high risk of viral transmission. However, few studies have reported COVID-19 clusters in dental care settings. AIM: To investigate whether dental and oral/maxillofacial procedures are associated with the occurrence of COVID-19 clusters and measures taken to prevent nosocomial infection in dental clinics. METHODS: An online questionnaire survey on clinical activities (administrative control), infection control measures (environmental/engineering control, personal protective equipment, etc.), and confirmed or probable COVID-19 cases among patients and clinical staff was administered to the faculties of the dental and oral/maxillofacial surgical departments of university hospitals. FINDINGS: Fifty-one faculty members completed the questionnaire. All members were engaged in the treatment of dental and oral surgical outpatients and actively implemented standard precautions. Fourteen faculty members treated patients with COVID-19, but no infections transmitted from the patients to the medical staff were observed. In seven facilities, patients were found to have the infection after treatment (medical staff came in close contact), but there was no transmission from patients to medical staff. Four facilities had medical staff with infections, but none of them exhibited disease transmission from staff to patients. CONCLUSION: COVID-19 clusters are unlikely to occur in dental and oral surgical care settings if appropriate protective measures are implemented.

The adequate rocuronium dose required for complete block of the adductor muscles of the thigh.

BACKGROUND: Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS: Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced. Rocuronium, 0.15 mg/kg, was repeatedly administered intravenously. The adequate rocuronium dose required for complete block of the thigh muscles, defined as the cumulative dose of rocuronium administered until that time, and its correlation with the first twitch response of the adductor pollicis muscle on train-of-four stimulation after initial rocuronium administration was analyzed. RESULTS: The rocuronium dose found adequate for complete block of the thigh muscles was 0.30 mg/kg in seven patients and 0.45 mg/kg in the remaining four patients, which did not correlate with the first twitch response. At the time of complete block of the thigh muscles, the neuromuscular blockade level of the adductor pollicis muscle varied greatly, although the level was never more profound than a post-tetanic count of 1. CONCLUSION: Although the response of the adductor pollicis muscle to rocuronium cannot be used to determine the adequate rocuronium dose required for complete block of the thigh muscles, intense blockade, with maintenance of post-tetanic count at ≤ 1 in the adductor pollicis muscle is essential to prevent the obturator jerk.

Incidence of elevated procalcitonin and presepsin levels after severe trauma: a pilot cohort study.

Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses. In this study, 75 patients were included. PCT levels on days 0 and 1 were 0.1±0.4 and 1.8±6.3 ng/ml, respectively (P=0.02). PSEP levels on days 0 and 1 were 221±261 and 222±207 pg/ml, respectively (P=0.98). As per multivariate logistic regression analyses, packed red blood cell (PRBC) transfusion was the only independent risk factor for higher PCT levels on day 1 (P=0.04). Using PCT to diagnose sepsis in trauma patients on day 1 requires caution. PRBC transfusion was found to be a risk factor for increasing PCT levels. On the other hand, PSEP levels were not affected by trauma during the early phases.

Importance of absorbable surgical sutures for the prevention of stitch abscess after surgery in patients with oral squamous cell carcinoma.

BACKGROUND: To elucidate the significance of absorbable surgical sutures in the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC). MATERIAL AND METHODS: The subjects were 251 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using absorbable surgical sutures. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing between our present and previous data. RESULTS: There was only one stitch abscess among the 251 patients. A significant difference in the incidence of stitch abscess was found between the present data and our previous data. Of course, no significant correlations were found between the occurrence of stitch abscess using absorbable surgical sutures and the various factors seen in our previous analysis. CONCLUSIONS: A complete switch of surgical sutures from silk to absorbable surgical sutures is needed for surgery in patients with oral SCC.

Analysis and measurement of dielectrophoretic manipulation of particles and lymphocytes using rail-type electrodes.

A particle manipulation and sorting device using the dielectrophoretic (DEP) force is described in this study. The device consists of "ladder-type", "flip-type" and "oblique rail-type" electrode regions. The ladder-type and rail-type electrodes can generate a DEP force distribution that captures the particles, the DEP force of which is negative, in the area located at the center of the electrodes. The ladder-type electrode can align the particles with equal spacing in the streamwise direction. Using the flip-type electrode, which pushes the particles away, in combination with these electrodes, the direction of the particle and timing can be selected with high accuracy, reliability, and response. In the first half of this study, a numerical simulation is carried out to calculate the particle motion and evaluate the performance of the ladder-type electrode. Several models are used to investigate the influences of the non-uniformity of the electric field and the electric interaction of the surface charges and polarizations. Experiments are then carried out to demonstrate the motions of the particles and the sorting reliability. The trajectories and the probability density functions of the particles at the inlet and outlet of the electrode region showed that by using these electrodes the particles can be aligned, sorted, and guided accurately.

Circulating microparticles from diabetic rats impair endothelial function and regulate endothelial protein expression.

AIM: Diabetes mellitus increases the risk of cardiovascular disease, which is accompanied by functional and structural changes in the vascular system. Microparticles (MPs) have been described as biological vectors of endothelial dysfunction in other pathologies. However, the molecular mechanisms underlying their formation and signalling are unclear. We investigated the role of MPs derived from streptozotocin (STZ)-induced diabetic rats in endothelial function. METHODS: Male Wistar rats were injected with STZ to induce diabetes, and MPs isolated from control or STZ-induced diabetic rats were characterized by dot blotting (assessed by CD62P detections), flow cytometry (assessed by annexin V detections) and ELISA. Carotid arteries from rats were incubated with MPs, and expressions of enzymes and endothelium-dependent relaxation were analysed. RESULTS: The circulating levels of MPs, particularly the levels of platelet-derived microparticles, from diabetic rats were higher than those present in controls. Endothelium-dependent relaxation induced by acetylcholine (ACh) was attenuated in carotid arteries from STZ-induced diabetic rats. Following the incubation of control carotid arteries with MPs isolated from STZ rats, ACh-induced endothelium-dependent relaxation was impaired, but MPs isolated from control rats had no such effect. Furthermore, the effect of MPs was mediated by a decrease in expression of endothelial nitric oxide synthase (eNOS) and the overexpression of caveolin-1. CONCLUSION: Circulating MPs isolated from STZ-induced diabetic rats induce endothelial dysfunction in carotid arteries and regulate protein expressions of eNOS and caveolin-1. These data advance our understanding of the deleterious effects of circulating MPs observed in disorders with diabetic complications.

Immunohistochemical distribution and morphometric analysis of aquaporin-3 in oral squamous cell carcinoma.

This study aimed to evaluate the relationship of aquaporin-3 (AQP3) expression with clinico-pathological parameters and lymph node metastasis in patients with oral squamous cell carcinoma (SCC). The immunohistochemical distribution of AQP3 was investigated in normal squamous epithelium and SCC tissue of 48 cases of SCC of the tongue and floor of the mouth. The percentage of the total AQP3-positive SCC tissue area relative to the total tumour tissue area (T-AQP3) was calculated as a morphometric AQP3 parameter for each patient. Furthermore, the percentage of the AQP3-positive area relative to the SCC tissue area at the invasion front (F-AQP3) was calculated as another AQP3 parameter. The immunostaining pattern of AQP3 in SCC tissue was irregular and weaker than that in normal epithelium. Well-differentiated SCCs had higher T-AQP3 and F-AQP3 values than poorly differentiated SCCs. SCCs with an infiltrative invasion pattern had lower F-AQP3 than SCCs with expansive and intermediate patterns. SCCs with T-AQP3 <27% or F-AQP3 <17% showed an increased incidence of lymphatic metastasis, and multivariate analysis demonstrated that F-AQP3 was an independent prognostic factor of lymphatic metastasis. These results suggest that AQP3 is involved in keratinocyte differentiation and decreased AQP3 expression is associated with more aggressive tumour behaviour.

Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling.

PURPOSE: To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. METHODS: The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and >6 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. RESULTS: The F-OD was 2.67±0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77±0.33 DD (P<0.001). The F-RV was also significantly shorter than the MH-RV on the inner nasal area (from 0.85±0.16DD to 0.79±0.15DD; P<0.001), the inner temporal area (from 0.82±0.15DD to 0.77±0.14DD; P<0.001), and outer nasal area (from 1.70±0.31DD to 1.65±0.32DD; P<0.001), but it was significantly longer than the MH-RV in the outer temporal area (from 1.65±0.29DD to 1.68±0.29DD; P<0.001). CONCLUSION: Our results showed that successful closure of a MH by vitrectomy with ILM peeling and gas tamponade leads to a displacement of the center of the macula toward the optic disc.

Scleral thickness in highly myopic eyes measured by enhanced depth imaging optical coherence tomography.

PURPOSE: The purpose of this study was to determine the subfoveal scleral thickness in highly myopic eyes by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and to identify the ocular parameters significantly associated with the scleral thickness. METHODS: The subfoveal scleral thickness of myopic eyes (≥-8 diopters (D) or axial length ≥26.5 mm) was examined by EDI-OCT. The correlations between the thickness and the best-corrected visual acuity (BCVA), refractive error, axial length (AL), the subfoveal retinal thickness, choroidal thickness, and posterior staphyloma height 2 mm from the fovea were investigated. RESULTS: A total of 75 eyes of 54 patients (21 men, 33 women; mean age, 62.3±11.3 years; mean AL, 30.2±1.68 mm) were studied. Eighteen eyes had no pathological retinochoroidal lesions, and 57 eyes had retinochoroidal lesion, that is, myopic schisis, choroidal neovascularization, and other retinochoroidal pathologies. The mean subfoveal scleral thickness was 284.0±70.4 µm, and the thickness was significantly correlated negatively with the absolute value of the nasal and overall average posterior staphyloma height (P<0.05 and P<0.01, respectively). The subfoveal scleral thickness was also significantly correlated negatively with the relative value of the superior, nasal, and overall average posterior staphyloma height (P<0.05, P<0.01, and P<0.001, respectively). Stepwise analyses showed that the factor most significantly associated with the scleral thickness was the average relative posterior staphyloma height (F=16.0, P<0.001). The scleral thickness was not significantly different between eyes with and without myopic retinochoroidal pathologies (P>0.05). CONCLUSION: Posterior staphyloma formation was a key factor associated with a posterior scleral thinning in highly myopic eyes.

The prevalence of dogs with lymphocyte proliferative responses to food allergens in canine allergic dermatitis.

The aim of the present study was to examine the correlation between the results of lymphocyte proliferative test (LPT) specific to food allergens and allergic skin diseases in dogs. Investigations were performed in 138 dogs with allergic skin diseases diagnosed in a private animal hospital. Of the 138 animals, 97 cases had positive reactions in LPT specific to food allergens. Of these 97 dogs, 67 animals were diagnosed with canine atopic dermatitis (CAD), but 30 dogs did not have IgE antibodies to environmental allergens. As 14 dogs out of 30 animals showed a positive result, 12 dogs underwent elimination diet trial based on the test results and all of them showed improvement in the pruritus score. Therefore, we conclude that LPT is an effective diagnostic test for allergic skin disease. Results of the lymphocyte test are useful in the identification of food allergens for the elimination diet trial.

MRI findings of mucoepidermoid carcinoma of the parotid gland: correlation with pathological features.

OBJECTIVE: The aim of this study was to correlate the MRI appearance and pathological findings in each grade of the mucoepidermoid carcinoma (MEC) of the parotid gland. METHODS: We reviewed surgically proven MECs of parotid glands in 20 patients. Pathologically, 5 tumours were high-grade, 3 were intermediate and 12 were low-grade. MR images were evaluated with emphasis on signal intensities on T(2) weighted images, margin characteristics and lymph node metastasis, correlating these with pathological features. RESULTS: Among the high-grade MECs, four out of five tumours showed inhomogeneous low to intermediate signal intensity on T(2) weighted images, reflecting high cellularity. All tumours had an ill-defined margin, reflecting invasive tumour growth. Among the intermediate-grade MECs, all three tumours showed intermediate signal intensity on T(2) weighted images and two tumours had an ill-defined margin. Among the low-grade MECs, 11 of the 12 tumours had a hyperintense area on T(2) weighted images because of the existence of abundant mucin secreting cells. Seven tumours had an ill-defined margin, reflecting peritumoural inflammatory changes rather than invasive tumour growth. Lymph node metastasis was seen in three high-grade MECs. CONCLUSION: MECs of the parotid gland show variable MRI findings reflecting their histological nature, which seems to have certain tendencies depending on the tumour grade.

stx genotype and molecular epidemiological analyses of Shiga toxin-producing Escherichia coli O157:H7/H- in human and cattle isolates.

The relationship between human diseases caused by infection with Shiga toxin (Stx)-producing Escherichia coli (STEC) O157 strains and O157 strains isolated from cattle was investigated in an area where stockbreeding is prolific. For this purpose, the stx genotypes, the molecular epidemiological characteristics of 268 STEC O157 strains including 211 human-origin strains and 57 cattle-origin strains, and clinical manifestations of 210 STEC-infected people were analyzed. Of 211 human-origin strains, 92 strains (44%) were of the stx1/stx2 genotype, and 74 strains (35%) were of the stx2c genotype. Most of the people infected with stx2c genotype strains presented no symptoms or mild symptoms such as slight diarrhea, except for 3 patients with bloody diarrhea. Of the 57 cattle-origin strains, 27 strains (47%) were of the stx2c genotype and 17 strains (30%) were of the stx1/stx2 genotype. Pulsed-field gel electrophoresis (PFGE) and insertion sequence (IS) analysis demonstrated that 11 isolates (41%) of the 27 cattle isolates of the stx2c genotype had high homology (>95% identity) with human isolates. These results suggest that some genetic patterns of the stx2c genotype strains might be preserved in cattle or their surrounding environment for several years, and during these periods, they might have opportunities to infect people through various routes. Because of the mild virulence of the stx2c genotype strains, they seemed to be transmitted asymptomatically from cattle to humans and then spread from person to person. It may be a public health concern. Further, they occasionally cause severe symptoms in humans; therefore, caution is warranted for infections by stx2c genotype O157 strains, in addition to stx2-possessing genotype O157 strains.

[Plasmacytoid urothelial carcinoma of the bladder with prostate cancer: report of two cases]. / Variante plasmacytoïde de carcinome urothélial vésical et cancer prostatique : à propos de deux cas.

Plasmacytoid urothelial carcinoma (PUC) is a rare variant of urothelial carcinoma with aggressive clinicopathological behaviours. We experienced two cases of PUC of urinary bladder. Both cases were advanced cancer with extravesical invasion and lymph node metastases. They also had coexisting prostatic carcinoma, one was preoperatively diagnosed and the other was incidentally discovered after surgery. As these cases were the first report of PUC simultaneously associated with prostatic carcinoma, clinicopathological features and the treatment options were discussed.

Calcified nodule in the buccal submucosa: a case report.

A 34-year-old man developed an ovoid swelling in the right buccal submucosa adjacent to Stensen's duct. Computed tomography revealed a 25 x 20 mm, well-demarcated calcified mass. The excised mass was encapsulated by soft tissues and contained a calcified nodule measuring 15 x 15 x 10 mm. Histopathologic examination revealed the absence of neoplastic cells. The peripheral wall of the mass was infiltrated by inflammatory cells and contained hemorrhages with minimal calcifications. The central portion of the mass was composed of foreign body granuloma-like changes and multiple calcified nodules that were diffusely hyalinized with fibrous connective tissue. The patient has been followed for six years with no recurrence. Accurate diagnosis is important to avoid unnecessary and mutilating surgery. To our knowledge, this is the first reported case of a calcified nodule in the buccal submucosa of an adult.

A study of lesions induced in Seriola dumerili infected naturally with Streptococcus dysgalactiae.

An outbreak of disease in Seriola dumerili occurred from August to October in 2007 and 2008. The fish developed lesions of the caudal peduncle, pectoral and/or dorsal fin and the heart. The lesions were characterized by moderate to severe infarction with areas of microabscessation and multifocal granulomatous inflammation associated with the presence of Streptococcus dysgalactiae antigen. This is the first report to describe the immunohistology of the lesions induced in S. dumerili following natural infection with S. dysgalactiae.

Determinants of outcomes following acute child encephalopathy and encephalitis: pivotal effect of early and delayed cooling.

BACKGROUND: Acute encephalopathy/encephalitis is one of the most important causatives of mortality and neurological deficit during childhood. The aim of this retrospective observational study was to investigate clinical variables and therapeutic options associated with the outcome of children with acute encephalopathy/encephalitis. METHODS: Relationships between the clinical information at admission and the neurological outcome evaluated using Pediatric Cerebral Performance Category Scale (PCPC) at 12 months after admission were assessed in 43 patients who were treated at 10 Japanese paediatric intensive care units. RESULTS: Sixteen patients were cared for at normothermia, whereas mild hypothermia was applied to 27 children. In univariate analysis, ages ≤ 18 months, marked elevation in serum lactate dehydrogenase (LD) and aspartate transaminase, diagnosis of either acute necrotising encephalopathy or haemorrhagic shock and encephalopathy syndrome and longer hypothermic periods were associated with increased risks of death or severe neurological deficit, whereas hypothermia showed pivotal effects: the outcome of children cooled after 12 h of diagnosis was statistically invariant with normothermic children, but was significantly worse compared with children cooled ≤ 12 h. In multivariate analysis, younger ages and elevated serum LD were associated with adverse outcomes, whereas early initiation of cooling was related to favourable outcomes. For normothermic children, PCPC scores were dependent on the computed tomographic findings suggestive of cerebral oedema, serum LD levels and Glasgow Coma Scale at admission. For hypothermic children, PCPC scores depended on longer delays in cooling initiation. CONCLUSION: Without therapeutic hypothermia, the outcome of children was determined by variables suggestive of the severity of encephalopathy/encephalitis at admission. Hypothermia may have pivotal impacts on the outcome of children according to the timing of cooling initiation following acute encephalopathy/encephalitis.

[Thymic cancer with superior vena cava invasion reconstructed by ready-made Y-graft].

A 57-year-old woman was admitted to our hospital with a complaint of left supraclavicular lymph node's swelling in January 2007. Computed tomography (CT) showed the lobulated tumor suspected of superior vena cava (SVC) invasion, located in the anterior mediastinum, 5 x 3 cm in size. The patient underwent thymectomy, resection of SVC, and partial resection of the right upper lobe. SVC was reconstructed by ready-made Y-graft (Hemashied phi 18 x 9 mm). Histopathological diagnosis was thymic cancer, poorly differentiated squamous cell carcinoma. The patient was discharged on 21st postoperative day. Postoperative radiotherapy (RT : 12.6 Gy) was canceled for the side effect. Alternatively, adjuvant chemotherapy [carboplatin (CBDCA) +paclitaxel (PTX)] was administered. Additional RT (50 Gy) was given to the lesion of local recurrence 1 and half year after the operation. The patient was alive without any signs of recurrence after RT. Left side bypass graft was patent at 8 months postoperatively, but was obliterated thereafter. Right side bypass is patent at more than 2 years postoperatively. Ready-made Y-graft can be one of the choices of SVC reconstruction.