[A Case of Successful Drainage for Mediastinitis during Chemotherapy for Unresectable Advanced Esophageal Cancer].

A 78-year-old man complained of dysphagia. Gastrointestinal endoscopy showed a Type 2 tumor in the lower esophagus and a Type 0-Ⅱa lesion in the posterior wall of the upper gastric body. An enhanced CT scan showed several swollen abdominal and cervical lymph nodes as well as bilateral lung multiple nodules, suggesting distant metastasis. We diagnosed the patient with double cancers consisting of an unresectable advanced esophageal squamous cell carcinoma with multiple lymph nodes and lung metastases(Lt, cT3N4M1, cStage Ⅳb)and early gastric cancer(U, post, cType 0-Ⅱa, cT1N0M0, cStageⅠ). On day 4 of the first course of chemotherapy(docetaxel plus cisplatin plus 5-FU: DCF), a high fever was observed. A chest CT scan revealed suspected mediastinitis and right pyothorax due to perforation by the esophageal cancer. Thoracoscopic mediastinal drainage was immediately performed. CT-guided abscess drainage was added for a residual abscess in the right thoracic cavity on day 10 after drainage surgery. The patient's general condition improved, and he was discharged on 24th postoperative day. The patient was able to reinstitute and continue DCF therapy until disease progression.

Successful management of thymic neuroendocrine tumour with paraneoplastic limbic encephalitis.

A 42-year-old man was referred to psychiatry with acute onset of confusion and agitation. His screening computed tomography scan showed middle mediastinal tumours. Preoperative cerebrospinal fluid analysis was positive for anti-contactin-associated protein-like 2 antibody; possible paraneoplastic limbic encephalitis was diagnosed. Tumour resection was performed. Pathological examination showed thymic neuroendocrine tumour, stage IV. Postoperatively, the patient was treated with everolimus for adjuvant therapy, with complete improvement of encephalitis symptoms. The patient remained well without tumour recurrence or exacerbation of psychiatric disorders for 14 months after the operation.

Application of InSAR and GIS techniques to ground subsidence assessment in the Nobi Plain, Central Japan.

Spatial variation and temporal changes in ground subsidence over the Nobi Plain, Central Japan, are assessed using GIS techniques and ground level measurements data taken over this area since the 1970s. Notwithstanding the general slowing trend observed in ground subsidence over the plains, we have detected ground rise at some locations, more likely due to the ground expansion because of recovering groundwater levels and the tilting of the Nobi land mass. The problem of non-availability of upper-air meteorological information, especially the 3-dimensional water vapor distribution, during the JERS-1 observational period (1992-1998) was solved by applying the AWC (analog weather charts) method onto the high-precision GPV-MSM (Grid Point Value of Meso-Scale Model) water-vapor data to find the latter's matching meteorological data. From the selected JERS-1 interferometry pair and the matching GPV-MSM meteorological data, the atmospheric path delay generated by water vapor inhomogeneity was then quantitatively evaluated. A highly uniform spatial distribution of the atmospheric delay, with a maximum deviation of approximately 38 mm in its horizontal distribution was found over the Plain. This confirms the effectiveness of using GPV-MSM data for SAR differential interferometric analysis, and sheds thus some new light on the possibility of improving InSAR analysis results for land subsidence applications.

Intratracheal recurrence of thymoma 7 years after complete resection.

A 66-year-old woman with a massive anterior mediastinal tumour was diagnosed with type B2 thymoma. After 2 courses of chemotherapy, extended thymectomy and partial resection of the lung and large vessels were performed, and the tumour was completely resected. The patient received no postoperative therapy. Seven years after the surgery, follow-up chest computed tomography showed a papillary soft tissue tumour in the trachea almost obstructing the airway. Intratracheal tumour resection was performed under rigid bronchoscopy, and the pathological diagnosis of intratracheal recurrence of thymoma was made. The patient received postoperative radiotherapy and has remained alive without disease progression 9 months after the second operation.