[A case of pleural effusion in a patient with malignant lymphoma diagnosed by thoracoscopy with local anesthesia].

A 47-year-old woman was admitted for examination of massive right pleural effusion on chest radiography, together with chief complaints of dry cough and body weight loss. Exudative effusion was aspirated by thoracentesis, revealing many lymphocytes and a high level of adenosine deaminase. Thoracoscopy with local anesthesia was performed. Elevated white lesions and miliary nodules were observed, and these lesions were examined by thoracoscopic biopsy, leading to a diagnosis of malignant lymphoma. Treatment with chemotherapy (THP-COP) resulted in partial remission. Thoracoscopy with local anesthesia in cases of pleural effusion with malignant lymphoma can be a safe and useful procedure for diagnosis.

Practical application of meridian acupuncture treatment for trigeminal neuralgia.

This report evaluates the effect of meridian acupuncture treatment on trigeminal neuralgia. Ten patients aged 26 to 67 years (mean 55.4 years) who visited the outpatient Dental Anesthesiology Clinic at Tsurumi University Dental Hospital from 1985 to 1990 were studied. Five of the patients suffered from idiopathic and five from symptomatic trigeminal neuralgia. The patients underwent meridian treatment by acupuncture alone or acupuncture combined with moxibustion. The acupuncture method used was primarily basic treatment employing only needles without electrical stimulation. Meridian acupuncture treatments were repeated from two to four times a month. Five patients were restored to a pain-free state. The other five patients noted a decrease in pain, but with some level of pain remaining (significant pain in one patient). It is concluded that meridian acupuncture treatment is useful and can be one therapeutic approach in the management of trigeminal neuralgia.

Interstitial hyperthermia of malignant brain tumors by implant heating system: clinical experience.

An implant heating system using a ferromagnetic implant with low Curie temperature has been developed for treating human brain tumors. Safe and repeated hyperthermia was possible over periods averaging ten weeks in 23 out of 25 patients with malignant brain tumors without development of major side effects. Evaluation of the effects of this new treatment is still preliminary. Overall response rate was 34.8%. However, five of thirteen cases of malignant glioma and two of five cases of brain metastasis were responded well to interstitial hyperthermia given with or without irradiation. Pathological findings common to the treated tumors were circumscribed, ellipsoid shape of coagulation necrosis around the implant. Degeneration of tumor cells, hemorrhage, vascular stasis and thrombosis were found adjacent to the necrosis. In the future, a combination of interstitial hyperthermia with brachytherapy and chemotherapy may offer improved local control of brain tumor.

[Interstitial hyperthermia of malignant brain tumors using implant heating system (IHS)].

We have developed an implant heating system (IHS) for interstitial hyperthermia of brain tumors. IHS consists of three compartments: ferromagnetic implant with low Curie point, induction coil and generator to produce high frequency magnetic field. The device works as follows: It is heated up to a Curie temperature (Tc) by Eddy current under the magnetic field. Heat generated in the implant is conducted to the tumor tissue into which it has been implanted. To evaluate the effect of this hyperthermia, a brain tumor model was produced by innoculation of VX2 tumor cells and treated either by hyperthermia with IHS alone, chemotherapy with ACNU alone, or with a combination of both. The longest survival was obtained by the combined treatment, and significant prolongation of survival was found in the single treatment groups. In the Phase I clinical trial, one or several implants (1.8 mm X 15 mm, Tc = 68 degrees C) made of Fe-Pt alloy were placed in the tumor by CT guided stereotactic procedure, or manually during craniotomy. Hyperthermia of above 42 degrees C for 30 to 60 minutes twice a week was brought about in ten cases of malignant brain tumor. CT evaluation was made in nine cases treated for more than ten times in this way. Five out of the nine cases responded to this hyperthermia with irradiation. In conclusion, a safe, repeated and longterm treatment was possible without significant side effects. The hyperthermia with IHS may also be applicable to benign intracranial tumors and neoplasms in other part of body as well.

[Thermometry of hyperthermia].

Invasive thermometers with a thermo-couple or an optical fiber are widely employed in hyperthermia treatment. A non-invasive method is wanted, but we can not present one at present. Several results obtained in Japan on studies of non-invasive thermometry are as follows: Mizushina, after simultaneous measurement of microwave radiation of the three frequencies located between 1 to 4 GHz, determined in real-time temperature dependence on depth to 5 cm beneath the skin of a rabbit, Yamaura, with his 915 MHz-CT apparatus, obtained 0.4 degree C temperature resolution on the phantom made of a hot cylinder in a cool tank both filled with NaCl solution, and Amemiya et al., assuming use of an NMR apparatus, showed theoretically that temperature could be measured after about 1 minute with the error of +/- 0.5 degree C if one measures M0 parameter in focusing magnetic field mode.

Magnetic induction hyperthermia for brain tumor using ferromagnetic implant with low Curie temperature. I. Experimental study.

Experimental study was made on magnetic induction hyperthermia for brain tumor using ferromagnetic implant with low Curie temperature. Thermoseed (implant) was made of nickel-palladium alloy, which was confirmed to produce enough heat by eddy current and also to have low Curie point between 43 degrees C-58 degrees C. Using this implant heating system, the effect of hyperthermia on normal rat brain and intracutaneously inoculated rat gliosarcoma (T9) were studied. Heat conduction from seed was twice as much in tumor tissue as in normal brain. It was also found that the intradermal brain tumors were completely diminished within 4 weeks by single local hyperthermia at 45 degrees C for 60 min.