Simplified Attachable EEG Revealed Child Development Dependent Neurofeedback Brain Acute Activities in Comparison with Visual Numerical Discrimination Task and Resting.

The development of an easy-to-attach electroencephalograph (EEG) would enable its frequent use for the assessment of neurodevelopment and clinical monitoring. In this study, we designed a two-channel EEG headband measurement device that could be used safely and was easily attachable and removable without the need for restraint or electrode paste or gel. Next, we explored the use of this device for neurofeedback applications relevant to education or neurocognitive development. We developed a prototype visual neurofeedback game in which the size of a familiar local mascot changes in the PC display depending on the user's brain wave activity. We tested this application at a local children's play event. Children at the event were invited to experience the game and, upon agreement, were provided with an explanation of the game and support in attaching the EEG device. The game began with a consecutive number visual discrimination task which was followed by an open-eye resting condition and then a neurofeedback task. Preliminary linear regression analyses by the least-squares method of the acquired EEG and age data in 30 participants from 5 to 20 years old suggested an age-dependent left brain lateralization of beta waves at the neurofeedback stage (p = 0.052) and of alpha waves at the open-eye resting stage (p = 0.044) with potential involvement of other wave bands. These results require further validation.

[Inflammatory Pulmonary Myofibroblast Tumor Suspected of Pulmonary Metastasis of the Lung Cancer;Report of a Case].

Inflammatory myofibroblastic tumor (IMT) of the lung is a rare disease. The patient underwent the chemoradiotherapy for primary left lung cancer which showed complete responce (CR) by the treatment. A different nodule of 10 mm in diameter was found in the left lung by computed tomography (CT). Positron emission tomography(PET) showed positive detection correspond to the nodule ( SUVmax 4.82). A partial lung resection was carried out, and the tumor was diagnosed as IMT pathologically.

[Re-expansion Pulmonary Edema after Surgery for Spontaneous Tension Hemopneumothorax;Report of a Case].

A 23-year-old man was admitted to our hospital because of chest pain and dyspnea. X-ray and computed tomography showed left tension hemopneumothorax. After the emergent surgery, re-expansion pulmonary edema (RPE) occurred. Non-invasive positive pressure ventilation (NPPV) was applied to control RPE and RPE was successfully recovered. NPPV may be useful in managing RPE.

[Hemothorax Occurring after Chest Drainage for Tension Pneumothorax;Report of a Case].

A 23-year-old man was transported to our hospital complaining of chest pain and dyspnea. Chest X-ray revealed the right side tension pneumothorax with pleural effusion. A 12 Fr. chest tube was inserted. After 6 hours of chest drainage, the sign of intrathoracic bleeding appeared and the emergency operation was performed. The bleeding point was successfully coagulated with electrocautery. The postoperative course was uneventful.

[Thymoma with Pure Red Cell Aplasia;Report of a Case].

A thymoma with pure red cell aplasia (PRCA) is relatively rare. A 71-year-old woman complainted of dizziness and her blood cell count showed a severe anemia. She was diagnosed as PRCA by bone marrow aspiration biopsy, which showed marked decrease in number of erythroblasts. In addition, the chest computed tomography revealed a solid tumor in the anterior mediastinum. She underwent extended thymothymectomy through median sternotomy. The resected specimen was 10.5×9.7 cm in diameter. The pathological diagnosis was type AB thymoma of the World Health Organization classification, and Masaoka stage I. Ciclosporin was started to treat PRCA 3 months after the surgery, and she has been well for about 1 year after surgery without recurrence of thymoma or relapse of anemia.

[Thymoma with Multilocular Cystic Change;Report of a Case].

A 21-year-old male was pointed out an abnormal shadow on chest X-ray. Chest computed tomography showed a multilocular cystic mass of 10×4×4 cm in size in the anterior mediastinum. The tumor and the left lobe of the thymus was resected by median sternotomy. Pathologically, type AB thymoma as found in the wall of the cyst.

[Schwannoma in the Middle Mediastinum Originating from the Vagal Nerve；Report of a Case].

A 44-year-old woman was referred to our department with a mediastinal tumor detected by computed tomography performed as a preoperative examination for cervical cancer. There was a 32 mm solid mass in the area surrounded by the descending thoracic aorta, esophagus, left atrium, left lower lobe, and mediastinal pleura. The tumor was removed thoracoscopically. The mass was regarded as a neurogenic tumor arisen from the branch of the vagus nerve. Neither symptoms of postoperative neurological disorders nor signs of recurrence have been noted to date. The histopathological diagnosis was schwannoma.

[Thymoma showing enlargement and reduction in size with inflammatory events;report of a case].

An 87-year-old male who had gone surgery for bladder cancer in 1994, was pointed out a mass in the anterior mediastinum by follow up in May 2007. Thereafter, no change in size of the mass had been noted. In February 2011, however, enlargement of the tumor with inflammation and right pleural effusion was found. While waiting for surgery, the patient experienced regression of the tumor, and the pleural effusion disappeared. Tumor excision and combined resection of the lung and pericardium were performed. Postoperative histopathological findings showed Masaoka stageI thymoma of type B1 according to the World Health Organization( WHO) Classification. Granulation due to old inflammation, precipitation of cholesterin crystals, hemorrhages, and necrosis were noted in the tumor. In the differential diagnosis of tumors in the anterior mediastinum with spontaneous regression, thymoma should be considered.

[Report of a successful case of multidisciplinary therapy for a patient with lung and liver metastasis from rectal adenocarcinoma].

A strategy of multidisciplinary therapy is considered necessary for the longer survival of a patient diagnosed with advanced colorectal cancer. We report a successful multi-disciplinary therapy case of a 70's-year-old male who received pulmonary resection for metastatic lung cancer twice after primary resection for rectal cancer. Solitary metastatic liver cancer with portal vein tumor thrombus (PVTT) was diagnosed 5 years and 4 months after primary surgery. Although systemic chemotherapy was started immediately, disease control was poor and local pulmonary recurrence appeared. Although intrahepatic metastasis was considered the most important prognostic factor, radiation therapy against PVTT (50 Gy) was initially performed to control disease. After verifying that no new recurrent lesions had arisen during radiation therapy, a third pulmonary resection (in the left upper remnant lobectomy)was performed. Hepatectomy(in the right lobectomy)was then performed for curative purposes. Pathological efficacy of radiation therapy to PVTT was revealed as GradeIb according to Evans' classification. In accordance with the patient's request, no adjuvant treatment was planned. Seven years after primary resection no sign of recurrence is evident. Radiation therapy is suggested to be most useful for disease control and patient selection.

[A study of laparoscopic stoma creation for patients with malignant bowel obstruction].

UNLABELLED: We evaluated the efficacy of laparoscopic palliative stoma creation for patients with malignant bowel obstruction (MBO). PATIENTS AND METHODS: Twenty-four patients with MBO who underwent laparoscopic stoma creation between January 2009 and December 2012 were studied and their clinical outcome was evaluated retrospectively. RESULTS: Compared to the open approach, the laparoscopic approach led to significantly shorter operation times and a significantly lower incidence of surgical site infection( SSI). The rate of removal of the intestinal tube and intravenous drip after surgery was 100% and 88%, respectively, and the rate of oral intake was 100% after palliative stoma creation. The prognosis was 58% in 3 months and 29% in 1 year, and the median survival time was approximately 4 months. DISCUSSION: The quality of surgery by the laparoscopic approach was better than that by the open approach, and the quality of life( QOL) after stoma creation was better than that before surgery. Given the shorter operation time, lower incidence of SSI, and better QOL, laparoscopic stoma creation is a beneficial choice for palliative treatment in patients with MBO.

[A case of Stage IV sigmoid colon cancer cured with radical combined modality therapy].

The patient was a 54-year-old man who had undergone resection of the sigmoid colon for unresectable sigmoid colon cancer with multiple liver( H1), lymph node, and lung metastases at the previous hospital. Chemotherapy with 5-fuorouracil, Leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab was initiated after surgery. The outcome was partial response. The patient was introduced to our hospital because he had relocated. Based on the findings of the patient's computed tomography( CT) and positron emission tomography( PET)-CT scans, we decided to perform radical resection. We performed partial hepatectomy( S7 and S8) and pancreatoduodenectomy for metastases to the hepatoduodenal ligament lymph node. After confirming that there was no recurrence, he underwent right partial pneumonectomy. Currently, the patient shows no signs of recurrence. The therapy for colon cancer should include aggressive radical surgery to control metastasis.

[Long-term efficacy of chemotherapy for unresectable gastric cancer with multiple bone metastases-a case report].

A 49-year-old man was admitted to our hospital with back pain, appetite loss, and body weight loss in January 2009. Gastroduodenal endoscopy, abdominal computed tomography( CT), and magnetic resonance imaging( MRI) revealed type 4 advanced gastric cancer( signet-ring cell carcinoma) with multiple lymph node( No. 16 LNs), right adrenal gland, and multiple bone metastases. Between February 2009 and April 2011, 20 courses of S-1( 80 mg/m2) plus CDDP( 60 mg/m2) and zoledronic acid hydrate (4 mg/body) were administrated. Since May 2011, S-1 (70 mg/m2) and zoledronic acid hydrate( 4 mg/body) have been continued. The lymph node and adrenal gland metastases showed a complete response( CR), and the gastric tumor showed a partial response; however, the bone metastases did not show CR or progressive disease (PD) for 4 years after initiation of therapy. Chemotherapy with zoledronic acid hydrate is considered as a useful therapeutic option for advanced unresectable gastric cancer with multiple bone metastases.

[A case report of locally recurrent rectal cancer after low anterior resection that led to a pathological complete response to neoadjuvant chemoradiotherapy].

We report a case of low anterior resection that led to a pathological complete response of locally recurrent rectal cancer to neoadjuvant chemoradiotherapy. A 57-year-old male patient underwent low anterior resection for rectal cancer pathologically diagnosed as type 2, tub2>tub1,pSS,INF b,int,ly2,v2,pPM0,pDM0,no,M0,H0,P0, and fStage II. After 2 years and 11 months, local recurrence of his rectal cancer was identified by colon fiberscopy. Neoadjuvant chemoradiotherapy was conducted with CPT-11, UFT/LV, and radiation(50 Gy),and this recurrent lesion exhibited a partial response to the chemoradiotherapy regimen according to magnetic resonance imaging findings. Then, we performed total pelvic exenteration, and the pathological examination revealed a pathological complete response.

[A case of alpha-fetoprotein-producing recurrent lung adenocarcinoma successfully treated with radiation therapy(high-grade adenocarcinoma of fetal lung type)].

A 71-year-old woman with a high serum α-fetoprotein (AFP) level was closely examined systemically, and a solid nodule was identified in the right middle lobe of her lung by chest computed tomography. As this lesion was highly suspected to be primary lung cancer, right middle lobectomy was performed via hybrid video-assisted thoracic surgery. According to histopathological examination, this lesion consisted of papillary adenocarcinoma and well-differentiated fetal adenocarcinoma (WDFA). In addition, the component of WDFA was positive for AFP, according to immunohistochemical staining. The lesion was eventually diagnosed as AFP-producing primary lung adenocarcinoma, pT2aN2M0, pStage IIIA. The serum AFP level was promptly normalized after surgery. Three courses of adjuvant chemotherapy were administered, but her serum AFP level gradually increased. Thereafter, local recurrence was recognized at the mediastinum 5 months after surgery. Conventional irradiation was delivered to the ipsilateral hilum and mediastinum. Consequently, the metastatic lesion in the mediastinal lymph node was completely eradicated, and her serum AFP level decreased to normal limits. Currently, the patient is alive without local relapse for 23 months after surgery. It is believed that radiation therapy might be an effective treatment option for AFP-producing primary lung adenocarcinoma.

Surgical management of primary intrathoracic goiters.

Intrathoracic goiters account for 3.1%-5.8% of all mediastinal masses. Primary intrathoracic goiters, which receive their blood supply from mediastinal vessels and disconnect at the cervical thyroid, are even rarer. This report presents two cases of surgical resection of benign and malignant primary intrathoracic goiters. Usefulness of a whole-body (18)F-fluorine-2-fluoro-D: -glucose positron emission tomography/computed tomography study and intraoperative fine-needle aspiration cytology in the management of primary intrathoracic goiters is discussed.

Outcome of surgical resection for recurrent pulmonary metastasis from colorectal carcinoma.

BACKGROUND: The outcomes after repeat pulmonary resection for colorectal cancer (CRC) and the factors associated with the prognosis of these patients remain uncharacterized. METHODS: Data on 156 patients who underwent curative resection of pulmonary metastasis from CRC were reviewed. Repeat pulmonary resection was performed in 25 patients; the present study examined the outcomes and factors associated with prognosis after repeat pulmonary resection. RESULTS: The 5-year survival rate after the first pulmonary resection was 56.2%. A multivariate analysis identified a histological type other than well-differentiated adenocarcinoma, a high prethoracotomy serum carcinoembryonic antigen (CEA) level, and the presence of hilar or mediastinal lymph node metastasis as poor prognostic factors for the first pulmonary resection. The 5-year survival rate after repeat pulmonary resection was 42.1%. Hilar or mediastinal lymph node metastasis at the time of the repeat resection was significantly associated with poor survival. CONCLUSIONS: Repeat pulmonary resection for metastatic CRC provides satisfactory outcomes. Hilar or mediastinal lymph node involvement is consistently associated with a poor prognosis after the first and repeat pulmonary resections.

[Simultaneous surgery for left lung cancer and the aneurysm of an aberrant left subclavian artery in a patient with right aortic arch].

A 69-year-old man with right aortic arch was diagnosed as having left lung cancer (cT2aN1M0, cStage IIA) and an aneurysm of an aberrant left subclavian artery. The aneurysm measured 36 mm in diameter and was located 1 cm peripheral from the origin in the area known as "Kommerell's diverticulu Left carotid artery-to-left subclavian artery bypass graft was placed through a left supraclavicular incision prior to thoracotomy. This bypass graft effectively prevented neurological and ischemic complications of the brain and left upper extremity while we safely and successfully performed resection of the aneurysm along with radical surgery for left lung cancer through left thoracotomy. There have been only 10 case reports, including the present case, that have described surgical resection of lung cancer in a patient with right aortic arch. In addition, this is the 1st report to describe simultaneous surgery for both left lung cancer and an aneurysm of an aberrant left subclavian artery in a patient with right aortic arch.

Effect of wood properties on within-tree variation in ultrasonic wave velocity in softwood.

The radial variations in the velocity of longitudinal waves propagating through Japanese cedar and Japanese cypress were experimentally investigated. In addition, the tracheid length (TL), microfibril angle (MFA), air-dried density (AD), and moisture content (MC) were measured in order to determine the effect of wood properties on velocity variations within the wood trunk. For both species, the longitudinal wave velocities measured in the longitudinal direction (V(L)) exhibited minimum values near the pith. For Japanese cedar, V(L) increased from 3600m/s toward the bark and soon attained a constant value (=4500m/s). On the other hand, for Japanese cypress, V(L) kept increasing from 4000m/s near the pith to 4800m/s at the bark. These radial variations in V(L) coincided with those in the tracheid length. V(L) exhibited strong correlations with TL and MFA with a significant level of (p<0.01). These findings suggest that the TL and MFA greatly affect the radial variation in the ultrasonic wave velocity in softwood.

Prediction of chemotherapeutic effect on postoperative recurrence by in vitro anticancer drug sensitivity testing in non-small cell lung cancer patients.

BACKGROUND AND AIMS: The collagen gel droplet embedded culture drug test (CD-DST), is an in vitro anticancer drug sensitivity test. The test has been used with various types of malignant tumors, but the significance of clinical application remains unknown. The aim of the present study is to evaluate the ability of this test to predict the response to chemotherapy in non-small cell lung cancer (NSCLC) patients. METHODS: From January 2000 through March 2007, CD-DST data using the primary tumor specimens to anticancer drugs such as cisplatin (CDDP), carboplatin (CBDCA), paclitaxel (PAC), docetaxel (TXT), gemcitabine (GEM), and vinorelbine (VNR), was successfully obtained from 382 patients that underwent a radical resection for NSCLC. Eighty-one of those patients received 1st line chemotherapy using a "new generation" of anticancer drugs for postoperative recurrence. The chemotherapy regimen consisted of a CDDP (or CBDCA)-based combination (N=41), non-CDDP-based combination (N=1) and single agent (N=39). The predictability of the chemotherapeutic effect by the CD-DST data was analyzed retrospectively. RESULTS: Partial response (PR) was obtained in 24 patients (response rate=30%), stable disease (SD) in 33 (41%) and progressive disease (PD) in 24 (30%). Forty-two patients underwent chemotherapy with one or more CD-DST-sensitive drugs, 21 of whom showed PR (RR=50%), whereas only 3 (8%) patients showed PR with chemotherapy with regimen including no CD-DST-sensitive drugs. Good predictability was obtained, with a 50% positive predictive value (PPV) for PR and a 92% negative predictive value (NPV) by CD-DST. The predictive accuracy for the response based on the CD-DST data was 70%. Interestingly, a subset analysis according to recurrence site showed that the predictive accuracy was highest (86%) for CD-DST-based chemotherapy for recurrence in the lymph nodes. CONCLUSIONS: The application of the CD-DST for "new generation" anticancer drugs using surgically resected specimens of primary lesion in NSCLC patients may be clinically useful in the prediction of the response to chemotherapy for postoperative recurrence. CD-DST-oriented chemotherapy for postoperative recurrence especially in the lymph nodes may therefore be promising for the improvement of the treatment outcome.

Malignant pleural mesothelioma with long-term tumor disappearance of a local relapse after surgery: a case report.

INTRODUCTION: There have been few reports of spontaneous regression of malignant pleural mesothelioma, but the mechanism for this is unknown. We present a case report on a patient with malignant pleural mesothelioma showing apparent tumor disappearance in a local relapse after surgery. CASE PRESENTATION: A 73-year-old man presented with malignant pleural mesothelioma in the right thoracic cavity. A pleurectomy was performed, and as expected, the tumor locally relapsed with increasing chest pain. However, the symptoms suddenly improved while the tumor was apparently reduced, and spontaneous tumor regression was initially considered. The patient confessed that he had self-administered a mushroom extract with alternative parasympathetic nerve stimulation therapy thereafter. The complete disappearance of the tumor was clinically achieved during a 29-month follow-up with continuing self-treatment. CONCLUSION: This is the first report describing a malignant pleural mesothelioma patient in Japan showing long-term complete disappearance of a local relapse after surgery. This event was a tumor regression possibly due to an immunological effect of combined complementary and alternative therapy.