Search

OBJECTIVES To demonstrate the differences in clinical outcomes between lobectomy and segmentectomy for non-small cell lung cancer using propensity score matching. METHODS A single-centre, retrospective, matched cohort study was conducted in clinical T1N0M0 non-small cell lung cancer patients treated by surgery between 2012 and 2019. Differences in freedom from recurrence, overall survival, postoperative complications, chest drainage and preservation of pulmonary function between lobectomy and segmentectomy were evaluated using the propensity score model. Matched variables of patients were age, sex, comorbidity index and pulmonary function. Matched variables of tumours were tumour size, T-stage, fluorodeoxyglucose uptake on positron emission tomography, histopathology, lobe site and tumour distance ratio from the hilum. RESULTS Of the 112 patients treated by lobectomy and 233 patients treated by segmentectomy, 93 patients each from both groups were selected after the matching. The median tumour distance ratio from hilum was 0.7 in lobectomy and 0.8 in segmentectomy group (P = 0.59), i.e. almost outer third tumour location. There were no significant differences in freedom from recurrence (P = 0.38), overall survival (P = 0.51), postoperative complications (P = 0.94), drainage period (P = 0.53) and prolonged air leakage (P = 0.82) between the two. Median preservation of pulmonary function was 93.2% after segmentectomy, which was significantly higher than 85.9% after lobectomy (P, Pulmonary segmentectomy is expected to change the surgical treatment of clinical (c) T1N0M0 non-small cell lung cancer (NSCLC).

Background: Empyema is an infection of the pleura space for which antibiotics and source control are important treatments. Chest tube insertion is the most popular and widely used drainage technique. As much as possible, we customarily attempt to place the tube at the bottom in the thoracic cavity to consider the effects of gravity; however, the effectiveness of this custom is not well-defined. Therefore, we aimed to examine whether the position of the tip of the thoracic tube affects treatment failure in patients with empyema.Methods: In this retrospective observational study, empyema patients who underwent thoracic tube insertion were divided into two groups: those with the tip of the tube positioned below the 10th thoracic vertebra at the level of the diaphragm (lower position group) and those with the tip placed above the 9th thoracic vertebra (upper position group). We compared whether the position of the tube tip affected treatment failure. Stabilized inverse probability treatment weights (SIPTW) were used to balance the baseline characteristics between the groups. Treatment failure showed a composite outcome of hospital death, referral to surgeons for surgery, and additional chest tube insertion.Results: Among the 87 patients, 41 and 46 were in the lower and upper groups, respectively. No significant difference was observed in the composite outcomes between the groups (46.3% vs. 54.3%, P = 0.596). There was also no significant difference in the composite outcome between both groups after adjusting for SIPTW (52.3% vs. 68.8%, P=0.286).Conclusions: There were no significant differences in treatment failure in this empyema treatment study, in which the drain tip position was stratified by the 9th and 10th thoracic vertebrae. The position of the tip of the thoracic tube may not be important for empyema treatment as long as if it is in the thoracic cavity. Trial registration: The participants were registered retrospectively.

Background This study was aimed to examine the significance of fluorodeoxyglucose positron emission tomography in predicting prognosis after segmentectomy in lung cancer. Methods This was a retrospective cohort study, including 227 patients with cT1N0M0 nonsmall cell lung cancer who underwent positron emission tomography followed by segmentectomy between 2012 and 2019. Significance of tumor histology, T-stage, tumor size, and standardized uptake value on positron emission tomography in relation to recurrence-free survival were examined using Cox's proportional hazard analysis. Median follow-up period was 56 months (range: 1–95 months). Results Tumor stages were Tis in 25 patients, T1mi/T1a in 51, T1b in 98, and T1c in 53. Twenty-six patients (11%) experienced recurrences, including local (n = 8) and distant (n = 18). Multivariate analysis showed that the significant variables for recurrence-free survival were T-stage and standardized uptake value (p = 0.002 and 0.015, respectively), whereas tumor histology and tumor size were not significant (p = 0.28 and 0.44, respectively). When tumor size was divided into ≤2 cm and >2 cm for analysis, it was not significant again (p = 0.49), whereas standardized uptake value remained significant (p = 0.008). While standardized uptake value of tumors with recurrences was significantly higher than those without (4.9–2.8 and 2.6–2.5, respectively, p Conclusion Positron emission tomography could predict the prognosis after segmentectomy better than tumor size.

Chylothorax is an intrathoracic leakage of chyle due to thoracic duct damage. Malignant lymphoma is the most common nontraumatic cause of chylothorax. In March 2019, a 74-year-old woman presented to our department with bilateral pleural effusion and mesenteric/retroperitoneal masses. She was diagnosed with diffuse large B-cell lymphoma upon performing a biopsy. In May 2019, she was hospitalized for dyspnea due to pleural effusion, and thoracentesis revealed abundant chyle. Although the tumor shrunk after chemotherapy, chylothorax improvement was poor; thus, she could not be discharged. For the management of refractory chylothorax, lymphangiography, thoracic duct embolization, and pleurodesis were performed, and the chylothorax improved immediately. However, in May 2020, right chylothorax recurred without a relapse of malignant lymphoma, which did not improve with conservative treatment. Lymphangiography was performed again; however, treatment via the lymphatic vessels was difficult. Thus, pleurodesis was performed four times, after which the chylothorax regressed. Chylothorax is often refractory. When chemotherapy for malignant lymphoma does not improve chylothorax, multidisciplinary treatment is effective.

Aims To facilitate dose planning for convergent beam radiotherapy in non-small cell lung cancer (NSCLC), tumor response and histological distribution of residual tumors after induction chemoradiotherapy (ICRT) were compared between adenocarcinoma (AD) and squamous cell carcinoma (SQ). Methods Ninety-five patients with N1–2 or T3–4 NSCLC were treated with ICRT followed by surgery; 55 had AD and 40 had SQ. For the evaluation of distribution of residual tumors, the location of the external margin of residual tumors was assessed on surgical materials as follows: radius of whole tumor (“a”); distance between the center of tumor and the external margin of residual tumor (“b”); and its location (“b/a”). Results Of the 55 AD cases, 8 (15%) showed pathological complete remission, which was significantly less frequent than 22 of 40 SQ cases (55%) (p Conclusion AD showed worse tumor response to ICRT than SQ. After ICRT, AD remained at the periphery of primary tumor more frequently than SQ. It seems that, also in the convergent beam radiotherapy, the periphery part of AD would be more resistant than that of SQ.

Full-color LED lighting can emit any color; however, the color selection options are usually numerous for many users. Therefore, a user selects a color from a preset of color patterns in the control application. In this paper, we propose a system that can obtain personal color preferences from a picture of users' clothes and reflect the color to illuminate their room. This system allows users to create a comfortable indoor lighting environment without having to specify their color preference explicitly. Since the color of a clothe can change spatially, our system turns the spatial variation into temporal color changes. When temporal color change is performed on a raw picture that contains fine textures, the color transition can be highly rapid. Therefore, we use a self-organizing map (SOM) to organize pixels with similar colors in the neighborhood and then perform a random walk on the mapped pixels. Additionally, we perform a color transformation in the hue, saturation, and intensity (HSI) color space to prevent unwanted changes in brightness, which can impair the basic functionality of room lighting.

This study proposes the Home-life Assessment List “HAL” which promotes the review of lifestyle by scoring the resident”s life. In Japan, lifestyle-related diseases are caused by accumulation of daily habits such as unhealthy eating, lack of exercise, and stress. “HAL”” evaluates on a daily basis from IoT home appliance data and informs to residents their living conditions.

In this paper, we investigate the cause of the interconnectivity issue caused by the implementation specifications for updating GTK (Group Temporal Key) of wireless routers and range extenders due to differences in the interpretations of the manufacturers. We also propose a method to improve interconnectivity with a device side implementation. And we aim at contributing to the improvement of IoT devices interconnectivity such as ECHONET Lite devices.

In this paper, we have developed a multi-tone controllable line display with 64 LEDs, with which we can perceive images in the retina during eye movement called saccade. We evaluated the image dependence on visibility for this flashing line display. In the experiment, we performed a subjective evaluation of the visibility of four images by comparing linear gradation with gradation that changed exponentially based on the Weber-Fechner law of perceptual sensitivity. As a result, the visibility was improved in all images by considering the perceptual sensitivity.

Objectives: To examine the differences in clinical response, pathological response, recurrence, and survival between lung adenocarcinoma (AD) and squamous cell carcinoma (SQ) after induction chemoradiotherapy (ICRT) followed by surgery. Methods: Ninety-five patients with N1-2 or T3-4 non-small cell lung cancer were treated with ICRT followed by surgery between 2012 and 2018; 55 patients had AD and 40 had SQ. Differences in reductions of tumor size and fluorodeoxyglucose uptake on positron emission tomography after ICRT, as well as the pathological response, histological distribution of residual tumors, time to recurrence, and overall survival were compared between AD and SQ. Median follow-up period was 51 months. Results: After ICRT, SQ showed significantly more reduction in both the tumor size and fluorodeoxyglucose uptake than AD (p

This study sought to clarify the extent of segmentectomy that achieves greater lung preservation than lobectomy.This was a single-center retrospective cohort study involving 374 patients with lung cancer who were treated with either lobectomy or segmentectomy between 2013 and 2018. The percentage of preserved pulmonary function (%PPF) after surgery was compared among patients who underwent lobectomy (n = 164), segmentectomy of 2 or more segments (Seg ≥2S; n = 42), and segmentectomy of less than 2 segments (Seg2S; n = 168). Using perfusion scintigraphy, forced expiratory volume in 1 second of the preserved target lobe was measured to examine its effect on the %PPF. The number of resected subsegments (SSs) in segmentectomy that made the %PPF higher than that observed with lobectomy was also examined.Mean %PPF was lowest in those patients who underwent lobectomy (86%), followed by Seg ≥2S (89%) and Seg2S (95%) (P.001), but the difference between the lobectomy and Seg ≥2S was not significant (P = .21). The forced expiratory volume in 1 second of the preserved target lobe was significantly lower in the Seg ≥2S group than in the Seg2S group (P.001). The number of resected SSs was 6 to 12 in lobectomy, 4 to 7 in Seg ≥2S, and 1 to 4 in Seg2S. Although the %PPF after segmentectomy of less than 5 SSs (Seg5SS) was significantly higher than that after lobectomy (P.001), the %PPF after segmentectomy of 5 or more SSs (Seg ≥5SS) was not significantly different from that after lobectomy (P = .68).Both the Seg ≥2S and Seg ≥5SS groups did not differ from lobectomy in %PPF because of the low function of preserved target lobe.

In recent years, the proportion of single households has increased in Japan due to an increase in the number of households and a decrease in the average number of households [1]. The spread of smart houses using IoT devices using the international standard ECHONET Lite (ISO /IEO14543-4-3) [2] and the introduction of smart meters have made it possible to obtain residential power consumption. With the spread of IoT devices in ordinary homes, it is possible to check the operating information of each IoT devices in the house and life information such as power consumption. We believe that by continuously displaying life information to a householder, we can health promotion of that person. In this study, we examined the use of the ability to detect changes in the human eye as a method for continuously displaying life information. Propose interior lighting utilizing "Clump of Illumination" for promoting user health.

We propose an easy-to-use 3D documentation system for nursery activity that visualizes photos with embedded location and sound information, taken by childcare workers while they are taking care of the children. Most existing nursery documentation is made by hand as a piece of paper with printed photos and hand-written comments, which has high readability and freedom of layout and also is good in expressing the emotion of workers. On the other hand, this method has several drawbacks: 1. it requires time and effort of workers 2. it is hard to store for a long time and pick up later 3. it does not scale in sharing with other people, such as parents. Among several standard documentation formats, we chose the so-called "nursery mapping" style since it is suitable for visualizing positional information (which usually corresponds to the type of activity) and other forthcoming nursery sensing data. With the power of Wi-Fi-based indoor localization technique and voice recording/recognition while photo taking, our system allows a much easier generation of documentation of nursery activities with 3D visualization. Our system also has some typical advantages of online documentation systems such as large, almost permanent storage and easy sharing since the data is stored in cloud storage (Google Drive), and visualization is performed in common browsers.

Non-small cell lung cancer (NSCLC) involving the chest wall is usually treated with en bloc rib resection or parietal pleurectomy; however, the former causes chest wall deformity and the latter is associated with local recurrence. To prevent both these sequalae, we performed the “ribcage” procedure for tumors involving the chest wall after induction chemoradiotherapy. This was a single center retrospective study conducted from 2012 to 2018. The “ribcage” procedure is designed to preserve the ribs of patients with lung tumors involving chest wall and involves peeling the intercostal muscles and periosteum from the ribs, resulting in a birdcage-like appearance. Seventeen patients with NSCLC clearly involving the chest wall, but not destroying the ribs, were treated with induction chemoradiotherapy, followed by the ribcage procedure. A negative margin at the ribs was confirmed by intraoperative frozen sections in 16 of these patients, who then underwent the ribcage procedure. Complete resection was achieved in all 16 patients, none of whom experienced major postoperative complications. After a median follow-up period of 37 months, there was no evidence of local recurrence in any of the patients. Our findings suggest that the ribcage procedure is the preferable surgical option as it can prevent chest wall deformities as well as local recurrence.

OBJECTIVES To clarify differences in postoperative changes in systemic and regional pulmonary functions between segmentectomy and lobectomy in patients with lung cancer, we compared the 2 procedures using lung perfusion scintigraphy with a fusion image of single-photon emission computed tomography and computed tomography. METHODS This study is a retrospective matched cohort study of consecutively acquired data. Pulmonary function tests and perfusion single-photon emission computed tomography/computed tomography were conducted before surgery and 6 months after surgery to measure changes in forced expiratory volume in 1 s of a whole lung, contralateral lung and a lobe. After exactly matching the site of the resected lobe between the 2 procedures, propensity scores for age, sex, smoking status and pulmonary function were used to match them. RESULTS Of the 184 patients treated with segmentectomy and the 208 patients treated with lobectomy between 2013 and 2016, 103 patients were selected from each group after the matching. Whole lung function was significantly more preserved after segmentectomy than after lobectomy (P

In this paper, we developed a saccade type line display with 64 LEDs which realized high speed flashing. The developed line display consists of four printed circuit boards each of which flashes 16 LEDs and an AVR microcomputer which transfers image data to each circuit board. All the transferred image data were processed in parallel. As a result, the refresh time could be shortened to 42 (μs) per one line image. We found that the most perceivable flashing period was from 0.3 to 0.5 (ms) by the experiment. As a result, the five-level gray scale by PWM was achieved.