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We report selected insufflation technique using direct bronchial insufflation to visualize the intersegmental plane during total thoracoscopic segmentectomy. Following the transection of the bronchus using a stapler, a small incision was created in the dissected target bronchus, and direct air insufflation was performed at the small incision site. The target segment was inflated, while the preserved segments appeared to collapse, and a demarcating line was visualized between the inflated and deflated lung parenchyma. This technique quickly identifies the anatomic intersegmental plane without warranting special equipment such as jet ventilation or indocyanine green (ICG). Furthermore, this method saves time in creating inflation–deflation lines.

Supplementary Methods, Figures 1-10 from Telomerase-Dependent Oncolytic Adenovirus Sensitizes Human Cancer Cells to Ionizing Radiation via Inhibition of DNA Repair Machinery

OBJECTIVESIpsilateral reoperation after pulmonary lobectomy is often challenging because of adhesions from the previous operation. We retrospectively examined the surgical outcome and prognosis of ipsilateral anatomical resection for lung cancer after pulmonary lobectomy using a multicentre database.METHODSWe evaluated the perioperative outcomes and overall survival of 51 patients who underwent pulmonary lobectomy followed by ipsilateral anatomical resection for lung cancer between January 2012 and December 2018. In addition, patients with stage I non-small-cell lung cancer (NSCLC) were compared with 3411 patients with stage I lung cancer who underwent pulmonary resection without a prior ipsilateral lobectomy.RESULTSIpsilateral anatomical resections included 10 completion pneumonectomies, 19 pulmonary lobectomies and 22 pulmonary segmentectomies. Operative time was 312.2 ± 134.5 min, and intraoperative bleeding was 522.2 ± 797.5 ml. Intraoperative and postoperative complications occurred in 9 and 15 patients, respectively. However, the 5-year overall survival rate after anatomical resection followed by ipsilateral lobectomy was 83.5%. Furthermore, in patients with c-stage I NSCLC, anatomical resection followed by ipsilateral lobectomy was not associated with worse survival than anatomical resection without prior ipsilateral lobectomy.CONCLUSIONSAnatomical resection following ipsilateral lobectomy is associated with a high frequency of intraoperative and postoperative complications. However, the 5-year overall survival in patients with c-stage I NSCLC who underwent ipsilateral anatomical resection after pulmonary lobectomy is comparable to that in patients who underwent anatomical resection without prior pulmonary lobectomy.

The strong ground motions, large crustal deformation, and tsunami generated by the 2011 Tohoku-oki earthquake ( Mw 9.1) reveal that a large coseismic slip likely propagated to shallow depth in the Japan Trench. Although data acquired by onshore networks cannot resolve the slip behavior of the updip fault rupture, marine geophysical and geological studies provide direct evidence of coseismic slip to the trench. Differential bathymetry data show ∼50 m of coseismic seafloor displacement extending to the central Japan Trench (38–39.2°N). Seismic data show that coseismic slip ruptured the seafloor within the trench. Pelagic clays may have promoted slip propagation to shallow depths, whereas disturbed/metamorphosed clays may have restricted slip to the main rupture zone. Those observations imply that a smooth, broadly distributed, weak, clay-rich sediment in a shallow part of a subduction zone is a characteristic factor that can foster a large coseismic slip to the trench and, consequently, the generation of a large tsunami. ▪ During the 2011 Tohoku-oki earthquake ( Mw 9.1), more than ∼50 m of slip occurred on a fault that ruptured the seafloor in the central Japan Trench. ▪ The fault rupture reaching the seafloor caused a large tsunami. ▪ Marine geophysical explorations revealed that a clay-rich sediment in the subduction zone was one factor fostering the large fault slip. ▪ Understanding of slip behavior in the shallow portion of a subduction zone will help us prepare for future large tsunamis along the Japan-Kuril Trench.

In survivors of head and neck cancer (HNC), second primary lung cancer (SPLC) often develop as a result of a common risk factor, that is, smoking. A multicenter experience was reviewed to evaluate how the history of a diagnosis of HNC affects the outcomes of patients undergoing pulmonary resection for SPLC.A multicenter retrospective analysis of patients hospitalized between January 2012 and December 2018 was performed. From a cohort of 4521 patients undergoing therapeutic pulmonary resection for primary non-small cell lung cancer, 100 patients with a previous history of HNC (HNC group) were identified. These patients were compared with a control group consisting of 200 patients without an HNC history from the same cohort pair-matched with operating facility, age, sex, and pathologic stage of lung cancer.At the time of surgery for SPLC, the HNC group showed malnutrition with a lower prognostic nutritional index compared with the control group (P.001). The HNC group was determined to have postoperative complications more frequently (P = .02). The 5-year overall survival rates in the HNC and control groups were 59.0% and 83.2%, respectively (P.001). Statistically, HNC history, lower prognostic nutritional index, squamous cell lung cancer, and TNM stage were identified to be independently associated with poor survival.Patients with SPLC after primary HNC often present with malnutrition and are predisposed to postoperative complications and poor survival after pulmonary resection.

Monitoring slow earthquake activity in subduction zones can give important insight into the stress build-up and subsequent rupture extent of megathrust earthquakes. Extensive slow earthquake activi...

Previous reports have demonstrated that repeated surgical resections of resectable hepatic and pulmonary metastases from colorectal cancer contribute to a better prognosis. We retrospectively assessed the outcomes of 19 patients with colorectal cancer who underwent repeated resections of hepatic and pulmonary metastases between February 2007 and February 2017. The median observation period was 69.9 months, and 26 liver and 27 lung resections were performed. The cumulative 5-year survival rates after resection of the last metastasis was 75.1% and the median disease-free survival after resection of the last metastasis was 34.7 months. Although 7 patients showed recurrence and 4 patients died, 7 patients exhibited long-term survival. Univariate analysis revealed that simultaneous liver and lung metastases were significantly predictor of poor prognosis(p=0.039). Progress of the patients in the present study were comparable to those in previous reports. Therefore, we propose that repeated surgical resection of hepatic and pulmonary metastasis from colorectal cancer could improve patient prognosis. Further studies should examine to identify more accurate prognostic factor with large series.

Since the giant 2011 Tohoku earthquake and tsunami, much research has focused on the distribution of coseismic slip at shallow depths during this subduction megathrust event. Here we present seismic images obtained in the immediate vicinity of the trench axis, that show thrust faults and fold-and-thrust type deformation structures near the epicenter of the 2011 Tohoku earthquake where the large coseismic slip has been inferred, and chaotic structure and the absence of thrust faults in northern and southern source areas. Seismic profiles show evidence of slope failures of the trench inner wall in a proposed tsunami source region around 39°–40° N, where the slips estimated from previous studies are in disagreement. Our results show that structural characteristics in the trench axis may be related to the occurrence of shallow megathrust slip and tsunamigenesis in the Japan Trench.

A detailed time lapse seismic analysis of subsurface movements is presented using seismic 2D lines acquired prior to and after the Tohoku-Oki earthquake offshore Japan in 2011. Estimated movements of the seabed from the time lapse seismic data corresponds well with estimations using bathymetric data. On the shelf, we find seabed subsidence of up to 8–9 m, and closer to the Japan trench, we find a seabed uplift of more than 10 m. Along the 100 km long 2D seismic line, we find alternating subsidence and uplift. We find horizontal displacements at the seabed that are significantly larger, up to 40–50 m, however these estimates are more uncertain. Close to the Japan trench, these horizontal displacements are practically opposite in direction (pointing towards the trench from both sides) and large (˜15 m). At the sediment-basement interface, we estimate vertical subsidence of two independent large blocks (each 4 km wide) to be up to 14 m. This means that the sediment package in this region has been stretched by 5–6 m. This type of overburden stretching is similar to hydrocarbon reservoirs that compact due to production and produce corresponding overburden stretching. Several examples of new faults, new layering and orientation of sedimentary layers are found. Implications for subsurface storage of CO2 in areas close to subduction zones are also discussed. This is a submitted manuscript of an article published by Elsevier Ltd in International Journal of Greenhouse Gas Control, 12 January 2019.

Background Ureteroarterial fistula is a rare life-threatening complication of indwelling ureteral stents. The mechanism has not yet been fully evaluated using intravascular imaging. Case presentation An-84-year-old female was referred to our unit because of large volume pulsatile bleeding from the left ureter during routine stent exchange in the urology department. The hematuria was initially managed by rapidly exchanging for a new stent; however, the patient went into hypovolemic shock due to acute blood loss. The patient underwent implantation of the bilateral ureteral stents due to urinary retention caused by retroperitoneal fibrosis 2 years ago. To prevent ureteral infection, occlusion of the stents and stone formation, the stents were exchanged every 6 months. Computed tomography revealed contact between the left ureter and the common iliac artery. Therefore, ureteroarterial fistula was suspected and endovascular therapy was performed. Although angiography did not show definite blood flow into the ureter, a soft guidewire was advanced from the subintima of the external iliac artery to the left ureter. The diagnosis of ureteroarterial fistula was confirmed. Intravascular ultrasound identified the stent in the ureter and its connection to the subintima of the external iliac artery. The ureter did not contact directly to the inner lumen of the iliac arteries according to the ultrasound findings; therefore, we considered that the risk of stent-graft infection might not be high. After coil embolization of the ipsilateral internal iliac artery, a covered stent was implanted in the external iliac artery to seal the subintimal entry. The patient had no further episodes of any gross hematuria on dual anti-platelet therapy, when the ureteral stent was exchanged three time during 1 year after the endovascular therapy. Conclusions We demonstrated a case of ureteroarterial fistula, in which intravascular ultrasound allowed to visualize the communication between the ureter and the subintimal lumen in the external iliac artery. Electronic supplementary material The online version of this article (10.1186/s42155-019-0060-6) contains supplementary material, which is available to authorized users.

The Semi Additive Process (SAP) has gained more attraction over the past years because it enables very fine lines and spaces for the production of IC-Substrates. When operating with lines and spaces (L/S) of $10/10 \mu \mathrm {m}$ and less the copper thickness variation is one of the critical parameters which has to be controlled within a tight range in order to avoid reliability problems in assembly or during the lifetime as described in several papers [1], [2]. The key process parameter here is called the copper thickness within-unit distribution (WUD) or copper thickness within-panel-distribution (WPD). Another important parameter is the current density used for the copper plating process. Higher current density operating range of an electrolyte results in in better productivity. But both parameters are usually influencing each other. The existing POR might operate at a current density at 1.5 A/dm2 but increasing the current density in order to improve the productivity means the copper thickness variation within the panel will increase. This is not beneficial for the quality of the product, as the market is looking for a tight control of the copper thickness variation on a IC substrate.Already in 2013 a SAP Electrolyte was introduced to the market which is established meanwhile as a POR at IC-substrate manufacturers. Now in 2017 an upgraded electrolyte was developed in order to overcome this conflict of productivity and copper thickness variation. The novel SAP Copper electrolyte was optimized in its formulation so that higher current densities may be applied while still keeping very good copper thickness within unit distribution (WUD) results. Continuity of innovation and invention as expected by Moore’s Law are needed to reduce cost and increase capability. Challenges like within-unit distribution become a critical factor for the subsequent processing steps.The technical paper will contain results of copper thickness and the copper thickness variation (WUD), microsection pictures, DOE Results, dimple results, filling performance and further data. The novel electrolyte shows capabilities to operate at > 3A/dm2 which brings almost an improvement of the productivity by a factor of 2! The new electrolyte also brings further improvement regarding the Cu thickness variation as tighter tolerances may be realized. This is important for the later process steps during package manufacturing. Other Parameters of the new electrolyte will be shown as well like ductility and copper crystal structures of the new electrolyte.

Background: Patients with squamous cell carcinoma (SqCC) of the lung sometimes have a comorbid pulmonary disease such as pulmonary emphysema or an interstitial lung disease (ILD), both of which negatively affect patient outcome. The aim of this study was to determine the outcome of patients in a multicenter database who underwent surgery for cT1aN0M0 peripheral SqCC lung cancer. Methods: The medical records of a total of 228 eligible patients from seven institutions were reviewed to evaluate the impact of concomitant impaired pulmonary function and other clinicopathological factors on overall survival (OS) and relapse-free survival (RFS). Results: Six patients with positive or unclear tumor margins were excluded. Of the 222 remaining study patients, 42 (18.9%) and 97 (43.7%) patients were found to have coexisting restrictive or obstructive ventilatory impairment, respectively. Over a median follow-up period of 30.6 months, the 5-year OS and RFS were 69.0% and 62.6%, respectively. By multivariate analysis, ILDs identified on high-resolution computed tomography (HRCT), pulmonary function test results indicating a restrictive ventilatory impairment, and wedge resection were found to be independent risk factors for poor OS. An increased level of serum squamous cell carcinoma antigen (SCC-Ag) (>1.5 ng/mL) and the same risk factors for poor OS were independent risk factors for recurrence. Among patients who underwent anatomical lung resection (lobectomy and segmentectomy, n=173), a restrictive ventilatory impairment was an independent risk factor for poor OS, and increased serum SCC-Ag level, ILDs on HRCT, and restrictive ventilatory impairment were independent risk factors for poor RFS by multivariate analysis. Factors such as visceral pleural invasion, and lymphatic or vascular invasion were not significantly associated with outcome. Conclusions: A restrictive ventilatory impairment negatively affects the outcome of patients with cT1aN0M0 peripheral SqCC lung cancer.

A repeated bathymetric survey reveals seafloor displacement between before and after geodynamic events. We evaluated the less-known spatial resolution and estimation error of the seafloor displacement observation from a vessel-based multi-narrow beam bathymetric survey. In this evaluation, bathymetric data from vessel-based and near-seafloor high-resolution autonomous underwater vehicle (AUV)-based surveys in the same area were used. Simulated vessel-based bathymetric “before and after” data of the seafloor displacement were made using AUV-based bathymetric data. The displacement was verified by comparing these simulated data using the analysis conditions that no locational errors of beam sounding points exist, a footprint effect is uniform, depth accuracy is constant in the analysis area, and there are no depth offset between two data. As a result, we found that the smallest vertical seafloor displacement that can be detected occurs when the horizontal extent of the deformation is larger than several times the size of the footprint (area of the narrow sounding beam projected onto the seafloor) of the used vessel’s multi-narrow beam echo sounder, and in the situation that the amplitude of the depth difference is greater than the accuracy of the vessel-based depth measurement (standard deviation of measuring error). When local slopes of the bathymetry are gentler than those of the artificial variation appeared in the depth differences between two data, the horizontal seafloor displacement seems to be difficult to resolve accurately. The local slope of the artificial depth variation is derived from the wavelength and the amplitude which are equivalent to ~1–3 times of the footprint size and the accuracy of the depth measurement, respectively.

To investigate detailed fault distributions and shallow geological structure offshore northwestern Sumatra, we obtained high-resolution Multi-Channel Seismic (MCS) reflection data around the Sunda Trench, trench slope, and forearc high regions offshore northwestern Sumatra. In general, trench-parallel anticlinal ridges are distributed from trench slope region to forearc high region. Two kinds of different vergence systems are characterized in the Sumatra forearc region; landward vergence is dominant in the lower trench slope region, and seaward vergence is dominant in the forearc high region. Moreover, piggyback or slope basins are recognized between anticlinal ridges. Deformation in the uppermost part of these basins, that is referred to ‘recent’ deformation in this paper, can be identified not only along major thrusts but also between major thrusts and the lower trench slope, suggesting these are related to recently active faulting. Several but the largest number of such deformation are distributed along a major thrust located in the middle of the forearc high region, whereas few are done along other major thrusts.

We carried out underway geophysical survey in the transit of the JAMSTEC R/V Mirai MR08-06 Leg-1. The cruise was an unprecedented opportunity to collect data in regions of the Pacific Ocean where it has sparsely been surveyed. Our multibeam bathymetric and shipboard gravity survey track crossed over the Pacific, the Antarctic, and the Nazca plates, and covered lithospheric ages varying from zero to 150 Ma. The survey revealed kilometer-sized fine-scale structures of seafloor fabrics; i.e. abyssal hills and fracture zones, and distribution of seamounts or knolls. These are not detectable in satellite altimetry data only. As well as contributing to the world's seafloor mapping, our survey results also show valuable evidence towards the plate tectonic reconstruction and help us look into the oceanic lithosphere formation and evolution, since the directions of tectonic stress and seafloor spreading mode are the major factors that can affect the morphology of lineated abyssal hills, etc.

We present differential bathymetry and sediment core data from the Japan Trench, sampled after the 2011 Tohoku-Oki (offshore Japan) earthquake to document that prominent bathymetric and structural changes along the trench axis relate to a large (∼27.7 km 2 ) slump in the trench. Transient geochemical signals in the slump deposit and analysis of diffusive re-equilibration of disturbed SO 4 2– profiles over time constrain the triggering of the slump to the 2011 earthquake. We propose a causal link between earthquake slip to the trench and rotational slumping above a subducting horst structure. We conclude that the earthquake-triggered slump is a leading agent for accretion of trench sediments into the forearc and hypothesize that forward growth of the prism and seaward advance of the deformation front by more than 2 km can occur, episodically, during a single-event, large mega-thrust earthquake.

The straightforward but unexpected relationship presented here relates crustal thickness to magma type in the Izu-Ogasawara (Bonin) and Aleutian oceanic arcs. Volcanoes along the southern segment of the Izu-Ogasawara arc and the western Aleutian arc (west of Adak) are underlain by thin crust (10–20 km). In contrast those along the northern segment of the Izu-Ogasawara arc and eastern Aleutian arc are underlain by crust ~35 km thick. Interestingly, andesite magmas dominate eruptive products from the former volcanoes and mostly basaltic lavas erupt from the latter. According to the hypothesis presented here, rising mantle diapirs stall near the base of the oceanic crust at depths controlled by the thickness of the overlying crust. Where the crust is thin, melting occurs at relatively low pressures in the mantle wedge producing andesitic magmas. Where the crust is thick, melting pressures are higher and only basaltic magmas tend to be produced. The implications of this hypothesis are: (1) the rate of continental crust accumulation, which is andesitic in composition, would have been greatest soon after subduction initiated on Earth, when most crust was thin; and (2) most andesite magmas erupted on continental crust could be recycled from “primary” andesite originally produced in oceanic arcs.

Subduction zone models often assume that the shallowest part of the plate interface slips aseismically. Images of the subduction trench next to the Tohoku-oki epicentre, captured using seismic reflection data 11 days after the 2011 earthquake, reveal deformation structures in sediments next to the trench, indicating that fault slip did reach the sea floor.

A previous study of a longitudinal profile along the Bonin ridge concluded that remarkably thin forearc crust (< 10 km thick) along the northern half of the ridge indicates that the crust there was formed by forearc spreading during the initial stage of subduction along the Izu-Bonin intra-oceanic arc. However, a profile across the Bonin ridge shows a thicker crust. In this study, we construct a model that takes into account seismic and gravity data from both profiles. Re-modeling of the seismic data showed a north-south aligned area of thin crust (∼10 km thick) at the center of the Bonin ridge; this structure was confirmed by gravity data. The seismic data at the eastern end of the across-arc profile suggests that the crust thickens beneath the trenchward slope of the Bonin ridge. However, a petrological model suggests a trenchward extension of forearc oceanic crust that formed during the initial stage of subduction. Although further detailed investigation is required, we suggest that this contradiction can be explained either by the subduction of buoyant crust immediately beneath the forearc oceanic crust, or by the presence of a serpentinized mantle wedge beneath the forearc oceanic crust.

背景．縦隔リンパ節転移を発見契機とした甲状腺癌の報告は少ない．症例．77歳男性．検診で右上葉に腫瘤が認められた．PETで肺腫瘤にSUVmax 8.2の集積を認めた．高位縦隔リンパ節2個にも異常集積を認めた．胸骨正中切開下に，右上葉切除+縦隔リンパ節郭清を施行した．混合型小細胞癌（小細胞癌+腺癌）と診断された．縦隔リンパ節は甲状腺乳頭癌の転移であった．術後補助化学療法後に甲状腺の手術を施行し，8 mmの甲状腺乳頭癌が認められた．結語．肺癌手術時に縦隔リンパ節転移で発見された不顕性甲状腺癌の1例を報告した．肺癌で気管周囲にリンパ節転移を認める時，不顕性甲状腺癌の転移の可能性がある．