Junpei Hashimoto

Recurrence of Thymoma: Clinicopathological Features, Therapy, and Prognosis

Factors influencing the recurrence or persistence of thymoma after therapy were investigated in 127 patients with thymoma, including 75 with thymoma and myasthenia gravis. The rate of recurrence or persistence was 19% (24 of 127 patients) overall, 11% (8 of 75 patients) in myasthenic thymoma, and 31% (16 of 52 patients) in nonmyasthenic thymoma. The more advanced the clinical stage, the higher the rate of recurrence or persistence. The recurrence/persistence rate for patients with the same clinical stage was higher in those with nonmyasthenic thymoma (8% in Stage I, 11% in Stage II, 36% in Stage III, and 75% in Stage IV) than in those with myasthenic thymoma (0 in Stage I, 13% in Stage II, 18% in Stage III, and 20% in Stage IV). The prognosis for patients having subtotal resection of tumor was good in myasthenic thymoma (recurrence/persistence rate, 17%) in contrast with nonmyasthenic thymoma (recurrence/persistence rate, 78%). These results suggest that nonmyasthenic thymoma is more malignant than myasthenic thymoma. Postoperative radiotherapy was effective in preventing the recurrence or persistence of thymoma after therapy.

Myasthenia Gravis in Elderly Patients

The clinical features and the effect of thymectomy were compared between 27 elderly patients (Group 2) and 119 young adult patients (Group 1) with myasthenia gravis (MG). In the elderly group, MG was type I in 3 patients, type IIA in 6, type IIB in 17, and type III in 1; and in the young group, type I in 6, type IIA in 36, type IIB in 73, and type III in 4. The association rate with autoimmune disease in patients without thymoma was 12.5% (1/8) in Group 2 and 21.3% (20/94) in Group 1. Autoimmune diseases were not seen in any patients with thymoma. The clinical stage of thymoma was not significantly different between the two groups. The rates of remission and of palliation at 3 years after thymectomy were 18.2% and 72.7%, respectively, in Group 2 patients with thymoma, 21.4% and 78.6% in Group 1 patients with thymoma, 50% and 100% in Group 2 patients without thymoma, and 50% and 98.1% in Group 1 patients without thymoma.

133Xe-Radiospirometry and lung cancer-A tentative nomogram to detect subsegmental obstructions.

例の原発性肺癌症例を用いて, 133Xe Radiospirometryを行い, 患側の換気分布比 (V%), 肺容量分布比 (V%) および肺血流分布比 (Q%) を測定し, これらパラメ-タ-から肺癌による閉塞亜区域枝の数を予測するノモグラムを試作した.一方気管支造影所見から閉塞亜区域枝数を実測した.各パラメーターで予測された閉塞亜区域枝数と実測した数値の相関性はそれぞれ推計学的に有意 (p<0.001) で, V%ではr=0.838, V%ではr=0.834, Q%ではr=0.846であった.我々が試作したノモグラムの問題点について論じた.