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Catamenial pneumothorax (CPX) is an aetiologically very complex disease for which the treatments for pneumothorax and endometriosis are generally adapted. However, emphasizing secondary prevention, we developed a new method. This powerful new technique for prevention of pneumothorax during menstruation by surgical pleurodesis using absorbable mesh is presented. CPX is a relatively rare disease characterized by recurrent pneumothorax during menstruation. Although pathological diagnosis is desirable, CPX is clinically defined as recurrent pneumothorax synchronized with the menstrual cycle. Unfortunately, conventional therapy, including hormonal treatment and surgical procedures, seems to be associated with a high rate of recurrence; there is no well-established treatment for CPX. Recently, we developed a useful and effective operative method for spontaneous pneumothorax, with which one can remove the lesion site and sew a polyglactin mesh on the lung concurrently by endoscopic linear cutter under video-assisted thoracoscopic surgery, dressing the lung with polyglactin mesh to reinforce the stump and facilitating pleural adhesion for secondary prevention. We have used this method to resect pathological lung lesions and promote pleurodesis to prevent recurrence. In addition, polyglycolate felt was placed to cover the lesion site in the diaphragm in four cases of repetitive and treatment-resistant CPX as surgical pleurodesis, and successful results were obtained.

Background Various factors related to the sensitivity of non-small cell lung carcinoma (NSCLC) to 5-fluorouracil (5-FU) have been reported, and some of them have been clinically applied. In this single-institutional prospective analysis, the mRNA expression level of five folic acid-associated enzymes was evaluated in surgical specimens of NSCLC. We investigated the correlation between the antitumor effect of 5-FU in NSCLC using an anticancer drug sensitivity test and the gene expression levels of five enzymes. Materials and methods Forty patients who underwent surgery for NSCLC were enrolled, and the antitumor effect was measured using an in vitro anticancer drug sensitivity test (histoculture drug response assay) using freshly resected specimens. In the same sample, the mRNA expression levels of five enzymes involved in the sensitivity to 5-FU were measured in the tumor using real-time PCR. The expression levels and the result of the sensitivity test were compared. Results No correlation was found between dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), or DPD/OPRT expression and the antitumor effects of 5-FU. On the other hand, a correlation was found between thymidylate synthase (TS), folylpoly-c-glutamate synthetase (FPGS), and dihydrofolate reductase (DHFR) expression and 5-FU sensitivity. Conclusion Expression of FPGS and DHFR may be useful for predicting the efficacy of 5-FU-based chemotherapy for NSCLC.

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s S861dependent even if it was a low dose and serum leveldependent.

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Background: Various factors related to the sensitivity of non-small cell lung carcinoma (NSCLC) to 5-fluorouracil (5-FU) have been reported, and some of them have been clinically applied. In this single-institutional prospective analysis, the mRNA expression level of five folic acid-associated enzymes was evaluated in surgical specimens of NSCLC. We investigated the correlation between the antitumor effect of 5-FU in NSCLC using an anticancer drug sensitivity test and the gene expression levels of five enzymes.Materials and Methods: Forty patients who underwent surgery for NSCLC were enrolled, and the antitumor effect was measured using an in vitro anticancer drug sensitivity test (histoculture drug response assay) using freshly resected specimens. In the same sample, the mRNA expression levels of five enzymes involved in the sensitivity to 5-FU were measured in the tumor using real-time PCR. The expression levels and the result of the sensitivity test were compared.Results: No correlation was found between dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), or DPD/OPRT expression and the antitumor effects of 5-FU. On the other hand, a correlation was found between thymidylate synthase (TS), folylpoly-c-glutamate synthetase (FPGS), and dihydrofolate reductase (DHFR) expression and 5-FU sensitivity.Conclusion: Expression of FPGS and DHFR may be useful for predicting the efficacy of 5-FU-based chemotherapy for NSCLC.