分類不能の小児肺microcystic Parenchymal MALDEVELOPMENTの1例 (original) (raw)
Haigan, 2004
Background. Metastasis from lung cancer to the spinal cord or the optic chiasm is rare. Case. A 65-year-old man was given a diagnosis as T1N2M0 localized small cell lung cancer. He responded well to systemic chemotherapy and radiotherapy. Seven months after the first admission, his brain MRI revealed multiple brain metastases, and whole brain irradiation was performed. Thirteen months after the first admission, he experienced paresis of his legs and bitemporal hemianopia. His spinal cord MRI revealed multiple intramedullary metastasis, and cerebrospinal fluid showed malignancy. Leptomeningeal metastasis from small cell lung cancer was diagnosed. Spinal cord irradiation was performed, and his lower limbs paresis improved slightly. His eyesight failed gradually, and brain MRI revealed optic chiasm metastasis. Optic chiasm irradiation was performed, but his eyesight deteriorated. Paralysis of his legs and his body gradually increased, and 18 months after the first admission, he died. Conclusion. We report a case of metastasis from small cell lung cancer to the spinal cord and the optic chiasm.
Haigan, 2002
Pleural invasion by tumor is an important prognostic factor in patients with non-smallcell lung cancer. Most p3 patients are considered T3, but adjacent lobe invasion beyond the interlobar pleura is categorized as T2. However, the outcome of patients with adjacent lobe invasion beyond the interlobar pleura is controversial. Methods. To investigate the prognosis of p3 patients including those with adjacent lobe invasion beyond the interlobar pleura, 40 patients who underwent pulmonary resection between 1988 and 1998 were reviewed. The subjects included 15 with adjacent lobe invasion beyond the interlobar pleura (Int. group), and 25 with invasion to other organs or tissue (Non-int. group). Results. The 5-year survival rate of the Int. group and the Non-int. group was 44.4% and 19.4%, respectively. There was no significant difference between the two groups. Conclusion. At this moment, the patients with adjacent lobe invasion beyond the interlobar pleura are not considered T2. Further studies of more cases are needed to obtain a statistically significant difference between Int. and Non-int. groups. (JJLC. 2002; 42: 163-167) KEY WORDS-Non-small-cell lung cancer, Pleural invasion, Interlobar pleural invasion
Nihon Kikan Shokudoka Gakkai Kaiho, 1998
We reviewed 14 cases of tracheobronchial foreign bodies in infants treated between 1982 and 1996 at the Osaka Red-Cross Hospital. In all cases, the foreign bodies were successfully removed using a ventilation bronchoscope 'under general anesthesia. The most common foreign body was a peanut, as noted in other reports. Chest X-ray findings suggested hyperlucency in 7 cases, pneumonia in 2 and mediastinal shift in 2, while there were no remarkable changes found in 3 cases. Major signs and symptoms were dyspnea, wheezing and coughs in 13 cases, fever in 10 and cyanosis in 7. Preoperative administration of steroids was effective in facilitating removal of a long-standing foreign body. We suggest that steroids should be preoperatively administered to patients who have retained a foreign body for a long period.
Ｔｋ‐ｐｏｌｙａｇｇｌｕｔｉｎａｔｉｏｎを示した極小未熟児の１例
Journal of the Japan Society of Blood Transfusion, 1992
A case of acquired transient Tk polyagglutination in a premature infant is described. A 1401 g female infant born at 28 weeks gestation developed clinical sepsis and necrotizing enterocolitis in the 6th day after birth. She underwent ileostomy due to perforation of small bowel. At this time, her erythrocytes were agglutinated by most adult sera including group AB sera. She had previously typed as group AB. The reactivity of her red blood cell with six selected lectins was specific for Tk transformation. Negative reaction with anti-N was also observed. The polyagglutination was much weaker after washed red blood cell transfusions and disappeared at day 13. She failed to respond to treatment and died at 14 days of age. Though blood cultures were consistently sterile, methicillin resistent staphylococcus aureus (MRSA) was cultured from the catheter tip placed in an umbilical artery. Klebsiella spp and MRSA were isolated from the peritoneal cavity. Whether these two organisms could be responsible for her polyagglutinable state or not remains unclear.
急性A 型大動脈解離術後，人工心肺離脱不能症例に対してVeno-Arterial Extracorporeal Membrane Oxygenation を使用し救命した1 例
日本血管外科学会雑誌, 2013
We report here a case of acute aortic dissection (Stanford Type A) with severe aortic regurgitation (AR) successfully treated by postoperative ECMO (extracorporeal membrane oxygenation). The patient was a 52-year-old man who was transferred to our hospital after complaining of chest-back pain. An emergent operation was performed after diagnosis of a type A acute aortic dissection with severe AR. We performed ascending aortic replacement under hypothermia arrest and retrograde cerebral perfusion. ECMO became necessary, because of postoperative acute respiratory failure. We used axillary artery cannulation with a graft anastomosis for inflow perfusion in ECMO because of central support with antegrade flow and excellent upper body oxygenation. During ECMO, anticoagulation with nafamostat mesilate was used to control bleeding complications. Postoperative bleeding decreased gradually and the patient was successfully weaned from ECMO 65 hours after the operation with no neurological complications. The recovery was uneventful, and at discharge the patient was able to walk out of the hospital without assistance. In this case, V-A ECMO with axillary arterial perfusion was performed successfully after acute aortic dissection, with no cerebral complications. Moreover, we reported that nafamostat mesilate was effective in preventing bleeding during ECMO.
Nippon Jibiinkoka Gakkai Kaiho, 2005
The management of metastatic squamous cell cartinoma in cervical lymph nodes from an unknown primary. Am
重度のえん下障害で発症し対照的な経過を辿った延髄外側症候群の２例
The Japanese Journal of Rehabilitation Medicine, 2004
Severe dysphagia occurs in over 50% of lateral medullary syndrome (LMS) cases, and the prognosis varies greatly among individuals. Predicting the prognosis of the dysphagia from data acquired at the acute phase is very important in selecting both the type and duration of dysphagia treatment. Here we examined whether radiological findings and severity of dysphagia in the acute phase could accurately predict prognosis and treatment required. We experienced 2 cases of LMS in which magnetic resonance imaging in the acute phase showed medullary lesions on the ipsilateral side of the medulla in each patient. Videofluorograhic examination of swallowing revealed severe dysphagia with an absence of the swallowing reflex. Both patients received swallowing therapy, including thermal stimulation, supraglottic swallow, and the Mendelsohn maneuver. While dysphagia was significantly improved one month post onset in one patient, the loss of swallowing reflex continued for more than one year in the other patient. These findings indicate that radiological data and severity of dysphagia in the acute phase cannot accurately predict the prognosis of dysphagia in LMS patients.
胸部結節状陰影と間質性肺病変の検出に関するＬＣＤとＣＲＴモニタの比較
Japanese Journal of Radiological Technology, 2006
Soft copy reading of digital images has been practiced commonly in the PACS environment. In this study, we compared liquid-crystal display (LCD) and cathode-ray tube (CRT) monitors for detection of pulmonary nodules and interstitial lung diseases on digital chest radiographs by using receiver operating characteristic (ROC) analysis. Digital chest images with a 1000×1000 matrix size and a 8 bit grayscale were displayed on LCD/CRT monitor with 2M pixels in each observer test. Eight and ten radiologists participated in the observer tests for detection of nodules and interstitial diseases, respectively. In each observer test, radiologists marked their confidence levels for diagnosis of pulmonary nodules or interstitial diseases. The detection performance of radiologists was evaluated by ROC analyses. The average Az values (area under the ROC curve) in detecting pulmonary nodules with LCD and CRT monitors were 0.792 and 0.814, respectively. In addition, the average Az values in detecting interstitial diseases with LCD and CRT monitors were 0.951 and 0.953, respectively. There was no statistically significant difference between LCD and CRT for both detection of pulmonary nodules (P=0.522) and interstitial lung diseases (P=0.869) . Therefore, we believe that the LCD monitor instead of the CRT monitor can be used for the diagnosis of pulmonary nodules and interstitial lung diseases in digital chest images.