In 12 pneumothoraxs and 14 tuberculous empyemas of the autopsied cases at the Kiyose National Sanatorium, fibrosis of a lung tissue was observed histologically. Used materials were obtained mainly from diseased lobes.
I classified fibrosis of a lung tissue in four stages, and observed it in relation to pleural sclerosis, exsudate and pus of a pleural space, duration of pneumothorax and empyema, opaque lung, and tracheobronchial tuberculosis. Generally speaking, these factors did not lead a tissue to a irreversible stage of fibrosis and fibrosis of a lung tissue seemed to be effectively influenced by a former inflammatory process.
Both of fibrosis of a lung tissue and pleural sclerosis binders a collapsed lung lobe from re-expanding. Recently, decortication or strepto-kinase and-dornase or trypsin has been used successfully on a therapy of tuberculous empyema and unexpandable lung. Regarding to this, we should not forget unperceived or obvious tuberculous foci in collapsed lung, so a use of these treatments must be carefully evaluated.
I discussed indication and contra-indication of these treatments at each stage of pleural sclerosis and fibrosis of lung.
As a summary, I concluded that artificial pneumothorax treatment should be carefully conducted and maintained to avoided empyema.
I discussed on clinical findings of “unexpandable lung”.
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