The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Volume 6 , Issue 7
Showing 1-15 articles out of 15 articles from the selected issue
  • Kenji Inui, Khaled Reshad, Yutaka Takahashi, Toru Shindo, Yoshimitsu T ...
    1992 Volume 6 Issue 7 Pages 740-746
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    Six patients (5 males and 1 female) underwent operation for localized pulmonary aspergillosis at the Shimada Municipal Hospital from September 1980 to December 1986. The mean age was 55. Three patients had tuberculosis with cavity, one had acute myelogenous leukemia ; the underlying disease was not known in the other two patients. The surgical procedures were : one partial resection of the lung, one segmentectomy, three lobectomies and one pneumonectomy. The postoperative courses were uneventfull except in one case, in which air leakage continued for four weeks. This article describes the present indications for surgical treatment for localized pulmonary aspergillosis.
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  • Satoshi Sakai, Mitsuharu Kokubo, Makoto Ishikawa, Sinji Murakawa, Yosh ...
    1992 Volume 6 Issue 7 Pages 747-754
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    Twenty-five patients with thymoma were subjected to surgical treatment in our department from 1972 to 1990. Patients with non-invasive type (stage I), stage III, stage IVa, and stage IVb were 16, 6, 2 and 1, respectively. Twenty-two patients underwent surgical resection and 3 patients underwent exploratory thoracotomy.
    Histologically, 8 patients were found epithelial cell type, 5 patients lymphocytic type and 12 patients mixed type.
    The five-year survival rate was 85% in non-invasive type, and 58% in invasive type. Jn non-invasive type, 5-year survival rate was 100% in patients without myasthenia gravis (MG) and 56% in patients with MG. The prognosis of patients with MG was significantly poorer than the one of patients without MG. MG was causes of death in two of three patients who died among patients with MG. 5-year survival rate by histological type was 100% in lymphocytic type, 73% in epithelial cell type and 51% in mixed type.
    5-year survival rate according to the surgical modalities, were 85% in patients with total resection, 80% in subtotal resection and 33% in exploratory thoracotomy.
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  • Kenji Inui, Khaled Reshad, Yutaka Takahashi, Toru Shindo, Toshiki Hira ...
    1992 Volume 6 Issue 7 Pages 755-759
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    Seventeen patients (15 males and 3 females) with lung abscess were treated in the Shimada Municipal Hospital from September 1980 to Desember 1986. The mean age was 54. Seven patients were treated surgically, three because of relapse, one with combined empyema, one with bilateral pneumothorax and two with severely injured lung following pulmonary infarction or postoperative mediastinitis. There were many background factors in all 17 patients. The ouocome was yery good except in two cases. Generally lung abscess is treated with antibiotics, but in some cases surgical treatment is still necessary. This article describes today's indications for the surgical treatment of lung abscess.
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  • Masahiko Higashiyama, Hideoki Yokouchi, Osamu Doi, Ken Kodama, Ryuhei ...
    1992 Volume 6 Issue 7 Pages 760-766
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    This is a report of six patients with pulmonary adenocarcinoma of the fetal lung type characterized by clear cytoplasm with much glycogen and no sarcomatous features, unlike pulmonary blastoma. Five were males with a history of heavy smoking. All lesions were located in the periphery of the right lung, and most of them appeared as coin-like shadows on chest X-ray films. Preoperative cytological examinations often showed malignancy, but the histological type was misdiagnosed in most cases. Lobectomy was performed in five patients and pneumonectomy in one. Five tumors were stage I, and one was stage IIIA. Two patients died of tumor recurrence and one of pneumonia three are alive without recurrence. Interestingly, in the patients with tumor recurrence, there were histological features of an admixture with fetal lung type adenocarcinoma and other histological types, such as the usual type of adenocarcinoma or small cell carcinoma. These results suggest that radical operation should be performed in ptatients with pulmonary adenocarcinoma of the fetal lung type, taking clinicopathological features into account, although the “pure” fetal lung type has a good prognosis.
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  • Toshihiko Sakamoto, Noriaki Tsubota, Masahiro Yoshimura, Maki Kubota, ...
    1992 Volume 6 Issue 7 Pages 767-773
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    We treated three adults with intrapulmonary bronchogenic cysts and different clinical findings.
    Case 1 had symptoms and an air-fluid level on chest x-ray.
    Case 2 had no symptoms or an air-fluid level.
    Case 3 had an air-fluid level but no symptoms.
    The cysts were resected, and the rest of the lung tissue in the lobe was preserved.
    Even if the inflammatory process covers the cyst and much effort is required, one must save the normal lung tissue.
    For this reason, bronchogenic cysts should be removed as soon as the diagnosis is made, and lobectomy should be avoided.
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  • Wataru Chiba, Rikuro Hatakenaka, Satoru Sawai, Takaaki Konishi, Hisao ...
    1992 Volume 6 Issue 7 Pages 774-779
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    Bochdalek hernia in very rare in adults. We recently treated an adult with Bochdalek hernia. The patient was a 41-year-old male with Down's syndrome. Chromosome analysis showed a genotype of 47XY +21, indicating Down's syndrome. Chest X-ray films showed a mass in the left supradiaphragmatic region, but the patient was asymptomatic. The spleen was seen in both the thoracic and abdominal cavities in CT scans. We diagnosed Bochdalek hernia and performed a left thoracotomy. The area of the defect in the diaphragm was 70 cm2, and the hernia sac containing the spleen protruded into the thoracic cavity from the abdominal cavity. It was easy to replace the spleen into the abdominal cavity, but we were unable to suture the defect of the diaphragm directly. Finally, we closed the defect with a Gortex soft tissue patch. This is the first report of a case of Bochdalek hernia in a patient with Down's syndrome.
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  • Kan Okabayashi, Masakatsu Hamada, Kouichi Yano, Tsunehiro Oyama, Masaa ...
    1992 Volume 6 Issue 7 Pages 780-785
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    Four cases of mediastinal tumors associated with von Recklinghausen's disease are reported. Two neurofibromas arose from the vagus nerve, one of those is revealed histologically malignant lesion inside a benign tumor. One was a very rare invasive thymoma in a patient with myasthenia gravis, associated with an anterior chest wall malignant schwannoma which developed in the field of irradiation of the thymoma. The fourth patient was suspected to have neurofibroma with destruction of ribs, and also had a giant mesenteric neurofibroma. Although von Recklinghausen's disease is generally thought not to be associated with an abnormality of chromosomes, one of the three patients had abnormal chromosomes. We conclude that surgical treatment and careful follow-up are required in patients with von Recklinghausen's disease because of the possibility of malignant changes.
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  • Katsunari Matsuoka, Masayoshi Kuwabara, Kazumi Itoi, Kenichi Okubo
    1992 Volume 6 Issue 7 Pages 786-791
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 47-year-old woman was found to have a coin lesion on a chest roentgenogram. CT examination showed a homogeneous smooth surfaced round mass in the right upper lobe. There was no calcification in it. Fiberoptic bronchoscopy demonstrated no abnormalities. An operation was performed, and the tumor was resected. It had a smooth surface and was elastic hard. Histological examination of the resected specimen showed spindle shaped cells with elongated nuclei and cystic or cleft-like space lined with non-ciliated epithelial cells. The diagnosis was fibroleiomyomatous hamartoma. Localised fibroleiomyomatous hamartoma is very rare, and only one case has been reported in the literature as far as we know.
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  • Koichi Yanai, Jinichi Haga, Hiroshi Sakuma, Akio Ohishi, Hitoshi Inoue ...
    1992 Volume 6 Issue 7 Pages 792-797
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 64 year-old man was treated 40 years ago with artifical pneumothorax for pulmonary tuberculosis. He came to our hospital complaining of bloody sputum, and left chronic pyothorax was diagnosed. Thoracic drainage and continued administration of antibiotics unfortunately led to persistent bloody fluid, requiring thoracoplasty for hemostasis. No definite diagnosis was made before thoracoplasty. The histological diagnosis was diffuse large cell, B-cell type malignant lymphoma in a portion of the pyothoracic wall. Chemotherapy with cyclophosphamide, epirubicin, vincristine and prednisolone was administered postoperatively. The patient is now under ambulatory treatment 10 months postoperatively.
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  • Kunio Narita, Hiroshi Iwanami, Haruhisa Hiyoshi, Masanori Tachibana, M ...
    1992 Volume 6 Issue 7 Pages 798-803
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 62-year-old male was admitted to our hospital complaining of right sided chest pain on Oct. 16, 1991. He was found to have adenocarcinoma of the right B8, involving the right lateral chest wall, the diaphragm and upper surface of the liver. Surgery was performed on Nov. 5, 1991. The right middle and lower lobes, the right lateral chest wall (ribs 7-10), the right side of the diaphragm and the upper part of the liver were resected. The cut surface of the liver was coated with fibrin glue, closed with sutures, and covered with a Teflon sheet to prevent leakage of bile and blood. The diaphragm was reconstructed with Teflon sheet and the thoracic wall with Marlex polyethylene mesh.
    Although, many reports have demonstrated that reduction surgery provides no improvement in the prognosis of patients with advanced lung cancer, extensive operations with pre-and postoperative adjuvant therapy occasionally improve the survival rate. We think it is important for surgeons to attempt relative curative resection in cases of advanced lung cancer when there is no other effective therapy.
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  • Mitsuharu Kokubo, Hiroshi Sugimoto, Satoshi Sakai, Tsuneo Tanaka, Haru ...
    1992 Volume 6 Issue 7 Pages 804-810
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 40-year-old male with dyspnea was diagnosed as having bilateral emphysematous bullae. His preoperative state was Hugh-Jones IV dyspnea. Preoperative pulmonary function and blood gas analysis were reduced to VC 960 ml. %VC 25%, FEV 1.0 620 ml, PaO2 65 Torr. Pulmonary perfusion scintigraphy showed large defects in the right lung field.
    We determined that the right compressed lung tissue could not be expanded after removal of the bulla. The bulla in the left lung was removed in preparation for cardiopulmonary bypass. Pulmonary perfusion scintigraphy showed increased perfusion in the right lung field because of IPPB after the bullectomy. We determined that the right compressed lung tissue could be expanded by removal of the bulla.
    He successfully underwent bullectomy on the right. His postoperative condition was good (Hugh-Jones I). Pulmonary function tests and blood gas studies were markedly improved to VC, %VC 84%, FEV 1.0 2170 ml, PaO2 72 Torr four months after surgery.
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  • Tsuneyo Takizawa, Masanori Terashima, Teruaki Koike, Masaaki Sugawara
    1992 Volume 6 Issue 7 Pages 811-817
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    During a routine examination, a 52-year-old male's sputum cytology was reported to be class V although his chest roentgenogram showed no abnormalities. Fiberoptic bronchoscopy revealed a small nodular lesion in the left B1+2 and mucosal redness and irregularity of the left B6. Squamous cell carcinoma was detected in transbronchial biopsies of both lesions. The patient underwent left S1+2+ S3 segmentectomy and left S6 sleeve segmentectomy with lymphnode dissection. Subepithelial invasion by squamous cell carcinoma was confirmed histologically in both resected bronchi. There were no postoperative complications and he is well without any evidence of recurrence one year and 4 months after surgery.
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  • Noriaki Kurimoto, Shinya Yamamoto, Masamitsu Enomoto, Masaki Murayama, ...
    1992 Volume 6 Issue 7 Pages 818-824
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 70-year-old female was treated surgically for adeno-cystic carcinoma on the truncus intrmedius bronchus. Local invasion by this tumor was severe, but during the operation we saw no relationship between the bronchus and the tumor. Echography of the resected bronchus in water found to be useful in the diagnosis of local invasion.
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  • Hisayuki Aoyagi, Yutaka Yamaguchi, Mitsutoshi Shiba, Michio Fujino, Ya ...
    1992 Volume 6 Issue 7 Pages 825-831
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A giant mediastinal teratoma which is asymptomatic for 25 years was diagnosed in a 55-year-old male admitted to our hospital because of dyspnea, fever and cough. Chest X-ray examination revealed a huge mass shadow in the left hemithorax. Respiratory function tests showed a mixed type of pulmonary dysfunction. To prevent abrupt circulatory disorder due to tumor extirpation, the contents of the tumor were drained gradually before operation. A histological diagnosis of mature teratoma was established, and no component of pancreatic tissue or elevation of amylase activity was ebserved. This could explain why this giant mediastinal tumor was asymptoratic for many years.
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  • Noriyoshi Sawabata, Sogo Iioka, Takashi Tohjo, [in Japanese], [in Japa ...
    1992 Volume 6 Issue 7 Pages 832-836
    Published: November 15, 1992
    Released: November 10, 2009
    JOURNALS FREE ACCESS
    A 66-year-old man had had artifical pneumothorax at 28 years of age as a treatment for left tuberculosis, developed marked dyspnea due to left tuberculous empyema. The severity was a grade VI in the H-J Classification. He subsequently underwent treatment extraperiosteal fluid plombage thoracoplasty by the “Kinchu method”. His dyspnea improved to grade II in the H-J Classification within four months after the operation, and an X-ray film revealed aeration in the left lung. The %VC improved from 37% to 57%, and the forced one second expiratory volume (FEV1.0) also improved from 0.62l to 1.09 l. Perfusion lung scans showed that left lung prfusion volume increased from 60 ml to 150 ml. Therefore, it was considered that 690 ml (88. 5 %) of the 780 ml increase in FVC was due to an incease in volume of the right lung. Athough postoperative increase in the rate of ventilation was observed in the left lung, an iprovement of blood flow was not demonstrated by ventilation-perfusion scintigraphy.
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