Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1996
Review[Thoracoscopic surgery for diagnosis and treatment of pleural and mediastinal disease].
We studied the usefulness of thoracoscopic surgery in the diagnosis and treatment of pleural and mediastinal lesions. 1. Thoracoscopic surgery was the best method for biopsy of pleural lesions or effusion-retaining disease. Thoracoscopic surgery allowed extensive intrathoracic inspection and collection of relatively large tissue samples, even though it is less invasive than thoracotomy. 2. ⋯ Thoracoscopic surgery is indicated for treatment of the following five pleural diseases: (1) benign pleural tumors; (2) localized mesothelioma; (3) persistent pleural effusions; (4) pyothorax; and (5) chylothorax. 4. Benign mediastinal tumor is a clear indication for thoracoscopic surgery, but utmost caution must be exercised in applying this technique to the treatment of malignant tumors. 5. Thoracoscopic extended thymectomy with a collar incision of the neck is a useful and relatively non-invasive technique for the treatment of myasthenia gravis without thymoma.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1996
[Defensin in plasma and in bronchoalveolar lavage fluid from patients with acute respiratory distress syndrome].
We measured the levels of defensins, antimicrobial peptides, and cytotoxic peptides in azurophil granules of neutrophils in plasma, and in bronchoalveolar lavage fluid (BALF) from patients with the acute respiratory distress syndrome (ARDS). High levels of plasma defensins were observed in samples from patients with ARDS. ⋯ A significant correlation was found between the concentration of defensins and that of IL-8 in BALF from patients with ARDS. These findings suggest that the lung injury in ARDS is caused by defensins released by neutrophils that accumulate in the lungs.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1996
Case Reports[Repeated pneumonia in the middle lobe caused by congenital bronchoesophageal fistula].
A 52-year-old woman was admitted to our hospital because of repeated episodes of pneumonia in the middle lobe. She had also experienced coughing during meals. The history and chest CT findings suggested the presence of a bronchoesophageal fistula. ⋯ These findings indicated that the repeated pneumonia in the middle lobe was caused by a congenital bronchoesophageal fistula. Examination of the resected fistula showed that it was a Braimbridge type I bronchoesophageal fistula. Although of at least 49 cases of congenital bronchoesophageal fistulas with esophageal diverticula have been reported in the Japanese medical literature, we know of no previous case in which such a fistula was associated with middle-lobe pneumonia.