Nihon Kyōbu Shikkan Gakkai zasshi
-
Nihon Kyobu Shikkan Gakkai Zasshi · Feb 1991
Case Reports[Assessment of the permeability of the pulmonary microvasculature using radiotracers in a case of adult respiratory distress syndrome].
A 48-year-old man with small cell lung cancer developed ARDS, and massive pulmonary edema fluid was obtained with the fiberoptic bronchoscopy. The pulmonary edema fluid to serum ratios of total protein and albumin were 0.72 and 0.85 respectively. The ratio of LDH was higher (2.71), while that of cholesterol was lower (0.11) than that of total protein. ⋯ The time activity curves of I-123 IMP and I-131 HSA in his blood samples revealed almost constant radioactivity from 5 minutes to 120 minutes after injection, while both radioactivity levels in pulmonary edema fluid samples increased with time. The clearance ratio of I-123 IMP to I-131 HSA was constant at each sampling time (mean +/- SD, 1.51 +/- 0.32). The linear correlation between I-123 IMP clearance and I-131 HSA clearance (r = 0.95, p less than 0.01) suggested that the clearance ratio of exudative plasma components may remain unchanged even if pulmonary microvasculature permeability has changed.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Feb 1991
[Hemopurification in the management of ARDS complicating multiple organ failure].
In the field of critical care medicine, it has been claimed that ARDS often develops as a part of multiple organ failure (MOF). Since multi-modality therapy is necessary in the management of MOF, it is also mandatory even in the management of ARDS. ⋯ However, our recent experiences suggest that continuous hemofiltration (CHF) and/or continuous hemodiafiltration (CHDF) are safest, most easily performed and effective hemopurification in the management of ARDS/MOF. The efficacy of hemopurification in the management of ARDS is summarized as follows. 1) Removal of humoral mediators and causative substances of ARDS following insults such as sepsis and trauma. 2) Treatment of pulmonary interstitial permeability edema which has been claimed to be one of the most important pathological conditions in ARDS. 3) Removal of excess water given as carrier in IVH solution and accumulating in the body. 4) Immunomodulation which has also been considered to be necessary in the treatment or prevention of ARDS.
-
Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.
-
Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1991
[Early changes of postpneumonectomy lung growth in premature rats].
Following pneumonectomy in animals, the contralateral lung increases in volume, weight, collagen content, protein, and cell number, reaching levels approximate to those of both lungs of control animals. The volume and weight response in quicker and more complete in young animals compared to old animals. The increase in the amount of DNA was found to be greater in young rats compared to old ones. ⋯ The fixed lung volume of group P reached that of group S or group C at three weeks. The activity of DNA polymerase and BrdU positive alveoli were increased only during the early period following pneumonectomy. DNA content in group P reached the same range as group S and C at 4 weeks, suggesting the occurrence of cellular hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1990
[Patterns of relapse in patients with small cell lung cancer--the effect of chest irradiation and prophylactic cranial irradiation combined with intensive chemotherapy on long-term survival].
The pattern of relapse was analyzed in patients with small cell lung cancer (SCLC). Of 180 patients treated with intensive combination chemotherapy between 1976 and 1987, 75 achieved complete response (CR). Of 47 patients with limited disease (LD), 20 (43%) initially relapsed in the chest and 7 (15%) in the brain. ⋯ The median survival time and 5-year survival rate of patients who received PCI were 23.1 months and 26.7%, which these figures were only 14.0 months and 8.3% for those who had not respectively. Analysis using Cox's proportional hazard model showed that PCI was the greatest prognostic factor favoring the SCLC patients achieving CR. These results indicate that chest irradiation and PCI in conjunction with intensive combination chemotherapy are effective for cases of SCLC with CR.