Kyobu geka. The Japanese journal of thoracic surgery
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A 44-year-old female was presented to our department with a 4-day history of shortness of breath and chest pain. The chest X-ray showed pneumothorax with completely collapsed left lung. Thoracentesis was performed. ⋯ Those patients were treated with supplemental oxygen without endotracheal intubation. Their oxygen saturation stabilized within 12 hours. They were successfully treated with the sole administration of oxygen.
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We reviewed the effect of obesity in the repair of type A acute aortic dissection (AAD). Between January, 2009 and June, 2010, repair of type A AAD was performed in 51 patients. We divided these patients into 2 groups according to body mass index( BMI). ⋯ The incidence of postoperative hypoxemia was greater in group O than that in group N(81.8% versus 53.6 %, p=0.036). The intubation period was longer in group O than that in group N(8.0±7.1 days versus 3.7±3.1 days, p=0.014), and the intensive care unit (ICU) stay was longer in group O than that in group N(13.7±8.8 days versus 9.3±5.9 days, p=0.04). Obesity is thought to be a risk of young-onset of AAD and postoperative hypoxemia, as well as a prolonged intubation period and ICU stay.
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Case Reports
[Catamenial pneumothrax treated in portable pneumothorax drainage kit; report of a case].
A 37-year-old woman visited our hospital for right pneumothorax and was treated using a portable thoracic drainage kit(Thoracic Egg). A month later, she had relapse of right pneumothorax with onset of a menestration. Catamenial pneumothorax was diagnosed clinically and the surgical treatment and a hormone therapy were recommended. ⋯ Thereafter, she relapsed pneumothorax 3 times, and was treated by rest or using Thoracic Egg. A Thoracic Egg was useful for management of spontaneous pneumothorax, but there is no report concerning the catamenial pneumothorax. Thoracic Egg may be a choice of treatment for catamenial pneumothorax of minor or moderate grade.
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We report a rare case of traumatic mediastinal hematoma treated by thoracoscopic surgery. A 78-year-old man accidentally fell down from the roof, and he was urgently transferred to our hospital. ⋯ Five days later, the large mediastinal hematoma was removed by thoracoscopic surgery. The patient recovered without any complications after our treatments.
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Case Reports
[Open heart surgery using cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia(HIT)].
Heparin-induced thrombocytopenia (HIT) is a life-threatening side effect of heparin therapy. We report an open heart surgery with cardiopulmonary bypass( CPB) using argatroban as an anticoagulant for a patient with HIT. A 72-year-old male with a history of percutaneous coronary intervention 5 years ago, was admitted to our hospital due to congestive heart failure and heparin 10,000 units/day was administered. ⋯ Though the surgical procedure itself was uneventful. We required about 4 hours to achieve adequate hemostasis after CPB. Postoperative course was uneventful.