Kyobu geka. The Japanese journal of thoracic surgery
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The record of 20 patients presenting with flail chest injury from 1998 to 2005 was reviewed to determine surgical indication and timing. There were 4 groups with each indication as followed: 1) 8 patients with surgical indication for injury regions other than fractured ribs, 2) 5 without improvement of flail chest after internal pneumatic stabilization for more than 10 days, 3) 4 performed surgical fixation positively for flail chest with respiratory failure, 4) 3 with strong deformation of the thorax without respiratory failure. Eight patients (40%) required artificial respiration for more than 6 days after surgical stabilization. ⋯ In patients with no improvement of flail chest after internal pneumatic stabilization for more than 10 days, surgical fixation reduces the period of internal pneumatic stabilization and the risk of pneumonia. For the elderly who can develop complications easily, early indication of surgical fixation should be considered. In patients with unconsciousness or ISS > or = 25, the extubation delays frequently after surgical fixations.
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A 46-year-old female with benign metastasizing leiomyoma was reported. The patient had undergone a lobectomy of thyroid for adenomatous goiter at the age of 30, and a myomectomy for uterine myoma and a modified radical masmectomy for breast cancer at the age of 32. The chest X-ray on health screening revealed multiple nodules in the bilateral lung. ⋯ The tumors of the right lung were resected under thoracoscopic surgery. Pathologically these lesions were diagnosed as benign metastasizing leiomyoma. Left lung nodules have been followed-up.
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Native aortic valve thrombosis is an uncommon event with heart valve disease, during cardiac catheterization, bacterial endocarditis, or a hypercoagulative state as in antiphospholipid antibody syndrome. We report a case of thrombus formation on a native aortic valve, which was found by the transesophageal echocardiography during thrombectomy of the lower limb. We supposed that the atheromatous plaque of aortic valve was related to thrombus formation.
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Clinical Trial
[Prophylactic effect of magnesium infusion against postoperative atrial fibrillation].
Atrial fibrillation (AF) is a common complication of cardiac operation. For the development of postoperative AF, various risk factors have been identified over the years. In a recent study, it was detected that low serum magnesium levels was an independent predictor of AF after coronary artery bypass grafting (CABG). The purpose of this study was to assess the prophylactic effect of intravenous magnesium infusion on postoperative AF. ⋯ Our findings indicate that magnesium sulfate infusion is effective for the prophylaxis of post operative AF.
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We report a case of a 67-year-old man with Salmonella infected aortic arch aneurysm. The patient presented with persistent high fever, chest pain, back pain and hoarseness. Laboratory studies showed the presence of severe inflammation. ⋯ Postoperative course was uneventful. The patient was discharged on the 60th postoperative day. He continues to take oral antibiotics.