Kyobu geka. The Japanese journal of thoracic surgery
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The subject was a forty five year old female who was admitted to our hospital with chief complaints of cough and thoracic distress. After detailed examination, she was diagnosed as having aneurysm of the noncoronary sinus of Valsalva and aortic regurgitation. ⋯ An operation for aortic root replacement was performed with Carrel patch method and had a good postoperative course. Only a few reports have been made on cases of aneurysm of the noncoronary sinus of Valsalva caused by chronic regional aortic dissection.
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A 30-year-old female had twice experienced right pneumothorax within 2 months that was related to the onset of menstruation, suggesting catamenial pneumothorax. Right thoracoscopy revealed the presence of "blue berry spots" and pinhole at the lateral part of central tendon in the diaphragm. No bulla or bleb was found on the right lung. ⋯ Histological findings showed endometriosis of the diaphragm. She was followed without hormonal therapy, but recurrent right pneumothorax occurred. Therefore she was given leuprorelin acetate for 5 months, and she is asymptomatic 7 months after surgery.
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Case Reports
[A case of tracheoesophageal fistula cured by surgical therapy after blunt trauma received 38 years ago].
We experienced a case of tracheoesophageal fistula successfully cured by surgical therapy after blunt trauma received 38 years ago. A 71-year-old man was injured blunt trauma at right chest by traffic accident in 1960, and was treated for pneumothorax and ribs fracture. In April, 1998, the patient came to the hospital for hemoptysis. ⋯ Prevention of tracheal stenosis was possible without resection of fistula and closure of trachea using esophageal all layers. This operation was seemed to be effective. This case is supposed to be the longest delay between time of injury and its repair in the world.
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Case Reports Comparative Study
[Clinical comparison of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung for each case].
Because we experienced each 1 operative case of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung discovered with pleural effusion, clinical comparison investigated both. The first case was suspected diffuse malignant mesothelioma of the pleura before operation, and we performed pleuropneumonectomy. But the pathologic diagnosis was adenocarcinoma of the lung, what is so called pseudomesotheliomatous carcinoma. ⋯ The pathologic final diagnosis was diffuse malignant mesothelioma of the pleura. In clinical differential diagnosis of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung, history of inhalation of asbestos and concentrations of hyaluronic acid in pleural effusion are helpful. And thoracoscopic biopsy is necessary in established diagnosis.
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The efficacy of predonation of autologous blood in reducing the use homologous blood during open heart surgery was investigated. Between January 1997, and February 1998, predonation and transfusion was studied in 100 consecutive open heart operations (CABG, 77; valve surgery, 17; ASD, 5; myxoma, 1). The guidelines for autologous predonation were as follows: an age < 70 years, a weight > 40 kg and a hemoglobin > 12 g/dl. ⋯ Homologous transfusion was done in only 5% of the those with predonation of 800 ml versus 69% at 400 ml and 71% at 200 ml. In conclusion, autologous blood transfusion is effective for reducing the homologous blood requirement. It also seems that predonation of 800 ml may be sufficient to allow open heart surgery without blood transfusion.