ABSTRACT
Canine heart worm disease is often life-threatening due to its various complications, including right side heart failure, caval syndrome and pulmonary eosinophilic granulomatosis. Several preventive medications and melarsomine have been developed and they are very effective to control heartworm infestation. However, in a case of severe infestation, melarsomine therapy often results in an unfavorable outcome because of the severe immune reaction caused by rapid killing of the adult worm. Surgical removal and an interventional method using flexible alligator forceps have been well described in the literature. Despite the usefulness of mechanical removal using flexible alligator forceps, the methodology still needs to be upgraded for increasing the applicability for treating dogs with severe infestation. We describe herein a newly developed percutaneous removal method for heartworms and this was successfully applied to 4 dogs with severe heartworm infestation. The follow-up studies also showed favorable outcomes with no complications.
Subject(s)
Animals , Dogs , Catheterization/veterinary , Dirofilaria immitis , Dirofilariasis/surgery , Dog Diseases/surgery , Echocardiography , Electrocardiography , Fluoroscopy/methods , Surgical Instruments/veterinary , Thoracic Surgical Procedures/methodsABSTRACT
The frequency or primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with mean 57.13+/-7.15 and 80.5%(70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9:1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left side in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in 16.1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage IIIa 54.1% and stage IIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal lymph node involvement was observed in 17 cases, and multi-level mediastinal lymph node involvement in 23 cases. Lower paratracheal lymph node and subcarinal lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic lymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95+/-17.21 months. Overall one-year survival rate was 75.1% and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage I, 92.2% and 30.5% for stage II, and 61.2% and 17.4% for stage IIIa, respectively. These findings correlate survival rate with tumor size, mediastinal lymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal lymph node metastasis and complete surgical resection.
Subject(s)
Female , Humans , Male , Carcinoma, Squamous Cell , Cause of Death , Chest Pain , Chylothorax , Cough , Follow-Up Studies , Hemoptysis , Hoarseness , Lung Neoplasms , Lung , Lymph Nodes , Mortality , Neoplasm Metastasis , Pneumonectomy , Pulmonary Edema , Sputum , Surgical Procedures, Operative , Survival Rate , Weight Loss , Wound InfectionABSTRACT
Cardiac rhabdomyomas are the most common primary tumor in infancy and childhood and are frequently associated with tuberous sclerosis. Although spontaneous regression of cardiac rhabdomyoma has been reported , prognosis of this tumor associated with subaortic stenosis is still considered to be poor and surgery continues to be indicated. A 4-day-old female was admitted due to tachypnea and cyanosis. Single rhabdomyoma arising from the interventricular septum associated with severe subaortic stenosis was partially removed under cardiopulmonary bypass. Excised tumor size was 0.7 X 0.9 X 0.4 cm in dimension. The postoperative course was uneventful and the infant discharged on the 14th postoperative day.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Cardiopulmonary Bypass , Constriction, Pathologic , Cyanosis , Echocardiography , Heart Neoplasms , Prognosis , Rhabdomyoma , Tachypnea , Tuberous Sclerosis , Ventricular Outflow ObstructionABSTRACT
The frequency or primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with mean 57.13+/-7.15 and 80.5%(70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9:1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left side in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in 16.1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage IIIa 54.1% and stage IIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal lymph node involvement was observed in 17 cases, and multi-level mediastinal lymph node involvement in 23 cases. Lower paratracheal lymph node and subcarinal lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic lymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95+/-17.21 months. Overall one-year survival rate was 75.1% and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage I, 92.2% and 30.5% for stage II, and 61.2% and 17.4% for stage IIIa, respectively. These findings correlate survival rate with tumor size, mediastinal lymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal lymph node metastasis and complete surgical resection.
Subject(s)
Female , Humans , Male , Carcinoma, Squamous Cell , Cause of Death , Chest Pain , Chylothorax , Cough , Follow-Up Studies , Hemoptysis , Hoarseness , Lung Neoplasms , Lung , Lymph Nodes , Mortality , Neoplasm Metastasis , Pneumonectomy , Pulmonary Edema , Sputum , Surgical Procedures, Operative , Survival Rate , Weight Loss , Wound InfectionABSTRACT
Congenital cystic adenomatoid malformation of the lung is a rare pulmonary malformation, Although it is one of the most common congenital anomalies which cause acute respiratory distress in the newborn infants, characterized by marked proliferation of terminal respiratory structures. We have experienced an unusual case of congenital cystic adenomatoid malformation associated with pectus excavatum. The patient was 3-year-old female who suffered from cough and high fever for 20 days, and antibiotic therapy was given in other hospital before transfer to our hospital. The findings on chest X-ray, chest CT, aortogram, and selective bronchial arteriogram showed cystic lesions in the right upper and middle lobe accompanied but severe pectus excavatum. Right bilobectomy for pulmonary lesion and costosternal elevation for pectus excavatum was performed simultaneously with successful result. The postoperative course was uneventful and the patient was discharged on the twentieth postoperative day.
Subject(s)
Child, Preschool , Female , Humans , Infant, Newborn , Cough , Cystic Adenomatoid Malformation of Lung, Congenital , Fever , Funnel Chest , Lung , Thorax , Tomography, X-Ray ComputedABSTRACT
Cardiac rhabdomyomas are the most common primary tumor in infancy and childhood and are frequently associated with tuberous sclerosis. Although spontaneous regression of cardiac rhabdomyoma has been reported , prognosis of this tumor associated with subaortic stenosis is still considered to be poor and surgery continues to be indicated. A 4-day-old female was admitted due to tachypnea and cyanosis. Single rhabdomyoma arising from the interventricular septum associated with severe subaortic stenosis was partially removed under cardiopulmonary bypass. Excised tumor size was 0.7 X 0.9 X 0.4 cm in dimension. The postoperative course was uneventful and the infant discharged on the 14th postoperative day.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Cardiopulmonary Bypass , Constriction, Pathologic , Cyanosis , Echocardiography , Heart Neoplasms , Prognosis , Rhabdomyoma , Tachypnea , Tuberous Sclerosis , Ventricular Outflow ObstructionABSTRACT
Congenital cystic adenomatoid malformation of the lung is a rare pulmonary malformation, Although it is one of the most common congenital anomalies which cause acute respiratory distress in the newborn infants, characterized by marked proliferation of terminal respiratory structures. We have experienced an unusual case of congenital cystic adenomatoid malformation associated with pectus excavatum. The patient was 3-year-old female who suffered from cough and high fever for 20 days, and antibiotic therapy was given in other hospital before transfer to our hospital. The findings on chest X-ray, chest CT, aortogram, and selective bronchial arteriogram showed cystic lesions in the right upper and middle lobe accompanied but severe pectus excavatum. Right bilobectomy for pulmonary lesion and costosternal elevation for pectus excavatum was performed simultaneously with successful result. The postoperative course was uneventful and the patient was discharged on the twentieth postoperative day.
Subject(s)
Child, Preschool , Female , Humans , Infant, Newborn , Cough , Cystic Adenomatoid Malformation of Lung, Congenital , Fever , Funnel Chest , Lung , Thorax , Tomography, X-Ray ComputedABSTRACT
The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prognosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively. The results were as follows : 1. Serum triiodothyronine(T3) reached to its nadir(30.05+/-17.5ng/dl, p<0.001) at 10 minutes after the start of CPB and remained low(p<0.05) throughout the study period. 2. Serum thyroxine(T4) concentration slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(fT4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37+/-0.81uIU/ml, p<0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum T3 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum T3 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.