ABSTRACT
Chylothorax is a serious postoperative complication in the field of thoracic surgery. To treat refractory chylothorax, various methods including surgery are employed. In this study, we report a patient with refractory chylothorax in whom treatment with octreotide acetate was successful, although the chylorrhea site could not be determined during additional thoracotomy.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Chylothorax/drug therapy , Octreotide/therapeutic use , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
Plasma cell granuloma of the lung is an uncommon and non-malignant neoplasm that may present difficulties in both diagnosis and management. We report a 52-year-old male who was admitted to our hospital due to fever and an abnormal shadow on chest roentgenography. Chest computed tomography revealed a tumor shadow with a cavity in the left upper lobe. However, neither bronchofiberscopy nor serum examinations suggested a diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed and postoperative pathological examination of the resected specimen showed plasma cell granuloma. The postoperative course was uneventful. No recurrence was observed 10 months after the operation. As plasma cell granuloma of the lung is histologically benign, surgery should be performed to preserve the maximal residual lung with no lesion. VATS is the method of choice for treatment of pulmonary plasma cell granuloma.
Subject(s)
Plasma Cell Granuloma, Pulmonary/surgery , Humans , Male , Middle Aged , Plasma Cell Granuloma, Pulmonary/diagnostic imaging , Radiography, ThoracicABSTRACT
We evaluated the applicability of functional MR imaging overlaid onto brain images superimposed venography for neurosurgical identification of the central sulcus. In 20 volunteers and 12 patients with brain tumors located around the sensorimotor cortex, gradient echo and large flip angle functional MR image was performed to allow visualization of flow effect and susceptibility related changes in relative large vein by motor hand task. Functional MR image acquired was overlaid on 3D anatomical image with 3D venography. Based on the 3D mapping, intra-operative cortical somatosensory evoked potentials (SEPs) were recorded. The significant activation area obtained from functional MR imaging was projected on an ascending cortical vein in 16 volunteers (80%) and 10 patients (83%). Comparing the anatomical activation map with visual inspection of the exposed cortical surface made it easy to identify the activation area during surgery. The cortical veins in 9 of 10 were validated as a central vein by intra-operative cortical recording of SEPs. Combination of functional MR imaging overlaid onto 3D anatomical image with venography and intra-operative SEPs permitted rapid and accurate localization of the central sulcus during surgery.
Subject(s)
Brain Mapping/methods , Brain Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Phlebography/methods , Somatosensory Cortex/pathology , Adult , Aged , Brain Neoplasms/physiopathology , Brain Neoplasms/surgery , Case-Control Studies , Evoked Potentials, Somatosensory/physiology , Female , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Prospective Studies , Somatosensory Cortex/physiopathology , Somatosensory Cortex/surgeryABSTRACT
The effects of trimebutine maleate (TM), a prokinetic drug, on gastrointestinal motility in patients with gastric ulcer were investigated. Twenty patients with active gastric ulcers were allocated to two groups; 10 patients received a proton pump inhibitor alone (PPI group), given orally, and 10 patients received oral TM in combination with a PPI (PPI + TM group), each for a period of 8 weeks. Electrogastrography (EGG) and gastric emptying were measured before and after the treatment period. During the active ulcer stage, tachygastria (more than 0.06 Hz) or bradygastria (less than 0.04 Hz) in the EGG frequency were observed in 9 patients either before or after meals. During the healed ulcer stage, tachygastria or bradygastria was observed in 4 of 10 patients in the PPI group, while in the PPI + TM group, 1 patient had tachygastria and none had bradygastria. Postprandial dip (PD) was observed in 3 of the 20 patients during the active stage, while after treatment, PD was observed in 3 patients in the PPI group and in 6 patients in the PPI + TM group, respectively. Gastric emptying in the PPI group did not show any change between before and after treatment, while that in the PPI + TM group improved significantly after treatment. These results suggest that TM may have an ameliorative effect on abnormal gastric motility in patients with gastric ulcer.
Subject(s)
Enzyme Inhibitors/administration & dosage , Gastrointestinal Agents/administration & dosage , Gastrointestinal Motility/drug effects , Omeprazole/analogs & derivatives , Stomach Ulcer/drug therapy , Trimebutine/administration & dosage , 2-Pyridinylmethylsulfinylbenzimidazoles , Administration, Oral , Adult , Drug Therapy, Combination , Female , Follow-Up Studies , Gastric Emptying/drug effects , Gastric Mucosa/drug effects , Gastroscopy , Humans , Lansoprazole , Male , Middle Aged , Omeprazole/administration & dosage , Stomach Ulcer/diagnosis , Stomach Ulcer/physiopathology , Treatment OutcomeABSTRACT
A 63-year-old male had multiple liver metastasis about 7 months after right hemicolectomy. Combination chemotherapy of 5'-DFUR and MMC was started about 2 months after the diagnosis of recurrence. The abdominal US showed a remarkable decrease in size and number of liver metastatic foci 4 weeks after the beginning of this therapy. As this response was continued for 18 weeks by abdominal CT, this was considered to be a case of partial response (PR). We consider that the combination chemotherapy of 5'-DFUR and MMC is available for patient having recurrent colon cancer with multiple liver metastasis.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colonic Neoplasms/drug therapy , Colonic Neoplasms/pathology , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Colectomy , Colonic Neoplasms/surgery , Drug Administration Schedule , Floxuridine/administration & dosage , Humans , Lymph Node Excision , Lymphatic Metastasis , Male , Middle Aged , Mitomycin/administration & dosage , Postoperative PeriodSubject(s)
Leiomyosarcoma/complications , Stomach Neoplasms/complications , Turner Syndrome/complications , Adolescent , Aged , Female , Humans , Middle AgedABSTRACT
Long-term survival of malignant teratoma is rare. A 16-year-old female with a suprasellar malignant teratoma survived for 11 years before succumbing to embryonal carcinoma. A suprasellar immature teratoma with increased serum alpha-fetoprotein level was verified histologically. Radiation therapy and combined chemotherapy were given after partial removal. Eleven years later, the primary lesion recurred as embryonal carcinoma.
Subject(s)
Brain Neoplasms/mortality , Teratoma/mortality , Adolescent , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/pathology , Female , Humans , Sella Turcica , Survival Analysis , Teratoma/diagnostic imaging , Teratoma/pathology , Time Factors , Tomography, X-Ray ComputedABSTRACT
Optical path analysis applying diffraction theory and geometrical ray tracing, and with collimation experiments shows that a hemiconic lens can convert the arc of blue radiation formed by Cerenkov second-harmonic generation to a parallel plane wave. To obtain an aberration-free plane wave, we modified the apex angle of the cone according to the birefringence of the waveguide. To correct chromatic aberration, we needed to have diode laser wavelength tuning with the aid of an achromatic cone lens doublet.
