ABSTRACT
A 74-year-old man was admitted with respiratory failure and treated for tracheobronchial stenosis due to metastasis of renal cell carcinoma. It improved after implantation of an expandable metallic stent (EMS). One year later, the metastatic tumor at the near distal side of the EMS increased; eventually serious respiratory failure occurred again. However, the delivery catheter of EMS could not be inserted by the usual procedure because there was a strong tracheobronchial curve. Finally it passed along the inside of the endotracheal intubation tube. The respiratory failure was improved by the second implantation of EMS with the method of stent in stent. EMS is often effective in a case with a strong curve and twist of the trachea/bronchi. It was also considered one way of letting the delivery catheter pass inside the endotracheal intubation tube if the patient's respiratory condition was maintained.
Subject(s)
Intubation, Intratracheal/methods , Metals , Palliative Care , Respiratory Insufficiency/surgery , Stents , Tracheal Stenosis/surgery , Aged , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/secondary , Humans , Kidney Neoplasms/pathology , Lung Neoplasms/complications , Lung Neoplasms/secondary , Male , Reoperation , Respiratory Insufficiency/etiology , Tracheal Stenosis/etiology , Treatment OutcomeABSTRACT
Subpopulations of regular and atypical lymphocytes in the peripheral blood of a 24-year-old man with an infectious mononucleosis (IM)-like syndrome associated with hepatitis A virus (HAV) infection were analyzed. The ratio of CD4+ to CD8+ cells was in the normal range (1.19 and 1.23 in the regular and atypical lymphocytes, respectively), with no increase in CD8+ cells. The percentage of CD8+/CD11b- cells was not increased in the atypical lymphocytes. However, CD45RO+ was expressed on 86.3% of CD4+ atypical lymphocytes. The present data suggest that atypical lymphocytes expressing CD4+/CD45RO+ may play the role of helper T cells in the immune system in the development of IM-like syndrome associated with HAV infection.
