[Surgically resected lung cancer in patients complicated with diffuse interstitial pulmonary shadow].

In 25 patients operated on for idiopathic interstitial pneumonia (IIP) associated with primary lung cancer, we clinically examined the predictive factors related to the acute exacerbation of IIP preoperatively and during operation. Most were male heavy smokers. Ages ranged 57 to 78 years. Standard surgery was performed in 11 patients, extended resection in 4 patients and limited resection in 10 patients. The incidence of postoperative acute exacerbation of IIP was 40% (10 patients). These patients were treated with steroid pulse therapy, 3 patients died due to acute exacerbation but 7 patients recovered. It seemed difficult to anticipate postoperative exacerbation of IIP based on preoperative patients evaluation and the degree of surgical invasiveness. Seven patients were alleviated with erythromycin before and after the operation and 4 patients were alleviated with high-dose steroid during or after surgery, with these patients not developing exacerbation of IIP. From these results, it was suggested that high-dose steroid administration during or after surgery and erythromycin before and after the operation were effective to avoid postoperative exacerbation of IIP.

[Solitary hemangioma of the rib; report of a case].

A case of solitary hemangioma which occurred in the rib. Tumor located in the right seventh rib, incidentally taken X-ray film demonstrated bone tumor, but she had no symptoms. Four years after, chest pain occurred and taken X-ray film, tumor size was inceeced. Computed tomography (CT) showed an expansile, well demarcated lesion, with thin corices and fine trabeclae. Chest wall, from the sixth rib to the eighth rib resection was performed and surgical margin was 4 cm. This case were diagnosed hemangioma of the rib. Hemangiomas of the bone are rare benign vascular tumors that account for less than 1% of all bony neoplasms. These lesions are most often occurring in the vertebral column or in the skull. The localization to the ribs is even more rare, with only sporadic case reports in the literature.

[11 operated cases of spontaneous hemopneumothorax].

UNLABELLED: During the period 1984-1993, we experienced 11 operated cases of spontaneous hemopneumothorax, which correspond 7.3% of total 150 cases of operated spontaneous pneumothorax. All cases were male, 19-36 years of age. From admission to the end of operation, 6 cases with hemorrhagic shock had bleeding of 2,305-6,670 ml, the average 3,708 ml, whereas 5 cases without shock had bleeding of 1,209-2,405 ml, the average 1,979 ml. In 9 cases operated within 5 days after admission (6 cases with shock and 3 cases without shock), the source of bleeding was detected, but in 2 cases operated over 6 days after admission, the source was not detected. For the emergency operation of hemopneumothorax, we employed axillary thoracotomy by half lateral position in order to avoid the blood pressure depression due to position changing of the patient. The operation performed safely with enough exposure, and all the patients recovered without severe complication. CONCLUSION: the treatment of spontaneous hemopneumothorax is better to choose early operation by axillary thoracotomy with half lateral position.