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Toshiteru Tokunaga Shin-ichi Takeda Noriyoshi Sawabata Masayoshi Inoue Hajime Maeda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(9):399-401
A 72-year-old woman with a diagnosis of suspected rheumatoid arthritis was admitted with multiple pulmonary nodules in the bilateral lung field. To obtain a diagnosis, a nodule was resected using video-assisted thoracic surgery. Microscopically, amorphous eosinophilic acellular substances were surrounded by inflammatory infiltrates, which were confirmed to be amyloid deposits by congo red staining. Thus, a diagnosis of pulmonary amyloidosis was obtained. The clinical features and diagnostic process are discussed. 相似文献
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Pulmonary vascular abnormalities in chronic obstructive pulmonary disease undergoing lung transplant
Victor I. Peinado Federico P. Gómez Joan Albert Barberà Antonio Roman M. Angels Montero Josep Ramírez Josep Roca Roberto Rodriguez-Roisin 《The Journal of heart and lung transplantation》2013,32(12):1262-1269
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Late pulmonary artery stump thrombosis with post embolic pulmonary hypertension after pneumonectomy 总被引:3,自引:0,他引:3
Ten years after right pneumonectomy for primary lung cancer, a 51 year old man developed a pulmonary artery stump thrombosis which produced microemboli in the remaining lung and, in turn, led to chronic pulmonary hypertension. This case strongly suggests that prolonged postoperative thromboembolic prophylaxis should be considered in patients undergoing right pneumonectomy. 相似文献
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Christoph Gebauer 《Surgery today》1982,12(2):148-159
Primary sarcomas of the lungs occur at frequencies of 1:100, as compared with carcinomas reported in our retrospective studies
covering 394 cases reported in the literature from 1957 to 1972 and 41 cases from 1957 to 1974. The average age was 45 years,
the disease usually occurred between the ages of 35 and 65, the peak being between 45 and 60 years. Distribution between sexes
was much the same as that seen in general. X-ray with rapid thoractomy provided the best clinical results. The literature
showed a postoperative survival time of 5 years in 19% and 44% of our own cases. The general metastasis, haematologenous and
lymphogenous were more or less equal and recidive tendency in 7% essentially varied, as related to the single histological
forms. Lymphosarcomas (28.6%) were the most frequent, the group of spindle-celled sarcomas, inclusive of leiomyosarcomas,
occurred in 40%. Histological maturity of the tissues and the prognosis according to active therapy were in parallel. A comparison
of 41 primary sarcomas of the lung with the 192 cases of carcinomas seen in our clinic showed no connection between sarcomas
of the lungs and smoking of cigarettes, pollution of the environment, industrial toxins or chronic bronchitis. These findings
relate to the peripheral localization as well as to the lack, of incidence among men, with regard to pulmonary adenocarcinomas.
An overall view of the characteristics led to the assumption of a probable endogenous tumour. A summarization of the characteristics
of pulmonary sarcomas and carcinomas revealed the role of primary sarcomas in the total complex of malignant tumours of the
lungs. 相似文献
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Masato Yoshida Nobuhiko Mukohara Hidefumi Obo Nobuchika Ozaki Tsutomu Shida Yutaka Okita 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(2):70-74
Pulmonary thromboendarterectomy was performed on a patient with chronic pulmonary thromboembolism showing thrombophilia. The
patient was a 56-year-old female with the above condition complicated by congenital protein C deficiency. She was admitted
to our hospital with severe dyspnea accompanied by right ventricular failure. A pulmonary arteriogram showed occlusion and
stenosis from lobar to segmental arteries Cardiac catheterization showed marked pulmonary hypertension. A lung perfusion scintigram
revealed multiple defects in the right and left lungs. After the insertion of an inferior vena cava filter, she was operated
on Following a median sternotomy, thromboendarterectomy of the bilateral pulmonary arteries was performed using deep hypothermia
and intermittent circulatory arrest. Circulatory arrest was employed in three periods totaling up to 36 minutes. After surgery,
she had improvements in pulmonary hypertension and pulmonary vascular resistance. She maintained improved lung functions,
and remained in the New York Heart Association functional class I for more than two years and eight months after surgery. 相似文献
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(Received for publication on Aug. 19, 1997; accepted on May 15, 1998) 相似文献
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Renda Circi MD Emre Boysan MD Bulent Behlul Altunkeser MD Nazif Aygul Kumral Cagli Kerim Cagli MD Erol Sener MD 《Journal of cardiac surgery》2020,35(4):942-945
Pulmonary artery aneurysm (PAA) is a rare entity with fatal complications. Its silent course contributes to large aneurysms with compression symptoms. We present a 39-year-old female idiopathic pulmonary arterial hypertension patient with a giant PAA causing severe pulmonary regurgitation (PR) and symptomatic left main coronary artery compression (LMCA). Since she had a failed LMCA stenting attempt, she underwent surgery. A valve-sparing David-like pulmonary trunk reconstruction and coronary artery bypass were performed. This case illustrates that David-like reconstruction procedure can be applied to the PAA with severe PR. 相似文献
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Nunes H Humbert M Capron F Brauner M Sitbon O Battesti JP Simonneau G Valeyre D 《Thorax》2006,61(1):68-74
BACKGROUND: Pulmonary hypertension (PH) is a rare complication of sarcoidosis, although it is not uncommon in advanced disease. METHODS: A retrospective series of 22 sarcoidosis patients (16 men) of mean (SD) age 46 (13) years with PH was divided into two groups depending on the absence (stage 0: n = 2, stage II: n = 4, stage III: n = 1) or presence (n = 15) of radiographic pulmonary fibrosis at the time of PH diagnosis. RESULTS: In both groups PH was moderate to severe and there was no response to acute vasodilator challenge. In non-fibrotic cases no other cause of PH was found, suggesting a specific sarcoidosis vasculopathy, although no histological specimens were available. In cases with fibrosis there was no correlation between haemodynamics and lung volumes or arterial oxygen tensions, suggesting other mechanisms for PH in addition to pulmonary destruction and hypoxaemia. These included extrinsic arterial compression by lymphadenopathies in three cases and histologically proven pulmonary veno-occlusive disease in the five patients who underwent lung transplantation. Ten patients received high doses of oral prednisone for PH (stage 0: n = 1, stage II: n = 4 and stage IV: n = 5); three patients without pulmonary fibrosis experienced a sustained haemodynamic response. Survival of the overall population was poor (59% at 5 years). Mortality was associated with NYHA functional class IV but not with haemodynamic parameters or with lung function. CONCLUSION: Two very different phenotypes of sarcoidosis combined with PH are observed depending on the presence or absence of pulmonary fibrosis. PH is a severe complication of sarcoidosis. 相似文献
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Hidenori Kawasaki Kiyoshi Ishikawa Masayuki Kuniyoshi Morio Ohta Tsutomu Kawabata Tsuneo Hirayasu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(1):21-25
A 73-year-old female was referred to our hospital in June 2000 for the evaluation of an abnormal shadow in the left upper
lobe of her lung and two other shadows in the left lower lobe. A computed tomography examination revealed an ill-defined tumor
with ground glass opacity in the left upper division segment, suggesting a primary lung adenocarcinoma, and two well-defined
nodules in the left lower lobe, suggesting metastatic carcinomas. A transbronchial lung biopsy of the tumor in the upper division
segment confirmed the presence of an adenocarcinoma but failed to provide a histological diagnosis for the nodules in the
lower lobe. A partial resection of the left lower lobe using video-assisted thoracoscopy revealed granulomatous tissue with
no signs of malignancy. A curative resection of the adenocarcinoma in the left upper division segment was therefore performed.
Histologically, the resected specimens obtained from the left lower lobe were diagnosed as cryptococcomas. The patient was
diagnosed as having a stage IA lung adenocarcinoma and two cryptococcomas. The patient is presently well and has not experienced
any recurrences or relapse for 3 years since the resection. 相似文献
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Jeffrey M. Silverman Peter J. Julien Louis Adler Michael C. Fishbein 《Lasers in surgery and medicine》1993,13(5):553-558
We evaluated the ability and safety of a laser fiber placed percutaneously into a pig's lobar pulmonary artery to lyse pulmonary artery blood clots that were created in situ. We developed a model to create blood clots in situ that could be placed in any desired location with a radio-opaque marker at the clot position. An excimer laser delivered energy to a flexible 600 μm fiber in three experiments and a coaxial 1.6 mm multifiber catheter in the last experiment Pre- and postprocedure angiograms obtained from each experiment demonstrated that partial laser dissolution of central pulmonary emboli in four pigs was accomplished successfully. To avoid perforation, it is imperative that the laser fiber remain coaxial during the entire lasing process. These results suggest that laser dissolution may become an adjunctive procedure for the treatment of central pulmonary emboli in those patients who cannot be treated medically. © 1993 Wiley-Liss, Inc. 相似文献
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Claus Neurohr Patrick Huppmann Dolores Thum Werner Leuschner Werner Von Wulffen Tobias Meis Hanno Leuchte Rainer Baumgartner Gregor Zimmermann Rudolf Hatz Stephan Czerner Lorenz Frey Peter Ueberfuhr Iris Bittmann Juergen Behr for the Munich Lung Transplant Group 《Transplant international》2010,23(9):887-896
Idiopathic pulmonary fibrosis (IPF) is a frequent indication for lung transplantation (LTX) with pulmonary hypertension (PH) negatively affecting outcome. The optimal procedure type remains a debated topic. The aim of this study was to evaluate the impact of pretransplant PH in IPF patients. Single LTX (SLTX, n = 46) was the standard procedure type. Double LTX (DLTX, n = 30) was only performed in cases of relevant PH or additional suppurative lung disease. There was no significant difference for pretransplant clinical parameters. Preoperative mean pulmonary arterial pressure was significantly higher in DLTX recipients (22.7 ± 0.8 mmHg vs. 35.9 ± 1.8 mmHg, P < 0.001). After transplantation, 6‐min‐walk distance and BEST‐FEV1 were significantly higher for DLTX patients (6‐MWD: 410 ± 25 m vs. 498 ± 23 m, P = 0.02; BEST‐FEV1: 71.2 ± 3.0 (% pred) vs. 86.2 ± 4.2 (% pred), P = 0.004). Double LTX recipients demonstrated a significantly better 1‐year‐, overall‐ and Bronchiolitis obliterans Syndrome (BOS)‐free survival (P < 0.05). Cox regression analysis confirmed SLTX to be a significant predictor for death and BOS. Single LTX offers acceptable survival rates for IPF patients. Double LTX provides a significant benefit in selected recipients. Our data warrant further trials of SLTX versus DLTX stratifying for potential confounders including PH. 相似文献