Pulmonary embolization-induced thymus hyperplasia in rabbits

The effects of pulmonary embolization on the thymus glands of rabbits were studied morphologically, morphometrically and immunohistochemically. Pulmonary embolization was induced by an intravenous injection of 0.4 ml of Sephadex bead suspension (particle size; 150 to 300 microns, about 2,000 per ml). Both mean weight and volume of the thymus of rabbits killed at 2 weeks after embolization, were about 1.5 times more than those in control animals treated with physiologic saline. Histological examinations showed enlargement of the cortex and medulla of the thymus, and the embolized Sephadex beads in the branches of pulmonary arteries of the lung. The area ratios of medulla/cortex, in the embolization group and in control, were not significantly different. The cells with immunohistochemically positive staining of anti-nuclear antigen of monoclonal antibody of Ki-67, were found in both portions of the medulla and cortex. These data suggest that pulmonary embolization in the rabbit induces true thymic hyperplasia. An intravenous injection of India ink into the right highest intercostal artery revealed the distribution of bronchial arteries, which send the branches to the right lobe of the thymus. In 2 out of 4 animals killed 2 weeks after pulmonary embolization, the left lobe of the thymus as well as the right were stained with the injected ink. As it is known that pulmonary vascular obstruction caused a marked increase in the bronchial blood flow, these data suggest that the thymus blood supply from the bronchial arteries increases in the conditions of pulmonary embolization, which might contribute to thymus hyperplasia.     

支气管肺动脉成形术在中心型支气管肺癌治疗中的应用

[目的]探讨支气管肺动脉成形术治疗中心型支气管肺癌的效果。[方法]回顾性分析2001年6月～2009年6月施行支气管肺动脉联合成形肺叶切除治疗的36例中心型支气管肺癌患者的临床资料,其中鳞癌26例,腺癌8例,小细胞未分化癌2例。pTNM分期:Ⅱa期8例,Ⅱb期12例,Ⅲa期16例,行左上支气管肺动脉成形术14例,右上肺动脉支气管成形术22例。[结果]全组无手术死亡病例,术后4例出现肺不张,4例并发肺感染,2例并发心律失常,均经对症、抗感染等处理后治愈,无支气管胸膜瘘、出血等严重并发症发生。术后随访时间5～65个月,平均32个月,全组术后1、3、5年生存率分别为88.9%(32/36)、55.6%(20/36)、44.4%(16/36)。[结论]肺动脉支气管成形术肺叶切除符合最大限度地切除肿瘤又最大限度保留肺功能的基本原则,特别是用于心肺功能储备差、不能耐受全肺切除的局部晚期患者,扩大了手术适应证。     

Bronchial atresia of additive anomalous bronchus

A case of bronchial atresia of additive anomalous bronchus in right middle lobe was reported. A mass and emphysematous lung were found on the chest roentgenogram. CT, and MRI, and it is not difficult to diagnose.     

纤维支气管镜肺泡灌洗治疗右肺中叶不张91例疗效观察

[目的]探讨经纤维支气管镜肺泡灌洗术的效果和安全性。[方法]对91例右肺中叶不张患者采用支气管肺泡灌洗术,并将其支气管内分泌物作病原学和病理学检查,同时支气管内局部使用抗生素和激素治疗,观察其疗效。[结果]91例右肺中叶不张患者,84例肺不张复张,明确了病因,临床疗效好;7例病程超过3个月,不张肺未复张。均未发生并发症及不良反应。[结论]纤维支气管镜肺泡灌洗术具有有效、安全、简便等优点,可适用于支气管内疾病的诊断和治疗。     

支气管肺血管成形重建治疗中叶肺癌

目的：探讨中叶肺癌最大限度保留健肺的手术方法。方法：1994年6月至1999年8月，对16例中叶肺癌分别采取了中叶切除加气管楔形切除12例，其中6例伴肺动脉部分切除，2例肺动脉袖式切除；另3例行中叶切除加支气管袖式切除，其中1例伴肺动脉部分切除；另1例行中下叶切除、肺上静脉与肺下静脉重建。结果：16例手术全部获得成功。1年生存率88％，3年生存率50％。结论：中叶肺癌采用支气管肺血管成形重建术，既最大限度切除病变，又充分保留健肺，扩大了手术适应症。     

Isolated bilateral pulmonary occlusion

BACKGROUND: Takayasu's arteritis (TA) is an unusual cause of bilateral and isolated pulmonary artery occlusion that may be difficult to distinguish from other aetiologies. AIM: Report a new case of isolated bilateral pulmonary occlusion. OBSERVATION: A 19 year-old girl presented to the hospital with a 2-year history of dyspnoea and recurrent hemoptysis. She was in respiratory distress on physical examination Clinical investigations revealed a total occlusion of the right pulmonary artery on perfusion lung scan. Pulmonary angiogrphy confirmed these data and revealed further more a partially occluded left lower lobe artery. Diagnosis of Takayasu's arteritis was suspected and a complete aortogram was made but proved to be normal. Corticosteroid therapy was prescribed but interrupted within 2 months for absence of clinical improvement. Patient's assessment revealed worsening of the clinical condition and she became oxygen-dependant. CONCLUSION: early diagnosis of isolated involvement of pulmonary arteries in TA while systemic arteries are normal may prove to be difficult. In spite of insufficient data to confirm TA, the latter seems to be the most probable diagnosis in our patient regarding clinical (young age) and angiographic arguments.     

Angiographic anatomy of arterial branches to the caudate lobe of the liver with special reference to its effect on transarterial embolization of hepatocellular carcinoma

The arterial branches to the caudate lobe of the liver have been little studied angiographically, so it has been thought that the branches can be rarely recognized on the hepatic angiogram. We evaluated it with the stereo or stereo-magnification angiograms in 106 cases. They were identified in 90 cases (84.9%), one branch in 75 cases, two branches in 15 cases. The branches had a variable origin. In 50%, it originated from the right hepatic artery. In some cases, it came from both the right and left hepatic arteries. Recently we treated 10 cases of hepatocellular carcinoma in the caudate lobe with transcatheter arterial embolization (TAE), the results were poor in them except for one. We think that the proximal and variable origins of the caudate lobe arteries are the main cause of the poor effect of TAE.     

Incidence and clinical significance of the esophageal branches originating from the bronchial artery

The authors investigated the incidence and extent of angiographic visualization of the esophageal branches originating from the bronchial arteries. Approximately 20% of 371 patients showed considerable blood flow to the esophagus. The left bronchial artery more often gives rise to the esophageal branches. Esophageal complications have been experienced in 8 cases following bronchial artery infusion of Mitomycin C for pulmonary carcinoma. Complications tend to occur in cases showing marked opacification of the esophageal veins or in those which a lesion locates in the peripheral portion of the lung. It is imperative to pay attention to esophageal branches of the bronchial artery in interventional angiography.     

Case report of intralobar pulmonary sequestration detected by lung cancer screening with low-dose spiral CT

A 52-year-old man underwent lung cancer screening with low-dose spiral computed tomography (CT) in a medical check-up at the Japanese Red Cross Kumamoto Health Care Center. He was asymptomatic. Chest x-ray on a medical check-up showed no abnormal shadows. CT scans revealed a nodule in the right lower lung, suggestive of its connection to the descending thoracic aorta. A diagnosis of pulmonary sequestration was considered. He was transferred to Kumamoto University Hospital for further examination. Contrast enhanced multidetector CT images demonstrated that a nodule in the right lower lobe and an anomalous artery ran from the descending thoracic aorta, flowed through the right lower lobe and returned to the right inferior pulmonary vein. Intralobar pulmonary sequestration was confirmed by contrast enhanced multidetector CT. We report this case of asymptomatic intralobar pulmonary sequestration diagnosed using contrast enhanced multidetector CT.     

微导管在介入治疗大咯血中的应用

目的：观察超选择性支气管动脉栓塞术治疗肺结核、肺癌及支气管扩张咯血的疗效。方法：对335例经内科止血治疗无效的咯血患者行超选择性支气管动脉栓塞。结果：335例患者治疗后即时止血率为100%,治愈率和总有效率分别为78.5%和96.7%,且未发生严重并发症。结论：应用超选择性支气管动脉栓塞术可快速有效治疗肺结核、肺癌及支气管扩张咯血,且具有较好的远期疗效。     

Association of lung cancer and airway particle concentration

Using 15 autopsy lungs containing nonresected lung cancers, we evaluated the exogenous mineral particle content of the upper and lower lobe parenchyma and of the upper and lower lobe bronchial mucosa. The bronchial mucosa from the lobe with the cancer was found to contain about three times the median mineral particle load of the bronchial mucosa from the lobe without the cancer, a statistically significant difference. No such difference was seen for mineral content of the parenchyma. This observation suggests that mineral particle deposition or accumulation in the bronchial mucosa may be related to respiratory carcinogenesis.     

Migrating pulmonary infiltrates due to a foreign body

A 67-year-old man was admitted with a postobstructive pneumonia of the right upper lobe of the lung. Initially neoplasm was considered, but eventually the obstruction proved to be a foreign body, more specifically, a tooth. Two years before, after an episode of pneumonia caused by anaerobic bacteria, he had been advised to have his remaining teeth extracted because of poor dentition. Hereafter the patient experienced several episodes of pneumonia in different lobes, both right and left sided which were due to the migrating foreign body in the bronchial tract. He recovered after bronchoscopic removal.     

Pulmonary, gastrointestinal and liver vascular malformations in Rendu-Osler disease

Hereditary hemorrhagic telangiectasia (HHT) is an angiodysplastic disorder transmitted in autosomal dominant fashion. This case report describes a 46-year-old woman with multiple arteriovenous malformations that eventually caused multiorgan failure. The diagnosis was made in the early childhood based on frequently recurring episodes of severe epistaxis. Telangiectases were found in the skin, the visible mucosal linings, gastrointestinal and bronchial mucosa and liver. Episodes of severe hemoptysis necessitated partial resection of the right lung middle lobe at the age of 22. Liver dysfunction associated with the primary disease was diagnosed by the characteristic clinical picture, laboratory findings and instrumental examinations including abdominal ultrasonography, upper endoscopy, liver CT venography.     

支气管动脉灌注联合125I粒子植入治疗中晚期肺癌的临床分析

目的：分析中晚期肺癌患者采用支气管动脉灌注联合125I粒子植入治疗的临床疗效。方法：回顾本院收治的120例中晚期肺癌患者的临床资料,将其分为实验组（支气管动脉灌注、125I粒子植入联合）和对照组（支气管动脉灌注）两组,比较两组临床疗效。结果：实验组术后肿瘤大小、有效率优于对照组（P〈0.05）。结论：对于中晚期肺癌患者来说,实施支气管动脉灌注联合125I粒子植入治疗效果显著,成为首先治疗方案。     

Two cases of Swyer-James syndrome

Two cases of Swyer-James syndrome are reported. Case 1; A 25-year-old man was admitted to our hospital to be treated for Mycobacterium avium infection. Chest X-ray film revealed hyperlucency in the right lower lung. High-resolution CT showed a low attenuation area and bronchiectasis in the right lower lobe. He had had two episodes of pneumonia in his childhood. 3D CT scan showed a narrowing of right lower pulmonary arteries. Case 2; A 65-year-old woman was admitted to our hospital with dyspnea on effort. Chest X-ray film revealed hyperlucency in the right lung. Chest CT scan on inspiration and expiration detected air-trapping, which is characteristic of this syndrome. In both cases, the volume of the hyper lucent lung was normal. From these clinical findings, we diagnosed these two cases as Swyer-James syndrome and in this paper described the clinical features and treatment.     

全胸腔镜非体外循环下冠状动脉旁路移植术的动物实验研究

目的研究全胸腔镜非体外循环下冠状动脉旁路移植术的可行性。方法家猪8头,体重35⁴5kg,在双侧胸壁打孔,取双侧乳内动脉。将左侧乳内动脉旁路移植至前降支,右侧乳内动脉旁路移植至右冠状动脉。结果 8头实验猪全部成活,总共成功游离左侧乳内动脉8条,右侧乳内动脉8条。共行吻合口16个。左侧乳内动脉与前降支的吻合时间为2545kg,在双侧胸壁打孔,取双侧乳内动脉。将左侧乳内动脉旁路移植至前降支,右侧乳内动脉旁路移植至右冠状动脉。结果 8头实验猪全部成活,总共成功游离左侧乳内动脉8条,右侧乳内动脉8条。共行吻合口16个。左侧乳内动脉与前降支的吻合时间为25⁴2 min,平均(37±15)min。右侧乳内动脉与右冠状动脉的吻合时间为3642 min,平均(37±15)min。右侧乳内动脉与右冠状动脉的吻合时间为36⁵2 min,平均(44±9)min。术后除1例右侧乳内动脉与右冠状动脉吻合口狭窄外,其余吻合口通畅情况均良好。结论全胸腔镜非体外循环下行左右冠状动脉旁路移植术是可行的,家猪是良好的合适的动物训练模型。     

多层螺旋CT对小儿支气管异物方面的临床诊断价值分析

目的：探讨经多层螺旋CT诊断小儿支气管异物的临床价值。方法2013年7月30日-2014年7月30日,我院接收52例支气管异物患儿,经PHILIPS Brilliance 64排螺旋CT对52例患儿进行诊断。结果异物类型：坚果类异物,玉米,果蔬类异物,豆类异物,骨块等;异物所处位置：气管分叉,左侧支气管,右侧支气管,左主支气管,右侧中叶支气管,右中间支气管,右侧下叶段支气管,左肺下叶段支气管,左肺下叶支气管;间接征象：4例肺气肿,1例胸腔积液,1例气胸,1例纵隔气肿,1例肺不张,2例皮下气肿,6例肺炎;直接征象：支气管腔内存在高密度阴影,管腔阻塞或者狭窄,支气管异物多以柱状的形态存在,此外,也存在不规则状、半圆形、环形、三角形、管状。结论经PHILIPS Brilliance 64排螺旋CT对支气管异物患儿进行诊断,病症确诊率高,无创,具有很高的临床诊断价值。     

基于CTA图像的髂总动脉分叉角大小与分叉附近斑块形成的相关性研究

目的:基于CT血管造影(CT angiography,CTA)图像探讨髂总动脉分叉角大小与其附近斑块形成是否具有一定的相关性。方法:选择影像科行下肢动脉CTA检查或腹部CT增强扫描的159例患者作为研究对象,155例患者被纳入研究范围。在原始轴位CT图像基础上进行冠状位多平面重建,测量髂总动脉分叉角并诊断分叉附近有无斑块形成,记录有斑块及无斑块患者的右侧髂总动脉、左侧髂总动脉及双侧髂总动脉的分叉角度。采用SPSS 19.0进行统计学分析。结果:右侧髂总动脉无斑块者平均夹角[(13.78±6.08)°]小于有斑块者[(24.01±7.47)°],角度大小与斑块形成之间有相关性(P<0.05);左侧髂总动脉无斑块者平均夹角[(12.85±6.45)°]小于有斑块者[(27.65±10.81)°],角度大小与斑块形成之间有相关性(P<0.05);双侧髂总动脉均无斑块者平均夹角[(26.58±9.28)°]小于均有斑块者[(48.37±15.72)°],角度大小与斑块形成之间具有相关性(P<0.05)。无论有无斑块,受检者的左侧髂总动脉平均夹角与右侧无统计学差异(P>0.05)。结论:髂总动脉分叉角大小与分叉附近斑块形成具有一定相关性,角度越大斑块越易形成,而左侧与右侧髂总动脉分叉角大小无统计学差异。     

Proliferation of lung cells in chronically hypoxic rats

Summary Alveolar hypoxia produces pulmonary hypertension and morphological alterations in the pulmonary vessels, such as media hypertrophy and hyperplasy of pulmonary arteries as well as development of smooth muscle cells in the wall of small precapillary arteries. Chronic hypoxia induces an increase in the DNA-synthesis rate of lung tissue and this study confirms this previously reported result using in vivo incorporation of ³H-thymidine. Autoradiographic investigations demonstrate an increase in the ³H-thymidine labelling index of cells in the bronchial epithelial lining, of lung parenchyma cells, and of smooth muscle cells in the media of pulmonary arteries after 9 days of exposure to a simulated altitude of 4250 m (Pb = 440 Torr).In contrast, in control tissue from rat liver and kidney chronic hypoxia inhibits the proliferation of sinusoid endothelial cells and Kupffer cells and also the proliferation of renal tubulus epithelial cells. Our results indicate that (1) chronic hypoxia stimulates proliferation of various cell types in the rat lung; (2) cells of the bronchial epithelial lining respond to chronic hypoxia with very high proliferation rates; and (3) the formation of new media smooth muscle cells may contribute to the adaptation process of the pulmonary arteries of chronically hypoxic rats.These results can contribute to the understanding of pulmonary hypertension, an often severe concomitant reaction of chronic lung diseases.     

320排螺旋CT冠状动脉造影对冠心病的筛选诊断

目的：探讨320排螺旋CT冠状动脉成像与冠状动脉血管造影对冠心病的诊断价值。方法：对100例冠心病患者进行CT冠状动脉造影检查后,其中25例患者亦进行了介入冠状动脉造影检查,比较2组检查结果间的差异。结果：以冠状动脉造影结果为金标准,320排螺旋CT冠状动脉成像诊断冠状动脉狭窄敏感度高,与冠状动脉造影检查的结果基本一致。CT冠状动脉造影能清晰地显示冠状动脉的左右主支及分支的全貌图像,能直观地观察到冠状动脉血管壁有无狭窄、钙化等情况。结论：320排螺旋CT冠状动脉造影对血管的狭窄、钙化病变及支架管腔显示准确率较高,且操作相对简单,时间短、无创、费用低,可作为常规冠心病的筛查体检和冠状动脉支架术后复查的检查方法。