Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jan 2011
Randomized Controlled TrialThe effect of sivelestat sodium hydrate on severe respiratory failure after thoracic aortic surgery with deep hypothermia.
Patients who undergo thoracic aortic surgery with deep hypothermia frequently have postoperative respiratory failure as a complication. Severe lung injury in these patients results in a fatal outcome. A specific neutrophil elastase inhibitor, sivelestat sodium hydrate, is an innovative therapeutic drug for acute lung injury. ⋯ The duration of mechanical ventilation, the length of stay in the intensive care unit, and the length of hospital stay were shorter in Group S, but not significantly. Sivelestat sodium hydrate is a specific neutrophil elastase inhibitor that improves pulmonary function in patients with severe postoperative respiratory failure following thoracic aortic surgery with deep hypothermia. The drug may shorten the duration of postoperative ventilation, intensive care unit stay, and hospital stay.
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A paraganglioma is a rare tumor that develops out of extra-adrenal chromaffin cells and pheochromocytomas originating from the adrenal medulla. Early diagnosis and surgical planning are crucial, since the tumor secretes catecholamine and is adjacent to large vessels in the abdomen. ⋯ Here, we present a case of paraganglioma in a 32-year-old male patient who initially presented with a stomachache. After conducting the required tests, we resected the tumor that was pressing against the vena cava in the interaortocaval region.
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Ann Thorac Cardiovasc Surg · Jan 2011
Release of serum S-100β protein and neuron-specific enolase after off-pump coronary artery bypass grafting with and without intracranial and cervical artery stenosis.
The aim of this study was to quantify the amount of brain damage suffered by patients who underwent off-pump coronary artery bypass grafting (OPCAB) in which S-100β protein and neuron-specific enolase were used. ⋯ Our findings show a correlation between the stenosis detected by MRA or cervical ultrasonography and brain damage after OPCAB.
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Ann Thorac Cardiovasc Surg · Jan 2011
Case ReportsTwo lung adenocarcinomas in the same lobe: multiple primaries or intrapulmonary metastasis?
Abnormal nodules were found in the left lung of a 52-year-old woman in segments 6 and 10 on a chest CT. These nodules showed no changes for 18 months, and we discontinued follow-up. Almost 5 years later, an abnormal shadow was found in her left lower lung field on a medical check-up chest X-ray. ⋯ Epidermal growth factor receptor gene mutations were examined, and the 2 lesions shared an L858R mutation. Although we expected EGFR gene mutation analysis would help us distinguish the 2 lesions from each other, it was of little help. Disease history can be more important in evaluating multiple pulmonary cancers.
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Ann Thorac Cardiovasc Surg · Jan 2011
Case ReportsPleomorphic adenoma of the subglottis mistreated as chronic obstructive pulmonary disease, report of a case.
Upper airway obstruction due to subglottic mass can be misdiagnosed. We report the case of a 66-year-old man who was treated for chronic obstructive pulmonary disease (COPD) before a diagnosis of pleomorphic adenoma of the subglottis was made. According to the history of chronic cough and exertional dyspnea, he was treated with inhaled corticosteroids for COPD. ⋯ After the excision operation, all symptoms disappeared. Histological evaluation revealed the diagnosis of pleomorphic adenoma. This case report emphasizes that not all chronic cough and dyspnea are attributable to COPD.