Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1994
Case Reports[A case of acute idiopathic mediastinitis that responded rapidly to treatment].
A 50-year-old man had a feeling of a foreign substance such as fish bone in his throat at breakfast. The feeling gradually changed to retrosternal pain and pain on swallowing, so he went to hospital, but the results of all examinations were normal. The next day he was referred to our emergency center because of the increasing pain and disturbance in swallowing. ⋯ Some antibiotics were given, based on the diagnosis of acute mediastinitis. The pain gradually subsided, and the tumorous shadow was obscured, without mediastinal drainage. Prompt therapy resulted in rapid improvement, and the patient was discharged on hospital day 23.
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Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jun 1990
[The role of thoracoscopy in pleural biopsy in cases with pleural effusion].
Between April 1985 and July 1989, 125 cases with pleural effusion were admitted to our department. The causes of pleural effusion were carcinomatous pleurisy in 47 cases, infection without tuberculosis in 34 cases, tuberculous pleurisy in 17 cases, cardiac insufficiency and hypoproteinemia in 11 cases, trauma and pneumothorax in nine cases, collagen disease in two cases and unknown origin in five cases. Carcinomatous pleurisy and tuberculous pleurisy, the differential diagnosis of which is very important, comprised 37% and 14% of all cases, respectively. ⋯ For thoracoscopic pleural biopsies, a high positive ratio of 84% was achieved (in carcinomatous pleurisy, 13 out of 15 cases; in tuberculous pleurisy, three out of four cases). This procedure was performed with minimal patient discomfort and no serious complications. Therefore, thoracoscopic pleural biopsy is recommended as a diagnostic procedure for cases with pleural effusion.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1997
Case Reports[Acute eosinophilic pneumonia induced by cigarette smoke].
An 18-year-old man was admitted to our hospital because of a dry cough and high fever of acute onset. A chest radiograph revealed diffuse bilateral infiltrates, mainly in peripheral lung zones. Laboratory data showed hypoxemia and leukocytosis, and no eosinophilia. ⋯ Therefore, a challenge test was done in which the patient smoked cigarettes. By 15 hours after the challenge, he had become severely hypoxemic and by 21 hours after the challenge his pulmonary function had decreased. In this patient, smoking cigarettes appeared to have induced acute eosinophilic pneumonia.
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Nihon Kyobu Shikkan Gakkai Zasshi · Feb 1996
Case Reports[Two cases of primary Sjögren's syndrome with pulmonary involvement histopathological study of open-lung biopsy specimens].
We report two cases of primary Sjögren's syndrome with pulmonary involvement, in which open lung biopsies were done. The patient in the first case was a 58-year-old woman and the patient in the second case was a 54-year-old woman. Both patients were admitted to our hospital because of dry coughing and exertional dyspnea. ⋯ Therefore, the histopathological diagnosis was cellular interstitial pneumonia with lymphoid follicles. Both patients were treated with oral corticosteroids. Symptoms were relieved and laboratory findings improved.