Surgery for pulmonary aspergillosis

Surgery for pulmonary aspergillosis was evaluated in 20 patients who underwent surgery. These included pulmonary aspergillosis in 17, bronchial aspergillosis in 2 and pleural aspergillosis in 1, respectively. The operative procedures were mainly lobectomy and segmentectomy except for one in whom fenestration was carried out. With advances in development of drugs such as fluconazole and miconazole, surgical outcome was improved without any operative death related to surgery as far as healthy polmonary tissues are preserved. Nevertheless, it is emphasized that severity of preexisting disorder should be precisely assessed prior to surgery

CEA in Esophageal Cancer Tissues

The presence of carcinoembryonic antigen (CEA) was assessed in cancer tissues of 53 patients with esophageal carcinoma. Positive rates of CEA staining in tissues were 81.1%. Well differentiated carcinomas tended to be well stained. The survival time in positive tissue CEA patients was longer than that in negative one. The measurement of a presence of tissue CEA is of help to judge the prognosis

Testicular Torsion in Undescended Testis : A Case Report and View of Sixty-two Cases in Japan

A 7-year-old boy with cerebral palsy was presented with a progressively enlarging tender, left inguinal mass. Examination revealed absence of the left testis in the scrotal sac. The left testis was palpable in the left superficial inguinal pouch. The right testis was normaly palpable in the right scrotum. A diagnosis of a torsion in the undescended left testis was confirmed by exploratory surgery. Orchidectomy of the left testis was performed and the remainder of the patient\u27s course was uneventful. We presented this case to describe the clinical features of testicular torsion in the undescended testis with a review of 62 cases in Japan. Specific emphasis was placed on the incidence, relationship of cerebral palsy to torsion, diagnosis, and treatment of testicular torsion in cryptorchidism

Availability of Low Potassium UW Solution for a 24 Lung

A comparative study of preservation solution was made in a 24 hour storaged donor lung between original UW (University of Wisconsin) solution (k = 120mEq/l) and Low potassium UW (k = 30mEq/l) solution. Preservation of a donor lung with low potassium UW solution was superior to that with original UW solution in terms of static compliance and pulmonary vascular resistance. In conclusion, the use of low potassium UW solution is of great value to storage a donor lung

Surgery for Traumatic Injury of the Trachea and Bronchus

Surgery for traumatic disruption of the trachea and the bronchus was evaluated with respect to the surgical outcome in three with tracheal injury and four with bronchial injury. In this series, the results were satisfied except for one who underwent delayed operation. Experience seems to indicate that the primary care to ensure security of air way is of great value in life-saving and guarantee of the outcome including pulmonary function following surgery. In conclusion, it is emphasized that the fortuitous result and preservation of pulmonary function are mandatory for pertinent treatment with expediously precise diagnosis

Surgery for Non-Small Cell Lung Cancer in the Elderly over 80 Years of Age

The surgical outcome was evaluated in 14 patients over 80 years of age with non-small cell lung cancer. The satisfactory results are predicted as far as surgical indication is limited to favorable candidates. Further postoperative cares for age-related diseases are required in a follow-up study. It is documented in 1989 that the mean survival age of 70 years old is 15.8 years in life and that of 80 years old is 8.67 years in Japan.1) However, the mean survival age is now tremendously increasing. The major items of concern include therapeutic choice for elderly patients with malignant disease. The surgical indication for lung cancer patients of the aged is shifting from 70 years of age to 80. In this study, the validity of surgery for patients over 80 years of age is assessed on the basis of a result of clinical experience

Surgery for Early Esophageal Carcinoma

Early esophageal carcinomas are clinicopathologically evaluated in 11 patients whose carcinomas are limited to the epithelium (ep) and the mucosa (mm). Most of ep and mm carcinomas were detected by mass-screening without any symptom. Even when mass examination for gastric lesion is attempted, precise examination of the esophagus should be made at the same time. It is assured that a ep and mm esophageal carcinoma ensured satisfactory outcome. It is emphasized that early detection is only a way to improve the surgical outcome of the treatment for esophageal carcinomas

Esophagectomy in Combination with a Resection of Involved Lung for Esophageal Cancer

The combined resection with involved lung for esophageal carcinoma was evaluated in terms of surgical indication and outcome in the 6 patients who underwent subtotal esophagectomy with pulmonary resection. It was confirmed that the operation was technically feasible but the surgical results were unsatisfactory. It was reasoned that grave surgical insult and adjuvant therapy to prevent recurrence result in immunodepressive status of the host and tends to accompany postoperative complications related to operative death. In conclusion, prevention of immunosuppression for the host is required by meticulous cares of nutrition and elimination of surgical stress by staged operation in order to obtain satisfactory result after surgery

The Outcome of the Treatments of Chest Trauma Patients

Ninety-nine patients with chest trauma were clinically evaluated in terms of their prognoses. In accordance with advances in thoracic surgery, the survival rates were remarkably improved. However, six deaths were encountered in this series. The causes of deaths were attributable to associated injuries extend to two or three regions including the head and the abdomen so that precise detection and proper treatments should be made as quickly as possible. In conclusion, the prognoses of serious chest trauma patients are influenced by the presence and the degree of concomitant injuries as well as proper urgent managements

Clinical Aspect of Peripheral Cholangiocarcinoma: A Study of 7 Hepatectomy Cases

To clarify the features and problems presented by a peripheral cholangiocarcinoma (CCC), seven patients with hepatectomy from the First Department of Surgery, Nagasaki University School of Medicine (6 patients), and from Department of Surgery, National Ureshino Hospital (one patient) were reviewed. Men predominate with ratio of 5:2, and an average age was 65.4 years. Tumor location was left lateral segment in 4 patients, right lobe, middle lobe and posterior segment in one, respectively. Three patients were associated with hepatolithiasis. Underlying liver disease was found in 4 patients (57%); cirrhosis in 3 patients, and chronic hepatitis in one. Initial symptoms were abdominal pain, fever and palpable abdominal mass. In imaging modalities available, the detection rates of tumor were 100% in CT and 67% in US and angiography, respectively. Combination of MRI and CT clearly showed tumor characteristics. The serum CEA was slightly elevated in 5 patients (83%), but serum CA19-9 rose strikingly in 3 patients. Most tumors showed an infiltrating growth along intrahepatic bile duct, with a portal vein thrombus and/or satellite tumors frequently. In 3 patients, early recurrence with intrahepatic metastasis occured within the first 6 months. The patient of poorly differentiated adenocarcinoma containing a squamous or signet ring cell carinoma showed an extremely poor prognosis. This study suggests that early detection of small CCC and an extended resection are the most important factors for the survival of patient