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1.
Video-assisted thoracoscopic surgery （VATS） for bilateral primary spontaneous pneumothorax 总被引：3，自引：0，他引：3
Chen YJ Luh SP Hsu KY Chen CR Tsao TC Chen JY 《Journal of Zhejiang University. Science. B》2008,9(4):335-340
Objective:To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Materials and methods: Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results: Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6±18.3) min (range 25-96 min) and (120.6±28.7) min (range 84-166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions: VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side. 相似文献
2.
Hwa-chan Lee Fen-fen Chen Ching-chu Lo Chung-jing Wang Wei-chun Lo Shi-ping Luh 《Journal of Zhejiang University. Science. B》2010,11(7):542-546
Cancer metastasis to the thyroid is extremely rare. The more commonly reported primary sites for metastasis to the thyroid
are the kidney, breast, lung, colon, esophagus, and uterus. Thyroid metastasis from the stomach has only been reported in
three cases. Herein, we report a 71-year-old man presenting with bilateral thyroid multinodular lesions. Bilateral near-total
thyroidectomy was performed due to airway compression with related symptoms. Wedge resection of a suspicious pulmonary nodule,
detected on CT, was performed for diagnosis. Polypoid lesions in the stomach were examined by trans-scopic biopsy. Poorly
differentiated adenocarcinomas with the same histological profiles were noted at these three sites. The immunohistochemical
staining for thyroglobulin of these specimens was negative. We conclude that a new thyroid mass appearing in a patient with
present or prior malignancies should raise the concern of metastatic disease. 相似文献
3.
This article discusses the sample size requirements for the interaction, row, and column effects, respectively, by forming a linear contrast for a 2×2 factorial design for fixed-effects heterogeneous analysis of variance. The proposed method uses the Welch t test and its corresponding degrees of freedom to calculate the final sample size in a 2-step procedure. The simulation results show that the proposed sample size allocation ratio can minimize the sampling cost, while at the same time the designated power is achieved. The article concludes with a discussion to reiterate the importance of sample size planning, especially for testing the iteration effect. 相似文献
4.
The authors used Johnson's transformation with approximate test statistics to test the homogeneity of simple linear regression slopes when both xij and xij may have nonnormal distributions and there is Type I heteroscedasticity, Type II heteroscedasticity, or complete heteroscedasticity. The test statistic t was first transformed by Johnson's method for each group to correct the nonnormality and to correct the heteroscedasticity; also an approximate test, such as the Welch test or the DeShon-Alexander test, was applied to test the homogeneity of the regression slopes. Computer simulations showed that the proposed technique can control Type I error rate under various circumstances. Finally, the authors provide an example to demonstrate the calculation. 相似文献
5.
Breast metastases from extramammary neoplasms are very rare. We presented a 66 year-old female with metastasis of small cell lung carcinoma to the breast. She presented with consolidation over the left upper lobe of her lung undetermined after endobronchial or video-assisted thoracoscopic surgery (VATS) biopsy, and this was treated effectively after antibiotic therapy at initial stage. The left breast lumps were noted 4 months later, and she underwent a modified radical mastectomy under the impression of primary breast carcinoma. However, the subsequent chest imaging revealed re-growing mass over the left mediastinum and hilum, and cells with the same morphological and staining features were found from specimens of transbronchial brushing and biopsy. An accurate diagnosis to distinguish a primary breast carcinoma from metastatic one is very important because the therapeutic planning and the outcome between them are different. 相似文献
6.
Background: Hepatic hydrothorax is defined as a significant pleural effusion in patients with liver cirrhosis and without underlying cardiopulmonary diseases. Treatment of hepatic hydrothorax remains a challenge at present. Methods: Herein we share our experiences in the treatment of 12 patients with hepatic hydrothorax by video-assisted thoracoscopic surgery (VATS).Repair of the diaphragmatic defects, or pleurodesis by focal pleureetomy, talc spray, mechanical abrasion, electro-cauterization or injection was administered intraoperatively, and tetracycline intrapleural injection was used postoperatively for patients with prolonged (＞7 d) high-output (＞300 ml/d) pleural effusion. Results: Out of the 12 patients, 8 (67%) had uneventful postoperative course and did not require tube for drainage more than 3 months after discharge. In 4 (33%) patients the pleural effusion still recurred after discharge due to end-stage cirrhosis with massive ascites. Conclusion: We conclude that the repair of the diaphragrnatic defect and pleurodesis through VATS could be an alternative of transjugular intrahepatic portal systemic shunt (TIPS) or a bridge to liver transplantation for patients with refractory hepatic hydrothorax. Pleurodesis with electrocauterization can be an alternative therapy if talc is unavailable. 相似文献
7.
Primary leiomyosarcoma of the nipple-areola complex is extremely rare. Less than ten such cases have been reported in English literature so far. Herein we describe a 52-year-old female presenting with a 1.5 cm× 1.1 cm×0.7 cm nodular lesion over her left nipple, and leiomyosarcoma was proved by pathological examination of the excised specimen. Positron emitted tomogram (PET) revealed no abnormal signal other than the primary site. Microscopically, this poorly circumscribed tumor was composed of interlacing bundles of smooth muscle cells with bizarre and pleomorphic nuclei, as well as prominent nucleoli. Its mitotic count was up to 7 mitoses per 10 high power fields (HPF). Immunohistochemical study of tumor cells revealed positive stain for α-smooth muscle actin and vimentin; and negative for cytokeratin, CD34 and S-100. Left simple mastectomy was undertaken and no residual mass lesion was noted on the resected specimen. Related literatures about the diagnosis and treatment for breast leiomyosarcoma will be presented here. 相似文献
8.
Shi-ping Luh 《Journal of Zhejiang University. Science. B》2010,11(10):735-744
Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been
gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder.
Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography
(CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies.
The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due
to its minimal invasiveness and high effectiveness for patients with these diseases. 相似文献
9.
Video-assisted thoracic surgery——the past, present status and the future 总被引：13，自引：3，他引：10
Video-assisted thoracic surgery （VATS） has developed very rapidly in these two decades, and has replaced conventional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option or a complementary procedure for some other more complex operations. In this paper we will review its development history, the present status and the future perspectives. 相似文献
10.
Preconditioning （PC） has emerged as a powerful method for experimentally and clinically attenuating various types of organ injuries. In this paper related clinical and basic research issues on organ preconditioning issues were systemically reviewed. Since lung injuries, including ischemia-reperfusion and others, play important roles in many clinical results, including thromboembolism, trauma, thermal injury, hypovolemic and endotoxin shock, reimplantation response after organ transplantation, and many respiratory diseases in critical care. It is of interest to uncover methods, including the PCs, to protect the lung from the above injuries. However, related studies on pulmonary PC are relatively rare and still being developed, so we will review previous literature on experimental and clinical studies on pulmonary PC in the following paragraphs. 相似文献