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1.
Intern Med ; 60(1): 123-130, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33390469

RESUMO

Case 1: A 65-year-old man with novel coronavirus infection (COVID-19) complicated with acute respiratory failure. On admission, the patient was started on favipiravir and corticosteroid. However, due to a lack of significant improvement, he was introduced to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Although iliopsoas hematoma occurred as a complication, the patient recovered. Case 2: A 49-year-old man with COVID-19 had been started on favipiravir and corticosteroid. Due to progressive respiratory failure, the patient underwent mechanical ventilation and ECMO. The patient recovered without complications. We successfully treated these severe cases with a multimodal combination of pharmacological and non-pharmacological supportive therapy.


Assuntos
Corticosteroides/uso terapêutico , Amidas/uso terapêutico , Antivirais/uso terapêutico , Oxigenação por Membrana Extracorpórea , Metilprednisolona/uso terapêutico , Pirazinas/uso terapêutico , Respiração Artificial , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Respiratória/terapia , Insuficiência Respiratória/virologia
2.
J Infect Chemother ; 27(1): 70-75, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32950393

RESUMO

OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Eliminação de Partículas Virais , Adulto , Fatores Etários , Idoso , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
3.
J Infect Chemother ; 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-33268271

RESUMO

A 49-year-old Japanese male was managed by mechanical ventilation due to coronavirus disease 2019 (COVID-19) pneumonia. Favipiravir as an antiviral therapy, and anti-inflammatory treatment were administered. SARS-CoV-2 RNA was detected in serum by the loop-mediated isothermal amplification (LAMP) method on Day 9; favipiravir treatment was continued. On Day 13, negative serum RNA was confirmed, followed by mechanical ventilation was removed. On Day 23, LAMP negative was confirmed in nasopharynx, after that the patient discharged on Day 27. We could treat successfully for severe COVID-19 pneumonia based on the LAMP method. We consider this method will be useful in COVID-19 treatment.

4.
Kyobu Geka ; 73(8): 574-577, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879282

RESUMO

The case was a 56-year-old man. A nodular shadow of the left upper lobe was found in the chest computed tomography, and a diagnosis of adenocarcinoma was obtained by bronchoscopy. Preoperative 3-dimensional computed tomography (3D-CT) angiography indicated an extremely rare pulmonary artery bifurcation abnormality in which A4b+5 and A8+9 bifurcate from the left main pulmonary artery. Thoracoscopic left upper lobectomy and lymph node dissection were performed. Pathological diagnosis was adenocarcinoma with pStage I B. The mediastinal basal pulmonary artery is extremely rare, and to our knowledge, the bifurcation pattern of this case has not been reported elsewhere. The 3D-CT angiography was useful to detect the anatomical vascular abnormalities of the pulmonary artery before surgery, for the safe performance of the thoracoscopic surgery.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Pulmonares/cirurgia , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Toracoscopia
5.
J Infect Chemother ; 26(11): 1220-1223, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32792249

RESUMO

Coronavirus disease 2019 (COVID-19) is spreading worldwide and poses an imminent threat to public health. We encountered 2 cases of COVID-19 with progression resulting in severe respiratory failure and improvement without any specific treatment. To examine the course of infection, we performed reverse-transcription (RT) polymerase chain reaction assay with serum specimens, and serum SARS-CoV-2 RNA was detected in both cases when body temperature increased and respiratory status deteriorated. We, then examined, retrospectively and prospectively, the clinical course during hospitalization by performing serial examinations of serum SARS-CoV-2 RNA status. The findings from our cases suggest that not only is detection of viremia useful as a predictive marker of severity, but also serial serum SARS-CoV-2 RNA results can be helpful for predicting the clinical course.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , RNA Viral/sangue , Insuficiência Respiratória/diagnóstico , Viremia/diagnóstico , Adulto , Idoso , Betacoronavirus/genética , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Humanos , Masculino , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , RNA Viral/isolamento & purificação , Insuficiência Respiratória/sangue , Insuficiência Respiratória/virologia , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Índice de Gravidade de Doença , Fatores de Tempo , Viremia/complicações , Viremia/virologia
6.
Kyobu Geka ; 73(3): 206-209, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32393704

RESUMO

The case is a 50-year-old woman. Video-assisted thoracic surgery (VATS) left upper division segmentectomy was performed for adenocarcinoma through a postero-lateral incision. The pathological result was stage ⅠA. A chest computed tomography (CT) examination 40 months after the operation revealed a nodule in contact with the left 6th rib. A recurrence due to pleural dissemination was suspected in the PET/CT examination, but the possibility of reactive granulation was also considered. Two months later, chest CT reexamination showed an enlargement of the nodule, and reoperation was performed. A fibrous structure that appears to be a silk thread for closing chest at the 1st operation was found on the chest wall. The pathological examination revealed chronic suppurative pleuritis and organizing pneumonia without malignancy, leading to a diagnosis of Schloffer tumor.


Assuntos
Neoplasias Pulmonares , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X
7.
Kyobu Geka ; 73(2): 157-159, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32393727

RESUMO

A 18-year-old man was referred to our hospital complaining of chest abnormal shadow of the left upper lung field in mass screening chest X-ray. Although his left anterior chest wall swelled, he did not recognize that. Computed tomography and magnetic resonance imaging demonstrated a dumbbell shaped tumor of the left 1st intercostal space which had grown both inside and outside the thoracic cavity. As a possibility of solitary fibrous tumor or myxoma was not excluded, the patient underwent tumor resection. A solid tumor connected to the 1st intercostal nerve was easily dissected from surrounding tissue. Pathological examination revealed the tumor was consisted of spindle shaped cells without atypia, and diagnosed as neurilemmoma without malignancy. Based on anatomical pathway of intercostal nerves, we speculate that the tumor originated from anterior cutaneous nerve.


Assuntos
Neurilemoma , Parede Torácica , Adolescente , Humanos , Nervos Intercostais , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
8.
Anticancer Drugs ; 31(3): 304-309, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31725047

RESUMO

Rhabdomyosarcoma is the most common soft tissue sarcoma that typically occurs in children and adolescents and is rare in adults. Furthermore, as cardiac tumor is rare, adult cardiac rhabdomyosarcoma is a very rare entity. Here, we report the case of a 68-year-old woman with cardiac rhabdomyosarcoma who was successfully treated with eribulin. She presented with sudden loss of consciousness, which was attributed to the cardiac tumor. The tumor was resected by emergency surgery and was diagnosed as embryonal rhabdomyosarcoma. Although surgical treatment alleviated her symptoms, the residual tumor increased in size after surgery and required multimodal treatment. First-line chemotherapy with the vincristine, actinomycin D, and cyclophosphamide regimen had to be discontinued owing to adverse events, and thus eribulin was used as a second-line treatment. Eribulin was better tolerated and helped maintain a stable disease status for >18 months. This reported case of cardiac rhabdomyosarcoma is the first case to be successfully treated with eribulin over a relatively long period. Eribulin therapy may thus be a viable treatment alternative for rhabdomyosarcoma.

9.
Intern Med ; 58(21): 3139-3141, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31292394

RESUMO

Dasatinib-related chylothorax is a rare adverse event, and the mechanism underlying its occurrence is still not fully understood. We herein report the case of a 73-year-old woman with chronic myeloid leukemia (CML) who developed dasatinib-related chylothorax refractory to conventional treatments, except for steroids. To the best of our knowledge, this is the first case of dasatinib-related chylothorax which was successfully controlled by combining diuretics with the Japanese herbal medicine "Goreisan." "Goreisan" is known to inhibit aquaporin channels and regulate the water flow. Our findings showed that "Goreisan" is an effective treatment option for uncontrollable dasatinib-related chylothorax.


Assuntos
Antineoplásicos/efeitos adversos , Quilotórax/tratamento farmacológico , Dasatinibe/efeitos adversos , Medicina Kampo , Fitoterapia , Extratos Vegetais/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Quilotórax/induzido quimicamente , Quilotórax/diagnóstico por imagem , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Derrame Pleural/induzido quimicamente , Derrame Pleural/diagnóstico por imagem , Radiografia Torácica
11.
J Infect Chemother ; 24(6): 487-491, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29454632

RESUMO

Primary effusion lymphoma (PEL) is a rare subtype of large B-cell lymphoma associated with human herpesvirus-8. Most cases are co-infected with Epstein-Barr virus (EBV). The prognosis of PEL is extremely poor and no optimal treatment regimen has been established. We report a case of EBV-negative PEL in a 49-year-old human immunodeficiency virus-positive man, presenting with massive bilateral pleural effusion.


Assuntos
Linfoma de Efusão Primária/diagnóstico por imagem , Linfoma de Efusão Primária/tratamento farmacológico , Linfoma de Efusão Primária/virologia , Viroses/diagnóstico por imagem , Viroses/tratamento farmacológico , Viroses/virologia , Antirretrovirais/uso terapêutico , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Coinfecção , DNA Viral/sangue , DNA Viral/imunologia , Tratamento Farmacológico , Quimioterapia Combinada , HIV/genética , HIV/imunologia , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 8/genética , Herpesvirus Humano 8/imunologia , Humanos , Linfoma de Efusão Primária/patologia , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Tomografia por Emissão de Pósitrons , Prognóstico , Baço/patologia , Viroses/patologia
12.
Intern Med ; 56(6): 687-689, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28321071

RESUMO

Massive hemoptysis is a medical emergency and needs immediate treatment. It occurs in a wide variety of pulmonary diseases and typically originates from the bronchial arteries. We herein report a very rare case of a patient bleeding from a right phrenic artery-to-pulmonary artery fistula accompanied with focal bronchiectasis in the right middle lobe of the lung. In this case, multi-detector computed tomography was useful for clarifying the etiology and the abnormal anastomosis and facilitated effective angiographic embolization.


Assuntos
Fístula Artério-Arterial/complicações , Artérias Brônquicas/patologia , Hemoptise/etiologia , Pulmão/patologia , Artéria Pulmonar/patologia , Idoso de 80 Anos ou mais , Angiografia , Fístula Artério-Arterial/terapia , Embolização Terapêutica/métodos , Feminino , Hemoptise/terapia , Humanos , Tomografia Computadorizada por Raios X/efeitos adversos
13.
Infect Agent Cancer ; 11: 37, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27536332

RESUMO

BACKGROUND: Primary effusion lymphoma is a rare distinct large B-cell neoplasm that is associated with Kaposi's sarcoma-associated herpesvirus (KSHV) infection. Over recent years, 9 KSHV-positive/Epstein-Barr virus (EBV)-negative PEL cell lines have been established. METHODS: Tumor cells were collected from the pleural effusion of a 49-year-old male with AIDS. Cells were grown in RPMI1640 culture medium supplemented with 10 % fetus bovine serum. Single cell cloning was performed successfully by a limiting dilution method in a 96-well plate. The cell line obtained was designated SPEL. RESULTS: SPEL cells showed gourd-shaped morphology with a polarized nucleus, expressing CD38, CD138, and Blimp-1, but not B cell markers such as CD19 and CD20. Polymerase chain reaction analysis revealed that SPEL cells were positive for KSHV but negative for EBV. Tetradecanoylphorbol acetate induced expression of KSHV lytic proteins and the production of KSHV particles in SPEL cells. Subcutaneous inoculation of SPEL cells into severe combined immunodeficiency mice resulted in the formation of solid tumors. Next-generation sequencing revealed the 138 kbp genome sequence of KSHV in SPEL cells. Suberic bishydroxamate, a histone deacetylase inhibitor, induced the expression of KSHV-encoded lytic proteins and cell death in SPEL cells. CONCLUSIONS: A new KSHV-positive and EBV-negative PEL cell line, SPEL was established. This cell line may contribute to furthering our understanding of the pathogenesis of PEL and KSHV infection.

14.
Respir Med Case Rep ; 19: 21-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27408783

RESUMO

Camostat mesilate is in widespread clinical use mainly to treat chronic pancreatitis, and drug-induced lung injury has not been previously reported. However, pulmonary infiltration with peripheral blood eosinophilia appeared after taking camostat mesilate for ten days. The histological findings showed eosinophilic infiltration into the alveolar space and interstitum, and drug lymphocyte stimulation test of peripheral blood was positive. Both peripheral blood eosinophilia and pulmonary involvements improved two weeks later with the cessation of this drug. To the best of our knowledge, this case is the first report of camostat mesilate-induced acute eosinophilic pneumonia.

15.
J Infect Chemother ; 22(11): 770-773, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27297635

RESUMO

Re-emerging multidrug-resistant typhoid fever is becoming a worldwide threat, especially in East Africa. At the beginning of 2015, an outbreak of typhoid fever started in the capital city of Uganda, and 1940 suspected cases were reported by 5 March 2015. In this report, we describe a case of typhoid fever caused by a MDR strain with HIV infection and hemoglobin S-syndrome thalassemia in an Ugandan from Kampala City. It is essential to consider MDR strains of Salmonella enterica serovar Typhi infections, including fluoroquinolone-resistant strains, in patients from Africa and Southeast Asia.


Assuntos
Febre Tifoide/diagnóstico , Febre Tifoide/epidemiologia , Adulto , Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Feminino , Infecções por HIV/microbiologia , Humanos , Salmonella typhi/isolamento & purificação , Febre Tifoide/microbiologia , Febre Tifoide/virologia , Uganda/epidemiologia
16.
Interact Cardiovasc Thorac Surg ; 17(2): 280-4, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23633560

RESUMO

OBJECTIVES: The use of staplers for thoracic surgery has been widely accepted and regarded as a safe procedure. However, adverse events (AEs) of stapling are occasionally experienced. The aim of this retrospective study was to analyse the AEs of stapling in pulmonary vascular surgery. METHODS: A retrospective multi-institutional review was conducted by the 29 institutions of the Central Japan Lung Cancer Surgery Study Group. All staplings of the pulmonary artery (PA) and vein in thoracic surgery were reviewed during the research period. RESULTS: Stapling of the PA and vein was performed 3393 times. The total number of AEs related to stapling was nine (0.27%). Eight events occurred intraoperatively and one occurred immediately after the operation. Intraoperative AE occurred more frequently than postoperative AE. AE in the PA occurred more frequently than in the pulmonary vein. The intraoperative AEs were oozing (n=3), stapling failure (n=2), laceration of the peripheral vasculature at compression (n=2) and technical injury of the vasculature at insertion (n=1). The causes of AEs were reported to be tissue fragility (n=3), stapler rocking during stapling (n=2), stapler-tissue thickness mismatch (n=2) and technical failure (n=1). The only postoperative AE was staple line rupture of the PV stump. No relationship was seen between the incidence of AE and cartridge colours, compression types of staplers or numbers of staple lines. CONCLUSIONS: Generally, stapling of the pulmonary vasculatures in recent thoracic surgery has been safe. Furthermore, the knowledge of the possible risks of pulmonary vascular stapling may help to decrease the AEs of stapling.


Assuntos
Artéria Pulmonar/cirurgia , Veias Pulmonares/cirurgia , Grampeamento Cirúrgico/efeitos adversos , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Distribuição de Qui-Quadrado , Desenho de Equipamento , Humanos , Japão , Complicações Pós-Operatórias/cirurgia , Reoperação , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Grampeadores Cirúrgicos , Grampeamento Cirúrgico/instrumentação , Fatores de Tempo , Resultado do Tratamento
17.
Kyobu Geka ; 65(3): 201-4, 2012 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-22374594

RESUMO

A 61-year-old female who was diagnosed with right lung cancer had right lower lobectomy by videoassisted thoracic surgery in June 2010. At the 7th post operative day( 7POD), the patient complained of dyspnea and chest X-ray showed right pneumothorax which was successfully treated by closed drainage and pleurodesis. Since then repeated right pneumothorax appeared and the same procedures were chosen for treatment. In September 2010, just after the pleurodesis for the 3rd time event, she lost consciousness. Brain computed tomography (CT) demonstrated air density area in bilateral internal carotid arteries and right parietal lobe, establishing the diagnosis of air embolism which was successfully treated by hyperbaric oxygen treatment.


Assuntos
Embolia Aérea/etiologia , Pleurodese/efeitos adversos , Pneumonectomia , Pneumotórax/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Pneumotórax/etiologia , Complicações Pós-Operatórias
18.
Kyobu Geka ; 64(10): 944-6, 2011 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-21899135

RESUMO

We report a case of 68-year-old-man with pulmonary metastases from hepatocellular carcinoma (HCC). Following right hepatic lobectomy in January 2005, 4 pulmonary metastases in the right lung were detected by chest computed tomography (CT) in September 2007. As chemotherapy was not effective, surgical resection (right upper lobectomy, partial resection of middle and lower lobe ) was performed. Secondary metastases in the left lung was detected in March 2008, and stereotactic radiotherapy was performed considering the site of tumor location and poor pulmonary function. Two years after radiotherapy, the patient is alive without recurrence.


Assuntos
Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/terapia , Radiocirurgia , Idoso , Humanos , Masculino
19.
Kyobu Geka ; 63(6): 496-9, 2010 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-20533744

RESUMO

Granular cell tumor is found in various organs but is rare in the mediastinum. We report a case of 21-year-old woman with a granular cell tumor in the left upper mediastinum. Chest computed tomography (CT) showed a 30 x 20 mm well circumscribed tumor in the left upper mediastinum. Tumor resection was performed. It was found that the tumor involved the sympathetic nerve. Histopathologically, the tumor consisted of cells with eosinophilic granules and diagnosed as a granular cell tumor.


Assuntos
Tumor de Células Granulares/patologia , Neoplasias do Mediastino/patologia , Feminino , Humanos , Adulto Jovem
20.
Nihon Kokyuki Gakkai Zasshi ; 40(4): 307-10, 2002 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-12096500

RESUMO

A 57-year-old man was admitted for pulmonary emphysema. Volume-reduction-surgery (VRS) was performed. Three days later, after he coughed hard, the right lung collapsed. Although surgery was repeated, the air leakage continued. Air leakage was immediately reduced by means of bronchial embolization with a spiral embolus. We suggest that bronchial embolization with a spiral embolus causes little harm and is an effective treatment for refractory pulmonary fistula in poor-risk patients.


Assuntos
Embolização Terapêutica/métodos , Complicações Pós-Operatórias/terapia , Fístula do Sistema Respiratório/terapia , Brônquios , Embolia Aérea/terapia , Adesivo Tecidual de Fibrina/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia/efeitos adversos , Enfisema Pulmonar/cirurgia
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