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Results for “PNEUMOTHORAX, ARTIFICIAL”

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PubMed2005

[Chronic tuberculous methicillin-resistant Staphylococcus aureus (MRSA) empyema with bronchopleural fistulae treated by open window thoracostomy followed by thoracoplasty and latissimus dorsi muscle transposition].

We describe a case of chronic tuberculous methicillin-resistant Staphylococcus aureus (MRSA) empyema with bronchopleural fistulae successfully treated by open window thoracostomy followed by thoracoplasty and transposition of the latissimus dorsi muscle. A 69-year old man with a history of artificial pneumothorax for pulmonary tuberculosis was referred to our hospital with fever and purulent bloody sputum. He was diagnosed as having right chronic tuberculous empyema with bronchopleural fistulae. Immediate tube thoracostomy markedly relieved symptoms except for low-grade fever. Sputum and empyema cavity cultures were repeatedly positive for MRSA. Open window thoracostomy (5th to 7th ribs resection) was performed to control the infection. The empyema cavity was cleaned with no residual calcified pleura. His condition gradually improved and he underwent thoracoplasty and transposition of the latissimus dorsi muscle 22 months after the initial surgery. He was discharged 25 days postoperatively in good condition. Seventeen months after the curative surgery, he remains well with no evidence of recurrence. A two-stage operation, open window thoracostomy to control infection followed by thoracoplasty and transposition of the latissimus dorsi muscle, is useful in cases of chronic tuberculous MRSA empyema with bronchopleural fistulae.

Aged↗

PubMed2006

[Reserves for enhancing the efficiency of treatment for pulmonary tuberculosis in adolescents].

Out of 222 adolescents with pulmonary tuberculosis, 115 received a short-term intensive DOTS chemotherapy and 107 had a conventional triple antibacterial treatment (TAT) regimen. The advantages of intensive chemotherapy were relatively better results with a reduction in the duration of treatment by 1.5-2 months; its disadvantage was more frequent (37.7% versus 18.7%) adverse toxic reactions. The local administration of TAT (lymphotropic as aerosols) promotes a decrease in toxic reactions and an increase in the efficiency of treatment for the destructive and bacillary forms of pulmonary tuberculosis. This is also favored by the timely use of collapse therapy--artificial pneumothorax and pneumoperitoneum (following 1.5-3 months).

Adolescent↗

PubMed1991

[A clinical study on intrathoracic malignant lymphoma with chronic tuberculous pyothorax].

The authors reported 3 male patients of malignant lymphoma developing from long-standing pyothorax. They had been suffering from tuberculous pyothorax for more than 30 years, after artificial pneumothorax therapy for pulmonary tuberculosis. The most common symptom was chest pain. It was difficult to detect the tumor mass by chest X-ray because of old inflammatory changes. Computed tomography and 67Ga scintigraphy were useful. The lesions tended to grow destroying the surrounding lung, chest wall and ribs. Histologically, 2 cases were diffuse large cell type and one was diffuse intermediate sized cell type. Immunologically, 2 cases were B-cell type lymphoma but one was not clearly classified. They received radiotherapy, but 2 cases died of respiratory failure. These findings suggest that B cell lymphoma might arise following chronic tuberculous pyothorax. Therefore such cases should be followed up carefully.

Empyema, Pleural↗

PubMed1991

Frequent chest X-ray fluoroscopy and breast cancer incidence among tuberculosis patients in Massachusetts.

The incidence of breast cancer was determined in 4940 women treated for tuberculosis between 1925 and 1954 in Massachusetts. Among 2573 women examined by X-ray fluoroscopy an average of 88 times during lung collapse therapy and followed for an average of 30 years, 147 breast cancers occurred in contrast to 113.6 expected [observed/expected (O/E) = 1.29; 95% confidence interval (CI) = 1.1-1.5]. No excess of breast cancer was seen among 2367 women treated by other means: 87 observed versus 100.9 expected. Increased rates for breast cancer were not apparent until about 10 to 15 years after the initial fluoroscopy examination. Excess risk then remained high throughout all intervals of follow-up, up to 50 years after first exposure. Age at exposure strongly influenced the risk of radiation-induced breast cancer with young women being at highest risk and those over age 40 being at lowest risk [relative risk (RR) = 1.06]. Mean radiation dose to the breast was estimated to be 79 cGy, and there was strong evidence for a linear relationship between dose and breast cancer risk. Allowing for a 10-year minimum latent period, the relative risk at 1 Gy was estimated as 1.61 and the absolute excess as 10.7 per 10(4) woman-years per gray. When compared to other studies, our data suggest that the breast is one of the most sensitive tissues to the carcinogenic force of radiation, that fractionated exposures are similar to single exposures of the same total dose in their ability to induce breast cancer, that risk remains high for many years after exposure, and that young women are especially vulnerable to radiation injury.

Breast Neoplasms↗

PubMed1990

The contributions of John B. Murphy to thoracic surgery.

John B. Murphy was a prominent surgeon who lived in Chicago from the 1880s until his death in 1916. During his career, he was associated with both Rush Presbyterian and Northwestern Medical Schools. He was responsible for popularizing the use of an artificial pneumothorax as an effective adjunct in the treatment of pulmonary tuberculosis. This modality was not, however, his original concept. In addition to all of the fields of general surgery, Murphy undertook the management of empyema and lesions of the chest wall and also performed thoracoplasty procedures. Although he had done several thoracotomy procedures in his laboratory, he rarely undertook this operation in a clinical setting. Drop ether anesthesia was used for all surgical procedures. Murphy did not use closed water seal drainage of the chest. His oration on thoracic surgery, given at the annual meeting of the AMA, in 1898, was an excellent monograph on the subject and undoubtedly contributed to the increased interest and progress in this field of surgery. Murphy was a wise surgeon, an able technician and a scholarly teacher. The high regard in which he was held by his contemporaries is best expressed by the remark of William Mayo, "...he was the surgical genius of our generation".

Chicago↗

PubMed1990

[Results of the surgical treatment of progressive fibrous-cavernous pulmonary tuberculosis].

The immediate and long-term results of surgical treatment of 162 patients with fibrocavernous pulmonary tuberculosis are described. In addition to resection interventions, the Novisibirsk Tuberculosis Research Institute developed and put into practice collapso-surgical techniques and those of a direct impact on a lung cavern. When operating 5 patients, an artificial therapeutic pneumothorax was applied to the opposite lung. All that ensured a complete clinical wellbeing in 80.8% of the cases judging by the results of their long-term follow-up. Unsatisfactory condition persisted in 8.1% of the cases, and 11.1% of the above patients died. Proper choice of surgical intervention in a specific case made it possible to decrease the associated risk and increase the surgical treatment efficiency to a great extent.

Adult↗

PubMed1990

[Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax].

Our previous study suggested a close relationship between a preceding chronic tuberculous pyothorax and the development of non-Hodgkin's lymphoma (NHL) in the pleural cavity. To confirm this further, 37 cases were collected, their clinical and pathological findings summarized. The age at first admission for lymphoma of patients ranged from 46 to 81 (mean 63) years, the male to female ratio being 5.2:1. All patients were admitted after a 22-55 (mean 33) year history of pyothorax resulting from artificial pneumothorax for treatment of pulmonary tuberculosis (29 cases) or tuberculous pleuritis (seven cases). The most common presenting symptom was chest pain. The diagnosis of pleural NHL was made by biopsy for 31 of the patients and at autopsy for the other six. Histologically 30 (81%) of 37 cases were of diffuse large cell type, and of these the immunoblastic type was the most common (22 cases). Immunological and immunohistologic studies revealed a B-cell nature of the proliferating cells in all but one tumor. Thirty-two patients received chemotherapy and/or radiotherapy. Twenty-seven patients died between one and 144 (median eight) months of diagnosis. Autopsies carried out in 23 cases revealed the disease to have been localized to the thorax in 11 patients. These findings indicated that malignant B-cell lymphoma arose as a monoclonal growth from a pool of proliferating polyclonal B lymphocytes in tissues affected by the chronic tuberculous pyothorax.

Adult↗

PubMed1989

[A clinical study of six surgically treated patients with malignant tumors arising from chronic pleuritis and pyothorax].

During the clinical course of chronic pleuritis and pyothorax, we frequently have found abnormal clinical signs such as increased abnormal chest shadows, subjective symptoms, such as chest pain and bloody sputum, and the appearance of atypical cells in the pleural effusion. It is very difficult and important to diagnose differentially worsening of chronic inflammation and occurrence of malignant tumors. We have surgically treated six patients with malignant tumors arising from chronic pleuritis and pyothorax, who had the above abnormal signs. All of them were made, and their average age was fifty three years. Two patients exhibited increased abnormal chest shadows, 5 had subjective symptoms (5 with chest pain, 2 with bloody sputum and 2 with fever), and 1 had atypical cells in the pleural effusion. Two patients had suffered from chronic pleuritis, who both had received artificial pneumothorax therapy for pulmonary tuberculosis, and the other 4 patients had suffered from chronic pyothorax, with mean duration of thirty years. The pathological diagnoses were 2 cases each of malignant pleural mesothelioma, squamous cell carcinoma, and malignant fibrous histiocytoma. The two patients with squamous cell carcinoma had pleurocutaneous and bronchopleural fistula. The operative methods were tumor resections with pleuropneumonectomy performed in 2 patients and pneumonectomy in 1. Absolute non-curative operation was performed in 1 patient, and postoperative radiotherapy in 3 patients. All patients died of tumor recurrence, although five of them underwent reoperation, chemotherapy and radiotherapy. Their duration of survival ranged from 3 to 15 months with a mean of 9 months after appearance of malignant tumor signs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

[The history and development of thoracoscopy].

The development of thoracoscopy is closely connected with the history of the artificial pneumothorax, of pleural suction drainage and of endoscopy. After its introduction in 1910 by Jacobaeus thoracoscopy was at first used mainly for therapeutic purposes (thoracocausty). With the onset of drug treatment of tuberculosis and the end of the area of pneumothorax therapy thoracoscopy was increasingly used as a diagnostic method. Today it is second in importance only to fibre bronchoscopy in pneumology.

Europe↗

PubMed1989

Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax. Summary of clinical and pathological findings in thirty-seven cases.

Our previous study suggested a close relation between a preceding chronic tuberculous pyothorax and the development of non-Hodgkin's lymphoma (NHL) in the pleural cavity. To confirm this further, 37 cases were collected from Japanese hospitals, and their clinical and pathological findings summarized. The age at first admission for lymphoma of patients ranged from 46 to 81 (mean 63) years, the male to female ratio being 5.2:1. All patients were admitted after a 22-55 (mean 33) year history of pyothorax resulting from artificial pneumothorax for the treatment of pulmonary tuberculosis (29 cases) or tuberculous pleuritis (seven cases). The most common presenting symptom was chest pain. The main tumor mass, detected by chest roentgenogram and computed tomographic scans, was situated in the pleura (28 patients), the lung near the pleura (five patients) and the pleura and lung (four patients). The diagnosis of pleural NHL was made by biopsy for 31 of the patients and at autopsy for the other six. Histologically 30 (81%) of the 37 cases were of the diffuse large cell type, and of these the immunoblastic type was the most common (22 cases). Immunological and immunohistologic studies revealed a B-cell nature of the proliferating cells in all but one tumor. Thirty-two patients received chemotherapy and/or radiotherapy. Twenty-seven patients died between one and 144 (median eight) months of diagnosis. Autopsies carried out in 23 cases revealed the disease to have been localized to the thorax in 11 patients. These findings indicated that malignant B-cell lymphoma arose as a monoclonal growth from a pool of proliferating polyclonal B lymphocytes in tissues affected by the chronic tuberculous pyothorax.

Aged↗

PubMed1987

[Pulmonary infection caused by a rare mycobacterium, Mycobacterium malmoënse].

The present case report is on a patient treated for tubercle in 1949 by an artificial pneumothorax. Thirty three years after the initial illness some radiological changes occurred suggesting a recurrence, especially as a bacteriological examination showed the presence of acid-alcohol fast bacilli on direct smear. Triple therapy (Isoniazid, Rifampicin, Streptomycin) was then prescribed, and was followed by a radiological improvement, even though the sputum remained positive. After multiple seedings, it was possible to isolate from 11 tubes and 2 expectorations a rare strain of mycobacterium: mycobacterium malmoense. The present observation seems to be the first indisputable French case of infection by this bacterium. From the opportunity presented by this observation the bacteriological characteristic of this mycobacterium, as well as the clinic aspects of the infection are discussed.

Humans↗

PubMed1971