Cardiac tamponade caused by coronary artery injury is an extremely rare postlobectomy complication. Herein, we present a case of cardiac tamponade due to coronary artery injury after a left upper lobectomy for lung cancer and discuss the possible cause of coronary artery injury.
Orthodontic mechanical stress induces various molecules, which cause structural changes in the proteins in periodontal
tissue. The expression kinetics of HSP47 in mouse periodontal ligament (PDL) tissue after application
of corrective mechanical stress and HSP47 expression during the PDL recovery were observed. Our examination
data are as follows: HSP47 is constitutively expressed in the PDL and defends cells from different types of stress
and maintains homeostasis under normal conditions. HSP47 is expressed in PDL fibroblasts on the pressure side
damaged by application of mechanical stress and contributes to the repair of collagen tissue by activating PDL
fibroblasts, supporting recovery from cell damage. These data suggests that, during bone addition to the PDL on
the tension side, HSP47 also acts as molecular chaperone, which assists the maturation of bone morphogenetic
proteins and aids osteoblast activation. On the other hand, it is possible that, when a mechanical stress is applied
to the periodontal membrane on the tension side for a time too short for bone addition and abnormalities
are caused in the collagen structure of the PDL fibroblasts, by functioning at the damage site, HSP47 inhibits
extracellular secretion of abnormal collagen, stores the modified protein in the endoplasmic reticulum, thereby
controlling decalcification of the PDL. HSP47 investigated in this study acts differently depending of the time
of expression.
The pharmacokinetic studies of intraperitoneal cisplatin (CDDP) for gastric cancer were discussed elsewhere, but those studies were investigated in patients with ascites. The purpose of this study is to compare the difference in pharmacokinetics between patients with malignant ascites and those curatively resected without ascites. One hundred mg of CDDP and 300 ml of saline were administered intraperitoneally for 9 curatively resected patients by catheter just after operation, and the same doses of CDDP were administered for 3 advanced or recurrent patients with ascites just after removal of whole fluid. Blood samples were corrected at 6 points after administration. Results were as follows: The 0-t area under the curve (AUC) and the Cmax of both total and free CDDP in the patients without ascites was higher than in the patients with ascites. The 0-infinity AUC and MRT of the ascites patients were higher than in the patients without ascites. These data suggest that intraperitoneal CDDP chemotherapy for gastric cancer as an adjuvant setting is more effective than chemotherapy for advanced malignant ascites patients.
We report the perioperative management of three patients with streptococcal toxic shock syndrome (STSS) caused by group A streptococcal infection. Three of two patients survived but one patient died from multiple organ dysfunction in spite of vigorous treatments. These patients required the treatments including administration of antibiotics, circulatory and respiratory care, surgical debridement, anticoagulant therapy for disseminated intravascular coagulation and hemofiltration. The early diagnosis and surgical intervention play a key role in the successful management of this syndrome because it has a rapid course and frequent fatal outcome. The anesthetic management of these patients should be targeted to maintain perfusion of the vital organs and to control the blood clotting disorders.
Most cases of paranasal sinuses cancer are histologically squamous cell carcinoma. However, adenocarcinoma is rarely found even among cases of submucosal mucous gland origin. As adenocarcinoma has tendencies to local recurrence and distant metastasis, the five-year survival rate of this type of tumor has been reported to be worse than that of squamous cell carcinoma. On the other hand, some investigators insist that the survival rate at 10 or 20 years should be discussed because of the slow-growing nature of this tumor. We report herein clinicopathological studies on six cases of adenocarcinoma of the paranasal sinuses, including one long survivor, a 63-year-old man who lived 11 years and 3 months after the first visit and 8 years after pulmonary metastasis.
