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Find video protocols related to scientific articles indexed in Pubmed.
[The role and landscape of surgical treatment for mycobacteriosis].
Kekkaku
PUBLISHED: 11-25-2011
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[Surgery for pulmonary multi-drug resistant (MDR) tuberculosis] For pulmonary MDR tuberculosis the author (me) had been operating many cases in Fukujuji Hospital JATA in fifteen years. For treatment, the points of operations are as follows: 1) Surgery is one of many treatable events, 2) The strategy is that cavitary foci as major sites of tuberculous expectoration have to be removed and other small foci are treated by not strong chemotherapies, 3) Final goal of surgical treatments is set up preoperatively, and its procedures are stepped up gradually. [Surgery for pulmonary non-tuberculous mycobacteriosis (NTM)] Major sites of pulmonary NTM expectorations are cavitary foci and bronchiectases. Main strategy of surgery for pulmonary NTM is the same as MDR tuberculosis, but multi-resections of cavitary and ectatic foci are more than MDR tuberculosis. Control rate of X-ray images is 80%, negative conversion rate is 88.9% in cases with more than one year postoperatively. But new or residual foci will be gradually growing up for several years postoperatively, so many discussions of surgical strategy for NTM are necessary now. [Surgery for pulmonary aspergillosis] Surgical treatments of pulmonary aspergillosis are difficult. Operations for them are mainly two procedures, resection of foci or no resection. The former is more radical than the later, but mortality rate is higher than usual pulmonary resection. However I think chest surgeons have to challenge to remove aspergillous foci, not aspergilloma but chronic necrotizing pulmonary aspergillosis.
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[Evaluation of tuberculosis treatment including levofloxacin (LVFX) in cases who could not continue standard regimen].
Kekkaku
PUBLISHED: 11-25-2011
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The purpose of this study was to evaluate tuberculosis treatment including levofloxacin (LVFX) and to investigate the effectiveness of changing drug regimens at our hospital.
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[A case of tuberculous pleurisy developing contralateral effusion during anti-tuberculosis chemotherapy].
Kekkaku
PUBLISHED: 09-20-2011
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A 55-year-old woman was admitted to our hospital because of chest pain, fever, and right pleural effusion that was exudative and lymphocyte-dominant with a high level of adenosine deaminase (ADA). Since her blood QuantiFERON-TB 3G test (QFT) was positive, she was diagnosed with tuberculous pleurisy. After initiation of anti-tuberculosis chemotherapy with isoniazid, rifampicin, ethambutol, and pyrazinamide, her symptoms improved. Later, liquid culture of the pleural effusion turned positive for Mycobacterium tuberculosis. On the 18th day of treatment, her chest X-ray and computed tomography exhibited pleural effusion in a moderate amount in the left thorax, with subsiding pleural effusion in the right thorax. Thoracocentesis demonstrated that the left thorax effusion was also exudative and lymphocyte-dominant, with elevated QFT response and high ADA concentration, suggesting tuberculous pleurisy. Mycobacterium tuberculosis was detected in the culture of a left pleural biopsy specimen obtained by thoracoscopy. We assumed that the left pleural effusion was due to paradoxical worsening because (1) on admission no effusion or lung parenchymal lesion was detected in the left hemithorax, (2) on the 14th day of treatment she was afebrile without pleural effusion on both sides, and (3) the bacilli were sensitive to the drugs she had been taking regularly. We performed drainage of the left effusion and continued the same anti-tuberculosis drugs, which led to the elimination of all her symptoms and of the pleural effusion on both sides. In conclusion, paradoxical worsening should be included in the differential diagnosis when contralateral pleural effusion is detected during the treatment of tuberculosis.
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[Invasive pulmonary aspergillosis with hemoptysis; a resected case whose bleeding point is detected pathologically].
Kyobu Geka
PUBLISHED: 09-09-2011
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A 55-year-old man, who presented with recurrent episodes of hemoptysis, was referred to our hospital under the diagnosis of invasive aspergillosis with a cavity in the right lung. Computed tomography showed a large thick-walled cavity in the right upper lung. He underwent right upper lobectomy. Pathological findings showed a large cavity in right upper lobe. Aspergillus was found in the cavity. A pseudoaneurysm, which was thought to be a cause of hemoptysis, originated from a ruptured pulmonary artery and protruded into the cavity. Hemoptysis is well-known symptom in aspergillosis patients, and surgery for aspergillosis with hemoptysis is sometimes performed. But it is very rare that bleeding point is detected microscopically.
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Risk factors that affect the surgical outcome in the management of focal bronchiectasis in a developed country.
Ann. Thorac. Surg.
PUBLISHED: 06-22-2011
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The purpose of this study was to demonstrate our surgical experience for focal bronchiectasis in the setting of modern diagnostic modalities and state-of-the-art medical treatment in a developed country.
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[Malignant lymphoma of lung with hypersensitivity pneumonitis].
Kyobu Geka
PUBLISHED: 06-21-2011
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We report a resected case of malignant lymphoma with hypersensitivity pneumonitis. A 62-year-old woman, who presented with fever, wheeze and dry cough was referred to our department under the diagnosis of malignant B cell lymphoma in lower lobe of the left lung and hypersensitivity pneumonitis. She underwent left lower lobectomy as a therapy for malignant lymphoma. Pathological findings showed multiple small nodules macroscopically, which was observed as bronchiolocentric interstitial pneumonitis with lymphocytes microscopically. Post operative course was uneventful and no sign of acute exacerbation was seen. It is rare that lung with hypersensitivity pneumonitis is observed as a macroscopical specimen. Hypersensitivity pneumonitis differs from idiopathic pulmonary fibrosis, but we have to take care of post operative course because post operative acute exacerbation was reported.
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Reversion rates of QuantiFERON-TB Gold are related to pre-treatment IFN-gamma levels.
J. Infect.
PUBLISHED: 02-25-2011
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The quantitative interferon (IFN)-gamma in response to Mycobacterium tuberculosis-specific antigens declines in tuberculosis patients after starting treatment, however, in some cases remains high despite clinical improvements. Our aim was to evaluate clinical parameters associated with remaining QuantiFERON-TB Gold (QFT-G) positive after treatment.
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Stratified Threshold Values of QuantiFERON Assay for Diagnosing Tuberculosis Infection in Immunocompromised Populations.
Tuberc Res Treat
PUBLISHED: 02-07-2011
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Background. The detection of latent tuberculosis (TB) is essential for TB control, but T-cell assay might be influenced by degree of immunosuppression. The relationship between immunocompetence and interferon (IFN)-? response in QuantiFERON-TB Gold (QFT) is uncertain, especially in HIV-negative populations. Methods and Results. QFT has been performed for healthy subjects and TB suspected patients. Of 3017 patients, 727 were diagnosed as pulmonary TB by culture. The absolute number of blood lymphocyte in TB patients was significantly associated with QFT. Definitive TB patients were divided into eight groups according to lymphocyte counts. For each subgroup, receiver operating characteristic curve analysis was conducted from 357 healthy control subjects. The optimal cut-off for the patient group with adequate lymphocyte counts was found, but this was reduced for lymphocytopenia. Conclusions. The lymphocyte count was positively associated with QFT. Positive criteria should be calibrated in consideration of cell-mediated immunocompetence and risk of progression to active TB.
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Combined typical carcinoid and acinic cell tumor of the lung.
Interact Cardiovasc Thorac Surg
PUBLISHED: 11-30-2010
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We report a case of combined typical carcinoid and acinic cell tumor of the lung in a 55-year-old female. A chest radiograph revealed an abnormal shadow. Computed tomography (CT) showed a tumor in the S3 segment of the right lung. The transbronchial biopsy yielded a diagnosis of non-small-cell lung cancer. Radical surgery was performed. The pathological diagnosis was combined typical carcinoid and acinic cell tumor of the right lung. This is third case of this tumor which has been reported.
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[A case of cold abscess of the chest wall due to thoracic drainage for tuberculous pleuritis].
Kekkaku
PUBLISHED: 09-18-2010
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A 56-year-old man underwent thoracic drainage for two weeks for tuberculous pleuritis. He was put on antituberculosis chemotherapy with INH (400 mg), RFP (450 mg), and EB (750 mg). Two months later, he developed an elastic hard subcutaneous mass in the area of the previous thoracic drainage. The mass was 10 cm in diameter, warm, reddish and painful. Chest computed tomography (CT) revealed localized and encapsulated empyema in the left thoracic space and a subcutaneous abscess with rim enhancement in the left lateral chest wall. Magnetic resonance imaging (MRI) demonstrated a dumbbell abscess in the subcutaneous tissue communicating with the empyema through the chest wall. A needle aspiration of the subcutaneous abscess had acid-fast bacilli smears of 2+ and tested positive by polymerase chain reaction (PCR) for Mycobacterium tuberculosis. Thus, he was diagnosed with a cold abscess of the chest, with the empyema in the thoracic space draining into the chest wall through the cut for artificial drainage. Continuation of the anti-tuberculosis treatment and the drainage of the empyema with repeated aspiration reduced the subcutaneous mass, and the clinical and radiological course was favorable. Both the smear and culture for acid-fast test became negative. After completion of chemotherapy, there has been no disease recurrence.
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Impact of peripheral lymphocyte count on the sensitivity of 2 IFN-gamma release assays, QFT-G and ELISPOT, in patients with pulmonary tuberculosis.
Intern. Med.
PUBLISHED: 09-01-2010
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This study evaluated the effect of peripheral lymphocyte count on 2 interferon-gamma release assays [QuantiFERON TB-Gold (QFT-G) and enzyme-linked immunospot (ELISPOT)] and their sensitivity in patients with pulmonary tuberculosis, including HIV-negative immunocompromised patients.
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[Pulmonary histoplasmosis diagnosed by transbronchial lung biopsy].
Nihon Kokyuki Gakkai Zasshi
PUBLISHED: 12-10-2009
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A 34-year-old Japanese man working in Mexico City since April 2004, was referred to our hospital in December 2005 because of a nodule in the left lingular bronchus, first pointed out in September 2005. Transbronchial lung biopsy (TBLB) revealed coagulation necrosis, which contained yeast-like cells stained with fungiflora Y stain. We diagnosed pulmonary histoplasmosis (histoplasmoma type) based on the shape of the fungi and on his residential history. The nodule, resected in January, presented histological findings in concordance with the TBLB specimen. We later confirmed his serum was positive for an anti-histoplasma antibody. The pathogen was identified as Histoplasma capsulatum by PCR using lung tissue. This is apparently the first report of Histoplasmosis diagnosed by TBLB. Since imported mycosis is increasing, we should accumulate cases to make guidelines for diagnosis and treatment.
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[A case of tuberculosis with multiple lung nodules, abdominal lymphadenopathy, and splenomegaly].
Kekkaku
PUBLISHED: 11-26-2009
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Abdominal tuberculous lymphadenitis is very rare. We report a case of pulmonary tuberculosis showing marked abdominal lymphadenopathy and splenomegaly. A 95-year-old man was admitted to our hospital because of abnormal chest X-ray and body weight loss in last 6 months. He had low grade fever with no abdominal pain. He did not have past history of tuberculosis. Laboratory examination showed mild renal dysfunction and mild glucose intolerance. Soluble interleukin 2 recepter was highly elevated (3800 U/ml). Tumor markers, such as carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA), and progastrin-releasing peptide (Pro GRP) were all within normal limit. Chest X-ray showed multiple nodules in bilateral lung fields. Chest computed tomography showed multiple nodules in bilateral lungs, especially in upper part of lungs, right hilar lymphadenopathy and upper mediastinal lymphadenopathy. Abdominal and pelvic enhanced computed tomography showed marked abdominal lymphadenopathy and splenomegaly (67 x 49 mm). Abdominal lymph nodes were hepatoduodenal (50 x 50 mm), splenic hilar (40 x 25 mm), upper paraaortic (30 x 60 mm), and small superior mesenteric (10 x 10 mm) lymph nodes. FDG-PET showed accumulation in the nodules of right lung field, right hilar lymph nodes, upper mediastinal lymph nodes, and abdominal lymph nodes. Bronchial lavage fluid (BAL) smear for acid-fast bacilli was positive, polymerase chain reaction for Mycobacterium tuberculosis was positive and acid-fast bacilli was cultured. Transbronchial lung biopsy specimen demonstrated non-specific intraalveolar organization and alveolitis. The patient was diagnosed as pulmonary tuberculosis, but about abdominal lymphadenopathy and splenomegaly we had to differentiate malignant lymphoma, and for definite diagnosis, laparotomy was necessary. But considering his age and general condition, we followed up carefully with anti-tuberculosis therapy. Pulmonary tuberculosis, abdominal lymphadenopathy and splenomegaly all showed marked improvement 4 months after starting anti-tuberculosis therapy with isoniazid, rifampicin, and ethambutol, so we clinically diagnosed abdominal tuberculous lymphadenitis and splenic tuberculosis.
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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.