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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
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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
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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
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【目的/意义】云计算的发展规模和应用范围的不断扩大使得云环境下的信息安全和隐私问题日益突出。
【方法/过程】建立云环境下高效的入侵检测系统逐渐成为入侵检测领域的重要研究内容。本文首先分析了当前云
环境面临的安全威胁以及常见的攻击手段,阐述了云环境的服务模式,然后重点论述入侵检测系统,提出一种云环
境下的入侵检测模型,最后对模型中网络流量进行分析,进而通过仿真与实验进行验证。【结果/结论】结果证明：云
环境下网络入侵检测系统确实能够降低检测时间以及误码率,提高准确率,具有良好的实时性和可扩展性。 相似文献
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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
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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
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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