We report two cases of a nonparasitic solitary huge liver cyst. The first case, that of a 42-year-old woman, was admitted with a chief complaint of upper abdominal pain. Computed tomography (CT) scans revealed a huge cyst, 10 cm in diameter, in segments 4 and 5 of the liver, and spontaneous rupture of the cyst with intracystic hemorrhage. Her general condition was improved by transcatheter arterial embolization (TAE). Percutaneous cystic needle aspiration cytological examination revealed no malignant cells, so she was discharged. After 3 weeks, however, the cyst had increased in size, and simple cystectomy was performed. Histological examination proved the cyst to be benign. The patient in the second case, a 70-year-old man, was admitted with epigastric discomfort and obstructive jaundice. CT scans revealed a huge liver cyst, 18 x 15 cm, in the right lobe of the liver, with dilation of the bile duct in the lateral segment. Magnetic resonance cholangiopancreatography showed compression of the left hepatic duct by the cyst and dilation of the bile duct in the lateral segment. Endoscopic retrograde cholangiopancreatography disclosed no communication between the bile duct and the cyst. Percutaneous transhepatic cyst drainage was performed, and minocycline hydrochloride was infused. The cyst was reduced in size, and the reduction has been maintained for 20 months since treatment.

Talc pleurodesis induces more marked changes in the pleural cavity than OK-432-induced pleurodesis.

ABSTRACT. It is well known that the minimum alveolar concentration (MAC) of inhalation anesthetic decreases with increasing age. However, there is limited information regarding the effect of age on MAC in dogs. This study was designed to determine the effect of age on sevoflurane MAC in dogs. MAC was determined in 6 young (2 years old) and 6 old beagle dogs (8 to 10 years old) under artificial ventilation. Anesthesia was induced via mask induction and maintained with sevoflurane in oxygen, and MAC was determined by using a tail clamp method. The sevoflurane MAC for the older dogs was significantly less than that for the younger dogs (1.86  0.29% vs 2.25  0.15%, P=0.007). The MAC of sevoflurane is profoundly affected by age in dogs.KEY WORDS: aging, anesthesia and analgesia, canine, minimum alveolar concentration (MAC), sevoflurane.J. Vet. Med. Sci. 71(11): 1509-1512, 2009 Sevoflurane is a volatile anesthetic agent with a relatively low blood/gas solubility coefficient resulting in rapid induction and recovery from anesthesia [28]. During the last decade, clinical use of sevoflurane has been spreading in veterinary species such as horses [3,14,24,31], cats [15] and dogs [1,2]. Sevoflurane is minimally metabolized and easily cleared in animals; however, it should be remembered that sevoflurane causes dose-dependent hypotension, hypoventilation, impaired cardiac contractility and hypothermia [21]. Because of these side effects, sevoflurane must be carefully titrated, and vigilant monitoring should be employed to avoid excessive anesthetic depth.MAC has been defined as "the minimum alveolar concentration of anesthetic at 1 atmosphere that produces immobility in 50% of those animals exposed to a noxious stimulus" [5]. It has long been known that MAC decreases with age in humans [8,20,22,26,29]. In human medicine, anesthetists can rapidly determine the depth of anesthesia in age-corrected MAC units for volatile anesthetics by using a normogram to estimate age-related MAC [16] and agerelated iso-MAC charts [23]. In the recent practice of veterinary anesthesia, geriatric animals have become a significant proportion of the patient population. Attention to the unique physiology and particular requirements of individuals within this age group will contribute to the provision of safe and effective anesthesia [9,19]. Veterinary practitioners believe that geriatric animals require a lower concentration of inhalation anesthetic to maintain anesthesia based on clinical experience. To the best of our knowledge, however, there are few reports on the relationship of MAC to age in veterinary species [11,17]. Furthermore, the relationship of sevoflurane MAC to age has not been evaluated in dogs. The purpose of the study reported here was to determine the effect of age on sevoflurane MAC in dogs. The authors hypothesized that the sevoflurane MAC value would be inversely related to age in this species.Six young beagles, 2 years of age (all male) and weighing from 9.7 to 11.8 kg (10.8  0.9 kg of mean  SD), and six old beagles, 8 to...

This method for determining a pulmonary resection procedure avoided postoperative deaths and severe cardiopulmonary complications, while achieving a good outcome.

Legionella pneumophila, a causative agent of Legionnaire's disease, is an intracellular pathogen. It intervenes in the signal transduction of macrophages by secreting effector molecules through the Icm/Dot type IV secretion system (T4SS). There is a connection between signaling cascades that regulate phagocytosis and the production of reactive oxygen species (ROS). Class I phosphatidylinositol 3-kinase (PI3-K) and its product phosphatidylinositol 3,4,5-trisphosphate (PI(3,4,5)P 3 ) play key roles in the reorganization of cytoskeleton (phagocytosis) and activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (ROS production). We investigated the production of PI(3,4,5)P 3 and recruitment of class I PI3-K and Rac1 during phagocytosis of L. pneumophila by macrophages. Transient recruitment of class I PI3-K as well as PI(3,4,5)P 3 production was observed around a phagocytosed T4SS mutant LELA3118 or avirulent mutant 25D in an early stage of infection. In contrast, class I PI3-K was recruited while accumulation of PI(3,4,5)P 3 was not observed around wild type JR32. Immunoglobulin G (IgG)-opsonized live JR32, which would activate class I PI3-K through the Fcγ receptor pathway, did not induce PI(3,4,5)P 3 production. Regardless of whether wild type or mutants were used, transient Rac1 accumulation was observed around bacteria. These results indicate that the phagocytosis of wild type L. pneumophila occurs via a special mechanism in which PI(3,4,5)P 3 production is absent. This suggests that L. pneumophila may inhibit the production of PI(3,4,5)P 3 , but not the recruitment of class I PI3-K and Rac1, in a T4SS-dependent manner. L. pneumophila may start the modulation of host signaling cascade immediately after contact with host cells to evade the ROS-dependent bactericidal system while completing entry into macrophages.

We performed surgical resection of synchronous multiple primary lung cancer, comprising adenocarcinoma and carcinoid components. The latter tumor was located within the central scar tissue formed by the adenocarcinoma (cancer-in-cancer). The patient was a 67-year-old Japanese woman who had a nodular lesion in the right S1 on chest computed tomography. Lung cancer was diagnosed intraoperatively by rapid needle aspiration cytology, and right upper lobectomy with mediastinal lymph node dissection was performed. Histological examination of the resected specimen revealed cancer-in-cancer, consisting of adenocarcinoma and a carcinoid tumor. The carcinoid component was localized within the central fibrous scar of the dominant adenocarcinoma component.

An early restoration of exercise capacity after lung resection is possible in patients without mediastinal lymph node dissection and in those who have a small thoracotomy wound.

The use of five preoperative parameters to select the pulmonary resection procedure minimized postoperative death and major complications.