BACKGROUND: It is a common practice to anesthetize patients before performing a thoracentesis. We postulated that this technique may cause a clinically significant difference in the pH of the pleural fluid. METHODS: We compared two methods of determining pleural fluid pH. Fifty patients undergoing diagnostic or therapeutic thoracentesis were enrolled. ...

BACKGROUND AND STUDY AIMS: Sarcoidosis is a chronic multisystem granulomatous disease that is often diagnosed after a finding of hilar and mediastinal lymphadenopathy on a chest radiograph. This often requires further evaluation by transbronchial biopsy or other clinical parameters. The present study is a descriptive, retrospective one using endoscopic ultrasound ...

OBJECTIVES: Sarcoidosis is characterized by a diffuse alveolar inflammatory process, although bronchial airways are often involved. This study compares the cellular profiles of induced sputum (IS), bronchial washing (BW), and BAL in newly diagnosed sarcoidosis patients to those in control subjects, and examines whether inflammatory cell counts from IS are ...

Charts and radiographs of sarcoidosis patients seen at a private university hospital and at a municipal hospital were reviewed to determine whether there was a difference in the severity of disease retrospectively. A standardized abstract form was used to identify and abstract information on new and continuing sarcoidosis patients seen ...

SETTING: Queen Elizabeth Central Hospital, Blantyre, and Zomba Central Hospital, Zomba, Malawi. OBJECTIVE: To evaluate treatment outcome of unsupervised ambulatory treatment (2R3H3Z3/2TH[EH]/4H) in Blantyre and 'standard' treatment (1STH[SEH]/11TH[EH]) in Zomba in human immunodeficiency virus (HIV) seropositive and seronegative patients with smear-negative pulmonary tuberculosis (PTB) and pleural TB. DESIGN: All patients ...

BACKGROUND: Alterations in Starling forces that favor pleural fluid formation include an elevation in capillary hydrostatic pressure and a fall in plasma oncotic pressure. Although venous hypertension is a well-recognized cause of pleural effusion, the frequency with which hypoalbuminemia in the absence of volume expansion leads to pleural effusion is ...

Pleural fluid analysis was performed in patients with idiopathic spontaneous pneumothorax. The objective of the study was to define the cell differentiation, and part of the cytokine profile, in relation to the duration of pneumothorax. In the 23 consecutive patients (19 men, mean age 34.2 years, 17 smokers), pleural fluid ...

Angiotensin-converting enzyme (ACE) genotypes may reflect prognosis in sarcoidosis. They were determined in 59 Finnish sarcoidosis patients and 70 healthy control subjects. The prognosis of the sarcoidosis patients was determined after follow-up for 1, 2, 3, 5 and >5 yrs and classified as good (normal chest radiograph and lung function, ...

The authors used chest computed tomography to determine the distribution of pulmonary lymphadenopathy in 40 patients with sarcoidosis. Using the American Thoracic Society lymph node map, the number and distribution of significant lymph nodes was calculated. Overall, lymphadenopathy was identified in 39 of the 40 patients. Mediastinal adenopathy was present ...

The pathophysiological explanation for fatigue, one of the most common symptoms in sarcoidosis, still has to be elucidated. It was hypothesized that the presence of fatigue is associated with an acute phase response in sarcoidosis. A cross-sectional study was performed in 38 sarcoidosis patients. Resting energy expenditure (REE) was measured ...

Out of 134, 12 sarcoidosis patients with symptoms of mucosal dryness as the first clinical manifestation were identified and compared with 30 consecutive unselected Sjögren's syndrome (SS) patients. Sicca manifestations were similar among the two groups, while parotid gland enlargement (PGE) was more frequently found in sarcoidosis patients (P < ...

BACKGROUND: The idea to enter the normal pericardial sac safely was unrealistic until recently. The development of a novel instrument (PerDUCER pericardial access device) for percutaneous access to the pericardium could potentially have a significant impact, not only on patients with pericardial diseases but even more, or primarily, on diagnosis ...

AIM: To evaluate thyroid function and the presence of antithyroid autoantibodies in patients with sarcoidosis, compared to patients with chronic obstructive pulmonary disease (controls). METHODS: Sera were obtained from 26 patients (19 women and 7 men) with active sarcoidosis, age and sex matched to 26 patients with diagnosed chronic obstructive ...

We reviewed the radiographic imaging of Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome to determine the findings of chest radiography, computed tomography, and gallium scintigraphy and to analyze the time course of the resolution of abnormalities on chest radiographs after the initiation of therapy. The patients were one ...

OBJECTIVES: To determine the age at which tuberculous pleural effusions occur, the radiological and biochemical characteristics of the effusions, the sensitivities of the various diagnostic tests, and the utility of combining clinical, radiological, and analytic data in diagnosis. METHODS: We studied the case histories of 254 patients in whom tuberculous ...

The authors studied radiographs and clinical histories of 29 patients with acquired immunodeficiency syndrome, symptoms of pulmonary infection, and simultaneous microbiologic evidence of Mycobacterium xenopi in the respiratory tract. The presence, nature, and distribution of radiographic abnormalities were determined and analyzed in accord with clinical information. In 26 (90%) patients, ...

SETTING: University Hospital, Kuala Lumpur, Malaysia. OBJECTIVE: To determine the incidence of hypercalcaemia in Malaysian patients with newly diagnosed tuberculosis (TB) before the commencement of antituberculosis treatment. DESIGN: A prospective study of consecutive patients with newly diagnosed bacteriologically and/or histologically proven tuberculosis in our institution from September 1994 to March ...

Granulomatous diseases can be visualized in vivo after the injection of indium-111-DTPA-octreotide (111In-pentetreotide), a radiolabelled somatostatin analogue. We evaluated whether somatostatin receptor imaging reflects disease activity, whether certain scintigraphic characteristics can predict the disease prognosis and whether repeat scintigraphy correlates with the clinical course in patients with sarcoidosis. 111In-pentetreotide was ...

The clinical manifestations of sarcoidosis are extremely heterogeneous and overlap with a wide gamut of infectious and noninfectious granulomatous disorders. Prognosis of sarcoidosis is highly variable. Spontaneous remissions occur in nearly two thirds of patients, but chronic, progressive disease may result in severe sequelae. Fatalities occur in 1% to 4% ...

BACKGROUND AND AIM OF WORK: Clinical appearance of sarcoidosis depends on the methods of case finding and geographical factors. In a further effort to clarify clinical characteristics of pulmonary sarcoidosis, we examined a larger population of consecutive pulmonary sarcoidosis cases throughout former West Germany and Switzerland. METHODS: In a prospective ...

STUDY OBJECTIVES: The aim of this study was to determine the role of complement components in pleural effusion measured with novel markers of complement activation, to assess which pathway of activation is predominant in different diseases, and to find out whether the analysis of complement components and their activation products ...

Five patients are reported who have pleural effusion and pyogenic vertebral osteomyelitis. In four of the five patients, the presenting problem was a large pleural effusion, and three of these four patients had an exudative effusion. Initial evaluation and investigations in these patients were directed toward the pleuropulmonary disease, delaying ...

OBJECTIVE: This study aimed to describe the clinical presentation, angiographic findings, and natural history of acquired arterial macroaneurysms diagnosed in 8 of 48 patients with peripheral multifocal chorioretinitis (PMC) (panuveitis with multiple peripheral punched-out chorioretinal lesions). DESIGN: A retrospective case-control study. PARTICIPANTS: Forty-eight consecutive patients with PMC, consisting of 13 ...

We evaluated the clinical and myopathological features of all patients with granulomas in muscle biopsy specimens identified over a 5-year period (1992-1996) at the Washington University Medical Center. Ten patients were found to have granulomas in their muscle biopsy specimens. Of these, eight patients had myopathic changes. Seven had dysphagia ...

BACKGROUND: Case reports and small case series have described patients with sarcoidosis and testicular carcinoma. The goals of this study were to determine the incidence of sarcoidosis in patients with testicular carcinoma seen at the Mayo Clinic between 1950 and 1996 and to examine the relation between these two diseases, ...

This investigation studied the general conditions and prognostic factors of pulmonary epithelioid haemangioendothelioma (PEH), which is a rare disease. Twenty-one patients were collected throughout Asia by a questionnaire. Age at the detection or onset of symptoms of PEH was 14-64 yrs (mean 44 yrs). Males were more likely to be ...

OBJECTIVES: To ascertain the frequency and to describe the clinical and biochemical features of cirrhotic chylothorax. DESIGN: A descriptive clinical study. SETTING: A community teaching hospital. PATIENTS AND METHODS: Since November 1989 to October 1995, 809 patients with pleural effusions were studied by thoracentesis. Pleural effusions with a concentration of ...

SETTING: A community teaching hospital in Alicante, Spain. OBJECTIVE: To assess the characteristics of tuberculous pleurisy (TP) in our hospital, and to evaluate the differences between primary and reactivation forms. DESIGN: Between January 1984 and December 1993, all human immunodeficiency virus (HIV)-negative patients with TP were included in the study. ...

OBJECTIVE: The purpose of this study was to document in a historical cohort the incidence and clinical observations of pneumothorax ex vacuo after therapeutic thoracentesis for malignant pleural effusions in patients with underlying parenchymal lung disease. MATERIALS AND METHODS: Forty pneumothoraces resulted from 512 therapeutic thoracentesis performed for malignant pleural ...

Thoracentesis with a chest tube insertion and drainage of large pleural effusion is widely performed in patients with malignant lung diseases. One potential problem with a conventional chest tube placement is occasional incomplete evacuation of effusion owing to inappropriate position of the tip where the drainage holes opened. We have ...

MCP-1 and MIP-1alpha exhibit chemotactic activity toward macrophages/monocytes and induce the production of inflammatory cytokines affecting granuloma formation. Up-regulated expression of MCP-1 and MIP-1alpha in the affected organ of sarcoidosis has been shown; however, the relationship between their plasma levels and the clinical course of this disease has not been ...

BACKGROUND: Infectious mediastinitis after cardiac operations is of great concern to cardiac surgeons because of its poor prognosis. Prompt surgical interventions such as debridement and irrigation are the key to treatment of infectious mediastinitis. METHODS: We surveyed retrospectively the cases of 722 consecutive cardiac surgery patients at our hospital. Mediastinitis ...

RATIONALE AND OBJECTIVES: The authors determine the usefulness of electron microscopy (EM) in the workup of patients with certain intrathoracic masses undergoing transthoracic needle biopsy (TNB). METHODS: Over a 4-year period, 1603 patients underwent TNB at our institution. Of these, 79 had EM examination of the aspirated material. The study ...

Pulmonary complications after orthotopic liver transplant (OLT) are frequent, involving high morbidity and mortality. We have determined the pulmonary complication incidence in 187 patients submitted to OLT at the General University Hospital "Gregorio Marañón" in the last 4 years, analyzing the type of infection, evolution, diagnostic and therapeutic measures and ...

BACKGROUND: Malignant pleural effusions are classically exudative, though occasionally they can be transudative. We attempted to determine the prevalence of transudative malignant pleural effusions and to describe their clinical and radiographic characteristics. METHODS: We studied the medical records of 215 patients with malignant pleural effusion, which contained complete data on ...

Video-assisted thoracoscopy (VAT) is usually performed under general anesthesia (GA). We performed an analysis to determine whether multithoracoport VAT under local anesthesia (LA) is feasible.Methods: Forty-five VAT under LA were performed in 34 men and 11 women (mean age 46.8 years) in the endoscopy room.Results: The waiting time for VAT ...

Tenascin is an extracellular matrix glycoprotein increased immunohistochemically in tumorous and fibrotic lung tissues as demonstrated by immunohistochemistry. We hypothesized that in bronchoalveolar lavage (BAL) fluid also the tenascin concentration would be elevated in patients with various fibrotic lung disorders. The aim of our study was to investigate whether BAL ...

We examined correlations between findings on chest high resolution computed tomography (HRCT), pulmonary function and values of serum angiotensin converting enzyme (ACE) in 25 patients with sarcoidosis. The most frequent CT features were small nodular opacities. The small nodules, representing the confluence of epithelioid granulomas, are strongly correlated with peribronchovascular, ...

Bromocriptine, which is used in the treatment of Parkinson's disease, can cause adverse pleuropulmonary reactions. Exposure to asbestos can result in similar lesions. Fifteen patients with former exposure to asbestos, who developed pleural fibrosis after treatment with bromocriptine, were observed independently in Sweden (11 patients) and Australia (four patients). The ...

Neurosarcoidosis affects 3% to 5% of patients with sarcoidosis. It involves primarily the central nervous system and/or the peripheral nervous system. The treatment of a patient with neurosarcoidosis is difficult, and functional improvement following intensive rehabilitation has not been described. We report a middle-aged man who presented initially with ophthalmologic ...

Transbronchial lung biopsy (TBLB), transbronchial needle aspiration (TBNA) of mediastinal lymph nodes and bronchoalveolar lavage (BAL) are routinely performed at fibreoptic bronchoscopy. Up to the present time, no data have been available on the efficacy of performing all three of these procedures simultaneously in the bronchoscopic work-up of sarcoidosis. A ...

Although fluid analysis usually is the first step toward identifying the cause of pleural effusion in patients with cirrhosis and ascites, there are no available data on the reliability of this approach, therefore, we retrospectively evaluated hematologic and biochemical parameters from pleural fluid analysis in 21 patients with hepatic hydrothorax ...

STUDY OBJECTIVE: Identification of predictive factors for the development of residual pleural thickening (RPT). DESIGN: Retrospective study. LOCATION: A 1,500-bed tertiary hospital. PATIENTS: Patients with pleural tuberculosis diagnosed between December 1991 and February 1995 in our Respiratory Disease Service. INTERVENTIONS: The clinical and radiologic characteristics, and measurements of microbiological and ...

In a retrospective study Adenosine deaminase (ADA), was assayed in 86 serum samples and 12 pleural fluid samples of patients with pulmonary tuberculosis. Serum and pleural fluid ADA levels were also examined in a group of 38 non-tuberculous patients with pleural effusion. Highly significant increases in both serum and pleural ...

Sarcoidosis or granulomatous reactions have rarely been reported in association with malignant melanoma (MM). We describe seven patients who presented with both granulomatous disease and MM, and discuss the physiopathological and prognostic significance of this association. In three patients, the granulomatosis was diagnosed as true sarcoidosis and in one patient, ...

Although most patients with sarcoidosis have a good prognosis, a significant proportion runs a more severe and prolonged disease course. There is no marker to distinguish these subpopulations of patients, however. To investigate the relationship between HLA haplotype and clinical course, 122 Scandinavian patients with sarcoidosis were genomically typed for ...

BACKGROUND: Neurological involvement is a significant cause of morbidity and mortality in patients with sarcoidosis. Detection and management of neurosarcoidosis remains problematic. Our interest in immunosuppressive agents for chronic sarcoidosis has given us experience with various agents for the treatment of sarcoidosis, including cyclophosphamide and methotrexate. METHODS: We analyzed all ...

BACKGROUND AND AIM OF WORK: Although sarcoidosis is a multisystem disease, mortality from sarcoidosis is usually due to respiratory failure. In order to identify those patients at risk of death from respiratory failure from sarcoidosis, we analyzed a seven-year experience of patients seen at the University of Cincinnati Interstitial Lung ...

Ultrasonographic features of seven patients with diaphragmatic rupture due to blunt trauma were analyzed. The ruptures occurred at the left hemidiaphragm in four patients and at the right in three. Direct ultrasonographic findings were as follows: disrupted diaphragm in four patients; nonvisualized diaphragm in three patients; floating diaphragm in two ...

BACKGROUND: Chest pain (CP), its cause unknown, is a common and often prominent symptom of sarcoidosis. METHODS: We determined the frequency and character of CP in patients with pulmonary sarcoidosis and examined its relationship with (1) length of time since diagnosis, (2) roentgenograhic stage, and (3) radiographic abnormalities on spiral ...