Scleroderma, also known as progressive systemic sclerosis (SSc), is a multisystem autoimmune disorder characterized by inflammation and fibrosis involving the skin as well as internal organs such as the vasculature, esophagus, and the respiratory tract. Pulmonary involvement consists most often of interstitial fibrosis and pulmonary vascular disease leading to pulmonary ...

STUDY OBJECTIVES: There are no studies focused on skeletal status in patients with diffuse parenchymal lung disease (DPLD). We hypothesized that patients with DPLD referred for lung transplantation would have a high prevalence of osteoporosis related to corticosteroid use or reduced pulmonary function and exercise capacity. DESIGN: Retrospective cohort study. ...

OBJECTIVE: To clarify the prevalence and clinical characteristics of obesity-hypoventilation syndrome (OHS) in a large number of patients with moderate to severe obstructive sleep apnea syndrome (OSAS). METHODS: Subjects comprised 611 patients with OSAS registered from 7 sleep centers and clinics and analyzed according to the definitions of the Respiratory ...

To determine clinical and routine laboratory factors associated with pulmonary edema secondary to scorpion envenomation. Retrospective study covering 13 years (1990-2002) in the medical Intensive Care Unit of a university hospital (Sfax-Tunisia). 428 patients older than 3 years who were admitted to the intensive care unit for scorpion envenomation were ...

A 25-year-old male who had no significant medical history presented abrupt onset of high-grade fever and chills without noticeable trigger. The patient sought for medical attention for subsequently developed dyspnea and chest pain. Radiological examinations revealed bilateral lung peripheral multiple opacities, some of which were cavitating, suggesting of septic pulmonary ...

Although acute exacerbations of idiopathic pulmonary fibrosis are well recognised, there are no studies documenting their prevalence or identifying pre-existing risk factors. This study analysed the clinical, radiological and pathological data of 11 patients who satisfied the criteria for acute exacerbation among 147 patients with biopsy-proven idiopathic pulmonary fibrosis. There ...

Patients with beta-thalassemia often present with a restrictive pattern at pulmonary function tests (PFTs) due to several pathogenetic factors. However, the long-term evolution is unknown. We performed a longitudinal study of pulmonary function in asymptomatic, non-smoking patients with beta-thalassemia major and intermedia. We looked for temporal changes in lung function ...

A retrospective study was carried out to evaluate the clinical course and outcome of disseminated strongyloidiasis treated in a regional hospital in Hong Kong over a 10-year period. Seven cases were identified, and the case history of each patient was analysed. The most common presenting symptom was fever (100%). Five ...

OBJECTIVE: To determine whether pulmonary arterial hypertension (PAH) is a prognostic factor for mortality in diffuse cutaneous systemic sclerosis (dcSSc), independent of interstitial lung disease (ILD). METHODS: ILD was diagnosed by high-resolution computed tomography and PAH (pulmonary arterial systolic pressure [PASP] > or =45 mm Hg) by echocardiography. All patients ...

Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which may result from a wide variety of disorders. In this study, we aimed to determine the main causes of hemoptysis in a reference hospital for chest diseases. All the patients who admitted to our emergency clinic with ...

BACKGROUND: Magnetic microparticles being ingested by alveolar macrophages can be used as a monitor for intracellular phagosome motions and cytoskeletal mechanical properties. These studies can be performed in the human lung after voluntary inhalation. The influence of cigarette smoking and lung diseases on cytoskeleton dependent functions was studied. METHODS: Spherical ...

BACKGROUND: Clearance of inhaled technetium-labeled diethylenetriamine pentaacetate (99mTc-DTPA) is a marker of epithelial damage and an index of lung epithelial permeability. The aim of this study was to investigate the role of 99mTc-DTPA scan in patients with Idiopathic Pulmonary Fibrosis (IPF). Our hypothesis is that the rate of pulmonary 99mTc-DTPA ...

INTRODUCTION: Diffuse alveolar hemorrhage (DAH) is a serious pulmonary complication seen in patients with autoimmune disorders and patients treated with chemotherapy or after hematopoietic stem cell transplantation. The clinical management of DAH is complex and the condition has a high mortality rate. Tissue factor is expressed in the lung alveoli ...

OBJECTIVE: Coronary and chronic lung diseases have become a common association. This comorbidity has been generically considered by most of the operative risk scores, but its functional severity has seldom been addressed by these models. Our objective was to analyze its prognostic relevance considering preoperative pulmonary function parameters. METHODS: All ...

BACKGROUND: Extrapulmonary tuberculosis is an uncommon disease in the U.S., even in immunosuppressed cancer patients. This study evaluated characteristics and frequency of extrapulmonary tuberculosis in patients at a tertiary care referral cancer center. METHODS: The records of all consecutive patients with Mycobacterium tuberculosis diagnosed during January 2001 through April 2005 ...

HYPOTHESIS: We hypothesized that surgical treatment would improve respiratory muscle strength in symptomatic hyperparathyroidism (HPT). DESIGN: Prospective clinical trial. SETTING: A tertiary referral center. PATIENTS: Fifteen consecutive patients with symptomatic HPT and 10 with euthyroid multinodular goiter (control group) without a history of obstructive or restrictive lung disease. INTERVENTIONS: Forced ...

OBJECTIVE: The purpose of this study was to evaluate the effect of lobectomy on pulmonary function in patients with chronic obstructive pulmonary disease. METHODS: One hundred thirty-seven patients were analyzed; 49 had normal pulmonary function tests, and 88 had chronic obstructive pulmonary disease. Different functional parameter groups were identified: obstructive ...

BACKGROUND: To describe the use of pumpless extracorporeal interventional lung assist (iLA) for transportation of patients with severe life-threatening acute lung failure from tertiary hospitals to a specialized centre. METHODS: Retrospective analysis in eight patients with severe lung failure requiring interhospital transport, in whom implementation of an iLA system at ...

OBJECTIVES: Dyspnea is a major symptom of both parenchymal lung disease and chronic heart failure. Underlying cardiac dysfunction can be assessed by measurement of cardiac-derived B-type natriuretic peptide or its precursor in plasma. However, no specific endocrine marker of the lung parenchyma has so far been identified. We therefore examined ...

OBJECTIVE: The objective of this study was to evaluate the prevalence of acute bronchodilator responses in patients who were evaluated for pulmonary lymphangioleiomyomatosis. METHODOLOGY: This study was a retrospective review of the medical records of 50 patients, who were assessed for lymphangioleiomyomatosis from 1978 to 2002 at Mayo Clinic in ...

OBJECTIVE: The aim of this study was to assess the incidence and factors associated with pulmonary complications of leptospirosis. METHODOLOGY: In a retrospective study, patients with a definite diagnosis of leptospirosis following a 6-week period of severe flooding in Hadyai city, Thailand, were reviewed. Pulmonary complications of leptospirosis were defined ...

BACKGROUND: Oxidative stress plays a role in the pathogenesis and progression of interstitial lung disease (ILD). Exhaled ethane is a product of lipid peroxidation that has been proposed as a biomarker of oxidative stress in vivo. OBJECTIVES: To determine whether the exhaled ethane level is elevated in patients with ILD ...

STUDY OBJECTIVES: To determine the impact on survival and clinical correlates of pulmonary hypertension (PH) occurring in patients with idiopathic pulmonary fibrosis (IPF). DESIGN: Retrospective study. SETTING: Tertiary care, referral medical center. PATIENTS: Among 487 consecutive patients with IPF, we identified 136 patients who underwent transthoracic echocardiography within 3 months ...

PURPOSE: The purpose of our study was to describe the pulmonary parenchymal changes of Behçet's disease using high-resolution computed tomography and to correlate them with pulmonary function tests. MATERIALS AND METHODS: Thirty-four patients with Behçet's disease (18 men, 16 women), 3 of whom were symptomatic, were included as the study ...

BACKGROUND: Fiber-optic flexible bronchoscopy (FFB) is a frequently performed procedure for the diagnosis and treatment of pulmonary disorders. However, hypoxemia occasionally occurs during FFB. OBJECTIVES: We attempted to examine the causes of arterial oxygen desaturation during FFB. METHODS: We studied 336 patients who underwent FFB without intervention between June 1, ...

STUDY OBJECTIVE: To describe the pulmonary findings at autopsy of blood and bone marrow transplant (BMT) recipients. DESIGN: Retrospective. SETTING: An academic medical center. PATIENTS: Seventy-one deceased adult BMT recipients. INTERVENTIONS: None. MEASUREMENTS: Antemortem and postmortem pulmonary findings. RESULTS: The transplants were allogeneic in 39 patients (55%), with a peripheral ...

OBJECTIVES: To determine whether cyclophosphamide is beneficial for patients with scleroderma lung disease (SLD). METHODS: The effect of 6 months' treatment with intravenous cyclophosphamide on the functional capacity of patients, lung function tests, high resolution computed tomography of the lungs, and cytology of bronchoalveolar lavage was evaluated in 21 patients ...

STUDY OBJECTIVE: Paragonimiasis is a typical food-borne parasitic disease that is common in Southeast Asia, the Far East, Latin American, and Africa. Recently, however, this disease has been seen in many parts of the world, largely due to increases in the numbers of immigrants and overseas travelers. The purpose of ...

BACKGROUND: Pulmonary alveolar microlithiasis (PAM) is a rare, chronic lung disease with unknown etiology and with a nonuniform clinical course. Nonuniformity of clinical course might be related to the degree of pulmonary parenchymal alterations, which can be revealed with high resolution computed tomography (HRCT). However, HRCT findings of PAM were ...

BACKGROUND: The role of bronchoalveolar lavage fluid (BALF) cell profiles in predicting the clinical outcome of idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP) is still under discussion. OBJECTIVE: To determine whether BALF cell profiles affect the survival of patients with UIP diagnosed by surgical lung biopsy/autopsy at the early stage ...

From 1983 to 2001, 7 patients with pulmonary alveolar proteinosis were admitted to the King Chulalongkorn Memorial Hospital. Presenting symptoms varied from asymptomatic (1 patient), progressive dyspnea on exertion (4 patients) to respiratory failure (2 patients). Other symptoms included dry cough and weight loss. Gradual onset of dyspnea could be ...

Recently, an increasing number of patients were presented to our clinics with febrile and respiratory symptoms associated with exposure to a new type of domestic ultrasonic humidifier. We report on 11 patients who developed recurrent episodes of fever, cough and dyspnea after repeated exposure to ultrasonic misting fountains at home. ...

OBJECTIVE: To assess the efficacy of tacrolimus in patients with anti-aminoacyl-transfer RNA synthetase (anti-aaRS)-associated interstitial lung disease (ILD) and idiopathic inflammatory myopathy (IIM). METHODS: Ninety-eight patients with anti-aaRS autoantibodies were identified in our IIM cohort of 536 patients. The medical records of 15 patients with anti-aaRS-associated ILD treated with tacrolimus ...

BACKGROUND: Chronic bird fancier's lung (BFL) has often been misdiagnosed as one of the idiopathic interstitial pneumonias (IIPs). METHODS: To define the clinical and pathological characteristics of chronic BFL, 26 patients with chronic BFL from whom a surgical lung biopsy specimen was taken between October 1992 and June 2001 were ...

Community-acquired viral respiratory tract infections (RTI) in lung transplant recipients may have a high rate of progression to pneumonia and can be a trigger for immunologically mediated detrimental effects on lung function. A cohort of 100 patients was enrolled from 2001 to 2003 in which 50 patients had clinically diagnosed ...

Niemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which is characterized by intracellular deposition of sphingomyelin in various body tissues. The disease is heterogeneous and classified into six groups. Pulmonary parenchymal involvement may be a feature of several subtypes of NPD, including type B. Progressive pulmonary involvement ...

OBJECTIVES: One-lung ventilation (OLV) during thoracoscopic surgery is associated with a significant decline in arterial PO(2) in patients with severe pulmonary emphysema and patients with preserved lung function. The authors hypothesized that patterns of arterial PO(2) changes are different in these 2 patient groups. DESIGN: Prospective nonrandomized study. SETTING: University ...

We sought to determine the clinical course and histologic findings in lung biopsies from a group of children who presented with signs and symptoms of interstitial lung disease (ILD) without identified etiology. Patients were identified from the pathology files at the Texas Children's Hospital who presented below age 2 years ...

OBJECTIVE: To provide a comprehensive update of the clinical picture of lymphangioleiomyomatosis (LAM) using two large patient registries. METHODS: A cross sectional questionnaire survey which included questions on 14 LAM symptoms, pneumothorax, tuberous sclerosis complex (TSC), date of diagnosis, and pulmonary function tests (PFTs). RESULTS: The response rate was 70.5% ...

A prospective study of 70 patients with life-threatening hemoptysis who had bronchial and systemic artery embolization with tris-acryl linked microspheres was performed over 15 months. The procedure was technically successful in 90% of patients and at 24 hr after the procedure (87%). Recurrent hemoptysis occurred in 13% of patients within ...

BACKGROUND: Septic pulmonary embolism (SPE) is an uncommon disorder with an insidious onset and is difficult to diagnose. STUDY OBJECTIVES: To characterize the presenting features and clinical course of patients with SPE. DESIGN: Retrospective study. SETTING: Tertiary care, referral medical center. PATIENTS: Fourteen subjects with SPE diagnosed during a 6-year ...

We studied whether the serotypes of Mycobacterium avium-Mycobacterium intracellulare complex (MAC) isolates determine the prognosis for pulmonary MAC disease. We prospectively monitored a cohort of 68 patients with pulmonary MAC disease for whom the serotype-specific glycopeptidolipids in isolates were identified using thin-layer chromatography and fast atom bombardment mass-spectrometry in 1990 ...

PURPOSE: To assess the difficulty of assigning a definitive clinical diagnosis of radiation (RT)-induced lung injury in patients irradiated for lung cancer. METHODS: Between 1991 and 2003, 318 patients were enrolled in a prospective study to evaluate RT-induced lung injury. Only patients with lung cancer who had a longer than ...

Peribronchiolar metaplasia (PBM) is a histologic lesion consisting of peribronchiolar metaplasia (PBM) of bronchiolar-type epithelium. Although widely recognized, PBM has received little attention in the pathologic literature and is not known to have clinical significance. We identified 15 cases in which PBM was the only major histologic finding in surgical ...

OBJECTIVES: To evaluate ex vivo purified protein derivative (PPD) specific Th1- and Th2-type functional responses in human tuberculosis (TB). DESIGN: IFN-gamma and IL-5 secreting cells were measured by a computer-assisted ELISPOT assay in the peripheral blood of patients with pulmonary TB, in patients with other respiratory diseases (control patients) and ...

We retrospectively reviewed 34 consecutive patients with serologically confirmed leptospirosis admitted during years 1992-2002. Nine patients (26.5%) had respiratory symptoms on admission including cough (n = 4), shortness of breath (n = 4), cyanosis (n = 2), and hemoptysis (n = 1). Six patients had pulmonary radiographic findings including (1) ...

Inflammatory myofibroblastic tumor (IMT) is an uncommon cause of solitary or multifocal lung nodules and can also be rarely found in various other extrapulmonary sites. Although this pseudotumor is benign, it can be locally very aggressive. The pathogenesis of IMT remains unclear; autoimmune or infectious origins have been hypothesized, so ...

OBJECTIVE: To estimate the prevalence of elevated pulmonary arterial pressures (PAP) as a correlate for pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc) in rheumatology centers in Canada. METHODS: During the one-year study period (June 2002-May 2003), charts of patients with SSc were reviewed to determine demographics, SSc ...

Alveolar proteinosis is a rare pulmonary disease, characterised by the accumulation of a proteinaceous material in the alveoli, which severely reduces gas exchange and causes progressive disability of the patient, usually moderate, but sometimes completely disabling. Whole-lung lavage (WLL) is the preferred technique for the treatment of this disease, and ...

BACKGROUND: Prospective data defining the clinical course in idiopathic pulmonary fibrosis (IPF) are sparse. OBJECTIVE: To analyze the clinical course of patients with mild to moderate IPF. DESIGN: Analysis of data from the placebo group of a randomized, controlled trial evaluating interferon-gamma1b. SETTING: Academic and community medical centers. PATIENTS: 168 ...