ABSTRACT
We report the case of a 58-year-old woman who suffered from progressive respiratory distress syndrome. Strongyloides stercoralis was disclosed in tracheal aspirations. A high serum level of antibodies directed to Aspergillus fumigatus was also found. Diagnosis, prevalence, microbiology, clinical consequences and treatment of strongyloidiasis are discussed. We also revisit to the diagnose criteria of allergic bronchopulmonary aspergillosis and his differential diagnosis. The puzzling aspect of this case was the association of two different diseases and the concern about the prevalence of strongyloidiasis in our regions.
Subject(s)
Aspergillosis, Allergic Bronchopulmonary/diagnosis , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , Animals , Aspergillosis, Allergic Bronchopulmonary/complications , Aspergillosis, Allergic Bronchopulmonary/microbiology , Aspergillus fumigatus/isolation & purification , Diagnosis, Differential , Female , Humans , Middle Aged , Strongyloidiasis/epidemiology , Strongyloidiasis/microbiologyABSTRACT
Catamenial pneumothorax is an unusual and rarely recognized entity that belongs to the thoracic endometriosis syndrome. The increase a number of published cases over the last years allows a more frequent diagnosis and understanding. We describe the story of a young woman with a recurrent right sided pneumothorax and discuss the different pathogenic mechanisms and current therapies. The rarity of the disease makes a prospective study very difficult. To this day, there is no consensus on a standardized therapeutic attitude.
Subject(s)
Endometriosis/complications , Pneumothorax/etiology , Thoracic Diseases/complications , Adult , Female , HumansABSTRACT
Idiopathic pulmonary fibrosis and pulmonary fibrosis associated with systemic diseases are the most frequent diffuse interstitial pulmonary diseases. They slowly but irrevocably progress towards terminal respiratory failure. They can also be complicated by severe acute respiratory failure and admission in the intensive care unit can be discussed. Despite invasive mechanical ventilation, anti-infectious and immunosuppressive treatments, the disease carries a high mortality rate. We report and discuss the case of a patient with idiopathic, pulmonary fibrosis (UIP) who underwent rapid clinical deterioration.
Subject(s)
Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/etiology , Humans , Male , Middle Aged , Pulmonary Fibrosis/complicationsABSTRACT
The expression of members of the IGF system in a mesothelioma from a patient suffering from hypoglycemia, in term placenta and HT29 colon adenocarcinoma cells were compared. Very high levels of IGF-II mRNA and protein were detected in the mesothelioma. Moreover, half of the IGF-II protein took the high-molecular-weight form. We also analyzed the parental imprinting status and the promoter usage of the IGF-II gene. Our results showed loss of imprinting (LOI) in the mesothelioma while the imprinting was maintained in HT29 cells, expressing moderate levels of the transcript. Promoter P4 was active in the three tissues we analyzed, whereas IGF-II mRNA transcription from promoter P3 was only detected in the mesothelioma and the placenta, expressing comparably high levels of the transcript. IGF-II gene structure was identical in the analyzed tissues and cells. The type-I receptor mRNA expression was very low in the tumor. IGFBP-2, -4 and -5 mRNAs were detected in the mesothelioma, while IGFBP-2, -3 and -5 transcripts were detected in the placenta. IGFBP-1 and -6 transcripts were not detected.
Subject(s)
Insulin-Like Growth Factor II/genetics , Mesothelioma/metabolism , Pleural Neoplasms/metabolism , Somatomedins/metabolism , Aged , Aged, 80 and over , Alleles , Blotting, Northern , Female , Gene Expression/genetics , Genomic Imprinting , HT29 Cells , Humans , Insulin-Like Growth Factor Binding Protein 1/genetics , Insulin-Like Growth Factor Binding Protein 2/genetics , Insulin-Like Growth Factor Binding Protein 3/genetics , Insulin-Like Growth Factor Binding Protein 4/genetics , Insulin-Like Growth Factor Binding Protein 5/genetics , Insulin-Like Growth Factor Binding Protein 6/genetics , Male , Mesothelioma/chemistry , Placenta/chemistry , Placenta/metabolism , Pleural Neoplasms/chemistry , Polymerase Chain Reaction , Promoter Regions, Genetic/genetics , RNA, Messenger/analysis , RNA, Messenger/genetics , RNA, Ribosomal, 18S/analysis , RNA, Ribosomal, 18S/genetics , Radioimmunoassay , Receptor, IGF Type 1/analysis , Receptor, IGF Type 1/genetics , Transcription, Genetic/geneticsABSTRACT
We describe three patients with unilateral facial pain due to non-metastatic lung cancer and review 11 published cases. Pain, most frequently located on the right side and around the ear, as well as digital clubbing can be clues to an early diagnosis. Compression of the vagus nerve by the tumour or by mediastinal adenopathy is most likely responsible for the facial pain and could play a role in pulmonary osteoarthropathy.
Subject(s)
Facial Pain/physiopathology , Lung Neoplasms/diagnosis , Adult , Female , Functional Laterality , Humans , Lung Neoplasms/physiopathology , Male , Middle AgedABSTRACT
Two women, aged 44 and 29 years, respectively, were admitted to the hospital in early 1987 for recurrent pneumothorax, dyspnea and a diffuse reticulonodular pattern evidenced on the chest x-ray film. Lung biopsy confirmed LAM in both patients. Both were treated sequentially with medroxyprogesterone and a LHRH agonist (buserelin) to achieve reversible medical castration. Neither subjective nor objective improvement was noted after 13 and 5 months, respectively, of buserelin therapy (900 micrograms/day, nasal spray) despite an effective suppression of the pituitary-gonadal axis. Medroxyprogesterone also was ineffective. Buserelin thus failed to control pulmonary LAM in these two patients, in spite of effective medical castration.
Subject(s)
Buserelin/administration & dosage , Lung Neoplasms/drug therapy , Lymphangiomyoma/drug therapy , Ovary/drug effects , Adult , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Drug Evaluation , Female , Humans , Lung Neoplasms/complications , Lymphangiomyoma/complications , Medroxyprogesterone/administration & dosage , Medroxyprogesterone/analogs & derivatives , Medroxyprogesterone Acetate , Pneumothorax/etiology , Recurrence , Tamoxifen/administration & dosageSubject(s)
Buserelin/therapeutic use , Lung Neoplasms/drug therapy , Lymphangiomyoma/drug therapy , Adult , Antineoplastic Agents/therapeutic use , Female , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lymphangiomyoma/diagnostic imaging , Lymphangiomyoma/pathology , Medroxyprogesterone/analogs & derivatives , Medroxyprogesterone/therapeutic use , Medroxyprogesterone Acetate , Tomography, X-Ray ComputedABSTRACT
In 15 patients with asthma attack, evidence of the uneven distribution of air flow during controlled ventilation was obtained by detection of ventilatory asynchronism expressed by the incurvated profile of tracheal pressure waves associated with the repetitive interruptions of air flow. It was observed that low values of PEEP (mean: 5 +/- 2.5 cm H 2O) induced an increase in transbronchial pressure able to overcome ventilatory asynchronism. In these conditions, an appropriate ventilation-perfusion ratio was restored and improved gas exchanges as indicated by the mean increase of arterial PO 2 from 66.3 mmHg (+/- 2.57) to 96.89 mmHg (+/- 4.41) (p = 0.0005) associated with a mean decrease in arterial PCO 2 from 53.66 mmHg (+/- 2.71) to 42.07 mmHg (+/- 1.64) (p = 0.0005). Simultaneously hemoglobin oxygen saturation rose from 82.31% (+/- 1.97%) to 95.74% (+/- 0.5%). In our patients, such values of PEEP were not high enough to influence the pulmonary arterial circulation. The means of the pulmonary arterial pressures obtained before (syst.: 32.3; diast.: 15.1; mean: 22.00 mmHg) were quite the same (p greater than 0.2) as with PEEP (syst.: 32.00; diast.: 14.00; mean: 21.1 mmHg). The mean of the wedge pressure was found to be 8.3 (+/- 74 mmHg) prior to and 8.4 (+/- 0.68 mmHg) after PEEP (p greater than 0.3). Mean cardiac output rose slightly from 5.27 l/min (+/- 0.24) to 5.77 l/min (+/- 0.38) during PEEP (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)