Subject(s)
Adhesives/therapeutic use , Bronchial Fistula/therapy , Fistula/therapy , Pleural Diseases/therapy , Endoscopy , HumansABSTRACT
Sub-clinical lung impairment, mostly represented by a reduced diffusion of alveolar gases, is a recognised complication of advanced primary biliary cirrhosis. The aim of the study was to evaluate the prevalence and type of pulmonary involvement in primary biliary cirrhosis and the relationship between lung function abnormalities and selected epidemiological and clinical variables. Sixty-one patients with different stages of primary biliary cirrhosis consecutively seen in our outpatient clinic were evaluated. The advancement of primary biliary cirrhosis was characterised by the histological stage, the presence of signs of portal hypertension and the Mayo Risk Score: a Cox regression model using serum bilirubin and albumin levels, prothrombin time, age and degree of oedema as selected variables. We measured static and dynamic lung volumes, by means of a spirometer, and diffusing capacity for carbon monoxide. Rheumatological disorders were evaluated by an independent rheumatologist. No patient complained of respiratory symptoms. Airway obstruction was present in one patient. In 24 patients (39%) the alveolar diffusion capacity was reduced. We did not find any significant relationship between diffusing capacity and smoking habits, advancement of liver disease and concomitant Sjogren syndrome. Reduced diffusion capacity showed a significant correlation with the presence of complete or incomplete CREST syndrome (p < 0.01) and with the presence of circulating anti-centromere antibodies (p < 0.05). Alveolar diffusion capacity is frequently impaired in patients with primary biliary cirrhosis, usually in the absence of clinical manifestations. These alterations mostly affect patients with concomitant CREST syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Liver Cirrhosis, Biliary/physiopathology , Respiratory Mechanics , Adult , Aged , CREST Syndrome/complications , Female , Humans , Hypertension, Portal/complications , Liver Cirrhosis, Biliary/complications , Lung Volume Measurements , Male , Middle Aged , Prospective Studies , Respiratory Function Tests , Sjogren's Syndrome/complications , SmokingABSTRACT
Pulmonary function was studied in sixty patients with pleural effusion and seventy patients with fibrothorax. The patients with pleural effusion were divided into three groups according to the extent of the effusion. The patients were submitted to spirometry and arterial blood gas analysis. The effects of pleural effusion on pulmonary function is evaluated with regards to the size of effusion. Small-size pleural effusion little affects arterial oxygen tension. Pleural effusion and fibrothorax have a similar pattern of pulmonary function.
Subject(s)
Lung/physiopathology , Pleural Diseases/physiopathology , Pleural Effusion/physiopathology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pleural Diseases/etiology , Pleural Effusion/complications , Respiratory Function Tests , Tissue Adhesions/etiology , Tissue Adhesions/physiopathologyABSTRACT
To evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) as a marker for the diagnosis of lung cancer we determined serum levels of this peptide in 255 patients with lung cancer and in 74 patients with chronic obstructive lung disease. A reference population consisting of 151 healthy volunteers was also studied. TATI concentrations were measured by radioimmunoassay. As a cut-off point we used the 99th percentile of the TATI concentrations in a reference population, which was 32 micrograms/l. TATI does not appear to be a good tumor marker in lung cancer. Its sensitivity is poor in comparison with CEA and TPA. The correlation between TATI levels and stage of the disease and histological type was weak.
Subject(s)
Biomarkers, Tumor/blood , Lung Neoplasms/diagnosis , Trypsin Inhibitor, Kazal Pancreatic/blood , Humans , Lung Neoplasms/blood , Lung Neoplasms/pathology , Neoplasm Staging , Reference ValuesABSTRACT
The effects of lung surgery on respiratory function were investigated in 80 patients; 17 patients were submitted to left pneumonectomy (LPN); 11 patients were submitted to right pneumonectomy (RPN); 7 patients underwent a left upper lobectomy (LUL); 16 patients a left lower lobectomy (LLL); 17 patients were submitted to right upper lobectomy (RUL); 12 patients underwent right lower lobectomy (RLL). All patients were submitted to spirometry and arterial blood gas analysis. The effects of lung surgery on respiratory function depends upon the extent of the resected tissue.
Subject(s)
Lung/physiopathology , Pneumonectomy , Adult , Aged , Female , Humans , Male , Middle AgedSubject(s)
Carcinoembryonic Antigen/blood , Carcinoma, Small Cell/blood , Lung Neoplasms/blood , Phosphopyruvate Hydratase/blood , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The Authors discuss the utility of alpha-fetoprotein (AFP) determination in mediastinal dysembryomas. AFP should be determined in all cases of mediastinal lesion. High levels of up to 500 ng/ml are a sure sign of germ cell tumors. An extremely high level (greater than 1,000 ng/ml) is an indication that the lesion is a mesoblastoma. An increase in the AFP level in the follow-up of patients affected by germ cell tumors is a sure sign of the recurrence of the disease.
Subject(s)
Mediastinal Neoplasms/diagnosis , Neoplasms, Germ Cell and Embryonal/diagnosis , Teratoma/diagnosis , alpha-Fetoproteins/analysis , HumansABSTRACT
Authors have studied AFP serum levels in 289 lung cancer. Only 2 cases (0.7%) showed little increase of this glycoprotein and liver pathologies were present in both patients, authors believe immunohistochemical study is necessary in lung cancers that show AFP increase.
Subject(s)
Biomarkers, Tumor/analysis , Lung Neoplasms/diagnosis , alpha-Fetoproteins/analysis , Humans , Lung Neoplasms/metabolismABSTRACT
Collagenovascular diseases, particularly rheumatoid arthritis, LES and scleroderma frequently involve the lung. A group of 15 patients with collagen vasculopathies was analysed with a view to identifying the most suitable invasive and noninvasive tests for the diagnosis of the interstitial fibrosis of the lung that often accompanies such disorders. Among the noninvasive tests only the respiratory function tests (especially DLCO) are adequately sensitive, while chest X-rays, gallium scintigraphy of the lung and ACE are relatively unreliable. Bronchoalveolar lavage is often altered (though the intensity varies considerably) and transbronchial biopsy appears to be the ideal diagnostic examination.
Subject(s)
Arthritis, Rheumatoid/complications , Lupus Erythematosus, Systemic/complications , Pulmonary Fibrosis/diagnosis , Scleroderma, Systemic/complications , Aged , Biopsy , Bronchoalveolar Lavage Fluid/analysis , Female , Gallium Radioisotopes , Humans , Male , Middle Aged , Pulmonary Fibrosis/etiology , Respiratory Function TestsABSTRACT
The difficulty involved in the diagnosis of primary pleural neoplasms (mesotheliomas) in described. Personal experience with assays of certain chemicals is the pleural fluid is reported with evidence of the value of pH, glucose and CEA as indications of malignity.
Subject(s)
Mesothelioma/diagnosis , Pleural Effusion/metabolism , Pleural Neoplasms/diagnosis , Carcinoembryonic Antigen/analysis , Diagnosis, Differential , Glucose/analysis , Humans , Hydrogen-Ion Concentration , L-Lactate Dehydrogenase/analysisABSTRACT
The value of CEA and Ca 19-9 assays in the diagnosis and staging of lung cancer is examined. The particular sensitivity of CEA especially in extensive or metastasised tumours is demonstrated. The minimal sensitivity of Ca 19-9 is pointed out but also its absolute specificity in high risk control groups (smokers and BPCO). It is therefore concluded that Ca 19-9 might be used together with CEA in the diagnosis and staging of lung cancer.
Subject(s)
Antigens, Neoplasm/analysis , Carcinoembryonic Antigen/analysis , Lung Neoplasms/blood , Antigens, Tumor-Associated, Carbohydrate , Humans , Lung Diseases, Obstructive/blood , Lung Neoplasms/pathology , Neoplasm StagingABSTRACT
The acute effects of the intravenous administration of 10 mg verapamil on pulmonary function changes induced by rapid saline infusion were studied in six normal subjects. Rapid intravenous fluid overloading caused on increase of closing volume (from 6.55 +/- 1.74 to 9.53 +/- 1.77%, p less than 0.05). After verapamil, the closing volume did not increase after infusion in three subjects and the mean increase was not significant (7.08 +/- 1.82 to 8.43 +/- 1.86%). These results suggest that the rapid administration of intravenous verapamil blunts respiratory function abnormalities caused by overhydration interstitial lung oedema.