ABSTRACT
Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a major public health issue, particularly in developing countries, and thus effective diagnostic methods for TB remain a central theme in basic and clinical research. To evaluate five antigens (38-kDa protein [38kDa], Rv3621c, Rv3618, 38kDa-ESAT-6 [38E6], and Ag85B-HBHA [AH]) in serological tests for TB patients, we recruited 288 patients and 201 healthy controls. The median IgG reactivity to 38kDa, 38E6, and AH was higher than that to Rv3618 and Rv3621c in pulmonary TB. 38kDa and 38E6 provided high sensitivities in pulmonary TB but low sensitivities in extrapulmonary TB (EPTB). The specificities achieved by 38kDa and 38E6 ranged from 82.0% to 93.9% in patients with non-TB respiratory disease (PD) and in controls. 38kDa and 38E6 exhibited lower sensitivities and higher specificities than their combinations with Rv3618. These findings provide useful information on the relative importance of the above five antigens and suggest that combinations of Rv3618 with 38kDa and 38E6 can increase their sensitivities, but their specificities need to be further increased.
Subject(s)
Antigens, Bacterial , Clinical Laboratory Techniques/methods , Mycobacterium tuberculosis/immunology , Tuberculosis/diagnosis , Antibodies, Bacterial/immunology , Humans , Immunoglobulin G/immunology , Sensitivity and Specificity , Serologic Tests/methodsABSTRACT
OBJECTIVE: To review the experience with the management of single lung transplantation for emphysema. METHODS: Between January 2003 and August 2006, single lung transplantation was performed in 6 patients for emphysema with cold low potassium solution flushing. A triple-drug regimen was adopted using steroids, mycophenolate mofetil and tacrolimus as the maintenance immunosuppressants. Chest radiograph score, oxygenation index, and pulmonary arterial pressure of the patients in early after the transplantation were reviewed. RESULTS: All the 6 patients survived for over 30 days after the operation, and 4 of them remained alive with good quality-of-life. Four patients recovered from acute rejection successfully after methylprednisolone pulse therapy for 3 days. One patient underwent reoperation for hemorrhage in the thoracic cavity and finally recovered; spontaneous pneumothorax of the autologous lungs occurred in two patients, who underwent reoperation but finally died 74 days and 77 days after the transplantation, respectively. CONCLUSION: Single lung transplantation is effective for end-stage emphysema. Carefully selected recipients and comprehensive design of the surgical procedures are critical to successful lung transplantation.
Subject(s)
Lung Transplantation/methods , Pulmonary Emphysema/surgery , Adult , Female , Humans , Middle Aged , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in lung cancer. METHODS: Fourty-two lung cancer patients were divided into two groups: the control group (22 cases) and experiment group (20 cases) who received activated carbon nanoparticles injection around the tumor either by endoscopic injection or intraoperative subserosal injection. The number of dissected lymph node, black-stained lymph node, positive lymph node and the side effect of the procedure were analyzed, respectively. RESULTS: No severe complication was observed in the experiment group. The operative time was not prolonged significantly in the experiment group either. However, the number of average lymph nodes dissected in the experiment group (25.5) was significantly more than that in the control group (14.6) (P <0.01). CONCLUSION: Local injection of activated carbon nanoparticles around the tumor during surgical exploration is effective, safe and easy to do for guiding lymphadenectomy in lung cancer patient.
Subject(s)
Charcoal , Lung Neoplasms/surgery , Lymph Node Excision/methods , Lymph Nodes/pathology , Adult , Aged , Female , Humans , Lung Neoplasms/pathology , Lymphatic Metastasis , Male , Middle Aged , Nanoparticles , PneumonectomyABSTRACT
OBJECTIVE: To report the management of the contralateral lungs in 4 cases with single allograft lung transplantation. METHODS: Four cases receiving lung transplantation were analyzed respectively. One presented with bilateral multiple lung cysts and three with chronic obstructive pulmonary disease (COPD) with bilateral bullae. In the case with bilateral multiple cysts, the contralateral lung remained untreated after operation. For the contralateral lungs in the three cases with COPD, one remained untreated, one received lung volume reduction surgery (LVRS) immediately after lung transplantation, and one received LVRS 47 days after lung transplantation. RESULTS: Three patients recovered after operation, and 2 of them survived more than 18 months. One patient with delayed contralateral LVRS died 74 days after lung transplantation. CONCLUSIONS: For advanced stage COPD with bilateral bullae, contralateral LVRS may be performed immediately after single lung transplantation. In patient with bilateral cysts only, the resection of the contralateral cysts may be avoided if there is no severe infection.
