ABSTRACT
Lobar torsion is a rare complication following lung transplantation. Early detection and immediate therapeutic intervention can lead to a favorable outcome. We report an unusual case of left lingular torsion following single lung transplantation performed for idiopathic pulmonary fibrosis. The patient experienced severe ventilatory compromise immediately after leaving the operating room, and a chest X-ray revealed a well-demarcated area of consolidation involving the left mid- and lower lung zones. Lingular torsion was promptly diagnosed and corrected surgically. The possibility of acute lobar torsion should be considered in lung transplant recipients who experience acute respiratory compromise in the early postoperative period. Early diagnosis and correction can avoid pulmonary infarction and the need for lobar resection.
Subject(s)
Lung Transplantation/adverse effects , Lung/pathology , Postoperative Complications/pathology , Torsion Abnormality/pathology , Humans , Lung/diagnostic imaging , Lung/surgery , Male , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology , Radiography , Torsion Abnormality/diagnostic imaging , Torsion Abnormality/etiology , X-RaysABSTRACT
Venous thrombo-embolic disease carries a high mortality rate and sometimes difficulties in diagnosis. Conventional pulmonary angiography remains the gold standard diagnostic test for pulmonary embolism. While contrast venography remains the gold standard modality to diagnose deep venous thrombi, the highly sensitive and specific venous ultrasonography makes it the most common initial test. The management of below-the-knee deep vein thrombosis and the indications for thrombolysis in pulmonary embolism are among the controversies explored.
Subject(s)
Venous Thromboembolism/diagnosis , Venous Thromboembolism/therapy , Anticoagulants/therapeutic use , Comorbidity , Humans , Pulmonary Embolism/epidemiology , Pulmonary Embolism/prevention & control , Pulmonary Embolism/therapy , Risk Factors , Venous Thromboembolism/epidemiology , Venous Thrombosis/epidemiology , Venous Thrombosis/therapyABSTRACT
Gastric bezoars have been associated with solid-organ transplantation. In this report we describe the occurrence of gastric bezoars in two patients who underwent sequential single-lung transplantation for severe chronic obstructive pulmonary disease, and analyze the possible pathophysiologic mechanisms responsible.
Subject(s)
Bezoars/etiology , Lung Transplantation/adverse effects , Pulmonary Disease, Chronic Obstructive/surgery , Stomach , Bezoars/diagnosis , Bezoars/surgery , Endoscopy , Female , Gastroparesis/complications , Humans , Male , Middle AgedABSTRACT
Length variants within a CA-repeat-rich region of intron 4 of the human SP-B (pulmonary surfactant protein-B) gene are associated with several lung diseases. The hypothesis that SP-B intron 4 affects mRNA splicing was studied. SP-B minigenes containing exons 1-6 with a normal-sized intron 4 (pBi4normal) or intron 4 containing deletions (pBi4del) of 193, 211, 264 or 340 bp were expressed in CHO (Chinese hamster ovary) cells by transient transfection. Two forms of SP-B transcripts, normal and incompletely spliced, were detected. With pBi4normal, normal-sized SP-B mRNA was the predominant form and a very low amount of incompletely spliced mRNA was present, whereas with the pBi4del variants the amount of normal SP-B mRNAs was lower and the amount of incompletely spliced mRNA was relatively high. Reverse transcription-PCR results and sequencing data indicated that the incompletely spliced SP-B RNA contained intron 4 sequence, and this incompletely spliced RNA was also observed in normal lung. Lung cancer tissues with intron 4 deletions exhibited a larger amount of abnormally spliced RNAs compared with normal lung tissue or cancerous tissue with normal-sized intron 4. The results indicate that intron 4 length variants affect SP-B mRNA splicing, and that this may contribute to lung disease.
