Synchronous bilateral typical carcinoid tumors of the lung.

A 44-year-old man was admitted to our hospital with cough and sputum symptoms. After observing bilateral masses in the chest X-ray, a tomography scan of the thorax revealed bilateral tumors. Bronchoscopic biopsies were performed. The histopathological examination showed bilateral typical carcinoid tumors. A left lower lobectomy and a right upper sleeve lobectomy were carried out subsequently. No pathological lesions were observed one year after the operation.

The role of taurine added to pulmonary reperfusion solutions in isolated guinea pig lungs.

An experimental comparative study on isolated guinea pig-lungs has been undertaken to determine the probable beneficial effects of adding taurine to pulmonary reperfusion solutions in lung ischemia-reperfusion. 20 guinea pigs were used. The isolated lungs (n = 10 in each group) previously being perfused by oxygenated Krebs-Henseleit solution were put in normothermic ischemic conditions. After 3 hours of normothermic ischemia the lungs were reperfused (with Krebs-Henseleit solution in the control group, Krebs-Henseleit solution plus taurine 10(-2) M in the experiment group) for 20 minutes. Pulmonary artery pressures, tissue malondialdehyde (MDA) and glutathione (GSH) levels were measured before and after the ischemic period and also at the end of reperfusion. Malondialdehyde and glutathione levels of the pefusate were measured before ischemic period and at the end of reperfusion. An electron microscopic analysis was performed on the lung tissues before and after the ischemic period and also at the end of reperfusion. Decreased pulmonary artery pressure, tissue perfusate MDA levels and increased perfusate GSH levels were observed in taurine added group. Electron microscopic evaluation supported our findings indicating preservation of lamellar bodies of type II pneumocytes. It is concluded that taurine may play an important role in protecting tissue against ischemia-reperfusion injury by functioning as an antioxidant.

The inhibition of pro-inflammatory cytokines with pentoxifylline in the cardiopulmunary bypass lung.

In addition to preventing tissue energy loss during cardiopulmonary bypass, pentoxifylline (Ptx) prevents the production of pro-inflammatory cytokines as well. The aim of this study was to investigate whether Ptx decreases the inflammatory effects of cardiopulmonary bypass on the lungs during open-heart surgery. The patients in the study group (n = 15) who were going through an open-heart surgery had 500 mg l(-1) of Ptx added to their prime solution, whereas the patients in the control group (n = 10) only received prime solution. Pre-pump and post-pump blood samples were obtained from both groups and assayed for interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor alpha (TNFalpha). Lung tissue samples that were obtained after the pump were examined with light microscopy and stained for tissueTNFalpha. Non-parametric Wilcoxon test was utilized for statistical evaluation. In the post-pump period, the difference in the IL-6, IL-8 and TNFalpha levels of the two groups was found to be statistically significant (P<0.005). The tissue samples from the control group had significant staining with TNFalpha. We think that Ptx has important protective effects on the lungs during cardiopulmonary bypass.

Intrapleural urokinase in the management of parapneumonic empyema: a randomised controlled trial.

We compared the effectiveness of intrapleural urokinase versus normal saline via a thoracostomy tube in the treatment of parapneumonic empyema in a randomised controlled study. Forty-nine patients with parapneumonic empyema were randomly assigned to receive either intrapleural urokinase or normal saline treatment. The daily volume instilled through a chest tube was 100 ml in both groups. Urokinase (100,000 IU/day) was diluted in normal saline before instillation. The mean duration for defervescence was shorter (7 +/- 3 vs 13 +/- 5 days, p<0.01) and the mean volume of drained fluid during the five-day treatment period was significantly greater in the urokinase group (1.8 +/- 1.5 vs 0.8 +/- 0.8 litres, p<0.001) than in the control group. The subsequent decortication rate was 60% and 29.1%, respectively (p<0.001). The duration of hospitalisation was also shorter in the urokinase group (14 +/- 4 vs 21 +/- 4 days, p<0.001) than in the saline group. We conclude that intrapleural instillation of urokinase in the management of parapneumonic empyema provides a better outcome and reduces the need for decortication.