RESUMO
The presentation of a Nocardia infection is quite variable. We report a case of nocardiosis presenting as endobronchial obstruction with postobstructive pneumonia and atelectasis, in a patient with a low index of suspicion for bronchogenic carcinoma. Our report emphasizes the importance of considering the diagnosis of endobronchial nocardiosis in patients with endobronchial obstruction and a low index of suspicion for carcinoma, as well as those with a high index of suspicion, but with repeatedly negative biopsies.
Assuntos
Broncopatias , Nocardiose , Nocardia asteroides , Broncopatias/diagnóstico , Broncopatias/tratamento farmacológico , Neoplasias Brônquicas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológicoRESUMO
We hypothesized that neutrophil adhesion and lung injury could occur independent of the surface receptor glycoprotein, Mo1 (C3bi receptor). We investigated whether preincubation of human neutrophil-derived cytoplasts (cell fragments that lack nuclei and granules and have a fixed number of surface Mo1 receptors) with plasma and lipopolysaccharide (LPS) would augment the cytoplasts' ability to cause lung injury when activated. We also investigated whether preincubating normal human neutrophils treated with anti-Mo1 antibody with plasma and LPS would increase the neutrophils' ability to adhere and cause lung injury. Human neutrophils infused into isolated salt-perfused rat lungs subsequently stimulated with phorbol 12-myristate 13-acetate (PMA) resulted in lung injury as assessed by the accumulation of 125I-bovine serum albumin in the lung parenchyma. The infusion of cytoplasts resulted in significantly less injury. Cytoplasts preincubated in 20% human plasma and LPS caused an increase in lung injury. Similarly, neutrophils treated with plasma, LPS, and anti-Mo1 antibody or neutrophils congenitally deficient in the Mo1 surface receptor and treated with plasma and LPS augmented lung injury. Plasma and LPS preincubation also increased anti-Mo1 antibody-treated neutrophil adhesion to endothelial cell monolayers after activation by PMA. Thus, plasma and LPS increase adhesion and lung injury caused by neutrophils or neutrophil fragments that share defects in Mo1 receptor expression.
Assuntos
Lipopolissacarídeos/toxicidade , Pulmão/patologia , Neutrófilos/fisiologia , Receptores de Complemento/fisiologia , Animais , Membrana Celular/fisiologia , Grupo dos Citocromos c/farmacologia , Humanos , Técnicas In Vitro , Pulmão/efeitos dos fármacos , Pulmão/fisiologia , Perfusão , Ratos , Receptores de Complemento/genética , Receptores de Complemento 3b , Superóxidos/metabolismo , Acetato de Tetradecanoilforbol/farmacologiaRESUMO
A 39-yr-old woman developed progressive exertional dyspnea 13 yr after receiving mediastinal irradiation for Hodgkin's disease. Chest roentgenogram showed a hyperlucent right lung. Pulmonary blood flow was markedly reduced on the right by ventilation-perfusion scanning. Pulmonary angiography showed attenuation and diffuse atrophy of the right pulmonary artery and its branches. This case represents a late and uncommon complication of mediastinal irradiation manifesting as a unilateral hyperlucent lung.
Assuntos
Doença de Hodgkin/radioterapia , Pulmão/diagnóstico por imagem , Neoplasias do Mediastino/radioterapia , Lesões por Radiação/diagnóstico por imagem , Adulto , Feminino , Humanos , Pulmão/efeitos da radiação , Linfonodos , Doenças Linfáticas/radioterapia , Pescoço , Radiografia TorácicaRESUMO
An analysis was carried out of 640 patients treated because of urolithiasis at the Urological Clinic of the Medical Academy in Warsaw in the years 1971--1974. Factors conducive to stone formation were analyzed. In infected urolithiasis, different bacterial floras were found in men and women. The importance of infections acquired in hospital by patients is emphasized. In primarily uninfected urolithiasis there were 35 per cent recurrences, as against 53 per cent recurrences in infected urolithiasis.
