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I Bestry

Publications and source records attributed to I Bestry.

32 records · Page 2Linked to original sources

[Kartagener syndrome and hemangiomatous proliferation of lung capillaries: case report and literature review].

The authors present a case of Kartagener syndrome complicated by pulmonary hypertension accompanied by the lung capillaries haemangiomatous proliferation (post mortem diagnosis). Review of a literature (23 published cases) of the haemangiomatous proliferation of lung capillaries emphasizes clinico-pathological aspects and differential diagnosis. A rarity of Kartagener syndrome is another interesting point of a published case.

Capillaries↗

[Pneumonia in patients after extracorporeal circulation].

Hospital infections are still an important problem of to-days medicine. The most common and dangerous one is pneumonia. The purpose of this study was to determine the cause of pneumonia in patients operated on under extracorporeal circulation. It was proved that micro-organisms responsible for pneumonia in our patients were Pseudomonas sp. and Staphylococcus aureus. No correlation between the bacterial flora cultured from the air in operating theatre and post-op. ward and bacterial flora responsible for pneumonia was found. It can be infer that pulmonary infections were rather caused by hospital cross-infections or endogenic infections in colonized patients.

Adult↗

[The role of radiotherapy in combined treatment of limited small cell lung cancer in relation to results of induction chemotherapy].

The comparison between results of chemotherapy (ChT) and ChT plus radiotherapy (RT) was performed in the group of 124 patients with limited SCLC. After induction ChT 25% pts obtained CR, 54%-PR and 21% did not respond. In 69 pts ChT was continued and in 55 others RT was added to ChT. The number of patients in whom tumor response was observed increased significantly after addition of RT to ChT. The degree of complete response had important impact on survival time. The pts who obtained CR had significantly longer survival time than those who achieved only PR or NR. Median survival time was very similar in both groups (13 months after ChT alone and 15 months after ChT plus RT). This was also true for the groups of patients who obtained CR after completion of treatment. Achievement of complete response is the most important factor for good prognosis. RT is indicated in those patients who achieved only PR after induction ChT.

Adult↗

[A case of lung eosinophilic granuloma (histiocytosis X) without clinical symptoms].

The asymptomatic case of eosinophilic granuloma (Histiocytosis X). 24 years old men with disseminated lung lesions which were present for six years was presented. Histiocytosis X was diagnosed on the basis of the examination of open lung biopsy specimen and high resolution computer tomography. The patient will be observed without treatment as no symptom were present and some regression of lung lesions was noted.

Adult↗

[Pulmonary arteriovenous fistulas].

Pulmonary arteriovenous fistulas are rare congenital malformations associated in 40% of cases with Osler-Weber-Rendu disease. PAF acquired in connection with the chest trauma, surgery and some inflammatory or neoplastic lung diseases were also described. In the Institute of Tuberculosis and Chest Diseases we have observed 11 cases of congenital PAF in 4000 resected lungs during the last years. In this report we described one more case with PAF. A 40 years old man was admitted to the Institute of Tuberculosis and Chest Diseases with hemoptysis. History and physical examination was unremarkable. Chest roentgenogram revealed a right upper lobe infiltrate. Tuberculosis or cancer was suspected and during the diagnostic procedures antituberculous drugs were given. After 3 weeks of treatment hemoptysis increased and chest roentgenogram revealed progression of the infiltrate in the right upper lobe and new lesions in the middle lobe. According to the character of X-ray progression which night be characteristic of active bleeding, a possibility of arteriovenous fistulas could not be excluded. As life threatening haemorrhage persisted right upper lobectomy without angiography was done. In the resected lobe arteriovenous fistulas were found. Angiography after operation was proposed but was refused by the patient. He is now well and symptoms free 5 months.

Adult↗

[Significance of bronchoscopy in the early phase of chemotherapy in patients with small cell lung carcinoma for assessment of tumor regression and prognosis].

70 SCLC patients (pts): 25 women and 45 men aged 34 to 76 with limited disease were treated with chemotherapy in Institute of Tuberculosis in the period 1.01.1987-31.12.1992. After 3-5 courses of chemotherapy restaging was done using chest X-ray examination, bronchoscopy with cytological examination of bronchial material, abdomen ultrasound examination and other methods according to clinical indications. Complete regression (CR) of the tumor in chest X-ray examination was found in 17 cases, partial regression (PR) in 37 cases and no response (NR)-in 16 pts. The degree of tumor regression on chest X-ray had significant prognostic value. The median survival time in this group was 20 months while median was 13.5 months in PR patients group and 11.5 in NR patients. Bronchoscopy revealed macroscopic or microscopic signs of cancer in 5 of 17 pts with CR on chest X-ray examination, in 23 of 37 cases with PR on X-ray and in 12 of 16 with NR on X-ray. The persistence of tumor signs in bronchoscopic examination seemed to worsen the prognosis in pts with CR on chest X-ray. Complete regression of tumor revealed during bronchoscopy did not have any prognostic significance if CR on the chest X-ray was not obtained. It was concluded that bronchoscopic examinations in early phase of chemotherapy is useful to further treatment planning only in these pts in whom CR of tumor on chest X-ray examination was confirmed.

Adult↗

[Correlation between chest examination with radiography, bronchoscopy and cytology of bronchial alveolar lavage in patients treated for small cell lung cancer].

In 129 SCLC patients (pts) 250 control fibrobronchoscopic (FOB) procedures were performed during chemotherapy. 71 pts had extensive disease and 58 limited disease. The evident correlation between radiologic and bronchoscopic assessment of tumor regression was confirmed in 60% of examinations. Tumor was visible during 16 bronchoscopic examinations in spite of complete regression on X-ray picture and on 53 chest X-ray examinations despite complete regression in the bronchi. Cancer cells found in 74 out of 250 bronchial washings samples were present significantly more often in these situations in which no regression of tumor in the bronchi was confirmed. Nevertheless tumor cells were also found in 3 out 57 cases in which complete regression on X-ray and in the bronchi was found. It was concluded that complete tumor regression on X-ray picture ought to be confirmed by bronchoscopy with cytologic examination of bronchial washing.

Adult↗

[Pulmonary aspergilloma caused by Aspergillus niger].

The authors present a case report of a 66 year old male that was admitted due to pulmonary lesions with cavitation localized in the upper left lobe. In the cavity an abnormal mass could be seen. In the differential diagnosis malignancy and tuberculosis were excluded. Fungi were cultured from the bronchial washings and sputum. Their morphological characteristics allowed them to be typed as Aspergillus niger. Slides from the thick, mucoid, black sputum demonstrated typical forms of the fungus. Polarized microscopy demonstrated calcium oxalate crystals. The final diagnosis was pulmonary aspergilloma caused by A.niger complicating a pulmonary abscess in the course of a pneumonia.

Aged↗

[Bacterial infections in pulmonary aspergilloma].

28 cavernoscopies were carried out in 26 patients. Complete or partial removal of mycetomas was achieved in 18 patients with 20 caverns. Under aerobic conditions Aspergillus fumigatus was cultured from the 28 removed mycetomas in 22 cases (78.6%) and bacterial organisms in 20 (71.4%). Bacteria were isolated from mycetomas that had demonstrable A. fumigatus organisms as well as from those that did not have them. In all infected mycetomas Gram negative rods were cultured, in only 4 cases Gram (+) cocci were found. Only in two cases of mycetomas under anaerobic conditions Gram (+) cocci were cultured. In most patients the organism could be demonstrated in sputum as well as in mycetomas. In 18 patients the pathogenic organism disappeared from sputum after removal of mycetomas. Also following removal of aspergillomas a decrease of sputum production was noted and it changed its character from purulent to mucoid.

Aspergillosis↗

[Cavernous changes as a result of pulmonary tissue hyperreactivity to Aspergillus fumigatus infection].

A case report is presented of a 74 year old male with chronic bronchitis in whom fever, malaise and sputum hypersecretion was observed. Inflammatory changes in the right upper lobe were found on a chest radiogram. Broad spectrum antibiotics and antituberculous agents did not produce any improvement. Due to the fact that Aspergillus fumigatus organisms were cultured from the sputum and the precipitin test was positive to aspergillin the diagnosis of Aspergillus fumigatus infection was made. 5-fluorocytosine--Ancotil did not bring any improvement. After initiating steroid therapy with 30 mg of prednisone an improvement was observed. This allowed to diagnose hyperreactivity to Aspergillus fumigatus as the cause of the disease.

Aged↗