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PubMed1998

Lung transplantation for pulmonary sarcoidosis.

Patients with end-stage sarcoidosis have now undergone lung transplantation successfully with good short-term and intermediate-term results. Lung transplantation for sarcoidosis requires several considerations unique to this disease. Selection of pulmonary sarcoidosis patients for transplantation requires that medical therapy has been exhausted. This may involve the use of corticosteriods and alternative medications. Causes of pulmonary dysfunction other than pulmonary sarcoidosis, such as bronchiectasis and myocardial sarcoidosis, must be excluded before candidates are considered for transplantation. The extent and severity of extrapulmonary disease must also be assessed and may preclude lung transplantation. The presence of mycetomas is considered a relative contra-indication by some transplant centres and an absolute contra-indication by others. Relatively few patients with pulmonary sarcoidosis have undergone transplantation and, therefore, there are few data on outcome. Sarcoidosis frequently recurs in the allograft, but rarely causes symptoms or pulmonary dysfunction. More severe acute rejection episodes may occur in sarcoidosis transplant recipients, although at present there is no evidence of an increased risk of obliterative bronchiolitis or increased mortality.

Aspergillosis↗

PubMed1998

[About the article "Colonization/infection of a lung transplant by Scedosporium inflatum"].

Explore the source record for details and available documents.

Antifungal Agents↗

PubMedDate not supplied

Surgical management of pulmonary tuberculosis.

Surgery for pulmonary tubercolosis (PTB) is now the second place treatment. Among the surgical indications the most debated is the multi-drug resistance of a focal pulmonary tuberculous disease. Other indications are: bronchiectasis, hemoptysis and the presence of a broncho-pleural fistula. Pulmonary Aspergilloma is a frequent indication for surgery; it is commonly a PTB sequela and causes severe complications. The presence of an unknown pulmonary mass or nodule is a surgical criterion because it might signal a cancer. Surgery therefore now constitutes a valid option for the treatment of clinical patterns of PTB unresponsive to medical treatment in severe, potentially fatal clinical conditions.

Aspergillosis↗

PubMed1998

[The Gullino 3-way tube for lavage and active aspiration in the treatment of post-pneumonectomy septic complications and subphrenic abscess].

(Gullino's) three-way tube consists of a large 30-35 cm long suction tube, with a diameter of 10 x 14 mm, closed at the proximal end close to which 6-8 holes have been made for suction along a 5 cm stretch. Two small tubes of equal length and with a diameter of 4-6 mm are glued or bound to the tube: one represents an air intake with a sealed opening above the suction holes; the other, used for washing, opens freely at the level of the closed proximal end of the large section tube. After a short review of the drama and disappointments in lung surgery concerning the treatment of postoperative septic complications, the authors briefly describe the advantages of the use of two-way suction drainage tubes: using air suction (Saratoga's and Shirley's model), and above all water suction, with irrigation-washing (Luizy's and Vankemmel's models). Compared to the two-way tubes, the paper then emphasises the advantages of the three-way model: using the flow of the lavage solution for the top, it is possible to obtain an improved, continuous and rapid washing and sterilisation of the pleural cavity, while suction from below serves to avoid stasis and in the event of bronchial fistula it is therefore easy to prevent broncho-pulmonary inundation. The three-way tube was used in two cases of post-pneumonectomy pyothorax, one of which was complicated by a bronchial fistula, and in a case of sub-phrenic abscess. In the treatment of pyothorax, the three-way tube must be divided into two parts: the large suction tube and the small air-intake tube, the two-way tube, and the small washing tube. The two-way tube must be positioned on the posterior axillary line in contact or nearly with the diaphragm, the small washing tube in the 1st anterior intercostal space and the patient must change decubitus with a certain rolling rhythm. Simple pyothorax may be resolved in 48 hours; bronchial fistula in 25 days and sub-phrenic abscess in 9. These are undoubtedly exceptional results, but require further confirmation.

Adenocarcinoma↗

PubMed1976

[Diagnosis and differential diagnosis of solitary pulmonary coin lesions].

In the present analysis, the diagnosis as well as the differential diagnosis of solitary pulmonary coin lesions are discussed. The coin lesions of 361 patients who were at our diagnostic ward from 1968 to 1970 were defined according to Rube [1967]. The investigations are in accordance with the routine examinations and were consciously demonstrated in nonselected patients in order to express the several diagnostic procedures, their field of indication and their efficiency in a balanced ratio. Therefore, the efficacy of the X-ray diagnosis could be proved in a broader range than in a collective of circular foci which would have been chosen exclusively under the aspect of the diagnosis by means of needle biopsy and which would reveal a higher percentage of morphological clarification of the focus.

Adolescent↗

PubMed1998

[Three resected cases of pulmonary cryptococcosis].

Case 1 was a 53-year-old female who had a small nodule in the right S3 segment on chest CT. As she was not diagnosed by transbronchial lung biopsy (TBLB), open thoracotomy was performed. Case 2 was a 65-year-old female who had a nodule with pleural indentation in the right S6 segment. As this nodule showed difficulty to differentiate from small lung carcinoma, thoracoscopic surgery was performed. Case 3 was a 63-year-old female who had multiple lesions with cavity in the left S4 and S5 segments, which was preoperatively diagnosed by TBLB. She was performed thoracoscopic partial resection of the lingular segment because of poor response to antimycotic agents. All cases received preventive antimycotic agents for one or two months after the operation. There was no recurrence or postoperative meningitis. Thoracoscopic surgery is the effective procedure for the diagnosis and treatment of the localized pulmonary cryptococcosis.

Aged↗

PubMed1962