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Results for “Pleural Effusion”

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PubMed1976

BCG treatment of malignant pleural effusions in the rat.

Intrapleurally injected cells of an ascitic rat tumour produced intrapleural effusions and solid pleural deposits. BCG, or its methanol extraction residue (MER) injected into the pleural space, suppressed tumour development and prolonged survival. Treatment was effective if given a few days before or after tumour injection. In contrast, active specific immunotherapy by repeated s.c. injection of viable or radiation-attenuated tumour cells in admixture with BCG was unsuccessful, and did not improve the response to intrapleural BCG treatment.

Animals↗

PubMed1977

Quinacrine in the management of malignant pleural effusion.

Twenty-five patients with malignant pleural effusion were treated with a single intrapleural dose of Quinacrine. Eighteen patients (72 per cent) had a significant response, with no reaccumulation of fluid for at least 2 months following treatment up to a maximum of 18 months in 2 patients. Seven patients (28 per cent) survived for longer than 1 year without evidence of recurrent effusion.

Breast Neoplasms↗

PubMed1978

Pleural effusion associated with primary lymphedema: a perspective on the yellow nail syndrome.

A 28-year-old woman with bilateral pleural effusions and generalized, primary lymphedema beginning with facial erysipelas at 6 years of age is presented. The pleural effusions were exudates with 250 cells per mm3, 92 per cent of which were lymphocytes. Lymphatic stasis was demonstrated by persistence of the blue dye in the dorsa of her feet 3 months after a lymphangiogram of both lower extremities, pelvis, and abdomen. Her nails were not remarkable. Our patient represents the twentieth recorded case of pleural effusion in association with primary lymphedema. Women have been afflicted more than twice as often as men, and the age of onset has varied from birth to the eighth decade. Yellow dystrophic nails may precede or follow lymphedema or the pleural effusion and have occurred in only 11 of the 20 patients.

Adult↗

PubMed1978

Erroneous classification of a pleural effusion. The role of a traumatic thoracentesis.

The separation of pleural effusions into exudates and transudates is based on the pleural fluid LDH and protein content compared to the simultaneous serum LDH and protein content. A patient in biventricular failure presented with a right pleural effusion that met the criteria of a transudate. After a traumatic thoracentesis the fluid met the criteria of an exudate.

Aged↗

PubMed1978

Tetracycline and quinacrine in the control of malignant pleural effusions. A randomized trial.

Eighteen patients with advanced metastatic malignancy who had 21 pleural effusions requiring sclerosis for control were randomly allocated to intrapleural therapy with tetracycline or quinacrine. Tetracycline produced partial or complete control of the effusion in ten of 12 trials for a median duration of 6 months (range 1.5 to 22 months). Partial or complete control was obtained in nine of ten trials with quinacrine, for a median duration of 3 months (range 1 to 13 months). All complete responders who died achieved control of their effusions until their terminal admissions despite clinical evidence of overt systemic tumor progression in the intervening period. Single-dose tetracycline therapy was accompanied by less fever (p less than 0.04) and less pleuritic pain (p = 0.09) than quinacrine. Tetracycline is effective, well tolerated, easily administered, and should be considered as the initial therapy for malignant pleural effusions requiring pleural sclerosis.

Clinical Trials as Topic↗

PubMed1976

Electron microscopy in the cytological examination of metastatic pleural effusions.

In a previous publication the ultrastructure of pleural effusions in cases of pleural mesothelioma was reported. The same method has now been applied to a study of effusions produced by pleural metastases. The findings are considered sufficiently conclusive to justify the use of electron microscopic cytology in determining the nature and sometimes the origin of such effusions.

Breast Neoplasms↗

PubMed1977

Pleuritis and pleural effusion in the horse: a study of 37 cases.

Pleural effusion in 37 horses, including 15 acutely affected and 22 chronically affected, was found to be due to a variety of causes, including lymphocarcoma, pulmonary granulomas, coccidioidomycosis, equine infectious anemia, pulmonary abscesses, chronic pneumonia, and primary septic pleural effusion. Age, breed, or sex predilection was not found. Horses with chronic disease had weight loss, increased respiratory rate, dull respiratory sounds in the ventral portion of the thorax, and varying degrees of anorexia. Many horses were anemic. Those acutely affected had respiratory distress or signs of colic and many were anorectic. Most horses with acute primary disease had small volumes of pleural fluid. Culture and cytologic examination of pleural fluid and tracheal washings revealed the causative organism in some instances, but in a number of "primary" cases there were negative results on bacterial culture. The latter cases must be differentiated from other causes of chronic weight loss in the horse.

Animals↗

PubMed1978

Pleural effusion--presenting sign in multiple myeloma.

A patient with multiple myeloma in whom recurrent right pleural effusion was the presenting sign of the disease is reported. An IgA (k) monoclonal component was found in both the pleural effusion and the serum. The bone marrow specimen was interpreted as typical for multiple myeloma and the pleural fluid contained numerous plasma cells. Treatment with cyclophosphamide was followed by clinical improvement and the disappearance of the pleural effusion.

Aged↗

PubMed1977

[Short and long term behaviour of pleural effusion cultures. (Report of 200 cases) (author's transl)].

Pleural effusions from 200 patients with benign or malignant pleural involvement have been cultured in vitro and observed from 48 hours to 9 months. The morphology and "social behavior" of the different types of cells are described. Mesothelial cells settle down quickly and come into contact with each other by long cytoplasmic processes. The tendency of epithelial malignant cells is to clump and grow in clusters. These "balls" of varying size are freed into the culture medium. Similar clusters may be found in benign effusions showing mesothelial hyperplasia. In case of malignant primary tumor of the pleura, the morphology of cultured cells is similar to that of mesothelial cells. In 3 cases, typical malignant epithelial cells have allowed us to discard the diagnosis of malignant mesothelioma. Discrepancies between conventional cytology and cell culture were found in 13 cases: in 6 cases, positive for malignant cells using conventional cytology, cell culture was negative. In 7 cases with negative routine techniques, cell culture disclosed malignant cells. Large multinucleated syncytia were observed in 15 cultures. They suggest a cytopathic effect similar to that seen in myxovirus infected cells. Correlation with the etiology of pleural effusions in these cases is described.

Cells, Cultured↗

PubMed1978

Pleural effusion disease in rabbits. Histopathological observations.

Pleural effusion disease (PED) is a generalized infection of laboratory rabbits caused by an unidentified agent, believed to be a virus. The histopathological response of 17 rabbits infected experimentally with this agent was studied. The light microscopical changes were minimal and the most consistent findings were alterations of the lymphoid tissue. Fatal infections were characterized by a uniform reduction of the splenic white pulp, focal degenerative changes of the thymus and lymph nodes and probably slight proliferative changes of the kidney glomeruli. In surviving animals there were transient myocardial and hepatic lesions and, after clinical recovery, proliferative changes in spleen, lymph nodes, interstitial lung tissue and probably kidney glomeruli. The results do not permit any conclusions to be drawn regarding the aetiology or the pathogenesis of PED infection.

Animals↗

PubMed1979

Study of immunoglobulins in pleura and pleural effusions.

The protein concentration of 35 pleural effusions was compared with that in the serum. The ratio of the pleural and serum concentration of albumin, IgG, IgA, and IgM is always below unity and appears to have no diagnostic value. However, the ratio of the concentration of these proteins was inversely related to their molecular weight. The underlying mechanism in malignant and inflammatory effusions appear similar and is in keeping with a diffusion process. Immunofluorescent staining of the pleura suggests the intercellular passage of the proteins through the mesothelial barrier.

Fluorescent Antibody Technique↗

PubMed1979

Pleural effusion secondary to ureteral obstruction.

Urinary tract obstruction may produce a pleural effusion detectable by chest x-ray film. This uncommon finding must be differentiated from intrathoracic and intraperitoneal causes of pleural effusion, including intrathoracic metastases when a malignant tumor is the cause of the urinary tract obstruction.

Aged↗

PubMed1979

[Eosinophilic pleural effusion during the course of a giardiasis. Report of a case (author's transl)].

A case of eosinophilic pleural effusion with coincidental intestinal infestation by Giardia lamblia is reported. After reviewing the possible causes of this type of pleuritis no clinical or laboratory data were obtained which could explain this condition, excepting the giardiasis, in the course of which there is no bibliographic reference in this sense. After the parasitosis had been treated with metronidazole the parasitologic negativization coincided with the disappearance of the pleural effusion. A review of the etiologies described in relation to eosinophilic pleural effusion and of the factors involved in the movilization of eosinophils, especially those which have a relationship with parasitosis, was carried out. Parasitosis may be capable of determining immune reactions with release of eosinophilotactic substances. The fact that the lung of experimental animals has been shown to be a suitable tissue for the release of factors with eosinophilotactic activity, could indicate that this organ has a special reactive capacity and probably, together with it, a closely related structure such as the pleura could have it too.

Eosinophils↗

PubMed1978

Perplexing pleural effusion.

Twenty-seven patients with perplexing pleural effusion were studied to determine clinical outcome. The value of performing pleuroscopic examination or open pleural biopsy (or both) in search of a diagnosis was assessed. After a mean follow-up period of six months, a diagnosis was reached in 16 patients, while 11 patients had no diagnosis after a mean follow-up period of 24 months. The causes for the effusions were neoplasm (eight patients), tuberculosis (one patient), blastomycosis (one patient), systemic lupus erythematosus (one patient), pulmonary infarction (two patients), and fractures of the ribs (three patients). The diagnosis was made by pleuroscopic examination or open biopsy in five patients, by autopsy in four, and by long-term follow-up studies in seven patients. When neoplasm or granulomatous disease was not suspected before surgery, pleuroscopic examination or open biopsy or both were nondiagnostic. These data support a policy of selecting patients for these procedures when a presumptive diagnosis of neoplasm or granulomatous disease is made but cannot be confirmed by less invasive methods. When the clinical data are too nonspecific to formulate a meaningful clinical impression, a more conservative approach is recommended.

Adult↗

PubMed1978

[Determination of glucose and fructose for the differential diagnosis of pleural effusions (author's transl)].

The glucose and fructose concentrations in the punctured liquid and the glucose effusion serum quotient were determined for 200 persons with pleural effusions of different genesis. It was tried to estimate the diagnostic value of this quotient for the differentiation of effusions of malignant, specific, nonspecific genesis and cardiac transsudations. A serum comparison value of the punctured fructose was determined in a control group of 30 persons with healthy metabolism value. The results of the examinations show, that a certain separation between the malignant and tuberculous exsudations is possible by means of the determination of glucose. The glucose level for the pleuritis exsudativa tuberculosa amounts to about 50 till 70 mg% whereas its value lies above the serum mean value for the malignant basic disease (glucose effusion serum quotient above 1). The determination of fructose seems to be limited suitable for the differentiation of the specific and nonspecific pleural diseases. The classification of the glucose and fructose concentrations has in relation with other examination parameters a differential diagnostic value, especially for the differentiation of malignant and specific pleural effusions. The tests for both parameters can be realized in every laboratory-clinical-chemistry.

Diagnosis, Differential↗

PubMed1978

Possible use of frequency-pulse-modulated electron capture gas-liquid chromatography to identify septic and aseptic causes of pleural effusions.

Frequency-pulse-modulated electron capture gas-liquid chromatography was used in conjunction with appropriate derivatization procedures to obtain chromatograms from extracts of pleural effusions. These chromatograms were used to rapidly classify the various types of pleural effusions. With this method we have been able to distinguish among a limited number of effusions caused by congestive heart failure, Mycobacterium tuberculosis, and some other types of bacterial empyemas and pleural effusions.

Chromatography, Gas↗

PubMed1975

Fine structure of granulocytes with cytoplasmic inclusions in pleural effusions from patients with rheumatoid pleuritis, tuberculous pleuritis and pleural carcinomatosis.

The fine structure of neutrophil granulocytes from pleural fluid obtained from patients with rheumatoid or tuberculous pleuritis or epidermoid carcinoma of the lung was identical irrespective of the primary disease of these patients. Homogenously stained lipid-like inclusions were present in the cytoplasm of the neutrophil granulocytes. They seemed to be formed de novo, as they lacked a distinct limiting unit membrane. The fine structure of the lipid-like inclusions gave no evidence to support the presence of immune complexes, these were probably located in the quantitative much fewer phagosomes of the granulocytes.

Adult↗

PubMed1977

[Local therapy of metastatic pleural effusions with zusammenfassung proteolytic enzymes (author's transl)].

From 1970 to 1976, 268 patients with pleural effusions underwent local therapy with the polyenzyme preparation Wobemugos; 235 patients were evaluable regarding the effectiveness of this therapy. In 115 of the cases, the primary tumour was carcinoma of the bronchus, in 86, carcinoma of the breast, in 9, mesothelioma and carcinoma of the ovary each, and in 16, other malignancies. There was a total remission of pleural effusions in 42% of the cases, a partial one in 41%, and no effect in 17%. In spite of the relatively large number of patients, some difficulties in interpreting the present results still remain and will be discussed in this paper.

Humans↗