Vancomycin penetration of uninfected pleural fluid exudate after continuous or intermittent infusion.

Blood and pleural exudate samples were obtained from 16 patients receiving intermittent or continuous infusions of vancomycin after lung surgery. The areas under the concentration-time curves for blood and pleural exudates were identical for both administration schedules, while continuous infusion allowed the concentrations in pleural exudates to be more sustained (mean concentration, 12 mg/liter).

[The thoracic surgery department].

The Department of Thoracic Surgery has been developed since 40 years, and particularly since 23 years at the Hôpital Erasme. The high rate of lung cancers did induce an important activity in surgical oncology, inside multidisciplinary teams. After a first attempt in 1969, lung transplantation is now successful.

Undiagnosed rupture of right hemidiaphragm--hepatothorax: a case report.

A case of late diagnosis of right diaphragmatic rupture due to blunt trauma is presented. Traumatic diaphragmatic rupture is an uncommon but severe problem in a patient with multiple injuries. One third of left-sided ruptures and half of right-sided ruptures have been undetected for several days.

Effects of lung volume reduction surgery for emphysema on diaphragm dimensions and configuration.

Part of the functional benefit provided by lung volume reduction surgery (LVRS) may be related to improvement in respiratory muscle function resulting from changes in diaphragm dimension and configuration. To study these changes, we obtained 3D reconstructions of the muscle using spiral computed tomography in 11 patients with severe emphysema before and 3 mo after surgery, and in 11 normal subjects matched for sex, age, height, and weight. Bilateral LVRS was performed by thoracoscopy in eight patients and by sternotomy in three patients.

Two-lung and one-lung ventilation in patients with chronic obstructive pulmonary disease: the effects of position and F(IO)2.

Unlabelled: We compared the effects of position and fraction of inspired oxygen (F(IO)2) on oxygenation during thoracic surgery in 24 consenting patients randomly assigned to receive an F(IO)2 of 0.4 (eight patients, Group 0.4), 0.

Diaphragm dimensions after single-lung transplantation for emphysema.

We used three-dimensional reconstructions obtained with spiral computed tomography to measure total diaphragm surface area (Adi), and the surface area of the dome (Ado) and of the zone of apposition (Aap) of the diaphragm in nine patients with single-lung transplantation (SLT) for emphysema and nine normal subjects matched for age, sex, height, and weight. Measurements were obtained at supine FRC, midinspiratory capacity, and TLC. In the normal subjects, Ado and Adi were greater on the right than on the left side, and the right dome was positioned more cranially than the left one, presumably because of the presence of the liver.

Lung rejection occurs in lung transplant recipients with blood chimerism.

Background: It has been postulated that chimerism after transplantation might promote graft acceptance. In the present study, we prospectively assessed blood chimerism in 10 lung transplant recipients during the first posttransplant year and investigated whether chimerism was associated with an immunologically stable situation of the graft.

Methods: The recipients' peripheral blood mononuclear cells were obtained before transplantation and at various time points during the first postoperative year.

Detection of blood chimerism after lung and heart-lung transplantation. The superiority of nested as compared with standard polymerase chain reaction amplification.

Migration of donor cells from the graft to various tissues of the recipient has been demonstrated after different types of solid organ transplants. Currently, the detection of donor cells in the recipient's tissues is most simply performed by polymerase chain reaction (PCR) amplification of a donor-specific gene. In the present study, we first determined in vitro the sensitivity of standard and nested PCR amplification with sequence-specific primers (PCR-SSP) of a donor-specific allele of the HLA-DRB1 gene and then used this technique to assess prospectively blood chimerism in two single-lung (SLT) and one heart-lung (HLT) transplant recipients.

Benign thoracic schwannoma and postoperative chylothorax: case report and review of the literature.

Among all the neurogenic tumours, the benign intrathoracic schwannoma is a rare tumour. Most often it is discovered by accident in the course of a routine X-ray examination of the thorax. Symptoms appear only when size becomes important.

Radiation-induced pulmonary veno-occlusive disease.

Late occurrence of radiation-induced pulmonary pneumonitis and fibrosis is well documented. We report an unusual case of radiation induced veno-occlusive disease (VOD) occurring six years following mantle irradiation for Hodgkin's lymphoma. The patient developed severe pulmonary hypertension and cor pulmonale.

Association of cadmium exposure with rapidly progressive emphysema in a smoker.

Rapidly progressive emphysema developed in a 59 year old smoker after exposure to cadmium fumes in a factory. Very high levels of cadmium in air sampled at the workplace and in the patient's blood, urine, and lung tissue confirmed massive exposure. These data strongly suggest an association between the patient's cadmium exposure and the development of emphysema.

Tumour-like presentation of pulmonary sarcoidosis.

We report a case of pulmonary sarcoidosis, which initially presented as a left apical infiltrate. The later course mimicked a pulmonary neoplasm, with left upper lobe atelectasis secondary to bronchial stenosis, resulting from both endobronchial sarcoidosis and extrinsic compression by enlarged lymph nodes. Extrinsic pressure from sarcoid nodes on the left main pulmonary artery and recurrent laryngeal nerve, also caused a reduction in pulmonary parenchymal perfusion and left vocal cord paresis.

Inhibition of hypoxic pulmonary vasoconstriction by increased left atrial pressure in dogs.

To further explore the mechanism of hypoxic pulmonary vasoconstriction, we studied the mean pulmonary arterial pressure (Ppa)/left atrial pressure (Pla) relationship at fixed cardiac index (Q) and the Ppa/Q relationship at several levels of fixed Pla in pentobarbital sodium-anesthetized dogs ventilated alternately in hyperoxia [fraction of inspired O2 (FIO2) 0.4 or 1.0] and in hypoxia (FIO2 0.

Penetration of ciprofloxacin into human pleural fluid.

The concentrations of ciprofloxacin (1.5 mg/kg of body weight) in serum and in uninfected pleural exudates were studied after one and three intravenous injections had been given at 8-h intervals. The drug was assayed in serum and in pleural fluid by high-performance liquid chromatography.

[NMR evaluation of neoplastic invasion of the pulmonary artery].

Bronchial tumors that invade the mediastinum are not necessarily inoperable. Whether surgery is possible depends, among other things, on the extent of pulmonary artery invasion. The authors have studied the value of cardiac-gated MRI and compared it with CT and venous DSA for staging tumor invasion.

[Neoplastic invasion of the pulmonary arteries. Evaluation by MRI. Preliminary experience].

Bronchial tumors invading the mediastinum are no longer systematically regarded as inoperable. Curative surgery has produced a significant survival rate and led to the adaptation of the TNM classification. The degree of invasion of the pulmonary artery is a criterion of operability.

Asbestos bodies in bronchoalveolar lavage reflect lung asbestos body concentration.

Asbestos body (AB) countings on both bronchoalveolar lavage (BAL) fluids and digested lung tissue samples were performed in one hundred consecutive subjects submitted to a thoracotomy procedure, mostly for lung carcinoma. A good correlation (r = 0.73) was found between the two groups of values for the total group of subjects.

Increased plasma motilin concentrations in small cell carcinoma of the lung.

Plasma samples from 21 patients with small cell carcinoma of the lung were screened for pancreatic polypeptide, somatostatin, motilin, and vasoactive intestinal polypeptide. One patient had severe impairment of both renal and liver function. In the 20 remaining subjects vasoactive intestinal polypeptide concentrations were normal, and only two patients had increased concentrations of somatostatin.

[Thymoma and pregnancy. Apropos of a case].

A case of thymoma associated with pregnancy is reported. This association is extremely rare (8 described cases) and the clinical outcome is most frequently unfavorable for the mother. The diagnosis was given by a standard chest X-ray performed routinely post-partum.

Combined heart-lung transplantation for terminal pulmonary lymphangioleiomyomatosis.

Combined heart-lung transplantation with cyclosporine is reported in a 26-year-old patient who presented with end-stage pulmonary lymphangioleiomyomatosis. The operation was successful and the patient's rehabilitation excellent over the first 7 postoperative months. She then developed obliterative bronchiolitis of unknown origin.