Mesalamine-induced lung injury in a patient with ulcerative colitis and a confounding autoimmune background: a case report.

Two years after being diagnosed with ulcerative colitis, a 57-year-old man taking oral mesalamine experienced severe respiratory distress due to left lung pleuropneumonitis. Eight months later, severe respiratory distress recurred due to right lung pneumonitis. Extraintestinal manifestations of inflammatory bowel disease or mesalamine-induced pulmonary injury were considered in the differential diagnosis, which was complicated by a history of aseptic meningitis and evidence of an ongoing autoimmune response.

Source of exhaled nitric oxide in primary biliary cirrhosis.

Background: Exhaled nitric oxide (NO) levels may be elevated in patients with liver cirrhosis and autoimmune diseases. Primary biliary cirrhosis (PBC) is often associated with keratoconjunctivitis sicca (Sjogren syndrome [SS]), an extrahepatic autoimmune manifestation. The aim of this study was to evaluate the source of increased exhaled NO (ie, alveolar vs airway) in patients with PBC, whether associated with SS or not, and to evaluate its impact on oxygenation abnormalities.

Closure of an iatrogenic tracheo-esophageal fistula with bronchoscopic gluing in a mechanically ventilated adult patient.

Management of acquired nonmalignant tracheo-esophageal fistula (TEF) in mechanically ventilated patients is controversial. Surgical correction is often contraindicated because the high operative risk and spontaneous closure is unlikely due to the positive pressure ventilation. We present a case of successful closure of an iatrogenic TEF in a mechanically ventilated patient with bronchoscopic application of fibrin glue.

Effect on dyspnoea and hypoxaemia of inhaled N(G)-nitro-L-arginine methyl ester in hepatopulmonary syndrome.

Hepatopulmonary syndrome--a complication of chronic liver disease-is characterised by hypoxaemia, which results from widespread intrapulmonary vascular dilatations. Amplified production of pulmonary nitric oxide is thought to be important in development of this disorder in patients with liver cirrhosis. Here, we report a 64-year-old man with hepatopulmonary syndrome associated with hepatitis-C-virus-related cirrhosis.

Exhaled nitric oxide in systemic sclerosis: relationships with lung involvement and pulmonary hypertension.

Objective: To measure nitric oxide (NO) concentration in exhaled air of patients with systemic sclerosis (SSc) and to investigate its relationships with lung involvement, complicated or not by pulmonary hypertension (PH).

Methods: Exhaled NO was measured by chemiluminescence in 47 patients with SSc (16 with PH) and in 30 controls. All the patients underwent Doppler echocardiography to assess pulmonary artery pressure (PAP), lung function tests, and thin section computed tomographic scans of the lung to quantify the extent of fibrosing alveolitis.

Exhaled nitric oxide and impaired oxygenation in cirrhotic patients before and after liver transplantation.

Background: Nitric oxide may be involved in the impaired oxygenation of cirrhotic patients, a condition that improves in most patients after liver transplantation.

Objective: To compare oxygenation and nitric oxide concentrations before and after liver transplantation.

Design: Before-and-after observational study.

Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis.

Impaired arterial oxygenation, ranging from increased alveolar-arterial oxygen gradient (AaDo2) to hypoxemia, is commonly present in patients with cirrhosis. Nitric oxide (NO), through pulmonary vasodilatation, may play a major role in the oxygen abnormalities of cirrhosis. Our aim was to study the relationship between NO production and O2 abnormalities in 45 nonsmoking patients with cirrhosis and without major cardiovascular and respiratory diseases.

Damage of the pharyngeal mucosa and hyperresponsiveness of airway in sinusitis.

Background: In sinusitis bronchoconstriction is supposed to originate from pharyngobronchial reflexes triggered by seeding of the inflammatory process into the pharynx.

Objective: Our aim was to evaluate whether in sinusitis bronchial and extrathoracic airway (EA) dysfunction correlate with morphologic abnormalities of the pharyngeal mucosa.

Methods: We performed histamine inhalation challenge, nasal lavage, and nasopharyngeal biopsies in 24 nonasthmatic patients with exacerbation of chronic sinusitis.

Systemic arterial air embolism and tension pneumothorax: two complications of transthoracic percutaneous thin-needle biopsy in the same patient.

Systemic arterial air embolism and tension pneumothorax are two rare and severe complications of transthoracic fine-needle biopsy. We report on a patient who developed both complications during the same procedure and recovered successfully after resuscitation and hyperbaric oxygen therapy. Favourable outcome of systemic air arterial embolism has been reported infrequently in the literature.

Clinical utility of tissue polypeptide antigen determination in lung cancer management.

In view of the fact that pulmonary malignancies still represent an important cause of tumor death and that the high rate of unsuccessful treatment may be partly due to the late clinical presentation, efforts should be spent not only to develop new and effective treatments but also to improve early diagnosis and to identify prognostic factors and parameters useful for the monitoring of the treatment. Tumor markers, if used properly, can provide a useful support for the management of patients suffering from various malignancies, including lung cancer patients. The clinical significance of one of the most widely used tumor markers, Tissue Polypeptide Antigen (TPA), has been reviewed and showed this marker to be useful to the clinician for the management of patients with pulmonary malignancy, as a complementary tool for diagnosing and staging the tumor as well as for monitoring treatment response or relapse occurrence.

Extrathoracic and intrathoracic airway responsiveness in sinusitis.

Background: Asthma associated with sinusitis is supposed to be sustained by bronchoconstrictive reflexes originating in extrathoracic airway (EA) receptors.

Objective: The study was designed to evaluate the relationship between EA responsiveness and bronchial responsiveness in sinusitis.

Methods: We performed histamine inhalation challenge in 106 patients with chronic sinusitis, during disease exacerbation and after treatment with antimicrobials and nasal flunisolide (100 micrograms daily) for 2 weeks.

Pulmonary lymphangioleiomyomatosis in postmenopausal women: report of two cases and review of the literature.

Pulmonary lymphangioleiomyomatosis, a disease largely confined to women in their reproductive years, is reported in two postmenopausal patients. Nine similar cases in the literature are reviewed. In older women, the disease appears to be similar to that described in younger women, with the possible exception that the clinical course may be longer and more benign after the menopause.

Postoperative bronchopleural fistula: endoscopic closure in 12 patients.

Twelve consecutive patients with postresectional bronchopleural fistula were treated with endoscopic application of tissue glue adhesive (methyl-2-cyanoacrylate). Eight patients had associated empyema. Endoscopic gluing was successfully accomplished in 10 cases (success rate of 83%).

Disappearance curves of tumor markers after radical surgery.

CEA serum levels were sampled from 15 patients with lung carcinoma, 12 patients with colon carcinoma, and 5 patients with gastric carcinoma before and after radical excision of the malignancy. In addition, TPA serum levels were measured in 7 patients with lung carcinoma and CA 19.9 serum levels in 9 patients with colon carcinoma, before and after curative surgery.

[Iatrogenic esophago-tracheal fistula treated with endoscopically administered fibrin glue].

Successful closure of a iatrogenic tracheoesophageal fistula by means of bronchoscopic application of fibrin glue in a 77-year old patient is reported. The fistula was completely obliterated after a single application of the glue, with resolution of the clinical and radiological signs. The procedure may be suggested as an alternative to surgery or as first attempt before surgery in very selected patients with TEF.

Development of a high-performance liquid chromatographic-mass spectrometric technique, with an ionspray interface, for the determination of platelet-activating factor (PAF) and lyso-PAF in biological samples.

An HPLC-mass spectrometric technique with an ionspray interface was developed for the determination of platelet-activating factor (PAF) and PAF-related compounds in biological samples. HPLC separations were performed using a reversed-phase column. The mass spectra showed intense [M + H]+ ions.

Bal T lymphocyte subsets are reduced in primary lung neoplasias.

Direct observation with an optic fibre bronchoscope facilitates the diagnosis, staging and treatment of both neoplastic and other lung diseases, and the varying diameters available enable IVth or even Vth-order bronchi to be examined. The technique can be employed for deep lung lavage or bronchoalveolar lavage (BAL) and for transbronchial biopsy. The BAL fluid, too, can be used to study lung cells and soluble components.

Respiratory symptoms, lung function tests, airway responsiveness, and bronchoalveolar lymphocyte subsets in B-chronic lymphocytic leukemia.

A respiratory questionnaire was completed and spirometry, tests for lung volumes, diffusion capacity for CO, and methacholine bronchial challenge were performed in 24 outpatients with B-chronic lymphocytic leukemia (B-CLL), aged 44-79, presenting in different stages of their disease. In 10 patients, bronchoalveolar lavage (BAL) fluid was also obtained. Ten of twenty-four patients had symptoms consistent with chronic bronchitis, unrelated both to smoking history and to the clinical stage.

Platelet-activating factor in bronchoalveolar lavage from patients with sarcoidosis.

Platelet-activating factor (PAF), a lipid mediator of inflammation and anaphylaxis, may play a role in several physiopathologic alterations of the lung. A lipid compound with physicochemical and biologic characteristics similar to synthetic PAF was extracted and purified from bronchoalveolar lavage (BAL) fluid of 15 of 34 patients with sarcoidosis. PAF was quantitated by a bioassay on washed rabbit platelets.

Pulmonary function in patients with pleural effusion of varying magnitude and fibrothorax.

Pulmonary function was studied in sixty patients with pleural effusion and seventy patients with fibrothorax. The patients with pleural effusion were divided into three groups according to the extent of the effusion. The patients were submitted to spirometry and arterial blood gas analysis.

Histamine hyperresponsiveness of the extrathoracic airway in patients with asthmatic symptoms.

Functional abnormalities of the extrathoracic airway (EA) may produce symptoms mimicking bronchial asthma. We assessed the bronchial (B) and EA responsiveness to inhaled histamine in 40 patients with asthmatic symptoms and in nine asymptomatic controls. FEV1 and maximal mid-inspiratory flow (MIF50) were used as index of bronchial and EA narrowing.

Pulmonary function in the patients submitted to lung exeresis.

The effects of lung surgery on respiratory function were investigated in 80 patients; 17 patients were submitted to left pneumonectomy (LPN); 11 patients were submitted to right pneumonectomy (RPN); 7 patients underwent a left upper lobectomy (LUL); 16 patients a left lower lobectomy (LLL); 17 patients were submitted to right upper lobectomy (RUL); 12 patients underwent right lower lobectomy (RLL). All patients were submitted to spirometry and arterial blood gas analysis. The effects of lung surgery on respiratory function depends upon the extent of the resected tissue.