Clinicopathologic characteristics of pediatric tuberculous pleural effusion: a retrospective analysis of 112 consecutive cases.

OBJECTIVE: The aim of this study was to describe the clinicopathologic characteristics of pediatric tuberculous pleural effusion (TPE) patients to make an accurate diagnosis. PATIENTS AND METHODS: Pediatric TPE patients who admitted to Shandong Provincial Chest Hospital were retrospectively reviewed from March 2006 to April 2015. RESULTS: 112 pediatric TPE patients were enrolled. The mean age was 11.6 ± 3.2 years. 60 (53.6%) patients were diagnosed as TPE, 40 (35.7%) were TPE+Pulmonary tuberculosis (PTB). 96 (85.7%) patients had fever (> 37°C), 81 (72.3%) had dyspnea, 63 (56.3%) had cough. Radiological test results showed effusions on the right side in 58 patients (51.8%), on the left side in 50 patients (44.6%), and on both sides in 4 patients (3.6%). 6 (5.4%) patients were acid-fast bacilli (AFB) smear-positive. 16 (14.3%) PCR positive patients were identified. 41 (36.6%) TB patients were culture-positive. Almost all effusions (99.1%) had the biologic characteristics of exudates. In 91.2% of the effusions, more than 50% of leukocytes were lymphocytes. Pleural adenosine deaminase (40 U/L) was positive in 74.5% of the patients, and erythrocyte sedimentation rate was raised in 84.1%. CONCLUSIONS: The usefulness of routine microbiological tests to diagnose pleural TB is limited by its poor sensitivity. Further studies should be performed to validate new techs and assays for pediatric TPE.

Pleural effusion adenosine deaminase is not accurate in diagnosis of pediatric tuberculous pleural effusion: a retrospective study.

OBJECTIVE: Pleural effusion (PE) adenosine deaminase (ADA) has good performance in detection of tuberculous pleural effusion (TPE). However, few study was conducted for its value in pediatric patients. To evaluate PE ADA in diagnosis of pediatric TPE, a retrospective study was performed. PATIENTS AND METHODS: 204 pediatric PE patients were enrolled, and then were grouped into TPE group (77 cases, aged 11.51 ± 0.40 years) and non-TPE group (127 cases, aged 6.39 ± 0.35 years). Man-Whitney U test was used to compare difference in pleural ADA between the two groups. The correlation between age and ADA activity was analyzed by Spearman's correlation coefficient analysis. RESULTS: In our study, there was no difference in pleural ADA between TPE (62.1 ± 4.2 U/L) and non-TPE patients (87.7 ± 10.0 U/L). Compared with empyema patients (183.8 ± 30.0 U/L), pleural ADA was lower in parapneumonic effusion (PPE) patients (63.4 ± 3.8, p < 0.01), or TPE patients (p <0.01). Correlation analysis showed that there were no correlation between age and pleural ADA within TPE, PPE or both patients (all p > 0.05). Meanwhile, there was no significant difference in PE ADA level between genders. CONCLUSIONS: Considering the fact that the majority of pediatric PEs is TPE and PPE, our study suggests that PE ADA isn't accurate in detection of pediatric TPE. Meanwhile, an extremely high ADA activity should raise suspicion of empyema or lymphoma.

Off-line separation and determination of rare earth elements associated with chloroplast pigments of hyperaccumulator Dicranopteris dichotoma by normal-phase liquid chromatography and ICP-MS.

An off-line normal-phase liquid chromatography-ICP-MS method has been used for separation and determination of the rare earth elements (REE) associated with chloroplast pigments of Dicranopteris dichotoma. The stability of REE-bound pigments was tested, and almost no destruction of REE-bound pigments occurred during the so-called normal-phase liquid chromatography. The accumulated free REE ions on the microcrystalline cellulose column were cleaned by elution with 5 mmol L(-1) 2-ethylhexyl hydrogen 2-ethylhexylphosphonate (P507), to avoid exchange of these free ions with metals from the pigments. When these precautions were taken, the method was applied to the study of REE-bound pigments in D. dichotoma. ICP-MS results showed REE were present in chlorophylls and lutein, although REE concentrations in carotene and pheophytin were both below procedural blank levels. By careful analysis of the eluate fractions containing chlorophyll a it was found that REE-bound chlorophyll a in D. dichotoma was slightly enriched in the fractions with relatively short retention time. Results indicated that the retention time of REE-bound chlorophyll a might be slightly less than that of magnesium chlorophyll a, and REE-bound chlorophylls might be of relatively low polarity in comparison with magnesium bound chlorophylls. This phenomenon could be explained by the special double-decker sandwich-structure of REE-bound chlorophylls, as was reported by us and other authors. On the basis of these results we preferred to consider that REE can replace magnesium in chlorophyll a of D. dichotoma, and that the role of REE-bound chlorophylls in photosynthesis cannot be neglected. These data might be useful for understanding of both the properties of REE-bound pigments and the effect of REE on plant photosynthesis.

Effect of lanthanide chloride on photosynthesis and dry matter accumulation in tobacco seedlings.

To investigate the physiological effects of rare earth ions, we have studied the effect of LaCl3 on the photosynthetic light reactions in tobacco (Nicotiana tobacum). When treated with 5-20 mg/L LaCl3 in Hoagland solution by water culture, the dry matter accumulation of different parts in tobacco, the content of chlorophyll increased gradually, but decreased when the concentration of LaCl3 was > or = 50 mg/L. The optimum concentration for growth appeared to be about 20 mg/L of LaCl3 in nutrient solution. La3+ promoted the activities of the Hill reaction, Mg2(+)-ATPase, and stimulated the rate of photophosphorylation in chloroplast at low concentrations, but inhibited them at high concentrations. It is concluded that La3+ stimulated the growth of tobacco seedlings and accelerated the photosynthetic light reactions at suitable concentration in vivo.

Use of intraoperative ultrasonography during hepatolithectomy.

Complete clearance of intrahepatic stones has long been a major surgical challenge. To reduce the incidence of residual stones, we used intraoperative ultrasonography (IOUS) to localize them and guide lithectomy in 38 patients with hepatolithiasis between July 1988 and December 1993. All patients had multiple intrahepatic stones; 24 had accompanying extrahepatic calculi. Hepatic stones were confined to the left intrahepatic biliary tract in 13 patients, to the right in 9, and in both lobes in 16. Twenty-three patients underwent common bile duct exploration followed by T-tube drainage, 8 had transhepatic lithotomy with or without choledocholithotomy, 3 had choledocolithotomy and Roux-en-Y side-to-side choledochojejunostomy, and 2 had hepaticojejunostomy, left lobectomy was performed in the remainder. In 35 patients cholecystectomy was performed at the same time. Complete clearance of the stones was achieved in 36 patients (94.7%). The incidence of retained stone was decreased to 5.3%. No associated complications occurred. IOUS can accurately localize intrahepatic calculi, directly orient lithotomy instruments to approach the stones, demonstrate the spatial relation between stone and intrahepatic critical structure, and thereby choose an optical route for transhepatic lithotomy. Imaging can be repeated at any time with no radiation exposure to the patient or the medical staff.

Determination of nickel in water by chemiluminescence.

The acetone chemiluminescence determination of nickel in water was investigated. Optimization data for the determination of Ni2+ and interference data for over 20 species are provided. The limit of detection for Ni2+ by this method is 2.5 ng ml-1, and the linear dynamic range is from 10 ng ml-1 to 1 microgram ml-1. The application of the method to the determination of Ni2+ in river and waste waters is discussed.