Exopolysaccharides from Klebsiella oxytoca: anti-inflammatory activity

Abstract Exopolysaccharides (EPS) produced by Klebsiella oxytoca are of environmental, pharmaceutical, and medicinal interest. However, studies about the anti-inflammatory activity of EPS produced by this microorganism still remain limited. The aim of this study was to produce, characterize, and evaluate the anti-inflammatory activity of EPS from K. oxytoca in a pleurisy model. Colorimetric analysis revealed that precipitated crude exopolysaccharides (KEPSC) and deproteinated exopolysaccharides (KEPS) present high levels of total carbohydrates (65.57% and 62.82%, respectively). Analyses of uronic acid (7.90% in KEPSC and 6.21% in KEPS) and pyruvic acid (3.01% in KEPSC and 1.68% in KEPS) confirm that the EPS are acidic. Gas chromatography-mass spectrometry analyses demonstrated that the EPS consisted of rhamnose (29.83%), glucose (11.21%), galactose (52.45%), and mannose (6.50%). The treatment of an experimental pleurisy model in rats through subcutaneous administration of 50, 100, 200, and 400 mg/kg of KEPS decreased both the volume of inflammatory exudate and the number of leukocytes recruited to the pleural cavity. The present data showed that EPS production by K. oxytoca using the method described is easy to perform and results in a good yield. In addition, we show that KEPS exhibit anti-inflammatory activity when administered subcutaneously in rats.

Síndrome de Rosai-Dormfan associada a Lúpus eritematoso sistêmico: relato de caso / Rosai-Dorfman syndrome associated with systemic erythematous lupus: case report

Objetivo: Relatar um caso de associação de Síndrome de Rosai-Dorfman e Lúpus Eritematoso Sistêmico acompanhado no ambulatório de Clínica Médica de nosso Hospital Universitário. Metodologia: O estudo é em formato de relato de caso, realizado a partir de revisão de prontuário e exames complementares. O termo de consentimento livre e esclarecido foi assinado pela paciente. Resultados: Paciente do sexo feminino, 37 anos, com quadro de pneumonia associada a derrame pleural recorrente e linfonodomega-lia generalizada. Na investigação clínica, foi realizado diagnóstico de Lúpus Eritematoso Sistêmico. Os exames anatomopatológico e imuno-histoquímico da biópsia linfonodal foi compatível com Síndrome de Rosai-Dorfman. Conclusões: A Síndrome de Rosai-Dorfman é uma doença benigna que pode mimetizar neoplasias. A progressão da doença é variável e não há tratamento efetivo estabelecido atualmente, sen-do o seguimento regular importante para avaliar compressão de estruturas vitais. Lúpus eritematoso sistêmico é uma doença inflamatória crônica com acometimento multissistêmico. Seu tratamento adequado costuma resultar em sobrevida longa e com qualidade. Importância do problema e comentários: De acordo com nosso levantamento bibliográfico, este é o quarto artigo relatando a ocorrência concomitante de Síndrome de Rosai-Dorfman e Lúpus Eritematoso Sistêmico em um paciente (AU)

Objective: To report a case of association of Rosai-Dorfman syndrome and Systemic Lupus Erythema-tosus followed at the Internal Medicine ambulatory of our University Hospital. Methodology: This stu-dy is in a case report format, carried out from a review of medical records and complementary exams. The consent form was signed by the patient. Results: Female patient, 37 years old, with a history of pneumonia associated with recurrent pleural effusion and generalized lymphadenopathy. In the clini-cal investigation, Systemic Lupus Erythematosus was diagnosed. The anatomopathological and im-munohistochemical exams of lymph node biopsy were compatible with Rosai-Dorfman Syndrome. Conclusions: Rosai-Dorfman Syndrome is a benign disease that can mimic neoplasms. The disease progres-sion is variable and, currently, there is no effective treatment established. Regular follow-up is important to assess vital structures compression. Systemic Lupus Erythematosus is a chronic inflammatory disease with multisystem affection. The appropriate treatment usually results in long-term and high-quality survival. Pro-blem impact and comments: According to our bibliographic survey, this is the fourth article reporting the concomitant occurrence of Rosai-Dorfman Syndrome and Systemic Lupus Erythematosus in a patient (AU)

Retentissement des pleurésies exsudatives sur les activités professionnelles

La pleurésie est une affection fréquente en Afrique, d'origine souvent infectieuse. Le but de notre travail était d'évaluer le retentissement de la pleurésie sur les activités professionnelles. Il s'agit d'une étude transversale, réalisée dans un service de médecine physique et réadaptation fonctionnelle, sur une durée de 9 mois. Etaient inclus les patients présentant une pleurésie avec ou sans atteinte parenchymateuse, menant une activité professionnelle. Les données pleuropulmonaires, l'état psychiatrique, et les capacités professionnelles ont été étudiés. 25 patients ont été inclus, d'âge moyen de 37,4ans et le sex-ratio de 2,1. Les travailleurs de force était plus représentés (60 %). Le syndrome d'épanchement pleural persistait dans 60% des cas. (60%). L'anxio-dépression était associée chez 92% des patients. Les autres signes associés à la pleurésie sont les réveils nocturnes (56%), la somnolence diurne (40%) et la fatigue (40%). Une répercussion sur les activités professionnelles (48% ) a été notée. Les facteurs déterminants de cette reprise d'activités sont la douleur(p=0,04), l'existence de céphalées matinales (p=0,03), les réveils nocturnes (p=0,09) et la rééducation (p=0,034). Conclusion : La limitation de ces conséquences professionnelles de la pleurésie, nécessite une prise en charge de la douleur sur tous ces aspects et de l'état psychologique

Risk factors predicting development of complications in 72 dogs with esophageal foreign bodies / 대한수의학회지

The aim of this study was to determine predictive risk factors implicated in complications in dogs with esophageal foreign bodies. Medical records of 72 dogs diagnosed with esophageal foreign bodies by endoscopy were reviewed retrospectively. Factors analyzed included age; breed; gender; body weight, location, dimension, and type of foreign body; and duration of impaction. To identify risk factors associated with complications after foreign body ingestion, categorical variables were analyzed using the chi-square or Fisher's exact tests and multivariate analysis, as appropriate. Complications secondary to esophageal foreign body ingestion included megaesophagus, esophagitis, perforation, laceration, diverticulum, and pleuritis. Univariate analysis revealed that the location and duration of impaction after foreign body ingestion were associated with an increased risk of esophageal laceration and perforation. Multivariate analysis showed that age, duration of impaction, and foreign body dimension were significant independent risk factors associated with the development of complications in dogs with esophageal foreign bodies. In conclusion, these results showed that longer duration of impaction and larger foreign body dimensions may increase the risks of esophageal laceration, perforation, and plueritis in dogs.

Traditional Medicine Doctor Kim Gwangjin's Battle against Jaundice during the Japanese Colonial Period / 의사학

This study aims to examine how traditional medicine doctors (醫生) of the Japanese colonial period in Korea treated patients and their own diseases with traditional medicine (漢方) and Western medicine (洋方) by analyzing Clinical Cases (治案) and A Diary of Jaundice Treatment (治疸日記) of Kim Gwangjin (金光鎭, 1885–1940). Through this inquiry, this study aims to reveal that the Japanese colonial period was a time when the traditional medicine and the Western medicine coexisted, and that this period cannot be simply defined as a dualism between “Western medicine, Japanese colonial government” versus “traditional medicine, governed public.” Kim Gwangjin's main method of medical treatment was traditional medicine. Clinical Cases include over 60 treatment cases, and they illustrate that he was a typical doctor at the time using traditional medical knowledge. In addition, Kim wrote A Diary of Jaundice Treatment from January 1939 to July 1940, a month before his death. The disease that led to his death was jaundice. He examined the changes in his abdomen every day, and recorded the changes in edema in upper extremities and testicles, urine and feces. While the treatment that Kim used in the early stages of jaundice were herbal medicines, he was not confined to the boundaries of the traditional medicine as he studied Western medicine to obtain a license of traditional medicine doctor from Japanese colonial government. He took a urine test to confirm whether his illness was jaundice or kidney disease and had X-ray imaging to check for pleurisy at a Western medical hospital in Daegu. Furthermore, he received a procedure to artificially drain bile, took a medicine to excrete bile into the feces, and had injection to treat neuralgia. Mostly, it was diarrhea that bothered Kim, who had been suffering from jaundice. Preventing diarrhea led to edema, and removing edema led to diarrhea again. He managed his symptoms by stopping the herbal medicine treatments and going on a raw food diet. Around this time, Kim relied the most on Ejisan (エヂ散). Ejisan was a type of new medicine mixed with traditional medicine and Western medicine that had the effect of treating edema and digestive disorders. Kim personally manufactured and took the drug until a month before his death, praising it as a necessary drug to treat jaundice. Kim was a traditional medical doctor during the Japanese colonial period. He also had the conventional wisdom that Western medicine was excellent in treating surgical diseases but not effective in internal medicine. However, he used both traditional medicine and Western medicine to treat symptoms of jaundice that have not been treated well and created a new medicine called Ejisan, which combined the two types of medicines. For him, Western medicine was a new medicine that improved the wrong aspects of traditional medicine or the old medicine, but there was still a realm of traditional medicine that Western medicine could not intervene. Furthermore, he published a new theory of traditional medicine called the Principle of Up and Down (升降論), which incorporates some Western medical knowledge. The Japanese colonial government required traditional medicine doctors to study Western medicine, and traditional medicine doctors had to learn Western medicine in order to survive. In the meantime, traditional medicine doctors such as Kim have brought about new changes by integrating the two medical treatments in the clinical field. The Japanese colonial government planned the demise of traditional medicine by forcing traditional medicine doctors to study the Western medicine, but the unexpected achievement brought about by traditional medicine doctors, who survived longer than the Japanese Empire and the colonial government, was an attempt to integrate Eastern and Western medicine.

Caso de autopsia: Paracoccidioides diseminada en paciente inmunocomprometido / Autopsy Case: Disseminated paracoccidiodes in an immunocompromised patient

Paracoccidioides brasiliensis is the predominant dimorphic fungal disease in Latin America. Males between 29 to 40 years of age are most often affected. Inhalation of the infecting particle produces a localized alveolitis. The organisms then may disseminate to the skin, mucous membranes, lymph nodes, adrenal glands, liver, spleen, bones, central nervous system and digestive tract, giving a multisystemic affectation, mainly in immunocompromised hosts. A male 34 years old with a history of immunocompromised VIH +, was studied. The characteristics in authopsy are described, with previous diagnosis of diseminated. Paracoccidioides brasiliensis, with intraalveolar hemorrhage, pleuritis and pericarditis. Deep systemic micosis and opportunistic are pathologies that present with increased frequency in recent years, mainly by the rise of the VIH+ infected population. Despite this circumstance, the coexistence of Paracoccidioide infection and VIH+ is scarce in the literature, and for that reason, we present this case of autopsy.

Bee venom stimulation of a lung meridian acupoint reduces inflammation in carrageenan-induced pleurisy: an alternative therapeutic approach for respiratory inflammation

Respiratory inflammation is a frequent and fatal pathologic state encountered in veterinary medicine. Although diluted bee venom (dBV) has potent anti-inflammatory effects, the clinical use of dBV is limited to several chronic inflammatory diseases. The present study was designed to propose an acupoint dBV treatment as a novel therapeutic strategy for respiratory inflammatory disease. Experimental pleurisy was induced by injection of carrageenan into the left pleural space in mouse. The dBV was injected into a specific lung meridian acupoint (LU-5) or into an arbitrary non-acupoint located near the midline of the back in mouse. The inflammatory responses were evaluated by analyzing inflammatory indicators in pleural exudate. The dBV injection into the LU-5 acupoint significantly suppressed the carrageenan-induced increase of pleural exudate volume, leukocyte accumulation, and myeloperoxidase activity. Moreover, dBV acupoint treatment effectively inhibited the production of interleukin 1 beta, but not tumor necrosis factor alpha in the pleural exudate. On the other hand, dBV treatment at non-acupoint did not inhibit the inflammatory responses in carrageenan-induced pleurisy. The present results demonstrate that dBV stimulation in the LU-5 lung meridian acupoint can produce significant anti-inflammatory effects on carrageenan-induced pleurisy suggesting that dBV acupuncture may be a promising alternative medicine therapy for respiratory inflammatory diseases.

Cas clinique de leptospirose révélée par des douleurs thoraciques et un ictere cholestatique chez un ouvrier de forage au Bénin

La leptospirose est une anthropozoonose à répartition mondiale, caractérisée par une forte incidence en milieu tropical et un grand polymorphisme clinique. La maladie est reconnue comme un problème de santé publique émergent aussi bien dans les pays en voie de développement que dans les pays développés. La contamination se fait soit directement par exposition à l'urine d'animaux infestés, soit indirectement dans l'eau souillée par les urines. La gravité de l'affection tient aux atteintes hépatiques et rénales. Aucune donnée publiée n'existe sur cette affection au Bénin. Nous rapportons un cas de leptospirose révélée à Cotonou par des douleurs thoraciques et un ictère cholestatique chez un ouvrier de forage

Rol de la cirugía en el manejo de la infección invasora por Saprochaete capitata / Role of surgery in Saprochaete capitata (S. capitata) sepsis in a patient with acute myeloid leukemia

Saprochaete capitata (S. capitata) fungal sepsis is a severe condition with a clinical presentation that is similar to other yeast originated fungal sepsis. It is observed in patients with hematological malignancies such as acute myeloid leukemia and neutropenia. We report a 23 year old male presenting with cough, fever and malaise. A bone marrow biopsy led to the diagnosis of acute myeloid leukemia. During the first cycle of chemotherapy the patient presented fever: blood cultures were positive for Klebsiella pneumoniae. Despite antimicrobial treatment, fever persisted; a computed tomography showed a focal splenic lesion; a left exudative pleural effusion appeared. A Matrix Assisted Laser Desorption Ionization-Time of Flight mass spectrometry identified the presence of S. capitata. After multiple antifungal treatments and pleural cavity cleansing by means of videothoracoscopy and laparoscopic splenectomy, the infection resolved and the patient completed his chemotherapy.

Real-time PCR assay for the diagnosis of pleural tuberculosis / Reacción en cadena de la polimerasa en tiempo real para el diagnóstico de tuberculosis pleural

Abstract Introduction: The diagnosis of pleural tuberculosis requires an invasive and time-consuming reference method. Polymerase chain reaction (PCR) is rapid, but validation in pleural tuberculosis is still weak. Objective: To establish the operating characteristics of real-time polymerase chain reaction (RT-PCR) hybridization probes for the diagnosis of pleural tuberculosis. Methods: The validity of the RT-PCR hybridization probes was evaluated compared to a composite reference method by a cross-sectional study at the Hospital Universitario de la Samaritana. 40 adults with lymphocytic pleural effusion were included. Pleural tuberculosis was confirmed (in 9 patients) if the patient had at least one of three tests using the positive reference method: Ziehl-Neelsen or Mycobacterium tuberculosis culture in fluid or pleural tissue, or pleural biopsy with granulomas. Pleural tuberculosis was ruled out (in 31 patients) if all three tests were negative. The operating characteristics of the RT-PCR, using the Mid-P Exact Test, were determined using the OpenEpi 2.3 Software (2009). Results: The RT-PCR hybridization probes showed a sensitivity of 66.7% (95% CI: 33.2%-90.7%) and a specificity of 93.5% (95% CI: 80.3%-98.9%). The PPV was 75.0% (95% CI: 38.8%-95.6%) and a NPV of 90.6% (95% CI: 76.6%-97.6%). Two false positives were found for the test, one with pleural mesothelioma and the other with chronic pleuritis with mesothelial hyperplasia. Conclusions: The RT-PCR hybridization probes had good specificity and acceptable sensitivity, but a negative value cannot rule out pleural tuberculosis.

Resumen Introducción: El diagnóstico de tuberculosis pleural requiere un método de referencia invasivo y demorado. La reacción en cadena de la polimerasa es rápida, pero su validación en tuberculosis pleural aún es débil. Objetivo: Establecer las características operativas de la reacción en cadena de la polimerasa en tiempo real (RT-PCR) sondas de hibridación para el diagnóstico de tuberculosis pleural. Métodos: Se evaluó la validez de la RT-PCR sondas de hibridación comparada con un método de referencia compuesto mediante un estudio transversal en el Hospital Universitario de la Samaritana. Se incluyeron 40 adultos con derrame pleural linfocitario. Tuberculosis pleural fue confirmada (en 9 pacientes) si el paciente tenía mínimo una de tres pruebas del método de referencia positiva: Ziehl-Neelsen o cultivo para Mycobacterium tuberculosis en líquido o tejido pleural, o biopsia pleural con granulomas; se descartó tuberculosis pleural (en 31 pacientes) si las tres pruebas eran negativas. Se determinaron las características operativas de la RT-PCR, mediante la Prueba Mid-P Exact, con el Software OpenEpi 2.3 (2009). Resultados: La RT-PCR sondas de hibridación mostró una sensibilidad del 66.7% (IC 95%: 33.2%-90.7%) y una especificidad del 93.5% (IC 95%: 80.3%-98.9%). El VPP fue de 75.0% (IC 95%: 38.8%-95.6%) y un VPN de 90.6% (IC 95%: 76.6%-97.6%). Se encontraron dos falsos positivos para la prueba, uno con mesotelioma pleural y otro con pleuritis crónica con hiperplasia mesotelial. Conclusiones: La RT-PCR sondas de hibridación tuvo una buena especificidad y una aceptable sensibilidad, pero un valor negativo no puede descartar tuberculosis pleural.

Loculated Tuberculous Pleural Effusion: Easily Identifiable and Clinically Useful Predictor of Positive Mycobacterial Culture from Pleural Fluid / 결핵및호흡기질환

BACKGROUND: Isolation of M. tuberculosis (MTB) is required in cases of Tuberculous pleural effusion (TBPE) for confirming diagnosis and successful therapy based on drug sensitivity test. Several studies have focused on predictors of MTB culture positivity in TBPE. However, the clinical role of loculated TBPE as a predictor of MTB cultivation from TBPE remains unclear. The aim of this study was to examine possible predictors including loculation of TBPE of MTB culture positivity in TBPE. METHODS: We retrospectively examined associations between clinical, radiological, microbiological, and laboratory characteristics and positive MTB culture from TBPE to determine a potent predictor of culture positivity. RESULTS: From January 2011 to August 2015, 232 patients with TBPE were identified. Of these, 219 were finally analyzed. Among them, 69 (31.5%) were culture positive for MTB in TBPE and 86 (39.3%) had loculated TBPE. In multivariate logistic regression analysis, the loculation of TBPE was independently associated with culture positivity for MTB in TBPE (adjusted odds ratio [OR], 40.062; 95% confidence interval [CI], 9.355–171.556; p<0.001). In contrast, the lymphocyte percentage of TBPE (adjusted OR, 0.934; 95% CI, 0.899–0.971; p=0.001) was inversely associated with culture positivity for MTB in TBPE. CONCLUSION: In clinical practice, identification of loculation in TBPE is easy, reliable to measure, not uncommon and may be helpful to predict the possibility of positive mycobacterial culture.

Complicaciones pulmonares de la neumonía química: A propósito de un caso / Pulmonary complications of chemical pneumonía; a case report

La aspiración de hidrocarburos puede causar un daño significativo a los pulmones al inducir una respuesta inflamatoria, alveolitis exudativa hemorrágica y pérdida de la función del tensioactivo pulmonar. El efecto secundario más grave de la aspiración de hidrocarburos es la neumonía por aspiración. Anteriormente se han notificado casos de neumotórax, neumatocele, síndrome de dificultad respiratoria aguda (SDRA), absceso pulmonar, fístula broncopleural, derrame pleural bilateral hemorrágico y pioneumotórax. En este artículo presentamos el caso de un paciente hospitalizado debido a neumonía por aspiración que desarrolló pleuritis y neumotórax después de ingerir disolvente para pintura. Se presenta este caso ya que raramente se ha informado en niños como causa de complicaciones pulmonares diferentes. Es necesario evaluar integralmente a los pacientes con complicaciones asociadas a la intoxicación por hidrocarburos. Debe evitarse el alta hospitalaria temprana de los pacientes, quienes deben ser controlados durante, al menos, 48 horas, aunque no tengan síntomas respiratorios. Debe considerarse que los pacientes con neumonía química pueden tener complicaciones pulmonares graves.

Hydrocarbon aspiration (HA) can cause significant lung disease by inducing an inflammatory response, hemorrhagic exudative alveolitis, and loss of surfactant function. The most serious side effect of HA is aspiration pneumonia. Pneumothorax, pneumatocele, acute respiratory distress syndrome (ARDS), pulmonary abscess, bronchopleural fistula, bilateral hemorrhagic pleural effusion and pyopneumothorax were previously reported. Hereby we report a patient hospitalized due to aspiration pneumonia who developed pleurisy and pneumothorax after drinking paint thinner. It is presented as it was seldom reported in children to cause distinct pulmonary complications. Patients with complaints associated withhydrocarbon poisoning must be fully evaluated. They must not be discharged from the hospital early and must be followed for at least 48 hours even if they don't have respiratory symptoms. It should be kept in mind that severe pulmonary complications can develop in patients with chemical pneumonia.

Corticosteroid Therapy for Refractory Uremic Pleurisy / 이화의대지

Uremic pleuritis is a fibrinous pleuritis of unknown pathogenesis in patients with chronic kidney disease. Although it responds to regular dialysis or repeated thoracentesis, cases that are refractory to those therapies have been reported. We report a case of uremic pleuritis which showed marked improvement following corticosteroid therapy. The effusion was exudate, and negative in cytology and microbiology. Pleural biopsy revealed chronic inflammation with fibrosis. The pleural effusion did not respond to chest tube drainage and continuance of hemodialysis. With a diagnosis of refractory uremic pleuritis, we started methylprednisolone. The pleural effusion responded to the treatment and resolved without complication.

Utility of adenosine deaminase (ADA), PCR & thoracoscopy in differentiating tuberculous & non-tuberculous pleural effusion complicating chronic kidney disease.

Background & objectives: Pleural effusion is a common occurrence in patients with late-stage chronic kidney disease (CKD). In developing countries, many effusions remain undiagnosed after pleural fluid analysis (PFA) and patients are empirically treated with antitubercular therapy. The aim of this study was to evaluate the role of adenosine deaminase (ADA), nucleic acid amplification tests (NAAT) and medical thoracoscopy in distinguishing tubercular and non-tubercular aetiologies in exudative pleural effusions complicating CKD. Methods: Consecutive stage 4 and 5 CKD patients with pleural effusions underwent PFA including ADA and PCR [65 kDa gene; multiplex (IS6110, protein antigen b, MPB64)]. Patients with exudative pleural effusion undiagnosed after PFA underwent medical thoracoscopy. Results: All 107 patients underwent thoracocentesis with 45 and 62 patients diagnosed as transudative and exudative pleural effusions, respectively. Twenty six of the 62 patients underwent medical thoracoscopy. Tuberculous pleurisy was diagnosed in six while uraemic pleuritis was diagnosed in 20 subjects. The sensitivity and specificity of pleural fluid ADA, 65 kDa gene PCR, and multiplex PCR were 66.7 and 90 per cent, 100 and 50 per cent, and 100 and 100 per cent, respectively. Thoracoscopy was associated with five complications in three patients. Interpretation & conclusions: Uraemia remains the most common cause of pleural effusion in CKD even in high TB prevalence country. Multiplex PCR and thoracoscopy are useful investigations in the diagnostic work-up of pleural effusions complicating CKD while the sensitivity and/or specificity of ADA and 65 kDa gene PCR is poor.

Clinical value of pleural biopsy in the etiological diagnosis of children with pleurisy / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.</p><p><b>METHOD</b>Totally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.</p><p><b>RESULT</b>(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.</p><p><b>CONCLUSION</b>Pleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.</p>

Diffuse Large B-cell Lymphoma Arising from Chronic Tuberculous Empyema

Pyothorax-associated lymphoma is a relatively rare type of lymphoma that occurs in patients who have long histories of tuberculous pleuritis or induced pneumothorax. It is a type of non-Hodgkin's lymphoma of mainly the B-cell phenotype and is strongly associated with Epstein-Barr virus infection. A majority of these cases have been reported in Japan, although some cases have occurred in Western countries. Here, we describe a case of pyothorax-associated lymphoma in a patient with a 30-year history of chronic tuberculous empyema. The patient underwent decortication under the impression of chronic empyema with fistula. The histopathologic diagnosis was a diffuse large B-cell lymphoma associated chronic inflammation.

Pleuris associada à criptococose em cão: relato de caso / Pleurisy associated with cryptococcosis in a dog: case report

A Criptococose é uma importante doença infecciosa fúngica, causada por uma levedura do gênero Cryptococcus, que acomete diferentes espécies inclusive o homem. Há poucos relatos na literatura sobre a criptococose pulmonar em cães. O presente trabalho relata um caso de criptococose em um cão apresentando alterações respiratórias, especialmente dispneia. O diagnóstico foi realizado por meio da citologia aspirativa, após toracotomia exploratória, sendo observado um quadro de pleuris grave. O paciente foi tratado durante 90 dias com itraconazol e apresentou, ao final do tratamento, a remissão completa dos sintomas relatados...

Cryptococcosis is a major infectious disease caused by a yeast from the Cryptococcus genre which affects different species including humans. There are few reports related to pulmonary cryptococcosis in dogs. A case of Cryptococcosis in a dog showing dyspnea was described. The diagnosis was done by aspiration cytology after exploratory thoracotomy, and a picture of severe pleurisy was observed. The diagnosis was done by needle aspiration cytology after thoracotomy. Severe pleuris frame was observed. Treatment with itraconazole was performed for 90 days, and at the end of the treatment the dog presented complete remission of reported symptoms...