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1.
J Oral Rehabil ; 45(3): 240-249, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29314191

RESUMEN

Current bibliometric analyses of the evolving trends in research scope category across different time periods using the H-classics method in implantology are considerably limited. The purpose of this study was to identify the classic articles in implantology to analyse bibliometric characteristics and associated factors in implantology for the past four decades. H-Classics in implantology were identified within four time periods between 1977 and 2016, based on the h-index from the Scopus® database. For each article, the principal bibliometric parameters of authorship, geographic origin, country origin, and institute origin, collaboration, centralisation, article type, scope of study and other associated factors were analysed in four time periods. A significant increase in mean numbers of authors per H-Classics was found across time. Both Europe and North America were the most productive region/country and steadily dominated this field in each time period. Collaborations of author, internationally and inter-institutionally had significantly increased across time. A significant decentralisation in authorships, institutes and journals was noted in past four decades. The journal of Clinical Oral Implant Researches has raised its importance for almost 30 years (1987-2016). Research on Complications, peri-implant infection/pathology/therapy had been increasing in production throughout each period. This is the first study to evaluate research trends in implantology in the past 40 years using the H-classics method, which through analysing via principle bibliometric characteristics reflected a historical perspective on evolutionary mainstream in the field. Prominence of research regarding complications may forecast innovative advancements in future.


Asunto(s)
Investigación Biomédica , Implantación Dental , Periodoncia , Edición/normas , Bibliometría , Bases de Datos Factuales , Implantes Dentales , Humanos
2.
Int J Tuberc Lung Dis ; 23(6): 678-684, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-31315699

RESUMEN

BACKGROUND Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) share common risk factors. They could therefore be expressed in a single patient. However, the prevalence, clinical characteristics and prognosis of individuals with comorbid IPF and COPD are not known. METHOD From 2003 to 2007, the Korean Interstitial Lung Disease Study Group created a register for idiopathic interstitial pneumonia using 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) criteria. Of the 1546 IPF patients assessed, 143 had decreased lung function consistent with COPD (IPF-COPD). COPD was diagnosed based on age (≥40 years) and pulmonary function (forced expiratory volume in 1 sec [FEV1]/forced vital capacity [FVC] ratio < 0.7). RESULTS The median age of the IPF-COPD group was 71.0 years (interquartile range 66.0-76.0); most patients were male (88.1%). FVC (%) was significantly higher in the IPF-COPD group; however, FEV1 (%) was significantly lower in the IPF-COPD group (P < 0.001). Diffusing capacity of the lung for carbon monoxide (DLCO) was not significantly different between the two groups. In survival analysis, age and FVC (%), but not COPD, were significantly associated with prognosis (respectively P = 0.003, 0.001 and 0.401). COPD severity was also not related to prognosis (P = 0.935). CONCLUSION The prevalence of IPF-COPD was estimated to be ∼9.2% among all IPF patients; prognosis of patients with IPF-COPD was not worse than those with IPF alone. .


Asunto(s)
Fibrosis Pulmonar Idiopática/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Adulto , Anciano , Femenino , Volumen Espiratorio Forzado , Humanos , Fibrosis Pulmonar Idiopática/complicaciones , Fibrosis Pulmonar Idiopática/mortalidad , Fibrosis Pulmonar Idiopática/patología , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/patología , Sistema de Registros , República de Corea/epidemiología , Capacidad Vital
3.
Int J Tuberc Lung Dis ; 12(6): 698-700, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18492342

RESUMEN

This study investigated the potential role of vitamin D-receptor (VDR) gene polymorphisms in susceptibility to lung disease caused by non-tuberculous mycobacteria (NTM). TaqI and FokI polymorphisms were compared in 124 patients and 127 controls. The genotype, allele and haplotype frequencies did not differ between patients and controls. TaqI and FokI polymorphisms of the VDR gene do not appear to be responsible for host susceptibility to NTM lung disease, at least in this Korean population. An association cannot, however, be completely ruled out, as only two single nucleotide polymorphisms of the VDR gene were studied in this report.


Asunto(s)
Pueblo Asiatico/genética , Predisposición Genética a la Enfermedad/etnología , Enfermedades Pulmonares/genética , Infecciones por Mycobacterium/genética , Infección por Mycobacterium avium-intracellulare/genética , Polimorfismo de Nucleótido Simple , Receptores de Calcitriol/genética , Adulto , Femenino , Humanos , Corea (Geográfico) , Enfermedades Pulmonares/etnología , Enfermedades Pulmonares/microbiología , Masculino
4.
Int J Tuberc Lung Dis ; 10(9): 1001-7, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16964791

RESUMEN

OBJECTIVE: To compare the clinical and radiographic features of pulmonary tuberculosis (PTB) and non-tuberculous mycobacteria (NTM) lung disease in patients with acid-fast bacilli (AFB) positive sputum specimens. DESIGN: The initial clinical and radiographic features of 229 PTB patients were compared with those of 70 patients with NTM lung disease. The most commonly involved organisms in the NTM lung disease cases were Mycobacterium avium complex (n = 38, 54%) and M. abscessus (n = 26, 37%). RESULTS: Clinical and radiographic findings that were more common in patients with NTM lung disease than in PTB patients were: older age (P < 0.001), non-smoker (P < 0.001), history of previous TB treatment (P < 0.001), absence of pleural effusion (P = 0.017), involvement of middle and/or lower lung zones (P = 0.007), and bilateral disease (P = 0.005). Multivariate analysis showed that older age (> or = 40 years), non-smoker, previous TB treatment, absence of pleural effusion and involvement of middle and/or lower lung zones were significant independent predictors for NTM lung disease. CONCLUSIONS: There is considerable overlap in the clinical and radiographic appearances of PTB and NTM lung disease. The isolation and identification of causative organisms are mandatory for a correct diagnosis in patients with AFB-positive sputum specimens.


Asunto(s)
Enfermedades Pulmonares/microbiología , Infecciones por Mycobacterium no Tuberculosas/microbiología , Esputo/microbiología , Tuberculosis Pulmonar/microbiología , Colorantes , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
Int J Tuberc Lung Dis ; 9(9): 1046-51, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16158899

RESUMEN

OBJECTIVE: To investigate the recovery rate of non-tuberculous mycobacteria (NTM) from acid-fast bacilli (AFB) smear-positive sputum specimens at a tertiary care medical centre in South Korea with a high pulmonary tuberculosis (PTB) burden. DESIGN: Retrospective analysis of data from AFB smear- and culture-positive sputum specimens collected between January 1998 and December 2001. RESULTS: Over 4 years, 1328 sputum specimens collected from 616 patients were AFB smear- and culture-positive. NTM were recovered from 9.1% (121/1328) of the smear-positive sputum specimens, and from 8.1% (50/616) of patients with smear-positive sputum. NTM were isolated at least twice in 94% (47/50) of the patients from whom NTM was recovered. The most common organism found was Mycobacterium avium complex, followed by M. abscessus. CONCLUSION: These results suggest that a substantial proportion of patients at a tertiary care medical centre in South Korea with AFB smear-positive sputum specimens may have NTM lung disease rather than PTB.


Asunto(s)
Infecciones por Mycobacterium/diagnóstico , Esputo/microbiología , Tuberculosis Pulmonar/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Corea (Geográfico) , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
Chest ; 110(4): 977-84, 1996 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-8874255

RESUMEN

OBJECTIVE: To assess the utility of CT in the evaluation of pulmonary tuberculosis in patients without AIDS. PATIENTS AND METHODS: This-section CT scans for suspicion of pulmonary tuberculosis were obtained from 226 patients. A total of 38 patients were excluded; the reasons were unavailability of final results (n = 18), patient unavailability for follow-up (n = 13), and coexistence of tuberculosis and aspergilloma (n = 7). The results from 188 patients were used for this study. After assessing the patterns of parenchymal lesion, involved segments, and presence of cavity, bronchiectasis, and bronchogenic spread of the lesion with CT, tentative diagnosis and disease activity were recorded. RESULTS: With CT, 133 of 146 patients (91%) with tuberculosis were correctly diagnosed as having pulmonary tuberculosis whereas 32 of 42 patients (76%) without tuberculosis were correctly excluded. CT diagnosis of lung cancer (n = 8), bacterial pneumonia (n = 2), pulmonary metastasis (n = 1), chronic hypersensitivity pneumonia (n = 1), and diffuse panbronchiolitis (n = 1) turned out to be tuberculosis. Conversely CT diagnoses of tuberculosis appeared pathologically as lung cancer (n = 5), bacterial pneumonia (n = 4), and pulmonary paragonimiasis (n = 1). Active (71/89, 80%) and inactive state (51/57, 89%) of disease respectively could be correctly differentiated by CT. CONCLUSION: CT can be helpful in the diagnosis of pulmonary tuberculosis in most cases. On the basis of CT findings, distinction of active from inactive disease can be made in most cases.


Asunto(s)
Pulmón/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Tuberculosis Pulmonar/diagnóstico por imagen , Adulto , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Estudios Prospectivos , Tuberculosis Pulmonar/terapia
7.
Chest ; 113(2): 344-50, 1998 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9498950

RESUMEN

STUDY OBJECTIVES: To define the clinical characteristics of the patients showing bronchoscopic findings of bronchial narrowing or obliteration with black pigmentation on overlying mucosa (we named this finding as "anthracofibrosis"), and to determine the association of anthracofibrosis with tuberculosis. PATIENTS AND METHODS: The subjects of this study consisted of 28 patients; 8 men and 20 women, ranging in age from 42 to 86 years. The distinctive clinical features, natures of bronchoscopic lesions, and radiologic findings were analyzed retrospectively and summarized. Bacteriologic studies and results of pathologic examinations were also assessed. RESULTS: Chief complaints were cough (20/28) and dyspnea on exertion (17/28). The abnormal bronchoscopic findings were identified most frequently in the right middle lobe bronchus (n=21/28) while more than one part of the bronchial tree was narrowed in 22 patients. Abnormalities of bronchial airways on CT were associated with peribronchial cuffs of soft tissue or surrounding lymph nodes. In 17 patients, active tuberculous infection was confirmed either bacteriologically (n=15) and/or histologically (n=8). Pathologic study of the lesion obtained by bronchoscopic biopsy or thoracotomy showed dense bronchial and/or peribronchial fibrosis with interspersed black pigments. CONCLUSIONS: These findings strongly suggest that bronchial stenosis or obliteration with anthracotic pigmentation in the mucosa was caused by a fibrotic response to active or old tuberculous infection. To prevent the spread of tuberculosis and avoid unnecessary invasive procedures, detailed examinations for the presence of active tuberculosis should be performed in patients with this unique bronchoscopic finding.


Asunto(s)
Enfermedades Bronquiales/etiología , Tuberculosis Pulmonar/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Bacterias/aislamiento & purificación , Biopsia , Bronquios/microbiología , Bronquios/patología , Enfermedades Bronquiales/diagnóstico por imagen , Enfermedades Bronquiales/microbiología , Enfermedades Bronquiales/patología , Líquido del Lavado Bronquioalveolar/citología , Líquido del Lavado Bronquioalveolar/microbiología , Broncoscopía , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Constricción Patológica/microbiología , Constricción Patológica/patología , Tos/etiología , Disnea/etiología , Femenino , Fibrosis , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Membrana Mucosa/patología , Pigmentos Biológicos , Estudios Retrospectivos , Esputo/citología , Esputo/microbiología , Toracotomía , Tomografía Computarizada por Rayos X , Tuberculosis Pulmonar/diagnóstico por imagen , Tuberculosis Pulmonar/microbiología , Tuberculosis Pulmonar/patología
8.
J Crit Care ; 15(3): 103-12, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11011823

RESUMEN

PURPOSE: The purpose of this article is to evaluate the effect of positive end-expiratory pressure (PEEP) during partial liquid ventilation (PLV) and to investigate if lung damage associated with mechanical ventilation can be reduced by PLV. MATERIALS AND METHODS: Twenty-two New-Zealand white rabbits were ventilated in pressure-controlled mode maintaining constant tidal volume (10 mL/kg). Lung injury was induced by repeated saline lavage (PaO2 < 100 mm Hg). Two incremental PEEP steps maneuvers (IPSMs) from 2 to 10 cm H2O in 2 cm H2O steps were performed sequentially. The control group received the first IPSM in the supine position and were turned prone for the second IPSM. In the PLV group (n = 7), 12 mL/kg of perfluorodecalin was instilled after lung injury before the two IPSMs. The early prone group (n = 7) received both IPSMs in the prone position. Parameters of gas exchange, lung mechanics, and hemodynamics as well as pathology were examined. RESULTS: During the first IPSM, the PLV group showed a significant increase in PaO2 after instillation of perfluorodecalin (P < .05) and then showed a dose-dependent increase in PaO2 with PEER. The control and EP groups showed improvement in PaO2 only at higher PEEP, eventually showing no intergroup differences at PEEP of 10 cm H2O. During the second IPSM only the PLV group retained its ability to increase PaO2 to the level obtained during the first IPSM (P < .05 compared with control and EP groups). During the first IPSM all three groups showed increasing trend in static compliance (Cst) with PEEP peaking at PEEP of 8 cm H2O. During the second IPSM, only the PLV group showed increase in static compliance with PEEP (P < .05 compared with other groups). Lung histology revealed significantly less hyaline membrane formation in the PLV group (P < .05). CONCLUSION: PLV shows dose-dependent increase in oxygenation with PEEP and may reduce lung damage associated with mechanical ventilation.


Asunto(s)
Ventilación Liquida , Respiración con Presión Positiva , Respiración Artificial/efectos adversos , Síndrome de Dificultad Respiratoria/prevención & control , Análisis de Varianza , Animales , Hemodinámica , Pulmón/patología , Masculino , Oxígeno/metabolismo , Presión Parcial , Posición Prona , Conejos , Distribución Aleatoria , Respiración Artificial/métodos , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/patología , Mecánica Respiratoria , Posición Supina
9.
Ann Acad Med Singap ; 23(3): 322-6, 1994 May.
Artículo en Inglés | MEDLINE | ID: mdl-7944242

RESUMEN

The contrast sensitivity test (using Vistech charts) was performed on a consecutive sample of 1612 eyes of 807 Republic of Singapore Air Force personnel (two diseased eyes excluded), which had no known ophthalmic disorder. This yielded a large sample norm of spatial Contrast Sensitivity Function (CSF) distribution curves, based on the local population. Although all subjects had their refractive errors fully corrected by spectacles, whenever necessary, to visual acuity of 6/6 or better, myopes had lower mean contrast sensitivity, in the higher spatial frequencies, compared to the emmetropic. Postulates were offered to explain this association, including the concept of micro-amblyopia. Pilots and aircrew performed consistently better than the ground crew, suggesting that target acquisition training may improve contrast sensitivity. Interestingly, sex was also shown to be associated with differences in contrast sensitivity: females were found to have lower spatial contrast sensitivity compared to males. Age was associated with poorer contrast sensitivity only at the lower spatial frequencies in this study sample, while race, with that of higher frequencies; Chinese having lower contrast sensitivity than other races (a heterogeneous group consisting of Malays, Indians, Eurasians and Others). The association of contrast sensitivity with race highlights the importance of using normograms based on the local population. All the above associations were statistically significant at P = 0.05, and independent of each other, based on analysis by multiple regression.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Sensibilidad de Contraste/fisiología , Adolescente , Adulto , Factores de Edad , Aviación , China/etnología , Etnicidad , Femenino , Humanos , Hiperopía/fisiopatología , Masculino , Persona de Mediana Edad , Personal Militar , Miopía/fisiopatología , Errores de Refracción/fisiopatología , Factores Sexuales , Singapur , Agudeza Visual/fisiología
10.
Int J Tuberc Lung Dis ; 17(3): 412-7, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23407232

RESUMEN

SETTING: Patients with new pulmonary infiltrates on chest computed tomography (CT) scans at a tertiary centre in South Korea. OBJECTIVE: To demonstrate associations among radiological changes, blood eosinophilia (E) and Toxocara (T) seropositivity. DESIGN: We retrospectively reviewed blood eosinophilia, Toxocara seropositivity, history of raw meat intake and radiological features, and divided study patients into four groups according to blood eosinophilia and Toxocara seropositivity. RESULTS: Among 150 patients, 62 were E- and T-positive (E+T+), 45 were E-negative and T-positive (E-T+), 7 were E-positive and T-negative (E+T-), and 36 were E- and T-negative (E-T-). History of raw meat intake was found in 95 (63%) patients. The type and number of lesions on CT did not show any significant differences among the four groups. Among 119 patients who were not diagnosed with a specific disease, transient or migrating lesions were seen in 93% of E+T+, 93% of E-T+, 80% of E+T- and 52% of E-T- patients (P < 0.0001). Furthermore, the frequencies of migrating or new lesions and improvement were significantly higher in the Toxocara-positive group (88/95, 93%) than in the Toxocara-negative group (14/24, 58%; P = 0.002). CONCLUSION: Transient and migratory pulmonary infiltrates on chest CT scans were associated with blood eosinophilia and Toxocara seropositivity. Clinicians should consider asymptomatic toxocariasis as a cause of unexplained new pulmonary infiltrates in countries with dietary habits of raw meat intake.


Asunto(s)
Enfermedades Pulmonares Parasitarias/parasitología , Pulmón/parasitología , Toxocara/aislamiento & purificación , Toxocariasis/parasitología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Enfermedades Asintomáticas , Dieta/efectos adversos , Ensayo de Inmunoadsorción Enzimática , Eosinofilia/parasitología , Femenino , Contaminación de Alimentos , Humanos , Pulmón/diagnóstico por imagen , Enfermedades Pulmonares Parasitarias/sangre , Enfermedades Pulmonares Parasitarias/diagnóstico por imagen , Masculino , Carne/parasitología , Persona de Mediana Edad , Valor Predictivo de las Pruebas , República de Corea , Estudios Retrospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos X , Toxocara/inmunología , Toxocariasis/sangre , Toxocariasis/diagnóstico por imagen , Adulto Joven
11.
Anaesth Intensive Care ; 39(5): 862-7, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21970130

RESUMEN

An elevated serum lactate level is associated with morbidity and mortality in patients with severe sepsis and septic shock. In patients with hepatic dysfunction, however an elevated serum lactate level may be due to either impaired lactate clearance or excessive production. Thus, we evaluated whether the initial serum lactate level was also associated with mortality in septic shock patients with hepatic dysfunction. A retrospective observational study enrolled 307 patients with septic shock admitted to the intensive care unit (ICU) between May 2007 and July 2009. Hepatic dysfunction was defined as a serum total bilirubin > 34.2 micromol/l (2 mg/dl). Selected patients were divided into high (> or = 4 mmol/l) and low (< 4 mmol/l) lactate groups, according to the initial serum lactate level. Of 307 patients with septic shock, 118 (38%) patients with hepatic dysfunction were eligible for this study. The median lactate levels were 5.9 (interquartile range 4.7 to 9.0) and 2.6 (interquartile range 1.7 to 3.2) mmol/l for the high and low lactate groups respectively (P < 0.001). The initial serum lactate level was strongly associated with in hospital mortality in a univariate analysis (P < 0.001). After adjusting for potential confounding factors, the initial serum lactate level remained significantly associated with in-hospital mortality (odds ratio 1.281, 95% confidence interval 1.097 to 1.496, P = 0.002). In conclusion, the serum lactate level could be useful in predicting the outcome of patients with septic shock regardless of hepatic dysfunction.


Asunto(s)
Ácido Láctico/sangre , Hepatopatías/sangre , Hepatopatías/complicaciones , Choque Séptico/sangre , Choque Séptico/complicaciones , Anciano , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Estudios Retrospectivos , Análisis de Supervivencia
12.
Int J Tuberc Lung Dis ; 15(5): 674-9, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21756521

RESUMEN

OBJECTIVE AND DESIGN: To determine how pulmonary paragonimiasis may be confused with lung cancer, we retrospectively analysed the clinical and radiological characteristics of 47 patients (27 males, median age 55 years; interquartile range 49-61) with serologically or histopathologically confirmed pulmonary paragonimiasis seen between October 2004 and December 2009. RESULTS: Respiratory symptoms were present in 29 (62%) patients; the remaining 18 (38%) were asymptomatic. Chest radiography (CXR) revealed intrapulmonary parenchymal lesions (n = 35, 75%) more frequently than pleural lesions (n = 11, 23%). Of the 47 patients, 28 (60%) were referred for suspected lung cancer. The majority of these patients had no symptoms, and 22 (79%) patients with suspected lung cancer had nodular or mass lesions on CXR. As a result, additional diagnostic procedures were performed to make an accurate diagnosis in these patients, including bronchoscopy in 20, transthoracic lung biopsy in 11 and fluorodeoxyglucose positron emission tomography in seven. Surgical lung resection was performed unnecessarily in six patients. CONCLUSIONS: Pulmonary paragonimiasis presenting with nodular or mass lesions on CXR is common. Clinicians should therefore include pulmonary paragonimiasis in the differential diagnosis of asymptomatic nodular lesions in the lung in patients who have lived in or travelled to paragonimiasis-endemic areas.


Asunto(s)
Enfermedades Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico , Paragonimiasis/diagnóstico , Biopsia , Broncoscopía/métodos , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/parasitología , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Paragonimiasis/diagnóstico por imagen , Paragonimiasis/patología , Tomografía de Emisión de Positrones , Radiografía , República de Corea , Estudios Retrospectivos
13.
Anaesth Intensive Care ; 36(3): 411-7, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18564803

RESUMEN

Flexible bronchoscopy is a useful diagnostic procedure in patients with respiratory failure due to unexplained pulmonary infiltrates, but its safety and usefulness in ventilator-dependent patients with severe thrombocytopenia have not been established. A retrospective review of the medical records of all patients who underwent bronchoscopy while receiving mechanical ventilation support at Samsung Medical Centre, Seoul, Korea between January 2002 and July 2006 was conducted. The medical records of 37 patients with severe thrombocytopenia (platelet count <50,000 /microl) at the time of bronchoscopy were analysed. Mean platelet count was 27,300+/-12,500 /microl. The most common underlying condition was haematologic malignancy, which occurred in 21(56.7%) patients, followed by severe sepsis in five (13.6%) and post-liver transplantation complications and autoimmune disease in four each (10.8%). The procedures performed were bronchoalveolar lavage in 33 patients, washing in three and transbronchial lung biopsy in five. Two patients died within 24 hours of completing the procedure. In patients surviving longer than 24 hours, there was no significant decline in oxygenation index (PaO2/FiO2), sequential organ failure assessment score or simplified acute physiological score II after the procedure. Lung compliance significantly decreased at two hours post-bronchoscopy but recovered to the pre-bronchoscopy level by 24 hours. Intensive care unit mortality was 51.4% (19 of 37 patients). Bronchoscopy was helpful in confirming the diagnosis in 17 patients (45.9%). Therapeutic modifications were made in 14 patients (37.8%) after bronchoscopy. Severe thrombocytopenia per se should not preclude bronchoscopy, even in patients receiving mechanical ventilation.


Asunto(s)
Broncoscopía , Respiración Artificial , Trombocitopenia/complicaciones , Adulto , Anciano , Broncoscopía/efectos adversos , Cuidados Críticos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Sistemas de Atención de Punto , Intercambio Gaseoso Pulmonar , Pruebas de Función Respiratoria , Análisis de Supervivencia , Trombocitopenia/sangre
14.
Eur Respir J ; 30(4): 736-42, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17567674

RESUMEN

The aims of the present study were to investigate the expression of Toll-like receptor (TLR)2 on the peripheral blood monocytes of patients with nontuberculous mycobacterial (NTM) lung disease and healthy controls, and to assess the responses of these monocytes to TLR2 agonists such as Mycobacterium avium and lipoteichoic acid (LTA). Reverse transcriptase-PCR was used to analyse TLR2 mRNA expression in peripheral blood monocytes from 17 NTM patients and 10 healthy controls. mRNA and protein secretion levels were also determined for the cytokines interleukin (IL)-12 p40 and tumour necrosis factor (TNF)-alpha. Expression of TLR2 mRNA by peripheral blood monocytes after stimulation with M. avium or LTA was lower in NTM patients than in healthy controls. IL-12 p40 and TNF-alpha mRNA and cytokine secretion levels were also lower in patients than in healthy controls. Treatment with anti-TLR antibody decreased M. avium- and LTA-induced IL-12 p40 and TNF-alpha production in healthy controls, but not in NTM patients. The present results suggest that the downregulation of Toll-like receptor 2 and the resulting decreased production of interleukin-12 p40 and tumour necrosis factor-alpha following Mycobacterium avium or lipoteichoic acid stimulation may contribute to host susceptibility to nontuberculous mycobacterial lung disease.


Asunto(s)
Regulación de la Expresión Génica , Enfermedades Pulmonares/metabolismo , Enfermedades Pulmonares/microbiología , Infecciones por Mycobacterium/metabolismo , Infecciones por Mycobacterium/microbiología , Receptor Toll-Like 2/biosíntesis , Citocinas/metabolismo , Femenino , Predisposición Genética a la Enfermedad , Humanos , Subunidad p40 de la Interleucina-12/metabolismo , Lipopolisacáridos/metabolismo , Masculino , Persona de Mediana Edad , Monocitos/metabolismo , Mycobacterium avium/metabolismo , ARN Mensajero/metabolismo , Ácidos Teicoicos/metabolismo , Factores de Tiempo , Factor de Necrosis Tumoral alfa/metabolismo
15.
Curr Opin Pulm Med ; 3(5): 332-5, 1997 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9331533

RESUMEN

There is no question that most interstitial lung diseases result in structural alteration of the small airways as well as the alveoli. These structural changes of the airways produce airflow abnormalities that, depending on their extent and severity, are reflected in a variety of tests of pulmonary function. However, in most situations, obstructive lung disease rarely dominates the clinical picture. Airflow limitation may be the predominant defect in patients with Wegener's granulomatosis, lymphangioleiomyomatosis, and chronic eosinophilic pneumonia. Concomitant risk factors such as cigarette smoking or dust inhalation may contribute to airway obstruction. Sporadic cases of interstitial lung disease progressing to overt airflow obstruction have been reported. The clinical significance of airway narrowing in interstitial lung disease is a maldistribution of ventilation that causes abnormalities on gas exchange, thereby increasing the work of breathing and possibly the sensation of dyspnea.


Asunto(s)
Bronquios/patología , Enfermedades Pulmonares Intersticiales/complicaciones , Resistencia de las Vías Respiratorias , Constricción Patológica/etiología , Humanos , Enfermedades Pulmonares Intersticiales/fisiopatología , Intercambio Gaseoso Pulmonar , Ventilación Pulmonar
16.
J Korean Med Sci ; 14(2): 113-27, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10331555

RESUMEN

Idiopathic interstitial pneumonias are currently classified into four categories: usual interstitial pneumonia, nonspecific interstitial pneumonia with fibrosis, acute interstitial pneumonia and desquamative interstitial pneumonia. The fibrotic process in interstitial pneumonias appears to result from a complex interaction between fibroblasts, other lung parenchymal cells and macrophages. The complex relationship between the local release of growth-promoting cytokines by alveolar macrophages and resident fibroblasts represents a necessary step for fibrosis or remodeling after lung injury. Injury to the epithelium and basement membranes is likely necessary for the fibrotic process to occur. Usual interstitial pneumonia, most frequent among interstitial pneumonias and has a poor prognosis, appears on high-resolution CT as patchy subpleural areas of ground-glass attenuation, irregular linear opacity, and honeycombing. Nonspecific interstitial pneumonia with fibrosis, the second most frequent and has a better prognosis than usual interstitial pneumonia, appears as subpleural patchy areas of ground-glass attenuation with associated areas of irregular linear opacity on CT. Acute interstitial pneumonia with high mortality rate presents as extensive bilateral airspace consolidation and patchy or diffuse bilateral areas of ground-glass attenuation. Desquamative interstitial pneumonia with good prognosis presents as patchy subpleural areas of ground-glass attenuation in middle and lower lung zones.


Asunto(s)
Enfermedades Pulmonares Intersticiales/patología , Humanos , Enfermedades Pulmonares Intersticiales/diagnóstico por imagen , Enfermedades Pulmonares Intersticiales/fisiopatología , Radiografía
17.
J Ultrasound Med ; 18(6): 403-10, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10361845

RESUMEN

The aim of our study was to verify whether ring-down artifacts posterior to the right hemidiaphragm on abdominal sonography reflected pulmonary parenchymal abnormalities. Forty patients (group 1) with abdominal diseases and 32 patients (group 2) with proved various pulmonary abnormalities involving the right lung base underwent abdominal sonography with 2-4 MHz transducers. In these two groups, the presence and number of ring-down artifacts were assessed and correlated with peridiaphragmatic lung findings on chest radiographs or computed tomographic scans. In 21 patients (group 3) with multiple (more than five) or numerous (10 or more) ring-down artifacts, chest radiographs were reviewed to see if any peridiaphragmatic pulmonary abnormalities were present. In group 1, one or several (less than five) ring-down artifacts were shown in 27 of 40 (68%) patients. In these patients, computed tomography showed insignificant focal intra- and interlobular septal thickening in the peridiaphragmatic right lung. In group 2, 31 of 32 (97%) patients showed multiple or numerous ring-down artifacts. In group 3, chest radiographs showed various pulmonary abnormalities in 20 of 21 (95%) patients, including emphysema, idiopathic interstitial pneumonia, bronchopneumonia, and interstitial edema. Although nonspecific, ring-down artifacts posterior to the right diaphragm on abdominal sonography may be used to predict pulmonary abnormalities when encountered on abdominal sonography in patients without specific pulmonary symptoms.


Asunto(s)
Abdomen/diagnóstico por imagen , Artefactos , Diafragma/diagnóstico por imagen , Enfermedades Pulmonares Intersticiales/diagnóstico por imagen , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Radiografía Abdominal , Radiografía Torácica , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Ultrasonografía
18.
Radiographics ; 17(3): 555-67; discussion 568-70, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9153696

RESUMEN

The advantage of volumetric computed tomography in the thorax is the possibility of acquiring both multiplanar and three-dimensional (3D) images, thus enabling precise diagnosis and evaluation of extent of disease involving the airways. Multiplanar and 3D images appear to be useful for global understanding of the status of the tracheobronchial tree, particularly for evaluation of focal stenosis of the airways. Such images seem to be especially useful in evaluating the longitudinal extent of airway lesions, thus providing valuable information for preparing a road map for bronchoscopy, for surgical planning, and for follow-up of treatment response. However, multiplanar and 3D images do not appear to be useful in lesion detection or evaluation of transaxial extension. Multiplanar and 3D images also seem to be helpful in demonstrating whether a lesion is endobronchial, submucosal, or peribronchial. The quality of such images appears to be excellent or good in almost all patients.


Asunto(s)
Enfermedades Bronquiales/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Enfermedades de la Tráquea/diagnóstico por imagen , Tuberculosis/diagnóstico por imagen , Adulto , Anciano , Enfermedades Bronquiales/diagnóstico , Broncoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Tráquea/diagnóstico , Tuberculosis/diagnóstico
19.
J Comput Assist Tomogr ; 24(1): 9-18, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10667651

RESUMEN

Thoracic involvement occurs more frequently in systemic lupus erythematosus than in any other connective tissue diseases, and more than half of patients with the disease suffer from the involvement. Primary intrathoracic manifestations include pleural disease (effusions and/or thickening), acute lupus pneumonitis, subacute interstitial lung disease including bronchiolitis obliterans organizing pneumonia and non-specific interstitial pneumonia with fibrosis, chronic interstitial lung disease of usual interstitial pneumonia, pulmonary hemorrhage, pulmonary vascular disease, small airway disease of bronchiolitis obliterans, and pulmonary arterial hypertension. Secondary intrathoracic manifestations include atelectasis due to diaphragmatic dysfunction, opportunistic pneumonia, drug and oxygen toxicity, aspiration, and pleuropulmonary consequences of cardiac and renal failure.


Asunto(s)
Enfermedades Pulmonares/diagnóstico por imagen , Lupus Eritematoso Sistémico/diagnóstico por imagen , Radiografía Torácica , Enfermedades Torácicas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Biopsia , Diagnóstico Diferencial , Humanos , Enfermedades Pulmonares/etiología , Enfermedades Pulmonares/patología , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/patología , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/etiología , Enfermedades Pleurales/patología , Enfermedades Torácicas/etiología , Enfermedades Torácicas/patología
20.
AJR Am J Roentgenol ; 173(4): 949-53, 1999 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-10511155

RESUMEN

OBJECTIVE: We assessed serial changes in high-resolution CT findings and pulmonary function in patients with nonspecific interstitial pneumonia with fibrosis. MATERIALS AND METHODS: Serial high-resolution CT findings in 13 patients with biopsy-proven nonspecific interstitial pneumonia with fibrosis (mean follow-up period, 11 months) and pulmonary function tests (mean follow-up period, 11 months) were retrospectively analyzed. On CT, the presence and extent of ground-glass opacity, irregular linear opacity, honeycombing, and consolidation were assessed. RESULTS: On initial CT, all patients had areas of ground-glass opacity (mean +/- SD, 21.6% +/-14.4) and irregular linear opacity (5.0% +/- 5.2). The areas of ground-glass opacity decreased significantly on follow-up CT (13.5% +/- 10.5, p = .003). The areas of irregular linear opacity decreased slightly (4.2% +/- 5.2, p > .05). Initial forced vital capacity (69.4% +/- 16.0) improved significantly on follow-up examination (83.9% +/- 16.5) (p = .003). The decrease in the extent of ground-glass opacity on CT correlated significantly with changes in forced vital capacity (r = -.702, p = .007) and diffusing capacity for carbon monoxide (r = - .597, p = .031). CONCLUSION: In patients with nonspecific interstitial pneumonia with fibrosis, areas of ground-glass opacity decrease on follow-up high-resolution CT, and the extent of decrease correlates significantly with that of functional improvement.


Asunto(s)
Enfermedades Pulmonares Intersticiales/diagnóstico por imagen , Fibrosis Pulmonar/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Femenino , Humanos , Enfermedades Pulmonares Intersticiales/diagnóstico , Masculino , Persona de Mediana Edad , Fibrosis Pulmonar/diagnóstico , Pruebas de Función Respiratoria , Tomografía Computarizada por Rayos X/métodos
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