Sophora moorcroftiana is a perennial leguminous low shrub endemic to the middle reaches of Yarlung Zangbo River in Tibet. It is an important species to fix sand dunes and to avoid the formation of shifting sands; therefore, its progressive over-exploitation may enhance land desertification. The levels and distribution of genetic variability of this species were evaluated from 10 natural populations at 24 loci encoding 13 enzymes, using allozyme analysis by starch gel electrophoresis. Data obtained revealed moderate levels of genetic variation within populations (Pp=27.5%, Ap=1.5, Hep=0.122) and a considerable divergence among populations (FST=0.199). Significant positive correlations (r2=0.49, p<0.05; r2=0.46, p<0.05) were found between elevation and both mean number of alleles per locus (A) and gene diversity (He) in the studied populations of S. moorcroftiana. Lower genetic diversity in lower elevation populations might be due to the negative effects of human pressures and habitat fragmentation, to adaptation to high altitudes as a consequence of a peripatric speciation process, or to directional gene flow along the river basin from the source populations located in the west at higher altitudes. The evaluation of the degree of threat has led to the inclusion of this species in the category of EN ("endangered"), and conservation strategies for this endemic species are discussed on the basis of these findings.
Sophora/genetics , Alleles , Altitude , Conservation of Natural Resources , Gene Frequency , Genetic Variation , Isoenzymes/genetics , Sophora/enzymology , Tibet
Different percutaneous interventions can be used to treat coarctation of the aorta. However, a great amount of information is still needed regarding the long-term course. This article reviews our experience spanning 21 years in the percutaneous treatment of aortic coarctation. Four different conditions for treatment were considered. The first condition 1 (group 1) was balloon angioplasty in neonates and infants with untractable heart failure (n = 54; mean age, 1.2 +/- 1.4 months). After balloon angioplasty, most infants sustained significant clinical improvement. However, 9 patients died in the hospital (17%). As a result, we monitored the course of the 45 survivors during a mean period of 10 +/- 6 years (range, 1-19). During this follow-up period, 17 patients needed a single additional intervention on coarctation (8 underwent surgery and 9 were treated percutaneously). After this second treatment, 11 patients needed one or more further interventions. The actuarial survival probability was 83% at 19 years, with 43% of patients remaining surgery free and 23% reintervention free. The second condition (group 2) was balloon angioplasty in children and adults with coarctation of the aorta before the stenting era (n = 28; mean age, 13 +/- 8 years). After treatment, serial hemodynamic and angiographic studies were performed. The long-term relief was higher in patients with a discrete type of coarctation. The rate of late aneurysm formation was 6%. The third condition (group 3) was stent palliation in infants and children younger than the age of 6 years (n = 17; mean age, 2.1 +/- 1.7 years). The stent was implanted for nondilatable stenoses, as a nondefinitive procedure. Stent palliation provides complete initial relief in hypoplastic coarctations or life-threatening conditions. However, further stent expansion is required to ensure adequate stent diameter in the growing aortic wall. In addition, late intrastent proliferation may occur in small stent diameters (18%) and aneurysm formation in hypoplastic coarctations (18%). Both late complications can be managed percutaneously. The fourth condition (group 4) was stent repair of severe aortic coarctation in adults, adolescents, and children older than the age of 6 years (n = 73; mean age, 20 +/- 12 years). Significant relief was observed after treatment, which persisted at follow-up. One patient died at treatment (1.3%). After a mean follow-up of 5 +/- 3 years, all 72 patients remained symptom free and no restenosis or late aneurysm were detected.
Angioplasty, Balloon , Aortic Coarctation/therapy , Cardiac Catheterization , Adolescent , Adult , Blood Vessel Prosthesis Implantation , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Stents , Time Factors , Treatment Outcome
AIMS: Combinations of surgery and chemotherapy have a favourable impact on survival in the treatment of disseminated neoplastic disease isolated to the lung. Sample and technical factors have made the reproduction of the published results difficult. METHODS: In this study we report experience over 10 years. RESULTS: From 1989 to 1999 40 patients underwent metastasectomy. Thirty received chemotherapy. The median survival is 51 months, similar to other published series. CONCLUSION: Survival benefit can be observed in small series of such cases.
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Adolescent , Adult , Aged , Female , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Survival Rate
BACKGROUND: Ischemia-reperfusion injury with the resulting inflammatory response is a devastating complication of lung transplantation; much of the tissue damage could be diminished by control of the inflammatory response. Recent studies have show that antithrombin III (AT III) has an anti-inflammatory effect in addition to its established role in the regulation of blood coagulation. Thus, we hypothesized that the administration of AT III might help to prevent ischemia-reperfusion injury after lung transplantation. METHODS AND RESULTS: The study was performed in a dog model of orthotopic lung transplantation. Dogs were randomly assigned to receive either vehicle (controls) or AT III. We observed that in control dogs, during the 180-minute period after lung transplantation, the arterial O(2) partial pressure decreased and both the alveolar-arterial O(2) difference and the pulmonary vascular resistance increased. By contrast, these parameters remained unchanged in the group of dogs receiving AT III. Dogs with transplants receiving AT III did not show an increase in cell adhesion molecules, and histological examination revealed almost an absence of inflammatory response. The administration of AT III produced a marked increase in serum prostacyclin (PGI(2)) levels, whereas in control dogs, the PGI(2) levels did not change. The beneficial effect of AT III was not observed when dogs received indomethacin to prevent the stimulation of PGI(2) release by AT III. CONCLUSIONS: Our results demonstrate that AT III prevents ischemia-reperfusion injury in a dog model of lung transplantation and that this effect is conditioned by an increase in PGI(2) production.
Antithrombin III/pharmacology , Lung Transplantation , Lung/drug effects , 6-Ketoprostaglandin F1 alpha/blood , Animals , Antithrombin III/metabolism , Cell Adhesion Molecules/biosynthesis , Cell Adhesion Molecules/drug effects , Dogs , Epoprostenol/antagonists & inhibitors , Epoprostenol/metabolism , Hemodynamics/drug effects , Indomethacin/pharmacology , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/metabolism , Lung/pathology , Lung/physiopathology , Pulmonary Alveoli/drug effects , Pulmonary Alveoli/pathology , Pulmonary Alveoli/physiopathology , Pulmonary Gas Exchange/drug effects , Reperfusion Injury/physiopathology , Reperfusion Injury/prevention & control , Time Factors
OBJECTIVE: To analyze the incidence, treatment and follow up of airway complications after lung transplantation. METHODS: From October 1993 to April 2000, 104 lung transplants were performed in 101 patients. One hundred and fifty one bronchial anastomoses at risk were included in the study (29 single lung and 61 sequential double lung). Donor lungs were flushed both antegradely and retrogradely with Eurocollins. In the recipients, either a single or a sequential bilateral lung transplantation was performed when indicated. The bronchial anastomosis was telescoped and covered with peribronchial tissue in all cases. Postoperative fiberoptic bronchoscopic examinations were dictated by clinical grounds. Recipient variables were recorded and analyzed to assess possible differences between both complicated and non-complicated groups. RESULTS: Eight bronchial anastomotic complications (5.3%) occurred in six patients (6.8%). All complicated cases developed in sequential bilateral lung recipients (P=0.08): stenosis (n=5), granulation tissue (n=2), and bronchial dehiscence (n=1). Treatment consisted of lobectomy and subsequent completion pneumonectomy in one patient, rigid bronchoscopy dilation in two, balloon bronchodilation in two, laser debridement and stenting in one, and conservative therapy in two cases. One patient with severe sepsis and bronchial dehiscence died on day +30. The rest of the patients remain well so far. Airway complications were related to longer intubation periods (P<0.01). Other perioperative donor and recipient factors including the incidence of infections and acute rejection episodes, and actuarial survival, did not differ between groups. CONCLUSION: In our experience, the incidence of airway complications after lung transplantation is 5.3%. The careful surgical technique and organ preservation, the close surveillance of rejection and infection, and early postoperative extubation might play a role in reducing this incidence. Either surgical therapy or bronchoscopic dilation and stenting methods may contribute to resolve these complications.
Bronchi/pathology , Lung Transplantation/adverse effects , Adolescent , Adult , Anastomosis, Surgical , Bronchi/surgery , Bronchoscopy , Constriction, Pathologic , Female , Granulation Tissue , Humans , Middle Aged , Surgical Wound Dehiscence/etiology
UNLABELLED: Pneumonectomy continues to be associated with high rates of morbidity and mortality. OBJECTIVE: The aim of this study was to determine the mortality and morbidity rates after pneumonectomy and to analyze perioperative risk factors related to mortality. PATIENTS AND METHODS: The cases of 266 patients undergoing pneumonectomy between January 1986 and December 1997 were reviewed retrospectively: 241 patients with lung cancer, 4 with pulmonary metastasis, 9 with bronchiectasis and 12 with other benign diseases; 13% received neoadjuvant therapy. The bronchial stump was stapled in 92%, sutured in 8%, and covered with autologous tissue in 73%. Intrapericardial pneumonectomy was performed in 32%, pneumonectomy extended to the chest wall or diaphragm in 9%, and completion pneumonectomy was performed in 3%. We collected general demographic data, medical histories, pulmonary function data and surgical technique. Deaths and postoperative complications within the first 30 days after pneumonectomy were also known. RESULTS: Two hundred sixty-six pneumonectomies were performed [right 102 (38%); left 164 (62%)] in 249 men (93%) and 17 women (7%) who were 58 +/- 11 years of age (20 to 79 years). The rate of early postoperative death (30 days) was 5.6%. Mortality rates were higher among patients over 70 years of age (p = 0.045), diabetics (p = 0.038), patients undergoing neoadjuvant therapy (p = 0.031), those with FEV1 under 1,800 ml (p = 0.013), cases of right-sided pneumonectomy (p = 0.001), cases of extended pneumonectomy (p = 0.037) or those without coverage of the bronchial stump (p = 0.005). Mortality was also higher when complications appeared involving the bronchial stump (p < 0.01), heart (p < 0.001), respiration (p < 0.001) or digestion (p = 0.002). Overall morbidity was 40%. Surgical complications developed in 23%: postpneumonectomy empyema (10%), bronchopleural fistula (7%) (with no significant difference related to stapling or suturing), hemothorax (3%) and wound complications (3%). Twelve patients (4.5%) underwent second operations. Cardiac morbidity was 20% (atrial fibrillation in 12%), respiratory morbidity was 8% and other complications appeared in 19% of cases. CONCLUSION: In our experience, mortality after pneumonectomy is 5.6% with an overall complication rate of 40%, mainly due to surgical and cardiac complications. Coverage of the bronchial stump with autologous tissue reduces the risk of postoperative death due to fistula and/or empyema after pneumonectomy.
Lung Diseases/surgery , Pneumonectomy/adverse effects , Postoperative Complications/epidemiology , Adult , Aged , Female , Humans , Lung Diseases/complications , Male , Middle Aged , Retrospective Studies , Risk Factors
Objetivo: Determinar la tasa de mortalidad y morbilidad tras neumonectomía y analizar factores de riesgo perioperatorios relacionados con la mortalidad. Pacientes y métodos: Se han revisado retrospectivamente 266 pacientes sometidos a neumonectomía entre enero de 1986 y diciembre de 1997: 241 casos por carcinoma broncogénico, metástasis pulmonares en 4, bronquiectasias en 9 casos y otra afección benigna en 12 pacientes; el 13 por ciento de los casos recibieron terapia neoadyuvante. El muñón bronquial se suturó mecánicamente en el 92 por ciento y manualmente en el 8 por ciento, y se realizó cobertura del mismo con tejido autólogo en el 73 por ciento de los casos. La neumonectomía fue intrapericárdica en el 32 por ciento, extendida a pared torácica o diafragma en el 9 por ciento y se completó neumonectomía tras resección menor previa en el 3 por ciento de los casos. Se recogieron datos demográficos generales, antecedentes patológicos, datos de función respiratoria y técnica quirúrgica. También se obtuvieron datos de mortalidad y complicaciones postoperatorias en los primeros 30 días tras la neumonectomía. Resultados: Se han realizado 266 neumonectomías, 102 derechas (38 por ciento) y 164 izquierdas (62 por ciento), en 249 varones (93 por ciento) y 17 mujeres (7 por ciento), con una media de 58 ñ 11 años (rango, 20-79 años). La mortalidad postoperatoria temprana (30 días) fue del 5,6 por ciento. La mortalidad fue superior en pacientes mayores de 70 años (p = 0,045), diabéticos (p = 0,038), sometidos a terapia neoadyuvante (p = 0,031), con FEV1 menor de 1.800 ml (p = 0,013), en las neumonectomías derechas (p = 0,001), extendidas (p = 0,037) o sin cobertura del muñón bronquial (p = 0,005). Asimismo, la mortalidad fue mayor cuando aparecieron complicaciones del muñón bronquial (p < 0,01), complicaciones cardíacas (p < 0,001), respiratorias (p < 0,001) y digestivas (p = 0,002). La morbilidad global fue del 40 por ciento. Aparecieron complicaciones quirúrgicas en un 23 por ciento de los casos: empiema posneumonectomía (10 por ciento), fístula broncopleural (7 por ciento) (sin diferencias entre sutura manual y mecánica), hemotórax (3 por ciento) y complicaciones de la toracotomía (3 por ciento). Doce pacientes se reoperaron (4,5 por ciento). La morbilidad cardíaca fue del 20 por ciento (fibrilación auricular en el 12 por ciento), la morbilidad respiratoria fue del 8 por ciento y otras complicaciones aparecieron en el 19 por ciento de los casos. Conclusión: En nuestra experiencia, la mortalidad tras neumonectomía es del 5,6 por ciento, con una morbilidad global del 40 por ciento, principalmente debida a complicaciones quirúrgicas y cardíacas. La cobertura del muñón bronquial con tejido autólogo reduce el riesgo de muerte postoperatoria por fístula y/o empiema posneumonectomía. (AU)
Middle Aged , Adult , Aged , Male , Female , Humans , Risk Factors , Postoperative Complications , Pneumonectomy , Retrospective Studies , Lung Diseases
OBJECTIVE: The aim of this study was to analyze the postoperative progress and medical management in the Pediatric Intensive Care Unit (PICU) of patients that underwent bilateral lung transplant. PATIENTS AND METHODS: From April 1997 to June 1998, 10 pediatric lung transplants were performed at the Hospital Reina Sofía (Córdoba, Spain). There were 4 males and 6 females (mean age 11.5 years, range 5 to 15 years). Indications for transplantation were cystic fibrosis (n = 9) and one pulmonary fibrosis secondary to viral infection. Before the transplant, two patients required mechanical ventilation for acute respiratory decompensation and one patient was ventilator-dependent. Immunosuppression consisted of corticosteroids, azathioprine and cyclosporine or tacrolimus. Post-transplantation management included early extubation, when possible, optimal fluid balance to prevent lung edema, low aggressive mechanical ventilation and adequate treatment of complications, such as rejection and infection. RESULTS: There were no peri-operative mortalities. The mean stay in the PICU was 28 days (median: 17 days) and the mean time on mechanical ventilation was 19 days (median: 5.5 days). The most frequent complications were rejection (n = 8), hyperglycemia (n = 6), renal failure (n = 4), arterial hypertension (n = 4) and respiratory infections (n = 3). There were no airway complications. CONCLUSIONS: Even if the post-operative period in pediatric lung transplant patients is difficult, the results have been good with an important improvement in the quality of life of these patients has been achieved.
Critical Care , Lung Transplantation , National Health Programs , Adolescent , Child , Child, Preschool , Critical Care/statistics & numerical data , Female , Humans , Immunosuppression Therapy/statistics & numerical data , Lung Transplantation/statistics & numerical data , Male , National Health Programs/statistics & numerical data , Postoperative Care/statistics & numerical data , Postoperative Complications/epidemiology , Spain , Treatment Outcome
The success of lung transplantation to a large extent depends on effective protection of the graft from ischemic injury after reperfusion. Although mechanisms have not been clarified, the pathologic findings of ischemic injury after reperfusion are similar to adult respiratory distress syndrome, a condition in which the blood coagulation contact system is activated. This study evaluates the effect of C1-esterase inhibitor (C1-INH), the main inhibitor of the blood coagulation contact system, on short-term lung function in a dog model of orthotopic lung transplantation. Twelve lung transplantations were performed after 24 h of ischemic time. Dogs were randomly assigned to receive either vehicle (Control) or C1-INH. After the lung transplantation in the control group, Pao2 decreased by 84% and both the AaPO2 and the Qs/Qt% increased (340 and 530%, respectively, p < 0.01); these parameters remained unchanged in the C1-INH group. The hypoxemia observed in control animals was associated with decreased blood coagulation contact factors, complement consumption, increased expression of adhesion glycoproteins in leukocytes, and extensive intraalveolar and interstitial neutrophil infiltration. In contrast, C1-INH administration prevented hypoxemia, the decrease in blood coagulation contact factors, the activation of the complement system, the increase in expression of leukocyte adhesion molecules, and inflammatory cell infiltrate. This study has demonstrated that in a dog model of lung transplantation, the administration of C1-INH prevents early pulmonary dysfunction, and it suggests that activation of blood coagulation contact system and complement are important mechanisms causing ischemic injury after reperfusion.
Complement C1 Inactivator Proteins/pharmacology , Lung Diseases/prevention & control , Lung Transplantation , Lung/drug effects , Postoperative Complications/prevention & control , Reperfusion Injury/prevention & control , Animals , Complement C1 Inactivator Proteins/therapeutic use , Disease Models, Animal , Dogs , Hemodynamics , Hypoxia/etiology , Hypoxia/prevention & control , Lung/pathology , Lung/physiopathology , Lung Diseases/etiology , Lung Diseases/physiopathology , Lung Transplantation/physiology , Postoperative Complications/physiopathology , Pulmonary Gas Exchange
To assess the usefulness of extended cervical mediastinoscopy (ECM) in the staging of bronchogenic carcinoma, an ECM was performed prospectively in 50 patients with bronchogenic carcinoma of the left lung. The ECM was used after evaluation of disease operability and computed tomographic findings, and was performed simultaneously with standard cervical mediastinoscopy. In ECM, using the same cervical incision as in a standard cervical mediastinoscopy, dissection is performed behind the anterior face of the sternum. The aortic arch is reached at the level of the origin of the innominate artery. The mediastinoscope is then passed by sliding it along the left anterolateral face of the aortic arch until it reaches the aortopulmonary window. Extended cervical mediastinoscopy was considered positive when a nodal biopsy result consistent with a neoformative process or direct invasion of the mediastinal structures was found. Four patients with positive standard cervical mediastinoscopy and negative ECM were excluded. A false negative ECM was defined as the presence of infiltrated adenopathies at the paraaortic level detected on postoperative histologic study. The ECM was positive in 5 patients in whom operation was contraindicated. Resectability in the remaining 41 patients was 97.6%. Postoperative pathologic study showed infiltrated adenopathy in 3 patients (2 subcarinal, 1 subaortic) accounting for 40 true negatives (the subcarinal group is inaccessible by ECM). This study suggests that ECM has outstanding specificity (100%), sensitivity of 83.3%, and a diagnostic accuracy of 97.8%. A positive predictive value of 100% and a negative predictive value of 97.5% were also identified by this study.(ABSTRACT TRUNCATED AT 250 WORDS)
Carcinoma, Bronchogenic/pathology , Lung Neoplasms/pathology , Mediastinoscopy , Adult , Aged , Biopsy , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Mediastinoscopy/methods , Mediastinum/pathology , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity
We assessed omental revascularization of heterotopic tracheal implants in rats, and investigated the influence of factors that can enhance revascularization. The trachea of the donor animal was excised in two parts, and each tracheal allograft was implanted in the omentum of two recipients. The influence of mechanical factors was evaluated by applying traction at both ends of the graft with and without drainage of the tracheal lumen, and the influence of pharmacologic factors by giving cefonicid, hydrocortisone, cefonicid plus hydrocortisone, or cyclosporine and azathioprine during the postoperative period. Revascularization of the graft from the omentum with preservation of the tracheal structure was established. Graft viability showed significant differences between the tracheal implants to which no traction had been applied and those with traction at both ends. Tracheal allografts from animals receiving immunosuppressants were completely viable and no significant differences were found between the controls and animals in this group.
Omentum/surgery , Trachea/blood supply , Trachea/transplantation , Animals , Female , Male , Rats , Rats, Sprague-Dawley , Stress, Mechanical , Transplantation, Heterotopic
Thirty-five patients who had undergone surgery for non-small cell bronchogenic carcinoma with isolated involvement of the chest wall were reviewed. The diagnosis was preoperatively suspected in 80% of cases. En-bloc resection of the invaded chest wall was performed in 25 cases and parietal pleurectomy in ten in which the pleura was easily dissectable from the costal plane. Of the eight patients with major complications in the early postoperative period, six, including the two who died perioperatively, had undergone en-block resection. The 5-year actuarial survival rate was 22% overall and 36% in the patients without lymph node involvement. No significant relationship between survival and type of operation or degree of chest wall invasion was found. Isolated involvement of the chest wall by non-small cell bronchogenic carcinoma does not necessarily contraindicate surgery with curative intent. Parietal pleurectomy is valid in selected cases. Long-term survival depends basically on node involvement.
Carcinoma, Bronchogenic/surgery , Lung Neoplasms/surgery , Actuarial Analysis , Adult , Aged , Brain Neoplasms/secondary , Carcinoma, Bronchogenic/mortality , Carcinoma, Bronchogenic/pathology , Carcinoma, Bronchogenic/secondary , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/epidemiology , Neoplasm Staging , Postoperative Complications/epidemiology , Retrospective Studies , Survival Rate , Treatment Outcome
In assessing the value of systematic evaluation of extrathoracic extension for potentially resectable, non-small-cell bronchogenic carcinoma, a prospective study was conducted in 146 patients. The study protocol included computed tomographic (CT) scan of the brain and upper abdomen, abdominal ultrasonography, and whole-body bone scanning. The findings were matched with the clinical presentation, histologic features, and TN staging, having found out that non-small cell bronchogenic carcinoma does not follow a set pattern to metastasize. The rate of metastasis for adenocarcinoma is not only significantly larger (p less than 0.05) but it does not correlate with the TN staging, in contrast to what happens with the squamous cell carcinoma (p less than 0.01). None of the squamous cell carcinomas in intrathoracic stage I was found to metastasize. Twenty-one percent (4/19) of brain metastases were asymptomatic (three adenocarcinomas and one squamous cell carcinoma with multiorgan metastasis). Bone scanning detected metastasis in 3.4 percent (4/116) of the asymptomatic patients, and three of the four patients with asymptomatic metastasis had nonskeletal foci. In 61 percent (11/18) of patients with hepatic metastasis, we did not find organ-specific indicators to suspect it. The series showed a 7.5 percent incidence of adrenal metastasis. Our findings suggest the convenience of performing an upper abdominal CT scan and/or ultrasonography in all patients, except for those with asymptomatic stage I squamous cell carcinoma; we also suggest brain CT scanning for all patients with adenocarcinomas and large-cell carcinomas as well as for those with squamous cell carcinoma with neurologic symptoms, and whole-body bone scanning only in those patients with clinical and laboratory indication of possible bone involvement by metastatic disease.
Carcinoma, Bronchogenic/pathology , Lung Neoplasms/pathology , Abdominal Neoplasms/diagnosis , Abdominal Neoplasms/secondary , Bone Neoplasms/diagnosis , Bone Neoplasms/secondary , Brain Neoplasms/diagnosis , Brain Neoplasms/secondary , Carcinoma, Bronchogenic/diagnosis , Carcinoma, Bronchogenic/secondary , Female , Humans , Male , Middle Aged , Neoplasm Staging , Prospective Studies , Tomography, X-Ray Computed , Ultrasonography
The cell membrane enzymes, Alkaline Phosphatase and Gamma Glutamyl Transferase, have been studied in lung aspirates from healthy subjects and lung cancer patients. These enzymes were studied, in the latter, both in healthy and in neoplastic tissue. The enzymatic activity both in the lung aspirate and in the neoplastic tissue was significantly lower in poorly differentiated cancers when compared to well or moderately differentiated tumors. Similarly, analysis revealed that there was a statistically significant decrease in the activity of both enzymes in lung aspirates from patients with bronchogenic tumors when compared to healthy controls. The results obtained in this present work, together with the easiness of obtaining a lung aspirate suggest that these enzymes should be determined in order to obtain further information about the histological origin of lung cancer. These enzymatic changes could be explained with the "fatalism" theory for neoplastic tissue as we explain in this work.
Alkaline Phosphatase/analysis , Bronchoalveolar Lavage Fluid/analysis , Carcinoma, Bronchogenic/enzymology , Lung Neoplasms/enzymology , Membrane Proteins/analysis , gamma-Glutamyltransferase/analysis , Bronchoscopy , Carcinoma, Bronchogenic/pathology , Humans , Lung Neoplasms/pathology
A case of pulmonary melanoma is presented. Because of the tumor's evolution and clinical features and, in particular, its pathoanatomic characteristics, we believe that it complied with sufficient criteria for classification as primary bronchopulmonary malignant melanoma. The literature is briefly reviewed.
Bronchial Neoplasms , Lung Neoplasms , Melanoma , Bronchial Neoplasms/pathology , Humans , Lung Neoplasms/pathology , Male , Melanoma/pathology , Middle Aged
Arteriovenous Fistula/diagnostic imaging , Brain Abscess/diagnostic imaging , Bronchiectasis/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imaging , Arteriovenous Fistula/complications , Brain Abscess/etiology , Diagnosis, Differential , Humans , Male , Middle Aged , Radiography
