Diffuse lymphoid interstitial pneumonia

MacFarlane, A., and Davies, D. (1973).Thorax,28, 768-776. Diffuse lymphoid interstitial pneumonia. A woman developed linear shadows in the chest radiograph at the age of 54 years. Over the next 11 years she gradually became thin and breathless. When she died she had clubbing of the fingers and extensive consolidation with some honeycombing in her lungs. Necropsy examination showed large yellowish-brown deposits in the lungs. Microscopically these were composed of sheets of mature lymphocytes. There was complete destruction of the lung architecture and there were deposits of hyaline material. In the less affected areas the distribution was interstitial. Other organs were not involved. There was no evidence that this was a localized tumour of lymphatic origin. The condition is best regarded as a rare variety of interstitial pneumonia, the classification of which is reviewed briefly.     

Amoxycillin levels in sputum, serum, and saliva

Stewart, Sheila M., Anderson, Isobel M. E., Jones, G. R., and Calder, Margaret A. (1974).Thorax, 29, 110-114. Amoxycillin levels in sputum, serum, and saliva. The levels of amoxycillin in sputum, saliva, and serum from 22 patients were estimated. Fifteen patients had pneumonia and seven had acute exacerbations of chronic bronchitis. The drug was given orally in a dose of 500 mg four times daily.     

Videothoracoscopy-assisted surgical lung biopsy for interstitial lung diseases

Objectives

Surgical lung biopsy (SLB) by videothoracoscopy for diffuse interstitial lung diseases is recommended for detailed diagnosis. Because substantial mortality and morbidity are associated with this procedure, its safety and diagnostic yield should be validated.

Methods

Sixty-four patients with diffuse interstitial lung disease who received SLB by videothoracoscopy between 2007 and 2013 were retrospectively analyzed for mortality, surgical complication, and diagnosis. Criteria for the procedure included patients <70-year old, who had at least 60 % vital capacity and at least 40 % diffusion capacity. Patients with radiologically definite usual interstitial pneumonia were not eligible.

Results

One conversion from the 3-port approach to thoracotomy due to bleeding occurred. Mean operation and anesthesia times were 63 and 133 min, respectively. The mean hospital stay was 6 days. Only 10 patients (16 %) received prophylactic steroid and/or elastase inhibitor administration. Neither deaths nor acute exacerbations of interstitial pneumonia occurred within 60 days after surgery. Pneumothorax occurred in four cases (6 %) after discharge, which was associated with lower % vital capacity and intraoperative steroid administration. Prolonged air leak and postoperative pneumonia were observed in 2 and 1 patients, respectively. Postoperative diagnosis was obtained in all patients. A group of connective tissue disease-related interstitial pneumonia (n = 15) and chronic hypersensitivity pneumonitis (n = 18) were the major diagnoses. Discordance between pre- and postoperative diagnoses was observed among usual interstitial pneumonia, non-specific interstitial pneumonia, and chronic hypersensitivity pneumonia.

Conclusions

Surgical lung biopsy for diffuse interstitial lung diseases is safe under appropriate inclusion criteria and provides definite diagnosis.     

Purulent pericarditis in children: an analysis of 28 cases

Weir, E. K., and Joffe, H. S. (1977).Thorax, 32, 438-443. Purulent pericarditis in children: an analysis of 28 cases. Bacterial pericarditis was diagnosed in 28 children under the age of 13 years during a five-year period at one hospital. The diagnosis was established clinically in 26 cases; in two the condition was first recognized at necropsy. Staphylococcus aureus was isolated in 22 patients, including all 12 with associated osteitis. The other principal primary condition was pneumonia.     

Rupture of the diaphragm

Christiansen, L. A., Stage, P., Bille Brahe, E., and Bertelsen, S. (1974).Thorax, 29, 559-563. Rupture of the diaphragm. A 23-year series of 25 patients with rupture of the diaphragm is presented.     

Pulmonary calcification following smallpox handler''s lung

Ross, P. J., Seaton, A., Foreman, H. M., and Morris Evans, W. H. (1974).Thorax, 29, 659-665. Pulmonary calcification following smallpox handler's lung. A follow-up study of six nurses who developed smallpox handler's lung during the 1962 South Wales smallpox epidemic and of the surviving smallpox patients is reported. The development of extensive punctate calcification in the chest radiographs of five of the nurses, together with the absence of abnormalities of lung function, is taken to support the view that the disease is a modified smallpox pneumonia rather than an allergic alveolitis.     

Haemolysis related to mitral valve replacement with the Beall valve prosthesis

Henderson, B. J., Mitha, A. S., le Roux, B. T., and Gotsman, M. S. (1973).Thorax, 28, 488-491. Haemolysis related to mitral valve replacement with the Beall valve prothesis. Experience of valve replacement with the Beall compressed Teflon disc valve in 59 patients confirms that the incidence of clinically significant late red cell destruction is high. An apparently previously unrecorded high incidence of early haemolysis, so severe in one patient as to be directly the cause of death, is reported. In 29 patients there was massive haemolysis in early convalescence, not recognized in urine from some hours after the end of bypass and never encountered with other designs of prosthetic valve or homograft valve.     

Replacement of heart valves with frame-mounted tissue grafts

Ionescu, M. I., Pakrashi, B. C., Mary, D. A. S., Bartek, I. T., and Wooler, G. H. (1974). Thorax, 29, 56-67. Replacement of heart valves with frame-mounted tissue grafts. Between April 1969 and March 1973, 213 patients had heart valve replacement with frame-mounted autologous or homologous fascia lata or with heterologous pericardial grafts. There were 111 single aortic, 95 single mitral, and seven tricuspid valve replacements.     

Errors in the measurement of vital capacity: A comparison of three methods in normal subjects and in patients with pulmonary emphysema

Hutchison, D. C. S., Barter, C. E., and Martelli, N. A. (1973).Thorax, 28, 584-587. Errors in the measurement of vital capacity: a comparison of three methods in normal subjects and in patients with pulmonary emphysema. Three methods of measuring the vital capacity have been compared in six normal subjects and in six with pulmonary emphysema, according to a randomized design. The methods were (a) the inspiratory vital capacity (IVC), (b) the expiratory vital capacity (EVC), and (c) the forced vital capacity (FVC).     

Elective operations for left ventricular asynergy

Gerbode, F., Kerth, W. J., Hill, J. D., Banerjee, S., and Marcelletti, C. (1974).Thorax, 29, 282-286. Elective operations for left ventricular asynergy. Operative results in 45 patients with symptomatic left ventricular asynergy are reviewed. The main symptoms were congestive heart failure in 77·7%, angina in 31·1%, arrhythmias in 11·1%, and systemic thromboembolism in 2·2% of the patients.     

Transposition of the great arteries: A review of 37 cases after Mustard''s operation

Ihenacho, H. N. C., Patel, R. G., Singh, S. P., Astley, R., and Parsons, C. G. (1973).Thorax, 28, 448-452. Transposition of the great arteries. A review of 37 cases after Mustard's operation. Thirty-seven children with transposition of the great arteries have undergone Mustard's operation in Birmingham Children's Hospital from May 1968 to December 1971. Thirtythree of these had simple transposition of the great arteries and four were complicated. All but two had some previous palliative procedures. Ten patients died before discharge from hospital and there were two late deaths, one after three months and the other after eight months. Bleeding, dysrhythmia, and hypotension were common immediate postoperative complications, while recurrent heart failure and persistent atrioventricular block occurred in five and four patients respectively.     

Radiographic appearance of bronchial carcinoid

Altman, R. L., Miller, W. E., Carr, D. T., Payne, W. S., and Woolner, L. B. (1973).Thorax, 28, 433-434. Radiographic appearance of bronchial carcinoid. The chest radiographs of 67 patients with bronchial carcinoid were reviewed. Seven had negative radiographs. Fifty-five had single abnormalities, the common manifestations being collapse or pneumonitis (21 patients), a small peripheral mass (20 patients), and a hilar or perihilar mass (11 patients). Five patients had multiple abnormalities, the most common combination being a mass with evidence of bronchial obstruction such as collapse of the related segment or lobe. Comparison with other reports revealed a significant difference in the frequency of the various abnormalities, a difference probably due to chance variations in the locations and to the age of the tumours at the time of diagnosis.     

Pulmonary blastoma: a case report

Rao, K. M., Gupta, R. P., Das, P. B., John, S., and Walter, A. (1974).Thorax, 29, 138-141. Pulmonary blastoma. A case report of a pulmonary blastoma is presented. A tumour was suspected at surgery and on histological examination this proved to be a pulmonary blastoma. A short review of the histogenesis and methods of treatment is given.     

Primary mediastinal tumours

Al-Naaman, Y. D., Al-Ani, M. S., and Al-Omeri, M. M. (1974).Thorax, 29, 475-481. Primary mediastinal tumours. A review of 28 patients with primary mediastinal tumours seen over a five-year period is presented. Clinical and pathological features of a heterogeneous group of tumours are emphasized. Since a number of patients presented with mild symptoms or were asymptomatic (especially adults), the importance of routine chest radiographs is stressed. Complete excision was accomplished in all patients with benign lesions. Malignant lesions were usually partially resectable and carried a poor prognosis.     

Bronchiectasis: results of surgical and conservative management: A review of 393 cases

Sanderson, J. M., Kennedy, M. C. S., Johnson, M. F., and Manley, D. C. E. (1974).Thorax, 29, 407-416. Bronchiectasis: results of surgical and conservative management. A review of 393 cases. A consecutive series of 393 cases of bronchiectasis referred to a thoracic surgical unit has been followed up for one to 15 years. About two-thirds were managed surgically and one-third conservatively. The progress of the patients is analysed and the results of treatment are evaluated. The role of associated bronchitis is considered and indications for surgery are defined. It is our opinion that the current bias towards conservative management is unjustified.     

Pulmonary function in bronchial carcinoma

Legge, J. S., and Palmer, K. N. V. (1973).Thorax, 28, 588-591. Pulmonary function in bronchial carcinoma. Pulmonary function was measured preoperatively in 330 patients with bronchial carcinoma. Obstructive bronchitis was present in 62%. Of 225 patients considered fit for thoracotomy and lung resection, 13 developed postoperative ventilatory failure and six died of this. Those who developed ventilatory failure had more marked airway obstruction, lung hyperinflation, and higher arterial carbon dioxide tensions, and also increased respiratory frequencies and physiological dead space/tidal volume ratios on exercise.     

Brucella melitensis endocarditis: successful treatment of an infected prosthetic mitral valve

O'Meara, J. B., Eykyn, Susannah, Jenkins, B. S., Braimbridge, M. V., and Phillips, I. (1974).Thorax, 29, 377-381. Brucella melitensis endocarditis: successful treatment of an infected prosthetic mitral valve. A 38-year-old man had a mitral valve replacement for rheumatic calcific mitral stenosis and regurgitation; following this operation he remained well for 10 months. He then presented with cough, abdominal pain, and rigors, and Brucella melitensis type 3 was repeatedly isolated from blood cultures. His clinical condition deteriorated rapidly and an emergency valve replacement was performed. He was then treated with co-trimoxazole for 12 months and made an excellent recovery. This is the first reported case of brucella endocarditis arising de novo on a prosthetic heart valve.     

Repeated partial endoscopic resections as treatment for two patients with inoperable tracheal tumours

Nakratzas, G., Wagenaar, J. P. M., Reintjes, M., Scheffer, E., and Swierenga, J. (1974).Thorax, 29, 125-131. Repeated partial endoscopic resections as treatment for two patients with inoperable tracheal tumours. Two cases of tracheal tumour are described, one a carcinoid and the other an adenoid cystic carcinoma (cylindroma). Both patients were treated by repeated partial bronchoscopic resections. The patients are in good health nine and three years respectively after treatment.     

An economical method of comparing inhaled bronchodilators in reversible diffuse airways obstruction: With special reference to a β-2 stimulant—salmefamol

Lal, S., Dash, C. H., and Gribben M. D. (1974).Thorax, 29, 317-322. An economical method of comparing inhaled bronchodilators in reversible diffuse airways obstruction: with special reference to a β-2 stimulant—salmefamol. A method is described for comparing the bronchodilator effect of a large number of drugs. It involves self-recording of peak expiratory flow rate by patients at home. From the experience gained, the method was used to compare isoprenaline, orciprenaline, terbutaline, salbutamol, and salmefamol with an inert pressurized aerosol. The results of the comparison show that the method is simple and practical and that salmefamol would seem to have a more prolonged bronchodilator effect than the other drugs tested.