Biopsies in pneumology]

The techniques of different bioptic and cytological examinations performed in pneumology are presented. The various indications for these biopsies in pulmonary, pleural and mediastinal pathology are considered. Interpretation of results leads to a precise diagnosis and to diagnostic information on lesions otherwise difficult to define. In some cases conclusions cannot be reached because of the insignificant changes observed on too small samples.     

Biopsies in pneumology: pleuroscopies-biopsies]

From already published cases and from those recently obtained (511 in all) the authors recollect their experience in lung biopsy : in 426 cases, a precise diagnosis was made by different methods. After having statistically analyzed the validity of pleuropulmonary multipuncture by comparison with pleuroscopy-biopsy, they underlined the necessity to use, in the latter technique, a flexible fibroscope, much used in bronchoscopy. They conclude in classifying the indications for each method in relation to the topography and the type of disease.     

Effectiveness of the use of high-energy lasers in bronchology]

Bronchoscopy by laser radiation was performed in 141 patients. CO2 laser was used in 89 patients: 25 had pulmonary tuberculosis, 6 tumours, 35 stump inflammation, and 23 other diseases. YAG laser was used in 52 patients: 15 of them had tumours, 21 bronchial tuberculosis, 6 osteochondropathy and 10 other diseases. A good therapeutic result was obtained in most patients but in certain cases (malignant tumours) it was palliative. Special features and technical difficulties encountered during work with different types of lasers in fibroscopy under anesthesia and in fibrobronchoscopy under local narcosis are discussed. No complications were registered. Formation of the so-called "white thrombus" at the site of laser photodestruction was described which required removal during control bronchoscopy.     

不稳定型心绞痛危险度分层和冠状动脉造影的关系

目的探讨不稳定型心绞痛危险度分层和冠状动脉病变的关系,观察能否通过不稳定型心绞痛危险度分层预测不稳定型心绞痛患者的冠状动脉病变程度。方法按照中华医学会心血管病学分会提出的不稳定型心绞痛危险度分层,将145例不稳定型心绞痛患者分为高、中、低三个危险组,比较三组间冠状动脉造影术显示的病变程度。采用Gensini积分方法,对各支冠状动脉病变程度进行定量评定,将其危险度分层赋予分值,低危险组1分,中危险组2分,高危险组3分,测定该分组和冠状动脉病变危险程度、冠状动脉完全闭塞病变及三支病变的关系。结果低、中、高三个危险组冠状动脉病变积分分别为30．43、39．10和68．05分,高危险组积分显著高于低、中危险组（P=0．000）,而低、中危险组之间积分差异无统计学意义。不稳定型心绞痛危险度分组与冠状动脉病变程度显著相关。结论不稳定型心绞痛危险度分层和冠状动脉病变程度相关,可以作为冠状动脉完全闭塞病变和三支病变的预测因素。     

Preliminary clinical findings on the Kiel classification of malignant Lymphomas

Summary In 75 patients with non-Hodgkin Lymphomas the influence of the histopathological form, as judged by the Kiel classification, on the epidemiology and prognosis of the disease was examined retrospectively.The different forms of the Kiel classification influence in a typical way the age specific incidence rates and the prognosis of the disease.

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Vorläufige klinische Befunde zur Kiel-Klassifikation der malignen Lymphome

Zusammenfassung In einer orientierenden retrospektiven Studie werden an einem Krankengut von 75 Patienten der Krankheitsgruppe der Nicht-Hodgkin Lymphome der Einfluß der histopathologischen Form, beurteilt nach der Kiel-Klassifikation, auf die Epidemiologie und Prognose der Erkrankung untersucht. Die verschiedenen Formen der Kiel-Klassifikation beeinflussen in charakteristischer Weise das altersspezifische Krankheitsauftreten und die Prognose der Erkrankung.

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Presented at the Workshop for the Classification of Non-Hodgkin's Lymphomas, Airlie House, Warrenton, Virginia, Sept. 4–5, 1975     

Pulmonary sarcoidosis -- clinical and bronchoscopic findings in relation to the radiographic stage

The classification of pulmonary involvement in sarcoidosis is based upon the radiographic stage of disease. We investigated 170 patients with new detected sarcoidosis (stage I / II / III: 79 / 39 / 52) for differences between the stages in demographic data, lung function values and results of BAL. With a multinomial logistic regression model to estimate probabilities, we found an increased probability for stage I with lower age (p < 0.001), higher IVC and FEV1 (p < 0.001), a less intensive smoking history (p<0.035), in BAL with a lower count of eosinophils (p < 0.014), mast cells (p < 0.004), CD8 lymphocytes (p < 0.015) and a less content of alkaline phosphatase (p < 0.004). For stage III the opposite results apply. With higher cell counts in BAL the probability of stage II increased, of stage III decreased (p < 0.013). The most relevant diagnostic BAL parameter in sarcoidosis, i.e. the count of lymphocytes and CD4 cells, was not different between the radiographic stages. Conclusion: Between patients with different radiographic stages of sarcoidosis there are differences in demographic data, lung function values and the pattern of alveolitis.     

Bouveret's syndrome: the clinical and radiological findings]

Bouveret's syndrome is an unusual presentation of gallstone ileus, due to duodenal obstruction. It is produced by the migration of biliary calculus through a cholecystogastric or cholecystoduodenal fistula. We present 3 new cases of Bouveret's syndrome, and the clinical and radiological findings on different imaging procedures (plain abdominal radiography, barium studies, ultrasonography and computed tomography). On the basis of these cases, we discuss the diagnostic and possibly therapeutic merits of digestive endoscopy and about the different surgical procedures.     

Preliminary clinical findings on the Kiel classification of malignant lymphomas.

In 75 patients with non-Hodgkin Lymphomas the influence of the histopathological form, as judged by the Kiel classification, on the epidemiology and prognosis of the disease was examined retrospectively. The different forms of the Kiel classification influence in a typical way the age specific incidence rates and the prognosis of the disease.     

Occlusive thromboaortopathy (Takayasu's disease): clinical findings and angiographic classification

We report the findings in 26 cases of occlusive aortopathy (Takayasu's disease) encountered during eight years. The mean age was 25.3 years and female to male ratio was 2.7:1. Chest and local pain, fever, hypertension (70%) and absent pulses were accompanied by high erythrocyte sedimentation rate (ESR) 38 to 126 mm, eosinophilia 4 to 26%. All immunological tests were negative except tuberculin-test (PPD) with 65% positive. EKG was normal in three cases, 23 showed left ventricular hypertrophy, ST-T changes in two and acute myocardial infarction in two cases. The classification: Type I cervico-brachial or arch type with five cases, type II thoraco-abdominal type with six cases, type III peripheral type with four cases and generalized types combination of two or more of three types and/or pulmonary artery involvement, showed good correlation with clinical findings and prognosis. The occlusive aortopathy is an inflammatory disease of unknown origin, an auto-immune or genetic etiology may be involved.     

Discrepancies between laparoscopic and histological findings in the stage diagnosis of chronic viral hepatitis]

We studied about the discrepancies of stage diagnosis between laparoscopic and histological findings in the clinical course of chronic viral hepatitis. We noticed discrepancies in 26% of chronic hepatitis B and 18% of chronic hepatitis C. Many cases were judged more advanced by laparoscopic staging than by histological staging. The group with different stage diagnosis showed high frequency of reddish markings and patchy markings indicating severe necro-inflammatory reaction and regenerative reaction in laparoscopic findings. This suggests that existence of active inflammation might be a cause of discrepancies in stage diagnosis. The cumulative incidence of hepatocellular carcinoma was significantly higher in the cases judged more advanced by laparoscopy even in the same histological stage. This indicates that laparoscopic staging should be more reliable for predicting prognosis in each patient.