1/3. Two patients with microscopic polyangiitis and unusual pulmonary manifestation.We encountered two patients with microscopic polyangiitis (MPA) associated with unusual pulmonary manifestations. The first patient was a 45-year-old man who had worked in amine for 3 years when he was young. On admission, chest x-rays showed long-standing silicosis and a new patchy infiltration. The second patient was a 52-year-old female. On admission, chest x-rays showed bilateral patchy infiltrations. Since then, variable patterns of patchy infiltration have waxed and waned repeatedly. The renal biopsy revealed that both patients had glomerulonephritis associated with small vessel vasculitis but with few or no immune deposits. There was neither granulomatous inflammation nor eosinophilic infiltration. Myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA) was positive in both patients. After treatment with glucocorticoids and cyclophosphamide, radiological findings were minimal and stable. These two cases show that patients with MPA have a wide spectrum of radiological findings.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. Single lung transplantation for end-stage silicosis: report of a case. Lung Transplant Group.After successful animal studies since 1986, a single left lung transplantation was performed on a 35-year-old male patient with end-stage silicosis in July 1991. The surgical technique was similar to that used by the Toronto Transplant Group, except for some modification in bronchial anastomosis. The donor lung was preserved by simple surface cooling after the administration of heparin, methylprednisolone and PGE1. The ischemic time for the donor lung was 3.5 hours. A cardiopulmonary bypass through the femoral vessels was applied for a duration of 90 minutes. Immediate postoperative complications included massive bleeding, disseminated intravascular coagulation, adult respiratory distress syndrome and acute graft rejection. Fortunately, we overcame these complications through intensive care. immunosuppression included antilymphocytic globulin, cyclosporine, azathioprine and corticosteroids. The results of this single lung transplantation were satisfactory. The patient was doing well and was able to satisfactorily breathe room air six weeks after the transplantation. Unfortunately, the patient died of opportunistic systemic aspergillosis six months after the transplantation. In conclusion, lung transplantation is an effective treatment for patients with end-stage lung diseases, and the results of this first single lung transplantation in taiwan are encouraging and promising.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/3. A diffuse form of pulmonary silicosis in foundry workers.Pulmonary silicosis usually is characterized by typical hyalinized, concentric nodules as seen under the microscope and in the corresponding roentgenogram. In the case of three foundry workers, lung biopsy specimens contained no nodules. The chest roentgenograms were not suggestive of silicosis. Examination of the biopsy tissue by scanning electron microscopy and energy dispersive x-ray analysis (EDXA) revealed significant (P less than .05) amounts of silicon in the thickened fibrous tissues of septa, pleura, and around blood vessels, enough to permit the diagnosis of silicosis. All three patients had severe functional impairment. It is not clear at this time what factors were responsible for a diffuse distribution of silicon in these cases.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |