Abstract:
:We treated five patients with a past history of tuberculous pleural infection that led to chronic, quiescent, loculated empyema. Reactivation of TB was associated with formation of BPF and recovery of drug-susceptible Mycobacterium tuberculosis from sputum. All patients had recurrence of positive sputum cultures that yielded tubercle bacilli resistant to drugs they were receiving. The lungs demonstrated gross thickening with calcification of both visceral and parietal pleura. Two patients underwent retreatment chemotherapy followed by decortication-empyemectomy and lung resection surgery; both are now culture-negative for TB. One patient received retreatment chemotherapy but refused surgery; he remains clinically stable with negative sputum cultures. Two other patients' organisms became drug-resistant and they remain sputum-culture positive. We believe that thick, calcified pleural walls limit penetration of drugs into the infected empyema space, resulting in suboptimal drug concentrations and drug resistance. Intensified chemotherapy and surgical intervention should be considered in these cases.
journal_name
Chestjournal_title
Chestauthors
Iseman MD,Madsen LAdoi
10.1378/chest.100.1.124subject
Has Abstractpub_date
1991-07-01 00:00:00pages
124-7issue
1eissn
0012-3692issn
1931-3543pii
S0012-3692(16)37387-1journal_volume
100pub_type
杂志文章相关文献
CHEST文献大全abstract::What is the meaning of these findings to the practicing chest physician? First, leukotrienes are potent airway constrictors; they are capable of reproducing the type of airway constriction observed in asthma. The role of leukotrienes in this regard has yet to be established, but experiments to test the importance of t...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.89.3.414
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Despite increasing knowledge about partial liquid ventilation (PLV), the optimal dose of perfluorocarbon (PFC) is not yet established. Because there exist normal regions in the lung with ARDS and because PLV in the normal lung results in worsened gas exchange, we postulated that the optimal dose of PFC for P...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.1.199
更新日期:2000-01-01 00:00:00
abstract::A 25-year-old man was treated with gastric lavage and activated charcoal for alcohol and drug overdose; immediately following the initial treatment he developed tension pneumothorax successfully managed with a chest tube. The patient presented four weeks later with a charcoal-containing empyema, an unreported conditio...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.87.3.404
更新日期:1985-03-01 00:00:00
abstract::Large-scale, randomized clinical trials have produced over the last few years a wide consensus about the role of thrombolysis in the treatment of acute myocardial infarction (AMI). It has been estimated from the trials with broader inclusion criteria that about 40% of the patients admitted to coronary care units with ...
journal_title:Chest
pub_type: 杂志文章,meta分析
doi:10.1378/chest.101.4.116s
更新日期:1992-04-01 00:00:00
abstract::Pulmonary embolism is a common and potentially lethal disease. Given the variable presentation and associated morbidity of this condition, an accurate and efficient diagnostic algorithm is required. Clinical pretest probability serves as the root of any diagnostic approach. We, thus, review several clinical decision r...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.10-2468
更新日期:2011-08-01 00:00:00
abstract:STUDY OBJECTIVES:We sought to compare arterial oxygen partial pressure (PaO2) relationships between a 15.1% hypoxia inhalation test (HIT) at sea level and a hypobaric chamber exposure equivalent to 2,438 m (8,000 feet) of altitude above sea level in patients with chronic obstructive pulmonary disease (COPD) and healthy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.2.352
更新日期:1995-02-01 00:00:00
abstract::In a 52-year-old man, chronic eosinophilic pneumonia (CEP), suggested by clinical history and marked eosinophilia in the peripheral blood and in the bronchoalveolar lavage fluid, has been diagnosed on open lung biopsy. Nevertheless, chest roentgenograms never showed any infiltration during the course of the disease. E...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.84.5.637
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Identification of sleep-disordered breathing (SDB) using questionnaires is critical from a clinical and research perspective. However, which questions to use and how well such questionnaires perform has thus far been fraught with substantial uncertainty. We aimed at delineating the usefulness of a set of que...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.11-3164
更新日期:2012-12-01 00:00:00
abstract::To elucidate the criterion for amplitude of circadian FEV1 variation suitable for phase analysis, six FEV1 measurements within a day were made on 346 days in 125 stable asthmatic children aged 8 to 12 years. Since coefficient of variation (CV) of FEV1 within a day in nonasthmatic children in our laboratory is less tha...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.3.771
更新日期:1992-09-01 00:00:00
abstract::Retractions of the lower ribcage (chest wall distortion [CWD]) during inspiration are frequently observed with moderate to severe respiratory disease in the infant. Laryngotracheobronchitis (LTB) results in a reversible partial airway obstruction with severe CWD. We wished to measure the motion of the chest wall durin...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.6.1842
更新日期:1993-06-01 00:00:00
abstract:STUDY OBJECTIVES:We sought to determine the adaptability and effectiveness of a new esophageal balloon technique to measure changes in esophageal pressure (Pes) as a reflection of pleural pressure with progressive incremental exercise testing in normal subjects. DESIGN:An 8F (0.9 cm) esophageal balloon catheter (Smart...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.112.3.829
更新日期:1997-09-01 00:00:00
abstract::To assess the prognostic significance of myocardial contractile reserve in patients with idiopathic dilated cardiomyopathy (DCM) without overt heart failure (New York Heart Association functional class I or II), seventy-one patients underwent exercise radionuclide angiography in addition to clinical, radiographic, hem...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.2.344
更新日期:1997-02-01 00:00:00
abstract::False-negative results from transthoracic needle aspiration biopsy of malignant lung masses may occur if a central necrotic area is present and is the source of the biopsy material. The purpose of this study is to determine if the use of ultrasonic guidance can improve the sensitivity of lung needle biopsies in this c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.5.1452
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Bedside ultrasound examination could be used to assess jugular venous pressure (JVP), and thus central venous pressure (CVP), more reliably than clinical examination. METHODS:The study was a prospective, blinded evaluation comparing physical examination of external jugular venous pressure (JVPEXT), internal...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.10-1301
更新日期:2011-01-01 00:00:00
abstract::Measurement of lung volumes is an integral part of complete pulmonary function testing. Some lung volumes can be measured during spirometry; however, measurement of the residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC) requires special techniques. FRC is typically measured by one ...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.11-2964
更新日期:2012-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether monoclonal antibody (Mab) detection of tumor-associated antigen expressed on sputum epithelial cells precedes clinical presentation of second primary lung cancer. DESIGN SETTING/PARTICIPANTS: Eleven oncology centers collaborate in the accrual of 1,000 patients with stage I non-small...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.106.6_supplement.385s
更新日期:1994-12-01 00:00:00
abstract::Forty-eight children with known asthma (ranging in age from 2 to 16 years) were studied during an acute attack. Each received either terbutaline or epinephrine subcutaneously in a random double-blind fashion. Measurement of heart rate, respiratory rate, and systemic arterial systolic and diastolic blood pressures and ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.72.5.614
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Despite the increasing aging population and the high prevalence of OSA in elderly adults, little is known about cognitive effects of OSA and the effectiveness of CPAP treatment. Therefore, this study investigated whether elderly patients with OSA present cognitive deficits and functional and structural alter...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.15-0171
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:Our objective was to compare respiratory muscle performance, pulmonary mechanics, and gas exchange between the BiPAP S/T-D ventilation system (Respironics Inc; Murrysville, PA) and the Servo Ventilator 900C (Siemens-Elma AB; Sweden) with similar inspiratory and expiratory airway pressure in patients who...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.114.5.1390
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Current treatment strategies for asthma and chronic obstructive pulmonary disease (COPD) emphasize the inhalation route, yet patients often misuse metered-dose inhalers (MDI). To address this problem, patient education by medical personnel has been recommended and a variety of alternate inhaler devices have ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.1.111
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To investigate the interrelationship of free radicals (FRs), ischemic preconditioning (IP), and hemodynamic function in coronary artery bypass graft (CABG) patients. DESIGN:Prospective, randomized, and controlled clinical study. PATIENTS:Forty CABG patients were randomized into an IP group (n = 20) and a co...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.119.4.1061
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Cystic fibrosis (CF) airway secretions are abnormal, contributing to decreased clearance and a cycle of infection and inflammation. CF sputum properties may predict disease progression. We hypothesized that sputum viscoelasticity and clearance abnormalities would inversely correlate with pulmonary function d...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.03.005
更新日期:2018-08-01 00:00:00
abstract::A patient with unruptured congenital aneurysm of the left coronary sinus of Valsalva presented with acute right-sided heart failure due to right ventricular outflow tract obstruction. The mechanism for such an acute presentation may have been a sudden increase in the size of the aneurysm. The surgical importance of th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.2.578
更新日期:1992-02-01 00:00:00
abstract::Hyperlipemia in an acyanotic patient with diabetic ketoacidosis, alcoholism, and pancreatitis produced a falsely elevated concentration of methemoglobin (19 percent) and a lower-than-expected oxygen saturation measured with an automated spectrophotometer (IL-282 CO-Oximeter). In addition, there was a "normal" hemoglob...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.1.84
更新日期:1984-07-01 00:00:00
abstract::We describe the Ca2+ movements in smooth muscle cells at rest and during activation and relaxation as deduced from transplasmalemmal Ca2+ fluxes and contractile respnses. The general picture which emerges is: the resting cell has a [Ca2+]cyt below 10(-7) M and large gradients are poised across both the cell membrane a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.78.1_supplement.157
更新日期:1980-07-01 00:00:00
abstract::The severity of pulmonary hypertension was evaluated by right cardiac catheterization in 89 patients with stable chronic obstructive pulmonary disease, both at rest and during maximum treadmill exercise. Thirty-one patients were found to have pulmonary hypertension at rest, defined as a mean pulmonary arterial pressur...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.2.185
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:Portable monitoring is a convenient means for diagnosing sleep apnea. However, data on whether one night of monitoring is sufficiently precise for the diagnosis of sleep apnea are limited. RESEARCH QUESTION:The current study sought to determine the variability and misclassification in disease severity over ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.039
更新日期:2020-07-01 00:00:00
abstract::Solitary extramedullary plasmacytomas are uncommon neoplasms. They occur most frequently in the upper aerodigestive tract and account for 4% of the nonepithelial tumors in this site. The evolution of a plasmacytoma is unsteady and symptoms at presentation have included dystonia, dysphagia, oral pain, cough, and dyspne...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.6.1657
更新日期:1996-06-01 00:00:00
abstract::Continuous measurement of mixed venous oxygen saturation (SvO2) has been suggested as an adjunct in monitoring critically ill patients. We evaluated SvO2 monitoring in 24 patients suffering from complicated myocardial infarctions. Cardiac output and arterial lactate levels were measured when there were persistent 5 pe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.3.607
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:Patients admitted to the medical ICU (MICU) are often subjected to multiple radiologic studies. We hypothesized that some endure radiation dose exposure (cumulative effective dose [CED]) in excess of annual US federal occupational health standard limits (CED ≥ 50 mSv) and 5-year cumulative limit (CED ≥ 100 m...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.01.019
更新日期:2018-05-01 00:00:00