This study showed that long-term therapy with omalizumab for up to 3 years was well tolerated with significant improvement both in symptoms and lung functions. Accordingly, long-term omalizumab treatment may be recommended for responders.

Pneumoconiosis was diagnosed by open lung biopsy in two dental technicians who had interstitial lung disease. Mineralogical analysis was performed to investigate the origin of the dust that had been inhaled. A marked accumulation of silicon and phosphorus was found in both cases. The hard metals chromium and cobalt were also found. Dental technician's pneumoconiosis is a complex pneumoconiosis in which such dust and hard metals may play a role.

Asthma is a chronic disease that may cause remodeling of the airways. We aimed to observe the effects of the combined use of inhaled budesonide and formoterol on both the reversibility of remodeling and structural changes in the airways. Thirty-six male patients (age range, 20-31) with mild-to-moderate persistent asthma were given inhaled formoterol and budesonide treatment for three months. Bronchial diameter (BD) and bronchial wall thickness (BWT), as measured by high-resolution computerized tomography, and reticular basement membrane thickness (RBMT), assessed in bronchoscopic biopsy specimens, were compared with pretreatment findings. Twenty-two age-matched male controls were also enrolled. BDs of the patients were significantly smaller than in the controls, whereas BWT and RBMT were greater. After three months BWT and RBMT of the subsegmental airways significantly decreased and BD increased. There was a prominent eosinophilic and lymphocytic infiltration in the bronchial mucosa of the asthmatics, and the eosinophilic infiltration significantly improved with treatment. Both serum total IgE and eosinophil counts were related to eosinophilic infiltration in the biopsy samples (r = 0.494 and r = 0.463, respectively). FEV(1) was positively correlated with the diameters of the segmental and subsegmental airways (r = 0.491 and r = 0.265, respectively) and negatively correlated with BWT of the subsegmental airways (r = -0.293) and with the RBMT of both the segmental and subsegmental airways (r = -0.597 and r = -0.590, respectively). We suggest that treatment with inhaled formoterol and budesonide may reverse increased RBMT and BWT as part of remodeling in patients with asthma.

Background: Hemodynamic and hemostatic abnormalities are reportedly frequent in chronic obstructive pulmonary disease (COPD). Objectives: We investigated the changes in systolic pulmonary artery pressure (PAPs) and hemostatic status and the effects of systemic steroid treatment (SST) during COPD exacerbation. Methods: Consecutive 26 male and 4 female patients as well as 10 controls were enrolled. The nonsteroid treatment (NST) group received standard treatment without steroids, and the other group received additional SST. Initial values of blood gases, spirometry and PAPs, P-selectin, D-dimer and fibrinogen levels, activities of thrombocyte aggregation, antithrombin III (AT III), protein C (PC), protein S, activated PC resistance (APCR), prothrombin time and partial thromboplastin time were obtained and compared with values at day 10. Results: Improvement in spirometry and blood gases was more prominent with SST. At presentation, patients had higher PAPs, P-selectin, D-dimer and fibrinogen but lower AT III levels than controls. PAPs and fibrinogen levels significantly decreased in the SST group while P-selectin levels further increased in the NST group. The D-dimer level significantly decreased in both groups. Means of AT III, PC and protein S increased in the SST and decreased in the NST group, but only the decrease in PC in the NST group was meaningful. Compared with the controls, AT III levels in the NST group and activated PC resistance in the SST group were significantly decreased. Thrombocyte aggregation tests suggested an incline after 10 days in both groups. Conclusions: We suggest that in patients with COPD exacerbation, addition of systemic corticosteroids to treatment results in better outcome in normalization of PAPs, hemostasis, pulmonary functions and blood gases.

We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.

Thyroid metastasis of lung cancer is rarely observed in clinical practice. The primary cancers which metastasize to the thyroid gland are mostly renal cell carcinoma, lung cancer, and breast cancer. Transient destructive thyrotoxicosis is caused by massive metastasis of extrathyroid tumors. We herein present a case report of a patient with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. A 66-year-old man complained of swelling around the right side of the neck, dyspnea, progressive weight loss, and palpitation starting since 3 months before his admission. The patient was diagnosed with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. The case report presented here illustrates the challenge of making a definitive and adequate diagnosis, particularly if the patient presents with 2 potential causes of thyrotoxicosis. Thyroid scintigraphy is an important tool for differential diagnosis of thyrotoxicosis.

We assessed whether acid fast bacilli (AFB) determination in gastric lavage (GL) and bronchial lavage (BL) contributes to diagnosis in cases radiologically suggestive of pulmonary tuberculosis but with either negative AFB in sputum or the inability to expectorate sputum. Of 129 cases recruited for the study, 22 were excluded due to evaluation as inactive disease or non-tuberculosis disease. The remaining 107 cases were evaluated in 2 groups. Group A consisted of 49 patients that could not expectorate sputum and from whom GL was obtained. In group B, BL was performed in 58 patients that had negative sputum smear. Smear positivity was 61.2% (30/49) and culture positivity was 30.6% (15/49) in group A, 51.7% (30/58) and 81% (47/58), respectively, in group B. Thirteen cases, in whom AFB could not be detected microbiologically but who were radiologically strongly suggestive of tuberculosis, were regarded as tuberculosis according to "from treatment to diagnosis" criteria. In conclusion, detection of AFB positivity in the diagnosis of tuberculosis is important in terms of early initiation of treatment and detection of resistant bacilli. Therefore, we suggest that it would be helpful to obtain GL in cases where the patient is unable to expectorate sputum, and perform BL in cases with negative sputum smear.

In TP, the development and degree of RPT are significantly correlated to the glucose, CRP, AAG, and TNF-alpha levels in the pleural fluid.