The present study was designed to evaluate inflammatory changes in collapsed lungs during 1-lung ventilation, using the assistance of a bronchoscopic microsampling probe.Serial albumin and interleukin (IL)-8 concentrations in epithelial lining fluid (ELF) were measured in 7 patients undergoing resection of lung tumors. The samples were taken after induction of anesthesia (baseline), thirty minutes after 1-lung ventilation was started (point 2), just before resuming 2-lung ventilation (point 3), and thirty minutes after 2-lung ventilation was restarted (point 4). The albumin and IL-8 concentrations in ELF were significantly increased at point 2 and point 3, respectively, and remained to be high, compared to the baseline. The increase in IL-8 at point 3 was correlated with the interval of 1-lung ventilation, however, none developed specific acute lung injury. These findings suggest that inflammatory changes can occur on the epithelium of collapsed lung even in patients underwent successful and standard thoracic surgery.
A 59-year-old womanwas diagnosed with incomplete type Beh^et's syndrome in 1994. The patient was hospitalized with pharyngitis and fever in August 2000, and was treated using non-steroidal anti-inflammatory drugs (NSAIDs). Symptoms improved and she was discharged. After only 3 weeks, she reported swallowing disturbance due to retrosternal pain. Esophagoscopy revealed multiple shallow oval ulcerations in the middle esophagus. Colonoscopy revealed aphthous lesions in the rectum. Prednisolone (0.5 mg/kg) was initiated for treatment of esophageal involvement. Symptoms gradually improved and subsequent esophagoscopy revealed complete healing of esophageal ulcerations. (Internal Medicine 42: 696-699, 2003)
Rhabdomyolysis is a syndrome resulting from skeletal muscle injury with release of muscle cell contents into the plasma. It is often associated with alcohol abuse, muscle compression and generalized seizure. It may also follow viral infections like influenza. Tecnetium-99m phosphate compounds are useful for bone scintigraphy. But proper interpretation of this bone agent scintigrams must include careful analysis of extraskeletal accumulations, such as cerebrospinal lesions, carcinoma, acute myocardial infarction, myocarditis and inflammatory myopathy. This case was a 74-year-old female who developed rhabdomyolysis associated with influenza A viral infection. We report the usefulness of Tecnetium-99m phosphate scintigraphy for early diagnosis, location and extent of the muscle damage of viral induced rhabdomyolysis.
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