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Background: This study aimed to review the outcome of patients treated with surgical resection for necrotizing lung infection with various co-morbidities and complications. Methods: The records of 26 patients treated with pulmonary resection for necrotizing pneumonia between July 2004 and January 2010 were retrospectively reviewed. Surgical procedures included large wedge resection (n = 1), lobectomy (n = 19) and bilobectomy (n = 6). Results: The study cohort consisted of 21 men and 5 women aged 35–85 years (mean 64.7 ± 15.0 years). Twenty-three (88.5%) patients had underlying risk factors. At surgical consultation, 17 patients presented with progressive respiratory distress; 6 required ventilatory support; 12 had empyema, and in 5 patients the conditions were complicated by bronchopleural fistula. Four patients had septic shock requiring vasopressor support. Three patients developed hemoptysis. Two patients had bilateral diffuse pneumonia. Klebsiella pneumoniaeand Streptococcusviridans were the most common pathogens. The right lower (n = 13) and right middle lobes (n = 10) were the most frequently affected. Four deaths (15.4%) occurred: 3 due to perioperative progressing pulmonary infection/inflammation and 1 due to hepatorenal failure. Postoperative empyema occurred in 3 patients. One patient became ventilator dependent. Conclusion: Pulmonaryresection for necrotizing pneumonia is a feasible treatment option in patients with progressive pulmonary sepsis.

Background/Aims: Retinol-binding protein 4 (RBP4) has been shown to be associated with insulin resistance and fatty acid metabolism. We hypothesize that RBP4 might play a role in fetal growth and that cord serum RBP4 may act as a marker of fetal growth, independent of fetal insulin levels. Methods: Twenty-one women having fetuses in the top quartile (>75th percentile) of birth weights for gestational age were enrolled into the trial, along with 21 women having fetuses in the bottom quartile (<25th percentile) of birth weights for gestational age. Serum RBP4 and insulin levels were analyzed. Results: Cord serum RBP4 and insulin concentrations were significantly higher in the top quartile group (14.3 ± 3.7 ng/ml, 3.8 ± 5.2 µIU/ml) than in the bottom quartile group (11.3 ± 2.6 ng/ml, 0.9 ± 1.4 µIU/ml; p = 0.004, p = 0.017). Cord serum RBP4 and insulin as well as gestational age (r = 0.744, r² = 0.553, p < 0.001) were significantly correlated with fetal birth weights. Conclusion: Cord serum RBP4 concentrations were higher in subjects with top quartile fetuses than in those with bottom quartile fetuses. Cord serum RBP4 concentrations were significantly correlated with fetal birth weight. These findings may indicate that cord serum RBP4 plays a regulatory role in fetal growth.

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