Search PubMed⌕ Search

Biomedical subjects

S A Sahn

Publications and source records attributed to S A Sahn.

At least 73 records · Page 4Linked to original sources
PubMed1993

Early inflammatory response of minocycline and tetracycline on the rabbit pleura.

The histopathologic findings were compared from 20 mg/kg intrapleural tetracycline hydrochloride (TCN) and three doses of intrapleural minocycline hydrochloride (5, 10, and 20 mg/kg) (MCN) in New Zealand white rabbits. Both TCN and MCN produced an early neutrophilic predominant pleural effusion that became mononuclear over 48 h. There was no difference in pleural fluid accumulation, number of adhesions, or histologically measured visceral and parietal pleural thickness between TCN and MCN (all p = ns). The TCN, 20 mg/kg, produced more visceral pleural plaque than MCN, 5 mg/kg (p < 0.05). Increasing MCN doses resulted in greater pleural fluid neutrophil accumulation. With higher dose MCN, greater mesothelial cell desquamation and fibroblast proliferation was evident compared to the 5 mg/kg dose. The MCN and TCN produce similar histopathologic condition in the rabbit pleura which suggests that MCN should cause a similar clinical response in humans.

Analysis of Variance↗
PubMed1993

A comparison of rotation and nonrotation in tetracycline pleurodesis.

Previously, we have shown rapid and complete dispersion of tetracycline hydrochloride in the pleural space following chest tube instillation. To assess the clinical relevance of this observation, we randomized patients with symptomatic pleural effusions to rotation (R) (n = 19) and nonrotation (NR) (n = 21) groups following administration of tetracycline hydrochloride, 20 mg/kg (n = 30); 300 mg of minocycline hydrochloride (n = 6); and 500 mg of doxycycline hydrochloride (n = 4) through a chest tube. Patients in the R group were maneuvered through six positions for the 2 h that the chest tube remained clamped. The NR patients remained supine for 2 h. Rotation and nonrotation groups were similar in demographics, source of pleural effusion, symptoms, and serum and pleural fluid analyses (all p = NS). A chest radiograph was scored based on pleural fluid recurrence throughout survival or up to 12 months. Survival, duration of chest tube instillation, and success of pleurodesis assessed by radiographic pleural fluid reaccumulation (73.7 vs 61.9 percent; R vs NR) were similar (p = NS). Rotational maneuvers appear to offer no benefit to the success of pleural symphysis after intrapleural instillation of tetracycline class agents.

Aged↗
PubMed1993

Tips for monitoring the position of a central venous catheter. How placement can go awry--even when the anatomy is normal.

Malpositioning of a central venous catheter can cause potentially life-threatening complications. Knowledge of thoracic anatomy and close attention to proper insertion technique increase the likelihood of, but do not ensure, proper placement. Selection of a right-sided venous entry site reduces the risk of malpositioning. The return of nonpulsatile, dark-colored blood is a strong, but not infallible, indication of venous placement. Do not assume that venous system valves preclude malpositioning. Use chest films to confirm accurate insertion. When these are equivocal, take simultaneous blood samples from a peripheral artery and the central line; the samples will have markedly different blood gas levels if the catheter is in a vein.

Catheterization, Central Venous↗
PubMed1993

Pleural effusion in lung cancer.

Pleural effusions are common in the setting of lung cancer. A pleural effusion associated with lung cancer is an ominous finding, but a small percentage of patients are candidates for curative surgery. The clinician must establish whether the effusion is malignant, excluding the possibility of curative surgery; paramalignant, which may or may not exclude surgery; or whether it is unassociated with cancer. When a malignant pleural effusion is diagnosed, the clinician must decide on the most appropriate form of palliation for the symptomatic patient. In the symptomatic patient with a reasonable life expectancy and pleural fluid pH of more than 7.3, chemical pleurodesis appears to be the most effective and least morbid therapy.

Adenocarcinoma↗
PubMed1992

Pulmonary hypertension and human immunodeficiency virus infection. Two reports and a review of the literature.

Pulmonary hypertension may be primary (idiopathic) or secondary. While the etiologies for secondary pulmonary hypertension are diverse, infection with the human immunodeficiency virus (HIV) has not been included. To date there have been 16 reported cases of pulmonary hypertension in the HIV-infected population. Plexogenic arteriopathy was the most common pathologic finding. We report two HIV-infected patients who were concomitantly found to have pulmonary hypertension with plexogenic arteriopathy. One patient had lymphocytic interstitial pneumonitis, an entity not previously associated with pulmonary hypertension. We review the 16 previous cases of pulmonary hypertension and HIV infection and discuss this association.

Adult↗
PubMed1992

Hamman's sign revisited. Pneumothorax or pneumomediastinum?

Louis Hamman described distinctive chest noises and emphasized their association with pneumomediastinum in 1937. However, the etiology of Hamman's sign remains incompletely defined and its association with pneumothorax underemphasized. We present a patient with pneumothorax and Hamman's sign assessed by computed chest tomography. Tomography suggested an alternate genesis of Hamman's sign; free pleural air may be cyclically channeled through a lung fissure thus creating chest sounds.

Adult↗
PubMed1992

A prospective study of amylase-rich pleural effusions with special reference to amylase isoenzyme analysis.

By analysis of pleural effusions from 200 patients, 25 cases of amylase-rich effusions were identified, for an overall incidence of 13 percent. Four of the 25 patients (16 percent) had evidence of pancreatitis. These patients had higher mean ratios of pleural fluid to serum amylase levels (18 +/- 6.3 [SEM] vs 4.8 +/- 1.3) compared to patients with nonpancreatic diseases (p = 0.003); all four exhibited a predominant pancreatic isoenzyme profile. Of the 21 patients with nonpancreatic amylase-rich effusions, lung cancer was the most commonly associated condition (8 patients). In 14 of the 21 patients in whom an isoenzyme profile was obtained, salivary-type amylase was predominant. Amylase-rich pleural effusions occur frequently, and pleural fluid isoamylase determination is specific for pancreatitis-associated effusions. The finding of a pleural effusion rich in salivary isoamylase should prompt an evaluation for carcinoma (particularly of lung primary), but may also be seen in other pleural inflammatory conditions.

Amylases↗
PubMed1992

Pleural disease in pregnancy.

Pleural effusions, pneumomediastinum, and pneumothorax are known complications of pregnancy. Although reported in small series and anecdotal case reports, the serious nature of these complications and the potential for misdiagnosis during the events of labor and delivery warrant a careful review of the available literature. In this article the incidence, clinical manifestations, and, where appropriate, therapeutic options of these disorders are discussed.

Antibodies, Antiphospholipid↗
PubMed1991

Pleural fluid analysis in malignant mesothelioma. Prognostic implications.

Pleural fluid characteristics of 26 patients diagnosed with malignant mesothelioma over an 18-year period were reviewed and compared with those of patients with effusions due to other malignancies. Survival from time of initial thoracentesis was directly correlated with pleural pH and decreased pleural fluid/serum glucose ratios but was not related to protein or LDH concentration. Decreased pleural fluid pH was statistically related to a decreased pleural fluid/serum glucose ratio. Patients with low pH (less than 7.30) pleural effusions had statistically decreased mean survival and decreased mean pleural fluid/serum glucose ratios compared with patients with normal pH (greater than or equal to 7.30). Patients with malignant mesothelioma pleural effusions had statistically decreased mean pleural fluid pH compared with patients with other malignant pleural effusions. Decreased levels of pleural fluid pH and pleural fluid/serum glucose ratios have negative prognostic significance and probably correlate with the degree of tumor bulk affecting the pleural surface.

Blood Glucose↗