PubMed · 13496298
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R SAYGIN. 1957. [Tuberculous bronchiectasis].. https://pubmed.ncbi.nlm.nih.gov/13496298/
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STUDY OBJECTIVE: To review our experience with specific characteristics, indications, and results of pulmonary resection in children with middle lobe/lingula syndrome. DESIGN: Retrospective cohort study. SETTING: Thoracic Surgery Department, Chest Diseases Hospital, Kuwait. PATIENTS AND INTERVENTION: Thirteen children with middle lobe, lingula, or both syndromes were treated with pulmonary resection from January 1995 to December 1999. RESULTS: The mean age was 7.5 years (range, 5 to 10 years). Eight patients were girls, and five were boys. All patients underwent high-resolution CT and bronchoscopy. Bronchiectasis and atelectasis of right middle lobe, lingula, or both was noted in nine patients. Bronchial stenosis and inflammation of the bronchus was found endoscopically in four patients. The indications for surgery were recurrent respiratory tract infection with persistent atelectasis and bronchiectasis in nine patients, and recurrent respiratory tract infection with bronchiectasis in four patients. A right middle lobectomy was done on seven patients and a lingulectomy on four patients. Two patients underwent staged thoracotomies (right middle lobectomy and lingulectomy). There were no operative deaths. Only two patients had postoperative complications: atelectasis (n = 1), and pneumothorax (n = 1). Mean follow-up was 3.5 years (range, 3 to 5 years) for all patients. Nine patients were asymptomatic, and four patients had improved. CONCLUSION: Right middle lobe or lingula syndrome with the presence of bronchiectasis, bronchial stenosis, or failure of lung to re-expand are indications for early pulmonary resection.
OBJECTIVE: Water is the main constituent of mucus, and its concentration is likely to be important in all aspects of mucus function, including ciliary clearance. The objective of this study was to investigate the effect of water content and osmolality of the mucus on mucociliary transportability. METHODOLOGY: Rheology and ciliary transportability of 10 sputum samples that had been subjected to various manipulations were measured using a mucus-depleted bovine trachea model. RESULTS: It was shown that addition of sodium chloride 0.2 Osmoles/kg (0.585% weight for weight) increased the transportability by 41% (P < 0.01). Evaporation of the sputum to 50% of its original weight caused a 118% increase in transportability (P < 0.0006), but iso-osmolal removal of 50% of the liquid with filter cards led to a non-significant, 25% increase in transportability. Parallel plate viscoelasticity was approximately doubled in both the evaporated and liquid-depleted samples, but was not changed by the addition of 0.2 Osmoles/kg of sodium chloride. The correlation between the osmolality of sputum and ciliary transportability (r = 0.54, P= 0.005) was better than the correlations between the viscosity (r = 0.21, P= 0.27) or elasticity (r = 0.23, P= 0.23) and ciliary transportability. CONCLUSIONS: These results suggest that the osmolality of sputum exerts a greater influence on mucociliary clearance than its viscoelastic properties.
A case of a 54-year-old woman exhibiting the yellow nail syndrome with exudative pleural effusions, lymphoedema, pericardial effusion, rhinosinusitis and bronchiectasis is described. This case illustrates the rather benign course of the syndrome over ten years. A review of the literature is provided. The etiology of the syndrome is obscure, while the pathogenesis seems to involve impaired lymphatic drainage. The entity should be considered in the differential diagnosis of bilateral pleural effusion. It is likely that the condition is not as rare as it appears from the number of published reports, and a greater awareness of its various forms will probably lead to more frequent diagnosis.