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At least 19 recordsLinked to original sources
PubMed1990

[A study of lung cancer with presence of pleural effusion at the time of thoracotomy--cytologic evaluation of a relatively small amount of pleural effusion and prognosis after removal].

The cytologic evaluation of a relatively small amount of pleural effusion in lung cancer at the time of thoracotomy has not been previously considered, and prognosis after removal has not been clarified. In order to clarify these points, 99 cases of removed lung cancer with presence of pleural effusion at the time of thoracotomy were examined following cytology. Our study was conducted with regard to the amount and nature of pleural effusion, pleural effusion cytology, tumor development and its relation to prognosis. On the basis of this study a formula was developed relating the occurrence rate of cytologically positive pleural effusion with the development of tumor employing multivariate analysis, specifically the multiple regression analysis. 21% of these cases showed cytologically positive pleural effusion, indicating an absence of its correlation to the amount of pleural effusion; the conducting of cytology regardless of the amount of pleural effusion was found to be significant in determining the precise stage. The occurrence rate of cytologically positive squamous cell carcinoma was significantly few compared with those in other cell types. Regarding the pleural effusion of a relatively small amount, the prognosis after removal showed a relatively high three-year survival rate of 32% for those cases with negative pleural metastasis despite the positive showing of pleural effusion cytology, indicating the viability of surgery. From the occurrence rate of cytologically positive pleural effusion (Y) and the degree of pleural metastasis (X1)/the degree of pleural invasion (X2)/the degree of lymph nodes metastasis (X3), the following formula was obtained employing multiple regression analysis: Y = 0.344X1 + 0.050X2 + 0.034X3 + 0.075 (proportion 0.840).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

The serum-effusion albumin gradient in the evaluation of pleural effusions.

The objective of the study was to compare the serum-effusion albumin gradient (serum albumin level minus pleural effusion albumin level) to Light's traditional criteria (pleural fluid/serum total protein ratio greater than 0.5, pleural fluid/serum LDH ratio greater than 0.6, and pleural fluid LDH greater than 200 U/L) for identifying exudative pleural effusions. The design included prospective measurement of the serum-effusion albumin gradient and Light's criteria in patients with pleural effusions in an inpatient ward in a military teaching hospital. Fifty-nine consecutive patients with pleural effusions who were undergoing diagnostic or therapeutic thoracentesis in whom the etiology of the effusion could be determined were studied. Serum and pleural effusion fluid chemistries were measured in order to determine both the serum-effusion albumin gradient and Light's criteria. Using an albumin gradient of 1.2 g/dl or less to indicate exudates and greater than 1.2 g/dl to indicate transudates, 57 of the 59 patients (41 exudates; 18 transudates) were correctly classified. Two patients with malignant effusions were misclassified as having transudates. Although Light's criteria correctly identified all of the exudates, five patients with congestive heart failure were misclassified as exudates. Four of these patients had had previous diuretic therapy, and all had a clinical response to further diuretic therapy. We conclude that although Light's criteria for exudates are very sensitive, an albumin gradient of 1.2 g/dl or less tends to be more specific, especially in cases of chronic congestive heart failure.

Adult↗
PubMed1992

Experimental otitis media with effusion induced by middle ear effusion.

Experimental otitis media with effusion was induced in chinchillas by middle ear effusion, which was induced by an injection of immune complex into the tympanic cavity. To elucidate the pathogenesis of otitis media with effusion, cytologic and biochemical findings of the effusion and histopathology of the middle ear mucosa of effusion-induced chinchillas were compared with those of experimental otitis media with effusion induced by different procedures; eustachian tube obstruction, intratympanic inoculation of endotoxin, and immune reaction. No significant differences were seen in cytology, biochemistry, and histopathology among OMEs induced by these procedures. However, middle ear effusions, when compared with the corresponding sera, were proven to contain higher amounts of histamine and prostaglandin E2. These findings seem to demonstrate that middle ear effusion containing a large number of inflammatory mediators is essential for induction and prolongation of inflammatory reaction in the middle ear.

Animals↗
PubMed1977

Clinically silent pericardial effusions in patients on long-term hemodialysis. Pericardial effusions in hemodialysis.

The danger of cardiac tamponade occurring when pericarditis is accompanied by pericardial effusion, as opposed merely to the presence of a friction rub without effusion, has been unclear. Forty patients on hemodialysis were studied by physical examination, chest x-ray film, and echocardiography for evidence of pericarditis and pericardial effusion. Only two patients developed a friction rub during the study and were placed on regional heparin. Ten of 11 patients who were positive on echocardiogram for pericardial effusion had unremarkable physical examinations. These 11 patients had cardiomegaly as noted on chest x-ray examination. Eighteen of 25 patients without effusion also had cardiomegaly on chest x-ray film. No patient remaining on systemic heparin and having a pericardial effusion developed cardiovascular complications during hemodialysis. This study suggests that while many patients on longterm hemodialysis have pericardial effusion undiagnosed on the basis of physical examination, but noted on echocardiogram, special precautions to prevent tamponade during hemodialysis are not necessary. Also, posterior-anterior chest x-ray film showing a normal-sized heart will usually exclude significant pericardial effusion.

Cardiac Tamponade↗
PubMed1976

Otitis media with effusion: specific antibody activities against exotoxins in middle ear effusions.

Findings of recent immunologic studies on otitis media with effusion indicate that antibodies in middle ear effusions can either originate from serum and/or from local production in the middle ear cavity and Eustachian tube. Determination of specific antibody activity of different immunoglobulin classes in effusions and sera against certain bacterial antigens may aid in a better understanding of the pathogenesis of otitis media with effusion. A radioimmunosorbent assay was employed in the present study to determine specific antibody activity against streptolysin or staphylolysin. Although these antibody activities were mainly limited to IgG and IgA class antibodies in effusion as well as in serum, it was also found that SIgA of various types of the effusion possesses the antibody activity against these exotoxins. Findings of this study suggest that a local immunity functions in the middle ear cavity of patients with otitis media with effusions and that bacterial infection may contribute to the development of middle ear effusion in certain cases.

Antibodies↗
PubMed1990

Viscoelastic properties of middle ear effusions from pediatric otitis media with effusion and their relation to gross appearance.

The viscosity and the elasticity were measured in 146 individual middle ear effusions (MEEs) from 93 children with otitis media with effusion (OME). The effusions were classified into serous or mucoid type by their macroscopic appearance. The distribution of elasticity showed two peaks, corresponding to the peaks of serous and mucoid types of effusions. There were a small number of effusions in the intermediate range of elasticity, where the effusions were most effectively transported by the cilia. These findings suggests that the MEEs of pediatric OME are accumulations of rheologically suboptimal fluid in the middle ear cavity.

Child↗
PubMed1990

Viscosity of effusion in the middle ear and eustachian tube in patients with otitis media with effusion.

The viscosity of middle ear effusion (MEE) in the tympanic cavity and in the bony portion of the eustachian tube (ET) was compared in 11 specimens (10 patients) with otitis media with effusion (OME). Twenty microliters of effusion from the bony portion of the ET was sampled through myringotomy on the anterosuperior quadrant of the tympanic membrane with a micro-syringe with a curved needle. MEE in the hypotympanum was also sampled by separately puncturing the posteroinferior quadrant of the tympanic membrane. Using the microviscometer developed by one of the authors, the relative viscosity of these effusions were measured, and their natural logarithmic values were compared between the two sites mentioned above in each patient by obtaining their ratios (ET/ME). Effusion was found to have a significantly higher viscosity in the bony portion of the ET than in the hypotympanum (paired t-test: t = 3.859, p less than 0.01). In two patients with OME (serous mastoiditis) due to radiation to the temporal region, the ratios of the viscosity were comparatively small. On the other hand, excluding these two patients with serous mastoiditis mentioned above, the ratios were highest in two patients with a history of more than 60 days of hearing loss. These results were considered to be a clue to the possibility that viscous effusion aggravates ET function as a result of OME.

Adult↗
PubMed1979

Lysozyme activity and immunoglobulins in middle ear effusion fluid in acute purulent otitis media and in otitis media with effusion.

147 samples of punctured middle ear effusion fluid from cases of otitis media with effusion and 150 samples from patients with acute purulent otitis media were tested for lysozyme activity. In otitis media with effusion the concentration was 182.0 U/ml, in acute otitis 433.8 U/ml. The lysozyme concentration in otitis media with effusion depended upon the nature of the effusion. Serous fluid showed an activity of 124.8 U/ml and mucoid 311.6 U/ml, respectively. In culture-positive cases of acute otitis media the lysozyme level was 423.4 U/ml. Culture-negative cases showed about the same concentration, 438.3 U/ml. The possible role of lysozyme in defence systems of the middle ear is discussed.

Adolescent↗
PubMed1991

[Cytological, biochemical and immunologic parameters of pleural effusions. Presentation of differences in relation to the nature of the effusion].

In 96 patients with pleural exudates of known origin the authors assessed different cytological, biochemical and immunological parameters in the fluid and serum. In 44 patients the pleural effusions were malignant, in 26 tuberculosis, in 17 bacterial and 9 of viral nature. Statistical analysis was carried on mean values of studied parameters. The results indicate that only bacterial effusions differ significantly from the other pleural effusions. In effusions of malignant, tuberculous and viral nature the studied parameters did not differ significantly and cannot be used as differentiating criteria.

Adult↗
PubMed1989

Tuberculous pleural effusions: lymphocyte phenotypes in comparison with other lymphocyte-rich effusions.

This study investigated whether the analysis of T cell subsets and of activation markers on T cells in pleural fluids can be helpful for diagnostic purposes in tuberculous pleurisy and other lymphocyte-rich pleural effusions. Pleural effusion fluids were obtained from 18 patients with tuberculous pleurisy (TB), 21 with effusions following radiotherapy (RT) for a malignant disease, and 11 with congestive heart failure (CHF). Lymphocyte subsets were analyzed by a battery of monoclonal antibodies using an immunoperoxidase method. The majority of the lymphocytes were CD3-positive T cells (TB, 86 +/- 7% of lymphocytes; RT, 81 +/- 8%; CHF, 84 +/- 12%). The ratios of CD4-positive helper-inducer to CD8-positive suppressor-cytotoxic T cells were higher than those reported for the peripheral blood but not significantly different between the study groups (TB, 3.3 +/- 1.9; RT, 2.8 +/- 1.4; CHF, 2.5 +/- 1.1). The activation marker studies revealed that only a few pleural T cells were positive for CD38, CD25 (interleukin-2 receptor), HLA-DR antigen, and OKT9 (transferrin receptor), the proportion of CD25-positive T cells being higher in TB and in RT than in CHF and the proportion of HLA-DR-positive T cells being higher in TB than in CHF (P less than 0.05). Significant differences were not observed relative to the natural killer-cytotoxic phenotypes staining positive for Leu-7 or for CD16. Thus, we concluded that phenotypic analysis of lymphocytes is of limited diagnostic usefulness to differentiate tuberculous from other nonmalignant effusions.

Adolescent↗
PubMed1987

An immunological study of otitis media with effusion. Antibodies directed against coagulase-negative staphylococci in the effusion fluid.

From 14 chronic middle ear effusions (MEEs), 17 strains of coagulase-negative staphylococci (CS) were isolated. We then used an ELISA method to determine the antibody titers against these microorganisms in the corresponding effusion fluids and the blood sera of the patients and compared them to the antibody titers against a group of standard CS. In most cases, no specific immune response could be detected against the infecting CS in either the effusion fluids or in the sera. Our results can be explained by the inability of most CS strains to provoke a specific immune response in chronically inflamed middle ears due to their inhibition by non-specific antibodies, which reach the middle ear cavity by plasma leakage. The non-specific antibody titer against Staphylococcus hominis, however, seems to be much lower than against the other CS species. We found a high specific antibody titer against the infecting CS in the effusion fluid of a single case, but not in the serum. This finding supports the hypothesis that the middle ear mucosa has the ability to produce autonomous, local antibodies which are independent of a systemic immune response.

Adolescent↗
PubMed1992

Therapeutic and life-prolonging effect of intrapleural injection with a streptococcal preparation, OK-432, and IL2-cultured effusion lymphocytes to breast cancer patients with malignant pleural effusion.

We developed a local AIT using PEL cultured with TCGF combined with preadministration of OK-432. Twenty-six patients of breast cancer with pleural effusion have been treated with this therapy since 1983. PEL expanded and tumor cells collapsed by day 9 in culture with TCGF. Cultured PEL possessed significantly higher cytotoxic activity against autologous tumor cells than PBL cultured in the same condition (p less than 0.05), but there was no difference between their cytotoxic activities against K562. The proliferation rate of PEL obtained after intrapleural administration of OK-432 was higher than that obtained before OK-432 (p less than 0.01). Moreover, the cytotoxic activities against both autologous tumor and K562 of cultured PEL obtained after OK-432 administration was significantly (p less than 0.05) higher than those cultured PEL obtained before. Cultured PEL (1 x 10(8)-6 x 10(9)) were transferred into the pleural cavity after the intrapleural administration of OK-432 (1-5 KE). The volume of pleural effusion increased temporarily after the administration of OK-432 but significantly (p less than 0.01) decreased after AIT. Tumor cells disappeared cytologically in 22 patients at the last puncture of pleural effusion. Pleural effusion disappeared completely in 19 of 26 patients and decreased by more than 50% in volume in 6 patients. Performance status improved in 22 patients. The response rate for OK-432-combined AIT in the present study was 96%. The survival period of the patients treated by OK-432-combined AIT in this trial was significantly (p less than 0.002) prolonged compared to that of the patients receiving chemotherapy alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Proteinase activity in effusions from children with otitis media with effusion.

Proteinase activity has been demonstrated in middle ear effusions from patients suffering from otitis media with effusion. Proteinase activity was characterized by various biochemical, chemical and physical parameters. Chelators and sulfhydryl group reacting substances reduced the enzyme activity. Enzyme activity was positively correlated to the number of granulocytes present in the effusion. No correlation to bacteriological findings or to tympanic membrane status was seen and the proteinase activity showed wide ranges within different categories of middle ear effusions.

Child↗
PubMed1989

[Massive pericardial effusion in a patient with scleroderma with special reference to concentration of alpha-hANP in plasma and pericardial effusion].

A 41-year-old woman was admitted to our hospital because of scleroderma and combined valvular disease (mitral stenosis, aortic regurgitation, tricuspid regurgitation) associated with massive pericardial effusion. Plasma atrial natriuretic peptide (alpha-hANP) level was 130 pg/ml on admission, and increased temporarily with a decrease of pericardial effusion, without significant of changes of pulmonary capillary wedge pressure, pulmonary arterial pressure, right ventricular pressure nor right atrial pressure. These findings suggest that one of the mechanisms of alpha-hANP secretion, a stretch receptor mechanism, is interfered by the massive pericardial effusion. There was no relationship between atrial pressures and plasma alpha-hANP levels in this case. alpha-hANP concentration in pericardial effusion (486 pg/ml) was four to five folds higher than the plasma alpha-hANP levels.

Adult↗
PubMed1990

Yellow nails, lymphedema and pleural effusion. Treatment of chronic pleural effusion with pleuroperitoneal shunting.

Pleural effusion secondary to lymphedema may be chronic, symptomatic and refractory to treatment, occasionally requiring invasive and painful procedures such as chemical pleurodesis, open pleural abrasion or pleurectomy to achieve control of the effusion and gain symptomatic relief. We report a patient with yellow nail syndrome and chronic pleural effusion successfully treated with pleuroperitoneal shunting.

Aged↗
PubMedDate not supplied

Uveal effusion in Hunter's syndrome. Evidence that abnormal sclera is responsible for the uveal effusion syndrome.

A patient with Hunter's Syndrome (systemic mucopolysaccharidosis type II) was evaluated for bilateral uveal effusion syndrome. The right eye showed a circular peripheral choroidal detachment for 360 degrees. The left eye showed a larger circular peripheral choroidal detachment and an exudative retinal detachment. Evaluation of the sclera during combined sclerectomies and sclerostomies of the left eye revealed markedly thickening sclera and a reduced number of vortex veins. The surgery resulted in complete resolution of the choroidal detachment and exudative retinal detachment of the left eye. The presence of uveal effusion in Hunter's Syndrome, in which the sclera has been histologically demonstrated to be abnormally thickened, supports the recently proposed pathophysiology of the uveal effusion syndrome.

Adult↗
PubMed1985

Endotoxin in middle ear effusions: in cases with persistent effusion after acute otitis media.

Endotoxin in persistent middle ear effusions (MEEs) from children with acute otitis media (AOM) whose acute inflammation had cleared was assayed by Limulus test, parallel with the detection of bacteria. Seventy-five percents of MEEs were endotoxin positive, and the concentration of endotoxin in MEE was not related to the interval between the onset of AOM and the date of sample collection. However, the cases with MEE that had high concentration of endotoxin tended to have persistent MEE for more than one month after sample collection. Therefore, the presence of endotoxin may be one of the causal factors of a delayed recovery of AOM and of the development of otitis media with effusion.

Acute Disease↗
PubMedDate not supplied

Rheological properties of middle ear effusions from children with otitis media with effusion.

Freshly harvested middle ear effusions (MEE) were collected from children with otitis media with effusion. Both elasticity (G') and viscosity (eta') of the MEE were determined by an oscillating sphere magnetic rheometer and compared with transportability of the MEE on mucus-depleted frog palates. A maximum value of transport was obtained at G' of about 20 dyne/cm2 (at 1 Hz), and below this value there was a significant positive correlation between the transport rate and log G'. Above 20 dyne/cm2, the negative correlation between the transport rate and log G' was significant. This shows there is a sharp increase in transport with increase in G' up to 20 dyne/cm2, and at the higher value of G' there is a slow decrease in transport with increasing G'. A similar significant correlation between the transport rate and log eta' was observed.

Adolescent↗