Pleural involvement in cryptococcal infection

Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones.Pleural involvement in cryptococcal infections can manifest with or without pleural effusion.The presence of Cryptococcus spp.in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection,which is commonly determined by pleural biopsy,fluid culture,and/or detection of cryptococcal antigen in the pleura or pleural fluid.

Magnetic resonance imaging in distinguishing malignant from benign pleural disease

Objective To explore the role of magnetic resonance imaging (MRI) in distinguishing malignant from benign pleural disease.Methods All 64 patients were examined with both computed tomography (CT) and MRI. The morphologic features of pleural lesions and MR signal intensity on T1-weighted, T2-weighted and contrast-enhanced T1-weighted images were evaluated.Results Mediastinal pleural involvement, circumferential pleural thickening, nodularity, irregularity of pleural contour, and infiltration of the chest wall and/or diaphragm were most suggestive of a malignant cause on CT and MR images. Contrary to what has been reported in the literature, pleural thickness greater than 1?cm either on CT or on MRI did not reveal a significant difference between malignant and benign pleural disease (P>0.05, chi-square test). Using morphologic features in combination with signal intensity features, MRI had a sensitivity of 98% and a specificity of 92% in the detection of pleural malignancy. Conclusions Compared with those on CT, the morphologic features on MRI allowed a mostly equal and in some cases superior detection and evaluation of the spread of pleural disease. In combination with signal intensity and morphologic features, MRI is very useful in distinguishing malignant from benign pleural disease.

Cellular sources of interleukin 16 in benign and malignant pleural effusions

Background Interleukin 16 （IL-16） can be detected by ELISA in pleural effusion （PE） and its concentration is higher than in serum. This study investigated the cellular sources of IL-16 in PE. Methods The samples of PE were collected from 34 patients who were newly diagnosed having PE in the pleural cavity We performed cell culture to purify the pleural mesothelial cells （PMC）, Wright staining to count the purity and immunocytochemical stain to identify the cultured cells. The intracellular IL-16 expression was detected by flow cytometry （FCM）. The different cells in PE were first separated by magnetic cell sorting （MCAS） then the separated cells were cultured in RPMI1640 with 10% fetal calf serum （FCS）. We extracted the supernatant and detected IL-16 concentration by ELISA. The IL-16 protein was detected by immunohistochemistry and double immunofluorescence staining. Results The percentages of cells which secreted IL-16 were： CD3^＋CD8^- cells （（74.27±15.56）%, n=34）; CD3^＋CD8^＋ cells （（69.86±18.55）%, n=34）; CD19^＋ cells （（45.30±18.77）%, n=15）; CD14^＋ cells （（16.91＋16.69）%, n=15）; and PMC （（2.05±1.85）%, n=7）. The concentrations of IL-16 in the supernatant from cultured cells were： CD4^＋ cells （（102.50±42.51） ng/L, n=5）; CD8^＋ cells （（92.58±18.34） ng/L, n=5）; CD19^＋ cells （（79.85±5.62） ng/L, n=5）; CD14^＋ cells （（58.51±25.38） ng/L, n=5）; and PMC （（18.14±8.37） ng/L, n=5）. In lymphocytes, monocytes/macrophages and PMC, we could observe the cells that expressed IL-16 protein. In paraffin-embedded sections, we also could observe by immunohistochemistry the CD4^＋I L-16^＋ cells, CD8^＋IL-16^＋ cells, CD19^＋IL-16^＋ cells, and CD14^＋IL-16^＋ cells. Conclusions IL-16 in PE is mainly secreted by T lymphocytes, including CD3^＋CD8^- cells and CD^3＋CD^8＋ cells. CD19^＋ cells and CD14^＋ cells can also secrete IL-16, but the percentage of PMC that can secrete IL-16 is very low.

Major advances in respiratory medicine in China

Respiratory disease is the term for diseases of the respiratory system. These diseases range from mild and self-limiting such as the common cold to life-threatening such as bacterial pneumonia or pulmonary embolism. They are common and important causes of illness and death. In the US, people suffer 1 billion colds per year. One out of 7 people in the UK are affected by some kinds of chronic lung diseases, most commonly chronic obstructive pulmonary disease （COPD） and asthma. Respiratory disease accounts for over 10% of hospitalizations and over 16% of deaths in Canada.