Eosinophilic Pleural Effusion: A Rare Complication of Extracorporeal Shock Wave Lithotripsy

Background. Extracorporeal shock wave lithotripsy has been widely used to treat renal stones. The procedure is relatively safe with minor complications. Case. The patient is a 32-year-old man who presented with left sided pleural effusion after extracorporeal shock wave lithotripsy. Results. The pleural effusion study revealed an exudative fluid rich in eosinophils (30%). So, the diagnosis of eosinophilic pleural effusion as a complication of lithotripsy was made. Conclusion. Extracorporeal shock wave lithotripsy should be regarded as an etiology of unexplained eosinophilic pleural effusion after this procedure

Effects of Pentoxifylline on Oxygenation and Exercise Tolerance in Patients with Severe Chronic Obstructive Pulmonary Disease

Background: It was hypothesized that the use of Pentoxifylline would increase arterial O2 saturation and increase exercise tolerance in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: We tested this hypothesis in 23 patients with COPD and pulmonary hypertension. Patients were randomized to receive Pentoxifylline or placebo, each for a 12-week period, in a prospective, double-blind study to assess the effects of Pentoxifylline on oxygen saturation and exercise tolerance via pulse oximetry and the 6-Minute Walk Test (6MWT). Results: At the end of the 12 weeks, the six-minute walk distance rose from 351.9±65 meters to 393±67 meters in the Pentoxifylline group (10 patients) and increased from 328±79 meters to 353±66 meters in the placebo group (10 patients) (P=0.142). Resting oxygen saturation by pulse oximetry changed from 87±4% to 85±14% in the Pentoxifylline group and from 88±3% to 88±2% in the placebo group (P=0.676). There were no significant changes in dyspnea severity index and heart rate before and after the 6MWT. Conclusion: Pentoxifylline does not seem to improve exercise capacity and dyspnea in patients with severe and very severe COPD. Trial Registration Number: IRCT201202018889N

Transudative chylous pleural effusion: Case report

SummaryTransudative chylous pleural effusion is a very rare entity. Hereby we present a 46 year old man a case of chronic renal failure and nephrotic syndrome with chylous ascites, lower extremity edema and chylous transudative pleural effusion with slight response to ultrafiltration

Investigation of FOXP3 genetic variations at positions -2383 C/T and IVS9+459 T/C in southern Iranian patients with lung carcinoma

Objective(s): FOXP3 gene is an X-linked gene that encodes FOXP3 protein, an essential transcription factor in CD4+CD25+FOXP3+ regulatory T (Treg) cells.  We aimed, in the present study, to investigate the association of two FOXP3 polymorphisms, -2383 C/T (rs3761549) and IVS9+459 T/C (rs2280883), with lung cancer. Materials and Methods:  In a case-control study we analyzed genotypes and alleles frequencies at -2383 C/T and IVS9+459 T/C positions in 156 patients with lung cancer and 156 age and sex matched healthy controls in Southern Iranian population, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. The data were verified by direct automated DNA sequencing. Results: The frequency of -2383 T allele was significantly higher in the patients than in the control group (11.8% versus 5.9%, P-value=0.04, OR=2.13, 95%CI=1.04-4.54). T allele frequency at IVS9+459 T/C position was higher, compared to the controls, in the patients who presented the disease over 55 years old (69.9% versus 59.1%, P-value=0.04, OR=1.61, 95%CI=1.01-2.55) and also in SCLC patients (77.8% versus 59.1%, P-value=0.03, OR=2.42, 95%CI=1.05-5.59). No significant differences were found in the genotypes and haplotypes distributions between the cases and controls. A high degree of linkage disequilibrium was observed between two polymorphisms.  Conclusion: As the first study dealing with -2383 C/T and IVS9+459 T/C in lung cancer, our data conclusively suggest the association of -2383 T allele with susceptibility to lung cancer in Iranian population. The association of IVS9+459 T allele with susceptibility to lung cancer in old patients suggests the age-dependent effects of FOXP3 gene on cancer occurrence

Investigation of Programmed Cell Death-1 (PD-1) Gene Variations at Positions PD1.3 and PD1.5 in Iranian Patients with Non-small Cell Lung Cancer

Background: Tumor cells express PD-1 ligands to bind PD-1 on immune cells and escape immune responses. In the present study, we aimed to investigate whether single nucleotide polymorphisms at positions PD1.3 (+7146, rs11568821) G/A, and PD1.5 (+7785 C/T, rs2227981) may be considered risk factors for susceptibility to nonsmall cell lung cancer in the Iranian population. Methods: This study enrolled 206 histopathologically confirmed lung cancer patients and 173 age/sex matched healthy controls. We performed PCR-RFLP to determine the genotypes of the extracted genomic DNA. Results: The frequencies of PD1.3 GG, GA and AA genotypes were 171 (83%), 31 (15%) and 4 (1.9%) out of 206 patients, and 144 (83.2%), 26 (15%), and 3 (1.7%) out of 173 controls, respectively. The frequencies of PD1.5 CC, CT and TT genotypes were 78 (37.9%), 100 (48.5%), and 28 (13.6%) in patients, and 60 (34.7%), 89 (51.4%), and 24 (13.9%) in controls. There were no significant differences in genotype analysis between patients and controls at positions PD1.3 (P=0.98) or PD1.5 (P=0.80). No significant differences existed in the frequencies of alleles and haplotypes between the two groups (P>0.05). Conclusion: Our data have indicated no association between PD1.3 (+7146) G/A and PD1.5 (+7785) C/T with susceptibility to non-small cell lung cancer. Investigation of other PD1 genetic variations and emerged haplotypes are required to completely define the role of PD1 genetic variations in susceptibility to lung cancer

Genetic Polymorphisms of CCL22 and CCR4 in Patients with Lung Cancer

Background: An association between lung cancer and chemokines has been advocated in the recent years. This study aims at investigating the association between lung cancer and 16C/A single nucleotide polymorphism (SNP) (rs. 4359426) in C-C motif chemokine 22 (CCL22) as well as C1014T SNP (rs. 2228428) in C-C chemokine receptor type 4 (CCR4), which serves as the receptor for CCL22. Methods: Genotyping was performed in 148 lung cancer patients and 148 normal controls using Polymerase Chain Reaction-Restriction-Fragment Length Polymorphism (PCR-RFLP). The data were verified by direct automated sequencing. Results: Frequencies of CC, CA and AA genotypes of 16C/A SNP in CCL22 gene were 112 (75.7%), 33 (22.3%) and 3 (2.0%) in patients, and 119 (80.4%), 24 (16.2%) and 5 (3.4%) in controls respectively. No significant differences were observed in genotype frequencies at this position between cases and controls (P=0.34). Moreover, there was no significant association between CCL22 polymorphism and types of lung cancer in patients. The distribution of CC, CT and TT genotypes of C1014T SNP in CCR4 gene, was 76 (51.4%), 60 (40.5%) and 12 (8.1%) in patients, and 80 (54.1%), 49 (33.1%) and 19 (12.8%) in controls respectively. No statistically significant differences were observed in genotypes frequencies of CCR4 gene between patients and controls (P=0.24). The genotype inherited by patients observed not to be associated with the type of lung cancer (P>0.05). Conclusion: Results reveal that CCL22 gene polymorphism at position 16C/A and CCR4 gene polymorphism at position C1014T, appear not to be associated with susceptibility to lung cancer

Epstein-Barr virus hepatitis can cause transient hepatopulmonary syndrome

Introduction: Hepatopulmonary syndrome is commonly seen in the patients with chronic liver disease. Acute liver diseases are rarely associated with HPS. We have reported here a case of Transient HPS caused by Epstein-Barr virus hepatitis. Case report: The patient was a 31 years old man that came to hospital due to RUQ pain and yellowish skin. In examination the patient was tachypnic and O2 saturation was 71% with prominent JVP. ver enzyme and bilirubin were high. All viral hepatitis was negative except anti viral capsid antigen-antibody of EBV. In Blood gas PaO2 was 54 mmHg, O2 saturation 73% and alveolar-arterial gradient was 18 mmHg. Stress Echocardiography with saline injection reported pulmonary arterial pressure 32 cmHg with delayed opacification of left atrium. Conclusion: transient HPS can be manifestation in the acute hepatitis caused by EBV infection. Keywords: Epstein-Barr virus, Hepatitis, Hepatopulmonary syndrom