6 Surgical management is best guided by pulmonary and left ventricular or aortic angiography. Indication for surgery is a hypoplastic lung prone to atelectasis and infection.1 Many patients due to coexistent anomalies are surgical candidates and preplanning for the intubation of the patients in the ICU or operation room can be done.7 The intubation of the patients can cause prolonged atelectasis of the lung. Preplanning
for correct intubation or avoiding it can be considered. The organogenesis of the lung is influenced by genetic and epigenetic factors such as growth factors (e.g. EGF has stimulatory and TGF-β has inhibitory effect). Future development of gene therapy is the goal trying to prevent lung injury and promote lung repair.6 Furthermore lung organogenesis can be influenced by environmental factors in positive and negative ways. For example, hyperoxia occurring in treated premature infants adversely see more affects lung development and must be avoided if possible.6 “
“Granulomatous reactions are seen in a wide variety of diseases as infectious diseases, sarcoidosis, crohn disease, wegener granulomatosis, romatoid artritis, berilyosis, drug reactions, foreign body aspiration. We present 3 cases referred to our clinic with presumptive diagnosis of tuberculosis
(TB) were diagnosed as nontuberculous granulomatous diseases. A 63-year-male selleck chemicals patient had right axillary lymphadenopathy (LAP) measuring 20 mm in diameter. LAP biopsy was reported as suppurative granulomatous lymphadenitis. He was referred to our clinic with presumptive diagnosis of TB. With detailed anamnesis we learned that LAP was developed 1 month after thorn prick right hand index finger. Chest radiography was normal (Fig. 1). PPD was 10 mm. Sputum smears Acid Fast Bacilli (AFB) and TB cultures were negative for five times. Erithrocyte sedimentation GNA12 rate (ESR) was 16 mm/h. Serum ACE, calcium and urinary calcium levels were
within normal range. All other laboratory findings were normal. Abdominal and neck Ultrasonography (US) examinations were normal. Because of history of thorn prick, Francisella tularensis agglutination test was performed by presumptive diagnosis of Tularemia and it was reported as 1/1280 positive. Treatment with Streptomycin and Doxycycline was started. A 25-year-old male patient admitted to a clinic with a complaint of left axillary swelling. US revealed left axillary LAP measuring 27 × 12 mm in size. Axillary LAP biopsy was reported as necrotizing granulomatous lymphadenitis. He was referred to our clinic with presumptive diagnosis of TB. Chest radiography was normal (Fig. 2). ESR was 12 mm/h. Serum ACE, calcium and urinary calcium levels were within normal range. All other laboratory findings were normal. PPD was 12 mm. Three sputum smears AFB and TB cultures were negative. Neck US yealded bilateral cervical lymphadenopathy largest measuring 6 × 13 mm in size.