Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-four cases (55 foci) of primary tracheal malignancies were reviewed retrospectively. Radiologic material was available in 32 cases (33 tracheal foci). The most frequent primary malignant tumor of the trachea was squamous cell carcinoma (54.5%), followed by adenoid cystic carcinoma (18%) and adenocarcinoma (9%). The radiologic appearance of the tumors could be divided into intraluminal, wall-thickening, and exophytic forms. Wall-thickening and exophytic forms in this study accounted for 62% of the tumors. This indicates that malignant tumors of the trachea tend to extraluminal invasion. Tomography and computed tomography are the most helpful methods of radiologic examination for tracheal tumors. Bronchoscopy and radiologic examination are complementary procedures. The chief advantage of imaging is the demonstration of tracheal wall thickening and extraluminal changes. Hemoptysis, dyspnea, and cough were the most common symptoms. Four cases (7%) in our series presented as thyroid tumors due to direct extension into the thyroid gland. Fifteen of the 54 cases (28%) were associated with other carcinomas of the head and neck and the lung.
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PMID:Primary malignant tumors of the trachea. A radiologic and clinical study. 238 16

Fifty-three patients with recurrent and advanced stage (III and IV) non-small-cell lung cancer (NSCLC) were treated with a combination of bleomycin, etoposide (VP-16-213), and cis-diamminedichloroplatinum (BEP). Forty-eight patients were appraisable for response. The response rates were 44% for the entire group, 57% in 30 patients with combined squamous-cell and large-cell carcinoma, and 22% in 18 patients with adenocarcinoma (40%, 50%, and 19%, respectively, if patients not appraisable for response are included as nonresponders). The median survival time of patients with squamous-cell and large-cell carcinoma was slightly longer than that of patients with adenocarcinoma (23 weeks v 19 weeks). Patients with responsive disease survived significantly longer (median, 34 weeks) than did patients with unresponsive disease (median, 16 weeks) (P = .001). In the entire group, the median survival time of patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 was better (23 weeks) than of those with a status of 2 or 3 (15 weeks), but this difference was not seen in the subgroup with squamous-cell and large-cell carcinoma (24 weeks v 23 weeks, respectively). Thus, the performance status was not of prognostic value in the histologic subgroups experiencing the best response rate. There were two treatment-related deaths, but otherwise the toxicity of BEP was acceptable. Only four of the 119 treatment cycles were followed by fever even though there was significant neutropenia (0.5 X 10(9)/L) after 20 of 97 treatment cycles. The majority of patients receiving BEP experienced relief of cough, hemoptysis, pain, and fatigue associated with their disease. There was a good correlation between objective responses and palliation of symptoms. Thus, BEP offers good palliation, particularly for patients with squamous-cell and large-cell lung cancer.
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PMID:Combination chemotherapy with bleomycin, etoposide, and cisplatin in metastatic non-small-cell lung cancer. 241 9

Palliative therapy for previously irradiated patients with symptomatic recurrent endobronchial malignancy is a difficult problem. We have had the opportunity to treat 20 such patients with high dose rate (50-100 rad/min) endobronchial brachytherapy. Eligible patients had received previous high dose thoracic irradiation (TDF greater than or equal to 90), a performance status of greater than or equal to 50, and symptoms caused by a bronchoscopically defined and implantable lesion. The radiation is produced by a small cobalt-60 source (0.7 Ci) remotely afterloaded by cable control. The source is fed into a 4 mm diameter catheter which is placed with bronchoscopic guidance; it may oscillate if necessary to cover the lesion. A dose of 1,000 rad at 1 cm from the source is delivered. We have performed 22 procedures in 20 patients, four following YAG laser debulking. Most had cough, some with hemoptysis. Eight had dyspnea secondary to obstruction and three had obstructive pneumonitis. In 12, symptoms recurred with a mean time to recurrence of 4.3 months (range 1-9 months). Eighteen patients were followed-up and reexamined via bronchoscope 1-2.5 months following the procedure; two were lost to follow-up. All had at least 50 percent clearance of tumor, and six had complete clearance; most regressions were documented on film or videotape. In six, the palliation was durable. The procedure has been well tolerated with no toxicity. We conclude that palliative endobronchial high dose rate brachytherapy is a useful palliative modality in patients with recurrent endobronchial symptomatic carcinoma.
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PMID:High dose rate intraluminal irradiation in recurrent endobronchial carcinoma. 241 6

Direct current therapy (DC therapy), consisting of the application of electric current directly to the lesion, with chemotherapy using BLM was performed in 4 advanced inoperable lung cancer patients in whom chemotherapy and radiotherapy were not effective or could not be performed. Fluoroscopically two electrodes were inserted percutaneously into the tumor under local anesthesia. The distance between the two electrodes was about 3-4 cm. About 10 volts of direct current for 1 hour (totally over 40 coulombs) was passed between them using a DC treatment processor model 85 (Inter Nova Co., Ltd.), and simultaneously 15-30 mg of BLM was administered intravenously according to the general condition of the patient. The histologic type was adenocarcinoma in 3 cases and there was 1 large cell carcinoma. This treatment was performed once in 3 cases and twice in another. A reduction of tumor size was recognized in 3 cases (2 adenocarcinomas and 1 large cell carcinoma). In another adenocarcinoma case it was not measurable in size because of infiltrative shadow but histologically tumor destruction was recognized within a short period after DC therapy. The complications were mainly slight fever and light pain during the procedure. There was one small amount of hemoptysis and one pneumothorax but it was not necessary to perform special treatment for these complications. DC therapy with chemotherapy is based on our basic experimental experience that some anticancer agents accumulate around the electrodes in lung tissue when direct current is passed. In addition, current itself has cytocidal effects in some cases. Our clinical experience suggested the usefulness of this therapy to treat lung cancer lesions locally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Direct current therapy with chemotherapy for the local control of lung cancer]. 248 18

Between 1940 and 1985, 24 cases of primary carcinoma of the trachea were registered at the London Regional Cancer Centre. The most common presenting symptoms were hoarseness, haemoptysis and cough. Twenty patients had epidermoid carcinoma and four had adenoid cystic carcinoma. Because of different clinical behaviours, the two histologies were separately analyzed. Of the 20 patients with epidermoid carcinoma, 19 received radiotherapy as primary treatment and one patient did not receive radiotherapy because of advanced disease. Radiation doses ranged from 4000 to 6000 cGy and most patients had megavoltage irradiation. Treatment result was disappointing. Only one patient remained disease-free at 15-month follow-up and all other patients had persistent or recurrent tracheal tumour. Median survival for all 20 patients was 5 months (range 1 to 19 months). Of the four patients with adenoid cystic carcinoma, two had primary surgery and postoperative radiotherapy and two had primary radiotherapy. Two patients died of disease, at 5 months and 8 years from diagnosis. Two surviving patients had 15-month follow-up: one had persistent disease and the other was free from recurrence. In this study, radiotherapy within the range of doses given was found to be an ineffective primary treatment for tracheal carcinoma.
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PMID:Radiotherapy for primary carcinoma of the trachea. 254 38

It is imperative to be familiar with anatomical variation in the branching formation of the bronchial artery for radiologists attempting an interventional angiography to the pulmonary diseases such as hemoptysis or pulmonary carcinoma. The anatomy of the bronchial arteries reported by Cauldwell et al. is the most frequently quoted literature in the world as well as in Japan. However, we had noticed that some discrepancies exist between our clinical experience and those in Cauldwell's report regarding anatomical variation of the bronchial arteries. Then, we reviewed the bronchial arteriograms in 640 patients. We included 412 patients in investigation, in which it was possible to identify the branches supplying all pulmonary lobes. In 50 out of 640 patients, catheterization of the branches supplying the lesion was failed. Branching formation of the bronchial arteries is extremely variable and complicated by presence of the accessory bronchial arteries and anastomosing branches from the systemic arteries, which may be enlarged in various pathological conditions. Our results showed that the most common branching type was single artery on each side (50.0%), followed by common trunk (14.1%). The incidence of single on the right and dual on the left, most common in Cauldwell's series, was only 12.9%. Kasai and Chiba also pointed out these differences in their detail report investigating 100 cadavers. These discrepancies between the data may be due to differences of methodology or due to differences between the races. The authors feel that Cauldwell's data should not be referred to the anatomical variation of the bronchial artery in Japanese.
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PMID:[Clinical investigation of the branching formation of the bronchial arteries in the Japanese]. 259 88

Twenty-two cases of bronchopulmonary carcinoid tumor diagnosed in Iceland in the 30-year period 1955-1984 were analyzed. Carcinoid comprised 2% of all primary lung tumors registered in that period. The crude incidence was 0.36 cases/100,000 population/year. The patients' mean age was 48 years and 68% were female. The most common presenting symptom was recurrent pneumonia; only three patients had hemoptysis. One patient had carcinoid syndrome. Two of the 22 tumors were peripheral. Tumor size was 0.8-9 cm, mean 2.8 cm. Of the resectable bronchial tumors, 80% had invaded the pulmonary parenchyma and 18% had metastasized to lymph nodes. Four carcinoid tumors were atypical and showed more malignant behavior. One of them was originally diagnosed as oat-cell carcinoma. Sixteen patients with resectable carcinoid tumor were alive 3 1/2 to 29 years after removal of the tumor.
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PMID:Bronchopulmonary carcinoids in Iceland 1955-1984. A retrospective clinical and histopathologic study. 261 47

In order to relieve complete obstruction of the thoracic esophagus due to spinocellular carcinoma, thirteen patients, all of them in good or at least regular general conditions were submitted to a bypass using a isoperistaltic gastric tube. The disease itself was treated by radiotherapy after surgery. Only one patient died at the hospital due to an error in the radiotherapy schedule. Cervical fistula was observed in six patients seven days after surgery; local treatment was enough for complete healing in five out of six. In one patient surgery was performed in order to repair the anastomotic area. Stenosis was observed in three patients but in all cases it was possible to overcome it by endoscopy. With the progress of the disease other complications were observed such as hemoptysis and respiratory distress. The survival rate was nine months (running between five and sixteen) but it should be noted that swallow capacity was maintained until death. The employed of a bypass of isoperistaltic gastric tube seems to be a desirable alternative in the treatment of esophageal cancer because it allows the reestablishment of deglutition before any treatment such as radiotherapy alone or combined with surgery.
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PMID:[Esophagoplasty with bypass using an isoperistaltic gastric tube in the treatment of cancer of the thoracic esophagus: study of 13 cases]. 263 94

Suppurative complications to aspiration pneumonia occur if the initial aspiration and subsequent pneumonitis go unrecognized or untreated. Anaerobic cavitary disease is typically an indolent process, whereas necrotizing pneumonia is more fulminant and deadly. Rarely are aggressive diagnostic measures necessary in the community-acquired setting. Most patients, even with necrotizing pneumonia, respond well to high-dose penicillin and show clinical improvement within a week to 10 days. Clindamycin may be preferred in cases of severe underlying disease or when penicillin fails to yield signs of recovery. The presence of empyema not only increases the duration of therapy but also is fraught with complications and carries a higher mortality rate (20 vs 5 per cent). Necrotizing pneumonia and pulmonary abscess that develop in the nursing home or hospital setting require a more aggressive diagnostic approach, and broad-spectrum antibiotic coverage is necessary. In spite of these measures and appropriate antibiotic selection, nosocomial-acquired disease carries a mortality rate of 30 to 50 per cent. Surgical intervention, once the mainstay of therapy, is now reserved for patients with complications such as massive hemoptysis, failure to respond to chest tube thoracostomy in the presence of empyema, abscess drainage that fails with postural drainage, and diagnosis of carcinoma.
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PMID:Aspiration pneumonia, necrotizing pneumonia, and lung abscess. 265 1

A case of a 73-year-old woman, complaining of exertional dyspnea and hemoptysis, is reported. About twenty years earlier, she had been diagnosed as having a thyroid carcinoma and had undergone a partial thyroidectomy. Bronchoscopic findings showed an endobronchial polypoid tumor which obstructed the intermediate bronchus almost completely. The polyp was about 3cm in length and protruded from the entrance of the middle lobe bronchus. The histologic findings revealed it to be a metastasis of the papillary thyroid carcinoma. After a polypectomy, the hypoxemia and dyspnea showed remarkable improvement.
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PMID:[A case of lung metastasis of thyroid cancer with endobronchial polypoid growth]. 266 82


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