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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to describe the clinical, computed tomographic (CT), and pathologic findings of large cell neuroendocrine carcinoma (LCNEC) of the lung. CT and pathologic findings as well as clinical features of surgically proven LCNEC of the lung were reviewed retrospectively in 11 consecutive patients (eight men and three women; mean age, 63 years; range, 44-77 years). Chest CT showed peripheral mass or nodule (n = 8) and central mass with distal atelectasis (n = 3). Six tumors were accompanied by mediastinal (n = 3) and hilar (n = 3) lymph node enlargement at CT. On pathologic examination, all resected tumors showed necrosis of variable extent (mean: 38%, range; 10-70%). The areas of intrinsic lipoid pneumonia and tumor emboli in two patients appeared at CT as areas of ground-glass opacity surrounding the tumor. Mediastinal nodal metastases were seen in three (27%) patients. Pathologic staging of 11 patients was IB in six, IIA in one, IIB in one, IIIA in two, and IIIB in one. Follow-up data showed extrathoracic metastases in four patients at mean follow-up period of 15 months. One patient died of distant metastasis 5 months after the surgery. CT findings of LCNEC of the lung are nonspecific and similar to those of other non-small cell lung cancers and extrathoracic metastasis is seen in approximately one third of the patients with follow-up study.
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PMID:Large cell neuroendocrine carcinoma of the lung: clinical, CT, and pathologic findings in 11 patients. 1142 14

Since 1993, 272 patients underwent surgery on gastrointestinal tract: 92--for gastric ulcer, 79--for duodenal ulcer, 29--for cancer of the stomach, 67--for cancer of the colon, 5--for other diseases. The main operations were resection of the stomach (195), hemicolectomy (23), abdominal-anal and anterior resection of the rectum (44). In 135 patients group 1 all stages of surgery on gastrointestinal tract were performed with "Auto Suture" instruments (USA). In 137 patients group 2 anastomosis was created by two-layer nodal suture with Russian auto-suture instruments (UKL-60, UO-40) during some stages of operation. Postoperative complications occurred in 57 (20.9%) patients: 14 (5.1%) in group 1 and 43 (15.8%) in group 2. Predominant complications were suppuration of the wound (7 and 14 cases, respectively), anastomositis (2 and 10), pneumonia (8--only in group 2), bleeding in anastomotic zone (5--only in group 2). After surgery 7 (2.6%) patients died due to causes not associated with method of surgery or anastomosis creation. Advantages of modern auto-suture instruments in surgery of gastrointestinal tract are demonstrated: reduction of surgery time, simplicity and reliability of anastomosis creation, possibility of use in hard to reach abdominal parts (low anterior resection of the rectum), better postoperative period, a 3-fold decrease of postoperative complications number.
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PMID:[Use of present-day suturing instruments in gastrointestinal surgery]. 1152 2

The purpose of this article was to review the patterns and morbidity of regional recurrence (RR) in patients with early breast cancer, efficacy of salvage therapy for RR, and complications of regional nodal treatment. A retrospective evaluation of 1,158 patients with stage I or stage II breast cancer treated with conservative surgery and radiotherapy (RT) between 1979 and 1994 was performed. Seven hundred fifty patients underwent axillary surgery, and 229 patients received RT as their only treatment of the regional lymphatics. Regional nodal RT was given to 168 patients who also had axillary surgery. The regional lymphatics of 11 patients were not treated. The patterns and morbidity of RR, relapse management, and complications related to regional nodal treatment were reviewed from the patients' records. With a median follow-up of 88 months, a total of 31 patients (2.7%) developed a RR. Nine of 31 patients (29%) with an RR experienced significant morbidity, including pain, fungating tumor, dysphagia, dyspnoea, and/or sensory motor changes at diagnosis. Nineteen patients (61%) had symptomatic residual or progressive regional disease after salvage therapy at last follow-up or death. Six of nine patients (67%) who developed an isolated axillary recurrence and underwent salvage surgery had no further axillary recurrence. The addition of regional nodal RT to breast irradiation significantly increased the incidence of symptomatic pneumonitis (1% without regional nodal RT and 4% with regional nodal RT, p < 0.001). Combined axillary dissection and nodal irradiation resulted in a significantly higher incidence of arm edema compared with either alone (9.5% with axillary dissection, 6.1% with RT to the axilla and supraclavicular fossa, and 31% with combined modality therapy, p < 0.001). Five of 380 patients (1%) who received RT to the axilla and/or supraclavicular fossa developed a transient brachial plexus neuropathy. Although RR was uncommon in patients treated with axillary surgery and/or regional nodal irradiation, salvage therapy failed to eradicate the recurrence in approximately two thirds of the patients with a RR. Ongoing research is essential to optimize regional control with an acceptable level of risk of treatment complications. Sentinel lymph node biopsy, if validated as an accurate method of staging the axilla in patients with breast cancer, would allow selective avoidance of regional nodal treatment and hence the associated morbidity.
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PMID:Competing considerations in regional nodal treatment for early breast cancer. 1185 56

Early stage, medically inoperable non-small-cell lung cancer is a treatable disease. A thorough clinical work-up is necessary to optimize management for this group of patients. Thoracic radiation therapy has been used for such patients with achievement of durable local control and prolonged survival. To improve upon the results of standard fractionation radiation therapy, novel approaches are needed. Dose escalation may further enhance local tumor control and survival rates. Efforts to minimize irradiation to normal lung parenchyma are necessary. Multiple strategies to optimize the therapeutic ratio are being investigated. Elimination of elective nodal irradiation may reduce late toxicity of treatment but may compromise locoregional control. Other strategies, such as intensity-modulated radiation therapy with dose volume histograms will help minimize lung parenchyma irradiation, which will reduce the probability of radiation pneumonitis. Chemotherapy appears to play a minimal role in the treatment of inoperable limited disease, but researchers continue to conduct investigational trials with active chemotherapeutic agents in the hopes of reducing local and distant tumor failures.
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PMID:Inoperable localized stage I and stage II non-small-cell lung cancer. 1205 90

Carcinoids are neuroendocrine neoplasms. Bronchial carcinoids are unusual, malignant primary neoplasms that characteristically involve the central airways and typically exhibit well-defined margins and bronchial-related growth. Bronchial carcinoids include low-grade typical carcinoids and the more aggressive atypical ones. They usually affect patients in the 3rd through the 7th decade of life who are often symptomatic with cough, hemoptysis or obstructive pneumonia. Rarely, the initial symptoms are related to the secretion of hormones causing carcinoid or other endocrine syndromes. Bronchial carcinoids radiologically manifest as hilar or perihilar masses, with or without associated atelectasis, pneumonia or bronchiectasis. At CT-scan the relationship of these tumors with the bronchial tree is usually seen, and they show contrast enhancement or calcification. Even if the radiological signs may be suggestive for bronchial carcinoid, the definitive diagnosis is reached only by the tissue sampling. Bronchoscopic biopsy is the more effective way to identify the nature of carcinoid tumors because of their frequent central location. The treatment of choice is the surgical resection which should be carried out with maximum respect for the residual lung and bronchial tissues. Endoscopic ablations in well defined cases, bronchotomy and lung resections with or without bronchoplastic procedures have been described. Hilar and mediastinal lymph node sampling and examination should be ever performed during open procedures. Positivity of the nodal tissues could influence the resection procedure and is related with the prognosis, specially for the atypical carcinoids. Chemo- and radiation therapy are not effective in improving the long-term outcome in those patients with advanced disease. The long-term outcome is strictly related with the histological subtype and the lymph node status. Local recurrences and distant metastases are more frequent in the atypical carcinoids which manifest a more aggressive behavior. During the last decade, the importance of the use of somatostatine analogues (octreotide) in the staging, early detection of the recurrent disease and its management such as that of the associated carcinoid syndrome became clear.
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PMID:[Bronchopulmonary carcinoid tumours]. 1214 71

Two hundred and forty eighty deaths from pulmonary tuberculosis were analyzed in adults. The most frequent cause of deaths was progressive tuberculosis, mainly as caseous pneumonia (60.9%) and the less frequent one was a multicavernous process with bronchogenic (28%) and hematogenic (15%) dissemination. The high incidence of specific intrathoracic lymph nodal lesions, which has increased from 10.8% in 1994-1995 to 30.4% in 1997-1999, and a larger number of hematogenic dissemination from 6.7 to 25.6%, respectively, are noteworthy. Progressive tuberculosis was most commonly favoured by the patients' inadequate attitude towards their health: delayed visits to a doctor when they have symptoms of the disease, the absence of fluorographic examinations, treatment errors due to their incompliance.
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PMID:[Composition and morphological characteristics of deaths from tuberculosis]. 1216 24

Positive enzyme immunoassay (EIA) was found in 59.6% of patients of tuberculosis. Positive responses were significantly more frequently detected in patients with pulmonary tuberculosis than in those with intrathoracic lymph nodal tuberculosis (ITLNT) (62.2 +/- 7.4 versus 38.9 +/- 11.8%, respectively; p < 0.05. There was no significance difference in the rate of positive responses in patients with ITLNT (38.9 +/- 11.8%) and healthy individuals inoculated with Mycobacterium tuberculosis (17.6 +/- 9.5%). Sixteen (61.5%) patients with pneumonia showed a positive response, which amounted to 38.5% specificity of the method. The findings suggest that EIA may not be used as a screening test for early diagnosis of tuberculosis in children and teenagers and for differential diagnosis of pulmonary tuberculosis and nonspecific pneumonia. EIA data may be assessed only in combination with other diagnostic criteria.
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PMID:[Value of enzyme immunoassay in the diagnosis and differential diagnosis of abacillary tuberculosis in children and teenagers ]. 1261 28

From 1986-2001 we treated 31 patients with cystic neoplasms of the pancreas. 13 patients showed a cystadenocarcinoma including one rare case of a serous cystadenocarcinoma. A curative resection (R0) was possible in 10 patients (resection rate: 76.9%). After median 61 months (range 29-144 months) 8 patients are alive without evidence of tumour. 2 patients died 2 months (pneumonia) and 36 months (local recurrence) respectively after operation. The latter case of tumour recurrence showed nodal involvement (pN1) in the Whipple specimen. One patient died 44 months after Whipple procedure with tumour-positive resection margin (R1 Situation) from local recurrence and hepatic spread. Our data reflect the good prognosis of cystic neoplasms of the pancreas reported in literature after curative resection--a result of the different biological behaviour compared with ductal adenocarcinome.
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PMID:[Cystic pancreatic tumors--differential diagnosis, surgical therapy. Prognosis of cystic pancreatic tumors]. 1270 75

Interferon-alpha2b (IFNalpha2b) is the only form of systemic adjuvant therapy for stage III melanoma with documented survival benefit. Radiotherapy can also be utilized in the adjuvant setting in patients at high risk of nodal basin recurrence. As IFNalpha2b is associated with substantial toxicity, we sought to determine both the systemic and radiation-related toxicities in patients treated with combined adjuvant IFNalpha2b and regional adjuvant radiotherapy delivered in the setting of a single institution. Eighteen consecutive patients who commenced adjuvant IFNalpha2b between November 1997 and August 2002 were analysed retrospectively for toxicities associated with the combination of IFNalpha2b and adjuvant radiotherapy (40-50 Gy in 15-25 fractions) to nodal basins delivered during the maintenance phase of IFNalpha2b therapy (median dose during radiotherapy of 6.5 MU/m three times per week). Seven out of 18 patients who received concurrent radiotherapy and IFNalpha2b displayed grade 3 skin reactions. Severe radiation-induced toxicity was seen in three further patients, one who developed radiation pneumonitis, one who developed severe oral mucositis, and one who developed wound dehiscence that took 10 months to resolve. Non-radiation-related toxicity to IFNalpha2b therapy was typical for this dose and schedule. We conclude that concurrent use of adjuvant radiotherapy and IFNalpha2b may enhance radiation-induced toxicity. However, overall we found concurrent radiation and IFNalpha2b could be safely delivered with appropriate clinical monitoring.
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PMID:Concurrent adjuvant radiotherapy and interferon-alpha2b for resected high risk stage III melanoma -- a retrospective single centre study. 1517 93

Infections caused by nontuberculous mycobacteria (NTM) commonly manifest as lymphadenitis in otherwise healthy children, as pneumonia in patients with chronic airway diseases, and as disseminated disease in patients with immunosuppression. The aim of this case report is to describe imaging findings (sonography, electrical impedance scanning, MRI) in children with NTM infection of the head and neck and to give some information about microbiologic findings and therapeutic options. In children presenting with enlarged neck masses and radiologically demonstrated nodal masses, the diagnosis of infections with NTM should be considered.
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PMID:[Lymphadenitits caused by nontuberculous mycobacteria]. 1538 79


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