Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-two patients with initially unresectable rectal adenocarcinoma were treated with preoperative irradiation and surgery between March 1970 and March 1986 at the University of Florida (Gainesville, FL). No patient received adjuvant chemotherapy. All patients had follow-up for at least 5 years; 23 (55%) had follow-up for 10 years or more. Five patients (12%) underwent an exploratory laparotomy before irradiation; the remaining 37 patients were clinically thought to have unresectable disease. Eighteen patients had tumor fixation to one structure, and 24 patients (57%) had fixation to two or more structures. Lesions that exhibited impaired mobility but not complete fixation were considered to be clinically resectable and are not included in this series. The dose of preoperative irradiation ranged from 3,500 to 6,000 cGy at 180 cGy per fraction; 30 of 42 patients received 4,500 to 5,000 cGy and only 4 patients received less than 4,000 cGy. Forty-one patients were operated on 1 to 11 (mean 4.6) weeks after the completion of radiotherapy; 1 patient died of aspiration pneumonia after completing irradiation but before the planned resection. Resection of the rectal cancer was accomplished in 37 patients. Four patients were found to have extensive unresectable disease at laparotomy. Twenty-one patients had a complete resection: 11 were stage B2, and 10 were stage C2. Twenty patients had incomplete resection due to positive margins (8 patients), distant metastases with or without positive margins (8 patients), or no resection due to extensive disease (4 patients). Two patients died after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Preoperative irradiation and surgery for initially unresectable adenocarcinoma of the rectum. 161 88

Lung imaging with N-isopropyl-p-123I-iodoamphetamine (123I-IMP) was performed to estimate the pulmonary lesion imaging findings in 3 patients with bronchogenic carcinoma (2: bronchioloalveolar carcinoma and 1: adenocarcinoma) and 18 with noncancerous lung diseases (10: bacterial pneumonia, 1: viral pneumonia, 1: aspiration pneumonia, 1: radiation pneumonitis, 4: pulmonary tuberculosis and 1: obstructive pneumonitis due to an endobronchial lipoma) at 30 min and 4 hr after i.v. injection of 111 MBq of 123I-IMP. These patients all exhibited infiltrates only in the chest radiograms. Decreased uptake of 123I-IMP was observed in the cancerous infiltrating lesions in 3 patients with bronchogenic carcinoma at 30 min and 4 hr, while the uptake of 123I-IMP was normal or increased at 30 min and intense at 4 hr in all 18 noncancerous infiltrating lesions. Therefore 123I-IMP lung imaging can be used to differentiate bronchogenic carcinoma from noncancerous lung disease in patients who exhibit infiltrates only in the chest radiograms.
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PMID:[Differentiation of infiltrates between lung cancer and noncancerous lung disease by 123I-IMP lung imaging]. 236 96

The complications and mortality rate of R3 radical gastrectomy using a left thoracoabdominal approach were studied in 38 patients with adenocarcinoma of the gastric cardia. There were two hospital deaths and two anastomotic leaks. There was a high rate of complications following surgery (subphrenic abscess, eight; severe chest infection, five; aspiration pneumonia, two; wound infection, two; and reactivation of tuberculosis, one). The hospital stay ranged from 11 to 39 days (median 21 days). Thirty-five patients had microscopic evidence of serosal involvement (S2). Thirty-three of the patients had lymph node metastases and 17 patients had involvement of N2 nodes. Four patients had histological evidence of residual suture line tumour, but only two of these returned with recurrence at the anastomosis. Follow-up (median 3 years) revealed that splenic artery nodal involvement (N2) did not worsen the prognosis after radical resection. Despite a high complication rate, thoracoabdominal radical gastrectomy is associated with an acceptable perioperative mortality rate, adequate symptom palliation and encouraging medium-term survival. The left thoracoabdominal approach gives excellent exposure for radical resection of cancer of the gastric cardia and should be the procedure of choice for curative resection of this tumour.
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PMID:Adenocarcinoma of the cardia: treatment by thoracoabdominal R3 radical gastrectomy. 239 23

From 1985 to 1987, 22 head and neck sites in 20 patients with recurrent tumors were treated with interstitial thermoradiotherapy (ITRT). The sites treated were 15 neck (68%), four tongue (18%), two parotid (9%), and one buccal mucosa (4%). Squamous cell carcinoma was diagnosed in 21 sites and adenocarcinoma in the other. All patients had prior radiotherapy (RT), including 15 who underwent a combination of RT and surgery. Interstitial RT with iridium 192 (mean dose, 40 Gy) was combined with interstitial microwave hyperthermia (mean thermal dose, 90 units). Complete response (CR) was obtained in 15 (68%) sites and partial response (PR) in seven (32%) sites. There were no local recurrences in the 15 CR patients during a period of observation of up to 30 months. Of the seven PR patients, one had radical neck dissection and is free of tumor after 28 months. Tumor volume was an important factor influencing CR (P less than .001), whereas RT and thermal dose were not (P = .3). Of the 20 patients treated, 19 experienced major subjective benefit. Serious complications occurred in two patients: one had localized soft tissue necrosis, the other had aspiration pneumonia. ITRT was well-tolerated by patients despite prior aggressive therapy. High objective response rate and low toxicity demonstrate the value of this treatment combination in the management of patients with postradiation recurrence of head and neck tumors.
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PMID:Interstitial thermoradiotherapy for recurrent head and neck cancer. 276 38

The mortality and morbidity of oesophagectomy are examined in this retrospective review of 128 patients with benign and malignant oesophageal disease. There were 11 deaths in hospital. The operative mortality was not influenced by age, sex, or the approach to oesophagectomy, but was significantly greater in patients given chemoradiation therapy before surgery. Complications were frequent in the early postoperative period and some were due to avoidable errors in technique or selection of operative approach. Follow-up was complete in over 90% of survivors. Late complications included aspiration pneumonia secondary to gastric stasis following total oesophagectomy and anastomotic recurrence after the one-stage procedure of gastro-oesophagectomy. When the whole stomach is used to replace the oesophagus a pyloroplasty is advised. The one-stage operation is not recommended for squamous cancer of the distal oesophagus and adenocarcinoma of the cardia.
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PMID:Oesophagectomy: the lessons learnt from 128 cases. 346 39

Primary adenomatous tumors of the middle ear and mastoid are rare. We recently cared for a man with a far-advanced primary adenocarcinoma of the middle ear and mastoid. Complete tumor removal was accomplished by a modified infratemporal fossa approach and was supplemented with postoperative radiation therapy. The postoperative complications of aspiration pneumonia and cerebrospinal fluid (CSF) leakage through the wound stimulated subsequent incorporation of temporary gastrostomy and CSF shunting into our surgical procedure. Now, 23 months after surgery, the patient is without evidence of recurrent disease. His case illustrates our approach to the management of such extensive temporal bone lesions as well as some of the potential problems which may be encountered.
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PMID:Primary adenocarcinoma of the temporal bone with posterior fossa extension: case report. 371 11

"Blunt" transhiatal esophagectomy was performed in 23 selected patients. Nineteen had squamous carcinoma of the esophagus (upper third, 1; middle third, 12; distal third, 6), and 2 had adenocarcinoma of the distal esophagus. The other 2 patients had severe lye strictures. Resection with reconstruction was performed in one stage. Esophagogastric continuity was restored using the stomach in the posterior mediastinal position in 20 patients and in the substernal position in 2. The colon in the posterior mediastinal position was used in 1 patient with a lye stricture. Transmural tumor extension or cervical or celiac nodal metastases or both were present in 18 of 21 patients with carcinoma. There was 1 hospital death due to pericardial tamponade. Morbidity included a transient cervical anastomotic leak in 3 patients, one temporary and three permanent unilateral recurrent laryngeal nerve palsies, one intraoperative splenic injury, and severe hemorrhage requiring sternotomy for control in 1 patient. Pulmonary complications occurred in 4 patients: aspiration pneumonia (1) and moderate atelectasis (3). Three patients have died (11, 12, and 17 months postoperatively) in the group with cancer, with follow-up time of 3 to 30 months (mean, 15 months). Transhiatal blunt esophagectomy is a safe and effective procedure in many patients with either esophageal cancer or extensive, benign esophageal strictures.
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PMID:Transhiatal (blunt) esophagectomy for malignant and benign esophageal disease: clinical experience and technique. 405 15

Fifty consecutive patients with metastatic carcinoma who underwent cryohypophysectomy were studied. Of these, 26 had breast cancer, 19 had prostatic cancer, one had malignant melanoma, one had cancer of the kidney, and three had metastatic adenocarcinoma from an unknown primary tumour. After cryohypophysectomy, excellent pain relief was obtained in 48% of patients, good or acceptable pain relief was obtained in 40%, and poor or no relief in 12%. Two patients died: one of aspiration pneumonia and one of an unknown cerebral cause. Sixteen patients developed diabetes insipidus, of whom three required therapy with vasopressin; eight patients developed a cerebrospinal fluid leak, two of whom required surgical repair; and four patients developed meningitis, which resolved in three after antibiotic therapy. Results are compared with those from other published reports. Pain relief from cryohypophysectomy is surmised to be due to the production of endorphins, but no proof of this is available.
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PMID:Cryohypophysectomy for the relief of pain in malignant disease. 669 92

We retrospectively studied 42 patients hospitalized for Stevens-Johnson syndrome at the Veterans General Hospital-Taipei between 1979 and 1991. Twenty-seven patients were males and 15 females; the ages ranged from 7 months to 82 years old with a mean age 50. The most common precipitating factor was drugs among which diphenylhydantion was the leading offender followed by nonsteroidal anti-inflammatory agents and allopurinol. Sixteen cases might be etiologically associated with infection, including 13 with upper respiratory infection, one with acute hepatitis B, one with pulmonary tuberculosis, and one with fever of unknown origin that was suspected to be viral infection. Although mycoplasma infection was thought in the literature to be a common etiologic factor of Stevens-Johnson syndrome, it was scarcely found in our study. Four patients were not treated with systemic steroids but still recovered uneventfully. Systemic steroid as a whole was not proved to be necessary, but early large-dose steroid therapy might abbreviate the course of the disease. The mortality rate was 11.9% which differs unremarkably from the reported rate (5-15%). Two patients died of pneumonia with sepsis, one of hemorrhagic shock (bleeding of adenocarcinoma of stomach), one of aspiration pneumonia, and one of sepsis with disseminated intravascular coagulation, upper gastrointestinal bleeding, and hyperglycemic hyperosmolar nonketotic coma.
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PMID:[Stevens-Johnson syndrome: a review of 42 cases]. 849 Jul 98

We studied 10 lung cancer patients with pneumonia insusceptible of conservative treatment. All patients underwent urgent pulmonary resection to control their pneumonia induced by the tumor and to cure the cancer. The causes of pneumonia were bronchial obstruction by the tumor itself or aspiration of the tumor necrosis. The patients comprised 9 men and 1 women. The age range was 37 to 72 years with a median age of 57 years. There were obstructive pneumonia in 3 patients and aspiration pneumonia in 7 cases. The average size of tumor was about 4.7 and 7.5 cm, respectively. The histological type of lung cancer was squamous cell carcinoma in 6 and adenocarcinoma in 4. There were 1 stage 1,1 stage IIIA and 3 stage IIIB tumors. Lobectomy was performed in 8 patients and pneumonectomy in 2 patients. Nine patients underwent the operation under one-lung ventilation. A median period of preoperative administration of antibiotics was 6.2 days. The curative operation for lung cancer was performed in 3 patients and non-curative operation in 7 patients. Postoperative complications were pneumonia in 2, subcutaneous abscess in 2 and arrhythmia in a case of pneumonectomy. All non-curative patients died in 5 years, but two curative patients survived long time for 31 and 75 months, respectively. We performed urgent pulmonary resection for lung cancer patients to cure fatal pneumonia and cancer. There were no hospital death. Urgent pulmonary resection could prevent early death caused by fatal pneumonia by tumor itself.
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PMID:[The study of urgent pulmonary resections for lung cancer accompany with pneumonia]. 902 17


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