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)

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

"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

To our knowledge, blastic transformation of splenic marginal zone lymphoma, a recently characterized low-grade lymphoproliferative disorder, has not been reported previously. In this regard, we report the unique case of a 70-year-old woman whose untreated splenic marginal zone lymphoma underwent blastic transformation 3 years after diagnosis. Her hematologic medical history started in 1988 as thrombocytopenia refractory to steroids associated with atypical lymphoid infiltrate in the bone marrow. She underwent splenectomy in 1989, which revealed splenic marginal zone lymphoma. One year later, the patient developed lymphadenopathy noted in the chest, axillary, abdominal, and retroperitoneal lymph nodes. Because she was asymptomatic, treatment was limited to a conservative supportive regimen. The nodal lymphoma cells had features associated with marginal zone lymphoma and expressed B-cell monotypic kappa light chain. She was readmitted for the last time 2 years later with findings of 16% blasts in the peripheral blood and massive infiltration of the bone marrow by large blastoid cells. The blasts showed dispersed chromatin and prominent nucleoli, and possessed a moderate amount of clear cytoplasm. The blasts, like the previous nodal and splenic lymphomas, had a CD20-, CD19-, IgM-positive phenotype, but lacked reactivity for CD5, CD10, and CD23. The patient displayed clinical remission after treatment with vincristine and prednisone, but died of aspiration pneumonia 1 month later. These observations suggest that, similar to the other low-grade lymphoproliferative disorders, an untreated splenic marginal zone lymphoma may undergo high-grade blastic transformation.
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PMID:Blastic transformation of splenic marginal zone B-cell lymphoma. 1078 61

We report an elderly patient with diffuse large B cell lymphoma harbouring Epstein-Barr virus that showed spontaneous regressions with subsequent relapses three times. The patient died of aspiration pneumonia without any anti-neoplastic treatment 5 years 10 months after the initial onset of lymph node swelling. In the literature, there are several reports of aggressive non-Hodgkin's lymphoma cases that showed spontaneous regressions without relapse till the last observation. Over half of the cases were the extra-nodal type. The tendency toward regression of swollen lymph nodes detected by clinicians occurs within 2 weeks after biopsy. If the remaining lymph nodes show a tendency to decrease in size after biopsy without any anti-tumor therapies, the patient may develop spontaneous regression.
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PMID:Spontaneous regression of diffuse large B-cell lymphoma harbouring Epstein-Barr virus: a case report and review of the literature. 1751 May 35

Streptococcus intermedius is a Gram-positive commensal of the oral cavity with tendency to cause brain and liver abscesses. Mediastinal involvement from S. intermedius is very rare. We present a case of 22-year-old male with newly detected mediastinal conglomerate nodal mass. On his way for bronchoscopy, he developed seizures and was found to have three brain lesions. The aspirate from brain biopsy grew S. intermedius whereas the aspirate from mediastinum showed only acute inflammation. Follow up imaging after antibiotic treatment showed interval resolution of brain abscesses and the mediastinal mass. We believe that the patient had aspiration pneumonia from S. intermedius which then metastasized to mediastinum and brain. Our aim is to make physicians aware of this unusual presentation of S. intermedius infection as a mediastinal mass. A strong effort should be made to isolate the organism from the involved body sites and fluid cavities to confirm the diagnosis.
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PMID:Conglomerate mediastinal mass of a different etiology. 2930 10