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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Extravascular coagulation and fibrinolysis is an integral part of inflammatory reactions. Disordered expression of procoagulant and profibrinolytic factors by mononuclear phagocytes of the lung (i.e. lung alveolar macrophages (LAM) and interstitial macrophages) may have important bearings on inflammatory lung tissue destruction and repair. Based on this hypothesis we have measured the presence of trigger molecules and activation products of the coagulation and fibrinolytic system in cell-free bronchoalveolar lavage fluid and in bronchoalveolar cells. Patient groups with chronic obstructive disease (COLD) (n = 76), idiopathic pulmonary fibrosis (IPF) (n = 29), sarcoidosis (n = 22), lung cancer (n = 36), pneumonia (n = 39), acquired immunodeficiency syndrome (AIDS) (n = 17) and a control group (n = 60) were studied by bronchoalveolar lavage (BAL). In all patient groups tissue thromboplastin (TPL) and fibrinopeptide A (FPA) were significantly increased compared to controls. Plasminogen activator (PA) activity was significantly lower in patients than in normals, and usually associated with high levels of antifibrinolytic activity. The level of PA inhibitor (PAI-2) was not significantly higher in any patient group compared to controls. The sensitivity of the method for fibrin degradation products (FDP) analysis was not high enough to detect FDP in BAL fluid of control individuals, whereas such products could be demonstrated in 25-53% of patients in various categories. We conclude that disordered expression of procoagulant and plasminogen activator activities in bronchoalveolar lavage fluid may reflect a milieu that favours accumulation of fibrin in inflammatory lung tissue and form the basis for the development of pulmonary fibrosis.
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PMID:Local activation of the coagulation and fibrinolysis systems in lung disease. 238 54

We determined the incidence of increased bronchoalveolar lavage (BAL) fluid eosinophil percentages in 1,059 consecutive patients undergoing bronchoscopy with BAL over a 33-month period. Forty-eight (48) patients were found to have 5% or more BAL eosinophils. The most common causes for increased BAL eosinophils were interstitial lung diseases (40% of patients), acquired immunodeficiency syndrome (AIDS)-associated pneumonia (17% of patients), idiopathic eosinophilic pneumonia (15% of patients), and drug-induced lung disease (12% of patients). Together, these four diagnoses accounted for 84% of all patients. In contrast, eosinophils were uncommon in the BAL of patients with the adult respiratory distress syndrome, lung cancer, community-acquired pneumonia, or immunocompromising diseases other than AIDS. The finding of increased BAL eosinophils was most helpful in patients presenting with unexplained pulmonary infiltrates. In these patients, this finding was often an important clue to the final diagnosis. We conclude that although the finding of an increased percentage of BAL eosinophils is uncommon, when present it is relatively specific for a limited number of diseases.
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PMID:Diagnostic significance of increased bronchoalveolar lavage fluid eosinophils. 238 17

Levels of serum elastase 1 in a variety of respiratory diseases were studied. In patients with pulmonary emphysema, pulmonary fibrosis, bronchial asthma, or pulmonary infections, including pneumonia and pulmonary tuberculosis, serum elastase 1 levels were greater than those of an age-matched control group. In lung cancer patients, however, the serum elastase 1 level was within normal limits. Although alpha 1-antitrypsin levels were significantly higher in patients with pulmonary infections and lung cancer than in the normal group, they were within normal limits in patients with pulmonary emphysema, pulmonary fibrosis, and bronchial asthma. Alpha 2-macroglobulin levels were slightly increased in patients with pulmonary emphysema and pneumonia. These results suggest that the increases in serum elastase 1 levels in these respiratory diseases may be mainly caused by an imbalance of elastase/antielastase system in the lung tissue and the bloodstream.
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PMID:Elastase/antielastase systems in pulmonary diseases. 245 93

A total of 210 cases of terminal pneumonia were studied out of 1183 autopsied cases at Tenri Yorozu Hospital from 1978 to 1985. Underlying diseases included lung cancer (77 patients), gastric cancer (26 patients), leukemia (24 patients). There was no statistical significance between the time from death until autopsy and the bacterial examination of autopsied lung and blood. P. aeruginosa and Klebsiella sp. were the most frequently isolated organisms. Seventy percent of isolated organisms were gram negative bacilli. In spite of administration of antibiotics, bacteria isolated from specimens before death were sometimes the same as the one isolated from specimens after death. In addition it was recognized that multiple intensive examinations of sputum are necessary for rapid diagnosis of pneumonia. It was also noted that the longer the duration of antibiotic administration, the more frequently P. aeruginosa was isolated. Finally the possibility of pneumonia should be kept in mind in compromised hosts.
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PMID:[A clinical study of terminal pneumonia]. 251 33

Complex hygienic, clinical and epidemiologic studies were carried out at 2 enterprises producing asbestos-technical products. It was established that the workers engaged in the production of such products were exposed to relatively low levels of asbestos-containing dust. The course, complications and outcome of asbestos-associated fibrosis were studied in 110 patients. The study revealed that asbestosis was characterized by its slowly progressing development. Asbestosis complications included lung tuberculosis, chronic intersticial pneumonia, and lung cancer. Proceesing from the epidemiologic survey higher risk of malignant neoplasms of the lungs was established in patients with asbestosis in comparison with those exposed to asbestos-associated fibrosis were studied in 110 patients. The study revealed that asbestosis was characterized by its slowly progressing development. Asbestosis complications included lung tuberculosis, chronic intersticial pneumonia, and lung cancer. Processing from the epidemiologic survey higher risk of malignant neoplasms of the lungs was established in patients with asbestosis in comparison with those exposed to asbestos-containing dust but having no occupational disease. The study findings were used for the substantiation of dispensarization principles for patients with asbestosis. The number of follow-up, laboratory and other examinations along with basic curative and preventive measures were pointed out.
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PMID:[Basic principles of mass screening of patients with asbestosis]. 252 66

Patients with extensive small-cell lung cancer were given induction chemotherapy consisting of cyclophosphamide, vincristine, cisplatin, and etoposide (COPE) every 3 weeks for four cycles. Responding patients then received chest and elective whole-brain irradiation. Patients presenting with brain metastases received therapeutic brain irradiation during the first cycle of chemotherapy. No maintenance therapy was given, but two late intensification cycles of COPE were given at weeks 24 and 48. Among the 34 evaluable patients, the response rate to induction chemotherapy was 59%, with 10% achieving a complete response (CR) and 49%, a partial response (PR). Of the 18 patients who completed chest irradiation, 3 achieved a CR, producing an overall CR rate of 18%. Five patients completed the projected course of treatment. The median duration of response for all patients was 8 months (range, 2-30+ months) and the median survival was 9 months (range, 1-30+ months). Complete responders had a median response duration of 9 months and a median survival of 11 months. This regimen produced significant myelosuppression, with 5 neutropenic deaths (13%) occurring in the 38 patients evaluable for toxicity; an additional 16% required hospitalization for fever while neutropenic. Only six patients (13%) had nadir platelet counts of less than 50,000/mm3 with no episodes of thrombocytopenic hemorrhage. Nausea, vomiting, and neurotoxicity were mild to moderate in all patients. One patient with no evidence of disease died of radiation pneumonitis at 6 months. While producing significant toxicity, this regimen did not result in a CR rate or survival advantage that would suggest its superiority over standard regimens for small-cell lung cancer.
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PMID:Cyclophosphamide, vincristine, cisplatin, VP-16 and radiation therapy in extensive small-cell lung cancer. A Southwest Oncology Group Study. 254 13

The role of radiotherapy in the initial management of small-cell lung cancer (SCLC) is a matter of current debate. Unfortunately, compared to other cell types, radiotherapy for SCLC is limited in its use. The value of radiation therapy in palliation is unquestioned. SCLC is quite sensitive to both radiation therapy and chemotherapy. However, in extensive disease radiation therapy is secondary to combination chemotherapy. In limited disease, it is well documented that thoracic irradiation increases locoregional tumor control and improves the complete remission (CR) rate. However, the patients given high-dose thoracic irradiation concurrently with chemotherapy are the possibility of local toxicity, especially, drug induced pneumonitis. Recently, the optimal sequence of radiation therapy and chemotherapy has been discussed. We believe that it is better to start with chemotherapy. With prolongation of survival related to intensive combination chemotherapy, brain metastases become more frequent. Therefore current therapeutic regimens include prophylactic cranial irradiation (PCI) soon after the attainment of CR, but it has not prolonged survival. So there are conflicting reports about neurotoxicity after PCI. It is difficult to reach any firm conclusion in regard to the value of PCI.
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PMID:[The role of radiotherapy in the treatment of small-cell lung cancer]. 254 80

We report a case of bronchopleural fistula after preoperative neo-adjuvant chemotherapy for advanced lung cancer. A 55-year-old man admitted to our institution and was diagnosed to have advanced lung cancer. Right pneumonectomy was carried out after chemotherapy. Parietal pleura and the right main bronchus were thick because of severe fibrosis due to chemotherapy. On the 16th postoperative day, bronchopleural fistula was found. After drainage, further resection of bronchial stump and wrapping with omentum was carried out. However, he died of pneumonia due to repeated bronchopleural fistula. Since this experience, we use omental wrapping procedure in patients undergoing surgery for the hilar type lung cancer after chemotherapy, and conclude that omental wrapping is useful for prevention of bronchopleural fistula.
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PMID:[Use of omental pedicle flap for the prevention of bronchopleural fistula after surgery: an unsuccessful case in a management of bronchopleural fistula]. 259 22

Between 1974 and 1987, 14 patients (10 male and 4 female) underwent thoracotomy for treatment of pulmonary mycosis. They were studied on their clinical findings and surgical treatment. The median age was 48 years (range 19 to 71 years). Fourteen cases consisted of 9 aspergillosis and 5 cryptococcosis. None of them was either debilitated or immunosuppressed before falling ill. Five of the 14 patients had other pulmonary disease and 11 had symptoms; i.e. hemoptysis or bloody sputum in 4 cases, chest pain in 3, fever in 3, cough and sputum in 2. Nine aspergillosis consisted of 4 aspergilloma, 3 aspergillus pneumonia and 2 aspergillus empyema. Three cases of aspergillosis occurred in preexisting cavity. Five cryptococcosis consisted of 3 pseudotumorous, 1 disseminated small nodular, and 1 infiltrative types. Preoperative diagnosis was as follows; pulmonary mycosis 5, pulmonary tuberculosis 4, lung cancer 3, empyema 1 and hydropneumothorax 1. Four patients underwent partial resection, 8 lobectomy, 1 pneumonectomy, 1 muscle prombage and thoracoplasty. The prognosis is satisfactory. All patients are alive and has no recurrence. On histopathological examination, in aspergilloma cases, invasion of aspergillus to surrounding lung tissue was not seen. In addition to well-known fact that blood-borne dissemination hardly occurred in aspergilloma in contrast to cryptococcosis. These findings suggest that aspergilloma and solitary lesion of cryptococcosis should be resected, and adjuvant chemotherapy should be accompanied for cryptococcosis.
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PMID:[A study on clinical findings and surgical treatment of pulmonary mycosis]. 260 Apr 62

Imipenem/cilastatin sodium (IMP/CS) was administered to patients with severe infections complicated by hematological disorders and solid tumors to assess its efficacy and safety. Primary diseases in this series of 76 cases included 37 cases of hematological disorders (acute leukemia in 25 cases, malignant lymphoma in 7 cases, aplastic anemia in 3 cases and 2 other diseases) and 38 cases of solid tumors (lung cancer in 7 cases, gastric cancer in 11 cases, esophageal cancer in 6 cases, pancreatic cancer in 3 cases, bile duct cancer in 4 cases, hepatocellular cancer in 3 cases, and 4 other diseases). Following results were obtained. 1. Types of infection in hematological diseases were sepsis in 5 cases, suspected sepsis in 24 cases, pneumonia in 5 cases and 3 others. The efficacy rates were 100% in sepsis, 62.5% in suspected sepsis, 80% in pneumonia and 73% in all cases. 2. Types of infection in solid tumors were sepsis in 2 cases, suspected sepsis in 13 cases, pneumonia in 10 cases, cholecystitis in 2 cases, cholangitis in 5 cases, liver abscess in 2 cases, and 4 others. The efficacy rates were 50% in sepsis, 69.2% in suspected sepsis, 80% in pneumonia, and 71.1% in all cases. 3. IPM/CS was administered in single use in 66 cases and in combination with other antibiotics in 9 cases. The efficacy rate in the single use was 72.7% and that in the combination use was 66.7%. 4. The efficacy rate in 35 cases of first use was 71.4% and that in 40 cases of second use was 72.5%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical evaluation of imipenem/cilastatin sodium against severe infections complicated with hematological disorders and solid tumors]. 261 13


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