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

Current videoendoscopic technology and percutaneous techniques of exposure and dissection have been successfully applied to abdominal surgery with favorable results. Application of this technology to our practice of thoracoscopy is the basis of this report. Videothoracoscopy has been performed in 39 patients for the following indications: chronic pleural effusion, interstitial lung disease, mediastinal lymphadenopathy in lung cancer, persistent air leak after decortication, mediastinal mass, recurrent spontaneous pneumothorax, hydropneumothorax with persistent air leak, and pleural-based mass. The technique we employ includes lateral decubitus positioning and double-lumen endotracheal intubation with ipsilateral lung collapse. The videoscope, retractors, and instruments are introduced through separate 10-mm incisions. Percutaneous manipulation of instruments and the videoscope is guided by images produced on television screens without dissection, and if resection is performed, the incision is enlarged to allow specimen retrieval. Procedures performed using this technique include pleural biopsy, partial pleurectomy, lysis of adhesions, lung biopsies, staging lymph node biopsy, lung nodule biopsy, pleural-based mass resection, and mediastinal mass biopsy and resection. This videoendoscopic technique greatly improves visualization of thoracic anatomy, facilitating thoracoscopy and enhancing exploration of the chest. It is preferred over conventional thoracoscopy and, in some patients, reduces the magnitude of operation by avoiding thoracotomy.
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PMID:Videothoracoscopy: improved technique and expanded indications. 157 Sep 69

The presence of antibodies to adult T cell leukemia (ATL) antigen: HTVL-I was studied in patients with chronic interstitial lung diseases such as diffuse panbronchiolitis (DPB) and idiopathic interstitial pneumonia (IIP). Anti-HTLV-I antibody was detected with a high frequency among these diseases (35% in DPB and 7% in IIP) compared with other diseases and healthy controls. We have termed the clinicopathological condition that includes these two disease categories of interstitial lung disease (DPB or IIP) and hematologic disorder (ATL associated with HTLV-I carrier state) HTLV-I associated bronchiolo-alveolar disorder (HABA). At the same time, HTLV-I related reaction (diffuse pattern for MT-1 and/or MT-2) was found except positive reaction of the antibody (granular pattern for MT-1) by immunofluorescent assay. The incidence of HTLV-I related reaction was high in interstitial lung diseases with a rate of 45% in DPB and 53% in IIP. Thus, the total frequency of presence of antibodies and related reactions was 80% in DPB and 60% in IIP. In lung cancer, the frequency was also high, although it was less than in DPB and IIP. We termed cases of anti-HTLV-I antibody positive lung cancer HTLV-I associated lung cancer (HALC). One typical patient with IIP who initially showed HTLV-I related reaction showed a positive antibody reaction 2 years later. Finally he presented with adenocarcinoma with effusion a further 2 years later. In order to examine HTLV-I proviral DNA integration, southern blotting by PCR was performed in patients with HTLV-I related reaction.2+ suggesting one of the causes of DPB.
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PMID:[HABA (HTLV-I associated bronchiolo-alveolar disorder)]. 163 42

The suppressive activity of alveolar macrophages (AM) obtained from bronchoalveolar lavage (BAL), on PHA stimulation of autologous peripheral blood lymphocytes (APL) was evaluated. The effect on lymphocyte stimulation was evaluated by coculturing the AM and APL cells at a ratio of 1:1. PGE2 released by AM during the culture period was measured by a radioimmune assay. The patients included in the study were 11 cases with interstitial lung disease (ILD), 8 cases of lung cancer (CA), and 5 controls (CO). Addition of AM of patients from the CA group resulted in slight suppression of lymphocyte stimulation in 4 cases, slight enhancement in 3 cases and no effect in one case. AM from the CO group induced slight suppression in 4 out of 5 cases. AM from all 11 ILD cases exerted a significant high suppressive activity (65.6% +/- 18.2 - P less than 0.001 by comparison with the CO and CA groups). In ILD cases, a dichotomous pattern was found in regard to relation between high suppressive activity of AM and release of PGE2: in idiopathic pulmonary fibrosis (IPF) patients, high suppressive activity of AM (70.4% +/- 15.4) correlated well with elevated secretion of PGE2: 3.58 +/- 0.26 ng/ml/10(5) cells (P less than 0.02 compared to CO). AM from sarcoidosis patients suppressed PHA stimulation by 61.6% +/- 19.3 but secreted only 0.357 +/- 0.26 ng/ml/10(5) cells of PGE2 (P less than 0.02 compared with the idiopathic pulmonary fibrosis group). Therefore, it seems that other factors, in addition to PGE2, might be involved in the suppressive activity of AM from interstitial lung diseases.
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PMID:Correlation between PGE2 production and suppressor activity of alveolar macrophages from patients with interstitial lung diseases. 316 69

Today it is believed that mast cells (MC) are important not only in IgE-mediated reactions, but also in delayed hypersensitivity reactions, and that their functions are mediated by factors released by T lymphocytes. Recent studies have shown their presence in bronchoalveolar lavage (BAL) of patients with asthma and interstitial lung disease. MC have been identified by us in the BAL of patients with sarcoidosis and lung cancer, and in controls. A statistically significant correlation has been found between MC and lymphocytes, CD3+ and CD4+ cells present in BAL, thus supporting the hypothesis of interactions between T lymphocytes and MC in immune reactions at the alveolar level.
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PMID:Mast cells in bronchoalveolar lavage in sarcoidosis: correlation with alveolar lymphocytes. 323 5

The term of "chronic interstitial pneumonia" had been more accurately redefined by Liebow and, subsequently, by Otto and had been subdivided by different pathomorphological phenomena. The interstitial-proliferative type is of particular interest, in this context. Reported in this paper is the bioptic histopathological pattern of 15 patients with interstitial lung disease of the interstitial-proliferative type, with these findings being correlated to clinical symptoms. A distinction is made between an independent form in its own right and a histologically identical interstitial phenomenon accompanying other pulmonary diseases, primarily in concomitance with lung cancer, and recordable also from postmortem investigations. Interstitial-proliferative inflammations are adequately controllable by antibiotics.
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PMID:[Interstitial lung diseases of the interstitial-proliferative type]. 323 31

The objective of this study was to verify whether the assay of carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) can increase the sensitivity and specificity of serum CEA for the diagnosis of lung cancer. We examined 72 subjects, 53 males and 19 females, 18 affected with peripheral lung cancer (10 adenocarcinoma, 6 squamous cell carcinoma, 1 small cell lung cancer, 1 adenosquamous carcinoma), 19 with acute pneumonia, 14 with chronic obstructive pulmonary disease (COPD), 6 with interstitial lung disease (ILD), and 15 healthy subjects. CEA was assayed in blood and in BALF using microparticle enzyme immunoassay (MEIA) (IMX Abbott). The mean serum CEA value in the lung cancer group did not differ from that in each group of non-neoplastic subjects, neither was it different from that in healthy subjects. The mean BALF CEA in patients with lung cancer, pneumonia, and COPD was significantly increased compared with that in healthy subjects, whereas there was no difference between the three groups of patients. The ratio of BALF CEA was not significantly different in the three groups of patients. There were no differences according to the histological type of the tumour (adenocarcinoma or squamous cell carcinoma). Based on the results in healthy subjects, the upper limits of normal were defined for serum CEA, BALF CEA, and CEA/albumin ratio. Thus, the sensitivity of BALF CEA in detecting lung cancer (50%) was higher than that of serum CEA (33%), although clinically not useful. In addition, BALF CEA had only 59% specificity compared to 100% of serum CEA. The diagnostic accuracy was 79% for serum CEA and 56% for BALF CEA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bronchoalveolar lavage fluid level of carcinoembryonic antigen in the diagnosis of peripheral lung cancer. 766 86

Radionuclide study for pulmonary diseases is divided in three large categories, respiratory function of ventilation and perfusion, non-respiratory function such as mucocilliary movement, epithelial permeability, and tumor imaging. Ventilation and perfusion scintigraphy are useful for the diagnosis and follow up of pulmonary embolism, obstructive lung disease, etc. A new ventilatory agent, 99mTc-technegas, is now available and many studies with this gas have been reported. As a tumor imaging agent, 201TlCl is coming popular for the diagnosis of lung cancer and early detection of metastatic lesions. Tumor detection with 99mTc-MIBI is also tried to differentiate the malignant tumor from the benign process. As applications of nuclear medicine for the interstitial lung disease, 67Ga scintigraphy and measurement of epithelial permeability with 99mTc-DTPA are available for an evaluation of activity of the disease and damage of lung epithelial integrity. In this report, significance and useful application of the radionuclide methods were summarized.
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PMID:[New trends of pulmonary nuclear medicine]. 783 8

Thoracoscopy has become an important tool in the diagnosis and management of intrathoracic disease. Between April 1991 and October 1992, 93 patients underwent thoracoscopy. Lung resection was performed on nineteen patients for diagnoses of interstitial lung disease and on seven patients for pulmonary nodules. Eleven patients underwent therapeutic lung resection for management of pneumothorax or air leaks. Sixteen patients underwent thoracoscopy for pleural disease. This was to diagnose mesothelioma (2), to lyse benign adhesions (2), to drain empyema (2), and to evacuate loculated pleural effusion (10) thoracoscopically. Nine patients underwent thoracoscopic staging for lung cancer. Thirteen patients underwent thoracoscopic staging for esophageal cancer as part of a prospective trial. Other indications for thoracoscopy included pericardiectomy (6), sympathectomy (2), and resection of mediastinal mass (4). Thoracoscopy is an excellent option for patients at high risk from standard thoracotomy and may allow procedures to be performed which would prevent the need for open thoracotomy, resulting in shorter hospital stay and less postoperative pain.
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PMID:Efficacy and safety of thoracoscopy for diagnosis and treatment of intrathoracic disease: the University of Maryland experience. 804 59

Except for benign pleural effusion, asbestos-related pulmonary complications, including asbestosis, malignant mesothelioma and bronchogenic carcinoma, usually occur more than 20 years after exposure. Pleural plaques and pleural thickening serve as markers for asbestos exposure, but they are not associated with an increased risk of malignancy. Clinical criteria for the diagnosis of asbestosis include a reliable history of asbestos exposure, an appropriate interval between exposure and disease detection, radiographic evidence of pulmonary fibrosis, decreased vital capacity and diffusing capacity, and bilateral posterior inspiratory crackles. A lung biopsy is indicated only to rule out other causes of interstitial lung disease. A history of dyspnea, pleuritic chest pain, fatigue, weight loss and pleural effusion in a former asbestos worker is suggestive of mesothelioma. Cigarette smoking greatly increases the risk of lung cancer in asbestos workers.
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PMID:Pulmonary complications of asbestos exposure. 804 65

The past 2 years have witnessed the evolution of video-assisted thoracoscopy in the United States. Performance of the procedure has now moved from the university center to the community hospital. It is clear that thoracoscopy is the modality of choice for both the diagnosis and management of pleural disease (except mesothelioma); the identification of undiagnosed peripheral pulmonary nodules; the removal of simple mediastinal cysts; and the performance of wedge biopsy for interstitial lung disease and simple pericardial procedures. Its role in the management of primary lung cancer and esophageal disease remains to be defined. There are four areas that currently need to be addressed as the present role of therapeutic thoracoscopy evolves: (1) instrumentation, (2) economics, (3) a credentialing process, and (4) its application in certain procedures. All of these are addressed in this presentation.
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PMID:The present role and future considerations of video-assisted thoracoscopy in general thoracic surgery. 837 99


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