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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Out of 1,251 patients above 65 years of age staying at the Charles Foix Hospital (prolonged hospitalization) and the St. Joseph Hospital (acute cases), 168 had one or more positive blood cultures. Urinary tract infection is a major source of septicemia due to gram negative bacilli. It is important to stress cases of septicemia due to pneumococcal pneumoniae, eschars, and other skin lesions. Mortality varies between 33 and 36%, depending upon the hospital. Collapse, although infrequent, still portends a grave prognosis (61% of cases of collapse led to death at Charles Foix Hospital). The combination of more than two risk factors considerably worsens the prognosis. Hypoproteinemia and dementia are every bit as grave as diabetes and cancer. A better isolation of the microorganisms involved in cases of septicemia in the elderly will lead to a more judicious choice of antibiotics. The administration of chemotherapy immediately after the samples were obtained remains the main guarantee of successful therapy.
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PMID:[Septicemia in the elderly (author's transl)]. 2 83

Pain, weakness, or paralysis from involvement of the spinal cord and nerve roots secondary to invasion of the vertebrae by a malignant tumor often can be avoided or alleviated by stabilization of the spine. Twelve patients with neoplastic infiltration of the cervical vertebrae were so treated. The operation of wiring, augmentation bone-grafting, and decompression of the spinal cord was successful after conservative methods failed. Indications for operation were: (1) unremitting pain in the neck, not relieved by bracing or radiation therapy; (2) a major degree of vertebral destruction with loss, or impending loss, of support for the head; (3) collapse of a vertebral body; or (4) neural deficit from local tumor invasion. A classification of our twelve patients into three groups helped to delineate the surgical procedure needed. The value of obtaining spinal stability and a solid fusion above and below the tumor was evident in eleven patients. For almost all of their survival time, they were comfortable. Surgical treatment may not appreciably extend the lenght of a patient's survival, but it generally improves the patient's quality of life.
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PMID:Metastatic tumors involving the cervical vertebrae: surgical palliation. 8 Dec 9

The noninvasive diagnosis of impaired mechanical integrity or compliance of the trachea is most accurately made by fluoroscopic observation recorded on video tape or cineradiography, with or without benefit of artificial contrast media (contrast tracheography). In particular, localized buckling, collapse or dilatation indicative of focal tracheomalacia may thus be diagnosed in vivo and correlated with diseases of the central airways. Congenital tracheomalacia is a rare, bu, well described entity. Cases of acquired tracheomalacia occur with increasing frequency, but are often not clearly recognized. We contrast the dynamic behavior of the normal trachea with the abnormal dynamics characteristic of focal tracheomalacia. Such lesions may result from trauma, surgical procedures, chronic irritation, inflammation, mechanical changes, or malignancy.
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PMID:Acquired tracheomalacia: etiology and differential diagnosis. 16 5

A multilaminar alteration of endoplasmic reticulum (ER) has been observed in tumor cells of eight patients with Hodgkin's disease and a patient with histiocytic lymphoma. These multilaminar structures are more numerous in dividing cells and thus appear to arise primarily during mitosis. The stacked membranes in the multilaminar structures possibly result from abnormal sticking of organelle membranes, as evidenced in this study of adherence of ER to other elements of ER, nuclear envelope, mitochondria, or lipid droplets. Multilaminar ER was identified in all mitotic tumor cells, a rare mitotic plasma cell, and numerous interphase Hodgkin cells. The paucity of multilaminar ER in normal mitotic cells and its virtual absence for normal interphase cells suggest that this structure represents a pathological alteration in tumor cells from patients with Hodgkin's disease and histiocytic lymphoma. The multilaminar defect of ER is associated with other atypical features of ER in Hodgkin tumor cells, including the excessive length and curving of ER profiles, the collapse of the ER cisternae, and the overall sparsity of this organelle. Other abnormalities observed in mitotic Hodgkin tumor cells include the presence of disorganized microtubules, large cytoplasmic vacuoles, and abnormally clumped chromosomal material and the persistence throughout mitosis of bodies suggestive of nucleoli and of the nuclear bodies of interphase cells.
Cancer Res 1976 May
PMID:Multilaminar endoplasmic reticulum and abnormal mitosis in Hodgkin tumor cells. 17 30

Two patients recieving intravenous high dose methotrexate (MTX) and intracutaneous BCG injections as adjuvant treatment for osteogenic sarcoma suffered sudden cardiovascular collapse within minutes of infusion of MTX. These cases demonstrate that anaphylactic or idiosyncratic reactions to MTX and/or contaminants in these preparations do occur and that careful patient monitoring is required.
Cancer 1978 Jan
PMID:Anaphylactoid type reactions in two patients receiving high dose intravenous methotrexate. 27 26

In attempts to heterotransplant human NPc into nude mice, using seven cultured cell lines, we have succeeded in growing a carcinoma simplex, composed of Epstein-Barr virus-determined nuclear antigen-positive and Epstein-Barr virus genome-positive cancer cells, at the injected site with two of the cell lines. These originated from a spindle-cell carcinoma (Chinese NPC-204) and from a combined-cell carcinoma (Chinese NPC-501), respectively. During the first few passages, wandering macrophages were prevalent and increased in number in response to the presence of the tumours. In conjunction with a gradual decrease in the number of wandering macrophages in the medullary sinuses, diffuse hyperplasia of lymphocytes occurred in regional lymph nodes. As a result of the release of lymphocytes and macrophages into the peripheral lymph nodes, the spleen underwent extensive change, as manifested by the collapse of the splenic cords and the formation of septa studded with granulomas. Under these conditions of immunosuppression, lymphatic metastases were observed during the periods between the 11th and 14th generations and the 24th and 30th generations with NPC-204 and between the 9th and 14th generations with NPC-501. The neighbouring lymph nodes, like the spleen, were often studded with epithelioid-cell granulomas, formed by the aggregation of macrophages around nuclear debris in the subcortical areas. We assume that the clumps of debris are the remnants of metastatic cancer cells which were probably killed by macrophages or by sensitized lymphocytes. If the lymph nodes contain a barrier of granulomas, they are not invaded by tumour cells from the cortical sinuses, except in the rare case of retrograde metastasis from the hilus. It would appear that macrophages can replace T lymphocytes, which are found in very small numbers in the nude mice used in this study, in killing tumour cells and, furthermore, in protecting the lymph nodes from the spread of metastases. Metastasis cannot occur in these nude mice when their lymphoreticular system, especially that of the spleen, is working in a stable balance.
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PMID:A histopathological study of lymphoid tissue reaction to metastatic nasopharyngeal carcinoma in nude mice. 31 Apr 17

Six months after right-sided spontaneous pneumothorax developed in a 56-year-old man, squamous cell carcinoma was discovered in the ipsilateral lung. Fifteen cases of bronchogenic carcinoma presenting as spontaneous pneumothorax have been reported in the English language literature. Possible pathogenetic mechanisms include: direct tumor invasion of pleura; rupture of a subpleural bleb (in an area of obstructive emphysema) or an emphysematous bulla (in an overexpanded portion of the lung associated with lobar or segmental collapse); or unknown. Patients with spontaneous pneumothorax who fail to achieve complete expansion after three weeks of therapy or who have persistent roentgenographic pulmonary infiltration should undergo further investigation for bronchogenic carcinoma.
Cancer 1977 May
PMID:Bronchogenic carcinoma presenting as spontaneous pneumothorax: case reports with review of literature. 32 55

Lung biopsy remains the essential cornerstone in the diagnosis of pneumocystis pneumonia. Whatever technique can establish this diagnosis safely and early in order to get treatment started quickly should be used. Open lung biopsy remains a candidate for the diagnostic method of choice because if offers some advantages over percutaneous needle biopsy. There is a greater supply of competent thoracic surgeons in most hospitals than of physicians who are proficient with needle biopsy. The direct vision afforded by thoracotomy enables selective biopsy of grossly involved lung that can be appreciated by direct vision and palpation; needle biopsy is random and blind in its sampling. A more generous tissue specimen can be obtained for pathologic examination; the pathologic diagnosis of an "unsatisfactory specimen" is unlikely to result from open biopsy. Open lung biopsy achieves a higher diagnostic yield earlier in the pneumonitis when pneumocystis pneumonia is confined to the perihilar regions inaccessible to percutaneous needle biopsy. Better control of hemostasis is achieved by direct vision and ligature in a group of patients characteristically at high risk for bleeding tendencies, and pneumothorax is controlled in open biopsy; thoracostomy prevents the later, uncontroled collapse of the lung when the patient returns to the ward where there may be some diagnostic and therapeutic delay in the treatment of pneumothorax in a patient who can tolerate little further respiratory compromise.
Natl Cancer Inst Monogr 1976 Oct
PMID:Open lung biopsy in the diagnosis of Pneumocystis carinii pneumonia. 108 51

Rare primary endobronchial malignancies were diagnosed in four adolescents: atypical bronchial carcinoid, mucoepidermoid carcinoma, bronchogenic (squamous cell) carcinoma, and non-Hodgkin's lymphoma. Metastatic disease was evident in each case. Three of the four patients died within one year of diagnosis. This paper describes each of these entities, illustrates their plain film and CT abnormalities (bronchial "cut-off", hilar mass, local congestive edema, lobar collapse, hyperinflation), and discusses the utility of CT in their diagnosis.
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PMID:Malignant endobronchial lesions of adolescence. 133 2

When airway obstruction is due to extraluminal compression and/or dynamic collapse, metal and silicone rubber prosthetic stents may stabilize the affected airway. Through a rigid bronchoscope, we inserted three metal stents in two patients and 18 silicone stents in 15 adult patients with symptomatic tracheobronchial compression and dynamic airway collapse. The underlying cause was malignancy in three patients; benign tracheobronchial malacia in three patients, two of whom refused surgical resection; and tracheobronchial stenosis that developed at the anastomotic site following lung transplantation in 11 patients. Clinical status and lung function studies were analyzed before and after stent insertion. Following stent insertion, airway diameter at least doubled and near normal patency of the affected tracheobronchial tree was achieved in every patient using stents of axial length 4 to 5 cm. The stents were well tolerated clinically, and all patients noted immediate relief of dyspnea. Following stent insertion, the forced vital capacity (FVC) increased from 64 +/- 21% predicted (mean +/- 1 SD) to 73 +/- 19% predicted, p less than 0.1; the forced expiratory volume in 1 s (FEV1) from 49 +/- 25% predicted to 72 +/- 26% predicted, p less than 0.02; the ratio of the FEV1/FVC from 59 +/- 16% to 78 +/- 15%, p less than 0.01; and the maximum flow at 50% expired FVC from 38 +/- 26% predicted to 72 +/- 31% predicted, p less than 0.01.
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PMID:Physiologic studies of tracheobronchial stents in airway obstruction. 141


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