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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-nine patients underwent bilateral pulmonary resection for severe multisegmental bilateral bronchiectasis at the Overholt Thoracic Clinic during the period 1937 to 1977. A total of 216 operations were performed, and 20 patients underwent three or more procedures. The operative mortality was 1.4% and the incidence of severe complications, 7%. Follow-up ranged from 1 to 30 years (average 10.2 years). Only 1 patient was lost to follow-up. Improvement in pulmonary symptoms was achieved in 83 patients; there was no improvement in 9 patients; and 4 patients were worse following resection. The results suggest that bilateral bronchiectasis need not be a contraindication to operation. In properly selected patients, lasting symptomatic improvement can be provided by resection.
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PMID:Bilateral pulmonary resection for bronchiectasis: a 40-year experience. 45 43

Thoracic surgery is done in the Research Institute for Pulmonary Diseases and Tuberculosis for about 25 years. 2463 lung resections on account of tuberculosis, 934 lung resections on account of intrathoracic tumors, among them 795 suffering from bronchial carcinoma, 422 operations because of nonspecific pulmonary diseases (bronchiectasis, lung abscess a.s.o.) and nearly the same number of operations because of spontaneous pneumothorax were performed in this time. Cystic lung disease, bullous emphysema, pulmonary mycosis and diseases of diaphragm and oesophagus were rarer indications for surgery. Since 1970 an increasing number of thoracic injuries by accidents were treated (70 patients). At the beginning collapse therapy (1953/54) was still in use (305 operations). In all the number of great thoracic operations 1978 was 5417. Besides, experimental investigations dealing with lung transplantation were done in dogs. These results are published in several papers. The technical experience gained by this research work could be utilized for clinical practice.
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PMID:[Contributions of thoracic surgery in the Research Institute for Pulmonary Diseases and Tuberculosis since its founding and under the presence conditions in the treatment of specific and nonspecific lung diseases (author's transl)]. 51 7

A 60-year-old patient with cyclic hemoptysis for 30 years was found to have bronchiectasis that was not present when hemoptysis began. Thoracic endometriosis and its possible relationship to bronchiectasis are discussed.
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PMID:Bronchial endometriosis and bronchiectasis. A possible relationship. 64 69

Thoracic computed tomography was performed in 32 patients who had undergone thoracoplasty as part of their treatment for pulmonary tuberculosis. Pleural thickening and the prevalence of bronchiectasis were more marked in the operated hemithorax. Bullae were more prevalent in the operated hemithorax but the difference was not statistically significant. In all but one patient, scoliosis was present. Illustrative examples are presented to demonstrate the range of appearances following this operation.
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PMID:Appearances on computed tomography following thoracoplasty for pulmonary tuberculosis. 326 11

Sam Robinson was born in Augusta, ME, in 1875. A graduate of Harvard Medical School, and of the Massachusetts General Hospital (MGH), he worked in the laboratory of Walter Cannon. While a junior at MGH he spent four months abroad with Ferdinand Sauerbruch. He returned to Boston and remained there until 1912, performing his first successful lobectomy for bronchiectasis in 1909. He made important contributions to the management of pneumothorax during operation, notably Sam Robinson's box. In 1912 he moved to Clifton Springs, NY. From 1915 to 1917 he was the first Chief of Thoracic Surgery at the Mayo Clinic. Illness, probably bronchiectasis, led him to abandon academic thoracic surgery in 1918 and retire to Santa Barbara, CA, where he practiced general surgery until 1947. He was President of the Association for Thoracic Surgery in 1922. In addition to the use of positive pressure and early resections, his contributions include artificial pneumothorax for tuberculosis and management of acute and chronic empyema. His colorful writings provide a vivid picture of the early days of our specialty.
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PMID:Samuel Robinson, pioneer thoracic surgeon (1875-1947). 352 12

Thoracic nontuberculous or atypical mycobacterial infections typically occur in patients who have underlying lung disease or an immunologic abnormality. These infections are usually indolent and the diagnosis is often difficult to establish and, even if confirmed, is of questionable clinical significance. The most common radiologic pattern is fibronodular opacities in the upper lobes similar to those seen with tuberculosis. Less commonly, patients may have scattered nodularity associated with bronchiectasis. If suspected by radiologic and clinical findings, culture should be obtained for diagnosis. This review focuses on nontuberculous mycobacterial disease in the thorax of the immunocompetent host.
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PMID:Pulmonary manifestations of nontuberculous Mycobacterium. 761 Feb 41

Correctly performed antituberculous chemotherapy, together with the early diagnostics of tuberculosis, significantly lowered the need for surgery. Surgery is limited to patients with poor or no response to chemotherapy. In the period between 1983-1992 212 tuberculous patients were operated in the Clinic for Thoracic surgery, the Institute for the Pulmonary Disease the operated patients had the following form of the disease: primary tuberculosis in 4 patients (1.87%), 104 patients (49.06%) had the postprimary form of the disease, 67 patients (31.60%) had tuberculoma (causative lesion) cavernous tuberculosis existed in 33 patients (15.57%), while only 4 patients (1.87%) had diffuse pulmonary lesion. Diagnosis of post-tuberculous syndrome was made in 68 patients (32.08%). Secondary aspergylloma existed in 36 patients while the frequency of bronchial stenosis and bronchiectasis was the same -m 31 patients (16.98% and 14.63% respectively). One patient had broncho-oesophageal fistula. Tuberculous empiema, complicating the disease, existed in 36 patients (16.98%). Comparing the two 5-years periods, (1983-87 and 1988 to 1992) the authors conclude that the number of operations for tuberculosis is decreasing. Treatment was successful in all patients except in a patient with a broncho-esophageal fistula, who died postoperatively slow lung reexpansion existed in 5 patients, and in two cases partial upper thoracoplasty had to be done in order to solve the complication of the initial treatment. In all cases postoperative antituberculous chemotherapy was performed taking in consideration the problem of possible drug-resistance. There were no recurrences.
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PMID:[Modern surgical treatment of pulmonary tuberculosis]. 778 90

Thoracic surgeons have often been embarrassed by the discrepancy between an improvement in symptoms and the unchanged or even worse results of spirometry in postoperative patients with either bullae or inflammatory lung disease. Forty-four patients with lung diseases, who underwent a total of 47 operations, were categorized as follows: 12 cases of empyema, 16 cases of giant bulla (undergoing surgery a total of 19 times), 4 cases of bronchiectasis, and 12 cases of other miscellaneous diseases. All patients were tested preoperatively and again 4-6 months after surgery on both the spirometer and treadmill exercise tests. The forced vital capacity (FVC) and forced expiratory volume (FEV1.0) results were as follows: the empyema group 1.82 +/- 0.52 liters preoperatively to 1.93 +/- 0.69 liters postoperatively and 1.47 +/- 0.44 liters to 1.56 +/- 0.53 liters, respectively; and the giant bulla group, 3.49 +/- 0.96 liters to 3.35 +/- 0.77 liters and 2.35 +/- 0.96 liters to 2.48 +/- 0.69 liters, respectively. However, the exercise time was prolonged in the empyema group from 6.00 +/- 3.77 min to 8.33 +/- 3.80 min (P < 0.01) and in the giant bulla group from 11.83 +/- 3.71 min to 12.92 +/- 2.84 min (P < 0.05). It was thus concluded that exercise testing should be chosen for the postoperative evaluation of patients with inflammatory pulmonary disease and giant bullae, especially if any discrepancies are seen between spirometry and performance status, because on the basis of our results, it appears that the benefits obtained by surgery are best measured by the dynamic values of exercise testing and not by the static values of spirometry at rest.
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PMID:The superiority of exercise testing over spirometry in the evaluation of postoperative lung function for patients with pulmonary disease. 805 86

Knowledge of common and uncommon thoracic pathologic conditions in children with acquired immunodeficiency syndrome (AIDS) can expedite disease management. Chest radiography, computed tomography (CT), and magnetic resonance (MR) imaging are useful in cases involving possible complications of thoracic AIDS. Lymphocytic interstitial pneumonitis (LIP) is generally seen on plain radiographs and CT scans as a diffuse, symmetric, reticulonodular or nodular pattern, occasionally associated with mediastinal or hilar adenopathy. Chronic consolidations and bronchiectasis may be observed in pediatric AIDS patients with no evidence of previous LIP. Bacterial pneumonia, a frequent initial manifestation of AIDS, appears as lobar or segmental consolidations on radiographs. Radiographic findings of Pneumocystis carinii pneumonia, the most common infection, include rapidly progressive increased air-space opacity with air bronchograms. Lymphoma often appears as a mediastinal or hilar mass, often without involvement of the lung parenchyma. Thoracic smooth muscle tumors have also been observed in children with AIDS. Multilocular thymic cysts have low attenuation on CT scans and increased signal intensity on T2-weighted MR images. Most pediatric AIDS patients with cardiac disease have cardiomegaly, often associated with pulmonary edema, at chest radiography. An esophagogram may show ulceration, plaque formation, mucosal edema, and dysmotility in patients with candidal esophagitis.
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PMID:Thoracic disease in children with AIDS. 894 40

The present study was designed to evaluate the pathological and immunohistochemical findings of Mycobacterium avium intracellulare complex (MAC) lung infection. A retrospective study was performed in five cases with positive cultures for MAC in whom lung resections were performed between January 1989 and December 1996. A determination of whether or not MAC caused pulmonary disease was made using the 1997 criteria defined by the American Thoracic Society. In addition, MAC was cultured from all of the five lung specimens. Pathological and immunohistochemical findings as well as chest computed tomography (CT) findings were evaluated in these five patients. Pathological findings of bronchiectasis, bronchiolitis, centrilobular lesion, consolidation, cavity wall and nodules were demonstrated, respectively, in relation to chest CT findings. Extensive granuloma formation throughout the airways was clearly demonstrated. Immunohistochemical staining demonstrated: 1) epithelioid cells and giant cells; 2) myofibroblasts extensively infiltrating the cavity wall; and 3) B-cells detected in aggregates in the vicinity of the epithelioid granulomas. This study identified pathological and immunohistochemical characteristics of Mycobacterium avium complex infection relative to chest computed tomography findings and allowed the conclusion that bronchiectasis and bronchiolitis were definitely caused by Mycobacterium avium complex infection.
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PMID:Pathological and radiological changes in resected lung specimens in Mycobacterium avium intracellulare complex disease. 1023 11


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