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

Two standardized respiratory questionnaires were administered to 946 white male participants in a long-term study of respiratory symptoms in Washington County, Md. One half of the men were given the 1960 respiratory questionnaire developed by the British Medical Research Council (MRC) at the start of the interview and a new questionnaire developed by the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) at the end. The order was reversed for the other half of the subjects. No important differences were found in the responses. To obtain a minimal basic history for evaluation of chronic obstructive pulmonary disease, either the MRC questionnaire or the corresponding questions from the ATS-DLD questionnaire may be used. More detailed information on a wider variety of historical items may be obtained by using the ATS-DLD questionnaire.
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PMID:Standardized respiratory questionnaires: comparison of the old with the new. 42 Apr 37

The survival of 320 patients, who were born in and after 1958 with cystic fibrosis and managed by the Departments of Thoracic Medicine and Gastroenterology, Royal Children's Hospital, Melbourne, is reviewed. Eighty per cent of patients survived to 11 years of age, and 64% to 18 years. Of patients managed between 1973 and 1977, 91% survived to 12 years of age, and 80% to 17 years of age. In the same period, 79% of patients survived for 16 years after diagnosis. Forty-four per cent of the 240 patients currently being managed have no significant permanent lung disease, and only 9% have advanced disease.
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PMID:Improved survival of patients with cystic fibrosis. 44 80

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 new Pulmonary Medicine-Thoracic Surgery service was established in a community hospital in July 1974. This report details the experience of 409 bronchoscopies performed from July 1, 1974 through Dec 31, 1976. There were no deaths and four complications--one aspiration and three pneumothoraces resulting from transbronchial lung biopsy. Final diagnoses for which bronchoscopy was done were as follows: cancer--141; infectious disease--97; interstitial disease--33; obstructive lung disease--58; hemoptysis--35; miscellaneous--45. In the cancer group, a cytohistologic diagnosis was made in 82 patients by bronchoscopy alone, 31 additional diagnoses were made by scalene node biopsy or mediastinoscopy, and the remainder by surgical exploration and/or resection. In 268 patients with benign disease, bronchoscopy established the diagnosis in 87% of the cases. Pulmonary Medicine tended not to repeat nondiagnostic bronchoscopy but rather to refer immediately for a definitive surgical procedure. Thoracic Surgery tended not to reduplicate bronchoscopy for the purpose of "confirmation." A conjoint medical-surgical approach to bronchial disease, at the community level and based on a mutual understanding of capability and limitation, is feasible, productive, and economical.
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PMID:Bronchoscopy in the community hospital. 62 19

Mechanical assisted ventilation for neonatal respiratory failure is associated with residual lung disease. Because ECMO rests the lungs, it has been suggested that ECMO will prevent chronic lung disease in survivors. To determine whether or not ECMO survivors have evidence of pulmonary sequelae, we studied 19 infants who were treated with ECMO for neonatal respiratory failure. Ten infants still required supplemental oxygen or pulmonary medications or both to treat clinical lung disease during the first six months of life. Thoracic gas volume was normal. Pulmonary mechanics in ECMO survivors were compared with those of 13 preterm infants with BPD at similar age. We conclude that a significant proportion of ECMO survivors have residual abnormalities in pulmonary mechanics at 6 months of age. We speculate that neonatal lung injury due to meconium aspiration and other causes is a more important determinant of abnormal pulmonary sequelae than the method of treatment.
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PMID:Pulmonary sequelae at six months following extracorporeal membrane oxygenation. 155 25

Thoracic disease in the HIV negative immunocompromised host is most frequently caused by infection. Patterns of involvement produced on the chest radiograph include (1) lobar or segmental consolidation, (2) nodules with rapid growth and/or cavitation, and (3) diffuse lung disease. The lung also may be directly involved by lymphoma, metastases, drug reactions, radiation pneumonitis, or nonspecific interstitial pneumonitis. The lung is a frequent target organ for opportunistic infections in AIDS patients, particularly of Pneumocystis carinii pneumonia and tuberculosis. Computed tomography may be particularly helpful in these patients in the detection of early disease and in the characterization of patterns and extent of involvement as well as complications.
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PMID:Thoracic disease in the immunocompromised patient. 157 Mar 94

Thoracic gas volume (Vtg) was measured in a whole-body, infant plethysmograph in 46 infants with recurrent wheezing after bronchiolitis, 25 infants with cystic fibrosis, and 6 infants without overt lung disease during the first 13 months of life. When related to weight or length, 56.5% of the bronchiolitic infants had low Vtg values, which were more than 2 SD below their predicted normal. The Vtg of the other groups was normal or above. The bronchiolitic infants with Vtg values in the normal range had more severe airways obstruction and it is probable that their Vtg values were also underestimated. Investigation of possible sources of technical or experimental error failed to reveal any explanation for the low Vtg in the bronchiolitic infants. In 5 infants, Vtg determined plethysmographically was correlated linearly to functional residual capacity determined by helium dilution, although Vtg values were greater in all. The administration of albuterol or treatment with steroids failed to make significant changes in Vtg in the bronchiolitic infants. It is suggested that there is a physiologic basis for the presumed underestimation of Vtg in wheezy infants after bronchiolitis, either because of uneven alveolar pressure changes within the chest leading to the effective exclusion of a portion of the lung volume or because there are some alveolar units with very low compliance that change little in volume during respiratory efforts against an occlusion. These results call into question the validity of the plethysmographic measurement of Vtg or airway resistance in these infants. If the error in Vtg is due to uneven alveolar pressure changes, it is suggested that the calculated specific airway conductance is probably correct.
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PMID:Can thoracic gas volume be measured in infants with airways obstruction? 394 21

The acquired immune deficiency syndrome is characterized by the development of multiple recurrent opportunistic infections or unusual neoplasms in individuals with no prior history of immune suppression. This report summarizes the thoracic diseases encountered in such patients before after death and the role of diagnostic techniques currently used in the evaluation of thoracic disease in 15 patients with this syndrome. Efficacy of treatment was determined by correlation with postmortem findings in all patients. Pulmonary disease was present in all 15 patients and necessitated 23 transbronchial biopsies in 11 patients. Pneumocystis carinii pneumonia and cytomegalovirus pneumonia were the most common findings. Nine open lung biopsies in eight patients disclosed either Pneumocystis carinii pneumonia or Kaposi's sarcoma. Esophageal disease was present in four patients, and endoscopic evaluation demonstrated Candida esophagitis (two), esophageal Kaposi's sarcoma (one), and cytomegalovirus esophagitis and Kaposi's sarcoma (one). Mean time to death from diagnosis of acquired immune deficiency syndrome was 7.7 months, with respiratory insufficiency being the most common cause of death (9/15, 60%). Pneumocystis carinii pneumonia was successfully eradicated in 70% of the patients. Candida esophagitis was ameliorated in both patients with the disease. Unsuspected pulmonary Kaposi's sarcoma, cytomegalovirus pneumonitis, and other infectious pathogens were documented at autopsy. These data reveal that Pneumocystis carinii pneumonia and Candida esophagitis can be managed successfully in patients with acquired immune deficiency syndrome if appropriately diagnosed. The major cause of death in this series was pulmonary insufficiency, often the result of severe cytomegalovirus infection. Thoracic surgeons must continue to play an aggressive and important role in the early diagnosis and management of potentially treatable pulmonary and esophageal disease in these patients.
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PMID:Thoracic manifestations of the acquired immune deficiency syndrome. 633 56

A combination of aspirin and prednisolone was used in an attempt to modify the pulmonary disease produced by thiacetarsamide treatment of heartworm-infected dogs. Results of 6 heartworm-infected dogs treated with prednisolone (1 mg/kg, daily for 4 weeks) and aspirin (10 mg/kg, daily for 4 weeks) after thiacetarsamide treatment were compared with previously published results of 3 groups of dogs (6 dogs/group). One of these 3 groups was a nontreated control group, another was treated with prednisolone, and the 3rd was treated with aspirin. All dogs, each with 9 adult heartworms transplanted, were treated with a 2-day, twice-a-day treatment of thiacetarsamide (1 mg/kg) 4 weeks after the transplant. Thoracic radiographs were taken before and at 1, 2, and 3 weeks after thiacetarsamide treatment to evaluate lung disease. Pulmonary arteriography was performed before and 3.5 weeks after thiacetarsamide treatment to evaluate pulmonary blood flow. After treatment, radiographs of the aspirin-prednisolone group were similar to radiographs of the prednisolone group, both with a marked attenuation of the parenchymal disease, as compared with the non-treated group. Addition of aspirin to prednisolone prevented the blood flow obstruction and intraluminal filling defects that were present in the groups not receiving aspirin. Sixteen of 54 transplanted heartworms survived thiacetarsamide treatment in both prednisolone-treated groups, in contrast to complete elimination of heartworms in the nontreated group. Aspirin may be considered for treatment of any heartworm-infected dog that does not have hemotypsis, but postthiacetarsamide use of prednisolone should be restricted to the dog that develops severe lung disease after the heartworms have been killed.
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PMID:An aspirin-prednisolone combination to modify postadulticide lung disease in heartworm-infected dogs. 652 31

Nonspecific bronchial hyperresponsiveness (BHR) is a hallmark of clinical asthma, but can be present in nonasthmatics as well. The diagnosis of asthma is based on clinical grounds, and no laboratory procedure can definitely establish its presence. This poses a problem in studies of asthma. If epidemiological studies are to provide valid information, the tools used must have a relative degree of predictive or diagnostic ability. This report determined whether the American Thoracic Society-Division of Lung Disease (ATS-DLD) respiratory questionnaire has the ability to predict different degrees of non-specific BHR. In the years 1983-1990, when the ATS-DLD questionnaire was used in our Natural History of Asthma study, 192 subjects completed the ATS-DLD questionnaire and underwent a standardized methacholine challenge. A recursive partitioning analysis of the ATS-DLD questionnaire was able to predict which questions would likely be answered if the subject had nonspecific bronchial reactivity to inhaled methacholine of 100 and 200 breath units. Positive responses for questions concerning treatment for asthma, wheezing, or shortness of breath, and emergency treatment for asthma predicted the presence of increased bronchial reactivity.
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PMID:The usefulness of questionnaire-derived information to predict the degree of nonspecific bronchial hyperresponsiveness. 755 71


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