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

Diffuse interstitial lung disease in asbestos-exposed workers is presumed to represent asbestosis. Among 176 asbestos-exposed persons for whom lung tissue was available, we found nine with clinical features consistent with asbestosis, but histologic sections failed to demonstrate asbestos bodies, the usual requirement for pathologic diagnosis of asbestosis (Group I). These nine were compared by analytic electron microscopy with nine persons with idiopathic pulmonary fibrosis (Group II), and with nine persons with all the criteria of asbestosis (Group III). The three groups did not differ significantly with respect to lung burden of chrysotile or tremolite and actinolite, but Group III had a lung burden of amosite and crocidolite that was three orders of magnitude greater than in Groups I and II, with no overlap. We conclude that (1) the American Thoracic Society criterion of "a reliable history of exposure" is sometimes difficult to define; (2) asbestos bodies are seen in tissue sections only when exposure has been reasonably high, and given the proper clinical setting, the presence of diffuse fibrosis and asbestos bodies in tissue sections are sensitive and specific criteria for a diagnosis of asbestosis; and (3) the prevalence here of 5.1% nonasbestos-induced interstitial lung disease among asbestos-exposed persons is artefactually high because of atypical case selection. However, because asbestosis is a disappearing disease, such cases will become more frequent. The identification of these other diseases is important because therapy and prognosis may differ from that of asbestosis.
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PMID:Idiopathic pulmonary fibrosis in asbestos-exposed workers. 189 81

Simple tests of lung function may be misleading in the assessment of patients with interstitial lung disease. Eight patients are described with cryptogenic fibrosing alveolitis (histologically proven in four) with severe breathlessness and low gas transfer (median DLCO 32.4%, range 9.2 to 35.3%, % predicted) in whom lung volumes were preserved [median VC 98.7, range 67.5-131.1%; median TLC 92.5, range 88.1 to 121.2, (% predicted)], and in whom there was no evidence of airflow obstruction [median FEV1/FVC 84.6, range 68-116 (% predicted)]. All were current or ex-heavy smokers. Thoracic high resolution computed tomography revealed upper zone emphysema, the extent of which was not appreciated using conventional chest radiography. The atypical physiological and radiological features can be explained by coincidental cryptogenic fibrosing alveolitis and emphysema and high resolution computed tomography was valuable in the assessment of these patients.
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PMID:Combined cryptogenic fibrosing alveolitis and emphysema: the value of high resolution computed tomography in assessment. 224 66

The study presents our experience with video-assisted thoracoscopy and video-assisted thoracoscopic surgery (VATS) at the Dept. of Thoracic and Cardiovascular Surgery at Odense University Hospital. All VATS-procedures performed in the period 1/1 1993-30/9 1994 were prospectively registered. Sixty-seven procedures were undertaken on 63 patients with a median age of 35 years (range, 13-75 years). Twenty diagnostic and 47 combined diagnostic and therapeutic procedures were performed. The indications were spontaneous pneumothorax, pleural changes, diffuse interstitial lung disease, Raynaud's disease, localized lung lesion, and abnormal chest X-ray in patients with previous extrathoracic malignancy. In patients with pneumothorax, the most frequent procedures were pleurodesis with fibrin glue sealant, wedge resection with endostapler, and pleural abrasion. In the remaining groups, the most frequent procedures were pleural biopsy, wedge resection of lung parenchyma, and thoracic sympathectomy. The median time consumption during the surgical part of the VATS-procedures was 50 minutes (15-130 min.), and median hospitalization time after VATS was three days (1-10). Drains were left for more than two days after 13 procedures (22%), most often due to air leakage or persisting pneumothorax. Four VATS-procedures were converted to thoracotomy, and three had thoracotomy at a later stage during hospitalization. All thoracotomies were related to preexisting disease. No major procedure-related complications occurred. A diagnosis was achieved in every case where VATS was aimed at being purely diagnostic. Two patients had sympathectomy with good results. We conclude that VATS seems of advantage for diagnosis and therapy in many cases of benign intrathoracic disease. In addition, a histological diagnosis can be achieved and operability assessed in many cases of intrathoracic malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Video-assisted thoracic surgery--2]. 765 92

Thoracic involvement occurs more frequently in systemic lupus erythematosus than in any other connective tissue diseases, and more than half of patients with the disease suffer from the involvement. Primary intrathoracic manifestations include pleural disease (effusions and/or thickening), acute lupus pneumonitis, subacute interstitial lung disease including bronchiolitis obliterans organizing pneumonia and non-specific interstitial pneumonia with fibrosis, chronic interstitial lung disease of usual interstitial pneumonia, pulmonary hemorrhage, pulmonary vascular disease, small airway disease of bronchiolitis obliterans, and pulmonary arterial hypertension. Secondary intrathoracic manifestations include atelectasis due to diaphragmatic dysfunction, opportunistic pneumonia, drug and oxygen toxicity, aspiration, and pleuropulmonary consequences of cardiac and renal failure.
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PMID:Thoracic involvement of systemic lupus erythematosus: clinical, pathologic, and radiologic findings. 1066 51

Understanding of the cellular and cytokine interactions associated with inflammation and fibrosis in interstitial lung diseases (ILDs) has increased substantially during the past few years. Presently, many agents are known to have the ability to induce ILDs, although only a small percentage of exposed individuals will develop the disease. In addition, the majority of ILDs are of unknown origin and many are labelled "idiopathic". Therefore, host susceptibility, genetic factors and, possibly, environmental cofactors may be important for the clinical expression of ILDs. The present review reports evidence of the genetic predisposition to develop ILDs of unknown origin, more specifically sarcoidosis, idiopathic pulmonary fibrosis (IPF), lymphangioleio-myomatosis and ILDs, in systemic sclerosis. For instance, for sarcoidosis and IPF several histocompatibility antigens have been associated with the development and/or the clinical presentation of the disease. Furthermore, there are also several types of ILD that are associated with inherited disorders, of which the tuberous sclerosis complex is only one example. This clearly indicates that pulmonary fibrosis can be influenced by genetic factors. Familial occurrence of sarcoidosis and IPF is also well known, although the exact modes of inheritance are debatable. Several studies have shown that extrinsic factors, such as single or multiple fibrosing agents, probably contribute to the development of clinical ILDs of unknown origin. It is probable that some of these studies deal with patients who do not have classical IPF, as recently defined by the American Thoracic Society (ATS)/European Respiratory Society (ERS) consensus. Therefore, the true role of these extrinsic factors in the development of IPF, or even sarcoidosis, remains speculative. With the help of animal studies and, more specifically, by using knock-out mice, it may be possible in the near future to unravel at least some of the genes that are responsible for the increased susceptibility of the development of interstitial lung diseases.
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PMID:Genetic predisposition and pathogenetic mechanisms of interstitial lung diseases of unknown origin. 1181 21

Two patients, aged 73 and 58 years, with diffuse pulmonary fibrosis underwent emergency open cholecystectomies (subcostal approach) under thoracic epidural anesthesia with 0.5% ropivacaine and fentanyl in spontaneous ventilation. Pulmonary fibrosis was due to amiodarone administration in the first patient and of unknowon cause in the second. Both developed arterial hypotension without bradycardia in spite of optimal preloading. Inotropoic support with low doses of norepinephrine was requiered for recovery in both cases with no adverse events after reversion of the sympathetic blocks. Postoperative epidural analgesia was very satisfactory. Thoracic epidural anesthesia is a useful alternative to general anesthesia for subcostal cholecystectomy in patients with diffuse interstitial lung disease in advanced stages.
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PMID:[Open cholecystectomy under thoracic epidural anesthesia in diffuse interstitial lung disease]. 1520 Jan 90

This article provides a comprehensive summary of typical imaging features of common interstitial lung diseases with an emphasis on high-resolution computed tomography (HRCT). The classification of interstitial lung disease that is used is in accordance with the consensus statement of the American Thoracic Society. The secondary pulmonary lobule is the basic anatomic unit that is used for standard description of findings on HRCT. Sarcoidosis, Langerhans' cell histiocytosis, lymphangioleiomyomatosis, collagen vascular diseases, and hypersensitivity pneumonitis are some of the common interstitial lung diseases that are addressed.
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PMID:Imaging of interstitial lung disease. 1533 Nov 86

This article continues the discussion of imaging of interstitial lung diseases that was begun in the last issue. We summarize the typical imaging features of idiopathic interstitial pneumonias, emphasizing high-resolution CT. Based on the American Thoracic Society classification system, the idiopathic interstitial pneumonias are discussed under these sections: idiopathic pulmonary fibrosis/usual interstitial pneumonitis, nonspecific interstitial pneumonitis, cryptogenic organizing pneumonia, desquamative interstitial pneumonitis, respiratory bronchiolitis-associated interstitial lung disease, acute interstitial pneumonitis, and lymphoid interstitial pneumonitis.
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PMID:Imaging of the chest: idiopathic interstitial pneumonia. 1556 14

The pathological classification of interstitial lung disease (ILD) includes two general groups, diffuse infiltrative pneumonia with a specific histological presentation due to primary disease of unknown or unrecognized cause and idiopathic ILD. Diagnosis is established on the basis of clinical, radiological and pathological findings. In the first group of diffuse infiltrative pneumonia, the diagnosis is usually straightforward, established on endoscopic biopsy, alveolar lavage or surgical material depending on the case. The pathological classification of idiopathic ILD requires a surgical specimen. The entities redefined by the American Thoracic Society and the European Respiratory Society (ATS/ERS) are: usual interstitial pneumonia, non specific interstitial pneumonia, chronic organized pneumonia, diffuse alveolar damage, desquamative interstitial pneumonia, desquamative interstitial pneumonia with respiratory bronchiolitis and lymphocytic interstitial pneumonia. The diagnosis of idiopathic pulmonary fibrosis is established in a precise clinical and radiological context with an aspect of common interstitial pneumonia of the biopsy material. It is important to recognized common interstitial pneumonia because of the severe prognosis and to distinguish it from non-specific ILD.
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PMID:[New classification of interstitial lung disease]. 1614 85

Interstitial pneumonia is a rare disease, posing a diagnostic challenge to pneumologists, pediatricians, radiologists and pathologists. Only by the combined efforts of the European Respiratory Society (ERS) and the American Thoracic Society (ATS) has has been possible to standardize the formerly different European and Northern American nomenclature of interstitial lung diseases (alveolitis versus interstitial pneumonia) in adults and to clearly and unambiguously define the diagnostic criteria. The ATS/ERS classification of 2002 comprises seven entities: usual interstitial pneumonia (UIP), non-specific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), cryptogenic organizing pneumonia (COP), lymphocyte interstitial pneumonia (LIP), and acute interstitial pneumonia (AIP). Using the ATS/ERS classification of interstitial pulmonary diseases in premature infants, infants and children is problematic, since UIP, RB-ILD and AIP do not occur at this age. Although infants with severe respiratory insufficiency may sometimes show morphological features similar to DIP or NSIP, this entity should rather be classified as chronic pneumonitis of infancy (CPI) because of differences in etiology, pathogenesis and prognostic outcome.
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PMID:[Interstitial pulmonary diseases]. 1645 42


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