Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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

Because of unanswered questions about reference values for single-breath carbon monoxide diffusing capacity (DLCO) in Chinese, standardized DLCO measurements were carried out in a selected sample of 257 healthy nonsmoking Chinese aged 20-70 years. The methods of measurement essentially followed the American Thoracic Society (ATS) recommendations. The measured DLCO was corrected to a standard hemoglobin value. Observed mean values for DLCO were 25.87 +/- 5.64 mL/min/mmHg in men and 21.16 +/- 3.88 mL/min/mmHg in women. Correlations of DLCO indices with anthropometric variables revealed that DLCO was best correlated with age in both sexes (r = -0.71 for men and r = -0.61 for women, p < 0.001). For alveolar volume (VA), the most significant correlation was found with height. For specific diffusing capacity (DLCO/VA), there was a significant negative relationship with age. Reference equations using age and body surface area (BSA) as independent variables for DLCO, VA and DLCO/VA were derived separately for men and women. An analysis of the distribution of residuals was Gaussian with simple linear regressions. Predicted values for DLCO and VA, as estimated in the present study, were much lower than equations derived from Caucasian populations. On the contrary, DLCO/VA values, as predicted by the present set of equations, were comparable to those of Caucasian equations. Therefore, differences in DLCO values between Chinese and Caucasians may be explained by differences in lung volume rather than by ethnic variations in the inherent characteristics of the alveolar capillary membrane. Predicted values for Chinese should be obtained from equations established from this study rather than extrapolated from those of Caucasians. The results of this study will be of value to clinical laboratories dealing with pulmonary function testing for Chinese patients.
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PMID:Single-breath carbon monoxide diffusing capacity: effect of body size and age in healthy nonsmoking Chinese. 136 7

Depending on the local extension of primary non-small cell lung cancer (NSCLC) and invaded T4 structure(s), 49 patients underwent complete (CR, n = 14) or palliative (PR, n = 13) resection of exploratory thoracotomy (ET, n = 22) between January 1982 and June 1988. Thoracic radiotherapy (TR) was given to all patients receiving PR (median dose, 43 Gy) and ET (median dose, 53 Gy). With a median follow-up of 44 months, overall 2- and 5-year survival was 25 and 5%, respectively. Patients undergoing ET plus TR had a significantly worse survival than those treated by CR (P = 0.041) and PR plus TR (P = 0.046). Only completely resected patients became long-term survivors (5-year survival, 29%) and significant predictors of their survival were previous weight loss, hemoglobin, and creatinine level, in univariate analysis, and previous weight loss in multivariate analysis. The site of initial treatment failure was mainly local for PR plus TR (85%) and systemic for CR (71%) and ET plus TR (86%). Presented results suggest that surgery might play a role for selected patients with T4 NSCLC, but advances in systemic and local therapy are necessary.
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PMID:Results of treatment and lessons learned from pathologically staged T4 non-small cell lung cancer. 171 30

Thoracic masses resulting from extramedullary hematopoiesis developed in two sisters of Moroccan origin with congenital dyserythropoietic anemia type II (HEMPAS). In one patient, the diagnosis of extramedullary hematopoiesis was confirmed histologically. The appearance of extramedullary foci of hematopoiesis mimicking mediastinal tumors has not been previously described in HEMPAS. These masses result from persistent erythropoietic stimulation associated with chronic hemolytic anemia. In both patients, detection of the asymptomatic masses was preceded by normalization of hemoglobin levels. Thus unexpected correction of a chronic refractory anemia associated with the appearance of mediastinal masses might be the heralding manifestation of an effective extramedullary hemopoiesis.
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PMID:Paravertebral extramedullary hematopoiesis associated with improvement of anemia in congenital dyserythropoietic anemia type II. 371 46

Diabetes is known to cause impaired endothelium-dependent relaxation of blood vessels. The purpose of this study was to determine whether this endothelial dysfunction is a permanent defect or is reversible after acute arginine supplementation in vitro or by surgical intervention in vivo using syngeneic pancreatic islet transplantation. Lewis rats were injected with streptozotocin to induce diabetes and were studied either 8 or 12 weeks later. Another group received syngeneic islets via intraportal injection at 8 weeks of diabetes and were allowed to become euglycemic for 4 weeks before study. Thoracic aortic rings were tethered in isolated muscle baths, contracted with a submaximal concentration of norepinephrine, and challenged with either the endothelium-dependent vasodilator acetylcholine or the endothelium-independent vasodilator nitroglycerin. Relaxation to acetylcholine (but not nitroglycerin) was reduced in both 8- and 12-week diabetic rings compared with age-matched control rings. Preincubation of diabetic rings in vitro with L-arginine (but not D-arginine) restored relaxation to acetylcholine to normal to rings from 8-week but not 12-week diabetic animals. Plasma basic amino acids (arginine, lysine, and histidine) were reduced by diabetes, whereas other neutral or acidic amino acids were unchanged (phenylalanine, proline, and glutamate), reduced (serine, cysteine, threonine, tyrosine, tryptophan, and aspartate), or elevated (isoleucine, leucine, and valine). Islet transplantation restored to normal the changes in plasma amino acids. Elevation in blood glucose and total glycosylated hemoglobin in diabetic animals was normalized after islet transplantation. Furthermore, islet transplantation completely restored the defective endothelium-dependent relaxation to acetylcholine in diabetic rings.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Syngeneic pancreatic islet transplantation reverses endothelial dysfunction in experimental diabetes. 765 36

The equation proposed by Cotes and coworkers is currently considered as the most acceptable to correct carbon monoxide diffusing capacity (DLCO) for hemoglobin concentration [Hb] by both the American Thoracic Society (ATS) and the European Respiratory Society (ERS) guidelines for standardization of DLCO. In a previous study on 24 anemic patients undergoing bone marrow transplantation (1), we found that DLCO is underestimated using the equation of Cotes and coworkers. To further explore this finding, 28 anemic patients ([Hb] = 8.2 +/- 1.0 (SD) g/dl) with chronic renal failure were prospectively studied during the recovery period of anemia (5.4 +/- 3.5 mo). In all 28 subjects, the slope deltaDLCO/delta[Hb] computed as ratio of overall change in DLCO to overall change in [Hb] throughout the study period was 1.40 +/- 0.72 ml CO/min/mm Hg/g/dl. The individual relationship between measured DLCO and [Hb] closely fitted a simple linear regression. The resulting equations for adjustment of DLCO (DLCOadj) to a standard [Hb] of 14.6 g/dl for men and 13.4 g/dl for women are: [equations: see text]. The present adjustment function for DLCO is linear and independent of the observed DLCO values, whereas the formulas previously proposed are curvilinear, DLCO correction varying with the measured DLCO values. For a measured DLCO of 15 ml CO/min/mm Hg and [Hb] ranging from 7 to 12 g/dl, the present DLCO adjustment is higher (by 2.7 ml CO/min/mm Hg, on average) than that proposed by Cotes and coworkers. This difference appears to be relevant for a precise interpretation of DLCO in patients with normocytic anemia in different clinical conditions.
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PMID:Adjustment of DLCO for hemoglobin concentration. 900 18

Oxygen-derived free radicals are believed to be involved in diabetes-induced vascular complications. The role of oxygen radicals in endothelial dysfunction in diabetes is not known with certainty. In this study we tested whether inhibition of lipid peroxidation using the potent inhibitor U74389F, a 21-aminosteroid also known as lazaroid, could prevent endothelial dysfunction in diabetes. Lewis strain rats were made diabetic by intravenous injection of streptozotocin. A subgroup of diabetic animals received daily oral doses of 10 mg/kg U74389F at 72 hours post streptozotocin and throughout the 8-week duration of diabetes. Thoracic aortas were isolated and suspended in isolated tissue baths and contracted with norepinephrine. Relaxation due to the endothelium-dependent vasodilator, acetylcholine, was impaired in diabetic aorta while relaxation due to A23187 and nitroglycerin was unaltered. Chronic treatment of diabetic animals with U74389F normalized the increase in plasma lipid peroxides as assessed by thiobarbituric acid-reactive substances but did not alter serum insulin levels, blood glucose concentration, nor total glycosylated hemoglobin. Increases in aortic catalase activity resulting from diabetes was not altered by U74389F. Despite reductions in lipid peroxides, U74389F did not prevent the diabetes-induced impairment in endothelium-dependent relaxation caused by acetylcholine. These data suggest that other pathways that are antecedent to lipid peroxidation may be responsible for endothelial dysfunction in diabetes.
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PMID:Chronic treatment with the 21-aminosteroid U74389F, an inhibitor of lipid peroxidation, does not prevent diabetic endothelial dysfunction. 931 Feb 71

In order to assess the additive effects of taking into account dead space volume (VD), carbon dioxide, hemoglobin (Hb) and carboxyhemoglobin on computation of single breath carbon monoxide diffusing capacity (DLCOsb), we sequentially applied all the corrections recommended by the 1987 American Thoracic Society (ATS) document on DLCOsb standardization. We used data from 739 men (333 nonsmokers and 406 current smokers) and 475 women (403 nonsmokers and 72 current smokers) who underwent measurement of DLCOsb in the decade 1985-1994 at the Lung Function Laboratory of our institute. With respect to the unadjusted DLCOsb value, significant small differences were found for all the corrected formulas, ranging from -0.18 to 1.48 ml/min/mm Hg in men and from -0.24 to 1.57 ml/min/mm Hg in women. After computing the percent change of DLCOsb [(unadjusted-adjusted value) x 100/unadjusted value], we observed that the correction for VD caused an underestimation of DLCOsb of about 5.8% in men and 7.7% in women. However, when all the corrections were considered, these figures decreased to about 0.9% in males and 2.9% in females. Regarding specifically the correction for Hb, the adjusted value was slightly lower in men, while it was some-what higher in women, with respect to the unadjusted DLCOsb. In conclusion, the corrections suggested by ATS in the computation of DLCOsb, when considered altogether, seem to account for a limited proportion of test variability in usual clinical conditions, especially in males.
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PMID:Single breath diffusing capacity for carbon monoxide: effects of adjustment for inspired volume dead space, carbon dioxide, hemoglobin and carboxyhemoglobin. 952 69

Thoracic physicians in New South Wales, Australia, and conservative in their administration of long-term oxygen therapy. Relatively few patients are being treated with it at present. Those who are use oxygen cylinders and concentrators in their homes. Use of long-term therapy is restricted to two groups: first, well-motivated patients who, after investigation and treatment, continue to have PaO2 values below 60 mm Hg and evidence of complications arising from hypoxia; and second, a few patients who have central apnea and severe desaturation of hemoglobin during sleep.
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PMID:Long-term oxygen therapy in Australia. 1031 2

Patients recruited for phase I trials are considered to have a poor prognosis, because the majority of them have already been heavily treated. We examined the survival of lung cancer patients admitted to phase I trials and treated with single new investigational chemotherapeutic agents or new investigational biological modifiers in the Division of Thoracic Oncology of the National Cancer Center Hospital between 1987 and 1993. Eighty-two patients had lung cancer among 121 patients registered in phase I trials. To identify prognostic factors, univariate and multivariate analyses were conducted. Median survival time (MST) from beginning of the phase I trial was 9.4 months, and the response rate was 4.2%. There were 11 (13.4%) early deaths within 3 months, and the death of 1 (1.2%) patient was treatment-related. Univariate analysis demonstrated that performance status, body weight loss, chemotherapy regimen, liver metastasis, number of metastatic sites, prior chemotherapy, and serum levels of hemoglobin, and lactate dehydrogenase were significant prognostic factors for survival. Among these factors, performance status >1, body weight loss >/=10%, and number of the metastatic sites >1 were selected as risk factors in multivariate regression analysis. The low-risk group, which included the 36 patients with no risk factors, had an MST of 13.9 months and an early death rate of 0%. The intermediate-risk group of 31 patients was characterized by patient having only one risk factor. These patients had an MST of 7.6 months and an early death rate of 13%. The high-risk group of 9 patients had two or three risk factors. These patients had an MST of only 1.5 months and a high early death rate of 78%. We conclude that the MST of lung cancer patients who participated in the phase I trials was 9.4 months. Therefore, it appears reasonable to have admitted these patients to the phase I trials. However, as the patients in the high-risk group had a poor outcome and high early death rate, they should not have been admitted to phase I trials. This prognostic model should be validated in other patient series.
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PMID:Survival and prognostic factors in lung cancer patients treated in phase I trials: Japanese experience. 1049 56

The objective of this study was to determine the frequency and severity of decreased arterial oxy-hemoglobin saturation during exercise in adults with cystic fibrosis at 1,500 m above sea level. A convenience sample of 50 adults with cystic fibrosis who did not have hypoxemia (oxygen saturation, < 90%) at rest were evaluated. Spirometry was performed according to American Thoracic Society standards, and maximal exercise tests were performed on an electronically braked cycle ergometer using a ramp protocol individualized for each patient. Pulse oximetry was measured every 2 min. When exercising at high altitude, 45 of 50 patients had a decrease in arterial oxy-hemoglobin saturation from baseline to some degree. In 29 patients, oxy-hemoglobin saturation fell below 90%; in 14 patients, it fell below 85%; and in 4 patients, it fell below 80%. Oxy-hemoglobin saturation decreased to < 90% in 12 of 14 patients with severe pulmonary disease (FEV(1) < 40% predicted), in 15 of 26 patients with moderate disease (40% less than or equal to FEV(1) < 70% predicted), in 2 of 6 patients with mild disease (70% less than or equal to FEV(1) < 90% predicted), and in 0 of 4 with normal pulmonary function (FEV(1) greater than or equal to 90%). Percent predicted FEV(1) (r = 0.57; P < 0.0001) and FEV(1)/FVC ratio (r = 0.52; P < 0.0001) most highly correlated with arterial oxy-hemoglobin saturation at peak exercise. We conclude that at 1,500 m above sea level, adult CF patients with obstructive airways disease are at significant risk for decreased arterial oxy-hemoglobin saturation during exercise. A supervised exercise test should be considered prior to recommending an exercise program for such patients.
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PMID:Oxygen saturation in adult cystic fibrosis patients during exercise at high altitude. 1174 46


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