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

Mycobacterium xenopi and Mycobacterium avium complex (MAC) are biochemically similar. To define the laboratory characteristics of M. xenopi that distinguish it from MAC, 53 M. xenopi isolates from different areas in the United States and 47 isolates recovered at one hospital were evaluated by 13 biochemical tests, AccuProbe MAC (Gen-Probe, Inc., San Diego, CA, USA), colony morphology, formation of X-colonies, pigmentation in response to light, growth on MacConkey agar without crystal violet, and relative growth rates at 25 degrees C, 36 degrees C, and 45 degrees C on solid media. Relative growth rates of 10 M. xenopi and 11 MAC isolates were measured at 25 degrees C, 36 degrees C, and 42 degrees C in Middlebrook broth processed using the BACTEC TB System. Ten M. xenopi were tested for p-nitro-alpha-acetylamino-beta-hydroxypropiophenone inhibition at 36 degrees C and 42 degrees C. Reevaluation of 81 isolates previously identified as MAC by biochemical tests alone revealed that two were M. xenopi. The most reliable characteristics distinguishing M. xenopi from MAC were the presence of X-colonies (M. xenopi 97% vs MAC 1%), positive 3-day arylsulfatase (M. xenopi 88% vs MAC 1%), growth at 25 degrees C (M. xenopi 0% vs MAC 100%), and AccuProbe MAC test results (M. xenopi 0% hybridized). Retrospective chart review of 37 patients using American Thoracic Society criteria revealed that six (16%) patients had clinically important isolates. At one of our hospitals M. xenopi was the second most common mycobacterial species isolated for 1990-1992, accounting for 27% of all isolates, whereas at our other hospital it accounted for 1% of isolates.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Laboratory and clinical evaluation of Mycobacterium xenopi isolates. 755 1

Recent technologic developments have introduced a number of improvements in the ability of clinical laboratories to cultivate and identify Mycobacterium tuberculosis complex more quickly than previously. These developments include more rapid detection of growth and tests to identify RNA or DNA of M. tuberculosis complex directly in clinical samples. United States Food and Drug Administration (FDA) panels have recently recommended approval of two direct amplification tests (DAT), the Gen-Probe MTD (San Diego, CA) and the AMPLICOR M. tuberculosis test (Roche Diagnostic Systems, Inc., Branchburg, NJ). The FDA has approved the MTD for identification of M. tuberculosis complex in respiratory specimens that are smear-positive for acid-fast bacilli (AFB). In addition, the specimen must be from a patient who has not received antituberculous medication for seven or more days or within the last 12 months. From the data reviewed by the FDA, the specificity (100%) and sensitivity (95%/96% in the two studies) of these two tests in AFB smear-positive specimens were found to be comparable to the Accuprobe (Gen-Probe) for identification of M. tuberculosis complex in culture, with the advantage that the DAT results are available much sooner. The DAT are significantly more sensitive than the AFB smear. However, in AFB smear-negative samples, the specificity, sensitivity, and positive predictive value were 96/99%, 48/53% and 24/58%, respectively, in the two studies. For some results, the Gen-Probe assay had the higher value and for others, the Roche assay was higher. The DAT result, particularly when discordant with the AFB smear, must be used in conjunction with clinical assessment. While both the MTD and the AMPLICOR M. tuberculosis test have undergone extensive testing in clinical laboratories, neither test has been examined for its utility in routine clinical use or public health settings in the United States. An American Thoracic Society Workshop was convened to examine the data and technology available to date, to develop a consensus addressing the appropriate use of the rapid diagnostic tests (in particular, DAT's) for tuberculosis, and to identify future research needs and directions. The consensus among three focus groups, clinical, laboratory, and public health, was that, while these tests are a major improvement over standard techniques, there is currently insufficient information on their clinical and public health utility. When the AFB smear and DAT are both positive, the diagnosis of tuberculosis can be considered to be established. Furthermore, when the AFB smear is negative and the DAT is also negative, it is unlikely that M. tuberculosis will be grown from that sample. When there is discordance between the AFB smear and the DAT, additional consideration must be given to the overall clinical picture and repeat testing should be done. It is recommended that the currently available DAT's always be performed in conjunction with microscopy and culture, and each test result must be interpreted within the overall clinical setting in which it is used.
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PMID:Rapid diagnostic tests for tuberculosis: what is the appropriate use? American Thoracic Society Workshop. 915 47

The General Medical Services (GMS) contract has focused the attention of United Kingdom (UK) general practitioners (GPs) on the provision of high quality routine care for patients with chronic disease. The quality markers defined by the contract endorse the need for objective diagnosis and structured care recommended by the British Thoracic Society/Scottish Intercollegiate Guideline Network (BTS-SIGN) guideline for the management of asthma and the National Institute for Clinical Excellence (NICE) guideline on the management of chronic obstructive pulmonary disease (COPD). In this paper the key recommendations of these guidelines and their implementation in the pragmatic world of general practice are discussed, with specific focus on diagnosis, monitoring, management, self-management and delivery of care.
Br J Gen Pract 2004 Jul
PMID:Respiratory medicine. 1523 18

Pulmonary mucinous cystadenocarcinoma (PMC) is a rare tumor characterized by mucin production. It is similar to tumors of the same name arising in the ovaries and pancreas. Here we describe the 20th case of PMC reported in the English literature. The patient was a 75-year-old woman with a 3-day history of bloody sputum. Chest radiography and computed tomography revealed a cavitary mass 5 cm in diameter in the posterior segment of the right lung. 18F-fluorodeoxyglucose positron emission tomography demonstrated intense uptake in the wall of the lesion. Right lower lobectomy was performed, and the pathology examination revealed this tumor to be a PMC. The preoperative serum CA 19-9 level was 162.3 U/ml (cutoff 37 U/ml) and decreased to 22.8 U/ml after resection. No mutation of epidermal growth factor receptor or K-ras gene was detected. Thoracic surgeons should bear in mind this rare tumor for the differential diagnosis of a pulmonary cystic lesion.
Gen Thorac Cardiovasc Surg 2007 Mar
PMID:Pulmonary mucinous cystadenocarcinoma: an extremely rare tumor presenting as a cystic lesion of the lung. 1744 15

The premiere issue of the Japanese Journal of Thoracic Surgery, known as "Kyobu Geka" in Japanese with English abstract, was launched in 1948. Articles of the journal become obtainable by PubMed in 1961 (volume 14). In the present study, the journal was evaluated using science database, Scopus and PubMed. Jpn J Thorac Cardiovasc Surg and Gen Thorac Cardiovasc Surg were used for comparison. A total of 7,490 articles published in "Kyobu Geka" by December 2008 were searched. Of these, 1,573 articles (21.0%) were cited for a total of 2,548 times. Articles cited by non-Japanese papers were mostly of rare case reports and experience of use of newly introduced devices. The authors' names and source titles of cited articles can be searched easily, and the information obtained is valuable for research, writing research grant applications and academic articles. In conclusion, although "Kyobu Geka" is published in Japanese, it has been cited by many international journals in many languages and, therefore, is making a fine performance.
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PMID:[Evaluation of "Kyobu Geka (the Japanese Journal of Thoracic Surgery)" using science database]. 1976 99

Thoracic aortic aneurysms are extremely burdensome to treat owing to their surgical complexity. In particular, major postoperative complications lower significantly patients' quality of life. Surgical treatment has recently shifted to thoracic endovascular aortic repair (TEVAR) to respect the patients' needs and improve postoperative quality of life. This procedure is radical and innovated for thoracic aortic pathology, but the devices and the delivery systems are immature because only a little over a decade and a half has passed since starting to use them. Ready-made stent-grafts were originally indicated only for degenerated aortic aneurysms, but aortic dissection and traumatic aortic transection will become the next targets for TEVAR. This review addresses the history and changes in TEVAR as well as the current TEVAR strategy. Finally, we describe a new trial of TEVAR for aortic dissections, traumatic aortic transections, and aortic arch aneurysms.
Gen Thorac Cardiovasc Surg 2010 Aug
PMID:Current strategy of endovascular aortic repair for thoracic aortic aneurysms. 2070 59

A 75-year-old man developed persistent dysphagia 2 months after successful total arch replacement with a long elephant trunk (ET) for a distal arch aneurysm. Enhanced computed tomography revealed not only complete thrombosis of the distal arch aneurysm, but also rapid expansion of another downstream aortic aneurysm with esophageal compression. Thoracic endovascular aortic repair was undertaken for this symptomatic aortic aneurysm, which was totally thrombo-excluded. ET might produce turbulent or jet-like blood flow from its tip in some situations and have a potential to accelerate the expansion of the downstream aneurysm. Additional endovascular ET completion is simple, effective, and less invasive.
Gen Thorac Cardiovasc Surg 2010 Dec
PMID:Rapid expansion of another downstream aortic aneurysm with the elephant trunk. 2117 Jun 28

Thoracic empyema after laparoscopic cholecystectomy is a rare complication. It is associated with dropped gallstones during the operation. In this case, we report a hepatocellular adenoma hemorrhage underneath an old diaphragm rupture, causing empyema after laparoscopic cholecystectomy.
Gen Thorac Cardiovasc Surg 2010 Dec
PMID:Thoracic empyema after laparoscopic cholecystectomy: an unusual cause. 2117 Jun 36

A 29-year-old man had been diagnosed with an anterior mediastinal cyst 6 years earlier and was undergoing follow-up. At a follow-up visit, a newly developed cystic lesion was found in the middle mediastinum; therefore, the anterior mediastinal cyst and the middle mediastinal cyst were resected by thoracoscopic surgery. It was observed that the middle mediastinal cyst originated from the thoracic duct, and the thoracic duct was clipped. Pathologically, the diagnosis was a thymic cyst of the anterior mediastinum and a thoracic duct cyst of the middle mediastinum. The patient developed chylothorax after surgery, and a second thoracoscopic operation was performed. It revealed that part of the clipping of the caudal thoracic duct was incomplete, and leakage of chyle was observed. Hence, the clipping was performed again. The course after the second surgery was good. Thoracic duct cysts are rare even among mediastinal cysts and thus require caution due to their tendency to expand.
Gen Thorac Cardiovasc Surg 2011 Feb
PMID:Thoracoscopic resection of a thoracic duct cyst that developed during follow-up for a thymic cyst. 2130 43

Thoracic splenosis (TS) is autoimplantation of ectopic splenic tissue in the thoracic cavity that occurs following splenic injury. Most cases of TS are asymptomatic and are diagnosed during the course of an evaluation of incidentally discovered pulmonary lesions. Some cases may be difficult to diagnose, especially if features suggesting TS are not recognized. This may lead to an extensive workup and unnecessary invasive diagnostic procedures including thoracotomy. Multiple, asymptomatic, left-sided pleura-based lesions associated with a history of thoracoabdominal injury and splenectomy are the key points that should alert one to suspect TS, which can then simply be confirmed with a (99m)Tcsulfa colloid radionuclide scan. If TS is suspected and radionuclide imaging studies are performed, further extensive investigations, such as bronchoscopy, biopsy, thoracoscopy, and thoracotomy, are not required as the radionuclide scan is definitive for diagnosis. Most cases are asymptomatic, so further treatment is rarely required; all cases are managed conservatively. We emphasize that all physicians, radiologists, pathologists, and interventionalists should recognize key features that suggest the diagnosis of TS, order appropriate imaging when it is suspected, and avoid unnecessary invasive diagnostic procedures including thoracotomy.
Gen Thorac Cardiovasc Surg 2011 Apr
PMID:Thoracic splenosis: know it--avoid unnecessary investigations, interventions, and thoracotomy. 2148 50


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