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

The incidence of elderly patients with small cell lung cancer is increasing in Japan. Because of the variation in their physical function and increasing co-morbid disease, elderly patients are usually excluded from clinical trials. Questionnaires were sent to 40 institutes of the "West Japan Thoracic Oncology Group", and answers from 33 (83%) institutes were obtained. Eighty-five percent of replies recognized the need of trials for limited disease (LD) and 70% for extensive disease (ED). We investigated the methods of staging procedures, and management of 351 small cell lung cancer patients aged 70 years or older diagnosed from 1994 to 1996 in 28 institutes. There were 173 patients aged 70-74, 120 aged 75-80, and 58 aged 80 years or older. Staging procedures including chest CT, abdominal CT, abdominal CT or Echo. Brain CT or MRI and bone scinti scan were performed in 333 (95%) patients. One hundred fifty-nine of 178 patients with LD and 143 of 168 patients with ED received anticancer therapy. Although 48% of PS 0-1 patients received 4 courses or more of chemotherapy, among the patients with ED 24% of patients with PS 2 and 19% of PS 3 patients received adequate chemotherapy. The response rate was 79% for LD and 69% for ED. Many elderly patients received insufficient courses and/or doses of chemotherapy but achieved a good response. Median survival for patients with LD and ED was 12 and 6 months, respectively. To determine suitable regimens for elderly patients with lung cancer, more clinical trials are definitely needed.
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PMID:[How should we treat elderly patients with small cell lung cancer?--information gathered by questionnaires and analysis of 351 patients aged 70 or over. West Japan Thoracic Oncology Group]. 1041 Jan 49

The results of MRI in 81 patients with morphologically verified lung cancer, mainly Stages IIIA and IIIB, were analyzed. They were compared with CT data in 37 cases and surgical findings in 28. MRI was performed by using Magnaview 0.04 T and Vectra 0.5 T apparatus in the T1- and T2-weighted SE and PC sequences as well in the fat-suppression mode. Thoracic metastases were evaluated from the direct signs tumor spread into the adjacent tissue and vessels. The criteria for the involvement of lymph nodes were their over 1-cm enlargement and characteristic changes in the intensity of signals from them. CT was found to yield less information on pleural, pericardial, and vascular invasion (66-75% sensitivity). MRI detected this type of cancer spread (88-94% sensitivity). Both techniques have nearly equal sensitivities in revealing intrathoracic lymphadenopathy. The interpretation of MRI data did not depend on the voltage of a magnetic field. It is recommended that MRI should be made after CT when there is a need for assessing large vessels or for making clear the data that remain open to question following CT.
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PMID:[Magnetic resonance tomography in the diagnosis of lung metastases in the mediastinum and thorax]. 1071 24

Thoracic disc herniations rarely occur; they vary with respect to the clinical symptomatic and do not always lead to neurological deficit. A patient is being reported on with first symptoms of unspecific back pain. The patient has been frequently treated within 12 months (at regular intervals) exclusively by chiropractic manipulation without a considerable success. It is the objective of this case report that in persistent and therapy resistant back pain without obvious neurological deficite beside native radiographs further diagnostic investigation (MRI) is indicated. Concerning chiropractic manipulations (mobilisation techniques with impulse) this paper recommends testing maneuvers, the consideration of contraindications (structural lesions, neurological deficite) and emphasizes the use of atraumatic manipulation techniques.
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PMID:[Thoracic intervertebral disk displacement: a rare differential diagnosis of segmental irritation--guidelines for use of chiropractic therapy]. 1072 34

Right atrial varices are rare. They were described for the first time by anatomo-pathologists at the end of the 19th century and beginning of the 20th century. They are situated in the lower part of the inter-atrial septum and rarely exceed 2 cm in diameter. Descriptions have been from post-mortem studies which have led to epidemiological analyses and have given rise to nosological controversies. The authors report a case characterised by the exceptional volume of the varices. This could have enabled the diagnosis to be suspected at transoesophageal echocardiography before surgery. Thoracic CT scan and MRI completed the iconography. In the literature, two other cases of cardiac varices diagnosed at echocardiography have been published: they were small tumours on the lower part of the interatrial septum and the diagnosis before surgery was that of a myxoma. These formations seem to correspond to chance findings and do not appear to give rise to symptoms.
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PMID:[Right atrial intracardiac varices. Review of the literature and case report]. 1083 96

The aim of this paper is to demonstrate the unusual MR features of thoracic syringomyelia following TB meningitis and to discuss the neurosurgical aspect of the treatment of this rare entity. Four years after a TB meningitis episode, a 30 year-old female patient developed a progressive spastic paraparesis. MR studies revealed multiloculated syrinxes throughout the thoracic cord. She had a syringo-subarachnoid shunt with a silastic "T" tube inserted. On the first postoperative day, she showed a dramatic neurological improvement, but unfortunately her paraparesis progressed to the preoperative level within a month despite diminished size of the syrinxes on the control MRI examination. Two and a half years after the operation the patient complained of having a burning type of central pain, and further deterioration in neurological function. Thoracic spinal MRI examination demonstrated enlarged syringomyelic cavities. At the second operation syringo-peritoneal shunt insertion was performed via right T10-11 hemilaminectomy using a "T" tube. At present, 4 months after the second operation, the patient's neurological examination demonstrated decreased spasticity, and improved strength in the legs compared to the preoperative level. MRI is the first choice of investigation in detecting TB related myelopathy as it provides a greater detail of pathological changes within and around the spinal cord such as syrinx formation and arachnoiditis. The MR findings are also helpful in deciding the management and predicting the outcome. Presence of multifocal loculations and arachnoid adhesions is the likely cause of treatment failures and poor prognosis.
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PMID:Syringomyelia--as a late complication of tuberculous meningitis. 1108 34

We encountered a patient with dumbbell-type schwannoma arising in the right brachial plexus with von Recklinghausen disease. The patient was a 9-year-old girl. An abnormal shadow was detected high in the thoracic cavity by thoracic radiography. Thoracic CT and MRI demonstrated at the apex of the thoracic cavity a tumor measuring 9.0 x 6.0 cm, which was diagnosed as a dumbbell-type neurogenic tumor derived from the brachial plexus. Most cases of such tumors growing inside and outside the spinal cavity have reportedly been treated in a single surgical procedure. However, since the tumor in this patient was large, the intrathoracic portion was removed first in order to minimize the magnitude of the surgical invasion. The residual intraspinal tumor was removed during subsequent surgery. No neurological problems were observed after surgery. Patients with dumbbell-type schwannomas arising in the right brachial plexus appear to be very rare, and this patient was considered noteworthy.
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PMID:[Case report of surgically treated dumbbell-type schwannoma arising in the right brachial plexus with von Recklinghausen disease]. 1129 92

Abstract. Initial investigations of a 70-year-old woman with clinical Cushing's syndrome, including overnight dexamethasone suppression test, CRH test, and pituitary MRI, suggested the presence of ectopic ACTH production. Thoracic computed tomography (CT) scan revealed a mass measuring 7 mm in the right lung, but it was thought to be an incidental opacity, leaving the source of ectopic ACTH undetermined for several years. During this period, although the size of the lung opacity did not change remarkably, serum cortisol levels became elevated to 43 microg/dl, and the patient's symptoms worsened. Tl-201 SPECT demonstrated intense accumulation in the right lung. The mass was surgically resected using thoracoscopy to investigate it as the focus of ACTH production. Histological and immunohistochemical examination confirmed that the area of intense Tl-201 uptake was an ACTH-producing bronchial carcinoid. Plasma ACTH and cortisol levels decreased immediately after the surgery. In conclusion, this case demonstrated Tl-201 scintigraphy as a useful tool in identifying the location of an ACTH-producing bronchial carcinoid.
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PMID:Thallium-201 scintigraphy was useful in diagnosing ectopic ACTH syndrome due to bronchial carcinoid. 1187 69

A 63-year-old man visited our hospital in January 1993 because of back pain, which had been present for a year and persisted. The patient was diagnosed compression fracture of thoracic spine by another hospital. Thoracic plain radiographs revealed destructive and sclerotic changes with reduction of height of T 8, T 9 vertebral body. He had kyphosis on this level. Radiographs of the chest revealed hyperostosis of bilateral proximal clavicle. We diagnosed SAPHO syndrome (synovitis, acne, pustlosis, hyperostosis, and osteomyelitis: SAPHO) with T 8, T 9 spondylodiscitis, however without any skin manifestations. Oral indomethacin was effective, however thoracic kyphosis progressed gradually. Spastic gait and paraplegia appeared from February 1998, at last on July he was unable to walk independently. MRI showed the compression of spinal cord on T 8, T 9 level. We performed circumferential decompression and fusion with instrumentation. His paraplegia improved after surgery. We describe a rare case of SAPHO syndrome with paraplegia due to a thoracic kyphosis.
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PMID:[A case of SAPHO syndrome with paraplegia due to a thoracic kyphosis]. 1235 64

Thoracic aortic atherosclerosis has been shown to be an important cause of severe morbidity and mortality. At the present time, the case of performance, detailed information obtainable, and availability make TEE the procedure of choice for the imaging of thoracic aortic atherosclerosis; however, further technical advances in MR and CT, particularly in MR plaque characterization and the use of plaque specific contrast agents, may allow for a less invasive and more complete evaluation of thoracic aortic atherosclerosis in the near future. Gadolinium-enhanced 3DMRA is the procedure of choice for the noninvasive detection of plaque in the proximal aortic arch vessels. Furthermore, both CT and MRI are better suited to evaluate penetrating atherosclerotic ulcers and their complications such as intramural hematoma, pseudoaneurysm formation, and aortic rupture.
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PMID:Diagnostic imaging of aortic atherosclerosis and its complications. 1248 31

We report the case of a patient with postural headache. A CT scan revealed bilateral subdural hygroma. Brain MRI showed diffuse pachymeningeal enhancement. A diagnosis of intracranial hypotension was therefore made. Thoracic cerebrospinal fluid leak was proved by radionuclide cisternography and contrast myelography. Conservative medical treatment was ineffective. Two thoracic epidural blood patches with radiographic control were made. We think the blood patch is the most important element for success.
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PMID:[Image-guided epidural blood patch as effective treatment of intracranial hypotension. A case report]. 1273 82


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