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At least 253 records · Page 14Linked to original sources
PubMed1998

[Clinical value of endoscopic ultrasound-guided transesophageal fine needle puncture of mediastinal lesions].

BACKGROUND AND OBJECTIVE: As the mediastinum has been a region difficult to access for biopsy, mediastinoscopy has been required in most cases. In a prospective study the value of transoesophageal endoscopic ultrasound (TEUS) guided aspiration biopsy was assessed as an alternative. PATIENTS AND METHODS: TEUS-guided fine-needle aspirations were performed between May 1995 and March 1998 in 35 patients with mediastinal space-occupying lesions. In all cases the conventional endoscopic method or percutaneous puncture-sonography had been impossible or had failed. In one patient it had been performed after a negative mediastinoscopy. RESULTS: In 34 patients (97%) the aspirated tissue cylinder could be evaluated histologically. There were no complications. Malignancy was demonstrated in 24 patients, and there were one case each of sarcoidosis, silicoanthracosis and two cases of retrosternal goitre. In four of seven patients the negative preoperative diagnosis was confirmed at operation or by follow-up. There were two false-negative results and in one patient there has been no definitive diagnosis. The accuracy of the method was thus 91.4%, the positive predictive value for malignancy 88.9% and the negative predictive value for malignancy 72.7%. Ultrasound alone was a poor predictor of malignancy in lymph node enlargement. CONCLUSION: TEUS-guided fine-needle aspiration of space-occupying mediastinal lesions is an effective and low-risk method that can in selected cases shorten the diagnostic process and avoid methods that are expensive or lead to complications such as transpulmonary biopsy guided by computed tomography or mediastinoscopy.

Adult↗
PubMedDate not supplied

Localised obliterative bronchitis due to non-occupational mineral dust inhalation.

We present a 56-year-old woman with an infiltrate in the right middle lobe secondary to obstruction of the right middle lobe bronchus by extensive submucosal fibrosis. This unique stenotic lesion of a central bronchus was caused by a domestically acquired localised central obstructive bronchitis due to the inhalation of mixed dust fibers, in the absence of advanced silicosis. This complication is a rare presentation of the myriad of pulmonary diseases associated with mineral dust inhalation.

Air Pollution, Indoor↗
PubMed2003

The implication of background anthracosis in the development and progression of pulmonary adenocarcinoma.

In order to characterize the relationship between background anthracosis and pulmonary adenocarcinogenesis, surgically resected tissues of 66 cases of stage I pulmonary adenocarcinoma, 4 cm or less at their greatest dimension, were examined. These cases were diagnosed based on the classification of small-sized adenocarcinoma of the lung (Noguchi et al., Cancer 75, 1995). Thirteen cases were diagnosed as types A (localized bronchioloalveolar adenocarcinoma, LBAC) and B (LBAC with alveolar collapse), 40 cases as type C (LBAC with a focus of fibroblastic proliferation), 8 as type D (poorly differentiated adenocarcinoma) and 5 as types E (bronchial gland type adenocarcinoma) and F (true papillary adenocarcinoma). The 5-year survival rate of types A and B cases was 100%, while those of type C, type D and types E and F were 52%, 48% and 39%, respectively. Nuclear accumulation of abnormal p53 protein in non-replacement type adenocarcinomas (types D, E and F) was detected more frequently than that in replacement type adenocarcinomas (types A, B and C) (P < 0.05). In each case, black dusty material was extracted from tumorous lesions and non-tumorous regions and blotted onto a nitrocellulose membrane. The anthracotic index (AI) was calculated with a densitometer. AIs of non-tumorous regions in early and replacement type adenocarcinomas (types A and B) were significantly less than in relatively advanced (type C) and poorly differentiated (type D) adenocarcinomas (P < 0.05). These results indicated that adenocarcinoma developing in heavily anthracotic lungs readily progresses to an advanced stage, or that adenocarcinoma with a less favorable prognosis tends to develop in severely anthracotic lungs.

Adenocarcinoma↗
PubMed2003

Genes and risk.

Explore the source record for details and available documents.

Anthracosilicosis↗
PubMed1978

Bronchopulmonary infection due to Branhamella catarrhalis: 11 cases assessed by transtracheal puncture.

Transtracheal punctures were performed in 193 miners of anthracosilicotic coal who presented with an acute exacerbation of chronic bronchitis. The transtracheal aspirates were bacteriologically positive in 104 patients. Branhamella catarrhalis was isolated in 15 patients; 10 of these responded to chemotherapy, as shown by the resolution of all symptoms and the disappearance of the organism on a repeat transtracheal puncture performed 48 hours after the end of treatment. One ampicillin-treated patient, whose bronchial secretions yielded a beta-lactamase-producing B catarrhalis, showed no improvement. But subsequent treatment with cefuroxime was followed by clinical and bacteriological recovery. B catarrhalis probably acted as an opportunistic respiratory pathogen in these patients, who were probably compromised hosts in view of their clinical history. B catarrhalis normally responds to the penicillins commonly used for respiratory infections, but if treatment fails a transtracheal puncture is essential to identify the strain and determine an appropriate antibiotic.

Ampicillin↗
PubMed1970

Cholelithiasis in Singapore. I. A necropsy study.

The present necropsy study shows an oriental pattern of gallstone disease in Singapore, namely, a relatively low overall frequency, an equal involvement of both sexes, a high proportion of pigment stones, and the common occurrence of choledocholithiasis associated with pyogenic cholangitis. There is a close association between opium addiction and cholelithiasis in the adult male Chinese in Singapore, and the long-term abuse of opium may be an important aetiological factor in the pathogenesis of oriental cholelithiasis.

Adult↗
PubMed1991

Occupational health and safety regulation in the coal mining industry: public health at the workplace.

The strategy for preventing occupational disease and injury in the coal mining industry employs several elements. Standards are set and enforced; technical assistance, research, and development are provided; and surveillance is conducted. Compensation for black lung is a vivid reminder of the consequences of failure to prevent disease. And, workers are represented by a union that encourages active participation in all aspects of this strategy. There are significant problems in each of these elements. Regulatory reform threatens to weaken many standards, there is a decline in government research budgets, surveillance is not well monitored, and compensation for black lung is significantly more difficult to obtain now than in the past. Moreover, the conservative governments of the past decade are not friendly towards unions. Nevertheless, the fundamental structure of disease and injury prevention remains intact and, more importantly, it has a historical record of success. The Mine Safety and Health Act provided for a wide array of basic public health measures to prevent occupational disease and injury in the mining industry. These measures have been effective in reducing both risk of fatal injury and exposure to respirable coal mine dust. They are also associated with temporary declines in productivity. In recent years, however, productivity has increased, while risk of fatal injury and exposure to respirable dust have declined. At individual mines, productivity with longwall mining methods appear to be associated with increases in exposure to respirable dust. These trends are not inconsistent with similar trends following implementation of regulations by OSHA. When OSHA promulgated regulations to control exposure to vinyl chloride monomer, enforcement of the standard promoted significant efficiencies in vinyl chloride production (5). Similarly, when OSHA promulgated its standard regulating exposure to cotton dust, this effort provoked modernization in the cotton textile industry (14). It is not inevitable that occupational health and safety regulations are associated with negative economic performance. On the contrary, in some instances, public health on the job and productivity are complementary.

Accidents, Occupational↗
PubMed1982

Electron microscopic investigations on dust penetration into the pulmonary interstitium in experimental pneumoconioses.

Pneumoconioses produced by intratracheal applications of various dusts (quartz, coal, cadmium and lead sulfide) in rats were investigated by electron microscopy in order to follow the pathway of the dust particles from the alveoli into the pulmonary interstitium. As postulated by Spencer in 1977 on the basis of light microscopic investigations, the dust particles produce necroses of the alveolar septae ('alveolar ulcers'). TWo forms of necroses appear to occur: with a less severe dust exposure, individual pneumocytes and their basement membrane are destroyed by dust particles. Dust-laden, macrophages are deposited here which are displaced into the stroma after re-epithelization of the alveolar defect. On the other hand, with massive dust exposure, almost all pneumocytes of the affected alveoli become necrotic. The affected alveoli collapse and are replaced by connective tissue, so that the dust is situated in the connective tissue stroma. A transcellular penetration of the dust particles into the pulmonary interstitium or an immigration of dust-laden macrophages into the pulmonary stroma through the intercellular junctions of intact pneumocytes was not observed in any of the pneumoconiosis models.

Animals↗
PubMed1997

Pulmonary endocrine cells in anthracosilicotic lungs.

It has been suggested by some studies of human and animal lungs that the products of pulmonary endocrine cells, particularly gastrin-releasing peptide, might play a role in fibrogenesis, but more recent detailed studies of fibrotic human lungs have failed to confirm this. We have made a detailed quantitative examination of a series of fibrotic human lungs to see if we could determine whether there was any relationship between endocrine cells and fibrosis. Using immunocytochemistry, we investigated the morphology, content, distribution and number of pulmonary endocrine cells in 15 pairs of fibrotic lungs from coal miners, and compared their features with those of equivalent cells in age-matched controls. Proliferation of endocrine cells was seen in the lungs of just two miners, in which it was focal and associated with acute bronchitis and bronchopneumonia. There was no difference between the miners and controls in the appearance (mostly solitary cells), content (predominantly gastrin-releasing peptide and calcitonin), distribution (mainly in small bronchi and bronchioles), or number (4.5 vs 4.1 cells per 10,000 epithelial cells, respectively) of endocrine cells. It seems unlikely that the substances secreted by these cells play any role in stimulating fibrosis in human lungs, but rather that they have a function in the inflammatory response to pulmonary injury.

Aged↗
PubMed1979

Occupational safety and health implications of increased coal utilization.

An area of major concern in considering increased coal production and utilization is the health and safety of increased numbers of workers who mine, process, or utilize coal. Hazards related to mining activities in the past have been especially serious, resulting in many mine related accidental deaths, disabling injuries, and disability and death from chronic lung disease. Underground coal mines are clearly less safe than surface mines. Over one-third of currently employed underground miners experience chronic lung disease. Other stresses include noise and extremes of heat and cold. Newly emphasized technologies of the use of diesel powered mining equipment and the use of longwall mining techniques may be associated with serious health effects. Workers at coal-fired power plants are also potentially at risk of occupational diseases. Occupational safety and health aspects of coal mining are understood well enough today to justify implementing necessary and technically feasible and available control measures to minimize potential problems associated with increased coal production and use in the future. Increased emphasis on safety and health training for inexperienced coal miners expected to enter the work force is clearly needed. The recently enacted Federal Mine Safety and Health Act of 1977 will provide impetus for increased control over hazards in coal mining.

Anthracosilicosis↗