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PubMedDate not supplied

Abdominal manifestations of sarcoidosis in CT studies.

OBJECTIVE: The purpose of this study is to demonstrate the spectrum of abdominal CT findings in patients with tissue proved sarcoidosis, estimate their prevalence, and correlate abdominal findings with stage of thoracic disease. MATERIALS AND METHODS: Between 1987 and 1993, 140 patients with tissue proved sarcoidosis underwent abdominal or chest CT at our institution. After exclusions, 49 patients remained. Abdominal CT was retrospectively reviewed and the findings arrived at by consensus. Chest radiography within 1 month of CT was available for 46 patients. Chest radiography was retrospectively reviewed and stage of thoracic disease arrived at by consensus. RESULTS: Splenic abnormalities consisted of splenomegaly, low density lesions, and punctate calcifications. Hepatic sarcoidosis manifested as hypovascular lesions, hepatomegaly, and punctate calcifications. Lymphatic abnormalities consisted of lymphadenopathy, most commonly between 1 and 2 cm, and an increased number of normal sized lymph nodes. CONCLUSION: Sarcoidosis produces splenic abnormalities in 53% of patients, liver abnormalities in 16%, and lymphatic findings in 43%. No correlation was demonstrated between the abdominal findings and stage of thoracic sarcoidosis.

Female↗
PubMed1991

[Using two monoclonal antibodies to detect lung carcinoma associated antigen in the sera of patients with lung cancer by BA-ELISA].

In this study two McAbs (LC86aE4 and LC86aC5) were chosen to detect circulating lung carcinoma associated antigen (LAA) in serum samples from 58 patients with lung cancer, 29 patients with nonmalignant thoracic diseases and 30 healthy donors by biotin-avidin (BA)-ELISA. Our data indicate that BA-ELISA was specific, sensitive, reproducible and simple. The rates of positive detection of LAAE4 or LAAC5 alone were found to be higher (44.8% and 48.3% respectively) in patients with lung cancer than in those with nonmalignant thoracic diseases (13.7%) and in normal donors (6.7%) (P less than 0.01). Furthermore, the combined detection of LAAE4 and LAAC5 resulted in a higher positive rate (62.3%) in lung cancer patients. The clinical application of these McAbs and the assay in the diagnosis of lung cancer is discussed.

Adenocarcinoma↗
PubMed1991

[Detection and characterization of antigen component of circulating immune complex in sera from patients with lung cancer by monoclonal and polyclonal antibodies].

A total of 117 serum samples from 58 patients with lung cancer, 29 patients with nonmalignant thoracic diseases and 30 healthy donors were tested and analyzed for antigen component in CIC with 5 McAbs and PcAb by Sandwich-ELISA. The results indicated that McAbs were reactive with lung cancer associated CIC (positive rates ranging from 20-32%), while PcAbs were reactive with CIC both from lung cancer patients and from those with non-malignant thoracic diseases (positive rates 45.7% and 41.4% respectively). A combined set using a panel of McAbs to detect CIC will give a higher positive rate (49.2%) than using a single McAb. We anticipate that the McAb-ELISA established in this study to detect antigen-specific CIC will be helpful in the clinical diagnosis and prognosis of lung cancer.

Adenocarcinoma↗
PubMed2001

A single-trocar technique for minimally-invasive surgery of the chest.

BACKGROUND: In thoracic surgery, the classic thoracoscope is used to perform simple maneuvers in the chest. We have devised a minimally invasive technique that requires only a single trocar. This technique is used in our department to diagnose and treat a wide range of thoracic pathologies. METHODS: Between October 1998 and August 1999, 37 patients underwent surgery prospectively for a thoracic disease through a single trocar. There were 19 men and 18 women with a mean age of 60 years (range, 40-85). The trocar was flexible or soft and had a diameter of 15-20 mm. A 2-cm skin incision was made in the planned intercostal space. The chest drain was always inserted under video control. RESULTS: The mean operative time was 53 +/- 5 min. One patient developed intraoperative bleeding that required intubation and a 5-cm mini-thoracotomy. In one patient with stage II empyema, it was necessary to insert another trocar. Chest tubes were removed after 77.7 +/- 7 h. Hospital stay was 4 +/- 1 days (range, 2-14). Histologic examination revealed malignant disease in 26 cases and benign disease in 11. Two patients (5.4%) developed wound infections. None of the patients had port site metastasis. There were no hospital deaths. CONCLUSION: Because of its simplicity, we recommend the use of this mini-invasive technique in place of the classic thoracoscope or video-mediastinoscope.

Adult↗
PubMed1994

[The status of surgical thoracoscopy in thoracic surgery].

Video-assisted thoracoscopic surgery is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of benign thoracic diseases. However the loss of palpation as well as the insufficiency of complete mediastinal lymphadenectomy are responsible for the uncertainty of the new method concerning curative oncological therapy. During the last two years we could replace thoracotomy by operative thoracoscopy in nearly all cases of recurrent pneumothorax and recurring pleural effusion. In a series of 447 endoscopic operations in 350 patients following distinct indications and strong prerequisites in terms of operating team and infrastructure of our department we could establish a high standard for this new operating method. The good postoperative results of this large series of thoracoscopic operations indicate the high rank of this new technique in thoracic surgery. Recurrence rates of 1.5% for pneumothorax surgery and 0 for pleurectomy for malignant pleural effusion can be compared to those in open thoracic surgery. Six weeks after the operation the postoperative lung function was normal in 80% of an initial group of patients.

Humans↗
PubMed1994

[Self-made fibrin sealant administered in thoracic surgery].

From April 1990 to May 1993, 15 patients with thoracic complication or thoracic diseases have been treated with self-made fibrin sealant. All patients have been cured successfully in a short time without thoracotomy. The methods of its make-up, administer and assessment were discussed. It is economical and effective. The major advantage is simple method and easily administered. It could be used in other surgery.

Adult↗
PubMed1999

[Surgical video-thoracoscopy].

Surgical video thoracoscopy represents a new surgical approach to thoracic disease. Its objective is to limit thoracotomy trauma to the pleural wall and at the same time to eliminate the consequences of post-thoracotomy pain and post-operative respiratory dysfunction. There are certain indications which are already accepted as the gold standard, others still require validation and the inverse that certain interventions will probably be excluded from the domain of video thoracoscopy with acquired experience. The best indications are: the treatment of spontaneous pneumothorax in a young person, lung biopsy, the excision of peripheral parenchymal nodules of uncertain aetiology, the diagnostic approach to mediastinal adenopathy notably nodes which are inferiorly situated and inaccessible to mediastinoscopy or anterior mediastinotomy, the debridement of purulent pleurisy and/or haemothorax, the initial exploration before thoracotomy of a pulmonary tumour accompanied by a pleural effusion which may be minimal or irregularities of the parietal pleura, a thoracic sympathectomy, pleural symphysis for pleural tumour pathology, the pleuropericardial fenestration in cases of double pathology, pleural and pericardial requiring both a diagnostic approach and symphysis.

Humans↗
PubMed1986

Magnetic resonance imaging of the pediatric thorax: initial experience.

Magnetic resonance imaging (MRI) is particularly useful in the pediatric patient. No ionizing radiation is used; there are no complicating side effects; the technique is noninvasive and painless. We reviewed our experience using a 0.15 T. resistive imager for diagnostic MRI of the pediatric thorax. We studied 16 children, aged 8 days to 16 years, with various thoracic diseases. Correlation of the MRI findings with computerized tomography (CT) was obtained in 10 children and with the surgical findings in 8. Spatial resolution was slightly less with MRI than with CT. Medium and large vessels are well seen without contrast medium injection. Tissue characterization with MRI is superior to CT and the normal thymus is well seen. The long scanning time can be a problem in young children but can be overcome using intramuscular sedation. Cardiac gated imaging was successfully tested.

Adolescent↗
PubMed2005

[Eighty cases of chronic respiratory failure treated with home noninvasive positive pressure ventilation].

We studied the clinical features and efficacy of home noninvasive positive pressure ventilation (NPPV) therapy in 80 patients to ascertain its indications and problems. The causes of chronic respiratory failure were restrictive thoracic diseases of post-tuberculosis sequelae (40 cases) and kyphoscoliosis (9 cases), COPD (8 cases), bronchiectasis (7 cases), and interstitial pneumonia (4 cases). One year survival rate of the patients with post-tuberculosis sequelae was 76% and most of the patients who started NPPV at their acute exacerbation died within several months. About half of the patients of COPD improved their quality of life (QOL) through NPPV. However, their survival rate 3 months later was only 69%. More than half of the patients with bronchiectasis felt that their QOL was improved by NPPV. Most of the patients with interstitial pneumonia died within 3 months indicating that NPPV is less useful for improving QOL of interstitial pneumonia PaCO2, after home NPPV, decreased significantly in the responder group (70.0 +/- 15.4 vs. 57.6 +/- 10.7[SD]Torr, p < 0.05), while PaCO2 in the non-responder group was unchanged (65.4 +/- 12.1 vs. 64.2 - 10.4 [SD] Torr). Body Mass Index (BMI) in the responder group tended to be higher than in the non-responder group. In conclusion, the restrictive thoracic diseases with post-tuberculosis sequelae and kyphoscoliosis are a good indication for NPPV and the therapy is also useful for patients with bronchiectasis who can dispose of their sputum by themselves. Home NPPV is suitable for patients whose PaCO2 decreases through NPPV and whose BMI is relatively high. QOL of interstitial pneumonia barely improves through NPPV, because interstitial pneumonia with hypercapnia is at the terminal stage.

Aged↗