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PubMed2004

Diagnostic ultrasonography in cattle with thoracic disease.

The pleura and lungs were evaluated by means of sonography in 55 bovine patients with diseases of the thoracic cavity. For these ultrasound examinations, a range of transducers was used. As the lung surface was most often involved in cases of pulmonary disease, it was possible to detect ultrasonographically bronchopneumonia, consolidation, pleural effusion, pulmonary emphysema and pleuritis. Determination of the amount of lung tissue affected provided prognostic information. It was not possible to visualise lesions located deeper within the lungs where peripheral tissue was not affected. A diagnosis of thoracic disease was made on the basis of clinical and ultrasonographic findings and confirmed in 33 cases at necropsy.

Animals↗
PubMed1978

Thoracoscopy: a useful tool in the diagnosis of thoracic disease.

During a 12-month period, 11 patients underwent diagnostic thoracoscopy for previously undiagnosed thoracic disease. In all patients, the diagnosis had been unobtainable by the usual diagnostic modalities of bronchoscopy, scalene node biopsy, mediastinoscopy, thoracentesis, or closed pleural biopsy. Thoracoscopy was diagnostic in 10 of the 11 patients. There was no morbidity or mortality. In all patients the indication for thoracoscopy was suspected malignancy. The majority of patients had recurrent pleural effusions in which routine cytological studies and tissue biopsies had been nondiagnostic. Pathological findings were mesothelioma in 3 patients, primary carcinoma of the lung in 4, congestive heart failure with pleural effusion in 1, metastatic carcinoma in 2, and inflammatory disease in 1 patient. Indications, techniques, and results are discussed. Thoracoscopy is a valuable tool in the diagnosis of thoracic disease; with it, unneccessary thoracotomy can often be avoided.

Aged↗
PubMed2006

Can selective CT angiography reduce the incidence of severe complications during transcatheter arterial embolization or infusion chemotherapy for thoracic diseases?

PURPOSE: To evaluate the usefulness of selective computed tomography (CT) angiography in preventing severe complications, such as spinal cord injury and broncho- esophageal fistula, during the transcatheter arterial embolization or infusion chemotherapy for thoracic diseases. MATERIALS AND METHODS: Data from 28 patients with thoracic diseases were retrospectively analyzed in terms of selective CT angiography procedures carried out before transcatheter arterial embolization or transcatheter arterial infusion chemotherapy. RESULTS: There were no spinal cord injuries (0/13 and 0/15) or broncho-esophageal fistula developments (0/13 and 0/15) during transcatheter arterial embolization and transcatheter arterial infusion chemotherapy, respectively. CONCLUSION: We conclude that selective CT angiography is potentially useful for reducing the incidence of severe complications during transcatheter arterial embolization or infusion chemotherapy for thoracic diseases.

Adult↗
PubMed2004

Three-dimensional imaging of thoracic diseases with multi-detector row CT.

The benefits of multi-detector row CT (MDCT) relative to single-detector row helical CT are considerable. Multi-detector row CT allows shorter acquisition times, greater coverage, and superior image resolution. These factors substantially increase the diagnostic accuracy of the examination. Three-dimensional (3D) volume data from MDCT provides various unique applications on thoracic diseases. These includes isotropic viewings, use of multiplanar reformation (MPR), maximum and minimum intensity projections (MIP and minIP), and volume rendering performed from external and internal perspectives allowing the user to "fly around" and "fly through" the structures. Recent advances in 3D volume rendering put real-time, interactive virtual reality guidance of the procedures such as bronchoscopy and surgery into practice.

Cardiovascular Diseases↗
PubMed2000

Endoscopic approaches to metastatic thoracic disease.

Traditional approaches to thoracic metastases and spinal cord compression have been well worked out and validated in the literature. Anterior decompression is clearly superior to laminectomy; vertebrectomy and reconstruction are indicated for sagittal collapse, instability, and pain; and surgical decompression is necessary in cases of bony impingement. The role of endoscopic and minimally invasive techniques in treatment of metastatic disease is evolving. Dr. Lieberman advocates the use of thoracoscopic anterior approaches as the principal application in these patients, whereas Dr. McLain has found that endoscopic assistance has vastly improved his results with posterolateral decompression. The two authors weigh the relative advantages and disadvantages of these approaches for the selected patient with metastatic thoracic disease.

Decompression, Surgical↗
PubMed2000

Controversy: endoscopic approaches to metastatic thoracic disease

Traditional approaches to thoracic metastases and spinal cord compression have been well worked out and validated in the literature. Anterior decompression is clearly superior to laminectomy; vertebrectomy and reconstruction are indicated for sagittal collapse, instability, and pain; and surgical decompression is necessary in cases of bony impingement. The role of endoscopic and minimally invasive techniques in treatment of metastatic disease is evolving. Dr. Lieberman advocates the use of thoracoscopic anterior approaches as the principal application in these patients, whereas Dr. McLain has found that endoscopic assistance has vastly improved his results with posterolateral decompression. The two authors weigh the relative advantages and disadvantages of these approaches for the selected patient with metastatic thoracic disease.

Journal Article↗
PubMed2004

[Usefulness of low-dose single-slice CT (SSCT) for mass screening to detect various thoracic diseases including lung cancer].

This study assessed the usefulness of SSCT for mass screening retrospectively in 8885 subjects (6781 men, 2104 women) who had received mass screening to detect thoracic disease by using SSCT from 1999 to 2003. In the 8885, 119 (1.3%) lesions were detected as active thoracic disease. These 119 lesions comprised 39 neoplasms and 80 instances of non-neoplastic disease. Of those with neoplastic lesions, 25 had lung cancer (adenocarcinomas, 20; Squamous, 3; carcinoids, 2), 7 had mediastinal tumors and 7, others. Non-neoplastic cases comprised 39 of COPD (pulmonary emphysema), 17 of pulmonary tuberculosis, 8 of non-tuberculous mycobacteriosis and 16 others. Surgical treatment was performed in 46 cases: 25 of lung cancer, 14 of non-cancerous neoplasms, 3 of pulmonary sequestration and 4 others. In the lung cancer cases, the post-surgical staging was I or II (stage I, 20; stage II, 5). Low-attenuation areas (LAA) were seen on multiple CT slices in 2.2% of all subjects (195). These 195 cases had no respiratory symptoms such as exertional dyspnea, But 39 of them had an FEV1.0% (FEV1.0/FVC) of less than 70%. All 39 had a history of smoking, We suggested that SSCT screening is a useful method of mass screening to detect thoracic neoplastic lesions as well as non-neoplastic lesions.

Adult↗
PubMed1994

Extrapulmonary thoracic disease caused by Blastomyces dermatitidis.

A case of blastomycosis is reported involving the mediastinum and compromising the plexus brachialis. The pathology, pathophysiology, and treatment of this patient and of a previously reported patient are discussed and compared with the characteristics of extrapulmonary thoracic disease caused by histoplasmosis. Because of the favorable response of these patients to prolonged antifungal therapy, blastomycosis should be considered in the differential diagnosis of invasive extrapulmonary thoracic disease.

Adult↗
PubMed2005

Mechanisms of improvement of respiratory failure in patients with restrictive thoracic disease treated with non-invasive ventilation.

BACKGROUND: Nocturnal non-invasive ventilation (NIV) is an effective treatment for hypercapnic respiratory failure in patients with restrictive thoracic disease. We hypothesised that NIV may reverse respiratory failure by increasing the ventilatory response to carbon dioxide, reducing inspiratory muscle fatigue, or enhancing pulmonary mechanics. METHODS: Twenty patients with restrictive disease were studied at baseline (D0) and at 5-8 days (D5) and 3 months (3M). RESULTS: Mean (SD) daytime arterial carbon dioxide tension (Paco(2)) was reduced from 7.1 (0.9) kPa to 6.6 (0.8) kPa at D5 and 6.3 (0.9) kPa at 3M (p = 0.004), with the mean (SD) hypercapnic ventilatory response increasing from 2.8 (2.3) l/min/kPa to 3.6 (2.4) l/min/kPa at D5 and 4.3 (3.3) l/min/kPa at 3M (p = 0.044). No increase was observed in measures of inspiratory muscle strength including twitch transdiaphragmatic pressure, nor in lung function or respiratory system compliance. CONCLUSIONS: These findings suggest that increased ventilatory response to carbon dioxide is the principal mechanism underlying the long term improvement in gas exchange following NIV in patients with restrictive thoracic disease. Increases in respiratory muscle strength (sniff oesophageal pressure and sniff nasal pressure) correlated with reductions in the Epworth sleepiness score, possibly indicating an increase in the ability of patients to activate inspiratory muscles rather than an improvement in contractility.

Carbon Dioxide↗
PubMed1993

[New diagnostic possibilities in roentgen diagnosis of thoracic diseases].

New feasibilities of procedure for the assessment of chest X-rays. Chest X-rays of 2800 patients were performed in order to establish a standardized procedure of optimized findings for chest X-ray evaluation. The out and in-patients consisted of men and women ranging from 17 to 89 years of age, and they suffered from diseases of all thoracic organs, from traumata, postoperative situations, and they had implantations. All visual comprehensive abnormalities observed on the X-rays were registered without any interpretation. These detail findings were gradually more and more classified and respectively sublimated to a descriptive minimum. In this way 22 detail findings of description and their differentiations as well as characterizations could be determined which were localized in 6 regions of descriptions. For the first time the region of description foreign objects was created. In consideration of pathophysiological mechanisms and clinical data the diagnosis of diseases of the chest can be found out, and even as an objective and suitable way for data-processing. Particularly control examinations and interindividual comparisons of findings can be evaluated without any doubt.

Adolescent↗
PubMed1992

Efficacy of nocturnal nasal ventilation in patients with restrictive thoracic disease.

We tested the efficacy of nocturnal nasal ventilation (NNV) using the BIPAP ventilator in patients with restrictive thoracic diseases by withdrawing them from NNV for an average of 1 wk. One male and five female patients were enrolled in the study; four with restrictive chest wall diseases, and two with muscular dystrophies. All patients had chronic CO2 retention (PaCO2 greater than 50 mm Hg) and had been improved by using NNV for at least 2 months before the study. Four patients were switched to the BIPAP ventilator from standard portable volume ventilators at least 1 month prior to the study without changes in gas exchange or symptoms. After withdrawal of NNV, patients had no deterioration in daytime vital signs, pulmonary functions, maximal inspiratory or expiratory pressures, or arterial blood gases compared with measures made immediately before withdrawal and 1 wk after resumption. However, patients had more dyspnea at rest, increased daytime somnolence, more morning headaches, less daytime energy, and felt less rested in the morning during withdrawal of NNV. Furthermore, nocturnal monitoring demonstrated greater tachycardia, tachypnea, oxygen desaturation, and hypoventilation during withdrawal of NNV. We conclude that NNV administered by the BIPAP ventilator is effective in ameliorating nocturnal hypoventilation and daytime symptoms in patients with chronic CO2 retention caused by severe restrictive thoracic diseases. These data also suggest that the efficacy of NNV may depend more on amelioration of nocturnal hypoventilation than on resting of ventilatory muscles.

Adult↗
PubMed2001

[Optimal screening tool for thoracic diseases: chest X ray or CT?].

There are good reasons to believe that screening of lung parenchymal diseases by CT is superior to chest radiographs. Nevertheless, conventional chest radiography often remains the first examination performed for evaluation of thoracic diseases and, irrespective of clinical indication, it plays an important role in screening procedures. The interpretation methodology of a chest radiograph in a screening condition is reviewed. Specific attention to poor detectability zones is emphasized and a check-list is proposed, mainly to reduce the risk of overlooking lesions. Techniques, indications and respective diagnostic values for both chest radiography and CT scan are analyzed and applied to the screening of lung cancer, asbestos exposure and tuberculosis.

Humans↗
PubMed1993

[The importance of CT-guided needle biopsy in the diagnosis of thoracic diseases].

In the report on 35 CT-guided fine needle transthoracic biopsies the authors show the relevance of invasive radiological methods in tumor diagnostics. The results are compared with those published in the literature. CT-guided transthoracic biopsy is of crucial importance in final diagnosis of certain thoracic diseases.

Biopsy, Needle↗