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At least 1,045 records · Page 58Linked to original sources
PubMed1980

Assessment of past asbestos exposure in patients: occupational questionnaire versus monitoring in broncho-alveolar lavage.

Two different methods have been tested for assessing retrospectively occupational exposure to asbestos dust in 80 cases with suspected asbestos-related thoracic diseases: 1) Occupational history was recorded by an interviewer using a standardized questionnaire. The patients were divided into three groups: those obviously exposed (E), those obviously not exposed (NE) and those with an inconclusive questionnaire (IQ). 2) Ferruginous bodies were isolated from lung washing fluid and counted under the light microscope. In the questionnaire groups, the proportions positive for ferruginous bodies in lung washing fluid were as follows: E, 29/33; NE, 1/7; IQ, 17/40. In cases positive for ferruginous bodies in lung washing fluid, the median numbers of bodies per ml of fluid were: E, 11.7 (range, 0.05-31,250); NE, 0.06; IQ, 1.1 (range, 0.06-350) Since the data provided by the two methods were in good agreement (P less than 0.001) for the E and NE questionnaire groups, the presence of ferruginous bodies in lung washing fluid is considered to be a good indicator of past exposure. In the IQ group, the monitoring of ferruginous bodies in lung washing fluid demonstrated exposure to asbestos in 43% of cases.

Asbestos↗
PubMed1995

Carpal tunnel syndrome. MR imaging diagnosis.

Carpal tunnel syndrome is a common condition that is often diagnosed by careful history and physical examination. Symptoms from cervical disc disease, thoracic outlet syndrome, and more proximal entrapment syndromes of the median nerve may be confused clinically with carpal tunnel syndrome. Incision of the flexor retinaculum in these patients will not relieve the symptoms, because the locus of the entrapment is not in the carpal tunnel. Electrophysiologic studies are invasive, painful, and may be equivocal on occasion. Furthermore, they provide little information into the cause of carpal tunnel syndrome. MR imaging is the best modality to image the carpal tunnel. It can define the locus of entrapment to the carpal tunnel. Findings includes swelling of the median nerve just proximal to the carpal tunnel, flattening of the nerve within the carpal tunnel, bowing of the flexor retinaculum, and increased signal intensity of the median nerve. Etiologic findings can differentiate space occupying lesions from diffuse inflammatory causes, and this may aid in management. Also, the signal characteristics of soft-tissue masses may be diagnostic. Knowledge of the course of the median nerve may be helpful when planning corticosteroid injection or surgery, especially with the endoscopic technique. MR imaging also may serve a role in postoperative evaluation of patients with recurrent symptoms by demonstrating an incomplete release of the flexor retinaculum or healing of an incised retinaculum. These unique abilities of MR imaging makes it a useful diagnostic tool not only for the initial evaluation and management but also in the postoperative evaluation of patients with carpal tunnel syndrome.

Carpal Tunnel Syndrome↗
PubMed1995

[Rare manifestation of actinomycosis as retroperitoneal space-occupying lesion].

Actinomycosis has to be included in the differential diagnosis of retroperitoneal masses especially when surrounding tissue is infiltrated. We present a 40 year old male patient with the rare manifestation of retroperitoneal actinomycosis. The definitive treatment consisted of surgical drainage and long-term penicillin therapy resulting in complete healing. Special features in clinical symptomatology and problems concerning diagnosis of actinomycosis are discussed.

Abscess↗
PubMed1995

[Computerized tomography of the thorax and abdomen. Cost-effectiveness].

This work was aimed at investigating the cost-effectiveness of body CT, toward better equipment allocation in a given area. CT economics were calculated taking into account four main parameters: equipment, drugs, sanitary material and personnel. The biological cost in terms of radiation exposure was calculated on the effective dose. Quality was evaluated by comparing it with that of our standard examinations and on the basis of the diagnostic yield according to the index of radiological diagnoses by the American College of Radiology (ACR). The economic cost of chest CT was It. L. 257,240, that of abdominal CT was It. L. 365,000 and that of both regions It. L. 464,620. The effective dose was relatively high, i.e., 15.2 mSV for chest CT, 18.65 mSV in men and 27.46 mSV in women for abdominal CT and finally 27.38 mSV in men and 33.59 in women for chest-abdominal CT. The coded diagnoses were positive in approximately 60% of the cases examined consecutively; positivity was related to clinically relevant conditions in most of the cases. The economics and the biological cost of body CT exams were closely related to exam quality, whose standard was high. The high rate of positive findings and the clinical relevance of the condition make an indirect indicator of high quality and of accurate patients selection. To conclude, the allocation of CT equipment in a given area should be preceded by a careful cost-effectiveness analysis, considering optimized equipment use as related to local clinical needs.

Abdominal Neoplasms↗
PubMed1995

Radiographic changes following radiotherapy in the patients with lung cancer. Is the irradiated area of the mediastinum in the simulation film a significant factor?

BACKGROUND: Radiation induced lung injury is an ominous adverse reaction in the management of thoracic disease by radiation therapy. Although the importance of the area of irradiated lung is well known, the irradiated area of mediastinum is little to be considered in the routine treatment. PURPOSE: To evaluate the significance of the irradiated area of the mediastinum in the simulation film for radiation induced lung injury. PATIENTS AND METHODS: A total of 208 patients with primary lung cancer treated with radiation therapy were analyzed for incidence of radiation induced lung injury. Lung injury was defined as the appearance of an abnormal shadow on the chest radiograph. CT images were used to differentiate recurrence or other conditions. Age, sex, irradiation dose, irradiated lung area, T and N factors of the tumor, irradiated mediastinum area, performance status of patients, location of irradiated fields and use of chemotherapy were analyzed with Cox's multivariate regression model. RESULTS: The cumulative rate of radiation induced lung injury at 12 months was 85%. Significant factor of radiation induced lung injury was irradiated area of the mediastinum (p = 0.03). Irradiated area of the lung (p = 0.18, n.s.), total tumor dose (p = 0.1, n.s.), use of chemotherapy (p = 0.08, n.s.) and location of irradiated field (p = 0.08, n.s.) may also have an effect on radiation induced lung injury. CONCLUSION: The irradiated area of the mediastinum is one of the significant factors in radiation induced lung injury.

Adult↗
PubMed1995

Videoendoscopic procedures in thoracic surgery: technical aspects and report of removal of a mediastinal cyst.

Current videoendoscopic technology and percutaneous techniques of exposure and dissection have been successfully applied to abdominal surgery with favorable results. Application of this technology to our practice of thoracic surgery is the basis of this report. Video-assisted thoracic surgery was performed in 36 patients for the following indications: Raynaud's syndrome, undefined pulmonary nodule, persisting spontaneous pneumothorax, T1 bronchial carcinoma, and mediastinal cyst. Videoendoscopic surgical procedures were accomplished using double-lumen endotracheal anaesthesia and a percutaneous stapling device. Procedures performed using this technique include thoracic sympathectomy, wedge or keel excision, blebectomy, lung apex stapling, parietal pleurectomy, and dissection of the mediastinal cyst. Median operating time was 45 min (range, 15 to 90 min). Tissue diagnosis was obtained in all patients. Median diameter of excised nodules was 10 mm (range, 7 to 70 mm). There were no operative deaths. The single complication was a prolonged air leak. This new method of thoracic surgery appears to benefit the patients. For us it proved a secure way to perform thoracic surgery. Our case of removal of a benign cyst in the posterior mediastinum shows that video-assisted thoracic surgery has expanding applications in the field of general thoracic surgery.

Adult↗
PubMed1994

[Hemoptysis: main etiologies observed in a pneumology department in Africa].

The aim of this work was to ascertain the main aetiologies of haemoptysis observed in the pneumo-phtisiology unit at the University Hospital of Treichville at Abidjan, Ivory Coast. A retrospective survey covering 5 years revealed 142 cases. The annual incidence of haemoptysis was 2.5% of the unit's admissions. The mean age of the patients was 33.2 years and 56.3% were at least 41 years of age. Men were predominate (72.5%). The haemoptysis was a sign of thoracic disease in 66.9% of the cases. The chest X-ray was judged abnormal in all the cases and suggested the aetiology in 87.3%. The main aetiologies were pulmonary tuberculosis (49.3%) and acute pneumopathy (with or without abscess) (13.3%). Other causes included bronchectasis (11.2%) and pulmonary aspergilloma (7.7%), followed by bronchogenic cancer (4.2%). The results of this study indicated that tuberculosis remains one of the main causes of haemoptysis at Abidjan.

Adult↗