Chest
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To identify serial changes in the appearances of the lungs on computed tomography (CT) in patients with established adult respiratory distress syndrome (ARDS). Second, to evaluate any relationship between the extent of morphologic abnormalities on CT anatomic and physiologic derangement using a numeric score of the severity of lung injury. ⋯ The CT appearances of patients with ARDS who survive are variable and relate to the pattern of disease in the acute phase. Furthermore, the extent of CT abnormalities correlates strongly with LIS in both the acute phase and at follow-up.
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Interstitial lung diseases often are accompanied by histopathologic evidence of alveolar type 2 cell alterations. In the alveolar milieu, the surfactant-specific protein A (SP-A) is a secretory product of alveolar type 2 cells. Therefore, we measured SP-A levels in bronchoalveolar lavage (BAL) fluids from patients with untreated sarcoidosis (n = 35) and hypersensitivity pneumonitis (HP [n = 10]) and compared the results with those from 21 healthy control subjects. ⋯ Mean SP-A in the control group was 4.0 micrograms/ml +/- 0.3 SEM. These results suggest that SP-A secretion is stimulated in sarcoidosis and HP. Further studies seem justified to investigate the role of the surfactant system in interstitial lung diseases as well as the potential clinical usefulness of SP-A measurements in BAL.
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The survival rate analysis of 130 patients with non-small-cell lung cancer who did not receive any specific anticancer therapy showed no statistically significant differences in the survival rates between various TNM combinations classified into stage groups II, IIIa, IIIb, and IV, as proposed by Mountain in 1989 and adopted by the American Joint Committee on Cancer. Following these findings, based on survival probabilities, two distinctive staging groups could be distinguished. The first stage group was composed of only the T1, 2N0, M0 combination, and the second of all other TNM combinations. In a purely biologic sense of tumor growth, the lymph node involvement appeared to be the crucial factor determining the length of survival.