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Purpose: Improved outcomes in lung cancer treatment are seen in high-volume academic centers, making it important to understand barriers to accessing care at such institutions. Few qualitative studies examine the barriers and facilitators to early-stage lung cancer care at US academic institutions. Methods: Adult patients with suspected or diagnosed early-stage non-small cell lung cancer presenting to a multidisciplinary lung cancer clinic at a US academic institution over a 6-month period beginning in 2019 were purposively sampled for semi-structured interviews. Semi-structured interviews were conducted and a qualitative content analysis was performed using the framework method. Themes relating to barriers and facilitators to lung cancer care were identified through iterative team-based coding. Results: The 26 participants had a mean age of 62 years (SD: 8.4 years) and were majority female (62%), white (77%), and urban (85%). We identified 6 major themes: trust with providers and health systems are valued by patients; financial toxicity negatively influenced the diagnostic and treatment experience; social constraints magnified other barriers; patient self-advocacy as a facilitator of care access; provider advocacy could overcome other barriers; care coordination and good communication were important to patients. Conclusions: We have identified several barriers and facilitators to lung cancer care at an academic center in the US. These factors need to be addressed to improve quality of care among lung cancer patients. Further work will examine our findings in a community setting to understand if our findings are generalizable to patients who do not access a tertiary cancer care center. [ABSTRACT FROM AUTHOR]

The article discusses the use of a new imaging technique, [68Ga] Ga-Trivehexin PET/CT, to detect a rare bronchial mucoepidermoid carcinoma. The study highlights the potential of this technique in diagnosing such tumors, which account for only 0.1-0.2% of all primary lung tumors. The research findings suggest that [68Ga] Ga-Trivehexin PET is a promising tool for identifying mucoepidermoid carcinoma, showcasing its efficacy in clinical practice. [Extracted from the article]

Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor. It is characterized by showing, on histopathological examination, clusters of vacuolated and clear tumor cells with epithelial differentiation surrounded by fibrocollagenous stroma and fibroblasts. The present study presents a rare clinical case of mandibular CCOC associated with an impacted tooth in a 26-year-old woman surgically treated with mandibulectomy and reconstruction with iliac crest bone graft. The patient has been followed up for 22 months without signs of recurrence. A search for case report/case series was carried out in the PUBMED database, as well as in the references of relevant previously published literature reviews. Ninety-six publications were identified, totaling 136 distinct cases reported. Female sex was the most affected (63.1%) with 63.3% of cases occurring in patients in the fifth, sixth, or seventh decades of life. The mandible was more affected than the maxilla (74.2%). Association of CCOC with impacted teeth was found in 2.4% of cases, thus rendering it a rare occurrence. The present case report corroborates the results of the survey regarding sex and anatomical location of the tumor; however, it contradicts the findings regarding age predilection. The case described is the fourth known occurrence of tooth impaction associated with the tumor and the first in a female. In conclusion, CCOC should be considered, as well as other malignancies, as a possible diagnosis of maxillary or mandibular intraosseous lesions even in unusual circumstances such as in association with impacted teeth and in young patients. [ABSTRACT FROM AUTHOR]

Immune control point (ICI) inhibitors represent a significant advance in the management and survival of cancers such as melanoma or non-small cell bronchial carcinoma. However, they induce unusual side effects, such as hypophysitis, which are rarely described elsewhere. This nationwide retrospective study describes the characteristics of hypophysitis reported in the French pharmacovigilance database (FPVD). We requested for all cases of ICI-related hypophysitis registered in the FPVD before May 2018. An endocrinologist and a pharmacologist reviewed all cases. About 94 pituitary cases were selected, involving 49 females and 45 men. Ipilimumab alone or in combination was the most represented ICI (56%). Most cases (61%) were grade 3 severity and the majority (90%) were corticotropic deficiency cases. Cases with thyroid and/or gonadotropic involvement were 21% and 1% respectively. Five patients (8%) had panhypopituitarism. Pituitary MRI, when performed, was in favor of hypophysitis in 50%. No patient recovered his previous hormonal function. The mean time of onset was significantly shorter with ipilimumab than other ICIs. ICI-related hypophysitis generate deficits that do not spontaneously recover, even at a distance from the event, unlike thyroiditis. Patients must then benefit from long-term coordinated onco-endocrinological management, adapted to their own specific deficits. [ABSTRACT FROM AUTHOR]

Objective: Pre-clinical studies with gallium-68 zoledronate ([68Ga]Ga-DOTAZOL) have proposed it to be a potent bisphosphonate for PET/CT diagnosis of bone diseases and diagnostic counterpart to [177Lu]Lu-DOTAZOL and [225Ac]Ac-DOTAZOL. This study aims to be the first human biodistribution and dosimetric analysis of [68Ga]Ga-DOTAZOL.Methods: Five metastatic skeletal disease patients (mean age: 72 years, M: F; 4:1) were injected with 150-190 MBq (4.05-5.14 mCi) of [68Ga]Ga-DOTAZOL i.v. Biodistribution of [68Ga]Ga-DOTAZOL was studied with PET/CT initial dynamic imaging for 30 min; list mode over abdomen (reconstructed as six images of 300 s) followed by static (skull to mid-thigh) imaging at 45 min and 2.5 h with Siemens Biograph 2 PET/CT camera. Also, blood samples (8 time points) and urine samples (2 time points) were collected over a period of 2.5 h. Total activity (MBq) in source organs was determined using interview fusion software (MEDISO Medical Imaging Systems, Budapest, Hungary). A blood-based method for bone marrow self-dose determination and a trapezoidal method for urinary bladder contents residence time calculation were used. OLINDA/EXM version 2.0 software (Hermes Medical Solutions, Stockholm, Sweden) was used to generate residence times for source organs, organ absorbed doses and effective doses.Results: High uptake in skeleton as target organ, kidneys and urinary bladder as organs of excretion and faint uptake in liver, spleen and salivary glands were seen. Qualitative and quantitative analysis supported fast blood clearance, high bone to soft tissue and lesion to normal bone uptake with [68Ga]Ga-DOTAZOL. Urinary bladder with the highest absorbed dose of 0.368 mSv/MBq presented the critical organ, followed by osteogenic cells, kidneys and red marrow receiving doses of 0.040, 0.031 and 0.027 mSv/MBq, respectively. The mean effective dose was found to be 0.0174 mSv/MBq which results in an effective dose of 2.61 mSv from 150 MBq.Conclusions: Biodistribution of [68Ga]Ga-DOTAZOL was comparable to [18F]NaF, [99mTc]Tc-MDP and [68Ga]Ga-PSMA-617. With proper hydration and diuresis to reduce urinary bladder and kidney absorbed doses, it has clear advantages over [18F]NaF owing to its onsite, low-cost production and theranostic potential of personalized dosimetry for treatment with [177Lu]Lu-DOTAZOL and [225Ac]Ac-DOTAZOL. [ABSTRACT FROM AUTHOR]

Introduction: Spinal bronchogenic cysts are rare findings, with only four cases of lumbar bronchogenic cysts reported in the literature. All of these bronchogenic cysts involved the conus medullaris. We present the first case of a lumbar bronchogenic cyst and arachnoid cyst arising from the cauda equina in a 68-year-old male. Uniquely, this bronchogenic cyst also contained components of an arachnoid cyst. Methods: Magnetic resonance imaging (MRI) demonstrated a compressive cystic lesion at the level of the L3 vertebra splaying the cauda equina. An L3/L4 laminectomy was performed with marsupialisation of the cyst. Results: Histological examination revealed pseudostratified ciliated columnar epithelium confirming the diagnosis of a bronchogenic cyst, as well as a pleated fibrovascular tissue lined by sparsely spaced small monomorphic arachnoidal cells, indicating an arachnoid cyst. Conclusion: We demonstrate that bronchogenic cysts can be successfully treated with marsupialisation. [ABSTRACT FROM AUTHOR]

The feasibility and effectiveness of transoral robotic surgery (TORS) in children with tongue base masses (TBMs) were evaluated. Eight pediatric patients who were treated with TORS for TBMs between January 2010 and January 2016 at a tertiary hospital included in the study. All pathologies were congenital lesions: four were lingual thyroglossal ductus cysts (LTGDCs), one was a minor salivary gland tumor, one was a vallecular cyst, one was a bronchogenic cyst, and one was an ectopic thyroid tissue. TORS was performed successfully in all cases. The mean robotic set-up and exposure time was 13.0 ± 2.1 min (range 10-16 min) and the mean robotic surgery time was 8.8 ± 6.9 min (range 4-25 min). Estimated blood loss was lower than 5 ml for one patient and lower than 50 ml for another one. The remaining patients' estimated blood loss was lower than 10 ml. No patient required tracheostomy intra- or post-operatively. Only one minor complication occurred on day 10 after surgery (minor bleeding), which was resolved without intervention. No major complications or recurrence were observed. Better visualization and small, flexible arms allow surgeons to treat TBM faster and easily using TORS. This leads to decreased morbidity compared to open and transoral endoscopic/microscopic surgical methods. In the future, we believe that TORS may become the gold standard method for the treatment of pediatric TBM with continued development of robotic technology. [ABSTRACT FROM AUTHOR]

Extralobar sequestrations constitute a rare form of congenital pulmonary airway malformations that are difficult to diagnose. Here, we report a rare case of a localized extralobar sequestration in the right superior portion of the mediastinum accompanied by congenital cystic adenomatoid malformation. A 19-year-old man presented with a right upper mediastinal mass that was detected using chest radiography, had a history of left spontaneous pneumothorax, and had undergone a bullectomy 4 years previously. The initial diagnosis included a mature teratoma and a bronchogenic cyst in the mediastinum; however, the presence of a cystic mass in the right upper lobe of the lung prompted further examination. A preoperative diagnosis of extralobular sequestration was finally determined using contrast-enhanced computed tomography. The aberrant artery was connected to the brachiocephalic artery, and its drainage vein was connected to the right pulmonary artery, uniquely behind the pericardium. Despite the unique location, right mediastinal extralobular sequestration with a congenital cystic adenomatoid malformation in the right upper lobe was confirmed pathologically. Examination of contrast-enhanced chest computed tomography (CT) and three-dimensional computed tomography images enabled a correct diagnosis. It is very important for surgeons to correctly diagnose and identify an aberrant artery and drainage vein to prevent uncontrolled hemorrhage. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered in the anterior esophagus at the level of the gastroesophageal junction and successfully resected with resolution of his symptoms. [ABSTRACT FROM AUTHOR]

Objective: To determine if a combination of CT and demographic features can predict EGFR mutation status in bronchogenic carcinoma.Methods: We reviewed demographic and CT features for patients with molecular profiling for resected non-small cell lung carcinoma. Using multivariate logistic regression, we identified features predictive of EGFR mutation. Prognostic factors identified from the logistic regression model were then used to build a more practical scoring system.Results: A scoring system awarding 5 points for no or minimal smoking history, 3 points for tumours with ground glass component, 3 points for airbronchograms, 2 points for absence of preoperative evidence of nodal enlargement or metastases and 1 point for doubling time of more than a year, resulted in an AUROC of 0.861. A total score of at least 8 yielded a specificity of 95 %. On multivariate analysis sex was not found to be predictor of EGFR status.Conclusions: A weighted scoring system combining imaging and demographic data holds promise as a predictor of EGFR status. Further studies are necessary to determine reproducibility in other patient groups. A predictive score may help determine which patients would benefit from molecular profiling and may help inform treatment decisions when molecular profiling is not possible.Key Points: • EGFR mutation-targeted chemotherapy for bronchogenic carcinoma has a high success rate. • Mutation testing is not possible in all patients. • EGFR associations include subsolid density, slow tumour growth and minimal/no smoking history. • Demographic or imaging features alone are weak predictors of EGFR status. • A scoring system, using imaging and demographic features, is more predictive. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to determine whether a qualitative approach or a semi-quantitative approach provides the most robust method for early response evaluation with 2′-deoxy-2′-[F]fluoro- d-glucose (F-18-FDG) positron emission tomography combined with whole body computed tomography (PET/CT) in non-small cell lung cancer (NSCLC). In this study eight Nuclear Medicine consultants analyzed F-18-FDG PET/CT scans from 35 patients with locally advanced NSCLC. Scans were performed at baseline and after 2 cycles of chemotherapy. Each observer used two different methods for evaluation: (1) PET response criteria in solid tumors (PERCIST) 1.0 and (2) a qualitative approach. Both methods allocate patients into one of four response categories (complete and partial metabolic response (CMR and PMR) and stable and progressive metabolic disease (SMD and PMD)). The inter-observer agreement was evaluated using Fleiss' kappa for multiple raters, Cohens kappa for comparison of the two methods, and intraclass correlation coefficients (ICC) for comparison of lean body mass corrected standardized uptake value (SUL) peak measurements. Results: The agreement between observers when determining the percentage change in SULpeak was 'almost perfect', with ICC = 0.959. There was a strong agreement among observers allocating patients to the different response categories with a Fleiss kappa of 0.76 (0.71-0.81). In 22 of the 35 patients, complete agreement was observed with PERCIST 1.0. The agreement was lower when using the qualitative method, moderate, having a Fleiss kappa of 0.60 (0.55-0.64). Complete agreement was achieved in only 10 of the 35 patients. The difference between the two methods was statistically significant ( p < 0.005) (chi-squared). Comparing the two methods for each individual observer showed Cohen's kappa values ranging from 0.64 to 0.79, translating into a strong agreement between the two methods. Conclusions: PERCIST 1.0 provides a higher overall agreement between observers than the qualitative approach in categorizing early treatment response in NSCLC patients. The inter-observer agreement is in fact strong when using PERCIST 1.0 even when the level of instruction is purposely kept to a minimum in order to mimic the everyday situation. The variability is largely owing to the subjective elements of the method. [ABSTRACT FROM AUTHOR]

Purpose: Infectious complications occur following pulmonary resections preceded or not by induction chemoradiotherapy. We aimed to investigate whether bacterial colonization of the bronchial tree at the time of surgery was associated with postoperative complications. Patients and methods: A retrospective analysis of all patients who underwent open anatomical pulmonary resections for malignancies at a single center was performed. Demographical data of the included patients, intraoperative data, and data on the postoperative course of patients were collected. Outcome of patients with a positive intraoperative bronchial culture was compared to patients with a negative bronchial culture. Relations between the presence of potential bacterial pathogens in the bronchial tree and other possible risk factors for the development of postoperative infectious and non-infectious complications, were analyzed using uni- and multivariate analysis. Results: Between January 2010 and January 2012, a total of 121 consecutive patients underwent open anatomical pulmonary resections for malignancy, of whom 45 were preceded by induction chemoradiotherapy and 5 by induction chemotherapy. Intraoperative bronchial cultures were taken from 58 patients (48 %). Patients with a positive bronchial culture developed significantly more infectious (88 % vs. 20 %, p < 0.001) and non-infectious complications (63 % vs. 12 %, p = 0.001). Positive intraoperative bronchial cultures showed the strongest association with the development of infectious and non-infectious postoperative complications (OR 24.8 and 12.2, respectively). After multivariate analysis, only BMI less than 20 kg/m and the presence of a positive intraoperative bronchial culture were found to be independent risk factors for the development of infectious complications. Chemoradiotherapy was not associated with postoperative complications in the present study. Conclusions: Bacterial colonization of the bronchial tree assessed intraoperatively, appears to be associated with higher rates of infectious and non-infectious complications after pulmonary resection. Whether early starting of appropriate antibiotics based on intraoperative-taken culture findings will reduce the infectious complication rate in a subcategory of patients needs to be investigated. [ABSTRACT FROM AUTHOR]

Bronchogenic cysts are congenital cystic lesions of foregut origin, usually intrapulmonary or mediastinal, while esophageal cysts generally originate within the esophagus. To the best of our knowledge, this is the first report of a case of a completely intramural bronchogenic cyst of the cervical esophagus in a neonate. [ABSTRACT FROM AUTHOR]

Video-assisted thoracoscopic surgery (VATS) has revolutionized the practice of thoracic surgeons and improved patient experiences and outcomes worldwide. The VATS approach has matured over the past decades and now accounts for approximately 50 % of all operations in specialized thoracic surgery units. The VATS procedure is less invasive and therefore allows a faster recovery of patients. Over the last 20 years VATS has developed into a safe and effective technique for the diagnostics and therapy of many thoracic diseases. With increasing experience thoracic surgeons can carry out more advanced and technically challenging interventions. Nowadays, VATS is the superior technique in many cases of thoracotomy. [ABSTRACT FROM AUTHOR]

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Copyright of Der Pneumologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Symptoms such as dyspnoea, haemoptysis, coughing frequently occur in patients with bronchial carcinoma. Usually, central airway obstruction, pleural effusion or vena cava compression syndrome cause dyspnoea. Interventional bronchoscopy techniques, e.g. laser coagulation, electrocautery and cryosurgery offer very effective means for the re-canalisation of central airway obstruction. Stent placement and high-dose radiation brachytherapy are the procedures of choice for the treatment of extrinsic stenoses. The use of bronchoscopic coagulation, balloon catheters and embolisation of bronchial arteries may control severe haemoptysis. All interventional bronchoscopic techniques show symptomatic improvement and overall survival benefit in patients with bronchial carcinoma. Pleural involvement and effusion reflect progression of disease. Treatment consists of thoracoscopic talc pleurodesis and the use of various types of pleural catheters. Angiographic interventions (bronchial artery embolisation, dilatation and stenting of the vena cava superior) are needed for massive haemoptysis and the cava compression syndrome respectively. [ABSTRACT FROM AUTHOR]

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A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life. [ABSTRACT FROM AUTHOR]

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Copyright of Der Pneumologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Radiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Radiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: In East Germany, uranium mining was performed on a large scale for approximately 45 years (1946–1990). In particular, the poor working conditions during the post-war years until 1955 led to a high level of occupational diseases. The present study gives an overview of the occurrence of occupational diseases during the mining period as well as after uranium mining was stopped in 1990. Methods: The number of occupational diseases which occurred during the mining period was calculated from the files of the former Wismut SDAG. Although exposure to uranium ceased after 1990, new cases of occupational diseases were recognized after that date. These were recorded by the German Federation Of Institutions For Statutory Accident Insurance And Prevention (HVBG). Results and Conclusions: Today, more than 35,000 cases of occupational diseases are known, and many more are expected. About two-thirds of them are lung diseases: 16,376 cases of silicosis/silicotuberculosis and 7,695 cases of bronchial carcinomas. The increase in the number of recognized occupational diseases is shown and discussed against the background of changes in criteria for recognition and in working conditions as well as the duration of the latency period. [ABSTRACT FROM AUTHOR]

Copyright of Der Radiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fifteen patients with bronchial carcinoma were treated with infusions of 10 mg Mitomycin C (MMC) in the bronchial artery feeding the tumor. The treatment was repeated three times with 2-3 weeks interval between treatments. Half of the patients then received radiation to the tumor area and mediastinum. All tumors decreased in size, complete remission occurred in two and partial remission in five patients. Survival time, however, was not prolonged and esophageal complications occurred in several patients. [ABSTRACT FROM AUTHOR]

Endobronchial laser therapy will be carried out predominantly at obstructing bronchial carcinomas of the major airways. Concerning tumors distal of the bifurcation, corresponding pre-examinations (angiography, bronchography, fluoroscopy) should make it sufficiently probable that, after the recanalization of a bronchus, the patient will have a functional benefit. At noncompletely obstructing tumors an occlusion of the bronchus may be prevented by an endobronchial laser resection. Only then is scarred stenosis suitable, if it concerns membranous changes; longer stenosis bring poor long-term results only. At a larger endobronchial bleeding the laser is not suitable for controlling the hemorrhage. The long-term results of the therapy for benign endobronchial lesions are good. The results of malignant changes depend basically on the localization and on the growth rate of the tumor. With a careful selection of patients very good immediate results may be obtained at nearly all endobronchial lesions. [ABSTRACT FROM AUTHOR]

Elevated glutamate concentrations are commonly observed in patients with advanced carcinoma, and glutamate was recently found to inhibit the membrane transport of cystine and to impair the function of macrophages and lymphocytes in vitro. We therefore investigated the possibility that elevated plasma glutamate levels may be quantitatively correlated with reduced lymphocyte reactivity and an impaired host response to the tumor. Here we report the results of a study on patients with bronchial carcinoma, which show that patients with plasma glutamate levels above 120 μ M have a lower lymphocyte response to mitogens and a substantially higher death rate than those with glutamate levels below 120 μ M. This correlation does not prove a causal role of glutamate, but it confirms predictions from the in vitro laboratory data. [ABSTRACT FROM AUTHOR]

Elevated glutamate concentrations are commonly observed in tumor patients, and glutamate was recently found to competitively inhibit the membrane transport of cystine. We therefore investigated the possibility that elevated plasma glutamate levels may damage the immune system. The experiments in this report demonstrate a link between the individual plasma glutamate level and the individual immunological reactivity as measured by mitogenic responses. This correlation has been analyzed in 39 colorectal carcinoma patients, 40 oat cell carcinoma patients, 24 large cell lung carcinoma patients, and 31 apparently healthy persons (blood donors). Blood cells from all three groups of tumor patients in comparison with cells from healthy persons produced markedly reduced mitogenic responses against PWM, and all three groups of tumor patients had on average significantly elevated plasma glutamic acid concentrations. Our analysis revealed a linear regression of the logarithm of the individual plasma glutamate levels (before therapeutic treatment) on the logarithm of the corresponding mitogenic reactivity against PWM for the entire population of 134 persons tested (correlation coefficient-0.80; level of significance P<0.00001). A statistically significant linear correlation with a similar regression equation was also observed in the group of the healthy blood donors ( n=31); correlation coefficient-0.56; P<0.01), indicating that this correlation is universal and not dependent on the presence of a tumor. Mitogenically stimulated murine lymphocyte cultures revealed an inverse correlation between glutamate concentration and cell proliferation in response to the mitogens PHA and PWM. [ABSTRACT FROM AUTHOR]

A brain metastasis of bronchial squamous cell carcinoma in a patient was cultivated. The cells with epithelium-like characteristics were selected from the primary culture, and were subcultured to establish a cell line. The cultured cells were identified to be neoplastic by means of heterologous transplantation to nude mice, in which tumors developed and reproduced histologic characteristics as were seen in the primary tumor of the patient. [ABSTRACT FROM AUTHOR]

Thirty-eight patients with four major types of bronchial carcinoma were studied to evaluate technetium-99m sestamibi imaging in the assessment of tumour necrosis and the detection of hilar and mediastinal lymph node metastasis. Quantitative analysis was also performed to ascertain whether tumour uptake values correlate with histological types of bronchial carcinoma. Of the patients, 34 showed tumour uptake on planar imaging ( n = 38) and 27 on single-photon emission tomography (SPET) ( n = 29), the overall sensitivity in the localisation of primary tumour being 89% with planar imaging and 93% with SPET. Four types of tumour uptake pattern were identified: (1) focal uptake, (2) focal uptake with a central hypoactive focus, (3) ring-like uptake and (4) no uptake (negative uptake). Tumour necrosis was diagnosed in 12 patients based upon histopathology ( n = 2) and density measurements and type of contrast enhancement on computed tomography (CT) scan ( n = 12). Defective tumour uptake was seen in 11 of these patients on planar images (focal uptake with a central hypoactive focus, n = 7; ring-like uptake, n = 2; and no tumour uptake, n = 2) and in 12 patients on SPET (focal uptake with a central hypoactive focus, n = 7, ring-like uptake, n = 3, and no uptake, n = 2). Hilar and mediastinal lymph node involvement was detected in ten patients on CT scan, nine on planar images and 11 on SPET. A total of 26 metastatic lymph nodes were detected on CT scan; 24 of these were seen on planar, and all 26 on SPET images. SPET disclosed five further lymph nodes with metastasis, all of which were confirmed by histopathological examination of the surgical material ( n = 3). The sensitivity in establishing the hilar and mediastinal disease was 90% on planar images, and 100% on SPET slices, but when the number of lymph nodes was taken into account, these values were 62% and 100%, respectively. Also, brain metastases were detected with SPET in three patients. The results of quantitative analysis of tumour uptake did not differentiate between squamous cell carcinoma and adenocarcinoma. We conclude that Tc-sestamibi, particularly with SPET imaging, is potentially useful in the follow-up of patients with bronchial carcinoma by differentiating residual or recurrent disease from postradiotherapy necrosis, and is as sensitive as CT scan in the detection of hilar and mediastinal lymph node metastasis. [ABSTRACT FROM AUTHOR]

A single-photon emission tomography (SPET) technique for the absolute measurement of tumour perfusion is described. Phantom studies have shown that source-background ratios are dependent upon source size and radial position within the phantom. A means of correcting source-background count ratios for these variables has been developed and used to correct tumour-lung ratios obtained in 28 patients with bronchial carcinomas who underwent technetium-99m hexamethyl-propylene amine oxime (Tc-HMPAO) SPET. On SPET images, the normal lung appears as a relatively homogeneous background. The relationship between Tc background concentration (kBq/ml) and counts/pixel was determined from phantom studies and the tumour Tc concentration from the background Tc concentration and corrected tumour-lung ratio. The total activity of the lipophilic Tc-HMPAO species injected was measured. The activity reaching the systemic circulation ( A) was obtained by subtracting the activity trapped in the pulmonary circulation (obtained from background Tc concentration and lung volume). Tumour blood flow may then be calculated from fraction of A contained in the tumour provided cardiac output and extraction fraction are known. Blood flow through the central region of tumours ranged from zero to 59.0 (mean 14.1) ml min 100 g and through the whole tumour from 0.6 to 68.0 (mean 20.6) ml min 100 g. [ABSTRACT FROM AUTHOR]

The tissue preserving resections for non-small-cell bronchial carcinoma can be grouped into three main categories: I. bronchoplastic procedures, II. angioplastic procedures, and III. concomitant broncho- and angioplastic procedures, and into the subgroups, standard and extended sleeve resection. The indications are; elderly patients, impaired respiratory reserve, limited tumour growth, and palliative surgery. The analysis of 229 cases yielded follow-up data in 192. The estimated 5 years survival rate was 34 per cent, 19 per cent and 14 per cent in categories I, II and III, respectively. The decrease in survival was due to a greater tumour burden. The operative mortality rate was 8.9 per cent in category I and 17 per cent in category III, such being comparable with standard or extended pneumonectomy, respectively. Surgical techniques and postoperative complications are discussed. [ABSTRACT FROM AUTHOR]

Flameless atomic absorption spectrophotometry was used to determine the chromium (Cr) content of samples taken at autopsy from the lungs, bronchi, and regional hilar lymph nodes of 50 randomly selected patients from urban and rural areas; these patients were not known to have been excessively exposed to Cr. On the average, the Cr concentration in the lungs of patients younger than 40 yr of age was approximately 2 μg/g; for patients over 40, the average Cr values were between 5 and 15 μg/g dry wt. The highest values were found in samples from the apex of the lung. The Cr concentration in lung and lymph nodes increased in proportion to age and the degree of anthracosis. Chromium content in the bronchial wall was very low in all cases. Chromium values up to ten times greater as compared to age-matched average values were found in scarred lung tissue, probably caused by a postinflammatory lymph vessel blockade. Slightly elevated Cr values were found in smokers' lungs. Chromium values in tissue from primary lung carcinomas ( n=9) were lower than those in neighboring lung tissue. Based on the results of this study the amount of Cr of lung and bronchial tissue does not appear to be associated with the induction of bronchial carcinoma. [ABSTRACT FROM AUTHOR]

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Copyright of International Archives of Occupational & Environmental Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Idiopathic bronchiolitis obliterans organising pneumonia (BOOP) is an uncommon but well-recognised condition that usually presents radiologically as bilateral multifocal patchy areas of consolidation on the chest radiograph and on computed tomography (CT). Five cases are described in which the presenting feature was that of a solitary pulmonary nodule. Four of these nodules showed evidence of cavitation and three patients presented with haemoptysis. In all cases the appearances closely resembled bronchial carcinoma. [ABSTRACT FROM AUTHOR]

From 1980 to 1990 we treated 107 non-small-cell lung carcinomas (NSCLC) with radiotherapy alone. The study was done to evaluate the prognostic factors in an absolutely negative selected group of patients with regard to the International Union Against Cancer (UICC) classification published in 1987. Patients who had a prior response to neo-adjuvant chemotherapy were excluded from the analysis. Therefore, a negative selection of 98 males and 9 females were treated. All patients were classified retrospectively according to UICC 1987. Nine males and 7 females were stages I and II, respectively. In stage IIIa there were 41 patients, and in stage IIIb 42. A total of 18 patients were staged IV. Results: 5-year overall actuarial survival was approximately 1 %. As main prognostic factor we found the stage of disease. Two-year survival rates in stages I and II were 25 %, in stage IIIa 20 %, in stage IIIb 12 % and in stage IV 0%. The Karnowsky Index (KI) was an important second factor: Patients with a good KI (90-100 %) had a 2-year survival rate of 27 %, and patients with a KI of 70-80 % had a 6.5 % 2-year survival rate. Other prognostic factors were: (1) given total radiation dose, (2) actual response to radiation therapy and (3) normal white blood cell (WBC) count. Leukocytosis is a negative factor for prognosis. We conclude that the stage and, among other factors, the general condition (KI, WBC), are relevant for the prognosis of patients with NSCLC. [ABSTRACT FROM AUTHOR]

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To study invasion of lung cancer in vitro a novel three-dimensional coculture assay consisting of living human tissues has been developed. Multicellular spheroids initiated from a new large-cell lung carcinoma cell line (GaL23), found to be invasive in immunodeficient mice, were confronted with precultured bronchial fragments derived from mucosal biopsies obtained during routine fiberoptic bronchoscopy. The bronchial fragments consist of a stromal core with scattered fibroblasts covered by a continuous surface epithelium resting on a basal lamina. During the first 2 wk of confrontation, a gradual retraction of the bronchial epithelium with subsequent adhesion of the tumor cells to the underlying basal lamina occurred. The following week, a limited invasion of tumor cells into the bronchial stroma was seen. To facilitate the entrance of tumor cells through the mucosal surface, the surface epithelium was removed prior to coculture by ethylenediaminetetraacetic acid (EDTA) buffer treatment. Upon confrontation, GaL23 cells then rapidly attached to and migrated on the exposed basal lamina and an increasing number of tumor cells was seen in the stroma during the first week of culture. This model offers opportunities for studying mechanisms of lung cancer adhesion, migration, and invasion using human bronchial mucosa as the natural target tissue. [ABSTRACT FROM AUTHOR]