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3021. Real-time bronchoscope tip localization enables three-dimensional CT image guidance for transbronchial needle aspiration in swine.
To determine the feasibility of using real-time bronchoscope position technology coupled with previously acquired three-dimensional CT data to enhance transbronchial needle aspiration (TBNA).
3022. The effect of adjunctive corticosteroids for the treatment of Pneumocystis carinii pneumonia on mortality and subsequent complications.
To assess the long-term safety of adjunctive corticosteroids in the treatment of Pneumocystis carinii pneumonia (PCP).
3024. Diffuse airway narrowing from carcinoma metastatic to the bronchial submucosa: identification by chest CT.
作者: D B Taichman.;G Tino.;J Aronchick.;C Reynolds.;W R Smythe.;J R Roberts.;D Haller.
来源: Chest. 1998年114卷4期1217-20页
The differential diagnosis of dyspnea in patients with prior malignancy and nondiagnostic chest radiographs is broad. We report a case of breast carcinoma diffusely metastatic to the bronchial submucosa presenting as obstructive airway disease. Chest radiographs failed to suggest metastatic disease as the cause of dyspnea. CT, however, revealed the unusual finding of diffusely thickened and narrowed airways. Carcinoma confined to airway submucosa was identified using bronchial biopsy. We suggest that diffuse airway narrowing from submucosal metastasis can be demonstrated by CT and should be added to the differential diagnosis of dyspnea in cancer patients with nondiagnostic chest radiographs and evidence of airflow obstruction.
3025. Myocardial infarction in critically ill patients presenting with gastrointestinal hemorrhage: retrospective analysis of risks and outcomes.
To determine the frequency of and risk factors for myocardial infarction (MI) in patients admitted to an ICU with GI hemorrhage, and the effects of MI on mortality and length of stay.
3026. Integrating patient preferences into health outcomes assessment: the multiattribute Asthma Symptom Utility Index.
To develop and evaluate a brief, easy-to-administer symptom assessment scale for use as a preference-based outcome measure in clinical trials and cost-effectiveness studies in asthma.
3027. Inspiratory flow rate and dynamic lung function in cystic fibrosis and chronic obstructive lung diseases.
作者: P S Sarinas.;T E Robinson.;A R Clark.;J Canfield.;R K Chitkara.;R B Fick.
来源: Chest. 1998年114卷4期988-92页
The peak inspiratory flow rates (PIFRs) generated by cystic fibrosis (CF) and COPD patients through a range of clinically relevant resistances have not yet been reported (to our knowledge). The objectives of this study were to (1) explore a relevant range of resistive loads and address whether patients with stable CF and COPD can generate the PIFR sufficient to disperse dry-powder inhalants (DPI) and (2) determine whether the optimal inspiratory flow rate effective for delivery of aerosolized pharmacologic therapeutic agents can be attained with a comfort rating acceptable to subjects.
3029. Correction of single-breath helium lung volumes in patients with airflow obstruction.
To determine whether alveolar volume (V(A)) measured during the single-breath diffusing capacity for carbon monoxide (DCO) can be used as a substitute measure for the multiple-breath total lung capacity (TLC) in subjects with and without airways obstruction.
3030. Liberation from mechanical ventilation: a decade of progress.
Multiple complications associated with mechanical ventilation mandate that clinicians expeditiously define and reverse the pathophysiologic processes that precipitate respiratory failure and then, detect the earliest point that a patient can breathe without the ventilator. Over the past decade, numerous laboratory and clinical studies have been reported that may inform transformation of the "art of weaning" to the science of liberation. We review these studies and use them to formulate a systematic approach to assure early, safe, and successful liberation of patients from mechanical ventilation.
3031. African-American race and antibodies to topoisomerase I are associated with increased severity of scleroderma lung disease.
作者: E L Greidinger.;K T Flaherty.;B White.;A Rosen.;F M Wigley.;R A Wise.
来源: Chest. 1998年114卷3期801-7页
To determine whether African-American race is independently associated with lung disease in scleroderma.
3032. Metabolic imaging of malignant pleural mesothelioma with fluorodeoxyglucose positron emission tomography.
The diagnosis of malignant mesothelioma is a challenging medical problem. CT often cannot differentiate between benign diffuse pleural thickening and malignant mesothelioma, while thoracentesis and CT-guided biopsies are insensitive. We have assessed the value of positron emission tomography (PET) with 2-fluoro-2-deoxy-D-glucose (FDG) in the evaluation of malignant mesothelioma.
3033. Relative occurrence of flow limitation and snoring during continuous positive airway pressure titration.
作者: I Ayappa.;R G Norman.;J J Hosselet.;R A Gruenke.;J A Walsleben.;D M Rapoport.
来源: Chest. 1998年114卷3期685-90页
To examine the relative temporal appearance of flow limitation and snoring during continuous positive airway pressure (CPAP) titration, compare their sensitivity as indicators of airway obstruction, and assess their relative utility as feedback variables for automatic titration of CPAP.
3034. Screening by specialists to reduce unnecessary test ordering in patients evaluated for tuberculosis.
To determine if screening by specialists could reduce unnecessary test ordering and reduce costs related to diagnostic workup in patients undergoing evaluation for tuberculosis.
3035. Etiology and pathogenesis of primary pulmonary hypertension: a perspective.
In recent years, considerable advances have been made in treating primary pulmonary hypertension (PPH). These have provided a series of therapeutic options, ranging from the oral administration of calcium channel blockers to the continuous infusion of prostacyclin and/or lung transplantation. These therapeutic advances have highlighted the need for the better understanding of etiology and pathogenesis. Among the key uncertainties, the following are defined as leading uncertainties: (1) the nature of the initiating lesion; (2) the shared pathogenetic mechanisms that culminate in the pathologic lesions of PPH; (3) the molecular genetic bases for familial PPH and for susceptibility to PPH; (4) understanding of the obliterative-proliferative occlusive process in the small muscular pulmonary arteries; and (5) redefinition of "primary" and "secondary," ie, a revised nomenclature of pulmonary hypertension. A revised classification based on etiology is presented.
3036. Primary cardiac sarcoma: a novel treatment approach.
Primary cardiac sarcomas carry a dismal prognosis with no known curative therapy using standard treatment approaches. By its very location, the possibility of a radical complete resection--the underlying principle in the management of any soft-tissue sarcoma--is precluded. While literally in a continuous "blood bath," cardiac sarcomas are associated with a very high rate of hematogenous metastases. This report describes the management of a case in a 51-year-old white man with a high-grade unresectable cardiac sarcoma who was treated with hyperfractionated (twice daily) radiotherapy to a total dose of 7,050 cGy along with a radiosensitizer, (5'-iododeoxyuridine. The patient currently is disease-free and functioning well more than 5 years following this novel treatment approach.
3038. The new onset of atrial arrhythmias following major noncardiothoracic surgery is associated with increased mortality.
To examine the incidence and consequences of atrial arrhythmias in surgical ICU patients following major noncardiac, nonthoracic surgery.
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