Xem 1-20 trên 111 kết quả Lung medicine
  • Management of Occult and Stage 0 Carcinomas In the uncommon situation where malignant cells are identified in a sputum or bronchial washing specimen but the chest radiograph appears normal (TX tumor stage), the lesion must be localized. More than 90% can be localized by meticulous examination of the bronchial tree with a fiberoptic bronchoscope under general anesthesia and collection of a series of differential brushings and biopsies. Often, carcinoma in situ or multicentric lesions are found in these patients.

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  • Lung cancer is the leading cause of cancer death among men and women in the United States with 170,000 deaths per year. This exceeds the sum of the next three leading causes of death due to cancer: breast, colon, and prostate. There are over 1 million deaths worldwide due to lung cancer, making it truly an epidemic. Fewer than 15% achieve a 5-yr survival. The vast majority (85%) present with advanced disease, although stage I patients may have a 5-yr survival approaching 70% (1).

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  • Other Organ Systems and the Future The use of stem cells in regenerative medicine has been studied for many other organ systems and cell types, including skin, eye, cartilage, bone, kidney, lung, endometrium, vascular endothelium, smooth muscle, striated muscle, and others. In fact, the potential for stem cell regeneration of damaged organs and tissues is virtually limitless. However, numerous obstacles must be overcome before stem cell therapies can become a widespread clinical reality.

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  • Harrison's Internal Medicine Chapter 85. Neoplasms of the Lung The Magnitude of the Problem In 2007, primary carcinoma of the lung affected 114,760 males and 98,620 females in the United States; 86% die within 5 years of diagnosis, making it the leading cause of cancer death in both men and women. The incidence of lung cancer peaks between ages 55 and 65 years. Lung cancer accounts for 29% of all cancer deaths (31% in men, 26% in women). Lung cancer is responsible for more deaths in the United States each year than breast cancer, colon cancer, and prostate cancer combined;...

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  • Further Readings Black C et al: Population screening for lung cancer using computed tomography: Is there evidence of clinical effectiveness? A systematic review of the literature. Thorax 62:131, 2007 [PMID: 17287305] Eberhardt W et al: Chemoradiation paradigm for the treatment of lung cancer. Nat Clin Pract Oncol 3:188, 2006 [PMID: 16596143] Hayes DN et al: Gene expression profiling reveals reproducible human lung adenocarcinoma subtypes in multiple independent patient cohorts.

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  • Staging of Small Cell Lung Cancer Pretreatment staging for patients with SCLC includes the initial general lung cancer evaluation with chest and abdominal CT scans (because of the high frequency of hepatic and adrenal involvement) as well as fiberoptic bronchoscopy with washings and biopsies to determine the tumor extent before therapy; brain CT scan (10% of patients have metastases); and radionuclide scans (bone) if symptoms or other findings suggest disease involvement in these areas.

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  • Lung cancer is the most frequent cause of cancer deaths in both men and women in the U.S. (1). Although tobacco smoking is accepted as the number one cause of this devastating disease, our understanding of the acquired genetic changes leading to lung cancer is still rudimentary. Lung cancer is classifi ed into two major clinic-pathological groups, small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC) (2). Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are the major histologic types of NSCLC....

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  • Inherited Predisposition to Lung Cancer While an inherited predisposition to develop lung cancer is not common, several features suggest a potential for familial association. People with inherited mutations in RB (patients with retinoblastomas living to adulthood) and p53 (LiFraumeni syndrome) genes may develop lung cancer. First-degree relatives of lung cancer probands have a two- to threefold excess risk of lung cancer or other cancers, many of which are not smoking-related.

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  • Clinical Manifestations Lung cancer gives rise to signs and symptoms caused by local tumor growth, invasion or obstruction of adjacent structures, growth in regional nodes through lymphatic spread, growth in distant metastatic sites after hematogenous dissemination, and remote effects of tumor products (paraneoplastic syndromes) (Chaps. 96 and 97). Although 5–15% of patients with lung cancer are identified while they are asymptomatic, usually as a result of a routine chest radiograph or through the use of screening CT scans, most patients present with some sign or symptom.

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  • Non-Small Cell Lung Cancer NSCLC Stages I and II Surgery In patients with NSCLC stages IA, IB, IIA and IIB (Table 85-2) who can tolerate operation, the treatment of choice is pulmonary resection. If a complete resection is possible, the 5-year survival rate for N0 disease is about 60–80%, depending on the size of the tumor. The 5-year survival drops to about 50% when N1 (hilar node involvement) disease is present. The extent of resection is a matter of surgical judgment based on findings at exploration.

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  • Superior Sulcus or Pancoast Tumors Non-small cell carcinomas of the superior pulmonary sulcus producing Pancoast's syndrome appear to behave differently than lung cancers at other sites and are usually treated with combined radiotherapy and surgery. Patients with these carcinomas should have the usual preoperative staging procedures, including mediastinoscopy and CT and PET scans, to determine tumor extent and a neurologic examination (and sometimes nerve conduction studies) to document involvement or impingement of nerves in the region.

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  • Tham khảo sách 'lung diseases – selected state of the art reviews edited by elvis malcolm irusen', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Major treatment decisions are made on the basis of whether a tumor is classified as a small cell lung carcinoma (SCLC) or as one of the non-small cell lung cancer (NSCLC) varieties (squamous, adenocarcinoma, large cell carcinoma, bronchioloalveolar carcinoma, and mixed versions of these).

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  • Another local approach uses adenoviral-mediated expression of the tumor suppressor p53, which is mutated in a wide variety of cancers. This strategy has shown complete and partial responses in squamous cell carcinoma of the head and neck, esophageal cancer, and non-small cell lung cancer after direct intratumoral injection of the vector. Response rates (~15%) are comparable to those of other single agents.

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  • Diagnosis and Staging Screening Most patients with lung cancer present with advanced disease, raising the question of whether screening would detect these tumors at an earlier stage when they are theoretically more curable. The role of screening high-risk patients (for example current or former smokers 50 years of age) for early stage lung cancers is debated.

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  • Small Cell Lung Cancer A simple two-stage system is used. In this system, limited-stage disease (seen in about 30% of all patients with SCLC) is defined as disease confined to one hemithorax and regional lymph nodes (including mediastinal, contralateral hilar, and usually ipsilateral supraclavicular nodes), while extensive-stage disease (seen in about 70% of patients) is defined as disease exceeding those boundaries. Clinical studies such as physical examination, x-rays, CT and bone scans, and bone marrow examination are used in staging.

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  • Table 85-5 Randomized Studies of Adjuvant Chemotherapy in NSCLC Stu dy Treatment mber Nu of Year 5edian M zard Ha Value p Patients Survival Survival Ratio (%) (95% CI) EC OG Surgery 242 9% 246 3 39 months vs. 0.9 3 (0.74– .56 0 3590 →RT vs. Surgery + post-op concurrent (II–IIIA) 38 1.18) 3 RT + cis/etoposide 3% months AL Surgery 603 1% 606 5 R N 6 0.9 (0.8– .59 0 PI (I–IIIA) alone vs. Surgery + post-op mitomycin/vindesin e/cisplatin 3% 4 1.1) Big Surgery 189 33 months 1.0 2 (0.77– .90 1.35) 0 Lung Trial alone vs.

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  • In September 2003, the National Institutes of Health (NIH) presented to the American people the goals of the NIH for medical research in the 21st century. Dr. Elias Zerhouni, who became director of the NIH in May 2002, had been Associate Dean for Research at Johns Hopkins School of Medicine before going to the NIH as the fi rst radiologist to head that agency. He had been trained in nuclear medicine while a resident in radiology at Hopkins.

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  • Mature lung surfactant protein C (SP-C) corresponds to residues 24–58 of the 21 kDa proSP-C. A late processing intermediate, SP-C i, corresponding to residues 12–58 of proSP-C, lacks the surface activity of SP-C, and the SP-Ci a-helical structure does not unfold in contrast to the metastable nature of the SP-C helix.

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  • We report the biochemical characterization of calhepatin, a calcium-binding protein of the S100 family, isolated from lungfish (Lepidosiren paradoxa) liver. The primary structure, determined by Edman degradation and MS/MS, shows that the sequence identities with the other members of the family are lower than those between S100 proteins from different species. Calhepatin is composed of 75 residues and has a molecular mass of 8670 Da. It is smaller than calbindin D9k (78 residues), the smallest S100 described so far....

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