ABSTRACT
The technique and predictive value for survival of initial and restaging bone marrow examinations in small cell carcinoma (SCC) of the lung were evaluated by 76 examinations of 72 patients. In 76 examinations, only 2 (2.6%) of the bilateral iliac crest bone marrow examinations revealed tumor cells unilaterally and these two were restaging examinations. If SCC was found in the marrow, bone marrow biopsy was always positive. In no instance was an aspirate positive with a negative bone marrow biopsy. Thus a unilateral bone marrow biopsy is an adequate technique for the initial staging of the bone marrow in SCC of the lung. Survival of patients with or without positive initial bone marrow examinations was not significantly different.
Subject(s)
Bone Marrow/pathology , Carcinoma, Small Cell/pathology , Lung Neoplasms/pathology , Biopsy, Needle , Humans , Neoplasm Staging/methods , Prognosis , Registries , Retrospective StudiesABSTRACT
On May 18, 1980, Mount St Helens, Washington State's most active volcano, erupted violently. Volcanic eruptions in recent geologic history have demonstrated tremendous environmental impact and caused significant loss of human life. Volcanic ash expelled during the eruption was deposited on much of eastern Washington and had a profound effect on local air quality. Although ash is relatively inert, analysis revealed a small but significant amount of free crystalline silica, the causative agent of silicosis. The fine particles of ash were of respirable size, and there was a remarkable increase in the volume of respiratory cases seen in emergency departments during the period of high airborne particulate levels. Numerous cases of injury indirectly related to the fall of ash were also seen. The long-term effect of exposure to this volcanic ash is unknown. A prompt, coordinated community medical response is necessary to protect the general population from the potential hazard of exposure to volcanic ash.
Subject(s)
Disasters , Emergency Service, Hospital/statistics & numerical data , Adolescent , Air Pollution/analysis , Conjunctivitis/etiology , Environment , Female , Hospital Bed Capacity, 300 to 499 , Humans , Male , Masks/supply & distribution , Middle Aged , Respiratory Tract Diseases/etiology , Silicosis/diagnosis , WashingtonABSTRACT
The utility of various diagnostic procedures, including fiberoptic bronchoscopy and bone marrow aspirate/biopsy for small cell carcinoma, was examined in 150 patients. From a chart review of the first 100 patients, 55 required an invasive procedure such as mediastinoscopy or thoracotomy to establish the tissue diagnosis. In 50 consecutive prospective patients, only four required an invasive procedure for tissue confirmation. Eighteen of the 50 prospective patients had positive iliac crest bone marrow aspirates or biopsies diagnostic for small cell carcinoma. Fiberoptic bronchoscopy was nondiagnostic in 15 prospective patients, but the bone marrow examination was diagnostic in 12 of this subgroup. The combination of fiberoptic bronchoscopy and bone marrow examination in patients with centrally located small cell carcinoma greatly reduced the need for more expensive and invasive diagnostic procedures.
Subject(s)
Bone Marrow Examination , Bronchoscopy , Carcinoma, Small Cell/diagnosis , Lung Neoplasms/diagnosis , Adult , Aged , Female , Fiber Optic Technology , Humans , Male , Middle Aged , Prospective Studies , Retrospective StudiesABSTRACT
A patient with a brain abscess was found to have multiple pulmonary arteriovenous fistulas. Differences in arterial blood gas levels at low and high lung volumes were used to quantify shunting. Using this technique one can objectively follow progression, remission, or stabilzation of pulmonary arteriovenous fistulas.
