Utility of multimodal sampling and testing during advanced bronchoscopy for diagnosing atypical respiratory infections in a -endemic region.

Background: The role of advanced diagnostic bronchoscopy (ADB) for assessing atypical respiratory infections is unclear. The purpose of this study was to ascertain: (I) the diagnostic utility of ADB-tissue sampling in patients with focal thoracic lesions due to atypical respiratory infections; (II) how multimodal bronchoscopic sampling and testing enhance diagnosis in a -endemic region.

Methods: A retrospective observational cohort study analyzing all ADBs performed over a 10-year period in patients with focal thoracic lesions diagnosed with a non-malignant disorder.

High-dose hypofractionated proton beam radiation therapy is safe and effective for central and peripheral early-stage non-small cell lung cancer: results of a 12-year experience at Loma Linda University Medical Center.

Purpose: We update our previous reports on the use of hypofractionated proton beam radiation therapy for early-stage lung cancer patients.

Methods And Materials: Eligible subjects had biopsy-proven non-small cell carcinoma of the lung and were medically inoperable or refused surgery. Clinical workup required staging of T1 or T2, N0, M0.

Hypofractionated proton beam radiotherapy for stage I lung cancer.

Study Objectives: To determine the efficacy and toxicity of high-dose hypofractionated proton beam radiotherapy for patients with clinical stage I lung cancer.

Design: A prospective phase 2 clinical trial.

Setting: Loma Linda University Medical Center.

Time course of serum cytokines in patients receiving proton or combined photon/proton beam radiation for resectable but medically inoperable non-small-cell lung cancer.

Purpose: We prospectively measured the levels of basic fibroblast growth factor (bFGF), tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, IL-10, and procollagen III peptide (P III P) in serum from non-small-cell lung cancer patients treated with photons combined with protons or protons alone. These factors were quantified because they may be extremely important in the development of side effects, and the treated volume integral dose may be crucial in inducing them.

Methods: Of the 12 participating patients, 6 with squamous cell carcinoma (SCC) and 3 with adenocarcinoma received combined photon/proton beam radiation, whereas 2 with SCC and 1 with large-cell carcinoma (LCC) received only proton radiation.

Effects of proton and combined proton/photon beam radiation on pulmonary function in patients with resectable but medically inoperable non-small cell lung cancer.

Study Objectives: We evaluated the effects on pulmonary function of irradiating lung cancer with protons alone or protons combined with photons.

Design: Prospective phase I/II study.

Setting: University medical center.

Proton-beam radiotherapy for early-stage lung cancer.

Study Objective: A prospective study was undertaken to assess the efficacy and toxicity of conformal proton-beam radiotherapy for early-stage, medically inoperable non-small cell lung cancer.

Design: Eligible patients had clinical stage I to IIIa non-small cell lung cancer and were not candidates for surgical resection for medical reasons or because of patient refusal. Patients with adequate cardiopulmonary function received 45 Gy to the mediastinum and gross tumor volume with photons with a concurrent proton boost to the gross tumor volume of an additional 28.

Pulmonary injury from proton and conventional radiotherapy as revealed by CT.

Objective: Although radiation therapy is used in early-stage inoperable lung cancer, it often results in injury to functional lung tissue. A study was undertaken to determine the frequency and severity of pulmonary injury revealed by CT in patients who had undergone conformal proton (to a limited volume) radiation therapy. We compared these findings with those from a group of patients who had undergone a combination of photon and conformal proton (to a larger volume) radiation therapy.

Exercise-induced complete heart block in a patient with chronic bifascicular block.

Heart block induced by exercise or associated with symptomatic, chronic bifascicular block can progress to high-grade atrioventricular (AV) block and sudden death. The authors describe a case of exercise-induced AV block in a patient with chronic bifascicular block. Thirty seconds of ventricular asystole were observed during exercise treadmill testing.

Embryonal carcinoma of the testis presenting as a left heart mass.

A 31-year-old man with a history of intravenous drug abuse and tooth abscess was admitted for evaluation of possible infective endocarditis. Echocardiography showed that he had a left atrial mass. The mass removed from the left atrium had the same histology as the primary embryonal carcinoma discovered in the right testicle during hospitalization.