Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy

Prognostic significance of surgical-pathologic multiple-station N1 disease in non-small cell carcinoma of the lung

Objectives: The surgical outcome of pathologic N1 disease in resectable, non-small cell lung carcinoma (NSCLC) is controversial. The prognosis of the patients with multiple/bulky N2 disease was invariably dismal. However, the prognostic significance of tumor involvement in more than one hilar or intralobar lymph node station has not been fully described. Methods: From 1996 to 2002, 181 patients with NSCLC had complete resection. Four levels of N1 nodes and N2 nodes were identified using the new regional lymph node classification for lung cancer staging. There were 67 patients (37%) with no nodal disease (NO), 43 patients (24%) with N1 and 71 patients (39%) with N2 disease. The N1 subgroup cases were reviewed. The prognostic significances of single and multiple N1 diseases were tested. Results: The cumulative postoperative survival at 3 and 5 years was 57 and 29%, respectively. The survival associated with single-station N1 disease was significantly better than that of multiple-station N1 disease (45 vs 32% at 5 years; P = 0.03). Five-year survival was similar in patients with multiple N1 disease and patients with single-station N2 involvement (32 vs 31% at 5 years; P = 0.84). However, no patient survived when tumor was detected in more than one mediastinal station (i.e. multiple N2 disease). Conclusions: It was suggested that N1 disease is a compound of two subgroups: one involving in one node and the other (multiple N1 disease) in which the postoperative prognosis was not statistically different from that of N2 disease. (C) 2003 Elsevier B.V. All rights reserved

Very Important Histopathological Factors in Patients with Resected Non-Small Cell Lung Cancer: Necrosis and Perineural Invasion

Background: The current staging system provides an anatomical classification of lung tumors; its secondary purpose is to allow the prognostic stratification of patients into homogeneous groups after surgery. In this work, intratumoral perineural invasion, lymphatic and blood vessel invasion together with the necrosis content of the tumor exclusive of the non-small cell cancer staging system were studied

Remote Control of Mobile Robot via Internet

The paper describes experiments in telerobotics via low-bandwidth communication channels. A mobile robot with sonar and infrared range-finding sensors as well as tactile and proprioceptive sensors at Manchester University in the United Kingdom was controlled by three of the authors from Bremen University in Germany in real time, using low bandwidth internet communication facilities. The experiments comprised remote surveying, fine motion control and object manipulation tasks. The purpose of the investigations was to determine whether remote access to robotics facilities can be achieved in this way (training and sharing of resoures), and whether the limited bandwidth of the internet is sufficient for more complex tasks than just crude motion control. 1 Introduction Remote manipulation of objects has been an issue for centuries (blacksmiths' tongs, for example), and following the development of suitable technology the field has progressed from purely mechanical manipulators to more soph..