Ultrasound Fissure Observation: Assessment of Lung by Pleural-Hub Affiliates.

BACKGROUND: Lung ultrasound examination is becoming an even more important part of pulmonologists' clinical routine. As indicated in the literature, the coordinates of any findings on lung parenchyma are based on surface landmarks or conventional quadrants. In our experience we have noticed that lung fissures are clearly detectable as interruptions of the pleural line, but this has never been investigated previously. The aim of this study was to evaluate whether lung fissures are detectable under normal conditions in routine clinical practice. METHODS: Ten operators were enrolled from Pleural-Hub, a scientific discussion group. After compiling a prestudy survey to investigate whether they had observed fissures previously, they were asked to note if the following fissures were detectable: posterior right (PR) and left (PL), lateral right (LR) and left (LL), anterior right (AR), and anterolateral left (AL). Enrollment was competitive, aiming to reach 100 case subjects. RESULTS: We found that general fissure detection was 61.3%, in particular: PR, 59%; LR, 75%; AR, 69%; PL, 45%; LL, 64%; AL, 56%. Single operators yielded different detection rates ranging from 90% to 25%, showing strong operator dependency. Before being made aware of general results operators indicated operator's skill and rib shadow artifacts as the principal factors affecting fissure detection. CONCLUSIONS: Lung fissures may be detected with ultrasound once adequate training is provided. This may allow the clinician a more precise anatomical delineation of pathology identified by lung ultrasound.

Prognostic factors and outcome of resected patients for gastrointestinal stromal tumors.

BACKGROUND/AIMS: The aim of this study was to analyze the outcome of 33 patients with primary gastrointestinal stromal tumors (GISTs) who were observed and treated in a single teaching hospital and followed up prospectively. METHODOLOGY: Thirty-three GISTs patients (21 male; 12 female; mean age: 57 +/- 12 years; range: 23-76 years) between June 1994 and October 2004, were reviewed retrospectively. Patient, tumor, and treatment variables were analyzed to identify patterns of tumor relapse and factors affecting survival. RESULTS: Of 33 patients, 30 patients (91%) had primary tumor without metastasis, and all of them underwent complete surgical resection of gross disease. Three patients (9%) had metastasis. Among patients radically resected, the 5-year actuarial survival rate was 85%, and the disease-free survival was 76%. Among patients resected for cure, there were 6 recurrences. The mean time to recurrence was 22 +/- 11 months (range: 4-36 months), and liver was the prevalent site for relapsing disease (n = 5; 83%). After recurrence, survival at 2 and 3 years was 44% and 0%, respectively. CONCLUSIONS: GISTs are uncommon sarcomas. Tumor recurrence tends to be intra-abdominal. Investigational protocols are indicated to reduce the rate of recurrence after resection and to improve the outcome for patients with GIST.