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Biomedical subjects

A A Conlan

Publications and source records attributed to A A Conlan.

At least 55 records · Page 3Linked to original sources
PubMed1983

Lung cancer resectability in urban Blacks.

Two hundred and eighty-one patients with carcinoma of the lung were seen over a period of 30 months in our unit. All patients were investigated and staged according to the system of the American Joint Committee for Cancer Staging. Patients with stage I or stage II disease were operated upon, but those with stage III disease or with a pre-operative diagnosis of small cell tumour were not considered for surgery. Of the 281 patients evaluated, 83 (29,5%) underwent thoracotomy and 55 (19,6%) resection.

Black or African American↗
PubMed1983

Congenital broncho-oesophageal fistula. A case report.

A case of broncho-oesophageal fistula causing bronchiectasis of the left lung is reported. Oesophagorespiratory fistulas without atresia of the oesophagus often have an insidious clinical course and most commonly present in adulthood. This rare congenital anomaly should be considered as a cause of chronic pulmonary sepsis. The clinical, radiographic and therapeutic features of this lesion are discussed.

Bronchial Fistula↗
PubMed1983

Late management of penetrating oesophageal injury. Case reports.

Two cases of oesophageal perforation at the thoracic inlet, due to penetrating trauma, are described. In the first case the diagnosis was established 2 weeks after injury; the second case was diagnosed within 30 hours, was treated unsuccessfully and referred to us 1 month after injury. The management of these severely ill patients is discussed. Defunctioning of the oesophagus was necessary in both cases, and later reconstruction was carried out in one of the patients.

Adult↗
PubMed1983

Retrosternal gastric bypass for inoperable esophageal cancer: a report of 71 patients.

Palliative substernal gastric bypass was performed in 71 patients with unresectable cancer of the intrathoracic esophagus. Fifty-six patients (78.9%) left the hospital, 53 eating normally and 3 on a soft diet. There were 15 hospital deaths (21%), 8 due to respiratory failure and pulmonary sepsis with tracheoesophageal fistulization. The remaining 7 deaths were due to aspiration and respiratory failure in 2 patients, anastomotic leakage with sepsis in 2, subphrenic abscess and septicemia in 1, mediastinitis in 1, and intestinal obstruction in 1. Anastomotic leakage occurred in 17 patients (23.9%), 5 of whom died. Wound infections developed in 28 patients (39.4%), 3 with mediastinal esophagocutaneous fistulas. Reestablishment of unimpeded swallowing, relief of respiratory aspiration, isolation of cancerous tracheobronchial infiltration, and freedom from incident-prone endoesophageal tubes were achieved in all patients leaving the hospital. Information is presented on 25 patients who were available for follow-up.

Adult↗
PubMed1983

Massive hemoptysis. Review of 123 cases.

Case histories of 123 patients with massive hemoptysis were reviewed. The causes of hemorrhage were active pulmonary tuberculosis (47), bronchiectasis (37), chronic necrotizing pneumonia (11), lung abscess (six), lung cancer (six), bronchovascular fistula (five), primary pulmonary fungal infection (four), and miscellaneous (seven). Conservative management was used in 66 patients, with 21 deaths (31.8%). Surgical management was used in 34 patients, with six deaths (17.6%). Endobronchial iced saline lavage was used in 23 patients, with one death. All patients treated by lavage stopped bleeding, and further therapy, either surgical (five) or medical (18), was given as appropriate. The early control of tracheobronchial hemorrhage by endoscopic means is an effective though transitory holding procedure. The unpredictability of massive hemoptysis is underscored by eight deaths from sudden, engulfing hemorrhage in seemingly stable patients awaiting endoscopy or operation.

Adolescent↗
PubMed1982

Agenesis of the diaphragm. A case report.

A case of agenesis of the right hemidiaphragm in a 6-year-old child is reported. The rarity, aetiological differences in comparison with other diaphragmatic hernias, and other embryological aspects of this anomaly are discussed. The diagnostic and therapeutic approach to this entity is also presented.

Child↗
PubMed1982

Giant chondromatous hamartoma of the first rib. A case report.

Primary rib tumours uncommon in children and their diagnosis and management pose unique problems. The majority of these growths arise from cartilage and are malignant. Chondrosarcoma of varying histological gradations is the common tumour. The distinction between benign and malignant tumours is seldom clear-cut. We describe the presentation, management and pathological features in a child with a gaint chondromatous hamartoma of the first rib.

Adolescent↗
PubMed1982

High-velocity missile injuries of the thorax.

Nine patients who sustained high-velocity missile injuries to the thorax are reported. Two types of injury were seen: a 'through-and-through' injury (6 patients), and a 'tangential' injury (3 patients). Six patients underwent thoracotomy: 3 had pulmonary resections and 2 had closure of bronchopleural fistulas, while 1 had repair of the diaphragm and liver, which were lacerated, and a pleural toilet. A further patient had a rib resection for empyema at a later stage. All patients had intercostal drains inserted as initial treatment. There were no deaths, and those patients who underwent pulmonary resection recovered fully and rapidly after operation. Extensive pulmonary damage and lobar infarction occurred with 'tangential' high-velocity missile injuries to the thorax.

Humans↗
PubMed1982

The operative management of acute post-pneumonectomy bronchopleural fistula after flush bronchial amputation.

Acute disruption of the bronchial closure after pneumonectomy causes severe problems in patient management. Radical attempts at closure of the fistula and space obliteration (thoracoplasty) carry a high mortality. The management of this condition by a series of staged operative procedures is described. Pneumonectomy has usually been performed for bronchogenic carcinoma and prognosis is therefore guarded. Several low-risk operative interventions, with discharge from hospital between procedures, provide a safe and effective management method in the case described.

Bronchi↗
PubMed1982

Early decortication for the disorganized pleural space.

Early decortication is advocated for the disorganized pleural space. This series reviews 85 patients operated on for haemothorax and empyema as a result of penetrating chest trauma (61 cases), blunt chest trauma (2), post-pneumonic empyema (15), tuberculous empyema (4) and chronic pneumothorax (2). The aetiology, surgical technique and results are discussed. In 83% of cases there was complete clinical recovery and radiological re-expansion of the affected lung.

Adolescent↗
PubMed1982

Cyclophosphamide, doxorubicin and celestin intubation for inoperable oesophageal carcinoma.

In a prospective randomized study, 24 patients with inoperable oesophageal carcinoma were treated. Of the tumours 19 were squamous cell carcinomas, 3 anaplastic cell carcinomas and 2 adenocarcinomas. All the patients were males and the mean age was 57 years (range 40-69 years). The performance status of all candidates was H1 (as classified by the American Joint Committee), or 70 - 80% on the Karnofsky scale. All 24 patients had Celestin tubes inserted and 12 were treated with pulse doses of doxorubicin (Adriamycin) and cyclophosphamide once every 3 weeks. The dosage used for doxorubicin was 40 mg/m2 and that for cyclophosphamide 700 mg/m2. No serious drug-induced side-effects occurred and tumour regression was observed. Although an increase in median survival is shown in the chemotherapy group, no conclusions on survival can be drawn owing to the small number of patients in this pilot study. The 3-weekly pulse chemotherapy programme was well tolerated. It can be conducted on an outpatient basis with minimum disruption of the patient's life.

Adenocarcinoma↗
PubMed1982

Empyema and the urban black.

Fifty consecutive Black patients with thoracic empyema were studied retrospectively. The causes of the empyema were penetrating thoracic trauma (27 cases), lung abscess (10), post-aspiration pulmonary disease (4), and pulmonary and pleural tuberculosis (4); a miscellaneous group of 5 patients had empyema complicating an infected pulmonary cyst, a hepatic amoebic abscess, necrotic pulmonary lymphoma, thoracic actinomycosis and blunt thoracic trauma. Fourteen patients had bronchopleural fistulas. Patients were treated by closed-tube thoracostomy drainage alone (6 cases), rib resection and drainage (36), pulmonary decortication alone (3), and pulmonary decortication in association with a thoracic operative procedure (5). Results of treatment were good in the majority of patients with empyema (41), in 7 cases results were poor, and 2 patients died. Serious underlying pulmonary disease was responsible for treatment failure. Empyema in the urban Black is associated with prolonged morbidity and severe social consequences.

Adolescent↗