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Biomedical subjects

A J House

Publications and source records attributed to A J House.

8 recordsLinked to original sources
PubMed1981

Accuracy of computed tomographic scanning in assessment of the mediastinum in bronchial carcinoma.

We believe that malignant involvement of mediastinum is a contraindication to attempted resection of bronchial carcinoma. It was hoped that computed tomographic (CT) scanning might improve our ability to assess the mediastinum prior to thoracotomy. The accuracy of CT scanning, performed with modern techniques, in assessment of the mediastinum of 22 patients with bronchial carcinoma has therefore been determined. In all the patients CT scan impressions have been correlated with the histologic findings at thoracotomy or mediastinoscopy. In detection of malignant involvement of the mediastinum, the CT scan had a sensitivity of 80% and a specificity of 76%. There was only one false negative CT scan report, and in this case the mediastinum was involved at a site which could not have been inspected at anterior cervical mediastinoscopy. We conclude that a negative CT scan makes mediastinoscopy an unnecessary screening procedure in determining resectability. Since there was a significant number of false positive CT scans, we feel that such a report necessitates tissue confirmation before the decision to withhold thoracotomy is made. The CT scan may help to determine the best test to achieve this tissue confirmation.

Bronchial Neoplasms↗
PubMed1979

Biopsy techniques in the investigation of diseases of the lung, mediastinum, and chest wall.

Closed biopsy techniques are available for the investigation of diseases of the mediastinum, hilus, and chest wall as well as for pulmonary and pleural disease. Biopsy via the bronchoscope is of greatest value in the diagnosis of endobronchial lesions, especially those that are centrally sited, and of diffuse pulmonary disease including opportunistic infections. Fluoroscopically controlled fiberoptic bronchoscopy is beginning to replace the transcatheter biopsy technique. In general, the use of large needles for biopsy should be avoided. Percutaneous fine needle biopsy is an effective means of sampling lesions of the mediastinum, hilus, and chest wall. However, this mode of biopsy is most widely used as a safe and highly accurate means of diagnosing localized pulmonary disease.

Adult↗
PubMed1978

Percutaneous lymph node aspiration biopsy: experience with a new technique.

Experience with post-lymphographic percutaneous fine needle aspiration lymph node biopsy is described in 13 patients with suspected metastatic malignant disease. All aspirations were performed using an anterior transabdominal approach under local anaesthesia with fluoroscopic guidance. In most patients more than one lymph node was biopsied. Four patients with confirmed metastatic disease had a positive biopsy in the appropriate lymph node. Seven patients with negative biopsies had the absence of metastatic disease confirmed by surgery or follow-up roentgenograms. One patient with a negative biopsy was lost to follow-up. There were two patients with negative biopsies in whom representative lymphoid tissue was not aspirated. No evidence of metastasis was found in these patients at surgery. No serious complications were encountered.

Adult↗
PubMed1977

The significance of an air oesophagogram visualised on conventional chest radiographs.

Air may occasionally be seen outlining the entire oesophagus on conventional chest radiographs, this being referred to as an air oesophagogram. The reported causes of this radiological sign are reviewed. The chest radiographs of 24 cases of scleroderma with oesophageal involvement, and 29 cases of achalasia, have been studied. An air oesophagogram was seen in three cases (12.5%) of scleroderma and three cases (10%) of achalasia, without an oesophageal air fluid level and with air in the gastric fundus. An air oesophagogram has not been previously described in achalasia. The significance of this sign, which was found to occur in advanced scleroderma and in early achalasia, is discussed.

Adult↗
PubMed1977

Evaluation of a new transthoracic needle for biopsy of benign and malignant lung lesions.

The results of 88 transthoracic needle biopsies of lung lesions using the Rotex biopsy instrument are analyzed. Of 57 malignant lung lesions, 55 were diagnosed correctly. Two patients with false negative biopsies had technically inadequate examinations. All but one of the 28 benign lung lesions were correctly diagnosed as nonmalignant. One false positive diagnosis of malignancy was made. The occurrence of complications was similar to those reported for conventional fine needle aspiration. The high accuracy rate is attributed to the effectiveness of the Rotex instrument in sampling the lesions and to the use of biplane fluoroscopy.

Adult↗