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Biomedical subjects

A P Naef

Publications and source records attributed to A P Naef.

At least 19 recordsLinked to original sources
PubMed1998

William E. Adams: Thomas Mann and The Magic Mountain.

The lobectomy for carcinoma of the lung performed by William E. Adams in 1946 on Thomas Mann, author of the tuberculosis saga The Magic Mountain, deserves to be added to Harold Ellis's series of "historically famous operations." This lobectomy, by which the surgeon cured his far more famous patient, was only one episode in his 40 eventful years as Chicago's leading pioneer in early thoracic surgery. The historic case is well documented by preoperative, operative, and pathology reports obtained through the courtesy of still-living witnesses and associates, friends of the author. Thomas Mann died 9 years later of an aortoiliac rupture at the University Hospital in Zurich. At autopsy no local recurrence or distal metastasis was found.

Famous Persons↗
PubMed1997

History of emphysema surgery.

Ever since the advent of modern chest surgery, surgical pioneers have attempted operations to alleviate, if not cure, patients with emphysema. From the physiologic standpoint illogical procedures such as costochondrectomy, phrenisectomy, or thoracoplasty lead to disastrous results, whereas the effect of operations on the autonomous nervous system was unpredictable. The only worthwhile procedure was bullectomy for localized bullous emphysema. The concept of volume reduction developed by Brantigan in the 1950s and rediscovered by Cooper is the only successful surgical approach to an essentially incurable pulmonary disease.

History, 20th Century↗
PubMed1993

Hugh Morriston Davies: first dissection lobectomy in 1912.

Hugh Morriston Davies (1879-1965), long before anybody else, performed the first anatomic dissection lobectomy for a tumor of the lung in 1912. By replacing the hilar mass-ligation-suture technique, he was decades ahead of his time, and had his patient not died 8 days after the operation, he would have preceded Evarts Graham's first lung resection for cancer by 21 years! An all-around chest physician and surgeon in one, he had introduced chest radiography and positive-pressure intratracheal anesthesia the year before, thus making the diagnosis and operation of this lung cancer possible. He concluded that lung cancer was accessible to surgical removal on condition of an early diagnosis. By destiny a surgeon as well as a physician, Morriston Davies was probably the earliest advocate of interdisciplinary teamwork in thoracic medicine.

History, 20th Century↗
PubMed1992

Forgotten pioneers in thoracic surgery.

The names of Carrel, Sauerbruch and Blalock are milestones in the early history of thoracic surgery. The recognition of contributions by less renowned contemporaries does not diminish the decisive part played by these founders of prestigious schools of thoracic surgery. Krönlein who in 1883 successfully performed what was probably the first lobectomy is never mentioned. The esophagectomy without thoracotomy publicized by Orringer in 1978 had already been done by Gray-Turner 47 years before, in 1931. McLean who discovered heparin, and Forssmann who introduced cardiac catheterisation by passing an ureteral catheter into his own heart ended up as small-town general surgeons. Horace Smithy of Charleston successfully performed an operation for mitral stenosis four months before Bailey and Harken. Unlike his famous contemporaries, he was unable to publicize his cases at medical meetings because that same year, 1948, he died from an aortic vascular stenosis. Vineberg, who had recommended and successfully performed internal mammary artery implantation since 1946, was smiled at as a utopian until his rehabilitation by Mason Sones' coronarography and until coronary bypass surgery developed into the greatest boom in thoracic surgery. Sir Henry Souttar, who is known to have operated successfully a mitral stenosis a quarter of a century before Bailey, when asked why following his 1925 success he did not persue mitral surgery answered: "Because I could not get another case!" As usual, surgical "break-throughs" met with the resistance of medical men. Before doctors became enthusiastic advocates and referred thousands of cases of pulmonary tuberculosis, and mitral and coronary stenosis, their opposition had to be overcome by successful operation of generally desperate cases.(ABSTRACT TRUNCATED AT 250 WORDS)

History, 19th Century↗
PubMed1991

[Tuberculosis--the starting point of thoracic surgery].

The amazing development of thoracic surgery was due to the extraordinary number of operations necessary in the treatment of diseases of epidemic proportions: tuberculosis, rheumatic heart disease and coronary disease. From 1939 onwards, the young chest surgeons were confronted with war wounds of the heart and great vessels. Back in civilian practice, they became the pioneers of an initially primitive, blind cardiac surgery. In the course of 40 years this surgery developed to become the highly specialized interdisciplinary specialty of today's cardiovascular surgery, the crowning of which is the routine heart transplantation of 1990.

History, 20th Century↗
PubMed1990

Successful closure of chronic BPF by thoracoscopy after failure of endoscopic fibrin glue application and thoracoplasty.

We report a case of chronic debilitating BPF following right upper lobe resection. Despite several endobronchial applications of fibrin glue, we could not close it. Since the patient was extremely debilitated by symptoms due to the BPF, a thoracoplasty was attempted but was not successful. Finally, the BPF was definitely closed by instillation of talc into the pleura through thoracoscopy. To our knowledge, this is the first reported case of chemical closure of a recalcitrant BPF by the route of thoracoscopy. It also shows the failure of endoscopic fibrin glue application in such a condition.

Bronchial Fistula↗
PubMed1989

[Progress in thoracic surgery since 1980].

Modern thoracic surgery was born at about the time the Swiss Surgical Society was founded. Tuffier, Rehn, Lilienthal, Thorek were some of the pioneers. Today the important developments are esophagectomy without thoracotomy, the routine performance of cardiac transplantation and the emergence of lung transplantation. The past, present and future of these developments are outlined.

Esophagus↗
PubMed1979

[Surgery of bronchial neoplasms].

Surgical resection is the most efficient therapy for lung cancer. Preoperative investigation should determine histology, local invasion and distant dissemination. Tumor-host relation (immunocompetence and tumor burden) is essential for long-term results. Relatively crude anatomical staging does not take biological parameters into account, and any case with lympho-glandular involvement (N1) should not be considered as stage I carcinoma. 520 cases treated by pulmonary resection are reviewed and common denominators for long-term survivors determined. Stage I epidermoid carcinoma treated by lobectomy or left pneumonectomy with a short history (survey cases) are the ideal candidates for surgical resection. The importance of early diagnosis by routine screening is stressed.

Bronchial Neoplasms↗
PubMed1979

[Federation of Swiss Physicians and the training of general surgeons].

The author recommends the Residency Program of the Halsted type as developed by D.C. SABISTON in the Departement of Surgery at Duke University. A two-year training in the basic problems, knowledge, and attitudes, common to all surgical subspecialties, is of fundamental importance (Fig. 1). The goal of this type of training is the US-Board Certification.--The Swiss Medical Federation considers the following factors as essential in a surgical training programm: The training of the general surgeon should be geared to broad principles without early overspecialisation. The training should allow a certain flexibility for the teacher as well as the candidate. A sufficient operative experience is paramount as well as the habit of a continuous education all trough a life-long surgical career and an understanding for economy in surgical practice.--The training of an university--or a private--surgeon does not give rise to important problems, whereas the training of surgeons for the medium sized and small Swiss hospitals represents a difficult problem. A double training in "visceral" and "orthopaedic" surgery with an accent on one or the other seems necessary in order to have one chief surgeon take the place of another during vacation, week-ends and illness. Even if such a complete training seems desirable, it can be justly questioned if under the present circumstances (emergency transportation, regionalized hospital organization, specialized hospital consultants) it is still justified to aim at the training of a "complete" surgeon who elsewhere, in a university hospital or in private practice or for that matter in other countries, is no longer absolutely necessary.

Certification↗
PubMed1977

[Bronchial adenoma].

Twenty-four patients with bronchial adenoma seen over a 20-year period are reviewed. Follow-up data was available in all patients. They included 19 with carcinoid, 2 with adenoid-cystic carcinoma, and 3 with muco-epidermoid carcinoma. Recurrent pulmonary infection, cough and hemoptysis were the most common clinical manifestations. Surgical resection was performed in all but one patient, who was treated by irradiation; bronchoplastic and conservative resectional procedures were used in 5 patients with carcinoid adenoma. Carcinoid tumors are considered to be very slowly-growing malignant neoplasms that sometimes give rise to metastases to regional lymph nodes. Such metastases were present in only one patient. All patients are alive and well. Adenoid-cystic carcinoma is a more aggressive tumor with a tendency to recur. Much of the difficulty in its treatment is due to its close proximity to the bifurcation of the trachea. One patient was operated upon three times for local recurrences and ultimately died from respiratory failure after the third operation. The other patient received radiation therapy with cobalt and is well, without recurrence, 3 years after the treatment. The 3 muco-epidermoid carcinomas were histologically similar to such tumors of salivary glands but behaved clinically like highly malignant tumors, no patients surviving 8 months after resection. The term bronchial adenoma is a misnomer. The neoplasms grouped under this heading should be called carcinoid adenoma, adenoid-cystic carcinoma, and muco-epidermoid carcinoma and considered as separate entities, since the ultimate course and prognosis is definitely different.

Adenoma↗