Search PubMed⌕ Search

Biomedical subjects

B D Daly

Publications and source records attributed to B D Daly.

At least 55 records · Page 3Linked to original sources
PubMed1989

Transsternal radical thymectomy for myasthenia gravis: a 15-year review.

Thymectomy is an accepted therapeutic modality for patients with myasthenia gravis. The selection of patients for operation and the surgical approach are controversial. We reviewed 52 patients (aged 18 months to 82 years; mean age, 34 years) treated with transsternal radical thymectomy between 1972 and 1987. Patients were symptomatically staged according to the modified Osserman classification. There was one hospital death and postoperative follow-up was obtained on 51 patients. Improvement after thymectomy was observed in 3 of 11 patients (27%) in Osserman stage I, 16 of 25 patients (64%) in Osserman stage IIA, and 13 of 15 patients (86%) in combined Osserman stages IIB, III, and IV. Preoperative Osserman stage, patient sex, and thymic histology correlated with postoperative clinical response. Transsternal radical thymectomy is effective therapy for myasthenia gravis. Sustained improvement is obtained in patients with moderate and advanced disease. The majority of patients with ocular disease do not benefit from operation.

Adult↗
PubMed1989

Evaluation of response following irradiation of juvenile angiofibromas.

Ten cases of angiofibroma treated by irradiation are reported. Relief of symptoms occurred by the end of treatment in eight patients. Objective regression was much slower, six having visible disease for greater than 6 months and four for at least 1 year. Only one was symptomatic. Radiological resolution lagged behind clinical improvement and was complete in only one of three asymptomatic patients evaluated by computed tomography (CT) at between 2 and 3 years after treatment. The significance of these residual masses seen on CT is unclear.

Adolescent↗
PubMed1989

Radiological appearances of colonic ring staple anastomoses.

The radiographic appearances of colonic staple ring anastomoses are presented. Staple ring disruption on plain abdominal radiographs in the early post-operative period suggests dehiscence of the bowel anastomosis and is an indication for urgent water-soluble contrast medium enema to confirm the diagnosis. Rectal stenosis can develop as a late complication of staple anastomosis and may be detected on barium enema.

Adenoma↗
PubMed1988

Tracheoesophageal fistula associated with Barrett's ulcer: the importance of reflux control.

A benign tracheoesophageal fistula occurring as a complication of Barrett's ulcerative esophagitis is described. Surgical control of gastroesophageal reflux resulted in healing of the fistula, obviating the need for a resective procedure or esophageal exclusion. Although Barrett's ulcer has been reported as a cause of acquired esophagorespiratory fistula, to our knowledge, the important role of reflux control in the management of this difficult problem has not been discussed.

Aged↗
PubMed1988

Bilateral ureteric carcinoma.

We report two rare cases of bilateral simultaneous ureteric carcinoma. The radiological features and problems of management are discussed.

Carcinoma, Transitional Cell↗
PubMed1988

Eloesser window thoracostomy for treatment of empyema: radiographic appearance.

The modified Eloesser procedure or open-window thoracostomy is a surgical treatment for chronic pleural empyema in which a relatively permanent drainage opening is created in the chest wall. The chest radiographs and CT scans of 13 patients who underwent a modified Eloesser window procedure were studied. On chest films, the Eloesser window characteristically appeared en face as an elliptical or crescent-shaped radiolucency with sharp superior and ill-defined inferior margins. It appeared in profile as a downward-sloping chest-wall defect with round superior and straight inferior margins. The first radiographs made after surgery often showed potentially confusing densities caused by the iodinated gauze used to pack the drained empyema cavity. On sequential chest films, the defect in the chest wall was always detectable, while the pleural cavity diminished in size and usually disappeared within 6 months. This analysis shows that the postoperative chest radiographs and CT scans in patients having the Eloesser window thoracostomy have features that are characteristic of the procedure.

Aged↗
PubMed1988

Medial talo-calcaneal coalition. Case report.

Medial talo-calcaneal coalition is an uncommon developmental anomaly consisting of a bony projection arising from the postero-medial aspect of the sustentaculum tali, which may articulate with another bony projection from the medial aspect of the talus. Fibrous, cartilaginous or bony ankylosis may occur. It usually presents in adolescents, and causes pain following exercise. It may cause a lump, and can predispose to flat foot and early osteoarthrosis. This condition is easily overlooked on routine views of the ankle, and may require oblique views and tomography for its detection and clarification.

Adolescent↗
PubMed1987

Mediastinal lymph node evaluation by computed tomography in lung cancer. An analysis of 345 patients grouped by TNM staging, tumor size, and tumor location.

To more clearly characterize the role of computed tomography in staging the mediastinal lymph nodes of patients with lung cancer, we analyzed computed tomographic and surgical findings in the chest in 345 consecutive patients with lung cancer who underwent operative staging. Patients were grouped according to the TNM staging system of the American Joint Commission, central or peripheral location of the primary tumor, lobar location of the tumor, and maximum tumor diameter as determined by computed tomography or gross pathology. One third of patients with abnormal findings on the computed tomographic scan did not have mediastinal lymph node metastases. Mediastinal metastases occurred frequently in patients with central cancers (38%). The predictive value of a negative scan in all patients was high (greater than or equal to 90%) except for patients with central T3 lesions (72%), left upper lobe lesions (83%), and central adenocarcinomas (75%). However, only the differences between central T3 and central T2 or T1 lesions, and between central adenocarcinomas and central squamous cell carcinomas, were unlikely to be due to chance alone (p less than 0.05). None of the lobar differences were statistically significant. The frequency of mediastinal metastases in patients with peripheral lesions was 15% (28 of 192 patients); computed tomography correctly identified enlarged mediastinal lymph nodes in all but seven patients. However, there were no true-positive computed tomographic scans in 59 patients with peripheral lesions 2 cm in diameter or smaller; accordingly, we suggest that computed tomography is not indicated for the sole purpose of mediastinal staging in this group. Ninety-four percent of patients in this series undergoing thoracotomy with a curative intent had a curative resection. Only 4% had unresectable lesions; palliative resections were done in 2%.

Adult↗
PubMed1986

Staging with CT.

Explore the source record for details and available documents.

Humans↗
PubMed1985

Corynebacterium hemolyticum endocarditis on a native valve.

We have described a patient with fatal Corynebacterium hemolyticum endocarditis on a native bicuspid aortic valve. This is the first report of endocarditis and the first fatal infection of any kind caused by Corynebacterium hemolyticum. This organism and other nondiphtheria corynebacteria must be considered as potentially serious pathogens in man.

Aged↗
PubMed1984

Treatment of chronic pancreatitic pleural effusion by percutaneous catheter drainage of abdominal pseudocyst.

A 53-year-old man entered the hospital with a large, right chronic pancreatitic pleural effusion. Computed tomographic examination of the abdomen and chest demonstrated a pancreatic pseudocyst that had extended into the mediastinum. After conventional closed-chest tube thoracotomy drainage failed to empty the pleural space, percutaneous abdominal pseudocyst drainage was instituted using computed tomographic guidance. The pleural effusion cleared promptly, and the pancreatic pseudocyst resolved gradually over seven weeks. Following termination of pseudocyst drainage, the patient has remained well for over two years with no recurrence of pancreatitis, pseudocyst, or pleural effusion. In contrast, three earlier patients with a chronic pancreatitic effusion managed conventionally had a complicated hospital course and required surgical intervention; two had recurrent pancreatitis following hospital discharge. Percutaneous catheter placement was unsuccessful in one of these three and, in retrospect, was infeasible in the other two. It is recommended that thoracoabdominal computed tomography be performed in all patients with a chronic pancreatitic pleural effusion, and that percutaneous abdominal catheter drainage be attempted in all patients with an accessible pancreatic or mediastinal pseudocyst. Such treatment may relieve respiratory insufficiency, minimize the risk of empyema or fibrothorax, and may promote pseudocyst closure without the need for surgery.

Chronic Disease↗
PubMed1984

Computed tomography. An effective technique for mediastinal staging in lung cancer.

Computed tomographic scans of the chest were utilized to stage mediastinal disease in 148 instances of bronchogenic carcinoma considered for resection in 146 patients. Nodes greater than or equal to 1.5 cm in diameter were interpreted as abnormal. All nodes positive by computed tomography were evaluated by mediastinoscopy, anterior mediastinotomy, or thoracotomy. All patients with negative computed tomographic findings underwent thoracotomy without prior surgical staging. Patients undergoing thoracotomy were divided into two groups. In Group I (first 51 instances) routine mediastinal exploration was not carried out; in Group II (last 97 instances) the mediastinum was explored in every patient and nodes were submitted for histopathological study. The computed tomographic and pathological findings on the mediastinal lymph nodes were compared. The sensitivity, specificity, and accuracy of computed tomography in Group I were 88%, 94%, and 92%, respectively, in Group II 75%, 89%, and 86%, and in the combined group, 80%, 91%, and 88%. The positive predictive index in Group I, Group II, and in the combined group was 88%, 69%, and 77%, respectively. It was lower for central than peripheral lesions (74% versus 88%) and was lowest for lesions in the right upper and left lower lobes. The negative predictive index was greater than 90% for all groups and all tumor sites except the left upper lobe, where it was 89%. Ten patients had false-positive scans, three with old mediastinitis and seven with postobstructive pneumonia; nine of the 10 had central lesions, and seven of these lesions were located in the right upper lobe. Eight patients had false-negative scans; six had para-aortic, subaortic, or postsubcarinal nodes. These nodes would not have been accessible to mediastinoscopy. In only one patient with false-negative nodes would routine mediastinoscopy have prevented thoracotomy and resection. Computed tomographic staging of mediastinal disease is indicated for all patients with lung cancer in whom operation is contemplated. Computed tomography directs the most appropriate staging procedure for patients with positive findings and obviates invasive staging for patients with negative findings.

Adult↗
PubMed1983

Development and in vivo testing of a chronic percutaneous prosthesis.

Significant progress has been made in the development of a percutaneous energy transmission system (PETS) designed to provide energy to intracorporeally implanted blood pumps for up to 2 years. The mean survival of our six most recent PETS implantations was 351 +/- 33 days. Four of these were explanted electively after a full year of implantation. Sinus formation around each prosthesis was limited by a biomaterial seal at the sinus termination point. The results support the hypothesis that collagen inhibits epidermal downgrowth. Continued development of systems based on this hypothesis is desirable.

Animals↗