Bovine neonatal ataxia associated with hypocupremia in pregnant cows.
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Animals↗
Biomedical subjects
D E Sanders
Publications and source records attributed to D E Sanders.
Percutaneous fine-needle aspiration biopsy. I. Its value to clinical practice.
From the experiences in dealing with 2591 cases of transthoracic and transabdominal fine-needle aspiration biopsies (1967-1978), we present our views on the value of this relatively new diagnostic method to clinical practice. Virtually any accessible localized lesion in any organ of the body can be investigated by fine-needle aspiration biopsy, which is considered most useful in patients with suspected malignant disease. Transthoracic and transabdominal fine-needle aspiration biopsy may provide information otherwise obtainable only by thoracotomy or laparotomy. It is an inexpensive and safe method with high accuracy for obtaining a pathologic diagnosis, and can impart some practical significance to clinical practice, especially in clinical management. The pitfalls in cytomorphologic interpretation, which often cause unsuccessful attempts, can be readily avoided with increased practical experience, as indicated by the increase in detection rate of lung cancer by fine-needle aspiration method from 82.8% in 1967-1968 to 93.4% in 1976 at the Toronto General Hospital. The accuracy of cytologic diagnosis plays a major role in spreading this still relatively unfamiliar but excellent diagnostic method. We believe that the method deserves widespread clinical application and when this happens, it will bring about great savings in health care resources.
Abdomen↗
Incentive spirometry: its value after cardiac surgery.
Treatment with intermittent positive pressure breathing (IPPB) and incentive spirometry (I.S.) was compared in 109 patients after heart surgery with cardiopulmonary bypass. Assessment was done by measurement of vital capacity, arterial oxygen tension and identification of the radiological signs of atelectasis. All patients were instructed pre-operatively in the treatment which was to be used. Vital capacity, arterial oxygen tension while breathing air for the first three postoperative days and the incidence of atelectasis showed no significant difference between groups. Ten minutes after treatment the arterial oxygen tension fell, but this was only statistically significant after I.P.P.B. At 60 minutes the arterial oxygen tension had returned to pretreatment level in both groups. The use of the incentive spirometer four times daily is no better than I.P.P.B., in preventing atelectasis after open-heart surgery. Possibly incentive spirometer treatment given more frequently may be more effective.
Cardiopulmonary Bypass↗
Current concepts in fine needle aspiration biopsy cytology.
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Biopsy, Needle↗
Pulmonary alveolar proteinosis: relationship to silicosis and pulmonary infection.
Pulmonary alveolar proteinosis is a rare disease with varied radiographic and clinical manifestations. Thirteen patients are presented and the role of pulmonary lavage in management is illustrated. Six patients had associated diseases such as nocardiosis, leukemia, and silicosis. The broad spectrum of relationships found in alveolar proteinosis suggests that it represents one mechanism by which the lung responds to a variety of insults.
Adolescent↗
High morbidity pneumonia in dairy calves in Ohio (a case report).
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Animals↗
Differentiating between right displaced abomasum and cecal torsion in cows.
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Abomasum↗
Exogenous lipoid pneumonitis.
The clinical and radiologic diagnosis of exogenous lipoid pneumonitis often goes unrecognized. A specific history of lipoid aspiration is rarely obtained unless specifically sought. We analysed the clinical, radiologic and pathologic findings in 11 patients with pathologically-proven exogenous lipoid pneumonitis. Lipid aspiration results in a predictable pathologic and consequently radiologic pattern of disease, often simulating bronchogenic carcinoma. Transthoracic percutaneous fine-needle aspiration biopsy is useful as a complementary procedure to bronchoscopy in making the diagnosis.
Adult↗
Pulmonary atelectasis and other respiratory complications after cardiopulmonary bypass and investigation of aetiological factors.
Radiological evidence of pulmonary complications and possible aetiological factors were investigated in 50 consecutive patients after heart operations with cardiopulmonary bypass. Atelectasis was the most frequent pulmonary complication except for small pleural effusions, with an incidence of 64 per cent. Several types of atelectasis frequently co-existed, with a predominance of the less extensive plate and subsegmental forms. The incidence of atelectasis was the same on each side and the site of atelectasis was basal in three quarters of the patients. Preoperative clinical and catheter data were unrelated to the incidence of atelectasis. There was a significant positive correlation between a short cardiopulmonary bypass time and plate atelectasis, between a large fluid load after bypass and segmental atelectasis, between re-operation for bleeding and subsegmental atelectasis and between post-operative gastric dilation and atelectasis. The type of operation, the use of the intra-aortic balloon and the length of postoperative respiratory ventilation were unrelated to the incidence of atelectasis. The mechanism of development of atelectasis is discussed.
Adult↗
Unusual manifestations of pulmonary aspergillosis.
Pulmonary aspergillosis is being diagnosed with increasing frequency, particularly in larger referral centers. The spectrum of lung pathology can be classified into 3 major groups: A) non-invasive mycetoma; B) allergic bronchopulmonary aspergillosis and C) invasive aspergillosis. Five patients with pulmonary aspergillosis are presented, illustrating unusual features of each major group. Transthoracic needle aspiration biopsy was diagnostic in 3 patients. It is important to differentiate a mycetoma developing in a pre-existing cavity from a cavitating Aspergillus abscess. The radiologic appearances may be similar, but evolution of the 2 lesions is entirely different.
Adult↗
The Bartlett-Edwards incentive spirometer: a preliminary assessment of its use in the prevention of atelectasis after cardio-pulmonary bypass.
A preliminary assessment of the effectiveness of the Bartlett-Edwards incentive spirometer was made using it as part of the post-operative treatment of 34 patients after open-heart surgery. Its effects on atelectasis were assessed by measuring vital capacity, arterial oxygen tensions, clinical signs and radiological changes. It was found that vital capacity fell after surgery to 41.5 per cent of the pre-operative level, but this rose after the use of the incentive spirometer by an average of 15.5 per cent. Arterial oxygen tensions were unaltered by the use of the incentive spirometer. Temperature, pulse and respirations were of little help in the early diagnosis of atelectasis, but all patients who were still pyrexic four days after operation showed radiological evidence of atelectasis. The incidence of atelectasis demonstrated radiologically was total 84 per cent and plate 69 per cent, sub-segmental 34 per cent and segmental 9 per cent. The implications of these findings are discussed.
Adult↗
The radiologic diagnosis of malignant tumors of the salivary glands.
Radiologic investigation of possible salivary gland malignancy may answer in part questions concerning the lesion under study. Is it an invasive tumor, as evidenced by tissue destruction? Is the tumor intrinsic or extrinsic in origin to the salivary gland? Does the tumor extend into the deep portion of the salivary gland or beyond it into surrounding soft tissues? Sialography plays the major diagnostic role in consideration of the radiologic diagnosis of malignant tumors of the salivary glands. However, certain advanced radiologic modalities such as salivary gland scanning with sodium pertechnetate or 67Gallium citrate, as well as cervical ultrasound and computed tomography, may prove useful. This paper attempts to provide some answers to these questions.
Adult↗
Surgical treatment for pulmonary emphysema.
Three in-vivo observations stimulated interest in surgical treatment for emphysema: (a) the destructive changes are rarely generalized, (b) the central portions of the lungs are frequently less seriously affected, and (c) marginal folding produces obstructive change in the more normal lung tissue. If destroyed avascular space-occupying areas can be removed, the compressed lung tissue may be stretched to fill pleural space in a functionally effective fashion. Residual elastic tissue will them maintain patency of terminal bronchioles. Preoperatively the extent of the destructive change can be defined most accurately by pulmonary angiography, and zones of functioning capilary circulation can be identified. Forty-seven patients with multifocal space-occupying emphysematous change have been treated surgically. The postoperative mortality was 21% but worthwhile long-term improvement has been obtained in 45% of patients presenting with disabling dyspnea. In these patients, surgical treatment warrants consideration if significant space occupation accompanies the bullous disease, provided alveolar vascularization can be demonstrated in the compressed adjacent normal lung tissue. Limited resections that preserve all vascularized and potentially functioning lung tissue are preferable. It is essential that obliteration of the hemithorax be obtained promptly in view of the high incidence of postoperative complications requiring secondary operative procedures, if 'leaks' and residual spaces are allowed to persist. Postoperative care in a respiratory intensive care unit is mandatory.
Adult↗
The radiologic diagnosis of malignant tumors of the larynx.
A variety of radiologic examinations are used to assess malignant tumors of the larynx. The primary role of radiographic examination is the pretreatment classification of laryngeal cancer, necessary to select the appropriate modality of treatment. The major radiologic modalities comprise conventional lateral radiography, anterior-posterior tomography, laryngography, xeroradiography, and high KV selective filtration radiography. Advanced radiologic modalities such as CT scanning and transverse B-mode gray scale ultrasound may also prove useful. It is the purpose of this presentation to define the role of these modalities in pretreatment definition of laryngeal cancer. Additionally, some comment is made as to the role of radiology in the diagnosis of post-radiation therapy recurrence of laryngeal cancer.
Adult↗
Intrathoracic manifestations of amyloid disease.
Nine cases of intrathoracic amyloid disease have been reviewed. A brief summary of historical material is presented along with detailed descriptions of the more pertinent cases. Observations suggest that a classification of the radiographic manifestations is needed with stress on massive calcific lymph node enlargement and a pulmonary lesion characterized by aggregations of small nodules.
Adult↗
The small bowel enema: experience with 150 examination.
Clinical application of the small bowel enema has received waxing and waning enthusiasm since it was first described in 1929. Our experiences with 150 small bowel enema studies is presented. The Sellink method was used for patients without ileostomy, (140), and retrograde studies for those with ileostomy. The merits of the small bowel enema compared to the conventional technique are discussed. The small bowel enema is the preferred method for radiologic assessment of the small bowel in patients whose clinical picture suggests small bowel disease.
Adult↗
Percutaneous aspiration lung biopsy.
A total of 182 percutaneous trans-thoracic aspiration biopsies were performed in 164 patients over a three-year period. In malignant neoplasms arising in the lung the diagnostic accuracy rate was 84%. In the non-malignant localized parenchymal lesions the accuracy drops considerably unless the lesion is cystic or cavitary. Some patients with non-parenchymal lesions were selected to assess further the value of this procedure. It proved much less rewarding in lesions of the chest wall, diaphragm and also in diffuse parenchymal disease. These lesions may be more accurately identified by other methods of biopsy. Lesions presenting as a mediastinal mass are an intermediate group and in selected cases helpful information can often be obtained by small-bore needle aspiration, particularly if a pericardial, bronchogenic or thymic cyst is suspected. Recent reports have shown that the aspiration of pulmonary lesions can be utilized to obtain viable tumour cells for chemosensitivity testing. The aspiration of nodular pulmonary lesions should be considered when a diagnosis is not forthcoming from the usual investigative means, since there has been little morbidity and no mortality in the series.
Biopsy↗