Search PubMed⌕ Search

Biomedical subjects

D R Sanderson

Publications and source records attributed to D R Sanderson.

At least 37 records · Page 2Linked to original sources
PubMed1983

Interstitial lung disease. Assessment by bronchoalveolar lavage.

Bronchoalveolar lavage is a new bronchoscopic technique that permits assessment of changes in the cellular traffic in the alveolar spaces. During a 16-month period, 120 patients underwent bronchoalveolar lavage at our institution. Control subjects (N = 11) had a predominance of alveolar macrophages (94 +/- 1%) with a few lymphocytes (4 +/- 1%), whereas 35 patients with idiopathic pulmonary fibrosis had a substantial increase in the number of polymorphonuclear leukocytes (17 +/- 2%), and 32 patients with sarcoidosis had an appreciable increase in the number of lymphocytes (27 +/- 2%). Further subtyping of these lymphocytes in 13 patients with sarcoidosis revealed the cells to be predominantly from the T-helper subclass (helper/suppressor ratio of 5.3/1.0; normal 1.8/1.0). In contrast, three other patients with a lymphocytic alveolitis (51 +/- 8% lymphocytes) had a pronounced predominance of T-suppressor lymphocytes (helper/suppressor ratio of 0.1/1.0) in the lavage fluid. Two of the three patients were thought to represent an unusual subset of patients with idiopathic pulmonary fibrosis, and the third patient had pulmonary involvement secondary to angioimmunoblastic lymphadenopathy. Thus, bronchoalveolar lavage may be a useful means by which to assess the influx of inflammatory or immune effector cells into the alveolar structures in patients with interstitial lung disease, and this procedure offers promise as a quantitative means by which to assess the disease activity and the response to therapeutic intervention in these patients.

Bronchi↗
PubMed1983

Roentgenographically occult lung cancer. A ten-year experience.

During the past 10 years, 54 patients, all men, were found to have roentgenographically occult lung cancer. The mean age was 61 years (range 45 to 76 years). All patients had abnormal findings on sputum cytologic study (carcinoma in 41 patients and squamous cell atypia in 13). The cancer was localized by bronchoscopy in all patients (range one to five examinations, mean 1.5). Seventy-five percent of the tumors were localized within 169 days of the abnormal sputum cytologic examination. Pulmonary resection for cure was performed in all patients: lobectomy in 38, pneumonectomy in nine, and bilobectomy in seven. Operative mortality was 5.6% (three patients). Fifty-eight cancers were resected, all squamous cell carcinomas (two had a component of large cell cancer). Tumor TNM classification (AJC) was TIS N0 M0 in 19 patients, T1 N0 M0 in 25, T1 N1 M0 in five, T2 N1 M0 in four, and T3 N0 M0 in one. Overall 5 year actuarial survival rate (lung cancer deaths only) was 90%. Five-year survival rate for the 44 patients with TIS N0 M0 and T1 N0 M0 neoplasms was 91%. Currently, 21 patients have died, but only 10 of lung cancer. Subsequent additional lung cancer developed in 12 patients (22%). Eleven of these patients had a second primary squamous lung cancer, six of which again were occult. We conclude that patients with occult lung cancer have a strong likelihood of long-term survival if treated early. Close surveillance is indicated because of the high incidence of a second primary lung cancer.

Aged↗
PubMed1982

Hematoporphyrin derivative in the detection and localization of radiographically occult lung cancer.

Hematoporphyrin derivative used in conjunction with the Mayo Clinic bronchofiberscopic fluorescence detection system allows accurate localization of radiographically occult early squamous cell carcinoma. Thirteen tumors were localized in 10 patients with radiographically occult lung cancer. Six were in situ with or without microinvasion and were also bronchoscopically occult. Localization of these 6 tumors was expedited by the use of hematoporphyrin derivative and the bronchoscopic fluorescence detection system. Hematoporphyrin-derivative fluorescence was not specific for carcinoma and was also detected in areas of moderate and marked squamous cellular atypia. Thus, although detection of hematoporphyrin-derivative fluorescence suggests the presence of cancer, proof depends on histologic or cytologic confirmation.

Bronchoscopy↗
PubMed1979

Esophagomyotomy versus forceful dilation for achalasia of the esophagus: results in 899 patients.

Between 1949 and 1976, 899 patients underwent treatment for achalasia of the esophagus at the Mayo Clinic, 431 by forceful hydrostatic or pneumatic dilation and 468 by a standardized transthoracic esophagomyotomy. Esophageal leak and mediastinal sepsis was an uncommon but major complication of both types of therapy, occurring four times more often with dilation (4%) than with myotomy (1%), although no deaths resulted from this in either group. The 30-day mortality was 0.2% after myotomy and 0.5% after forceful dilation. Although there was minimal morbidity and mortality with either modality, the late results were significantly superior after myotomy. Excellent to good results were obtained by 85% of the group treated with myotomy but only by 65% of those treated with hydrostatic dilation. Late poor results were encountered three times more frequently after dilation (19%) than after myotomy (6%). Analysis of poor results after myotomy indicates that late serious complications of gastroesophageal reflux developed in only 3% of patients operated on.

Adolescent↗
PubMed1979

Clinical application of a new endoscopic technique for detection of in situ bronchial carcinoma.

Hematoporphyrin is preferentially concentrated by cancer tissue and therefore is a potentially useful chemical marker. This report demonstrates the effectiveness of a photoelectric hematoporphyrin fluorescence detector used simultaneously with flexible fiberoptic bronchoscopy as a means of detecting and localizing bronchogenic carcinoma. The detector generates an audio signal when fluorescence is within the visual field of the bronchoscope. Of interest is that an audio signal was generated which indicated hematoporphyrin fluorescence in areas where no mucosal abnormality had been seen. These areas proved to be carcinoma in situ.

Aged↗
PubMed1978

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): Report of a case with respiratory tract involvement.

The term "sinus histiocytosis with massive lymphadenopathy," introduced in 1969 by Rosai and Dorfman, refers to a newly recognized disease entity characterized by painless cervical lymphadenopathy, fever, leukocytosis, increased erythrocyte sedimentation rate, and hypergammaglobulinemia. The typical course is one of insidious onset, protracted duration of the active disease state, and eventual spontaneous remission, occasionally with subsequent recurrences. Lymph nodes other than those in the cervical area may be involved, and extranodal involvement can occur (such as in the orbit, skin, or respiratory tract). Clinically, this entity may closely simulate malignant lymphoma or nonneoplastic conditions with lymphadenopathy. We present a case in which this disease process extensively involved the respiratory tract and produced obstructive symptoms. The otorhinolaryngologist should be aware of this disease entity and should include it in the differential diagnosis for patients with cervical lymph node enlargement or bronchial obstruction.

Adult↗
PubMed1978

Adenoid cystic carcinoma (cylindroma) and mucoepidermoid carcinoma of the bronchus. Factors affecting survival.

A review was made of the presentation, treatment, and follow-up of 20 patients with adenoid cystic carcinoma and 12 patients with mucoepidermoid carcinoma of the bronchus who were seen at the Mayo Clinic during the 50 year period 1927 through 1977. Three forms of therapy were employed: complete surgical resection, radiation therapy alone, and radiation therapy after endoscopic removal of tumor tissue. Superior results were obtained in the group with adenoid cystic carcinoma, when complete resection was possible. Significant survival and palliation of sepsis was achieved with subtotal resection. The mucoepidermoid carcinomas in this series were classified on the basis of histologic differentiation. Mucoepidermoid carcinoma of Grade 1 was managed by conservative pulmonary resection. Mucoepidermoid carcinoma of Grades 2 and 3 showed a greater propensity for malignancy. Widespread dissemination caused death with unresectable high-grade mucoepidermoid carcinomas of Grades 2 and 3.

Adolescent↗
PubMed1978

Detection of hematoporphyrin fluorescence during fiberoptic bronchoscopy to localize early bronchogenic carcinoma.

Photoelectric detection of fluorescence from hematoporphyrin-containing "occult" bronchogenic carcinoma is a potentially useful technique for localizing and delineating such cancers. A method is presented which would enable use of a fluorescence-detection system simultaneously with conventional illumination during flexible bronchofiberscopic examination. Preliminary data suggest that quantities of hematoporphyrin as small as 5 picograms can be detected on the surface of tumors by this method.

Bronchoscopy↗
PubMed1977

Cryosurgery of bronchopulmonary structures. An approach to lesions inaccessible to the rigid bronchoscope.

Cryonecrosis of the upper lobe of the lung and bronchi was safely inudced in healthy dogs by application of the cryoprobe to serosal surfaces or, through a bronchotomy, to the mucosal surfaces under direct vision. Seven days after cryosurgery, hyperemia of the bronchus was seen. By 14 days the bronchus at the target site was covered with cuboidal epithelium. Reappearance of normal ciliated epithelium occurred by 180 days after cryosurgery. Cartilage remained intact, and there was no evidence of formation of a stricture or other gross alteration of bronchial architecture. In the lung there was coagulation necrosis; and by 14 days after cryosurgery, there was fibrosis in the target area. There were no complications of the pleural space. Cryosurgery of tissues at the margins of the bronchotomy does not impair healing. Cryosurgery may reduce the necessity for extensive surgery in selected patients with bronchopulmonary tumors, including those inaccessible to the rigid bronchoscope. Clinically, eight patients with recurrent bronchogenic tumors have received palliation by transbronchoscopic cryosurgery.

Animals↗
PubMed1975

Anesthesia for prolonged bronchoscopy.

At the Mayo Clinic, experience with 22 patients undergoing bronchoscopy on 29 occasions has shown that prolonged operative manipulation in the airway can be carried out safely and satisfactorily using general anesthesia. Requisites for this procedure include a period of apneic oxygenation, an adequate-sized endotracheal tube, hyperventilation of the patient during operative manipulation, and careful attention to management of postoperative bronchospasm. Prolonged bronchoscopy under general anesthesia has permitted localization of occult bronchogenic carcinoma at an earlier stage than has been possible up to this point.

Adjuvants, Anesthesia↗
PubMed1975

The Mayo Lung Project for early detection and localization of bronchogenic carcinoma: a status report.

The Mayo Lung Project (MLP) is a screening program designed to detect bronchogenic carcinoma at a curable stage. Screening tests include chest roentgenograms, three-day "pooled" sputum cytology studies, and lung-health questionnaires. These are being applied every four months to a study population of outpatients who have a high probability of developing lung cancer. Initial patient acceptance of the screening program has been excellent. Small asymptomatic lung cancers have been detected both roentgenographically and cytologically. The two procedures have complemented each other with little overlap. Chest roentgenography has proved most useful in diagnosing peripherally situated cancers, whereas sputum cytology studies have been most effective in identifying early squamous cancer involving major airways. At present, more cancers have been detected roentgenographically than cytologically, but the cytologically detected cases appear to have a better prognosis. Roentgenographically occult cancers have been localized with regularity, although the localization process is complicated. Theoretically, vigorous application of radiologic and cytologic screening, combined with optimum use of localizing procedures and treatment, could increase the five-year survival rate among lung cancer patients to nearly 50 percent. However, the actual survivorship attained will ultimately be determined by currently imponderable factors such as patient acceptance of longterm screening, frequency of multicentric respiratory cancers, and incidence of noncancerous smoking-related diseases, especially chronic obstructive pulmonary disease and ischemic heart disease.

Aged↗