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Biomedical subjects

F M Shamji

Publications and source records attributed to F M Shamji.

32 records · Page 2Linked to original sources
PubMed1994

Systemic arterial supply to the lung without sequestration: an unusual cause of hemoptysis.

Systemic arterial supply to the lung without sequestration is an unusual vascular anomaly in which a portion of normal lung tissue is supplied by an artery arising from the aorta. This entity shares some features with bronchopulmonary sequestration and hypogenetic lung (scimitar syndrome) but has unique imaging features that allow preoperative diagnosis. The authors describe such a case in a 21-year-old man who presented with hemoptysis.

Adult↗
PubMed1993

Anterior mediastinal mass in a patient susceptible to malignant hyperthermia.

We report a malignant hyperthermia-susceptible patient who required investigation for a large, symptomatic anterior mediastinal mass. Multiple attempts at tissue diagnosis under local anaesthesia were unsuccessful. Following awake fibreoptic tracheal intubation, general anaesthesia was administered using ketamine, midazolam, and nitrous oxide, maintaining spontaneous ventilation. Prophylactic dantrolene was not used, to avoid potential muscle weakness and respiratory compromise. Diagnostic mediastinotomy was performed without incident. We conclude that ketamine anaesthesia is appropriate for patients with anterior mediastinal masses, and is considered safe in malignant hyperthermia-susceptible patients.

Adult↗
PubMed1993

Postpneumonectomy chylothorax.

Chylothorax complicating pulmonary resections is exceptional and management of this complication remains controversial. We report a case of chylothorax after a right pneumonectomy and radical subcarinal nodal dissection. Successful nonoperative management consisted of controlled tube drainage, fasting, and total parenteral nutritional support for a period of 2 weeks. A review of the literature reveals 27 other cases of this complication after intrapleural pneumonectomy: 12 were treated by conservative measures alone and 15 required surgical intervention. Factors that will determine the management and the ultimate success of conservative management include (1) a relative delay in initial occurrence, (2) a decrease in or complete cessation of leakage while receiving total parenteral nutrition, and (3) favorable lymphangiographic findings.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

Pulmonary resection and contralateral anomalous venous drainage: a lethal combination.

A 72-year-old acyanotic woman had development of acute right heart failure with systemic hypotension 2 hours after a curative right intrapericardial pneumonectomy for primary lung cancer. A postoperative pulmonary angiogram revealed a major left to right shunt through previously unsuspected partial anomalous venous drainage of the left upper lobe of the lung.

Adenocarcinoma↗
PubMed1992

Central neurogenic tumours of the thoracic region.

Of special concern in the management of neurogenic tumours arising in the thorax is spinal-cord compression resulting from either intraspinal lesions or vertebral-body destruction and collapse. A review of 16 cases disclosed three dumbbell tumours, six intrathoracic tumours, one case of neurofibromatosis with multiple intraspinal neurogenic tumours, two malignant neurogenic tumours with vertebral-body destruction causing spinal-cord compression and four foraminal lesions with central intraspinal (extradural) extension. There were 3 men and 13 women, ranging in age at the time of operation from 37 to 79 years. Three patients, of the six with intrathoracic tumours, were asymptomatic; the remaining 13 had preoperative symptoms ranging in duration from 3 weeks to 12 months (average, 9 months). Back pain with intercostal neuralgia was present in eight patients and neurologic signs were present in six patients. A routine chest radiograph was abnormal in 10 patients, and x-rays of the thoracic spine were abnormal in 4 of the other 6 patients. The tumour was excised surgically in all patients. Complications developed postoperatively in two patients: one had Horner's syndrome, transient paraparesis and bleeding; the other had a small subarachnoid-cutaneous fistula. The authors conclude that dumbbell neurogenic tumours and those causing vertebral-body destruction and collapse demand a multidisciplinary one-stage surgical approach. If the lesion is malignant and resection is not complete, radiotherapy or chemotherapy is necessary.

Adult↗
PubMed1988

Percutaneous embolotherapy in life-threatening hemoptysis.

Percutaneous embolization of the bronchial arteries to control massive or recurrent hemoptysis has become an accepted procedure, especially in treating patients with chronic pulmonary disease who are poor candidates for lung resection. Nonbronchial systemic collateral arteries and pulmonary arteries may contribute significantly to pulmonary hemorrhage, but embolization of these vessels has not been stressed in recent literature. When embolization of the bronchial artery fails to control hemoptysis, nonbronchial systemic collateral arteries should be embolized. If no systemic collaterals are present, then embolization of segmental pulmonary arteries may prove helpful.

Acute Disease↗
PubMed1988

Cystic disease of the lungs.

Cystic disease of the lung should be considered in the differential diagnosis of any patient presenting with respiratory symptoms. The most important aids available to the thoracic surgeon for the evaluation of cystic disease are history, physical examination, and chest radiograph. Confirmation of diagnosis often requires computed tomography, pulmonary and thoracic aortic angiography, and upper gastrointestinal barium series.

Adolescent↗
PubMed1988

Acute Pancoast's syndrome caused by fungal infection.

Nonmalignant causes of Pancoast's syndrome are extremely rare. The authors report the case of a 32-year-old man, receiving treatment for acute lymphoblastic leukemia, who had a clinical picture resembling that of Pancoast's syndrome. Invasive mucormycosis was diagnosed as the cause of the syndrome at emergency thoracotomy undertaken to control massive hemoptysis. In spite of adequate treatment, the patient died 5 weeks postoperatively of overwhelming sepsis. A review of the literature disclosed only two other similar cases. The authors conclude that the development of Pancoast's syndrome in the immunosuppressed patient should raise suspicion of an invasive fungal infection. A precise early diagnosis may allow successful, specific antifungal therapy to be instituted.

Adult↗
PubMed1987

Tuberculosis presenting as stridor.

A 40-year-old woman was seen with stridor and mediastinal widening secondary to tuberculous mediastinal lymphadenopathy mimicking neoplasm. Initially, stridor could only be controlled with high-dose corticosteroids, but following initiation of antituberculous chemotherapy corticosteroids were withdrawn successfully and the mediastinal lymphadenopathy resolved.

Adult↗
PubMed1985

Hypovolemic shock.

Hypovolemic shock is the most common form of shock seen clinically and has attracted the greatest laboratory interest. It is caused by a sudden decrease in the intravascular blood volume relative to the vascular capacity, to the extent that effective tissue perfusion cannot be maintained. The authors of this article discuss the pathophysiology of hypovolemic shock, the assessment of the patient in shock, the immunologic consequences of shock, impairment of cardiac function in hypovolemic shock, and the management of hypovolemic shock.

Body Fluids↗
PubMed1983

Open window thoracostomy in the management of postpneumonectomy empyema with or without bronchopleural fistula.

Postpneumonectomy empyema, with or without bronchopleural fistula, remains an infrequent but serious complication of pulmonary resection. We reviewed our experience with the Clagett procedure in 31 patients with postpneumonectomy empyema. Seven had empyema alone and 24 had empyema with bronchopleural fistula. Ten patients died of metastatic disease without attempted closure of the thoracostomy window. In eight patients the total Clagett procedure was completed; window closure was permanent in two patients, but the remaining six had recurrence of empyema (four of whom had persistent occult fistulas). In eight further patients, persistent infection prevented attempted closure of the window. Five patients refused further surgical procedures. In only two of 31 patients were we able to achieve permanent closure of the thoracostomy window. Based on this experience, we conclude that open window thoracostomy provides adequate drainage and an excellent interim or permanent treatment of the infected pneumonectomy space. However, the presence of persistent bronchopleural fistula prevents successful completion of the total Clagett procedure. In our series, there were no deaths related to empyema or the surgical procedures performed for it.

Anti-Bacterial Agents↗
PubMedDate not supplied

Fine needle aspiration biopsy of anaplastic thyroid carcinoma developing from a Hürthle cell tumor: a case report.

BACKGROUND: Anaplastic thyroid carcinoma is a highly malignant tumor in elderly people with a long history of multinodular goiter and is usually associated with a rapidly fatal clinical evolution. The tumor often develops as a result of anaplastic transformation of a slowly growing papillary carcinoma or follicular neoplasm. CASE: An 85-year-old woman had a multinodular goiter and had been asymptomatic, with a normal white blood cell count and chest radiograph three months prior to her hospital admission for the treatment. The tumor presented with low grade fever, leukocytosis, multiple metastatic lung nodules and enlargement of the intrathoracic thyroid in a period of three months, causing compression of the esophagus and trachea. Despite a total thyroidectomy, the tumor recurred within one month and caused dysphagia and death. CONCLUSION: FNAB permitted the diagnosis of an anaplastic thyroid carcinoma arising from an intrathoracic Hürthle cell tumor.

Aged↗
PubMedDate not supplied

Basaloid carcinoma of the lung with bronchiolo-alveolar cell differentiation. A case report.

AIMS: We report a case of pulmonary basaloid carcinoma with bronchiolo-alveolar cell differentiation. PATIENTS AND RESULTS: A 75 year-old presented with a tumor measured 2.0 cm and was located in the periphery of the left upper lobe. Histologically, the lesion consisted of nests of basaloid cells, and lumina and clefts lined by tumor cells with features of mucous cells or type II pneumocytes or with mixed features. CONCLUSIONS: Previously reported basaloid carcinomas of the upper aero-digestive tract and lung have been purported to have an aggressive behavior. The tumor in the present study had features of a histopathological low grade tumor including a low mitotic rate, no tumor necrosis and a growth pattern at the periphery similar to that of bronchiolo-alveolar carcinoma.

Aged↗