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Biomedical subjects

J F Beamis

Publications and source records attributed to J F Beamis.

36 records · Page 2Linked to original sources
PubMed1991

Endoscopic laser therapy for obstructing tracheobronchial lesions.

The Lahey Clinic experience using laser bronchoscopy for relief of obstructive tracheobronchial lesions during a 7-year period from 1982 to 1989 involves 269 patients treated with 400 procedures. The carbon dioxide (CO2) laser was used for tracheal stenosis and granulation tissue. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for all obstructing endobronchial neoplasms. Indications for therapy included severe dyspnea, hemoptysis, and postobstructive pneumonitis. All patients had relatively central lesions. A rigid bronchoscope was used to treat 88% of patients, and 12% of patients were treated with a flexible bronchoscope. One death occurred during the intraoperative period. Eleven deaths occurred within 1 week of therapy and were related to the presence of extensive malignant lesions or to coronary artery disease. Our experience indicates that bronchoscopic application of the CO2 or Nd:YAG laser affords effective palliation for patients with obstructive tracheobronchial lesions. The Nd:YAG laser is recommended for patients with bulky vascular endobronchial neoplasms, and the CO2 laser is best reserved for patients with benign tracheal stenosis and granulation tissue.

Bronchial Diseases↗
PubMed1989

Total cervical tracheal stenosis: treatment by laser, dilation, and stenting.

Twelve patients with total cervical tracheal stenosis were treated by endoscopic laser excision (neodymium:yttrium aluminum garnet or carbon dioxide laser), bronchoscopic dilation, and prolonged stenting with a silicone T-tube. All patients had previous traumatic or prolonged endotracheal intubation requiring a tracheotomy and presented with aphonia as the major complaint. Multiple laser and dilation treatments were necessary in ten patients. Average duration of T-tube placement was 6 months. Excellent results (decannulation and good voice) were achieved in eight patients with a follow-up of 9 months to 6 years. Persistent granulation tissue and some degree of fibrosis were the most common complications (eight of 12 patients). Two patients died of medical complications. A high success rate with this endoscopic technique justifies this approach as our initial therapy, with open surgical techniques reserved for failure.

Adult↗
PubMed1989

Teaching models for Nd:YAG laser bronchoscopy.

A number of groups have demonstrated the efficacy of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser bronchoscopy for treatment of patients with selected tracheobronchial disorders. This therapy involves a new technology, the laser, and new adaptations of conventional rigid and flexible bronchoscopy that are unfamiliar to many bronchoscopists. We describe two teaching models for laser bronchoscopy that have been employed successfully in our laser courses. Using these models, bronchoscopists can become familiar with laser bronchoscopic equipment and appreciate the interaction of laser and soft tissue in a controlled setting in the laboratory before applying this therapy to patients.

Animals↗
PubMed1987

A new rigid bronchoscope for laser fiber application.

A new fiberoptic rigid bronchoscope system, designed especially for laser fiber delivery, provides the endoscopist with an excellent conduit for application of the flexible fiberoptic bronchoscope, while still allowing maintenance of adequate ventilation. This system is designed for treatment of benign and malignant obstructing tumors in the trachea and mainstem bronchi. The bronchoscope will be available in sizes ranging from 6 mm to 10 mm in diameter.

Bronchial Neoplasms↗
PubMed1986

Safety precautions for bronchoscopic Nd-YAG laser surgery.

The application of the neodymium-yttrium aluminum garnet (Nd-YAG) laser in bronchoscopy originated in Europe in 1981 and is now widespread in the United States. Transmissible through flexible fiberoptic quartz fibers and an efficient coagulator of tissue, the Nd-YAG laser deeply penetrates tissue not readily predictable by the endoscopist. Dangers associated with the Nd-YAG laser include complications secondary to inadvertent exposure to normal tissues or structures, tracheobronchial accidents (perforation, hemorrhage, fire), and complications related to anesthetic technique (respiratory depression). Hypoxemia related to persistent hemorrhage, accumulation of secretions or debris or both, or anesthesia-induced respiratory depression is the common denominator of most intraoperative and postoperative complications. Careful selection of patients, intraoperative monitoring of ventilation and blood gases, and techniques of rigid bronchoscopy are stressed to avoid complications.

Anesthesia↗
PubMed1985

Lung cancer in women. Lahey Clinic experience, 1957-1980.

The incidence of lung cancer is increasing dramatically worldwide. Cancer of the lung, the number one cause of death from cancer in men in the United States, will soon surpass breast cancer to become the most frequent cause of cancer death in women. To detail the changing pattern of lung cancer, we reviewed the clinical features of all 1752 patients whose lung cancer was diagnosed at the Lahey Clinic from 1957 through 1980. Women comprised a constant proportion of the total number of clinic patients during this 24-year period. Lung cancer in women increased markedly from 13% of all patients (1 to 6.8 ratio of women to men) in 1957 through 1960 to 35% (1 to 1.8 ratio) in 1977 through 1980. The authors reviewed pathologic specimens of 394 women with lung cancer. No significant change occurred in cell type distribution over the years: adenocarcinoma, 38%; epidermoid carcinoma, 20%; large cell carcinoma, 15%; small cell undifferentiated tumor, 13%; and other cell types, 14%. The incidence of all lung cancer cell types (Kreyberg Group 1 and Group 2) increased in women who smoked. Our study suggests that smoking is a major causal factor in the rising occurrence of all lung cancer cell types in women as contrasted to the preponderance of Kreyberg Group 1 tumors in men who smoke.

Adenocarcinoma↗
PubMed1985

Subacute massive thromboembolic occlusion of a main pulmonary artery. Report of a case successfully treated by thrombolytic therapy and review of the literature.

Subacute massive thromboembolic occlusion of the left main pulmonary artery in a 52-year-old woman is described. This disease remains a rare entity with a much less dramatic presentation than acute massive pulmonary embolus. The presenting symptom was unexplained dyspnea. Physical signs and laboratory tests were nonspecific. The perfusion scan is the best screening test for this disorder. Antemortem diagnosis is established by pulmonary angiography. A literature review undertaken to ascertain the incidence of this entity as well as to recommend treatment of choice, be it medical or surgical therapy, was unrewarding. We decided to use thrombolytic therapy and found a marked improvement in the patient's symptoms and perfusion scan after 24 hours. Although thrombolytic therapy is commonly indicated for acute massive pulmonary embolism, we believe this mode of therapy should also be the initial treatment for subacute massive pulmonary thromboembolism.

Anticoagulants↗
PubMed1985

Endoscopic treatment of tracheobronchial malignancy. Experience with Nd-YAG and CO2 lasers in 506 operations.

Laser technology and the endoscope have been combined for the palliation of obstructive tracheobronchial malignant lesions. The neodymium-yttrium-aluminum-garnet (Nd-YAG) laser was used to treat 249 patients (447 operations), and the CO2 laser was used on 34 patients (59 operations). Hemorrhage, the major complication in both groups of patients, was more easily controlled with the Nd-YAG laser. One patient in the CO2 laser group died, and one patient in the group being treated with Nd-YAG laser bronchoscopy died. The Nd-YAG laser can be applied more efficiently through a fiber system, with better optic control and secure hemostasis. The commonest indications for treatment were dyspnea, obstructive pneumonia, and hemoptysis. Extrinsic compression was the most frequent reason for failure. The Nd-YAG laser, most often applied through open rigid bronchoscopes under general anesthesia, has become our treatment of choice for the palliation of tracheobronchial malignancy.

Adenocarcinoma↗
PubMed1985

More about the YAG.

Explore the source record for details and available documents.

Bronchial Diseases↗
PubMed1984

Nd-YAG laser therapy for tracheobronchial disorders.

The neodymium-yttrium aluminum garnet (Nd-YAG) laser has demonstrated its effectiveness in treatment of a number of benign and malignant tracheobronchial disorders. This laser has many advantages over past methods of endobronchial therapy, such as cryosurgery and electrocautery. It is a precise, no-touch method that produces little pain during therapy and little or no edema or infection afterward. Since the laser is a form of nonionizing radiation, therapy may be repeated as often as needed. Unlike the carbon dioxide laser, the Nd-YAG laser may be used with standard flexible endoscopes. Currently, the commonest indication for Nd-YAG laser therapy is obstruction of a large airway by an inoperable neoplasm. Whether this technique can be applied more widely in management of early lung cancer, possibly in combination with radiotherapy, chemotherapy, or surgery, will be determined by further study.

Airway Obstruction↗
PubMed1978

Metastatic coccidioidal endophthalmitis.

A severe granulomatous iridocyclitis developed in association with a cavitary pulmonary lesion in a 29-year-old man. The initial diagnosis and treatment was for pulmonary tuberculosis with tuberculous uveitis. Although the pulmonary lesion improved with antituberculous therapy, the condition of the eye deteriorated. An anterior-chamber tap was positive for Coccidioides immitis, and the patient was treated with intravenous and two intracameral injections of amphotericin B. The eye was ultimately enucleated three weeks after the initial intracameral injection, and yet was culture-positive for the organism. Histopathologic examination disclosed diffuse involvement of the anterior segment, with multiple spherules present within the iris and limbus.

Adult↗
PubMed1975

Changing epidemiology of lung cancer. Increasing incidence in women.

Recent worldwide reports show a large increase in the incidence of lung cancer in both men and women. To detail changes in the epidemiology of lung cancer relating to the incidence in men and women, we reviewed the patterns of diagnosis of 1145 patients with lung cancer seen at the Lahey Clinic between 1956 and 1972, during which time the proportion of all men and women seen was unchanged. The total number of women with lung cancer increased greatly and has almost doubled during this period. Lung cancer in women is now increasing at a faster rate than in men so that the male to female incidence has decreased from 6.8/1 (1957 to 1960) to 2.4/1 (1969 to 1972). We reviewed in detail the case histories and pathology of 231 women with lung cancer. No significant change was evident in cell type distribution during the study years. The most frequently seen tumors in women were adenocarcinoma (31 per cent), undifferentiated large cell cancer (22 per cent), epidermoid carcinoma (16 per cent), and undifferentiated small cell carcinoma (12 per cent). Among those women with known smoking histories, the group most responsible for the recent increase in women with lung cancer was comprised of smoking women in whom Kreyberg group 1 (smoking-related) tumors developed.

Adenocarcinoma↗
PubMedDate not supplied

Endoscopic treatment of subglottic and tracheal stenosis by radial laser incision and dilation.

Five patients with severe fibrous subglottic and tracheal stenosis were treated by endoscopic radial laser incision and dilation using both carbon dioxide and neodymium:yttrium aluminum garnet lasers. Good results were noted without complications in all patients in a follow-up period of at least 1 year. Careful selection of patients, excluding those with tracheal collapse or tracheomalacia, and preservation of tracheal epithelium with minimal heat and mechanical trauma are considered essential for good results.

Adult↗
PubMedDate not supplied

Obstructing tumors of the subglottic larynx and cervical trachea: airway management and treatment.

A series of 11 patients presenting with airway obstruction secondary to tumors involving the subglottic larynx and cervical trachea was treated with either carbon dioxide or neodymium:yttrium aluminum garnet laser tumor ablation. Choice of ventilation varied according to the site of airway obstruction: Venturi jet with ventilation laryngoscope for glottic and subglottic tumors and a specially designed ventilation laser fiber tracheoscope for tumors obstructing the cervical trachea. All patients subsequently had definitive treatment of the tumor and were relieved of the compromised airway. No complications associated with ventilation and treatment techniques were recorded.

Adult↗
PubMedDate not supplied

Universal ventilation laser tracheoscope.

A universal ventilation laser fiberoptic tracheoscope has been developed for use in endoscopic treatment of patients with obstructing benign and malignant lesions of the subglottis-cervicotrachea and laryngectomy tracheal stoma. This instrument features a ventilation connector for either side port or Venturi jet ventilation and a proximal connector with a sheath for delivery of a 0 degrees telescope, laser fiber, and suction catheter. Difficulties encountered with exposure and ventilation during laser treatment of the subglottis-cervicotrachea and laryngectomy stoma are overcome with this new instrument.

Endoscopes↗