Biomedical subjects
J S Simpson
Publications and source records attributed to J S Simpson.
The importance of monitoring during operations on conjoined twins.
Besides complete and careful preoperative investigation of thoracopagus conjoined twins, monitoring of the various parameters, such as arterial blood pressure, central venous pressure, blood pH, and temperature, are most essential for accurate blood replacement, maintenance of normal body chemistry and thermoregulation. Equally important is continued monitoring in the postoperative period when assisted ventilation may be required as well.Twin "A" returned from the operating room in excellent condition, breathing spontaneously through an endotracheal tube. Twin "B" returned on positive-pressure-assisted ventilation; this was to prove a poor prognostic sign as this twin died eight hours postoperatively.
Pneumoperitoneum in the newborn.
Between 1947 and 1964, 32 infants in the first two weeks of life were seen at The Hospital for Sick Children, Toronto, with radiological evidence of free air in the peritoneal cavity. The clinical picture and the radiological signs in these infants are described. Perforations were found at all levels of the gastrointestinal tract. The overall mortality rate was 59%. The stomach was the most common site of perforation; it occurred in 11 children, of whom five survived. Prompt surgery was essential for survival, but when immediate laparotomy is not practical, abdominal paracentesis may prove to be life-saving.
Effect of group therapy for breast cancer on healthcare utilization.
PURPOSE: The purpose of this study was to determine whether participation in a group psychosocial intervention by patients with breast cancer would result in an improvement in psychological measures and in reduced billings in general medical expenses. DESCRIPTION OF STUDY: Eligible women who had completed treatment for stage 0, I, or II primary breast cancer were prospectively and randomly assigned to either the intervention (n=46) or control (n=43) group. Both groups received the usual psychosocial care; however, the intervention group also participated in six weekly cognitive/behavioral psychosocial meetings. All were assessed on psychiatric symptoms, mood, depression, and coping strategies at four time periods: pre-intervention, post-intervention, 1-year follow-up, and 2-year follow-up. Alberta Healthcare billing records were obtained covering the 2-year follow-up period to determine the amount billed per person over the course of the study. RESULTS: Women in the intervention group had less depression, less overall mood disturbance, better overall quality of life, and fewer psychiatric symptoms than those in the control group, beginning immediately post-intervention and remaining so at 2 years post-intervention. Billing in the intervention group was an average of $147 less than in the control group, a 23.5% reduction. CLINICAL IMPLICATIONS: This is the first study to show that a psychosocial intervention can reduce direct healthcare billings in a sample of patients with cancer. Importantly, these findings help to justify the routine availability of such programs in cancer treatment facilities worldwide.
Value of fine needle aspiration cytology of the breast, with an emphasis on the cytodiagnosis of colloid carcinoma.
The fine needle aspiration (FNA) cytologic evaluation of 6,941 lesions of the breast was reviewed, with an emphasis on the cytodiagnosis of colloid carcinoma. The most common benign breast diseases in this series were fibroadenomas, cysts and fibrocystic conditions. All cases with an FNA diagnosis of suspicious were biopsied; a number of these were found to be carcinoma of the breast. In cases with an FNA diagnosis of carcinoma of the breast, a plan of management was immediately adopted on the basis of that diagnosis. Thirteen cases of colloid (mucinous) carcinoma of the breast were diagnosed by FNA cytology; in all, the cytodiagnosis was confirmed by the subsequent histologic diagnosis. The distinctive cytologic criteria that may be useful for making an FNA diagnosis of colloid carcinoma of the breast are discussed, and the FNA differences between the pure and mixed types of colloid carcinoma are noted.
The value of needle aspiration cytology of the breast, with an emphasis on the diagnosis of breast disease in young women below the age of 30.
Our experience with 4,739 needle aspirations of the breast was reviewed, with an emphasis on the diagnosis of carcinoma in young women under the age of 30 years. Among benign diseases, fibroadenomas were most frequently seen in younger women (24.3% of 919 cases) while cysts were most frequently seen in women 30 years of age and older (20.0%). Fibrocystic conditions were identified in approximately 30% of the women in each group. All younger women with suspicious diagnoses had fibrocystic disease at biopsy; in older women, 75% of the suspicious cases proved to be carcinomas while 25% proved to be fibrocystic diseases. Carcinomas were diagnosed cytologically in 1.3% of younger women and in 9.7% of older women. In young women, in whom breast carcinoma is a rare disorder, it is important that carcinoma be diagnosed without delay so that an appropriate plan of management can be adopted. These findings suggest that needle aspiration cytology can accurately make that diagnosis.
Immunocytochemical and ultrastructural study of the rare osteoclast-type carcinoma of the breast in a fine needle aspirate.
The cytologic findings in a fine needle aspirate from a case of the rare osteoclastlike carcinoma of the breast are described along with the immunocytochemical and ultrastructural findings. The ultrastructural and immunocytochemical findings suggest that the osteoclastlike giant cells in this type of carcinoma are not of epithelial origin, but rather are reactive and of a histiocytic-stromal origin.
Diagnosis of the rare solid and papillary epithelial neoplasm of the pancreas by fine needle aspiration cytology. Light and electron microscopic study of a case.
A case of the rare solid and cystic papillary tumor of the pancreas in a young woman is described. The diagnosis was made by fine needle aspiration cytology, with electron microscopic examination of the needle washings. The preoperative cytologic diagnosis enabled appropriate surgical treatment to be planned and carried out without undue delay. It is important to distinguish this rare tumor from other pancreatic tumors with similar cytohistologic features since, if diagnosed correctly and managed surgically, this neoplasm is associated with a good prognosis.