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Community Health Nursing↗
Biomedical subjects
J Westcott
Publications and source records attributed to J Westcott.
Comparative merits of conventional, computed tomographic, and magnetic resonance imaging in assessing mediastinal involvement in surgically confirmed lung carcinoma.
Thirty-four patients with operable malignant tumors of the lung had computed tomography and magnetic resonance imaging of the chest in addition to regular chest roentgenograms and bronchoscopy. The purpose of the study was to assess the extent of tumor involvement in the hilum and the mediastinum by direct invasion and by regional lymph node metastasis. At thoracotomy, 23 tumors were completely resected and 11 were treated by interstitial implantation of radioisotopes. In addition, a mediastinal lymph node dissection or sampling was performed to correlate nodal involvement with the preoperative studies. The tumor was peripheral in 21 patients and central in 13. Histologically, 18 tumors were adenocarcinomas, 14 epidermoid cancers, and two atypical carcinoids. Preoperatively, 18 tumors were classified as N0 disease, nine as N1, and seven as N2. Pathologically, 11 were N0, eight N1, and 15 N2. Plain chest roentgenograms correlated poorly with the nodal findings at operation. Both magnetic resonance and computed tomographic imaging were highly accurate in assessing the hilum and the presence of mediastinal adenopathy, with a sensitivity rate of 87%. Except for identifying contact with the mediastinum, neither method correlated well with mediastinal invasion when present (sensitivity rate 55% for computed tomography and 64% for magnetic resonance) and neither method could differentiate hyperplastic from metastatic nodes. Hence, no advantage of magnetic resonance over computed tomographic scanning was noted in assessing tumor involvement of the mediastinum by direct invasion or by regional lymph node metastasis.
Adult↗
Retardation of ethanol absorption by food in the stomach.
Ethanol diffusion from rat stomachs containing food particles was slower than from empty stomachs, and blood alcohol concentrations were lower in fed than in fasted rats given ethanol by gavage.
Animals↗
Detection of bronchial abnormalities: comparison of CT and bronchoscopy.
We evaluated the usefulness of CT as compared with both visual and pathologic findings from fiberoptic bronchoscopy (FOB) in detecting bronchial lesions in 100 consecutive patients undergoing both procedures. There was agreement between CT and visual FOB in 83% of cases and CT and pathologic FOB in 68%. In the malignant disease category CT detected bronchial abnormalities in 59% (27 of 46) as compared with 57% (26 of 46) by visual FOB; both agreed in 81% of the cases (37 of 46). On the basis of CT findings alone, we retrospectively divided the cases into those for which we expected FOB to have high diagnostic yield (peribronchial abnormalities, n = 49) and a low diagnostic yield (i.e., no bronchial abnormality, n = 51). For the malignant disease category, selection by CT findings resulted in successful diagnosis by FOB in 69% for the high yield group as compared with 29% for the low yield group. We conclude that CT has excellent correlation with visual and pathologic results of FOB in detecting bronchial abnormalities and that CT, when used as an initial screening test, can enhance the yield by allowing appropriate selection of patients.
Bronchial Diseases↗