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Biomedical subjects

K G Davidson

Publications and source records attributed to K G Davidson.

At least 19 recordsLinked to original sources
PubMed1992

Massive tumour embolism from primary lung cancer.

Massive systemic intra-arterial embolism of malignant lung cancer is a rare condition. When it occurs it usually follows pneumonectomy. Its occurrence is related to propagated tumour within a pulmonary vein and this may be suspected pre-operatively. Although the primary lung cancer may theoretically be curable, embolism is frequently widespread and is associated with a very poor prognosis. The importance of early intraoperative pulmonary vein interruption during lung cancer surgery is emphasized.

Adenocarcinoma↗
PubMed1990

201Tl scintigraphy in the staging of lung cancer, breast cancer and lymphoma.

To evaluate 201Tl in the detection of the primary tumour, lymph node involvement and mediastinal spread we have studied a total of 188 patients with histologically proven lung cancer, breast cancer or malignant lymphoma. Ten patients with benign lung disease were also examined. Static images were performed 20 min after intravenous injection of 75 MBq of thallous (201Tl) chloride. The results were compared with those of standard staging procedures including CT scanning and mediastinal exploration. Thallium-201 imaging was highly sensitive in detecting the primary tumour (lung cancer 86%, breast carcinoma 100%, lymphoma 85%), but showed low sensitivity in detecting mediastinal spread or lymph node involvement. Thallium-201 uptake was also observed in active sarcoidosis (one case) and active TB (two cases). We conclude that 201Tl imaging is unlikely to have a clinically useful role in the diagnosis or staging of lung cancer, breast cancer or lymphoma.

Adenocarcinoma↗
PubMed1990

Mitral annulus calcification.

A 67-year-old woman had aortic and mitral annulus calcification resulting in severe stenosis and incompetence of the valves. Mitral annulus calcification produces specific echocardiographic abnormalities which may forewarn of technical difficulties during surgery.

Aged↗
PubMed1988

Mechanical versus biological heart valves: a ten-year comparison in a single centre.

Between January 1977 and December 1986, 1606 Bjørk-Shiley tilting disc prostheses (BS) and 1346 Carpentier Edwards porcine prostheses (CE) were implanted in 1300 and 1156 patients, respectively, at the same institution. During the time of implantation, both valves have developed: the BS through standard disc and convexo-concave to monostrut, and the CE valves from standard to supra-annular. Newer valve types were used where applicable as they became available. Preoperative status in respect of age and cardiac rhythm were similar. There were significantly more females (64% BS: 54% CE, P less than 0.001); worse NYHA grade (74% Grade 111 and IV-BS: 56% 111 and IV-CE, P less than 0.001) more closed heart surgery (26% BS: 18% CE, P less than 0.001) and more previous open heart surgery (11.6% BS: 8.9% CE, P less than 0.001) in the BS group. All BS patients were anticoagulated and 49% of mitral CE patients and 7% of aortic CE patients were anticoagulated. There was no significant difference between the two groups in hospital mortality (BS 7.2%: CE 6.3%), late mortality (BS 2.5%/patient year: CE 3.2%/patient year) overall incidence of systemic embolism (BS 1.3%/patient year: CE 1.4/patient year), prosthetic valve endocarditis (BS 0.7%/patient year: CE 0.9%/patient year), valve failure (BS 0.5%/patient year: CE 0.9%/patient year) or peri-prosthetic leak (BS 1.2%/patient year: CE 1.3%/patient year). The incidence of systemic embolism in the aortic position was lower with the BS prosthesis (BS 0.2%/patient year: CE 1.2%/patient year, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Low serum testosterone as an indicator of metastatic bronchial carcinoma.

Serum testosterone concentrations were measured preoperatively in 39 men undergoing thoracotomy for histologically proved bronchial carcinoma, in 10 patients with pulmonary opacities that transpired to be non-malignant (benign group) and in 23 men were undergoing minor elective surgical procedures (control group). Thirteen of the 39 patients with known bronchial carcinoma were considered to have had curative surgery and 26 a palliative procedure when operative and pathological findings were taken into consideration. Low serum testosterone concentrations (less than 12 nmol/l) were detected in four patients in the curative group, in 22 in the palliative group (chi 2 test: p less than 0.001), three in the benign group, and in two patients in the control group. A low serum testosterone concentration in patients with bronchial carcinoma may be an indicator of metastatic disease and sequential serum testosterone estimations may prove useful in the follow up of patients thought to have undergone curative surgery.

Aged↗
PubMed1987

Björk-Shiley and Carpentier-Edwards valves. A comparative analysis.

Between January 1977 and December 1982, 986 Björk-Shiley and 744 Carpentier-Edwards valves were implanted in 774 and 620 patients, respectively, at the same institution. All Björk-Shiley patients and 57% of patients with a Carpentier-Edwards valve in the mitral position received long-term anticoagulation. Mean follow-up was 3.2 years (range 0 to 8.8) in the Björk-Shiley patients and 3.5 years (range 0 to 8.2) in the Carpentier-Edwards group. There was no significant difference between the two groups in hospital mortality (Björk-Shiley 7.6%; Carpentier-Edwards 6.0%), overall incidence of embolism (Björk-Shiley 1.4 per 100 patient-years; Carpentier-Edwards 1.6% py), endocarditis (Björk-Shiley 0.6% py; Carpentier-Edwards 0.8% py), periporsthetic leak (Björk-Shiley 1.6% py; Carpentier-Edwards 1.4% py), anticoagulant-related complications (Björk-Shiley 0.3% py; Carpentier-Edwards 0.1% py), valve failure (Björk-Shiley 0.78% py; Carpentier-Edwards 0.68% py), reoperation for complication (Björk-Shiley 1.68% py; Carpentier-Edwards 1.22% py), and late mortality (Björk-Shiley 3.1% py; Carpentier-Edwards 3.0% py). Actuarial freedom from valve-related events was similar in the two groups. In the aortic position, freedom from embolism was significantly better in the Björk-Shiley group than the Carpentier-Edwards group (Björk-Shiley 99% at 3 and 5 years; Carpentier-Edwards 96% and 92% at 3 and 5 years; p = 0.023). In the mitral position, the overall incidence of reoperation was higher in the Björk-Shiley group (1.78% py) than in the Carpentier-Edwards group (0.48% py) (p = 0.004). Actuarial analysis shows this difference to be confined to the first 6 years of follow-up. The commonest indication for reoperation was valve failure in both groups. However, when analysis is confined to this indication, the difference between the reoperation incidence in the mitral position becomes insignificant (Björk-Shiley 0.85% py; Carpentier-Edwards 0.29% py; p = 0.085). This study confirms the satisfactory performance of both the Carpentier-Edwards and Björk-Shiley valves in the short and middle term and indicates no clear-cut advantage for either prosthesis.

Anticoagulants↗
PubMed1986

Drug sensitivity of non small cell carcinoma of lung by clonogenic assay in several media.

Lung tumours of non small cell pathology were cultured by clonogenic assay in several media. Culture was successful in spleen conditioned medium, but only 57% grew and low plating efficiencies (PE) meant that only 23% of the original number produced significant drug results. Comparison of rat erythrocyte lysate (REL) medium with serum free defined medium (HITES) and HITES + 10% FBS demonstrated clear enhancement of PE in REL although growth was 100% successful in all these media. Ninety-three percent of samples tested against drugs in REL produced significant results. A later comparison of REL with McCoy's 5A + rbc +/- hydrocortisone produced relatively poor culture success for these 3 media and equivocal growth patterns. Low PE was attributed to age of rats used for rbc. Vindesine and cis-platinum cytotoxicity in spleen conditioned medium were 61% and 15% sensitivity respectively. These do not concur with clinical experience but the figures for overt resistance, at 39% and 69%, correspond with expected non-responders to these regimes. Drug testing in REL produced figures correlating more closely with clinical performance at 45% sensitivity to platinum and 36% of patients sensitive to both drugs, but the vindesine sensitivity at 55% is again discrepant with performance of this drug as a single agent.

Carcinoma, Non-Small-Cell Lung↗
PubMed1986

Combined plasmacytoma and squamous cell carcinoma.

A 63-year-old man was admitted to the Cardiothoracic Department of Glasgow Royal Infirmary for surgical treatment of a left suprahilar opacity. A left pneumonectomy was required to deal with an extensive upper lobe tumor. Histopathological examination, in addition to a moderately well-differentiated squamous cell carcinoma, revealed the presence of a band-like infiltrate of plasma cells and lymphoplasmacytoid cells at the main bronchial resection margin. Immunohistochemical studies confirmed this to be an extramedullary plasmacytoma by showing IgA and kappa positive monotypic cells. No paraprotein was detected in the serum. The value of immunohistochemistry in the differential diagnosis has been emphasized.

Bronchial Neoplasms↗
PubMed1986

Mediastinal imaging in lung cancer.

Sixty-six patients with lung cancer underwent mediastinal staging with gallium scanning, CT scanning and mediastinal exploration at mediastinoscopy and/or thoracotomy. Histological findings at time of mediastinal exploration were correlated with the results of the non-invasive staging scans. Gallium scanning had an accuracy of 78.8 per cent and CT scanning had an accuracy of 77.3 per cent. There was no evidence of increased test accuracy by performing both scans in the same individual. Either scanning technique may be utilised as a simple non-invasive mediastinal staging procedure, and where negative it is appropriate to proceed directly to thoracotomy.

Gallium Radioisotopes↗
PubMed1985

Intra-aortic balloon pumping: seven years' experience.

The indications for intra-aortic balloon pumping vary widely from country to country and from one cardiac surgical unit to another. Its use in Glasgow from 1976 to 1983 in 63 patients has been reviewed. Six of the patients (9.5%) had the intra-aortic balloon inserted before cardiac surgery, 43 (68.2%) at the time of surgery, and 14 (22.2%) in the postoperative period. Of the 63 patients, 11 could not be weaned from cardiopulmonary bypass despite intra-aortic balloon pumping, and died in the operating room. A further 35 patients had intra-aortic balloon pumping but died in the immediate postoperative period. Seventeen patients (27%) survived from six weeks to 3.3 years after receiving the support of intra-aortic balloon pumping. There was major morbidity in 11 patients (17%), all of whom developed degrees of ischaemia due to ileofemoral arterial obstruction in the leg in which the balloon was inserted. The conservative use of the method in this centre is reflected in the high mortality of these patients.

Adult↗
PubMed1978

Intrathoracic neural tumours.

The experience of one regional thoracic surgical unit in managing intrathoracic neural tumours over a 25-year period is presented. Neural tumour was diagnosed in 55 patients, of whom 41 were asymptomatic. In 11 patients complete resection was not achieved--the reasons for this and its effect on the outcome of the patient are discussed. There were 52 posterior mediastinal and three lateral chest wall tumours. The pathological distribution was as follows--benign nerve sheath tumours (neurofibroma, neurilemoma) 39, ganglioneuroma 13, and neuroblastoma 3. One neurofibroma recurred as a neurosarcoma six years after its apparently complete resection and was removed by an extensive resection at reoperation. One neuroblastoma recurred within the spinal canal four years after incomplete excision at thoracotomy--this patient died subsequently of widespread metastatic neuroblastoma. No other tumour is known to have recurred.

Adolescent↗
PubMed1977

Traumatic rupture of the ascending aorta and aortic valve following blunt chest trauma.

Traumatic rupture of the aorta at the level of the isthmus is a well-recognized injury following blunt chest trauma. By contrast, rupture of the ascending aorta and of the aortic valve in a road traffic accident is rare and does not appear to have been previously reported. The occurrence of such an injury in a 56-year-old man involved in a road traffic accident is reported. The diagnosis was made preoperatively following aortography and successful surgical correction involved aortic valve replacement with resection and grafting of the damaged area of the ascending aorta. The probable mechanisms involved in the production of this unusual injury are discussed.

Accidents, Traffic↗