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Biomedical subjects

W N Sinner

Publications and source records attributed to W N Sinner.

At least 37 records · Page 2Linked to original sources
PubMed1980

Risk factors in percutaneous transthoracic needle biopsy.

In percutaneous transthoracic needle biopsies, statistical analysis of complications in men and women of different age groups is believed to be helpful in borderline cases for a better evaluation of risk factors versus the value of the information gained by the procedure. The 95 percent confidence interval and the X2 test showed a significantly lower rate of pneumothorax in mediastinal and pleural based lesions as compared to intralobar changes. Age and sex were found to be the most important parameters for the rate and degree of pneumothorax. The incidence of pneumothorax (mean value 27,2%) steadily increased with age from 2 of 10 in the age group of 9 to 29 years, to 3 to 10 in age group up to 69 years in both sexes, and after 70 years it was as high as 4 of 10. In women the relative frequency of pneumothorax was lower for the respective age groups than in men. Other factors influencing the complications include: experience of the operator, size and depth of the lesion to be punctured and to a certain degree the outer diameter of the needle being used.

Adolescent↗
PubMed1980

[The computer tomographic differential diagnosis of benign and malignant lipoid masses in the mediastinum and their spread (author's transl)].

Details of the tissues in the mediastinum can nowadays be demonstrated by computer tomography (CT) pictorially and quantitative measurements of their density coefficient carried out. The diagnosis of a fat-containing tumour or of benign lipomatosis of the mediastinum and their differentiation from malignant lesions is important for treatment and prognosis. In the past this could only be done by surgery. CT permits this differentiation pre-operatively and by a non-invasive method. The extent of malignant tumours and their relationship to other mediastinal structures and their spread beyond the mediastinum can be determined.

Adolescent↗
PubMed1980

Pleuroma--a cancer-mimicking atelectatic pseudotumor of the lung. 55 consecutive cases studied by high KV radiography, bronchography, selective pulmonary angiography and needle biopsy.

A form of cancer--mimicking atelectatic pseudotumor of the lung called "pleuroma" is described. Since 1961 55 cases were studied by needle aspiration biopsy. Due to the usual "negative" results ("no cancer cells") of the needle biopsy, a radiographic pattern was recognized, of the basis of which the benignity of the lesion was correctly diagnosed in most cases. The radiographic appearance of these lesions was not only established with PA, lateral and oblique high KV radiographs, fluoroscopy with overpenetrated spot films, but also by bronchography, and selective pulmonary angiography. Needle biopsy was helpful in conforming a diagnosis in typical cases. However it was of paramount importance in atypical cases to recognize the lesion.

Adult↗
PubMed1980

Needle biopsy of histoplasmosis.

A case of histoplasmosis, simulating a bronchogenic carcinoma, was needle biopsied. "Histoplasma capsulatum" organisms were found in great numbers. Needle biopsy established an accurate diagnosis making an exploratory thoracotomy unnecessary and preventing the patient from an already planned lobectomy. Specific treatment with Amphotericin B healed the lesion.

Acute Disease↗
PubMed1980

Diagnostic and therapeutic aspirations of fluid containing masses: the role of ultrasound and computed tomography.

Twenty-eight patients have undergone diagnostic and/or therapeutic aspiration of fluid containing masses at Jackson Memorial Hospital over the last 8 months. The majority were diagnosed and aspirated under ultrasonic control while in a few cases CT was required. In 19 patients, a therapeutic aspiration was attempted. In 17, this was successful, none of these patients required surgical intervention. The role of ultrasound and CT in the diagnosis and treatment of fluid collection is emphasized. The technique for both diagnostic and therapeutic aspirations is stressed as well.

Abscess↗
PubMed1979

Pulmonary neoplasms diagnosed with transthoracic needle biopsy.

Results of transthoracic needle biopsy have been evaluated on the basis of fourteen years experience comprising 5300 procedures on 2726 patients. In 90.7% of the cases a diagnosis was established. Of these, 46.4% showed cytological evidence of primary or secondary malignancy. In 2.4% false positives and in 3% false negatives were noted. The most important complication was found to be pneumothorax, which was noted in 27.2%, but these cases did not as a rule call for treatment. Hemoptysis was observed in 2-5%. There was minor local bleeding around the lesion in 11% of the patients but this only required observation. In one case out of 1264 malignancies an implantation metastasis was found. There was a single case of air embolism with spontaneous recovery, but no mortality in this series. In our experience, needle biopsy represents a minor, inexpensive and safe procedure, which--with a simple technique--permits a direct approach to all kinds of localized lung lesion with a high degree of accuracy.

Aged↗
PubMed1979

Fatty tumors of the thorax demonstrated by CT.

The radiographic signs previously described for fatty tumors of the thorax although helpful are nonspecific. In the past, the diagnosis of benign fatty tumors of the chest in asymptomatic patients required surgical intervention. This report illustrates the gamut of fat-containing tumors of the thorax encountered over a recent 1 year period. CT proved to be helpful in the diagnosis and management on these cases. When the CT numbers of the fatty lesion was around -55 EMI units, intervention was felt to be unnecessary. However, when the CT number of the mass ranged from --10 to--20 EMI units, intervention was felt to be necessary since a malignancy could not be excluded on the basis of the CT findings alone.

Adult↗
PubMed1979

Early diagnosis of malignant pulmonary lesions. Importance of tumor size and growth rate.

The prognosis of peripheral lung cancer and the possibilities of an early diagnosis are discussed on the basis of a unique case of a small bronchogenic carcinoma which was followed with routine radiography over an eight year period. The tumor growth rate as reflected by volume doubling time is utilized for determination of the earliest possible visibility and evolution time. Certain conclusions are drawn about the importance of an early diagnosis and therapy for the prospective chances of a radical cure.

Aged↗
PubMed1978

[Serial observations on pulmonary emboli/infarcts with computerised tomography (author's transl)].

Fourteen patients with pulmonary emboli/infarcts were observed for at least three months by means of computerised tomography. In the acute phase all patients showed minimal changes radiologically, which were not diagnostic of pulmonary emboli; at the same time, computerised tomograms showed definite changes in attenuation in the pulmonary parenchyma and of blood vessels and pleura. A relatively constant and diagnostically valuable sign appears to be a triangular area of attenuation which indicates the presence of an infarct. Serial observations are valuable where there is a clinical suspicion of pulmonary emboli. It is possible to observe regression of the thrombus (due to recanalisation or thrombolysis) and to evaluate the effects of treatment.

Aged↗
PubMed1978

Needle biopsies of pulmonary lesions. Precautions and management of complications.

This review is based on 5300 needle biopsies. Complications and their precaution are discussed. Pneumothorax seldom has to be treated. Hemoptysis and small local bleeding are of no clinical significance. Tumor cell spread and air embolism may occur but extremely rarely. Indications, contraindications equipment, and biopsy technique are treated. A recent technical improvement in needle biopsy is described.

Biopsy, Needle↗
PubMed1978

Computed tomographic patterns of pulmonary thromboembolism and infarction.

A wedge shaped pulmonary density with its broad base against a peripheral pleural surface and with its tip pointing to the parahilar area is suggestive of pulmonary infarction. This pattern can be shown more often with computed tomography (CT) scanning than in plain chest X-ray films. In 16 patients with clinical evidence of pulmonary thromboembolism, often corroborated by diagnostic procedures other than CT, a variety of CT patterns of increased attenuation were noted. In seven (44%) of these cases, a distinct wedge shaped appearance was observed.

Adult↗
PubMed1978

[Pseudotumours of the stomach. X-ray and endoscopic correlations (author's transl)].

15 patients urgently suspected of gastric cancer on account of clinical and x-ray findings were subjected to preoperative gastroscopy. In all cases, a malignant gastric tumour could be excluded via gastroscopy with biopsy. However, in one remarkable case the clinical and x-ray findings had been so typical of a malignant tumour, that surgery was performed despite negative gastroscopy and biopsy. No tumour was found. The x-ray findings were correlated with those of endoscopy. Three patients had hiatal hernia (in one case combined with varices of the fundus of the stomach) and in one case each large and irregular plication was normal in seven cases. The results are discussed on the basis of the findings and relevant literature. It is concluded from this study that routine preoperative gastroscopy with biopsy is mandatory in clinical and x-ray suspicion of gastric cancer, since it may result in avoidance of surgery in some patients.

Contrast Media↗
PubMed1977

[X-ray negative pulmonary carcinoma with positive sputum cytology (author's transl)].

The repeated finding of malignant or suspicious cells in the sputum of an apparently normal person must not be ignored. Immediate and intensive attempts should be made to localize the carcinoma. Sometimes, in the presence of a central tumour an early diagnosis can be made radiologically. With peripheral tumours and early diagnosis is more likely. The most successful method for the early localisation of an occult bronchial carcinoma is fibre optic bronchoscopy, with selective bronchial aspiration. Consistent finding of malignant cells in the secretions from a lobar bronchus, provided contamination can be excluded, justifies surgery such as a lobectomy. Delay in instituting treatment while waiting for radiological or bronchoscopic confirmation reduces the chance of successful surgery because of the possibility of metastases or the development of cardiological or respiratory complications.

Aged↗
PubMed1976

Small-cell carcinoma of the lung. Cytological, roentgenologic, and clinical findings in a consecutive series diagnosed by fine-needle aspiration biopsy.

Small-cell anaplastic carcinoma was diagnosed cytologically in 54 of 2,726 consecutive transthoracic fine-needle aspiration biopsies. Histological material was available in 31 cases (28 anaplastic small-cell carcinomas, 1 carcinoid tumor, 1 adenocarcinoma, and 1 reticulum-cell sarcoma). Fine-needle aspiration cytology is reliable enough to permit a definite diagnosis of small-cell carcinoma, especially when combined with the roentgenograms and clinical findings.

Adult↗
PubMed1976

Implantation metastasis after percutaneous transthoracic needle aspiration biopsy.

The risk of tumour spread at aspiration biopsy of pulmonary tumours through the needle track has been analyzed by reviewing the case histories of 1 264 patients with a malignant tumour demonstrated by needle biopsy. Only in one case did metastatic tumour growth develop at the site of the biopsy. The history of this case is presented and the available literature on the subject discussed.

Aged↗
PubMed1976

Complications of percutaneous transthoracic needle aspiration biopsy.

After 5,300 percutaneous transthoracic needle aspiration biopsy procedures in 2,726 patients pneumothorax occurred in 27.2 per cent of the patients. Only 7.7 per cent required exsufflation or drainage. The factors influencing the relative frequency and the severity of pneumothorax are discussed. Bleeding around the punctured lesions was found in 11 per cent, and hemoptysis in 2 per cent but were of no clinical importance. In one case evidence of needle track implantation was found. The theoretical and practical importance of tumour cell spread and spread of infection through the needle track is discussed. No air embolism or mortality occurred.

Adult↗