Thomas H. Burford

Oat cell carcinoma of the lung: A review of 138 cases

All cases seen during the 11 years from 1956 through 1966 are reviewed. They comprised 10% of the bronchogenic cancer population. Males predominated 19:1. There was no positive correlation with cigarette smoking. In most of the patients symptoms were present less than 3 months before diagnosis. Only four patients (3.0%) had overt hypercoticism. Histologic confirmation was easily obtained; bronchoscopic biopsy was positive in 60% of the cases. Our operability rate (60%) and resectability rate (27%) are almost as high as for epidermoid carcinoma; others have reported much lower rates. There are two 5‐year survivors, the only asymptomatic patients in the series. In both, the tumor already had prominent vascular invasion, and one had regional lymph node involvement. The survival rate was 5.4% of the resected patients and 1.4% of the total group.

Recurrent coarctation of the aorta after successful repair in infancy

Abstract Twenty unselected infants who survived repair of coarctation of the aorta were restudied an average of 6.2 years postoperatively. Eight patients (40 percent) showed no significant difference in blood pressures between the arms and legs and had normal pressures in their arms. These patients have been followed up for an average of 5.1 years postoperatively. Another 8 patients (40 percent) had moderate blood pressure differences between the upper and lower limbs. These patients have been followed up for an average of 6.6 years postoperatively. Further follow-up of this group will be required to determine how many will need reoperation. Four patients (20 percent), although asymptomatic, had recurrent severe coarctation of the aorta that will require reoperation. These patients have been followed up for an average of 6.9 years postoperatively. The mechanism of the recurrent coarctation is not clear, but there is evidence that the coarctation is incompletely relieved in some and that it develops with growth in others. All infants surviving repair of coarctation of the aorta must be closely followed up for possible recurrent coarctation until they reach adult size.

Mediastinal Granuloma: A 15-Year Experience

ranulomatous lesions of the mediastinal compartment present widely varying clinical, roentgenological, and pathological picG tures. Surgical treatment of such a lesion was first proposed by Grace [4] in 1942, when he reported the removal of a mediastinal tuberculoma. In 1950 Samson, Heaton, and Dugan [12] reported 4 cases and questioned the accuracy of calling these lesions “tuberculomas.” Kunkel, Claggett, and McDonald [9], when reviewing 16 of their cases in 1954, suggested the term mediastinal granuloma be used because a specific etiological agent is rarely recovered. Since then a number of papers have appeared, most of them dealing with complications attributable to the process. Between 1949 and 1963 a total of 43 cases of mediastinal granuloma were seen on the Chest Surgical Service of Barnes Hospital. There was no unusual age or sex distribution (Fig. 1). T h e youngest patient was 5, the oldest 72. T h e average age was 37 years. There

Coronary artery occlusion, a complication of thoracic aortography in a patient with calcific aortic stenosis

Abstract An unusual case is reported in which thoracic aortography led to embolization of a coronary artery with material from a calcified aortic valve in a patient with calcific aortic stenosis.

Opacification from the Pulmonary Artery of an Anomalous Left Coronary Artery

Anomalous origin of the left coronary artery from the pulmonary artery was first reported by Konstantinowitsch (8) in 1906 and classically described by Abrikossoff (1) in 1911. A number of excellent reports have been made since that time (4, 7, 9, 13). In most patients with angiocardiographic studies the anomalous left coronary artery was opacified from the aorta via the right coronary artery and collateral circulation (2). In the literature, to date, brief reference has been made to only 3 cases (7, 14) in which it was opacified directly from the pulmonary artery, and there were no illustrations of the angiocardiograms. This is a case report of an infant in whom the anomalous left coronary artery was demonstrated angiographically by flow of contrast medium from the pulmonary artery. Case Report S. S., a two-month-old white female, entered the hospital because of persistent vomiting. She weighed 7 pounds, 14 ounces, having gained 10 ounces since birth, and there were no other symptoms. Physical examinatio...

THE ROLE OF SURGERY IN THE MANAGEMENT OF UNILATERAL PLEURAL EFFUSION

Excerpt The three most common causes of a persistent unilateral pleural effusion are tuberculosis, metastatic carcinoma and heart failure, although a variety of other disease processes can give ris...

The diagnosis of aorticopulmonary septal defect. A case report with successful surgical closure.

Abstract (1) A case is reported of successful repair of an aorticopulmonary septal defect despite pressures at a systemic level in the pulmonary artery. (2) The correct diagnosis was first suggested by the location of the dilution effect in the pulmonary artery on angiography, and was confirmed by retrograde aortography. (3) The clinical and catheterization features which are useful in the recognition of aorticopulmonary septal defects have been reviewed.