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Biomedical subjects

A F Barker

Publications and source records attributed to A F Barker.

29 records · Page 2Linked to original sources
PubMed1984

Pulmonary arteriovenous fistulas occluded by percutaneous introduction of coil springs.

Between July 1980 and July 1983, we occluded 30 pulmonary arteriovenous fistulas (PAVFs) in four patients by percutaneous placement of coil springs. All patients had significant right-to-left shunts and hypoxemia. One presented with recurrent cerebral abscesses following bilateral thoracotomy and lobectomy. The technique requires advancement of the catheter superselectively into the feeding artery just proximal to the fistula. Occlusion at this site preserves the maximum amount of functioning pulmonary parenchyma. Frequently more than one coil spring is required for occlusion. In our experience, the coil spring is a safe, effective, economical vaso-occlusive device for management of PAVFs.

Adult↗
PubMed1982

Percutaneous interventional catheter therapy for lesions of the chest and lungs.

Percutaneous, nonsurgical interventions using angiographic catheter techniques and radiologic guidance were used in the management of seven cases of various lesions of the chest and lungs. Successful catheter therapy included the embolization of a large, acquired, postinflammatory vascular malformation causing massive hemoptysis and a cavernous hemangioma of the chest wall. Sixteen pulmonary arteriovenous fistulas (one patient), an iatrogenic internal mammary artery-to-innominate vein fistula, and a persistent, postbiopsy bronchopleural fistula were successfully closed. Percutaneous drainage of a pyogenic lung abscess and the nonoperative retrieval of an intravascular foreign body that had embolized to the left pulmonary artery were also successfully achieved. Performed under local anesthesia with minimal morbidity, stress, and risk, interventional catheter therapy is remarkably cost-effective. Primary chest physicians are encouraged to consider this mode of therapy whenever applicable.

Adult↗
PubMed1981

Bronchoscopy and bone marrow examinations. An efficient strategy to establish the diagnosis of small cell carcinoma of the lung.

The utility of various diagnostic procedures, including fiberoptic bronchoscopy and bone marrow aspirate/biopsy for small cell carcinoma, was examined in 150 patients. From a chart review of the first 100 patients, 55 required an invasive procedure such as mediastinoscopy or thoracotomy to establish the tissue diagnosis. In 50 consecutive prospective patients, only four required an invasive procedure for tissue confirmation. Eighteen of the 50 prospective patients had positive iliac crest bone marrow aspirates or biopsies diagnostic for small cell carcinoma. Fiberoptic bronchoscopy was nondiagnostic in 15 prospective patients, but the bone marrow examination was diagnostic in 12 of this subgroup. The combination of fiberoptic bronchoscopy and bone marrow examination in patients with centrally located small cell carcinoma greatly reduced the need for more expensive and invasive diagnostic procedures.

Adult↗
PubMed1980

Post-traumatic bronchial stenosis and acute respiratory insufficiency.

A 31-year-old woman sustained multiple injuries, including severe contusion of the right lung with massive subcutaneous emphysema. Four weeks later she was transferred to our institution with post-traumatic adult respiratory distress syndrome and carbon dioxide retention, resulting from a postlaceration stenosis of the left main-stem bronchus. Bronchoplasty was contraindicated because of the serious condition of the patient. Repeated bronchial dilatations produced initial improvement in oxygenation and minute ventilation requirements. However, because of the nature of the stenosis and the lack of recovery of right lung function, the patient's encouraging clinical course reached a plateau and attempts at weaning from the respirator were unsuccessful. Bronchoplasty was performed on postadmission day 50 and resulted in gradual recovery of pulmonary function. Six months following discharge, the patient continues a steady improvement. Management of the patient's injuries represented a unique challenge previously unencountered.

Adult↗
PubMedDate not supplied

Alpha 1-antitrypsin-deficiency-related emphysema.

BACKGROUND: A congenital cause of emphysema resulting from alpha 1-antitrypsin (A1AT) deficiency affects 1 in 2500 individuals and could account for emphysema in 2 percent of all persons with emphysema. Individuals aged 30 to 45 years with chronic shortness of breath and coughing could have A1AT deficiency. METHODS: Using the key words "alpha 1-antitrypsin deficiency," "chronic obstructive pulmonary disease," and "emphysema," the MEDLINE files were searched from 1985 to the present. Data from articles published before 1985 were accessed from cross-reference of the recent articles. RESULTS AND CONCLUSIONS: Unlike smoker's emphysema, A1AT deficiency is panacinar, appears in middle-aged patients, and is more severe at the lung bases. Chronic bronchitis, mucous hypersecretion, and liver disease, as well as a family history of emphysema, are associated conditions. Clinical management includes the avoidance of smoking and atmospheric pollution. Also available is purified, functional human A1AT in quantities large enough for intravenous replacement or augmentation therapy. Future treatment for the disease includes synthetic elastase inhibitors and an aerosolized formulation of A1AT, which is currently under investigation.

Air Pollution↗