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Biomedical subjects

A J Gunning

Publications and source records attributed to A J Gunning.

At least 19 recordsLinked to original sources
PubMed1995

Isolated thoracic duct injury after penetrating chest trauma.

BACKGROUND: Isolated thoracic duct injuries as a result of penetrating chest trauma without any major vascular or tracheoesophageal injury seldom are seen. METHODS: A retrospective 13-year review identified 8 patients with this injury. RESULTS: Seven had supraclavicular or suprascapular knife stabs, and the eighth had a low-velocity gunshot injury entering the mid-lateral right chest wall. All 7 stab victims presented with left-sided chylothoraces, and the site of injury of the thoracic duct was within Poirier's triangle, the borders of which are the arch of aorta, the left subclavian artery, and the vertebral column as seen from a lateral approach. Five patients initially were treated conservatively for 13.4 +/- 4.4 days without success. Surgical intervention thus was necessary and was successful in all 8 patients. The thoracic duct injury was controlled successfully through a left posterolateral thoracotomy in 6 patients. A supraclavicular repair was attempted in 1 patient but failed to control the leak and required reexploration via the supraclavicular approach. The right chylothorax from the gunshot injury was explored via a right posterolateral thoracotomy; the leak into the pleura was identified and obliterated. CONCLUSIONS: As conservative management was uniformly unsuccessful, we advocate early operative management through a thoracotomy on the side of the chylothorax for this relatively rare injury.

Adult↗
PubMed1994

A technical approach to tracheal and oesophageal injuries.

Twenty patients with acute trauma to the trachea and oesophagus were managed in the last 6 years with a new technique. There were 2 female and 18 male patients with an average age of 26 years. The approach is direct, easy and reproducible. The approach is direct, easy and reproducible. The oesophageal rents are approached through the anterior and posterior tracheal lacerations without tracheal mobilisation. Muscle interposition was electively not used and cervical wounds not drained. Wound dehiscence was not experienced.

Adult↗
PubMed1991

The changing pattern of thoracic surgery in the United Kingdom 1963-1982.

During the period 1963-1982 a total of 11,459 patients with general surgical and thoracic conditions were admitted to the Churchill and John Radcliffe Hospitals in Oxford under the care of a single thoracic surgeon. 55.1% of the admissions were for general surgical conditions whereas 44.9% were for a thoracic disorder. The total period has been studied by dividing it into three subgroups of 7, 6 and 7 years (1963-1969, 1970-1975, 1976-1982). The percentage of thoracic patients treated during the three periods was found to be 48.86%, 41.73% and 50.11% respectively. The three periods studied have been subdivided into major disease groups and the changes in these groups have been studied in detail. During this 20-year period there has been a dramatic change in the makeup of a typical thoracic surgical practice. This is in part due to the changing pattern and prevalence of many of the diseases treated by thoracic surgeons, but is also due to a change in referral patterns, the distribution of patients between thoracic and general surgeons and also the dichotomy emerging between thoracic and cardiac surgeons.

Cardiac Surgical Procedures↗
PubMed1990

Intrinsic obstruction of the Procter-Livingstone tube.

Four instances of intrinsic obstruction of a Procter-Livingstone tube inserted for oesophageal carcinoma are described. The exact cause of the blistering is unknown, but it is thought to occur by absorption through the latex. It is suggested that if this complication is found, relief of obstruction may be obtained by perforation of the blister.

Equipment Failure↗
PubMed1986

Mixed tumours of the lung: a report of three cases.

Three patients with mixed tumours of the lung are presented. The difficulties making a histological diagnosis are stressed and the value of extensive examination of large amounts of tissue, and electron microscopy is emphasized.

Adult↗
PubMed1983

Inflammatory obstruction of oesophageal tubes.

Two patients, intubated for inoperable carcinoma of the oesophagus, recently presented with their tubes blocked by granulation tissue. This complication has not been previously reported. The tissue macroscopically resembled normal mucosa in one and recurrent tumour in the other. The presentation, aetiology, and significance of this granulation tissue is discussed.

Deglutition Disorders↗
PubMed1981

Failure of specific active immunotherapy in lung cancer.

A randomized trial comparing routine follow-up with a treatment regimen aimed at increasing specific anti-tumour immunity has been carried out in 95 patients after total surgical excision of lung cancer (not small-cell). Treatment consisted of inoculation with an autologous irradiated suspension of tumour cells combined with a small dose of C. parvum given intradermally during convalescence. Although treatment was associated with virtually no side effects, there has been no apparent benefit and input to the trial has now stopped.

Antigens, Neoplasm↗
PubMed1979

Treatment of chronic oesophageal perforations with special reference to an endoscopic method.

The endoscopic treatment of chronic oesophageal perforations (more than 18--24 h old) by the application of sodium hydroxide 20 per cent to the edges of the perforation is described. The importance of pleural and mediastinal toilet and the accurate siting of drainage tubes and full expansion of the lung, together with measures for diminishing oral, gastric and bilary secretions from the perforation, are stressed. Five patients who have been treated by this conservative method are presented and the method compared with the more radical surgery advocated by the majority of other surgeons.

Aged↗
PubMed1978

Ligation of patent ductus arteriosus in the very low birthweight newborn infant.

Surgical closure of a patent ductus arteriosus was performed in 8 low birthweight infants suffering from cardiorespiratory failure secondary to a large left-to-right shunt. Mortality from the operation was nil, but only 4 (50%) ultimately survived. Earlier intervention may reduce mortality in these high-risk infants.

Ductus Arteriosus↗
PubMed1976

Technique for cardiopulmonary bypass in the goat.

The goat is an ideal animal for intracardiac surgical investigation. The animal is docile and easy to care for; it has an ideal heart size, a high cardiac output and a long life expectancy. The animal tolerates cardiopulmonary bypass well and does not require blood transfusion. Anoxic cardiac arrest is tolerated for up to 35 minutes. Initial experience in 36 animals with operations on the right side of the heart resulted in a 72% long-term survival.

Animals↗