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Biomedical subjects

A M Wever

Publications and source records attributed to A M Wever.

31 records · Page 2Linked to original sources
PubMed1988

Radiotherapy as an alternative to surgery in elderly patients with resectable lung cancer.

From 1978 to 1983, 50 patients with a peripherally located non-small cell tumor of the lung were irradiated with curative intent. These patients were not operated upon because of poor cardiac or pulmonary condition, old age or refusal to operate. Mean age was 74 years, 40 patients being over 70 years of age. All patients had T1-2 N0M0 tumors according to the AJC classification and received 60 Gy to the primary tumor only. The overall response rate was 90%, with 50% complete responses in tumors smaller than 4 cm. The crude overall survival rates were 56% at 2 years and 16% at 5 years, with a median survival of 27 months. Age did not influence survival. There was a strong correlation of survival to tumor size, with 5-year survival rates of 38, 22, 5 and 0% in tumors with diameters of less than or equal to 2, 2-3, 3-4 and greater than 4 cm respectively. Only 5 out of 20 complete responders had a local recurrence, the 5-year survival in this group was 42%. These results compared favorably to a group of 86 patients over 70 years of age who were selected for operation in the same hospital. The 2- and 5-year survival rates in these patients were 48 and 26% respectively, median survival being 23 months. We conclude that in patients over 70 years of age with resectable lung cancer, radiotherapy with curative intent should be offered as an alternative to operation, especially if the tumor is not larger than 4 cm.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Krypton-81m ventilation studies as a parameter for lung capacity after lobectomy.

Spirometry and krypton-81m lung scans were performed in 17 patients before lobectomy was carried out for bronchogenic carcinoma to determine whether post-operative spirometric values could have been predicted from the pre-operative data. The patients were followed up at 3, 6 and 12 months post-operatively for lung function testing. It emerged from this study that good post-operative spirometric values could be predicted for VC (r = 0.80), and for FEV1 (r = 0.88), and to a much lesser degree for the TLC (r = 0.51) at 6 months after surgery. With time TLC and VC tended to increase, whilst the FEV1 remained at the same level.

Aged↗
PubMed1982

Doctor diagnosis and maternal recall of lower respiratory illness.

Epidemiological studies of respiratory illness in childhood have used the mother's recall of her child's respiratory illness experience as a measure of the frequency with which these illnesses occur. This paper explores the relationship between the diagnosis by the doctor of lower respiratory illnesses and the recall by the mother of the occurrence of these illnesses in a cohort of children in the first year of life. While there is a poor relationship between doctor diagnosis and maternal recall of these illnesses, the group of children reported by their mothers to have had bronchitis or pneumonia in the first year of life appear to suffer more respiratory illness than those children whose mothers recall no such illnesses.

Bronchitis↗
PubMed1982

Transpleural lung biopsy by the thoracoscopic route in patients with diffuse interstitial pulmonary disease.

Thoracoscopy was carried out in 81 cases of diffuse pulmonary disease in order to obtain lung tissue for biopsy. After we established artificial pneumothorax, the thoracoscope was introduced under local anesthesia, multiple biopsy specimens (theta 3 mm) were obtained under visual control, and an underwater sealed drain was left in place. The method was used to determine the cause of x-ray shadowing and respiratory distress in 26 immunocompromised patients. Within 2-48 hours, all biopsy specimens provided sufficient microbiologic and morphologic information to guide management, eg, specific antimicrobial drugs, decreasing or intensifying immunosuppression, or cytostatic therapy. Thoracoscopy was tolerated better than fiberoptic bronchoscopy, especially in hypoxic patients. Persisting or recurring pneumothoraces were seen in four patients and was not a major complication. In one very ill patient, the spleen was punctured accidentally before biopsy specimens were taken. Of 63 nonimmunocompromised patients, a histologic diagnosis was obtained in 57 (90 percent). In most of these patients, previous biopsy procedures had produced inconclusive results. Also in this group persisting or recurring pneumothoraces were seen in four patients, but closed eventually in a conservative way.

Biopsy, Needle↗
PubMed1981

Postoperative intrapleural BCG in lung cancer: lack of efficacy and possible enhancement of tumour growth.

Fifty-six patients out of a group of 99 with lung cancer received postoperative intrapleural BCG (Pasteur strain) in three different dosages (16 X 10(6) culturable particles (cp), 32 X 10(6) cp, and 64 X 10(6) cp). When comparing the whole group of 99 patients with a historical control group of 126 patients no statistically significant differences were found in survival and disease-free interval. The two groups were well matched in respect of age, sex, histology, stage of disease, and type of operation. Patients with epidermoid carcinoma stage I receiving BCG, however, did significantly worse than those who had not received BCG in terms of disease-free interval. This unfavourable trend was caused by earlier local recurrences rather than metastases. The possible phenomenon of enhanced tumour growth noted in or patients with epidermoid carcinoma stage I might be related to the dosages used in this study, but the different BCG strain used hinders comparison with other studies. We conclude that BCG has no beneficial effect on survival or on disease-free interval; possible enhancement of tumour growth in stage I epidermoid carcinoma was found.

Aged↗
PubMed1981

Clinical evaluation of five spirometers. Monaghan M403, Pneumoscreen, Spirotron, Vicatest and Vitalograph.

Five spirometers were compared with the Stead-Wells spirometer in 100 subjects, using the FVC and FEV1 as parameters. In addition, some physical characteristics were studied. The Stead-Wells is a water-sealed spirometer, recommended as a reference spirometer by the American Committees on Environmental Health and Respiratory Physiology. The Vicatest and Vitalograph are volume-displacement dry spirometers. They showed a very good linearity over their entire volume ranges; their FVC and FEV1 readings showed very good correlations with the readings of the Stead-Wells spirometer. The Monaghan, Pneumoscreen, and Spirotron are flow-integrating "electronic" spirometers. The volumes recorded were found to be dependent on the values of the flow; their FVC and FEV1 readings also showed good correlations with the readings of the Stead-Wells spirometer, but to a lesser extent than the two dry spirometers. Therefore, for routine assessment of ventilatory function we prefer, at present, the modern volume-displacement dry spirometers.

Evaluation Studies as Topic↗
PubMed1977

Serial pulmonary function tests in patients with asbestosis.

Serial lung function tests were performed on 17 patients with asbestosis. A marked fall in the transfer factor often preceded any significant decline in the vital capacity. Changes in vital capacity and transfer factor did not appear to give any indication of the prognosis in these patients. Death was more commonly due to carcinoma of the lung than to the effects of the lung fibrosis.

Aged↗
PubMed1976

Evaluation of two spirometers: a comparative study of the Stead-Wells and the vitalograph spirometers.

The characterisitcs and performance of the Vitalograph dry spirometer were studied, and a direct comparison was made with the Stead-Wells spirometer, as recommended by the Committees on Environmental Health and Respiratory Physiology of the American College of Chest Physicians. The Vitalograph calibrates well against the Stead-Wells spirometer for measurements of vital capacity and forced expiratory volume in one second in normal subjects and in patients with various pulmonary conditions. Both spirometers failed to satisfy the committees' recommendations for resistance and inertia, the Stead-Wells showing the better values. Nevertheless, it is suggested that the Vitalograph is very suitable for the routine assessment of ventilatory function in the laboratory or in population surveys. Its light weight, portability, and robustness give it an added advantage.

Airway Resistance↗
PubMedDate not supplied

Selection of variables from maximum expiratory flow-volume curves.

Various methods are in use for estimating physiological variables from maximum expiratory flow-volume curves, and some of these are recommended by international bodies for use on adults. We have compared eight such methods in 433 adolescents aged 12-16 years. The mean values of expiratory flows, FVC and FEV1 by each method differed less than 6% from those obtained by the method recommended by the ATS, except for MEF25, where differences between methods were substantially larger. The mean within-individual coefficients of variation of FVC and FEV1 did not differ between methods and improved from about 3.1 to 2.6% and 2.7 to 2.3% respectively when using 5 instead of 3 acceptable curves. For expiratory flows, the coefficients of variation ranged between 4.2 and 9.4% and improved slightly but not consistently when using more than 3 acceptable curves. Reproducibilities were systematically poorer when flows were derived from one "best" FVC manoeuvre. It is concluded that taking more than 3 acceptable blows is not cost-effective, even in inexperienced adolescents. An envelope method and maximum composite curve from FVC reproducible within 5% from the largest one are recommended for use with teenagers.

Adolescent↗