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Biomedical subjects

B Gipe

Publications and source records attributed to B Gipe.

12 recordsLinked to original sources
PubMed1998

Localization of bronchial intraepithelial neoplastic lesions by fluorescence bronchoscopy.

BACKGROUND: In the treatment of lung cancer, the best outcome is achieved when the lesion is discovered in the intraepithelial (preinvasive) stage. However, intraepithelial neoplastic lesions are difficult to localize by conventional white-light bronchoscopy (WLB). OBJECTIVE: To determine if autofluorescence bronchoscopy, when used as an adjunct to WLB, could improve the bronchoscopist's ability to locate and remove biopsy specimens from areas suspicious of intraepithelial neoplasia as compared with WLB alone. METHOD: A multicenter clinical trial was conducted in seven institutions in the United States and Canada. WLB followed by fluorescence examination with the light-induced fluorescence endoscopy (LIFE) device was performed in 173 subjects known or suspected to have lung cancer. Biopsy specimens were taken from all areas suspicious of moderate dysplasia or worse on WLB and/or LIFE examination. In addition, random biopsy specimens were also taken from other parts of the bronchial tree. RESULTS: The relative sensitivity of WLB + LIFE vs WLB alone was 6.3 for intraepithelial neoplastic lesions and 2.71 when invasive carcinomas were also included. The positive predictive value was 0.33 and 0.39 and the negative predictive value was 0.89 and 0.83, respectively, for WLB+LIFE and WLB alone. CONCLUSION: Autofluorescence bronchoscopy, when used as an adjunct to standard WLB, enhances the bronchoscopist's ability to localize small neoplastic lesions, especially intraepithelial lesions that may have significant implication in the management of lung cancer in the future.

Adult↗
PubMed1995

Subarachnoid hemorrhage: an unusual presentation of shock.

A 42-year-old woman became profoundly hypotensive shortly after arriving at our emergency medical center after a seizure. The patient's blood pressure did not respond to aggressive fluid resuscitation, administration of inotropic agents, vasopressors, or corticosteroids. After a thorough search for the cause of shock, she was found to have a subarachnoid hemorrhage (SAH). Hypotension is a rare occurrence in SAH. Several mechanisms of SAH are reviewed in this report and are invoked to explain this patient's lack of response to the standard therapies for hypotension. Emergency physicians should consider SAH in the differential diagnosis of refractory shock in patients who present with neurologic abnormalities.

Adult↗