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Biomedical subjects

C J Westermann

Publications and source records attributed to C J Westermann.

53 records · Page 3Linked to original sources
PubMed1988

Resection of more than 10 lung segments. A 30-year survey of 30 bronchiectatic patients.

A series of 30 bronchiectatic patients, treated by bilateral resection of 11, 12, or 13 lung segments, has been followed up for 30 years. The progress of the patients is analyzed and the results of treatment are evaluated. Ten patients required further resections for persisting collapse, kinking of the apical segment of a lower lobe, or because the previous resection had been too limited. The long-term results of these extensive bilateral resections in our group of patients are excellent. The quantitative function, more than 20 years after the last resection, lies markedly above the predicted value for the number of remaining segments. The qualitative function did not deteriorate over the years. It is clear that extensive bilateral bronchiectasis does not, per se, constitute a contraindication to resection, provided that at least six normal segments can be preserved.

Aged↗
PubMed1987

Mesenchymoma of the lung (so called hamartoma): a review of 154 parenchymal and endobronchial cases.

In a series of 154 patients (116 male and 38 female) with so called pulmonary hamartoma the peak incidence was in the sixth decade, with only three patients less than 20 years of age. Sequential radiographs showed that in 55 patients the tumour first appeared in adult life and that in 53 it progressively increased in size. The age incidence and progressive growth leads to the conclusion that the tumour is a benign neoplasm rather than a hamartoma, consisting of various connective tissues intersected by clefts lined by respiratory epithelium. The epithelial elements are regarded as entrapped non-neoplastic inclusions and the tumour as a purely mesenchymal neoplasm: the name mesenchymoma therefore seems the most appropriate. There were two recurrences after simple enucleation, 10 and 12 years later. A total of 142 tumours were parenchymal, and only 12 were endobronchial. All lobes were affected but there was a slight preponderance in the left upper lobe. Four patients had two (synchronous) mesenchymomas. There was an associated bronchial carcinoma in 11 patients, synchronous in six and metachronous in five.

Adolescent↗
PubMed1987

A comparative study of intravenous digital subtraction angiography and ventilation-perfusion scans in suspected pulmonary embolism.

We observed 102 patients suspected of having pulmonary emboli (PE) who underwent ventilation-perfusion (V/Q) lung scintigraphy and IV digital subtraction angiography (DSA). Only five DSA studies were inadequate for interpretation. In 81 of the remaining 97 patients (83.5 percent) the results of both studies correlated regarding the probability of PE. In 50 patients the results of both studies were highly suggestive of PE; in 31 patients DSA and V/Q were normal or classified as low probability of PE. There was disagreement in 3/97; in 13/97 one or both studies were nondiagnostic. The clinical data of these 16 patients are given. Conventional catheter pulmonary angiography was indicated in 11/102 patients to establish a firm diagnosis of PE. The results of V/Q and DSA correlated in 83 percent (49/59) of patients without chronic obstructive pulmonary disease (COPD) and in 84 percent (32/38) of the patients with COPD.

Adult↗
PubMed1987

Rheumatoid arthritis in the metacarpophalangeal joint.

A case is presented illustrating some of the basic principles in the development of deformity in the rheumatoid hand. Swanson flexible implant arthroplasties of the second through the fifth metacarpophalangeal joints are described and postoperative care and follow-up discussed. The authors conclude that surgery plays a crucial role in the early treatment of the rheumatoid hand.

Arthritis, Rheumatoid↗
PubMed1987

Dilatation, compensatory growth, or both after pneumonectomy during childhood and adolescence. A thirty-year follow-up study.

The ventilatory function of 230 patients with pneumonectomy, performed at ages ranging from 2 to 40 years, has been followed for more than 30 years (mean 33 years). We have tried to analyze whether the available data gave information about the nature and the mechanisms adapting the remaining lung to the larger than normal pleural space and about the persistence of this adaptation in the longer term. There were 32 patients with a persistent, disturbed forced expiration (mean 50% of vital capacity). This group of patients was excluded from the study to answer the above questions, because the subdivisions of the total lung capacity in this group differed significantly from those in the group of 98 patients with a normal forced expiratory volume of 72% (mean) of vital capacity. The data of the 98 patients, who were subdivided into seven age groups at the time of pneumonectomy, permitted the following conclusions: In the youngest age group (0 to 5 years), the ventilatory capacity is hardly smaller than the predicted capacity for two lungs; this suggests that compensatory growth by way of hyperplasia might have been the most important adaptive mechanism in this group. In the age group 6 to 20 years, a significant difference is still found as compared to the group of patients operated on at an older age; this difference indicates that in this period compensatory growth, possibly mainly simple hypertrophy, still played an important but gradually decreasing role. The fact that the effect of the adaptational mechanisms could be observed more than 30 years after ablation of one lung, without loss in quality of function (i.e., forced expiratory volume constituting a normal percentage of the vital capacity), indicates that the adaptive mechanisms also compensate for the loss in lung tissue in the longer term. A striking finding was the stability of the tidal volume/functional residual capacity ratio, which, especially in the younger age groups, was very close to the predicted value for two lungs. This finding is in agreement with the fact that most persons with a healthy remaining lung lead a normal family and social life after pneumonectomy.

Adaptation, Physiological↗
PubMed1986

Sustained-release terbutaline in nocturnal asthma.

Fifteen adult patients with nocturnal asthma entered a double blind study. They received a single evening dose of one sustained-release (SR) terbutaline tablet à 7.5 mg or an identical placebo tablet for 1 week, each in a randomised cross-over fashion in addition to their usual medication. In the 12 evaluated patients there was no change in evening PEF but a significant improvement in morning PEF (P less than 0.05) and in overnight fall of PEF (P less than 0.01) on active treatment. Symptoms were improved by both placebo and active medication. Three patients experienced tremor as a side effect. A single evening dose of SR-terbutaline can be of help in nocturnal asthma.

Adult↗
PubMed1986

Isolated granulomatous giant cell vasculitis of the pulmonary elastic arteries.

A 66-year-old man who developed an occluded left main pulmonary artery, clinically demonstrated by perfusion scan and pulmonary angiography, is described. Explorative thoracotomy revealed a granulomatous giant cell arteritis after pathologic examination of the surgically removed left lung. Detailed clinical and laboratory evaluation excluded a systemic disease.

Aged↗
PubMed1986

Bullectomy for giant bullae in emphysema.

The results of changes in dyspnea and pulmonary function are reported in 27 emphysematous patients followed up for about 10 years after removal of giant bullae, which occupied at least 50% of a hemithorax. In 10 patients bilateral bullectomy was done. The spirographic improvement depends on the type of bulla. Resection of bullae at open communication with the bronchial tree resulted predominantly in improvement of forced expiratory volume as a percentage of vital capacity, whereas after closed bullae were resected, the increase in vital capacity was most apparent. Dyspnea lessened in all patients. Seven older patients died of ventilatory insufficiency. Preoperatively they were clinically and functionally severely disabled. They improved markedly after bullectomy, and their mean survival time was more than 7 years. In all 27 patients improvement of dyspnea and pulmonary function lasted several years and only gradually returned to preoperative values and beyond. No giant bullae recurred in the observation period; neither was there an accelerated progression of the emphysematous process. Our present selection criteria, based on previous experience, are as follows: giant bullae occupying at least 50% of a hemithorax, definite displacement of adjacent lung tissue, exclusion of the presence of vanishing lung syndrome, and absence of chronic purulent bronchitis.

Adult↗
PubMed1983

Tracheobronchopathia osteochondroplastica. Report of four cases.

Tracheobronchopathia osteochondroplastica is a rare abnormality, characterised by the presence of polyps in the trachea and main bronchi; these polyps consist of cartilaginous and/or osseous metaplastic tissue. The clinical findings in four patients are described. The pathogenesis is unknown. Treatment is usually not indicated and the prognosis is good. Where there is significant obstruction of the airways, endoscopic removal seems to be the treatment of choice.

Aged↗
PubMed1981

IgE bound to mast cells in bronchial mucosa and skin in atopic subjects.

In immune reactions of the immediate type, IgE bound to the membrane of mast cells plays an important role. In 45 patients with allergy and 12 patients without allergy the IgE load on mast cells in bronchial mucosa and skin was measured by an immunofluorescent technique. In the allergic patients a positive score was found in 38 bronchial biopsies and 31 cutaneous biopsies. The difference is significant in favor of the positive score of the bronchus biopsy. A correlation between the titre of IgE, bound on mast cells and the number of mast cells was not found.

Adolescent↗