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Chukwumere E Nwogu

Publications and source records attributed to Chukwumere E Nwogu.

5 recordsLinked to original sources
PubMed2006

Palliation of malignant dysphagia in esophageal cancer: a literature-based review.

Esophageal cancer is a lethal malignancy and adenocarcinoma of the esophagus is increasing in incidence. Most patients present with locally advanced, unresectable or metastatic disease. The 5-year survival rate of patients with esophageal cancer is < 20%. Dysphagia is the most common presenting symptom of this disease and leads to nutritional compromise, pain, and deterioration of quality of life. Palliation is an important goal of esophageal cancer therapy. Severity is commonly measured using a dysphagia grade, and dysphagia is an integral component of quality-of-life instruments, such as FACT-E and EORTC-OES 24. Investigation of dysphagia includes radiographic studies such as barium or Gastrografin swallow, esophagogastroduodenoscopy, endoscopic ultrasonography, and other staging studies for esophageal cancer. Current management options for the palliation of dysphagia include esophageal dilatation, intraluminal stents, Nd:YAG laser therapy, photodynamic therapy, argon laser, systemic chemotherapy, external beam radiation therapy, brachytherapy, and combined chemoradiation therapy. The clinical situation, local expertise, and cost effectiveness play an important role in choosing the appropriate treatment modality. The benefits and disadvantages of these approaches along with a concise review of the literature are presented.

Adenocarcinoma↗
PubMed2005

Fluorescent human lung macrophages analyzed by spectral confocal laser scanning microscopy and multispectral cytometry.

Numerous highly fluorescent macrophages (MPhi), designated "smoker cells," exist in the lungs of smokers and subjects who have quit smoking within 5 years. The brightly fluorescent MPhi, however, are not present in the lungs of never smokers. Some investigators have speculated that the intense fluorescence of the MPhi is due to smoke-induced changes in the autofluorescence of naturally occurring (i.e., endogenous) compounds (e.g., NADP). In contrast, other researchers have theorized that the fluorescence is due to the uptake of tobacco smoke particulates (i.e., "tar"). Studies reported herein were undertaken to test the hypothesis that the origin of the MPhi fluorescence could be profiled with the novel technologies afforded by spectral confocal laser scanning microscopy (sCLSM) and multispectral cytometry (MSC). To this end, spectral emissions were obtained by sCLSM of optical sections of live MPhi isolated from fresh surgically excised human lung tissue and in air-dried lung tissue imprints. Confirmation of spectral profiles of these single cell observations was obtained in population studies with the use of high-throughput MSC in which multispectral analyses were performed with three different lasers. Proof of concept experiments demonstrated that relatively nonfluorescent MPhi from the lungs of nonsmokers became fluorescent upon short-term ex vivo exposure to tobacco smoke tar. Summarily, the studies reported herein document that the fluorescence of human lung MPhi is due to tobacco tar.

Fluorescence↗
PubMed2004

Discharge independence with minimally invasive lobectomy.

BACKGROUND: The effects of video-assisted thoracic surgery (VATS) pulmonary lobectomy on after-hospital care are not well known. METHODS: In a retrospective case-control study, 20 consecutive VATS cases were matched to 38 standard thoracotomies (open cases). RESULTS: Ages were 73.8 +/- 7.8 years with no initial differences between the groups. No hospital deaths occurred. Excluding 2 VATS and 6 open outliers, VATS cases had fewer hospital days (4.6 +/- 1.9 vs. 6.4 +/- 2.2, P <0.01), chest tube days (3.0 +/- 1.1 vs. 4.2 +/- 1.7, P = 0.01), and prolonged pain complaints (28% vs. 56%, P = 0.05). Transfer to care facilities or home nursing support was needed for 63% of open patients and only 20% of VATS patients (P = 0.015). Less personal care (10% vs. 21%), wound/medical care (0% vs. 13%), occupational/physical therapy (5% vs. 13%), or other home support (5% vs. 18%) was needed for VATS patients. CONCLUSIONS: In older populations, more independence and fewer resources after discharge favor VATS lobectomy over standard thoracotomy.

Aged↗
PubMed2002

Pulmonary lymphatic mapping in dogs: use of technetium sulfur colloid and isosulfan blue for pulmonary sentinel lymph node mapping in dogs.

Lung cancer is the most frequent cause of cancer death in the United States. The pattern of regional lymph node involvement is a major prognostic factor in a patient with nonsmall cell lung cancer. The accuracy of information obtained about the lymph node status of lung cancer patients can be potentially increased by sentinel node lymphatic mapping. This technique has been well studied in melanoma and breast cancer. It may be useful in increasing the detection of micrometastases and in decreasing the morbidity from complete mediastinal lymphadenectomy. We report an animal pilot study of pulmonary lymphatic mapping. The aim of our study was to gain experience in the surgical techniques for pulmonary sentinel node lymphatic mapping in an animal model prior to its application in humans. Technetium sulfur colloid and isosulfan blue dye were injected into different lobes of the lung followed by attempts to identify the sentinel node draining that specific portion of the lung. Technetium sulfur colloid identified the sentinel node in five of six dogs within 20 min after the radiotracer was injected into the lung parenchyma. Isosulfan blue dye identified the sentinel node in three of six dogs within 5 min. Both the agents are potentially useful, but we found greater technical ease in identifying the sentinel node with technetium sulfur colloid. Two single-institution pilot studies in humans have been performed. A multicentered study to validate and further refine this technique is necessary. Advanced pathologic techniques such as immunohistochemistry and reverse transcriptase-polymerase chain reaction can be used to enhance the accuracy of staging. This may facilitate proper application of novel therapeutic strategies to improve the current dismal prognosis of this disease.

Animals↗