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Biomedical subjects

D M Libby

Publications and source records attributed to D M Libby.

27 records · Page 2Linked to original sources
PubMed1981

Syphilitic aortic aneurysm presenting with the superior vena cava syndrome.

In a 65 year old man with hemoptysis, chest pain, weight loss, clubbing of the digits and a large mediastinal mass, the superior vena cava syndrome developed. He was treated for malignancy with radiation therapy and corticosteroids, but he died shortly after his admission to the hospital. Autopsy revealed syphilitic aortitis with an aneurysm of the ascending aorta compressing the superior vena cava and right mainstem bronchus. The postmortem serology corroborated the morphologic findings of tertiary syphilis. In this report we emphasize the important, although now uncommon, association between the superior vena cava syndrome and aneurysm of the aorta.

Aged↗
PubMed1981

Relief of hypoxia-related bronchoconstriction by breathing 30 per cent oxygen.

Airway resistance decreases when hypoxemic subjects with chronic obstructive pulmonary disease (COPD) breathe 30% O2. To verify this finding and to localize the site of action of O2, flow-volume curves on air and helium-O2 mixtures were obtained before and after subjects breathed 30% O2. Patients with COPD and hypoxemia showed an increase in flow rates and a decrease in the density dependence of flow while breathing 30% O2. Atropine produced a similar change in flow rates and density dependence, but then no further change occurred with 30% O2. Five control subjects with COPD, who performed the same sequence of tests without breathing 30% O2, showed no change in flow rates or density dependence. Normal control subjects also showed no change in flow rates or density dependence while breathing 30% O2. Breathing 30% O2, relieves hypoxia-induced bronchoconstriction and appears to act on large airways.

Aged↗
PubMed1980

Chronic eosinophilic pneumonia: an unusual cause of acute respiratory failure.

A 75-year-old man developed dyspnea, cough, peripheral radiographic infiltrates, eosinophilia, and severe hypoxemia requiring mechanical ventilation. An open lung biopsy revealed chronic eosinophilic pneumonia, and the patient recovered with corticosteroid therapy. Chronic eosinophilic pneumonia is a disease that should be included in the different diagnosis of treatable causes of acute respiratory failure.

Acute Disease↗
PubMed1979

Oxygen concentration from room air. A new source for oxygen therapy in the home.

Most oxygen concentrators use molecular sieves that selectively adsorb molecules according to their size and polarity. Their present rental cost is about half that of the traditional oxygen tanks or liquid-oxygen systems. Two concentrators have been tested. They are able to produce both high oxygen concentrations (95% oxygen at 2 L/min) and high flow rates (10 L/min with 40% oxygen), which remained stable for one week. After 24 hours of continuous use, neither machine concentrated toxic gases from room air in a city. Both were suitable for use with 24% and 28% Venturi masks.

Chronic Disease↗
PubMedDate not supplied

Elevated carcinoembryonic antigen levels correlating with disease recurrence in a patient with adenoid cystic carcinoma.

BACKGROUND: Carcinoembryonic antigen (CEA) is an oncofetal glycoprotein involved in cell recognition and adhesion. Serum CEA has been extensively studied as a potential chemical marker for malignancy, most notably in patients with colon carcinoma. Serum CEA measurements have not been reported for patients with salivary gland carcinomas. METHODS: Serum CEA was measured in a case study using enzyme immunoassay with monoclonal antibody specific for CEA. Tissue was examined with standard histologic and immunohistologic methods. RESULTS: A patient was initially seen with adenoid cystic carcinoma (ACC) of the trachea and had a markedly elevated serum CEA level which declined after surgical resection. The serum CEA level became elevated again when the patient developed abdominal metastases and then declined after debulking of the tumor. Immunohistochemical study of the tumor was positive for CEA. CONCLUSIONS: The measurement of serum CEA levels may play a role in the management of patients with ACC. Clinical investigation utilizing monoclonal antibodies against CEA, for imaging and for the delivery of chemotherapy and radiotherapy may be worthwhile.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Radiographic screening for cancer. Proposed paradigm for requisite research.

Computed tomography (CT) imaging as an excellent approach to the detection and characterization of small solitary pulmonary nodules (SSPN) raises three questions: (1) How often does CT imaging lead to detection of SSPN? (2) How often is such an SSPN malignant? (3) If malignant, how curable is it? The first question pertains to decisions about screening use of CT (clinical or mass screening), the second to decisions about screening for SSPN and diagnosis of malignancy given SSPN, and the third--in the context of known curability at ordinary clinical diagnosis--to decisions about screening for SSPN, diagnosis given SSPN and intervention given malignant SSPN. We present a three component study design that addresses these questions. The first is directed primarily to the first question. Some 1000 persons at high risk for lung cancer will be screened for SSPN using screening-type CT. The primary aim is to determine the prevalence of CT-detectable SSPN as a joint function of risk-relevant aspects of the person. The second component addresses the prevalence of malignancy among the detected cases of SSPN. To develop the prevalence function, a larger series of CT-detected SSPN will be obtained by developing a multi-center SSPN "registry." A subsequent, third component will focus on the registered cases of malignant SSPN screening incidentally detected and address their curability on the basis of long-term follow-up. This design, in lieu of a randomized trial, may represent a new paradigm for applied research on radiologic technologies in cancer screening, given its advantages in terms of research efficiency and implications to decisions about diagnostic workup and therapeutic intervention.

Decision Making↗
PubMedDate not supplied

Clinical utility of computed tomography in the diagnosis of pulmonary embolism.

This prospective clinical pilot study describes the clinical utility and cost effectiveness of computed tomography (CT) with contrast in the diagnosis and management of pulmonary embolism. The setting is a university teaching hospital, and the 20 patients, 26 to 81 years old, were found to have CT findings consistent with pulmonary embolism. Intraluminal pulmonary artery clots were observed on CT and contributed to clinical management, often obviating pulmonary arteriography. CT, particularly spiral CT, may demonstrate pulmonary embolism and offers advantages over ventilation-perfusion lung scanning and pulmonary arteriography in making the diagnosis of pulmonary embolism in high-risk patients or patients with preexisting parenchymal lung disease.

Adult↗
PubMedDate not supplied

CT-guided transthoracic needle biopsy following indeterminate fiberoptic bronchoscopy in solitary pulmonary nodules.

We evaluated the role of computed tomography (CT)-guided transthoracic needle biopsy (TNB) in patients with solitary pulmonary nodule and indeterminate flexible fiberoptic bronchoscopy (FOB). A review of 112 patients with solitary nodules under 3 cm in size who underwent TNB was carried out. A total of 48 patients had prior FOB with negative or indeterminate results. We reviewed the results of CT-guided TNB of these 48 patients with respect to the cytology results, nodule size and location, and complications of the procedure. Among the 48 patients who had FOB with indeterminate cytology, 32 were found to have malignant cytology on subsequent TNB. Among the remaining 16 patients, eight had diagnostic thoracotomy, which showed that six of the nodules were benign and two were malignant. The remaining eight patients who did not undergo surgery have been followed for more than 2 years, without evidence of growth. Results were not influenced by size or location. TNB offers a high yield for diagnosis in this patient population.

Biopsy, Needle↗