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Biomedical subjects

R G Vanderschueren

Publications and source records attributed to R G Vanderschueren.

29 records · Page 2Linked to original sources

Quantitative pathologic analysis of first and second primary cancers in double tumors of the lung.

In spite of the frequent occurrence of double tumors of the lung, pathologic reports on these tumors are rare. In this study, 34 patients with double tumors (10 metachronous and 24 synchronous) were quantitatively analyzed; in all cases, both the first and second tumors had been completely resected and had adequate archival material. One aim of the study was to investigate whether there was a difference in the malignancy of the first and second tumors, as evaluated from their pathologic features. A second question was whether the length of the disease-free interval between the first and second tumors or the survival could be predicted on the basis of any of the investigated features. It was found that the first and second tumors, whether synchronous or metachronous, were strikingly similar: there was no difference in any of the quantitative pathologic features studied (epithelial percentage, DNA index, mean nuclear area and standard deviation of the nuclear area). It was not possible to predict by either univariate or multivariate analysis from any of the parameters either the length of the disease-free interval between the first and second tumors or the survival. These quantitative pathologic similarities suggest that the malignancy of the second tumor (synchronous as well as metachronous) is not higher than that of the first tumor. Thus, in the case of metachronous tumors, the fact that most of the second tumors (60%) are detected at a higher (inoperable) stage is probably caused by inadequate follow-up and not by increased malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

DNA↗

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↗

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↗

Benign localized mesothelioma of the pleura.

Eleven cases of benign localized mesotheliomas of the pleura are described. Ten patients were asymptomatic and discovered by routine X-rays. In eight cases the tumour was localized in the visceral pleura and all tumours showed only a benign mesenchymal component. Non-neoplastic epithelial structures can become entrapped within the tumour. A benign clinical behaviour and an excellent prognosis could be expected after surgical resection.

Adult↗

[Pleural talcage in patients with spontaneous pneumothorax (author's transl)].

The insufflation of iodinised (1%) sterile talc in patients with spontaneous pneumothorax is presented as a safe and valuable method of treatment. A recidive pneumothorax occurs in 6.6% of the patients. This form of treatment should only be used in the forms of pneumothorax without bullous degeneration, which should be treated surgically. Pleural talcage can be performed under local anesthesia, without harmful repercussion on the patient or on the VC, FEV1, and diffusion capacity. In our experience, thoracoscopy provides the inestimable and necessary information for choosing the best way of treatment in patients with a spontaneous pneumothorax.

Humans↗

Influence on the depth of inhalation on the effect of the beta 2-receptor-stimulating drug fenoterol hydrobromide (berotec).

Study of the influence of different modes of administration of 200 microgram of fenoterol showed that in a selected group of patients, two thirds of the maximal obtainable decrease in airway resistance could be achieved within 3 min of local application of 200 microgram fenoterol onto the nasal mucosa, without inhalation into the lower airways. Aspects of the potential pathways by which inhaled substances reach their receptor or target sites are discussed.

Administration, Oral↗

Adjuvant therapy with levamisole in resectable lung cancer.

In view of the discouraging results that have been obtained so far with the use of cytotoxic chemotherapy as an adjunct to surgery, a double-blind placebo-controlled evaluation of the adjuvant use of levamisole was conducted in 211 resectable lung cancer patients, following these patients for 2 years after their operation. Levamisole (or the placebo) was given for 3 days every 2 weeks and the dose level ranged 1.1--3.8 mg/kg per day (a fixed dose of 3 x 50 mg was given to all patients). It appeared that recurrences and carcinomatous deaths had occurred significantly less often in patients who had received a high dose (i.e., 2.1--3,8 mg/kg: patients weighing 70 kg or less) but not in the patients who received a lower dose. Patients who had more advanced cancers at the time of surgery seemed to have profited more from the treatment, but the results did not seem to depend upon the histologic type of the tumor or on the immune status of the patients as estimated from the skin test reactivity at the start. There was also suggestive evidence that levamisole may be more effective in preventing hematogenous dissemination than in inhibiting recurrences in the lung or the mediastinal tissues. Levamisole, if dosed adequately, appears to be a very suitable adjuvant treatment in resectable lung cancer patients as judged from its efficacy and its lack of troublesome side-effects.

Adenocarcinoma↗

[Thorascopy under local anesthesia (author's transl)].

Thoracoscopy has proved to be a method of investigation which can give important diagnostic information in diseases of the pleura, the diaphragm, the mediastinum, the thoracic wall and in some peripheral pulmonary lesions. Th procedure can be accomplished safely under local anesthesia which has important advantages in the better recognition of certain abnormalities and avoids a general anesthesia in many patients in a poor cardiopulmonary conditions.

Anesthesia, Local↗