The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 1976
Immune reactivity in primary carcinoma of the lung and its relation to prognosis.
Detailed studies of immune reactivity were performed in 154 patients with primary lung cancer, 20 patients with benign thoracic lesions, and 109 healthy persons. Reactions to the 2,4-dinitrochlorobenzene (DNCB) skin test were postive in 73 per cent of patients with lung cancer and all (100 per cent) of the patients with benign disease (p less than 0.05). The incidence of DNCB reactions was 78 per cent for Stage I and II cancers (37 patinets), 73 per cent for resectable Stage III cancer (22 patients), and 66 per cent in patients with unresectable or inoperable Stage III cancer. ⋯ Svrvival curves were plotted in patients with Stage III disease according to the responses to three immune parameters: DNCB, absolute lymphocyte count, and PHS stimulation. Although patients with normal reactions generally had better survival rates, PHA responses showed the most significant correlation to survival. These tests support the usefulness of immune testing as an additional parameter of assessing biological risk in patients with primary lung cancer.
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J. Thorac. Cardiovasc. Surg. · Aug 1976
Case ReportsCongenital aortic stenosis. Experience with 43 patients.
Between September, 1967, and January, 1975, 43 patients underwent intracardiac repair for congenital aortic stenosis at the Buffalo Children's Hospital. The patients ranged in age from 2 days to 24 years, 6 of them being below one year of age. Valvular aortic stenosis was found in 21 cases (4 infants [Group I-A] and 17 older patients [Group I-B]), discrete subaortic membranous diaphragm in 11 (Group II); diffuse subvalvular muscular obstruction in 3 (Group III), supravalvular stenosis in 4 (Group IV), and multiple-level obstruction in 4 (2 infants [Group V-A] and 2 older patients [Group V-B]). ⋯ Results were fair or poor in Groups, I-A, V-A, and V-B. In children and adolescents, effective relief of the obstruction and of the symptoms can be obtained with minimal operative risk and minimal morbidity. In symptomatic infants, despite the high operative mortality rate, surgical intervention is indicated because of the poor prognosis.
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Air embolism following penetrating lung trauma has been reported infrequently and its existence is questioned. A death resulting from air embolism following a high-velocity gunshot wound is presented. Appropriate treatment and preventive measures are discussed.
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J. Thorac. Cardiovasc. Surg. · Jul 1976
Reconstruction of right ventricular-pulmonary artery continuity with a valved external conduit: unusual technical considerations.
The Hancock conduit containing a porcine xenograft valve has been used as part of the repair in 14 patients having complex congenital heart disease. The single death in this series resulted from the consequences of pulmonary vascular disease in a patient with truncus arteriosus. Several unusual technical considerations such as previous pulmonary artery banding, angulated Waterston anastomoses, and dextroversion required modifications in the standard approach to the correction of several of the anomalies encountered. This conduit has provided a satisfactory method to establish right ventricular-pulmonary artery continuity.