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Abstract: One hundred forty-two patients underwent surgery and related treatment for advanced stage (III, IV) non-small cell cancer of the lung. One hundred seventeen patients underwent up-front surgery, with a [...]

Background: Recognition of the importance of early diagnosis and aggressive, definitive surgical intervention has brought about a dramatic decline in mortality related to distal esophageal perforation. Methods: We retrospectively analyzed [...]

ABSTRACT Background. We evaluated the accuracy of computed tomography (CT) and positron-emission tomography (PET) in the mediastinal staging of non-small cell lung cancer. Methods. Between May 14, 1999, and November [...]

• Retrospective review was undertaken of 137 patients with occult papillary carcinoma of the thyroid (lesions 1.5 cm in diameter) who were operated on at the Mayo Clinic, Rochester, Minn, between 1926 and 1955. Mean follow-up period was 25.3 years. Operations were conservative. No patient underwent bilateral total lobectomy. For 55 patients with lymph node involvement, lymphadenectomy generally involved selective node excision or modified neck dissection. Subsequent surgery was required in 12 patients; modified radical neck dissection was necessary in only four. No operative deaths occurred. Long-term follow-up showed that all patients were alive and without disease or were dead without proof of thyroid-related disease. Thus, occult papillary thyroid carcinoma with or without nodal metastasis is a nonlethal and curable disease when treated by conservative surgical means. Radical surgical or medical extirpation of all thyroid tissue is unnecessary in the treatment of this disease.(Arch Surg 115:394-398, 1980)

• From a review of 266 cases reported in the literature and data on 15 other patients operated on at the Mayo Clinic for symptomatic, annular pancreas, the following three conclusions can be made. First, annular pancreas is an uncommon congenital anomaly, often not becoming symptomatic until late in life. Second, complicating congenital and acquired disorders must be recognized if patients are to be properly prepared for surgery. Sometimes associated problems may be recognized, whereas the annular pancreas may be overlooked. The chance of this happening is decreased by methodical inspection of the entire abdomen, especially all segments of the duodenum, because annuli can occur in any segment and can be partially or completely circumferential. Third, while there is no single operative procedure of choice, published experience militates against any direct attack on the offending annulus.(Arch Surg 115:46-50, 1980)

Thirteen patients were studied in the early postoperative period to determine the hemodynamic response to increasing levels of positive end-expiratory pressure (PEEP) following right atrium-pulmonary artery bypass (Fontan procedure). Hemodynamic data and arterial oxygen and carbon dioxide tensions were measured without PEEP and with PEEP = 3, 6, 9, and 12 cm H2O. Cardiac index decreased progressively with increasing levels of PEEP compared to PEEP = 0 (cardiac index = 2.7 ± 1.2 L/min/m2), and the decrease was significant at PEEP = 9 (cardiac index = 2.2 ± 0.8 L/min/m2, p < 0.05) and 12 cm H2O (cardiac index = 2.0 ± 0.7 L/min/m2, p < 0.05). Both arterial oxygen tension and pulmonary vascular resistance index increased significantly at all levels of PEEP studied compared to PEEP = 0. Significant positive trends were demonstrated for arterial oxygen tension and pulmonary vascular resistance index and a significant negative trend was shown for cardiac index with increasing PEEP. Heart rate, right atrial pressure, left atrial pressure, mean arterial blood pressure, and arterial carbon dioxide tension did not change significantly nor consistently with increasing PEEP. From these data it appears that PEEP is an effective means of raising arterial oxygen tension after right atrium-pulmonary artery bypass. A progressive fall in cardiac index occurs with increasing PEEP, and the fall becomes significant at PEEP > 6 cm H2O. The fall in cardiac index appears to be mediated by a significant rise in pulmonary vascular resistance index.