Publications by authors named "David W Johnstone"

BACKGROUND Castleman disease was first described in 1956 as mediastinal masses composed of benign lymphoid hyperplasia with germinal center formation and capillary proliferation closely resembling thymomas. It has been linked with many multi-system disorders, including myasthenia gravis. Cases of Castleman disease with corresponding myasthenia gravis have higher rates of postoperative myasthenic crisis, which are reported as high as 37.

View Article and Find Full Text PDF

Short-term extracorporeal membrane oxygenation is a useful adjunct to thoracic procedures. We report the cases of 2 middle-aged men who were supported with venovenous extracorporeal membrane oxygenation to facilitate tumor debulking and recanalization of the carina and mainstem bronchi. Neither patient had major complications or adverse events.

View Article and Find Full Text PDF
Article Synopsis
  • A multicenter trial assessed the Spiration Valve System (SVS) against standard medical care for treating severe emphysema in patients aged 40 and older.
  • The study found that the SVS led to significant improvements in lung function (FEV) and other health measures after 6 and 12 months, although it increased the risk of serious adverse events, particularly pneumothorax.
  • Overall, while SVS showed effective results for managing severe emphysema, the safety concerns highlighted the need for careful patient monitoring.
View Article and Find Full Text PDF

This study evaluates 5-year data from the NRG Oncology RTOG 0236 trial on the effects of sterotactic body radiation therapy in patients with inoperable stage I non–small cell lung cancer.

View Article and Find Full Text PDF

Thoracic surgeons traditionally have measured their outcomes in terms of mortality, complication rates, recurrence patterns, and long-term survival for their cancer patients. These metrics of quality continue to be important today, but increasingly surgeons are under scrutiny for resource utilization, patient experience, and cost effectiveness. Intelligent decisions about resource use require knowledge of utility, disutility, and cost -- information that is still limited and not easily implemented at the time treatment decisions are made.

View Article and Find Full Text PDF

Disinfection by-products (DBPs) arise when natural organic matter in source water reacts with disinfectants used in the water treatment process. Studies have suggested an association between DBPs and birth defects. Neural tube defects (NTDs) in embryos of untreated control mice were first observed in-house in May 2006 and have continued to date.

View Article and Find Full Text PDF

Purpose: Local and distant failure rates remain high despite aggressive chemoradiation (CRT) treatment for Stage III non-small-cell lung cancer. We conducted preclinical studies of docetaxel's cytotoxic and radiosensitizing effects on lung cancer cell lines and designed a pilot study to target distant micrometastasis upfront with one-cycle induction chemotherapy, followed by low-dose radiosensitizing docetaxel CRT.

Methods And Materials: A preclinical study was conducted in human lung cancer cell lines NCI 520 and A549.

View Article and Find Full Text PDF

Purpose: Adjuvant chemotherapy for resected non-small-cell lung cancer (NSCLC) is now accepted on the basis of several randomized clinical trials (RCTs) that demonstrated improved survival. Although there is strong evidence that adjuvant chemotherapy is effective in stages II and IIIA NSCLC, its utility in stage IB disease is unclear. This report provides a mature analysis of Cancer and Leukemia Group B (CALGB) 9633, the only RCT designed specifically for stage IB NSCLC.

View Article and Find Full Text PDF

Purpose: We report the toxicity profile and pharmacokinetic data of a schedule-dependent chemoradiation regimen using pulsed low-dose paclitaxel for radiosensitization in a Phase I study for inoperable non-small-cell lung cancer.

Methods And Materials: Paclitaxel at escalating doses of 15 mg/m(2), 20 mg/m(2), and 25 mg/m(2) were infused on Monday, Wednesday, and Friday with daily chest radiation in cohorts of 6 patients. Daily radiation was delayed for maximal G2/M arrest and apoptotic effect, an observation from preclinical investigations.

View Article and Find Full Text PDF

Purpose: To determine the national surgical practice patterns of care for operable lung cancer patients treated with radiation.

Materials And Methods: A nationwide survey of a stratified random sample of institutions was conducted for patients who had non-metastatic lung cancer, Karnofsky Performance Scores (KPS) > or =60, and who had received radiation therapy as definitive or adjuvant treatment. Among 541 patients, representing a weighted sample size of 42,335 patients nationwide, 131 (19.

View Article and Find Full Text PDF

Purpose: To determine the overall survival, progression-free survival, and toxicity associated with concurrent paclitaxel/carboplatin and thoracic radiotherapy for completely resected patients with stage II and IIIA non-small-cell lung cancer (NSCLC).

Patients And Methods: Eighty-eight eligible patients had surgical resection for pathologic stage II or IIIA disease and received postoperative paclitaxel and carboplatin. Concurrent thoracic radiotherapy at 50.

View Article and Find Full Text PDF
Postoperative chylothorax.

Chest Surg Clin N Am

August 2002

Chylothorax is an unusual complication of surgical procedures within the chest. Early recognition is important so that appropriate conservative measures can be applied. Operative intervention after a short course of supportive therapy will control most chyle fistulas.

View Article and Find Full Text PDF

Purpose: To compare the outcome of treatment of mediastinoscopy-verified N2 non-small-cell lung cancer treated with induction chemotherapy followed by either surgery or radiotherapy (RT), with both options followed by consolidation chemotherapy.

Methods And Materials: A randomized Phase III trial for Stage IIIA (T1-T3N2M0) non-small cell lung cancer was conducted by the Radiation Therapy Oncology Group (RTOG) and Eastern Cooperative Oncology Group between April 1990 and April 1994. After documentation of N2 disease by mediastinoscopy or anterior mediastinotomy, patients received induction chemotherapy with cisplatin, vinblastine, and mitomycin-C.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate how common and significant enlarged nonpalpable supraclavicular lymph nodes are in patients newly diagnosed with lung cancer using chest CT and ultrasound.
  • Out of 55 patients, 40% were found to have abnormalities in their supraclavicular lymph nodes, with most of these being malignant and detectable via CT.
  • The research concluded that using chest CT accompanied by ultrasound-guided biopsy is an effective, safe way to diagnose lung cancer and determine if the tumor can be surgically removed.
View Article and Find Full Text PDF