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Biomedical subjects

C H Organ

Publications and source records attributed to C H Organ.

At least 73 records · Page 4Linked to original sources
PubMed1991

Is the Whipple procedure a better palliative option for pancreatic cancer?

In recent years, improved results with the Whipple operation have been reported because of improved case selection, thorough intraoperative assessment, aggressive nutritional management, and technical superiority. Ninety-four cases of pancreatic cancer using the Whipple procedure at the University of Oklahoma Health Sciences Center between 1980 and 1986 were reviewed. The median survival time for patients reviewed was 4.5 months; 1- and 2-year survival rates were 16% and 6%, respectively. No survivals at 5 years were observed. Those who underwent resection (Group A) survived 12.9 months with 1- and 2-year survival rates of 54% and 27%. Those undergoing bypass procedures (Group B) had a median survival time of 6 months, with 1- and 2-year survival rates of 16% and 4%. No statistical difference in survival distribution was observed between Groups A and B. The median survival time of patients receiving a staging laparotomy with no therapeutic intervention (Group C) was 2.3 months. Group D patients either refused abdominal exploration or demonstrated signs of inoperability. Surgical mortality in Groups A and B was 8% and 10%, respectively. We suggest that clinical Stage 1 and carefully selected Stage 2 cases of pancreatic cancer should be treated by pancreatoduodenectomy. Stage 3 and 4 patients warrant simultaneous duodenal-biliary by-passes.

Aged↗
PubMed1991

Angiographic yield in penetrating extremity trauma.

Indications for angiography in the evaluation of penetrating extremity trauma remain controversial. Our experience was reviewed to determine the yield of angiography in penetrating extremity trauma and to correlate clinical findings with angiographic results. During an 81-month period from 1983 through 1989, 284 extremity arteriograms were carried out in 268 patients. The angiographic yield in patients with abnormal clinical findings was 51%. The angiographic yield in patients when proximity of the injury to major vessels was the only indication was 6% (7% with gunshot wounds and 0% with stab wounds). Neurologic deficit alone as an indication for angiography accounted for 55% of the angiograms interpreted as "negative" and none of those interpreted as "positive". We conclude that the use of angiography in patients with gunshot wounds to the extremity with "proximity injuries" to major vessels should continue, its use is not warranted in extremity stab wounds when proximity is the sole indication, and abnormal neurologic findings in the absence of other findings are a poor predictor of vascular injury.

Adolescent↗
PubMed1990

Surgery.

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General Surgery↗
PubMed1989

Surgery.

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General Surgery↗
PubMed1988

Vaterian cancer in siblings.

The simultaneous occurrence of Vaterian carcinoma in two siblings suggests a genetic influence in their pathogenesis. Their classic clinical presentation of obstructive jaundice and weight loss required pancreaticoduodenectomy for this neoplasm. Pedigree analysis revealed a third sibling who died from an unresectable periampullary malignancy. Neither of the probands exhibited, as late as the seventh decade, evidence compatible with a diagnosis of familial polyposis coli or Gardner's syndrome. Flow cytometry studies revealed an aneuploid distribution in one tumor and tetraploid in the other. The rarity of this neoplasm, in the absence of contributing epidemiologic factors, suggests that this is a pleotrophic manifestation of a cancer-prone genotype.

Adenocarcinoma↗
PubMed1988

Familial breast cancer: where the clinician and basic scientist interface.

In familial breast cancer certain cardinal features have been observed: (1) An early age of onset; (2) Excess bilaterality in paired organs; (3) Vertical transmission consistent with an autosomal dominant mode of inheritance; (4) Genetic heterogeneity; (5) A more recent observation of improved survival. Approximately 18% of breast cancer patients will demonstrate familial aggregation and only 8% will meet the criteria for syndrome identification. In an analysis of 106 hereditary breast cancer patients, the average age of diagnosis was 49 years. One-third (35%) were under the age of 45 at the time of diagnosis. This genotype is transmitted in a vertical manner from one generation to the next in accordance with an autosomal dominant pattern. The five-year disease-free survivorship was found to be 65% in our familial breast cancer population. In this familial population pregnancy did not influence the natural history of breast cancer in the same manner as with sporadic breast cancer. An algorithm for the clinician encountering a patient with familial breast cancer and the unaffected relative is outlined.

Age Factors↗
PubMed1988

Bilateral elastofibroma dorsi.

Elastofibroma, a rare, noncapsulated, benign entity (pseudotumor), is characterized by the proliferation of fibrous tissue with elastin and scattered islands of adipose tissue that occurs most often in the infrascapular area of elderly women. We report on a 44-year-old man with bilateral infrascapular elastofibromas.

Fibroma↗
PubMed1986

Is the treatment for thyroglossal duct cysts too extensive?

From 1970 to 1985, 64 patients underwent surgical management for thyroglossal duct cysts at the University of Oklahoma Health Sciences Center. Their ages ranged from 1 to 63 years with a mean of 12.4 years. Ninety-one percent of the patients were available for follow-up. All patients underwent one of three forms of treatment: the classic Sistrunk operation, a modified Sistrunk operation, or excision of the cyst only. Eleven percent had undergone a previous procedure. The majority of patients were found to have a cyst in the midline at the level of the hyoid bone. Eighty-eight percent of the patients underwent excision of the midportion of the hyoid bone. There were no postoperative deaths and the perioperative complication rate was 20 percent, the majority being wound-related. All recurrences took place within 4 months of operation. Factors that appeared to be associated with an increased risk of complications and recurrence included young patient age (less than 10 years), rupture of the cyst at the time of operation, infection, and failure to excise the midportion of the hyoid bone and the suprahyoid tract. One patient was found to have a mixed papillary and follicular carcinoma in the thyroglossal duct. We support the original premise of Sistrunk that "the cure of thyroglossal cyst are unsuccessful unless the epithelium-lined tract, running from the cyst to the foramen cecum is completely removed," including the hyoid bone.

Adolescent↗