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Biomedical subjects

D Carter

Publications and source records attributed to D Carter.

At least 217 records · Page 12Linked to original sources

Pet health insurances and contract services: the potential for practice involvement.

Pet medical insurance has appreciable advantages and the existing policies appear to provide a beneficial service. But administrative costs of the small premiums involved make it of doubtful commercial attraction or benefit to the client. However, practice contract service schemes reduce administrative costs and can provide many of the advantages of insurance. Such a scheme is described. A coordinating agency outside the practice to produce promotional material, contracts, formulae for setting premiums and exclusions and to act as an arbitration agency for disputes could be established given the demand.

Animals↗

Relationship of necrosis and tumor border to lymph node metastases and 10-year survival in carcinoma of the breast.

The pathologic findings of 330 patients with invasive carcinoma of the breast who were followed for 10 years after radical mastectomy was reviewed. The presence or absence of necrosis and the character of the border of the tumor were two factors which were observable in all cases. Necrosis in the carcinoma was associated with a higher mortality rate, a higher incidence of axillary node metastases, and a higher mortality rate in patients with axillary node metastases than were primary carcinomas without necrosis. Tumors with necrosis and a root border showed significantly more aggressive behavior than did those tumors with a rounded border and no necrosis.

Breast Neoplasms↗

Intraductal papillary tumors of the breast: a study of 78 cases.

Seventy-eight intraductal papillary tumors of the breast were followed. The 14 papillary carcinomas were all treated by mastectomy. Metastases did not occur. In 64 patients with papillomas, six developed carcinoma--two in situ and four invasive. The incidence of cancer was higher in patients with multiple papillomas and with papillomatosis. The current experience (1949-1967) is discussed relative to the previous experience at the same institution from 1895 to 1941.

Breast Neoplasms↗

Carcinoma in situ of the breast.

A series of 87 cases of carcinoma in situ of the breast was reviewed. IN 49 CASes in which lobular carcinoma in situ was shown on biopsy, three patients were found to have invasive carcinoma in the subsequently done mastectomy. All three of these cases were in a group of 14 patients shown in have bilateral lobular carcinoma in situ on biopsy. In a group of 38 patients with intraductal carcinoma on biopsy, seven were found to have invasive carcinoma in the mastectomy that was subsequently done. Lymph node metastases were found in one patient in the lobular group and four patients in the intraductal group. Three patients in the intraductal group died of cancer. None in the lobular group has died of cancer.

Breast Neoplasms↗

New horizons in lung cancer diagnosis.

Lung cancer is rarely diagnosed and treated while still localized. Sputum cytology allows detection of radiologically occult tumors but conventional endoscopic procedures frequently prove inadequate for localization. It is the purpose of this report to outline the endoscopic observations and methods we have developed in successfully localizing 17 consecutive, radiologically occult carcinomas discovered in the sputum of 15 patients. A detailed examination of the upper respiratory tract demonstrated occult tumors in two patients. A segment by segment fiberbronchoscopic study under anesthesia allows multiple brushings and meticulous handling of specimens. Lesion localization is provided as well as identification of synchronous second primary tumors. Biopsies at the lobar spur and carina assist in determining the proximal extent of carcinoma in situ at potential surgical margins. Newer methods should enhance our recognition of inapparent carcinoma in situ allowing more efficient and more accurate tumor localization and a better appreciation of its extent.

Bronchi↗

Relationships of morphology to clinical presentation in ten cases of early squamous cell carcinoma of the lung.

The morphologic changes in 10 patients who were found to have squamous cell carcinoma of the lung before they became evident on chest x ray are discussed. It is suggested that these cases have a long preclinical course as invasive carcinomas that ranges from a microscopic focus of microinvasion (possibly originating from in situ carcinoma in submucosal gland epithelium) to a large concentric carcinoma which may have metastasized to regional lymph nodes. Although the duration of the in situ phase of squamous cell carcinoma of the bronchus in not known, it was evident that the expanse of in situ carcinoma frequently far exceeded that of the invasive carcinoma, and usually extended proximal to the invasive lesion. It is important that the extent of the in situ lesion is determined preoperatively. Finally, multifocal in situ (or invasive) carcinoma was found in at least two of the cases, either synchronously or metachronously.

Adult↗

Aspiration pneumonia: experimental evaluation of albumin and steroid therapy.

An experimental model using an ex vivo perfused ventilated canine pulmonary lobe was used to study aspiration pneumonia. After intrabronchial acid instillation, the lobe weight tripled, air way pressure and pulmonary artery pressure doubled, and intrapulmonary shunting increased from 5.5% to 53.4%. If large quantities of albumin were added to the lobe perfusate 5 minutes after intrabronchial acid instillation, weight gain, air way and pulmonary artery pressure, and intrapulmonary shunting were unchanged from control levels. If large quantities of steroid were added to the lobe perfusate 5 minutes after intrabronchial acid instillation, the lobe weight doubled but air way pressure and pulmonary artery pressure, and intrapulmonary shunting were not significantly different from control values. It is surmised that intrapulmonary acid aspiration causes an immediate and marked changed in pulmonary capillary permeability. Albumin administration by counteracting this permeability change, and steroid administration by modifying the permeability change, are both beneficial following acid aspiration.

Albumins↗

Introital bacterial flora - effect of increased frequency of micturition.

Introital swabbing was performed on each of 20 premenopausal female volunteers over a 5-day period, 2 swabs being collected each day. During the last 3 days of the 5-day period the volunteers were requested to void every 2 hours. Analysis of our data shows: 1. Perineal bacterial flora varies in number and type of organisms from hour to hour and day to day. 2. Quantitative culturing is of little help in distinguishing colonisation of the introitus with urinary pathogens from mere intermittent contamination of the introitus with the same pathogens. 3. Our results suggest that 4 or more consecutive isolates of the potential urinary pathogens from the introitus over a 48-hour period signify colonisation. 4. Frequency of micturition increases the risk of colonisation of the introitus with potential urinary pathogens. The significance of these findings is discussed, in relation to the previous work of other investigators.

Adult↗

Local ablative procedures designed to destroy squamous-cell carcinoma.

In a series of experiments in dogs, the bronchial mucosa was either excised or destroyed prior to closure of a bronchial stump following a lobectomy or the reanastomosis of a divided bronchus. The experiments were designed to simulate the clinical situation in which focal areas of squamous-cell carcinoma in situ in the bronchial margin would be managed by local ablation of the mucosa rather than by excision of additional bronchus. The experiments demonstrated that the bronchial mucosa is not necessary for bronchial healing. They also demonstrated that functionally and morphologically normal bronchial epithelium regenerates across the denuded bronchus. The source of this regenerated epithelium appears to be the submucosal glands which remain in the bronchial wall after a variety of local ablative procedures. Since our clinical experience has demonstrated that these submucosal glands frequently contain small foci of squamous-cell carcinoma in situ, we have concluded that either excision or thermal destruction of the bronchial mucosa has very limited clinical application and should be considered only in patients who cannot tolerate excision of more than one lobe of the lung.

Animals↗

Carcinoma of the breast: pathological criteria as an aid in treatment.

Pathologic and clinical features of a group of breast cancer patients were studied in an effort to find out if the prognosis of any individual case of breast cancer could be assessed preoperatively. The size, location, type of tumor, histologic grade and presence or absence of metastatic nodes were studied. Unfortunately, it was not possible to predict the prognosis with any degree of accuracy. We must agree with Haagensen, who said, "The truth is that we already know enough regarding the inferiority of lumpectomy and simple mastectomy, with or without supplementary irradiation, to conclude that it is not wise or humane to condemn a woman to be treated with these methods."

Breast Neoplasms↗