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Biomedical subjects

D F Harrison

Publications and source records attributed to D F Harrison.

At least 19 recordsLinked to original sources

Substance use among women at risk for HIV infection.

This article reports results from a survey of culturally diverse women at risk for HIV infection in south Florida. Data concerning their substance use and its association with HIV risk behaviors are presented. Results indicate levels of consumption which exceed expectations based on general estimates of female substance use. Further, substance use was associated with specific behaviors and lifestyles which placed the women at increased risk for HIV infection.

Adult

Laryngeal morphology in sudden unexpected death in infants.

One hundred and four larynges removed from infants registered as dying from Sudden Infant Death Syndrome (SIDS) and 20 control larynges from infants of matching ages, were examined histologically. Excessive amounts of subglottic submucosal glandular tissue had reduced the available airway by more than half in 35 per cent of the SIDS larynges within the age group two of four months. In 30 per cent of this group the airway reduction was more than 60 percent. It is suggested that hyperplasia of subglottic mucous glands is one cause of fatal hypoxia in sudden unexpected infant death.

Exocrine Glands

Histologic evaluation of the larynx in sudden infant death syndrome.

Seventy-four larynges removed at death from children who died of sudden infant death syndrome (SIDS) have been studied by serial sectioning in the transverse plane. An increase in subepithelial glandular tissue is seen in many specimens, and the reduction in the available subglottic area has been measured with the Measuremouse Image Intensifying system. This preliminary report confirms that in some of these children with SIDS, particularly around the age of 3 months, there is a potentially lethal reduction in subglottic airway secondary to an increase in mucus-secreting glands, possibly from an associated mild upper respiratory tract infection. Accepting that adequate control infants within this age group who have not had any trauma to the laryngotracheal area are not available, these findings offer a possible explanation for what are always tragic events.

Body Weight

AIDS knowledge and risk behaviors among culturally diverse women.

This article reports results from a survey of women at risk for HIV infection. The sample (n = 620) included black (50.6%), white (28.7%), Hispanic (13.4%), and Haitian (5.0%) adult women from south Florida. Data concerning their AIDS knowledge, prevalence of risk behaviors, and perceived vulnerability are presented. Results indicate differences in certain knowledge areas and risk behaviors by race/ethnicity and a consistent incidence of unprotected sex with their main partners across all racial/ethnic groups.

Acquired Immunodeficiency Syndrome

Surgical management of hypopharyngeal cancer. Particular reference to the gastric "pull-up" operation.

Between the years 1965 to 1977, 58 patients with advanced hypopharyngeal squamous carcinoma were treated by pharyngolaryngoesophagectomy and total thyroidectomy. Operative mortality for potentially curable cases was 8.6%, with a crude three-year survival rate of 29% for all cases. Mortality was 37% for patients with postcricoid tumors. Long-term management was uncomplicated except for calcium metabolism; two patients died from nephrocalcinosis secondary to return of circulating parathyroid hormone. I discuss the role of this operation in the successful treatment of hypopharyngeal cancer.

Adult

Intrinsic weakness of the TNM system for classification of laryngeal cancer.

All tumor classifications are compromises based upon clinical or radiological evaluation with little concern for histology and intrinsic errors in application. Laryngeal cancer is no exception, and the present UICC system is critically examined with the intention of highlighting such deficiencies and relating them where possible to prognosis. Possible lymph node and systemic metastases are also considered in the light of personal experience and any intrinsic weaknesses evaluated in relation to variations in published cure rates. No better system is proposed, for at least this system encourages more accurate recording of clinical assessment.

Carcinoma, Squamous Cell

Rehabilitation problems after pharyngogastric anastomosis.

Fifty-three patients had pharyngolaryngoesophagectomy during the years 1965 to 1976 for lower hypopharyngeal or cervical esophageal cancer. The operative mortality--defined as the percent of patients who died within seven days of operation--was 7.5%, which is reduced to 5.6% if one patient with inoperable disease is excluded. Twenty-eight percent of patients survived for longer than one year, and there have been no problems with swallowing. Communication is possible in every patient who possesses good motivation, but the problems of long-term management of calcium metabolism still require attention.

Calcium

Saccular mucocele and laryngeal cancer.

Saccular mucoceles are a definite entity and probably occur more frequently than is supposed. Confusion with internal laryngoceles is possibly due to lack of understanding of basic anatomy and physiology. A 49-year-old man had a saccular mucocele that was possibly associated with laryngeal cancer, although a definitive diagnosis was only made two years later. The laryngectomy specimen was serially sectioned and showed an internal laryngocele on the side that was not operated one. This patient remains alive and well four years after excision of a T4 carcinoma, although a unilateral radical neck dissection was performed two years ago.

Animals

Resection of the manubrium.

Direct exposure of the superior mediastinum is essential when resecting subglottic tumours of the larynx, neoplasms of the cervical trachea or cervical oesophagus. This facilitates low resection of the trachea and clearance of the paratracheal nodes. This may best be carried out by removal of most of the manubrium sterni and both sternoclavicular joints and this operation has been performed in 22 patients with minimal morbidity or long term disability.

Esophageal Neoplasms