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Biomedical subjects

D M Morris

Publications and source records attributed to D M Morris.

At least 73 records · Page 4Linked to original sources
PubMed1986

Release of corrosion products by F-75 cobalt base alloy in the rat. II: Morbidity apparently associated with chromium release in vivo: a 120-day rat study.

There is concern whether in vivo corrosion of chromium-cobalt alloys releases ions containing trivalent [Cr(III)] or hexavalent [Cr(VI)] chromium. The question arises from indications that Cr(VI) is far more biologically active than Cr(III). Using a previously developed microsphere implant model, specimens of F-75 chromium-cobalt-molybdenum alloy were implanted in rats for periods up to 120 days. Blood and urine were collected at intervals during the study. Significant postoperative serum and urine chromium concentration elevations were observed. In addition, weight gain inhibition, lung morbidity, and animal mortality, related to the implant surface area to animal body weight ratio (SA/BW), were observed. Comparison of measured chromium serum concentrations with those concentrations found by others to be biologically active in tissue culture studies strongly suggests the release of Cr(VI) in this study.

Animals↗
PubMed1986

Carcinoma of eccrine sweat gland: experience with chemotherapy, autopsy findings in a patient with metastatic eccrine carcinoma, and a review of the literature.

Carcinoma of sweat glands is a very rare neoplasm of dermal appendages that is difficult to diagnose clinically and histologically. It has a potential for rapid growth and metastasis. Carcinoma of eccrine sweat glands, also known as eccrine carcinoma, is a distinct histologic subtype of sweat gland carcinoma. We report our autopsy findings and experience with chemotherapy in a patient with metastatic eccrine carcinoma. The pertinent literature and histologic classification of eccrine carcinomas are reviewed.

Aged↗
PubMed1986

Pneumocystography as an aid in the diagnosis of cystic lesions of the breast.

Pneumocystography is used in Europe in managing breast cysts. This involves aspiration, air insufflation, and completion mammography. Pneumocystography allows accurate delineation of the cyst wall and contents. Pneumocystograms that do not demonstrate intracystic lesions negate the need for cyst excision in many cases. Microcalcifications may become visible after pneumocystography. Intracystic masses, positive cyst fluid cytology, bloody cyst fluid, cyst recurrence, or evidence of an extrinsic mass compressing the cyst are all indications for operation. Intracystic cancers can and do metastasize. Pneumocystography may be beneficial in detecting these cancers.

Air↗
PubMed1986

Impaired IgG response to tetanus toxoid in human membranous nephropathy: association with HLA-DR3.

The IgG response to tetanus toxoid (TT) immunization was quantitated by by radioimmunoassay in patients with membranous nephropathy (MN) and healthy controls. Variation in subclass (ELISA) and electrical charge (isoelectric focussing, immunofixation & autoradiography) of the IgG response were also assessed. Total IgG and igG subclass responses were impaired in MN compared to controls, although this was only significant for IgG-3 (P less than 0 X 05). Non responders to TT were more common in MN, and response was independent of disease activity. No distinctive pattern of IgG subclass response or IgG spectrotype was seen in MN. Impaired response to TT was associated with HLA-DR3 among controls, and in MN (88 X 8% of whom were DR3) markedly depressed responses occurred in apparent DR3 homozygotes.

Antibodies, Bacterial↗
PubMed1986

Purification, partial characterization, and clinical evaluation of an adenocarcinoma-associated antigen.

The current investigation describes the purification and partial characterization of a new adenocarcinoma-associated antigen (ACAA). ACAA is a large molecular weight glycoprotein (Mr 790,000 by size chromatography on Sepharose CL-6B) that migrates in the alpha 1 region upon electrophoresis and is eluted from a DEAE-cellulose column at a 0.1 M NaCl concentration. ACAA is immunochemically and biochemically different from carcinoembryonic antigen, alpha-fetoprotein, pancreatic oncofetal antigen, human pancreatic tissue antigen, CA 19-9, ferritin, and acute-phase proteins. Assays for ACAA were carried out using a solid-phase sandwich enzyme immunoassay. The results indicate that ACAA is present in sera of all individuals. Patients with cancer have higher serum levels of ACAA than normal individuals. The greatest frequency of elevated serum values of ACAA was seen in patients with lung and pancreatic cancers followed by colorectal, breast, and prostate cancer. The measurement of ACAA levels may be valuable in the diagnosis and clinical management of patients with certain cancers.

Adenocarcinoma↗
PubMed1985

Hypnoanesthesia in the morbidly obese.

The advent of chemical anesthesia relegated hypnosis to an adjunctive role in patients requiring major operations. Anesthesia can be utilized with acceptable risk in the great majority of patients encountered in modern practice. But an occasional patient will present--such as one with morbid obesity--who needs a surgical procedure and who cannot be safely managed by conventional anesthetic techniques. This report describes our experience with such a patient and illustrates some of the advantages and disadvantages of hypnoanesthesia. The greatest disadvantage is that it is unpredictable. Close cooperation between the patient, hypnotist, anesthesiologist, and surgeon is critical. However, the technique may be utilized to remove very large lesions in selected patients. Hypnoanesthesia is an important alternative for some patients who cannot and should not be managed with conventional anesthetic techniques.

Adult↗
PubMed1985

The significance of metastasis to the bones and soft tissues of the hand.

We have treated six patients with cancer metastatic to the hand. All patients died within 6 months after the appearance of hand metastasis. We polled the combined membership of the American Association for Surgery of the Hand and the American Society for Surgery of the Hand to determine their experience with this problem. We also reviewed the pertinent literature concerning this subject. The information obtained from the literature and the poll confirmed our experience. We have managed these patients by amputation, feeling that reconstructive procedures were not indicated if the time necessary to rehabilitate the patient after reconstruction exceeds the patient's life expectancy.

Adult↗
PubMed1985

The response to further chemotherapy in patients with carcinoma of the breast who progressed while receiving adjuvant therapy.

The effect of known chemotherapeutic programs in patients with breast cancer who developed metastasis during or after adjuvant chemotherapy with L-PAM plus 5-FU (PF) were studied. Thirteen patients failed while receiving adjuvant therapy at 3-22 months from the time therapy started. Three patients failed 6-28 months after 2 years of therapy. Thirteen patients received PF followed by cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) at the time of progression on PF. Of these, ten received Adriamycin and vincristine (AV) at the time of progression on CMF. The response to CMF was 7%. No patient responded to AV after progression on CMF. Two of three patients treated with AV after failure on PF did respond, but both for only 6 months. This suggests that adjuvant therapy may render the tumor less responsive to further chemotherapy. Since most patients failed while on adjuvant therapy, this may indicate a poor prognosis regardless of the agents used.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Effect of postoperative radiotherapy on the development of small bowel obstruction in patients undergoing staging laparotomy for Hodgkin's disease.

Two hundred and ten previously untreated patients with hodgkin's disease underwent staging laparotomy at one institution. Medical records of these patients were retrospectively reviewed. The incidence of small bowel obstruction (SBO); whether or not the patient received abdominal radiotherapy and the portals used; whether or not the patient had undergone a previous operation for unrelated disease; and the outcome of operative treatment for the SBO were noted. Mean follow-up for all patients was 62.6 months (1 to 125 months). Ninety-two patients (Group I) were treated without radiotherapy; two developed SBO (2.2%). Patients treated with abdominal radiotherapy numbered 118 (Group II); seven developed SBO (5.9%). The difference between Groups I and II is not significant. Eighty-two received only paraaortic radiotherapy; two (2.4%) developed SBO. Thirty-six patients underwent combined paraaortic and bilateral iliac radiotherapy (Group IV); five developed SBO (13.9%). Data for Groups III and IV approach statistical significance (p = 0.053; Fisher Exact Test [two-Tail]). All obstructions were secondary to adhesions. Four patients in Group IV had significant morbidity associated with operative treatment of SBO. This was an infection in each case. Infections developed in these patients even when the bowel was not entered. Pneumonia and wound infections were most common. Careful evaluation postoperatively for signs of infection and aggressive pulmonary toilet are recommended.

Abdomen↗
PubMed1985

Diagnosing breast cancer using frozen sections from Tru-cut needle biopsies. Six-year experience with 162 biopsies, with emphasis on outpatient diagnosis of breast carcinoma.

Experience in a 6-year period with 162 frozen sections from needle biopsies of the breast is reported. The technique was used mainly to diagnose breast cancer in outpatients. The results of frozen section on needle biopsies are compared with frozen sections of excisional biopsies. The sensitivity of detection in breasts containing carcinoma using frozen section of breast needle biopsies was 77%. The sensitivity of detection of carcinoma in needle biopsies subsequently shown to contain carcinoma by paraffin section was 92.8%. The specificity of frozen sections of breast needle biopsies was 86.4% and was devoid of false-positive results. Interpretation of frozen sections of needle biopsies of breast lesions is reliable when performed by experienced surgeons and handled and interpreted by experienced pathologists.

Biopsy↗
PubMed1984

Screening for occult blood in selected patients. The potential for false-negatives.

Seventy-one patients presenting for elective hernia repair without gastrointestinal symptoms were screened for occult blood in their stools. All patients had stools negative for occult blood and were studied with proctosigmoidoscopy and barium enema. Polyps were found in 10% of the study population. The potential for missing polyps definitely exists if patients are selected for further studies only on the basis of tests for occult stool blood.

Barium Sulfate↗
PubMed1984

Primary head and neck reconstruction with a simultaneous ipsilateral pectoralis major myocutaneous flap and a deltopectoral flap.

Patients with large advanced tumors of the head and neck that are resectable may be reconstructed by using the combination of an ipsilateral pectoralis major myocutaneous flap and an ipsilateral deltopectoral flap. Preoperative planning is necessary. The PM flap must be elevated and care taken not to interfere with the internal mammary perforating arteries. The lateral chest incision must be made low enough to provide adequate skin and soft tissue in the DP flap. These two flaps provide adequate tissue with a reliable blood supply to reconstruct these large defects.

Head and Neck Neoplasms↗
PubMed1984

Maculopapular eruption resulting from systemic administration of 5-fluorouracil.

An unusual eruption was noted following a particularly prolonged course of intravenous 5-fluorouracil (5-FU) as treatment of metastatic breast carcinoma. This eruption differed from dermatologic reactions previously noted in response to 5-FU in that it was not confined to sun-exposed surfaces as is characteristic of the nonallergic responses to 5-FU, nor was its onset immediate and generalized, as is characteristic of the rare allergic responses to this drug.

Aged↗
PubMed1983

Hemoccult screening in selected patients. The hernia patient older than age fifty years.

Two hundred and forty patients, asymptomatic relative to gastrointestinal disease, who applied for elective hernia repair, were tested as outpatients for occult blood in the stool. Thirty-eight patients had one or more positive specimens. Significant pathologic characteristics were identified by lower gastrointestinal evaluation in 23 of these patients. One patient had an adenocarcinoma (Dukes' Stage B). Eight patients had polyps of various types, 11 patients had colonic diverticula, and three patients had anorectal disease. Patient compliance was excellent and the cost-benefit ratio appeared to be acceptable.

Age Factors↗
PubMed1983

Ineffectiveness of chemotherapy in patients with metastatic ependymoma of the cauda equina.

Six cases of intraspinal ependymoma metastasizing outside the central nervous system have been reported. This report documents a seventh case. This patient received multiple courses of combination and single-agent chemotherapy without evidence of tumor regression. All seven patients had four things in common: early onset of disease, numerous operations, massive local recurrence at the time distant metastases were noted, and a long time period from diagnosis to death.

Adolescent↗
PubMed1983

Clinically significant intestinal metastasis from a primary bronchogenic carcinoma.

Although abdominal metastasis from lung cancer are not unusual postmortem findings, they are rarely of clinical significance. Our patient's clinical course was complicated by intestinal obstruction secondary to metastatic lung cancer. With the current epidemic of lung cancer, we can expect more patients with abdominal complaints secondary to metastatic disease. In these patients, survival time averaged less than 60 days.

Carcinoma, Bronchogenic↗