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Biomedical subjects

D M Morris

Publications and source records attributed to D M Morris.

At least 91 records · Page 5Linked to original sources
PubMed1983

Mastectomy in the management of patients with inflammatory breast cancer.

Inflammatory carcinoma of the breast is rare and lethal. Since the early 1940s, operation except for biopsy has been contraindicated in patients with inflammatory breast cancer. Results with radiotherapy alone and with radiotherapy and chemotherapy are reviewed. Results of treating patients with initial chemotherapy and debulking surgery in patients who respond to chemotherapy are presented. Mastectomy may be safely performed in selected patients with inflammatory breast cancer. Local control will improve quality of life. By removing the breast and residual tumor after chemotherapy and/or radiotherapy, fungation, ulceration, and some of the clinical and psychological problems of uncontrolled local disease may be avoided. Mastectomy should be performed only in patients who responded well to preoperative therapy. Patients who do not respond to chemotherapy should be treated with radiotherapy and should not undergo operation. This approach has not been detrimental to survival or to ultimately achieving local control of the disease.

Breast Neoplasms↗
PubMed1983

Infection among 210 patients with surgically staged Hodgkin's disease.

To determine the incidence and types of infections in Hodgkin's disease, particularly those related to the overwhelming pneumococcal sepsis syndrome, 210 consecutive patients with previously untreated Hodgkin's disease who underwent staging laparotomy with splenectomy from March 1968 to October 1979 were reviewed. For 178 patients (85 percent) alive at the end of the study, the mean follow-up time was 68.1 months. Eighty-two serious infections occurred among 59 (28 percent) of the patients; 47 (57 percent) serious infections were microbiologically documented and 35 (43 percent) were clinically documented. Forty-seven microbiologically documented serious infections occurred in 34 patients and consisted of 23 episodes of pneumonia, 10 cases of bacteremia, seven wound infections, two cases of disseminated herpes zoster, one subphrenic abscess, and four miscellaneous infections. Microbiologically documented serious infections occurring during initial treatment or remission had lower incidences of leukopenia (29 versus 58 percent) (p = 0.09) and death (11 versus 53 percent) (p = 0.005) than those occurring after relapse of Hodgkin's disease. Of the microbiologically documented serious infections, 76 percent were associated with a predisposing factor(s) (leukopenia, postoperative state, steroids, peripheral neuropathy, leukemia), of which 34 percent were fatal. Microbiologically documented serious infections unassociated with a predisposing factor were never fatal, including the only episode of pneumococcal sepsis in the series. In contrast to microbiologically documented serious infections, only 14 percent of clinically documented serious infections (versus 38 percent) were fatal. The overwhelming pneumococcal sepsis syndrome and other infections thought to be associated with the asplenic state are uncommon problems in patients with Hodgkin's disease after splenectomy.

Adolescent↗
PubMed1983

Serum concentrations of chromium, cobalt and nickel after total hip replacement: a six month study.

Serum specimens were obtained from 15 patients before undergoing conventional total hip replacement and for periods of up to six months postoperatively. The specimens were analysed for chromium, cobalt and nickel by electrothermal atomic absorption spectroscopy. Serum chromium levels were found to rise to a pronounced postoperative peak and then diminish, although not falling to normal mean levels by six months. Serum cobalt levels either remained the same or decreased while serum nickel levels began to rise two to six weeks after surgery. These results are significant in that serum metal concentration changes have been reported for patients receiving metal-on-metal implants but not for patients with metal-on-polymer total hip implants of more modern designs.

Animals↗
PubMed1983

Inoperable stage III carcinoma of the breast.

When seen initially, 10% to 29% of patients with breast cancer have locally advanced, nonresectable lesions without evidence of distant metastases. Radiotherapy offers significant palliation for these patients but has little influence on survival. Preoperative chemotherapy can be used to shrink many of these lesions and make them resectable. Adjuvant chemotherapy for patients with histologically positive nodes is now reasonably well established and allows the treatment of the micrometastases that most of these patients have. Removal of the breast can prevent the development of bleeding, ulcerating masses on the chest wall in the later stages of the disease. The removal of the primary tumor may favorably influence the interdependence of primary and metastatic foci.

Breast Neoplasms↗
PubMed1983

The significance of lymph node involvement in patients with medullary carcinoma of the breast.

Sixty-two patients with medullary carcinoma of the breast were studied. Mean survival time was 105 months. When identical stages are compared, the five and ten year survival rates for patients with medullary carcinoma of the breast parallel those for patients with infiltrating ductal carcinoma. Age, duration of symptoms, site of the primary lesion, size of the primary lesion, menopausal status and postoperative radiotherapy and the number of positive axillary lymph nodes were all evaluated for independent effects upon survival. The number of involved axillary nodes appeared to be the only worthwhile prognostic indicator. We believe that patients with medullary carcinoma of the breast and positive axillary lymph nodes should receive adjuvant chemotherapy.

Adult↗
PubMed1983

Restaging laparotomy for Hodgkin's disease.

The role of restaging laparotomy (RL) in Hodgkin's Disease (HD) was studied in 39 patients. Four patients had two RL and two patients three RL; 47 RL were performed in the 39 patients. Twenty patients had prior radiotherapy, ten patients chemotherapy, and nine patients radiotherapy and chemotherapy. Twenty of the 39 patients had a prior staging laparotomy at the time of initial HD diagnosis. Four of 13 RL for suspected residual HD at the completion of treatment were positive. Two patients had nodal, one splenic, and one nodal plus ovarian cyst HD. Fifteen of 21 RL for suspected recurrent HD after a five-to-111-month (median = 36 months) disease-free interval were positive. Thirteen patients had nodal, seven splenic, four liver and two bone marrow HD. Five of ten RL to disclose intra-abdominal HD at the time of a peripheral node recurrence were positive. Subsequent treatment was altered in all five positive patients. One of three RL to confirm a clinical complete response disclosed residual HD in intraabdominal lymph nodes. All of the 22 negative RL patients remained clinically free of intra-abdominal disease for a median of 63 months after the procedure. RL is useful in assessing response after treatment of advanced HD. A negative RL is associated with prolonged disease-free survival.

Adolescent↗
PubMed1982

Preoperative management of patients with evisceration.

Evisceration is a complication familiar to all abdominal surgeons. This serious complication necessitates immediate return to the operating room for closure of the abdominal wound. Not infrequently, patients may face a significant delay before they can be taken to the operating room. The exposed abdominal contents may be protected by covering them with sponges soaked with povidone-iodine solution and a large plastic drape that sticks firmly to the skin.

Aged↗
PubMed1982

Management of cecal volvulus in debilitated patients.

We retrospectively evaluated ten cases of cecal volvulus. The average age of these patients was 57 years. Five patients were more more than 60 years old and three were over 70. All patients had significant delays in coming to the hospital, and all had concomitant medical problems that made them poor operative risks. Our data and data in the recent literature support a conservative approach in debilitated patients with acute cecal volvulus. We do not recommend resection of the cecum if it is viable at the time of operation. Resection remains the treatment of choice when gangrene is present, but primary ileotransverse colostomy is contraindicated in this population of patients.

Adolescent↗
PubMed1981

Maintenance of function and esthetics after partial mandibulectomy without bone grafting.

Partial mandibulectomy done for en bloc resection of oral or oropharyngeal cancer often produces a characteristic deviation of the chin toward the resected side. This results in esthetic, masticatory, and speech disabilities. The Joe Hall Morris biphase external pin fixation appliance was used in 20 patients, with excellent results in preventing such complications. In 12 to 14 weeks it maintained excellent stability of the remaining mandibular segments, which prevented muscle and scar contracture. None of the patients required bone grafting or other reconstructive surgery. The appliances also allowed the patients to open their mouths for intraoral care in the immediate postoperative period. Postoperative radiation or chemotherapy could be initiated without delay while the appliances were in place.

Adult↗
PubMed1980

Nonfunctioning retroperitoneal paragangliomas.

Nonfunctioning paragangliomas of the retroperitoneum are extremely rare tumors. As of this report, 30 cases are known from published data. Characteristics of these tumors and diagnostic techniques are herein described. Approximately 20 percent of these lesions are considered malignant. Surgical resection is the treatment of choice once the diagnosis is made.

Adult↗
PubMed1979

Porcine heterograft dressings for split-thickness graft donor sites.

As compared with previous methods of donor site care, procine heterograft dressings allow the donor site to heal faster, require less postoperative care, are associated with a lower infection rate and eliminate virtually all of the pain of the split-thickness wound. Our experience supports that of others. We believe our modifications of this technique to be superior to previous modalities of donor site care.

Bandages↗
PubMedDate not supplied

Combination chemotherapy for advanced squamous cell carcinoma of the head and neck.

Fifty-one patients (32 previously untreated, 19 previously treated) with advanced squamous cell carcinoma of the head and neck received a single course of combination chemotherapy consisting of high dose cis-platinum (DDP), bleomycin (Bleo), +/- high dose methotrexate (MTX). Thirty-three (65%) patients responded to therapy; 5 (10%) of these patients had a complete response. Previously untreated patients and those who received the three drugs (DDP, Bleo and MTX) had the highest response rates. The duration of response was 8 to 12 weeks. Seven (15%) patients showed a two-year survival rate. All nonresponders were dead of disease within two years. Three (56%) of the five complete-response patients and 4 (21%) of the partial-response patients survived for two years. The role of preoperative chemotherapy in head and neck cancer is yet to be conclusively defined.

Adult↗