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Biomedical subjects

E Myers

Publications and source records attributed to E Myers.

At least 37 records · Page 2Linked to original sources
PubMed1990

Reconstruction of the cervical esophagus: free jejunal transfer versus gastric pull-up.

Use of enteric grafts is a popular method for reconstruction of the cervical esophagus and hypopharynx. Free jejunal transfer (FJT) and gastric pull-up (GP) are the most popular methods used. This discussion is a retrospective review of our experience with 50 cases of free jejunal transfer and 15 cases of gastric pull-up. The graft survival rate was 94 percent (47 of 50) for free jejunal transfer and 87 percent (13 of 15) for gastric pull-up. Successful swallowing was achieved in 88 percent (44 of 50) of free jejunal transfers and 87 percent (13 of 15) of gastric pull-ups. Patients with free jejunal transfers were able to swallow and leave the hospital sooner: 10.6 versus 16.0 days and 22.3 versus 29.0 days, respectively. Fistulas occurred in 16 percent (8 of 50) of free jejunal transfers, most of which (6 of 8) healed spontaneously. Fistulas occurred in 20 percent (3 of 15) of gastric pull-ups, only one of which healed spontaneously. Stricture was the most common late complication for free jejunal transfers, 22 percent (11 of 50), whereas reflux was most common in gastric pull-ups, 20 percent (3 of 15). In patients with advanced cancer, extensive esophageal resection into the chest is often required, and gastric pull-up seems to be an easier and more direct form of reconstruction. In limited resection of the hypopharynx and esophagus, especially with proximal lesions, free jejunal transfer is simpler and avoids mediastinal dissection. This concept as well as other advantages and disadvantages of both techniques will be discussed.

Adolescent↗
PubMed1986

The use of intraoperative radiotherapy and external beam therapy in the management of desmoid tumors.

Desmoid tumors are rare nonencapsulated benign lesions that invade the musculoaponeurotic tissues of the body. Such tumors infiltrate insidiously, and attempts to remove them frequently fail, usually leaving residual tumor. The use of adjuvant radiotherapy to decrease the recurrence rate in partially resected extra-abdominal desmoids has been reported by several authors. The role of irradiation in the management of desmoid tumors is illustrated in a case that combined surgery, intraoperative radiotherapy, and postoperative external beam radiotherapy in the management of this lesion.

Adolescent↗
PubMed1985

Computerized data retrieval system for colon surgery.

Good clinical practice is based on a continuous reevaluation of one's own work as compared with published standards. That which limits particularly the private practitioner from examining and publishing his data, is not the lack of desire, but the scarcity of opportunities and resources to do so. Computers as tools for data retrieval and analysis for research purposes and patient management have been available for some time. They have been of limited utility for most surgeons because of an inhibiting size and/or training period, and illogical design. The authors discuss the limitations of much of the available computer "tools," and present a system, METABASE, specifically designed for colon and rectal surgeons to use in their private practices for data retrieval and analysis.

Colon↗
PubMed1985

Rectal prolapse in scleroderma: case report and review of the colonic complications of scleroderma.

Scleroderma of the colon is commonly associated with constipation, as was the case in a 70-year-old woman with rectal prolapse described by the authors. The chronic constipation in this patient may have been the cause of her rectal prolapse, but the onset of the prolapse and scleroderma at about the same time suggest that the scleroderma may have been a causative factor. A Ripstein repair of the prolapse was carried out. The authors discuss some of the complications of colonic scleroderma, which include megacolon, transverse and sigmoid colonic volvulus, telangiectasia, stenosis and diverticula and stercoral ulceration.

Aged↗
PubMed1983

Double stapling technique for low anterior resection.

A report is given on 26 patients (18 men and 8 women) undergoing low anterior resection for carcinoma of the rectum, using both the TA 55 and EEA staplers. The average age was 65 years (range, 45 to 92 years). The preoperative level of the lesion from the anal verge averaged 9.8 cm (range, 4 to 17 cm). All had well-differentiated or moderately well-differentiated lesions. All lesions were removed using the following technique. The TA 55 stapler was placed across the lower rectum at the distal resection margin. The EEA stapler was introduced into the rectum with the anvil removed. The shaft was then passed through the rectum stump either through or immediately adjacent to the staple line. The anvil was refitted and the anastomosis completed between the more proximal colon and the rectal stump. A defunctioning colostomy was employed in only one patient. There has been no mortality. Follow-up has been 2 to 16 months, and there has been no early recurrence. The postoperative level of the anastomosis averaged 5.5 cm (range, 2 to 11 cm). Stapler-related complications occurred in three patients. One of these patients developed a postoperative anastomotic leak, which necessitated a defunctioning colostomy. Two anastomotic strictures occurred following either an anastomotic leak or postoperative radiation therapy. Early incontinence to gas, night-time anal soilage, and urgency occurred in eight patients (30 per cent). These symptoms improved or disappeared within three months following operation. The authors' preliminary experience has shown the double stapling technique to have definite advantages. It obviates the use of lower purse-string suture and permits a lower and easier anastomosis. It avoids the problem of disparity of sizes of the two ends of the bowel. The rectum is not opened and fecal spillage is minimized. To date, results have been good without excessive complications.

Adenocarcinoma↗
PubMed1983

Tryptophan-induced stimulation of hepatic ornithine decarboxylase activity in the rat.

The effect of a single tube feeding of L-tryptophan on hepatic ornithine decarboxylase (ODC) activity in rats was investigated. The levels of ODC activity in the livers of control and experimental rats were assayed in vitro by measuring the release of 14CO2 from DL-[1-14C]ornithine. Single tube feedings of varying levels of L-tryptophan (2.5-30 mg/100 g body wt) to overnight-fasted rats 1 hr before sacrifice exhibited increases in the hepatic ODC activities. L-Tryptophan (30 mg/100 g body wt) tube fed to overnight-fasted rats 1/6 to 12 hr before sacrifice induced hepatic ODC activities which were significantly elevated beginning at 1 hr and peaking at 2 hr (6.5-fold increase over controls). In vitro [14C]leucine incorporation into protein using hepatic microsomes of tryptophan-treated rats was significantly increased at 1 hr in comparison with that of controls. The tryptophan-induced stimulation of hepatic ODC activity was not affected by prior adrenalectomy but was abolished by pretreatment with cycloheximide. These studies demonstrate that a single feeding of L-tryptophan can significantly enhance in the rat the activity of ODC, a key enzyme in the biosynthesis of polyamines.

Adrenalectomy↗
PubMed1981

The significance of electromechanical and osmotic forces in the nonequilibrium swelling behavior of articular cartilage in tension.

Studies were conducted of some of the nonequilibrium, electrolyte-activated, electromechanical and osmotic processes that can affect the tensile properties of articular cartilage. We measured changes in tensile force that were induced by altering the ionic environment of strips of cartilage held at fixed length. We compared the kinetics of changes in these macroscopically measured isometric tensile forces to theoretical estimates of the time constants that characterize the underlying physical and chemical mechanisms occurring within the cartilage specimens during the experiment. Changes in the tensile force induced by changing the bath neutral salt concentration surrounding the specimen appear to be rate-limited by the diffusion of the salt into the specimen. That is, the mechanical stress relaxation process resulting from changes in salt concentration seems to be occurring at least as rapidly as the diffusion of salt into the matrix. When the bath concentration of CaCl2 or HCl is varied, the rate of change in the resulting isometric stresses indicates that Ca++ and H+ ions are binding to the cartilage matrix macromolecules.

Animals↗
PubMed1980

Hemilaryngectomy for verrucous carcinoma of the glottis.

Seven patients with verrucous carcinoma of the glottis treated by hemilaryngectomy are analyzed. The diagnostic criteria for this tumor are reviewed. Close cooperation between the clinician and pathologist is necessary for the correct diagnosis. The controversy regarding radiation therapy is discussed. Hemilaryngectomy is concluded to be a successful surgical modality for limited verrucous carcinoma of the larynx.

Adult↗
PubMed1979

Cyclovergence: the motor response to cyclodisparity.

Static photographic evidence of the occurrence of cyclovergence is presented that supports and extends the result of Crone and Everhard-Halm (1975). Wide-angle complex targets were a necessary condition; simple horizontal line targets were insufficient. Our asymmetrical disparity targets supported in part the conformance of cyclovergence to Hering's Law but raised questions relating to the computational process that also acts to remove cyclodisparity and permits cyclofusion. Saturation and hysteresis nonlinearities were observed.

Eye Movements↗
PubMed1975

An epidemic of echovirus 18 meningitis.

The first reported outbreak of echovirus 18 meningitis in the United States occurred during the summer of 1972 in Durham, North Carolina. One hundred three cases of aseptic meningitis were seen at Duke University Medical Center over a period of four months. Most of the patients were less than 25 years old, black, and residents of Durham County or nearby counties.. Symptoms included headache (92%), fever (76%), nuchal rigidity (67%), and nausea and/or vomiting (51%). In contrast to previously published reports of echovirus 18 infection, diarrhea and rash were infrequent (6% and 5%, respectively). There were no deaths. Counts of white blood cells in the cerebrospinal fluid ranged from 0 to 1,540 cells/mm-3, but 90% of the patients had less than 500 cells/mm-3. Echovirus 11 was recovered from the cerebrospinal fluid of 55 of 78 patients, and echovirus 11 was isolated from two patients. Virus was recovered from the cerebrospinal fluid of 12 patients despite white blood cell counts in cerebrospinal fluid of less than 10 cells/mm-3.

Adolescent↗