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Biomedical subjects

E T Mays

Publications and source records attributed to E T Mays.

At least 19 recordsLinked to original sources
PubMed1987

Steroid related neoplasia in human liver.

Prior to the early 1970's, benign liver neoplasms were among the rarest of tumors. The seemingly rapid increase, especially in young females ingesting oral contraceptives, as well as the catastrophic presentation of many of the tumors resulting from liver rupture and hemoperitoneum, stimulated studies by several investigators. In the Liver Tumor Registry at the University of Louisville, we have examined the histologic material, and finalized the data on 227 tumors, the majority in young women. With few exceptions, they had used oral contraceptives or were either pregnant or immediately post-partum and presumably in a hyperestrogenic state. There have been 82 hepatocellular adenomas (HCA), 105 cases of focal nodular hyperplasia (FNH), and 31 hepatocellular carcinomas. The hepatocellular carcinomas occurred in non-cirrhotic livers, and 14 of the 31 cases were of a distinct, but rare type, polygonal cell carcinoma with lamellar fibrosis. While it seems reasonable to believe steroids play a role in adenomas and in FNH it is less certain that they produce hepatocellular carcinomas since malignant liver tumors are not uncommon in this age group without the use of oral contraceptives. With an estimated 50 million women either currently using or who have used oral contraceptives the risk must be very slight.

Adenoma↗
PubMed1984

Hepatic tumors induced by sex steroids.

Our study of more than 250 women with hepatic tumors, accessioned in our tumor registry at the University of Louisville, disclosed three types of tumor: FNH , HCA, and HCC. The ingestion of sundry kinds of sex steroids by the majority of these women, chiefly for purposes of preventing conception, warrants the suspicion that such hormones induced these different types of hepatic tumors. Publications by others reporting similar hepatic tumors in men using male sex steroids lends support to this hypothesis. Rupture of the hepatic tumor and consequent hemorrhage, producing hemoperitoneum, is a major risk factor. Other presenting symptoms are pain and palpable mass. Symptomatic women using OCs should be subjected to a CT or technetium hepatic scan as an initial screening assessment. Because of the imminent possibility of rupture, large turgid vascular tumors should be resected without biopsy. Biopsy-proved HCC should also be removed surgically. All other tumors, including small multiple tumors, will usually regress when exogenous sex steroids are withdrawn and pregnancy avoided. Other significant hepatic changes observed in this study are peliosis hepatis, periportal sinusoidal dilation, and vascular lesions. The branches of the hepatic artery and the tributaries of the portal vein show combinations of intimal and smooth muscle proliferation, vascular thickening, occlusive intimal thickening, and, at times, obstructing thrombosis. Similar smooth muscle proliferation in the afferent vessels of the livers of animals treated with sex steroids suggests that there is a cause and effect relationship in women using OCs.

Adolescent↗
PubMed1984

Determination of protein loss during aqueous and phase partition fixation using formalin and glutaraldehyde.

In phase partition fixation tissue is immersed in an organic solvent at equilibrium with an aqueous phase containing a fixing agent. By using radioisotope labeling techniques the effects of phase partition fixation on protein retention during fixation of tissue with formalin and glutaraldehyde have been determined and compared with those of standard aqueous fixation using these fixatives. It has been shown that retention of protein in tissue during phase partition fixation was as good or better than during aqueous fixation. Improved retention provides further evidence that phase partition fixation may be a useful alternative to aqueous fixation.

Animals↗
PubMed1983

Are hepatic arteries end-arteries?

Studies of intrahepatic arteries in vivo and after death give dramatically different results concerning the human hepatic circulation. Corrosion casts of human liver vasculature support the existing belief that hepatic arteries are end-arteries. However, in vivo studies using angiographic techniques after ligation of either the left or the right ramus of the hepatic artery demonstrate intrahepatic translobar collateral arteries capable of perfusing the entire occluded arterial system. There is no intermediate filling of sinusoids nor of portal venules. Traditional statements that hepatic arteries are end-arteries cannot be supported by the present findings.

Adult↗
PubMed1980

Options in treating trauma to the liver.

Many wounds of the liver are minor and require no corrective operations. If these patients are not killed by associated injuries, they usually survive. Hemorrhage from hepatic wounds is the most common cause of death. Selective ligation of appropriate blood vessels swiftly controls bleeding and does not cause septic hepatic necrosis because the liver in humans is sterile and collateral blood flow prevents complete infarction of hepatic tissue. Hepatic resection is dangerous in acutely hypovolemic patients, but hepatic resection is beneficial in treating the late complications of hepatic trauma. Liver-related sepsis after trauma to the liver can be obviated by elimination of gauze packs, absorbable hemostats, peritoneal drains, sutures and choledochal tubes.

Anti-Bacterial Agents↗
PubMed1979

Hepatic artery ligation.

The use of hepatic artery ligation (HAL) in various clinical situations is illustrated by presenting a series of eight patients. The indications for HAL included ruptured hepatic tumors, spontaneous liver rupture, delayed hemorrhage after liver trauma, hematobilia, hepatic artery aneurysm, and hemorrhage after liver biopsy. Conventional methods of hemostasis had been used in some of these patients, but failed to control hemorrhage. The reasons for the relatively late adoption of hepatic artery ligation in treating liver hemorrhage are discussed and placed in proper prospective. Hepatic artery ligation has been shown to be such an effective method of controlling hemorrhage from the liver that other methods, such as packing and mass suture, which are unsafe and ineffective, should be abandoned. Major resection should be done only when an entire lobe of the liver is reduced to pulp or when exposure and repair of the retrohepatic vena cava are necessary.

Adult↗
PubMed1978

Selective management of post-traumatic obstructing intramural hematoma of the duodenum.

Fourteen patients with post-traumatic obstructing intramural duodenal hematoma were reviewed. Seven patients underwent exploration for associated injuries. Evacuation of the hematoma was performed in two patients. Of 12 patients treated by fasting, nasogastric decompression and parenteral fluid therapy, late obstruction of the duodenum developed in one patient, and operation was required. Criteria are discussed regarding evacuation of intramural hematoma of the duodenum found at celiotomy for associated injuries. In the typical patient with an isolated intramural hematoma in whom no other indications for operation are identified, aggressive nonoperative therapy is the preferred treatment.

Abdominal Injuries↗
PubMed1977

A clinicopathologic study of steroid-related liver tumors.

A registry of liver tumors was started in late 1973 in an attempt to assess the relationship of these tumors to oral contraceptives or to other environmental factors. This report is concerned with the pathological aspects and the possible pathogenesis of the first 101 tumors accessioned. There were 44 instances of focal nodular hyperplasia, 40 adenomas, four unclassified but probably benign tumors, and 13 hepatocellular carcinomas. Eighty-one patients took oral contraceptives; six were associated with pregnancy; three had taken estrogens for long periods of time; one had a thecoma; four never took sex steroids; and in five the history was unknown. Tumor rupture and intrahepatic hemorrhage were frequent complications. It is possible that the vascular lesions associated with focal nodular hyperplasia could play a part in their pathogenesis as well as with rupture. Foci of adenomatous hyperplasia may be related to the development of adenomas. The association of these tumors with sex steroids could be coincidental. The fact that none of the patients had cirrhosis of liver fibrosis, and that androgenic anabolic steroid therapy has been associated with hepatocellular carcinomas in males, suggests that further study of the problem is necessary.

Adenoma↗
PubMed1977

Selectivity in the management of hepatic trauma.

Retrospective review of 178 consecutive patients who sustained hepatic injuries confirms that selective application of hepatic artery ligation is an efficient means of definitive hemostasis. Only two of 20 immediate deaths resulted from hepatic parenchymal hemorrhage. Over-all mortality (20%) was not significantly increased where hepatic artery ligation was used. Sepsis was the most frequent complication after severe hepatic trauma.

Abdominal Injuries↗