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Biomedical subjects

J C Ross

Publications and source records attributed to J C Ross.

At least 19 recordsLinked to original sources
PubMed1992

Fine-needle aspiration in the diagnosis of salivary gland disorders in the community hospital setting.

From 1983 to 1988, 47 patients with salivary gland disorders were assessed with fine-needle aspiration (FNA) before surgery. The preoperative fine-needle diagnoses were then compared with the postoperative pathologic findings. In the same period, 63 patients from two other community hospitals who had been evaluated preoperatively with FNA were studied retrospectively. The overall sensitivity of FNA for salivary neoplasms was 80.6%. Fine-needle aspiration was more sensitive in identifying benign tumors (88.4%) than malignant neoplasms (58.3%) and was least sensitive in identifying nonneoplastic salivary diseases (35.3%). Pleomorphic adenomas were correctly identified preoperatively in 96.2% of cases, whereas for malignant neoplasms, the diagnostic accuracy was highest for mucoepidermoid carcinoma (50%). To demonstrate the strengths of FNA as a diagnostic tool, as well as to delineate its limitations, we present our 5-year experience. Our FNA results are similar to those reported by the major European and American referral centers. Because our medical centers are community based, our results may more accurately reflect those seen by otolaryngologists in private practice. To date, no evidence of tumor seeding along the FNA tract has been reported.

Biopsy, Needle↗
PubMed1992

Ventricular dysphonia: a profile of 40 cases.

Ventricular dysphonia is a poorly understood disorder involving ventricular fold participation during phonation. A population of ventricular dysphonia patients was evaluated using phonatory function studies such as laryngovideostroboscopy, advanced acoustic analysis, and electroglottography to identify shared epidemiologic characteristics and to discuss possible neuromuscular mechanisms and causes. Forty patients with ventricular dysphonia were studied and epidemiologic, acoustic, and histologic data were analyzed. In almost all cases, the authors found abnormalities affecting the glottis caused by a related medical condition. The abnormalities included true vocal cord (TVC) aperiodicity in 100% of the patients, TVC asymmetry in 65%, a laryngeal mass or foreign body (usually Teflon) in 35%, TVC erythema or edema in 32.5%, and TVC bowing in 22.5%. Ventricular dysphonia seems to be primarily a compensatory mechanism for glottic dysfunction. Therapy is based on identifying and correcting the underlying abnormalities. Laryngovideostroboscopy is a particularly important tool in examining chronic dysphonia.

Adult↗
PubMed1989

Primary pulmonary hypertension: a look at the future.

Primary pulmonary hypertension is a well described but poorly understood illness. It is a disease of the small muscular pulmonary arteries in which proliferative lesions involving endothelial cells, smooth muscle cells and fibroblasts obstruct flow. Aggressive therapy with vasodilator drugs, especially calcium channel blockers, has improved the quality of life in a minority of patients; heart-lung transplantation is feasible for only a few. Rapid developments in the study of vascular biology in the last several years are likely to provide insight into the etiology and pathogenesis of primary pulmonary hypertension. The areas involved include the cell biology of pulmonary vascular endothelial and smooth muscle cells, studies of integrins, endothelial surface charge, angiogenesis and growth factors, endothelial-derived vasoactive substances, the effects of shear and the role of coagulation at the endothelial surface. The future looks bright for understanding and treating this difficult and cryptic illness.

Forecasting↗
PubMed1989

Before I forget.

Explore the source record for details and available documents.

Health Services↗
PubMed1988

The effects of irradiation on alaryngeal voice of totally laryngectomized patients.

The effects of radiation therapy on the ability of totally laryngectomized patients to produce voice and speech were examined using objective non-invasive methods. Moderate to severe losses were noted in patients producing voice with all types of alaryngeal modalities: tracheoesophageal, esophageal, and electrolaryngeal. Voice and speech losses were related to the impaired motility and vibratory capability of the esophageal wall and mucosa, to fibrosis of the submandibular region and to trismus. Tracheoesophageal and esophageal voice was recovered some weeks after completion of irradiation. No voice losses were observed in alaryngeal speakers who did not undergo voice restoration until after irradiation. All irradiated patients also showed various degrees of dysphagia during the treatment.

Humans↗
PubMed1988

Alpha-interferon in superficial bladder cancer: a Northern California Oncology Group Study.

Thirty-five patients with superficial transitional carcinoma of the bladder were treated intravesically with escalating doses of recombinant alpha-2-interferon administered weekly for 8 weeks. Of the 19 patients with high-grade intraepithelial neoplasia (17 carcinoma in situ [CIS], two severe dysplasia, all cytology positive), six (32%) had complete resolution of all histologic and cytologic evidence of disease (complete response). An additional three patients (16%) had complete resolution of CIS, but the interval appearance of a low-grade transitional cell neoplasm. Five (26%) had a partial response (complete resolution of all evidence of CIS on multiple bladder biopsies but persistently positive cytologic preparations). Sixteen patients with recurrent papillary tumors and extensive prior therapy were also treated. Four (25%) had a complete response. Twenty-three of the 35 patients had prior intravesical therapy. Seven of the 23 (30%) patients with prior intravesical chemotherapy or immunotherapy had a complete or partial response to interferon, while eight of the 12 patients (67%) without prior intravesical treatment responded. These responses were achieved with minimal local and systemic toxicity. Of the ten complete responders, five remain in continuous unmaintained remission for 18+ to 37+ months. Intracavitary alpha-2-interferon is an effective new treatment for some patients with bladder cancer.

Adult↗
PubMed1988

Speech restoration post-pharyngolaryngoesophagectomy using tracheogastric fistula.

Restoration of voice and speech in patients with gastric pull-up presents a formidable challenge, and many of these patients are left at best with a poorly functional electrolaryngeal speech. To improve this condition, a tracheogastric puncture stented with a biflanged self-retaining Groningen voice button was accomplished, resulting in gastric mucosa vibrations during exhalatory phase. The biomechanical characteristics of gastric vibrations and tracheogastric puncture candidate selection criteria are discussed.

Aged↗
PubMed1987

An interim prosthesis for the glossectomy patient.

The use of a simple patient-held prosthesis for improving speech in a patient with mandible and tongue resections has been described. As subjectively perceived and objectively verified, speech intelligibility improved in a test patient. There were no apparent risks or lengthy therapy. The ease of fabrication and low cost indicate that this prosthesis may be of value in aiding the speech of glossectomy patients.

Aged↗
PubMed1987

Division of the external urethral sphincter in the treatment of the paraplegic bladder: a preliminary report on a new procedure.

Division or resection of the external sphincter is a new operation designed to relieve retention of urine (or a high residue) in patients with an open bladder-neck and a narrow, rigid external sphincter area and in whom subarachnoid alcohol block, pudendal neurectomy or a bladder-neck resection have failed to help. The operation converts a chronic retention to an easily expressible bladder. Ten patients are reported. The operation technique is described. During the post-operative period care is necessary in preventing or dealing with clot-retention and with severe infection due to absorption of organisms in the urethra. The operation should not be attempted in patients with grossly dilated upper urinary tracts and in those with uncontrollable infection. The eight surviving patients have been spared the catheter life and, possibly, subsequent damage to the upper urinary tract.

Adult↗
PubMed1987

Fungal colonization of tracheoesophageal voice prosthesis.

Laryngectomized patients fitted with tracheoesophageal (TE) puncture voice prosthesis may experience frequent failures in adequate production of neophonation. In some cases, these phonatory problems result from obstruction of the voice prosthesis with various deposits. The nature of these deposits was studied with mycologic techniques and by light and scanning electron microscopy. Candida albicans and other fungal species were identified.

Candida albicans↗
PubMed1986

Nature of the glomerular capillary injury in human membranous glomerulopathy.

A differential solute clearance technique was used to evaluate glomerular capillary wall function in 20 patients with membranous glomerulopathy and massive proteinuria. The clearance of inulin, the filtration fraction, and the fractional clearance of uncharged dextrans of a radius of 28-48 A were depressed significantly below control values in 20 healthy volunteers (P less than 0.01). In contrast, the fractional clearance of dextrans of radius greater than 50 A was elevated markedly. A theoretical model of solute transport that depicts the major portion of the glomerular capillary wall as an isoporous membrane and the minor portion as a nondiscriminatory shunt pathway revealed the calculated glomerular ultrafiltration coefficient to be five times lower and mean pore radius of the major membrane component to be 4 A smaller than control values. However, the fraction of filtrate volume permeating the shunt pathway was three- to fourfold above control values and correlated strongly in individual patients with the fractional clearance of albumin (r = 0.76) and of IgG (r = 0.80). Lowering renal plasma flow by 24% during indomethacin therapy in seven patients resulted in a 74% reduction in proteinuria accompanied by a corresponding diminution of filtrate formed through the shunt pathway. Morphometric analysis of glomerular ultrastructure revealed the magnitude of depression of the glomerular filtration rate and of urinary protein leakage to be related strongly to changes in the epithelial layer of the glomerular capillary wall, but not to the density of subepithelial immune deposits. We conclude that glomerular capillaries in membranous glomerulopathy are characterized by a loss of ultrafiltration capacity and of barrier size-selectivity, and that subepithelial immune deposits do not provide a structural basis for these functional alterations.

Dextrans↗
PubMed1986

Sex chromosome fragment in a phenotypically normal female. Significance of occult Y-related material.

The authors report a 15-year-old short, nonvirilized, prepubertal female whose peripheral karyotype revealed a mosaicism in which 62 percent of the cells had a karyotype of 45X, and the other 38 percent had a karyotype of 46X plus a small unidentified marker chromosome. Since the authors were unable to determine from the karyotype whether this marker was derived from an X or a Y chromosome and because of the high risk for neoplasia in abnormal gonads containing Y material, she underwent surgical exploration, with removal of gonadal tissue. Microscopic examination of the streak gonads revealed a mixture of dysgenetic ovarian and testicular type tissues. The presence of testicular-like tubules strongly implied the presence of Y material in the genotype. Review of the literature reveals at least 19 similar cases in which presumed sex chromosomal markers or fragments were found in phenotypically normal females. Because of the risk of gonadal neoplasia in patients with occult Y chromosomal material, gonadectomy is indicated when the origin of the marker chromosome is uncertain.

Adolescent↗
PubMed1985

Treatment of intractable lupus nephritis with total lymphoid irradiation.

Ten patients with lupus nephritis and marked proteinuria (3.9 g or more/d) that did not respond adequately to treatment with prednisone alone or prednisone in combination with azathioprine were treated with total lymphoid irradiation in an uncontrolled feasibility study. Within 6 weeks after the start of total lymphoid irradiation, the serum albumin level rose in all patients in association with a reduction in the serum level of anti-DNA antibodies, an increase in the serum complement level, or both. Improvement in these variables persisted in eight patients followed for more than 1 year, with the stabilization or reduction of the serum creatinine level. Urinary leakage of albumin was substantially reduced in all patients. Side effects associated with radiotherapy included transient constitutional complaints in ten patients, transient blood element depressions in three, localized viral and bacterial infections in four, and ovarian failure in one. The results suggest that total lymphoid irradiation may provide an alternative to cytotoxic drugs in the treatment of lupus nephritis.

Adult↗
PubMed1985

Nonimmune hydrops fetalis in association with hemangioma of the umbilical cord.

Nonimmune hydrops fetalis is becoming the predominant form of fetal hydrops due to the declining frequency of Rh isoimmunization. Reported is the preterm delivery of a hydropic twin with umbilical cord and cutaneous hemangiomata. The unusual umbilical angiomatous malformation was associated with marked edema of the cord. This produced an ultrasonographic abnormality detected antenatally as a multicystic mass in close approximation to the fetal abdomen. The hydropic twin responded to aggressive neonatal management. It appears that hemangiomata of the umbilical cord may be causally related to fetal hydrops and may represent another entry in the differential diagnosis of this disorder.

Adult↗