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Biomedical subjects

J R Anderson

Publications and source records attributed to J R Anderson.

At least 343 records · Page 19Linked to original sources
PubMed1986

Genital injury and implied consent to alleged rape.

A review of 440 cases of reported rape was undertaken to see if sustaining injury to the genital area was an inevitable consequence of being raped. Injuries to areas other than the genital were taken as objective evidence that the victim did not consent to the encounter, while sperm found in her vagina that could not be accounted for by voluntary coitus was taken as objective evidence that penile penetration of the vagina had occurred. Of the 75 victims with objective evidence of both noncompliance and vaginal penetration, 28% sustained genital injury. The absence of genital injury does not imply consent by the victim or the absence of vaginal penetration by the assailant.

Expert Testimony↗
PubMed1985

Long-term survival following cancer of the male breast in Northern Ireland. A report of 81 cases.

Eighty-one patients with cancer of the male breast were studied. The majority (79) presented with a mass in the breast and in 8 patients the tumor was found by chance. Two patients presented with serosanguinous discharge. Average duration of symptoms was 11.9 months. Thirty patients had Stage I, 25 had Stage II, 16 had Stage III, and 8 had Stage IV disease. Fifty-three patients had simple mastectomy, nine had lumpectomy, six had radical mastectomy, and five had biopsy only. Eight had no local surgery. Overall 5- and 10-year survival allowing for all causes of death was 38% and 17%, respectively. Cox's (1972) proportional hazard regression model was used to assess the contribution of various factors to survival. Age at presentation, postoperative hormone therapy, postoperative radiotherapy, site of the primary tumor within the breast, and type of local surgery did not contribute to survival. Only the stage of disease contributed to survival and did so in the expected direction.

Actuarial Analysis↗
PubMed1985

The forehead lift. A review.

Our forehead lift technique is a modification of several techniques that have evolved since Lexer first elucidated a surgical approach to diminish the signs of aging in the upper part of the face. It essentially consists of the development of a forehead advancement-rotation flap through a coronal incision to deal with ptosis, and muscle incision and excision to deal with forehead and glabellar creases. The surgical goals are achieved readily in the vast majority of cases. Morbidity is minimal, but real, and can be decreased by astute observance of the details of the surgical techniques outlined. A review of 51 cases assessed success in achieving the surgical goals and the morbidity associated with the procedure.

Aging↗
PubMed1985

A scale for evaluating results of rhinoplasty.

A system was developed to numerically grade noses before and after rhinoplasty. Based on the use of photographs, it permits objective assessment of the amount of improvement resulting from operation. By extension, it could be used to rate surgical proficiency.

Esthetics↗
PubMed1985

Twenty-five years of injection sclerotherapy for bleeding varices.

Acute injection sclerotherapy has been used in Belfast for 25 years and the results are reviewed. During this period 264 patients had injection sclerotherapy for acute bleeding from oesophageal varices during 396 admissions; a rigid oesophagoscope was used and 447 injections were performed. The series includes 19 children who received 69 injections. Thirty-eight had extrahepatic portal venous hypertension and the remainder had intrahepatic disease. Overall, 81 were Child's grade A (including the 38 extrahepatics), 82 were grade B and 101 were grade C. Of the 396 admissions, acute injection sclerotherapy controlled bleeding in 362 instances (control rate 91.4 per cent); control rate in the children's group was 97.1 per cent and in the adults 90.2 per cent. The hospital mortality was 14.9 per cent (57 adults and 2 children). Nineteen deaths were due directly to bleeding oesophageal varices, two from bleeding gastric varices and seven directly or indirectly from oesophageal leaks. Most of the remaining deaths were due to liver failure. We consider that sclerotherapy is valuable in the control of variceal haemorrhage where bleeding is uncontrolled or recurs after vasopressin or tamponade in any admission.

Acute Disease↗
PubMed1985

Carcinoid tumours of the appendix.

Appendicular carcinoid tumours in 147 patients are presented. Two patients had evidence of metastatic spread at the time of presentation. Both patients had primary tumours less than 2 cm in diameter. Size remains the most reliable guide to the malignant potential of these tumours. If, after simple appendicectomy, a carcinoid tumour is found with a post-formalin fixation diameter greater than 1.5 cm then a subsequent right hemicolectomy should be considered.

Adolescent↗
PubMed1985

Volvulus of the splenic flexure of the colon.

Volvulus of the splenic flexure is a rare cause of large-bowel obstruction. Three cases are presented and the features of 17 previously reported cases reviewed. Resection with or without primary anastomosis is the procedure of choice to prevent recurrence.

Acute Disease↗
PubMed1985

Small bowel stricture following abdominal trauma.

A case of small bowel stricture developing 2 months after blunt abdominal trauma from a lap seat belt is presented. The cause of the stricture was probably a small perforation sustained at the time of the injury but overlooked clinically. At operation an abscess around the terminal ileum was found. The patient made an uneventful recovery following resection of the strictured small bowel.

Abdominal Injuries↗
PubMed1985

Moderate versus aggressive chemotherapy of nodular lymphocytic poorly differentiated lymphoma.

One hundred twenty-eight patients with purely nodular lymphocytic poorly differentiated lymphoma (NLPDL) without any prior therapy, entered on Eastern Cooperative Oncology Group protocol EST 2474, were analyzed for response, progression-free and overall survival. The restaged complete response rates with cyclophosphamide-prednisone (CP) (moderate regimen) of 54% compared favorably with those of the more intensive regimens; cyclophosphamide, vincristine, procarbazine and prednisone (COPP) (56%) and BCNU, cyclophosphamide, vincristine, and prednisone (BCVP) (53%). The toxicity of the regimens decreased from BCVP to COPP to CP. The median survival rate for the entire group was 7.8 years. Estimated progression-free survival at five years by regimen was COPP, 57%; BCVP, 26%; CP, 22% (P = .02). No other prognostic parameter significantly affected progression-free survival. In spite of the better progression-free survival of COPP-treated patients, the overall survival rates with the different induction regimens were similar. Maintenance therapy for patients in complete response at the end of induction therapy with periodic BCVP reinduction did not significantly affect the disease-free or overall survival. Cyclophosphamide-prednisone is a minimally toxic regimen effective in the treatment of NLPDL, but COPP, in view of its acceptable toxicity in this patient population and apparent superiority in providing a longer disease-free state, deserves further testing.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

The western black-legged tick, Ixodes pacificus: a vector of Borrelia burgdorferi.

To determine the significance of the western black-legged tick, Ixodes pacificus, as a vector of the Lyme disease spirochete, Borrelia burgdorferi, a tick/spirochete survey was conducted in northern California and southwestern Oregon from 1982 to 1984. Of 1,687 adult ticks collected off vegetation, 25 (1.48%) contained spirochetes. Of 715 ticks from Oregon, 14 (1.96%) were infected whereas 11 (1.13%) of 972 ticks from California harbored spirochetes. An isolate of 1 of the spirochetes reacted specifically when treated with monoclonal antibodies to B. burgdorferi. Polyacrylamide gel electrophoresis of a lysate of the isolate showed it to be nearly identical with 2 isolates of B. burgdorferi. Of the 25 infected I. pacificus, 17 had spirochetes in their midgut only; the remaining 8 ticks showed a generalized infection of all the tissues, with midgut, central ganglion and ovary or testes showing heavy spirochetal infections. Decreased immunofluorescent staining reactivity of spirochetes in tissues other than midgut in 6 of 8 I. pacificus with generalized infection may reflect adverse physiologic conditions for the development of spirochetes in the hemocele.

Animals↗
PubMed1985

Asymptotically efficient two-step estimators of the hazards ratio for follow-up studies and survival data.

Asymptotically efficient estimators of a common hazard rate ratio (for follow-up studies) and the proportional hazards ratio (for survival studies) are obtained by a single iteration of the "Mantel-Haenszel" estimator appropriate for each setting. Estimators of their variance are also developed. The two-step estimator for survival data and its variance estimator are shown by simulation to be minimally biased and the estimator is shown to be efficient relative to the Cox partial likelihood estimator in small samples.

Biometry↗