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Biomedical subjects

M H Cooper

Publications and source records attributed to M H Cooper.

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

Transplantation in HIV+ patients.

Twenty-five whole-organ recipients treated from 1981 through September 1988 were HIV carriers. Eleven were infected before transplantation, although this was not known until later in 8 recipients. The other 14 were infected perioperatively. Ten of the 25 recipients were infants or children. The organs transplanted were the liver (n = 15), and the heart or kidney (n = 5, each). After a mean follow-up of 2.75 years (range, 0.7-6.6 years), 13 recipients are alive. Survival is 7/15, 2/5, and 4/5 of the liver, heart, and kidney recipients, respectively. The best results were in the pediatric group (70% survival) in which only 1 of 10 patients died of AIDS. In contrast, AIDS caused the death of 5 of 15 adult recipients and was the leading cause of death. Transplantation plus immunosuppression appeared to shorten the AIDS-free time in HIV+ patients as compared to nontransplant hemophiliac and transfusion control groups. Accrual of HIV+ transplant recipients has slowed markedly since the systematic screening of donors, recipients, and blood products was begun in 1985.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Infratemporal fossa and lateral skull base dissection: long-term results.

In 1981, we described a new surgical technique featuring en bloc removal of infratemporal fossa malignancies. This approach offered a systematic resection of cancers in this region and was designated "stylohamular dissection" because the medial boundary of the bloc is surgical plane between the styloid process and the hamulus of the pterygoid. All structures lateral to this plane are removed, sparing the internal carotid artery. Since 1977, twenty infratemporal fossa and lateral skull base dissections have been performed for palliation of metastatic or recurrent disease in the infratemporal fossa. Most patients obtained palliation of trismus, facial pain, or relief from an unmanageable ulcerating lesion. This technique offers improved average disease-free intervals, as well as enhanced survival rates compared to non-en bloc resections. A summary of the case presentations, survival statistics, and surgical technique with detailed cadaver dissections are presented.

Adult↗
PubMed1989

Correlation of high resolution computed tomography and gross anatomic sections of the temporal bone. Part III. Cochlear and vestibular aqueducts.

Gross anatomic sections of isolated temporal bones (TB) were compared with high resolution computed tomography (CT) scans obtained utilizing contiguous 1.5-mm thick slices in the transaxial, coronal, and sagittal planes. Each TB was then sectioned at 2.0-mm intervals in planes parallel to those of the CT scans. Both the cochlear and vestibular aqueducts were best visualized in the coronal plane; the transaxial plane proved less reliable and the sagittal plane was not useful at all. The cochlear aqueduct in the coronal plane appears as a funnel-shaped configuration with its widest portion opening into the subarachnoid space. The vestibular aqueduct at its opening into the epidural space is well visualized in the coronal plane, and as it traverses the bone toward the vestibule it appears as an oval to spherical lucency, whereas in transaxial sections it is seen as a small longitudinal lucency.

Cochlea↗
PubMed1989

The value of postoperative chest radiology after major abdominal surgery.

A prospective study was carried out in which a chest radiograph was performed routinely on the third postoperative day on 35 consecutive patients who had elective abdominal surgery. The aim was to determine whether clinical symptoms and signs could be correlated with the radiographic appearances and whether the routine use of such an X ray could detect serious chest pathology before clinical signs developed. Thirteen patients (37%) had radiological evidence of complications and all had symptoms and (or) signs which suggested postoperative chest pathology. The 22 patients (63%) who had no radiological abnormality, could be subdivided clinically into those who were normal (29%) and those who had symptoms and (or) signs (34%). There was no significant difference between the groups in terms of previous surgery, sex, smoking, nature of surgical incision, age or duration of anaesthesia. There was a poor correlation between the diagnosis of the chest abnormality detected clinically and the diagnosis suggested by the radiographs. These findings suggest that a routine postoperative chest X ray is unnecessary in the absence of clinically detectable chest pathology.

Abdomen↗
PubMed1988

Economics of health care: challenges for the immediate future.

A number of widely held but largely false assumptions as to the nature of health and health care contributed to the very slow growth in the demand for health economics during the formative years of our health care system. A growing realisation, however, that hard rationing decisions are unavoidable has led to an increasing appreciation of the fact that policy makers and managers often lack the necessary basic information or the techniques relevant to the purpose. This paper proposes the formation of a centre for health economics and policy and outlines in broad terms its possible nature and research agenda.

Costs and Cost Analysis↗
PubMed1988

Correlation of high-resolution computed tomography and gross anatomic sections of the temporal bone: II. Vestibular apparatus.

High-resolution computed tomography (CT) of isolated temporal bones was performed in the transaxial, coronal, and sagittal planes at 1.5-mm intervals. The temporal bones were then sectioned at 2.0-mm intervals in planes parallel to the CT scans. The structures making up the vestibular apparatus were identified, and the planes in which each is best visualized were selected for the illustrations. The vestibule, oval window, tympanic cavity, and tympanic portion of the facial nerve are best seen in the transaxial and coronal planes; the arch of the superior semicircular canal in the transaxial plane and its limbs in the coronal plane; the arch of the posterior semicircular canal in the coronal and sagittal planes and its limbs in the transaxial plane; and the common crus in the sagittal plane. The horseshoe-shaped lateral semicircular canal is displayed in the transaxial plane, and the relationship of its lateral limb to the tympanic segment of the facial nerve is best demonstrated in the sagittal plane. The ampullae of all three canals can be appreciated equally well in all three planes.

Humans↗
PubMed1988

Microsurgical anatomy of the jugular foramen region.

The popularization of skull base approaches for lesions at the jugular foramen requires a thorough understanding of the normal anatomic features of this region. We present a series of color photographs with a review of the vital structures at the skull base in the region of the jugular foramen exposed via the infratemporal fossa approach. The jugular bulb and its relationship to the ninth, tenth, eleventh, and twelfth cranial nerves and to the internal carotid artery and otic capsule are demonstrated. All relationships are described in the lateral surgical position. The clinical usefulness of a thorough understanding of these anatomic associations is discussed.

Carotid Artery, Internal↗
PubMed1987

Preservation of the dissected and surgical anatomic detail in the human temporal bone.

Preservation and usefulness of human gross temporal bones that have been dissected or drilled have always been a problem. This article describes application of the technique of plastination developed by von Hagens to the temporal bone. The use of this technique permits development of a collection of both anatomically dissected and surgically drilled temporal bones which can be studied by the otolaryngologist at any level. The procedure involves impregnation of the specimen with uncured polymers--a silicone rubber of medium viscosity followed by curing in a vapor bath. The advantages of this technique are that the plastinated temporal bone can be studied and handled without any unpleasant odor and there is no need for liquid preservation. The potential problem of the specimen drying out and becoming useless is thus avoided.

Embalming↗
PubMed1987

Correlation of high-resolution computed tomography and gross anatomic sections of the temporal bone: Part I. The facial nerve.

Detailed anatomic analysis of the human temporal bone has been made possible by correlating high-resolution computed tomography (CT) with gross anatomic sections. Serial CT scans of isolated temporal bones were obtained in the transaxial (horizontal), coronal, and sagittal planes at 1.5-mm intervals. The temporal bone was sectioned at 2.0-mm intervals in planes parallel to the CT scans. Based on a correlation of these sections, the facial nerve canal was divided into four segments and the planes in which each is best observed are described and illustrated. The first segment in the internal auditory canal is best visualized in the sagittal plane, the labyrinthine segment and geniculate ganglion in the coronal and transaxial planes, the tympanic portion in the sagittal plane, the genu, between the tympanic and mastoid portion, in the sagittal plane, and the mastoid portion and the stylomastoid foramen in the coronal and sagittal planes.

Facial Nerve↗
PubMed1986

Sphenoethmoidectomy: the case for ethmoid marsupialization.

The authors report 510 sphenoethmoidectomies performed on 255 patients between 1969 and 1985. An overall polyp recurrence rate of 19.2% and less than a 1% complication rate are reported during that time. In patients followed jointly by the otolaryngologists and allergist, including 374 consecutive sphenoethmoidectomies on 187 patients who had this operation performed by the senior author, there was an overall polyp recurrence rate of 15% and a complication rate which was again less than 1%. Recent improvements in recurrence rates and diminished complication rates are attributed to better visualization and adherence to the concept of complete exenteration or marsupialization of the ethmoid labyrinth including middle turbinate resection in every case. Cooperation between the otolaryngologist and allergist is stressed, along with the realization that pulmonary and sinus diseases are frequently interrelated and may both be benefited by the performance of sphenoethmoidectomy in the patient with hyperplastic rhinosinusitis.

Allergy and Immunology↗
PubMed1985

Immediate and delayed effects of an enzyme-dependent mineralizing mouthrinse on dental plaque.

Twenty-two children aged 13 to 14 years rinsed for 3 X 1 min periods with a supersaturated calcium phosphate solution containing urea and monofluorophosphate. Plaque sampled one min after the last rinse showed a marked increase in water-extractable F and a smaller increase in Ca but no increase in water-extractable P. Water-insoluble forms of all three ions were elevated, however. The mean plaque pH was 8.28. Plaque sampled 24 hr after the last rinse showed significant increases in water-insoluble F and Ca only, and no increase in pH. The prompt pH rise and disappearance of water-soluble P suggest that, on exposure to the mineralizing solution, urea and monofluorophosphate are rapidly hydrolyzed by plaque enzymes to provide catabolites which cause the immediate precipitation of fluoridated calcium phosphate.

Adolescent↗