Cutaneous seeding of pancreatic carcinoma by fine-needle aspiration biopsy.
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Adenocarcinoma↗
Biomedical subjects
R C Russell
Publications and source records attributed to R C Russell.
Transmission and scanning electron microscopy of peripheral nerves.
Electron microscopy of peripheral nerve tissue by SEM and TEM facilitates a better understanding of the complex nerve architecture described by early light microscopists. Details of axonal morphology and the Schwann cell/myelin sheath complex in healthy and diseased nerves have been described in the literature. The techniques of tissue harvesting and processing and the observed appearance of peripheral nerves by electron microscopy should be useful to clinicians and researchers involved in peripheral nerve surgery and research.
Animals↗
Thyroidectomy.
Of all operations in general surgery, those on the thyroid have a special esteem, because the introduction of safe thyroid surgery by masters like Joll and Dunhill in this country and Crile and Lahey in the United States saved young lives, and returned the unpleasant features associated with untreated thyrotoxicosis to normal. The emphasis of these Princes of Surgery to anatomic detail and careful surgery with good haemostasis remain the hallmark of thyroid surgery today.
Dissection↗
Experience using the carbon dioxide laser in the removal of cutaneous tattoos.
A preliminary study was undertaken to determine if the carbon dioxide laser was a suitable technique for the removal of tattoos. Twenty-eight patients with 47 tattoos had their tattoos removed by the carbon dioxide laser. The results were assessed by an independent observer 1 year after completion of treatment. The most satisfactory results were obtained in patients with discrete linear tattoos of amateur origin. In those with polychromatic blocked-in tattoos of professional origin, hypertrophic scars occurred and the overall result was unsatisfactory.
Carbon Dioxide↗
Fine needle aspiration biopsy: a cautionary tale.
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Adrenal Gland Neoplasms↗
Extremity reconstruction using the free deltoid flap.
The deltoid fasciocutaneous flap is a thin, reliable flap that is easily dissected from the posterolateral arm. It has large-caliber vessels and is capable of sensory reinnervation to portions of the flap above the deltoid/triceps groove through the lateral brachial cutaneous nerve. There is little sensory return to the large vascular territory, which can be extended inferiorly below the deltoid triceps groove. The donor site can be closed primarily or skin grafted and when large may be objectionable to some patients. The flap is an excellent choice for extremity soft-tissue reconstruction on the plantar or palmar surfaces. Protective sensibility has returned to all reinnervated flaps. We present our experience in 10 patients with extremity problems.
Adult↗
The efficiency of various collection techniques for sampling Culex annulirostris in southeastern Australia.
Dry-ice (CO2) baited EVS (Encephalitis Virus Surveillance) light traps collected significantly more Culex annulirostris than unbaited EVS or CDC light traps, chicken-, guinea pig- and rabbit-baited EVS traps, or cubic foot resting boxes. Results from the animal-baited traps indicated a preference for bird versus mammal bait. Females sampled by the resting boxes had significantly lower parity rates than females sampled by dry-ice baited EVS traps. Parity rates were generally similar among females sampled by dry-ice baited EVS traps, unbaited CDC light traps and animal baited EVS light traps.
Animals↗
Subcutaneous heparin, plasma heparin levels and postoperative wound haematoma.
Ninety-five patients, over the age of 40, having general surgical operations, were randomly allocated to a control and test group. The test group received 5000 units of subcutaneous heparin two hours before operation and then 12-hourly for seven days. The patients in the control group received the same regimen of isotonic saline. There was a marked variation in the plasma heparin levels from patient to patient, and from day to day in the same patient. There was a significant increase in the incidence of wound haematoma in patients with a plasma heparin level greater than 0.2 units/ml. The results suggest that the increased incidence of wound haematoma previously reported is due to the increase of incidence in patients who have plasma heparin levels greater than 0.2 units/ml.
Adult↗
Accessory sphincterotomy (endoscopic and surgical) in patients with pancreas divisum.
Sixteen patients with the congenital anomaly of pancreas divisum have been treated by enlarging the orifice of the accessory papilla. Attempts to do this at duodenoscopy succeeded in only 5 of 12 patients, and only one had a good clinical result. Sphincteroplasty was performed surgically in seven patients; five had a good or fair result. Most patients with poor results have undergone pancreatic resection. One patient died post-operatively; the remaining 15 divide equally as good (5), fair (5) and poor (5) results at follow-up after periods ranging from 7 months to 5 years. Results appear to be better in patients presenting with recurrent attacks of acute pancreatitis than in those with chronic pain. The preferred management for these patients remains unclear.
Acute Disease↗
The late functional results of upper limb revascularization and replantation.
The functional results in 25 of 30 patients after successful upper limb revascularization or replantation were evaluated by subjective-patient surveying and objective measurements. Young patients with complete, sharply amputated extremities at the wrist level or those with incomplete injuries and uninjured peripheral nerves had the best functional results. Multiple-level, diffuse crush, or avulsion injuries, even if the injuries were incomplete, and patients with high-level nerve injury had less return of function.
Adolescent↗
Free vascularized small joint transfer to the hand.
Free vascularized digital joint transfers should provide joint stability, painless functional range of motion (ROM), tolerance of normal stresses without degeneration, and growth potential in children. In our department since 1977, seven transfers have been carried out in seven patients, including four children aged 4 to 11 years and three adults aged 19 to 46 years. Donor sites were the metatarsophalangeal joint of the second toe (four cases), the proximal interphalangeal (PIP) joint of the second toe (two cases), and the PIP joint of a useless amputated small finger (one case). Recipient sites were digital PIP and metacarpophalangeal (MP) joints (three cases each) and the MP joint of a thumb (one case). Six of the seven procedures were successful. There was retention of normal joint space and stable, painless functional ROM, while epiphyseal centers in the children remained open and showed normal growth. Follow-up ranged from 2 to 4.7 years, averaging 3.5 years. Some adherence of an associated extensor tendon has been observed. The feet have been asymptomatic. When digital joint replacement is required because of local causes of destruction, free toe joint transfer should certainly be considered in children and in young adults.
Adult↗
A study of nail bed injuries: causes, treatment, and prognosis.
Two hundred ninety-nine nail bed injuries were studied over a 5 1/2-year period. Methods of repair were described. Follow-up was obtained for 184 injuries. The injuries were defined, categorized, and analyzed according to defined result categories and results were graded from excellent to poor. Ninety percent of the repaired nail beds were graded good to excellent. Poorer results occurred with crush or avulsion injuries, with injuries of both nail bed and nail fold, and with associated infection.
Accidents↗
Cuffing techniques in microarterial surgery.
Four-stitch microarterial anastomoses reinforced with cuffs of artery, vein, or polyglycolic acid tubing were compared to standard eight-stitch repairs in the femoral arteries of 40 immature rats. The cuffing technique reduced the average repair time by 50% without compromising short- or long-term patency. Restricted vessel growth or anastomotic stenosis did not result from the presence of any of the cuffing materials. Polyglycolic acid tubing performed as well as autogenous cuffs. The cuffing technique helps minimize trauma to the vessel wall by reducing the number of sutures, and its application could significantly decrease the duration of ischemia in multiple digit replantations.
Animals↗
Aberrant expression of HLA-DR antigen on thyrocytes in Graves' disease: relevance for autoimmunity.
To investigate the expression of class II histocompatibility antigens HLA-DR in the thyrocytes in autoimmune thyroid diseases, 47 thyroidectomy specimens were examined by immunofluorescence with monoclonal antibodies to the nonpolymorphic region of the DR molecule. Aberrant DR expression was most marked in the Hashimoto gland, with the entire section being strongly stained. DR expression was seen in discrete groups of follicles in 20/26 thyroids from patients with Graves' disease, in 2/9 non-toxic nodular goitres, and in none of 11 specimens of "normal" thyroid. The presence of lymphoid foci, "activated" T-cells, and immune complexes on the follicular basement membrane were not regularly associated with the DR-positive thyroid acini. HLA-A,B,C expression was also increased in the diseased glands. Expression of HLA-DR thus seems to be one of the earliest manifestations of autoimmune lymphocytic thyroiditis.
Adult↗
Management of malignant obstructive jaundice at The Middlesex Hospital.
A total of 180 patients with malignant obstructive jaundice have been treated by 5 different methods: surgical resection; surgical by-pass; percutaneous prosthesis; endoscopic prosthesis; and endoscopic sphincterotomy (for papillary tumours). The spectrum of patients is unusual, because many elderly and ill patients were referred for nonoperative management. Operative by-pass, percutaneous and endoscopic prostheses gave similar overall results, with a mean survival of about 6 months. Patients with tumours of the papilla of Vater treated by endoscopy or surgery fared well; 11 of 18 were alive at follow-up. Median survival after resection of other tumours was 17 months. These results underline the need for randomized clinical trials, which are now in progress.
Adult↗
Nonsuppurative tenosynovitis secondary to foreign body migration.
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Adolescent↗
A scanning electron microscopy evaluation of peripheral nerve regeneration.
Regeneration of a transected peripheral nerve following repair is often impeded by scar formation and misdirection of axon sprouts. This paper describes the use of the scanning electron microscope (SEM) in conjunction with other physiologic tests to evaluate nerve regeneration. A central one centimeter segment was removed from the peroneal branch of both sciatic nerves in 37 white New Zealand rabbits. Sectioned nerves were divided into four experimental groups according to type of repair performed: (A) no repair; (B) mobilization and direct epineural repair; (C) interpositional nerve graft repair; (D) polyglycolic acid (PGA) conduit repair. Each animal was reexplored eight months later and nerves examined by electrophysiologic testing and scanning electron microscopy. Unrepaired nerves viewed by SEM showed impaired axonal regeneration and loss of fascicular morphology with increased scar tissue. Nerve sections of direct epineural and interpositional graft repairs showed the best return of axonal morphology. Nerves regenerated across a one centimeter gap through a PGA conduit demonstrated regrowth of small and large myelinated axons grouped into "mini-fascicles" with increased connective tissue. PGA conduit repairs were electrically inferior to graft and direct repairs as measured by conduction velocity and the amplitude of evoked response. These findings correlated well with anatomy seen on scanning electron micrographs. The scanning electron microscope proved an excellent adjunctive tool for the study of peripheral nerve regeneration.
Animals↗