Search PubMed⌕ Search

Biomedical subjects

R K Finley

Publications and source records attributed to R K Finley.

10 recordsLinked to original sources
PubMed1992

Results of surgical resection of pulmonary metastases of squamous cell carcinoma of the head and neck.

In this retrospective review of 58 patients (12 females and 46 males) with pulmonary metastases of squamous cell carcinoma of the head and neck treated between January 1, 1970, and December 31, 1989, we evaluated their clinical courses and analyzed the outcomes of those who underwent pulmonary resection. For the entire group of patients, factors predictive of survival in those patients with a diagnosis of pulmonary metastases included pulmonary resection of metastases (p = 0.0001), locoregional control of the head and neck primary tumor at the time of diagnosis of pulmonary metastases (p = 0.007), TNM stage of the head and neck primary tumor (p = 0.02), a single nodule seen on the chest radiograph (p = 0.02), and disease-free interval (DFI) from the primary tumor of the head and neck of 2 years or more (p = 0.05). Twenty-four of 58 patients underwent thoracotomy for resection of metastases. Four (17%) were found to have a second primary tumor of the lung. Of the 20 remaining patients who underwent explorative surgery for possible pulmonary resection, 18 (90%) underwent complete resection of all malignant disease with an estimated 5-year survival of 29%. In these patients, a DFI of less than 1 year was associated with a 5-year survival rate of 0%, whereas a DFI of 1 to 2 years was associated with a 5-year survival rate of 43% and a DFI of 2 years or longer had a 5-year survival rate of 33%. The number of malignant pulmonary nodules that were resected ranged from one to five and was not significant in predicting survival (p = 0.19). Of eight patients who underwent the resection of more than one malignant pulmonary nodule, 50% survived 2 years, but none survived 5 years. Resection of a solitary pulmonary metastasis from squamous cell carcinoma of the head and neck resulted in long-term survival in selected patients. Important prognostic factors included locoregional control of the head and neck primary tumor, the number of nodules seen on chest radiograph, the TNM stage of the primary tumor, and the DFI from the head and neck primary tumor. The value of resection in patients with more than one malignant pulmonary nodule remains to be defined for this group of patients.

Carcinoma, Squamous Cell↗
PubMed1991

Elimination of urinary retention following inguinal herniorrhaphy.

In a group of 880 patients undergoing inguinal herniorrhaphy using local anesthesia, the incidence of postoperative urinary retention was 0.2 per cent. During the same period, a similar group of 200 patients had their hernias repaired using general or spinal anesthesia. The incidence of postoperative urinary retention was 13 per cent. The authors contend that the use of local anesthesia in inguinal hernia repair almost eliminates postoperative urinary retention.

Adolescent↗
PubMed1990

Coverage of full-thickness burns with bilayered skin equivalents: a preliminary clinical trial.

A total of six patients have received bilayered skin-equivalent coverage of full-thickness burns, with takes of 50% to 70% in the later patients. These skin-equivalent grafts are constructed by combining allogeneic fibroblasts with collagen to form a sheet and adding a suspension of autologous epidermal cells to the surface of the collagen matrix. These bilayered skin-equivalent grafts have provided an expansion of at least fifteenfold to twentyfold for the area covered by the donor epidermis. By 8 months after grafting, the skin-equivalent grafts appeared smooth and approximated the color of normal skin. Long-term problems associated with hypertrophic scarring or graft fragility have not developed during the 18-month period of follow-up.

Adolescent↗
PubMed1987

Wilms' tumors in adults.

Four cases of adult Wilms' tumor are reported comparing their diagnoses, treatment, and survival with the world literature. The oldest recorded patient is herein described at age 84. Aggressive surgical and medical therapy is necessary to improve survival. Surgical exploration should be through a transperitoneal approach with the patient positioned such that access to the chest can be obtained for maximum exposure and resection. Chemotherapy consisting of actinomycin D and vincristine should be instituted in all patients. Radiation therapy must also be considered in any patient with the diagnosis of nephroblastoma.

Adult↗
PubMed1978

Immediate excision of burn wounds.

Early excision and grafting of body burns is a safe and efficient means of treatment. It reduces hospital stay and probably reduces septic complications. A group of 41 patients were so treated at Miami Valley Hospital Burn Therapy Program. Their hospital stay was less than that of patients treated and reported to the National Institute of Burn Medicine.

Burns↗
PubMedDate not supplied

The use of intestinal antibiotics to delay or prevent infections in patients with burns.

Bacterial colonization and infection of wounds in seriously burned patients often comes from the patient's indigenous bowel flora. A prospective randomized clinical trial that involved 30 patients with 20% or greater total body surface area burns was undertaken to evaluate the use of a standard antibiotic bowel preparation in the delay or prevention of bacterial colonization of the burn wound and sepsis. Certain enteric bacteria were seen less frequently in the treated group (Enterobacter organisms), but other bacteria appeared more often in the treated group (Proteus organisms and enterococci). The average time of colonization of the burn wounds was 6.1 days in the treated group and 6.7 days in the control group. Blood cultures were positive for enteric organisms earlier in the treatment group. Pseudomonads appeared earlier in the wound and blood cultures of the treated group than in the control group. The effect of antibiotic bowel suppression in patients with burns is varied and unpredictable. The bowel preparation may select certain organisms and lead to earlier colonization of the wounds. Overall outcome and survival was not improved by the use of an antibiotic bowel preparation in these patients.

Adult↗
PubMedDate not supplied

Burn size estimate reliability: a study.

A study was undertaken to assess any differences between physicians' and nurses' estimates of burn size from drawings of 10 hypothetical patients with burns. Patient drawings were sent to the 199 burn facilities that are listed in the American Burn Association's Burn Care Resources in North America 1989-1990. The mailings were randomized between physicians and nurses. In order to have an even distribution, the cover letter asked the individual who received the forms to fill them out himself or herself rather than to pass them on to someone else. Forty-one nurses and 16 doctors (29%) returned the completed forms. The length of experience in burn care for the nurses averaged 9.3 years (range, 2 to 20 years), and the length of experience in burn care for the physicians averaged 14.7 years (range, 1 to 30 years [p = 0.01]). There were significant differences in the estimate of mean burn size between the physicians and nurses for only the two smallest drawings; in these cases, size may have been hard to translate from the patient to the drawing. There were four smaller burn charts (less than 20% body surface area), and in two (50%) of these, there were significant differences in the estimation of the burn size. For the six larger burn charts (greater than 20% body surface area), there were no differences in the size estimates. With regression analysis, no trend was noted that correlated the size estimates with the length of experience in burn care for either the physicians or the nurses. Additionally, the participants were asked to indicate which method of estimating burn size was used in their units. Thirty-five percent use the Rule of Nines, 33% use the Lund & Browder chart, 5.3% use Berkow's method, 3% use other methods, and 1.75% use a combination of the Lund & Browder chart and the Rule of Nines. Twenty-one percent failed to indicate any preferred method. Estimates of burn sizes with the use of standardized burn forms were consistently the same whether estimates were made by physicians or nurses. Sixty-eight percent of the respondents used the Rule of Nines or the Lund & Browder chart to estimate burn size, but 21% of the respondents failed to answer the question about which method is used in their units. In conclusion, there appears to be little variance in estimation of burn size as made by experienced burn nurses and physicians, and use of these estimates in a centralized data bank should be reliable.

Burn Units↗
PubMedDate not supplied

Positioning screen.

Explore the source record for details and available documents.

Burns↗
PubMedDate not supplied

Micrografts: the "super" expansion graft.

A novel technique for producing micronized skin grafts that was introduced in a paper presented at the 1990 ABA meeting was evaluated to quantify maximum expansion. Twenty Sprague-Dawley rats were divided into two groups representing 10:1 and 25:1 expanded micrograft ratios, respectively. Grafted sites in both groups were shown to heal better than those of the control group, and both grafted groups showed comparable healing at day 10.

Animals↗