Search PubMed⌕ Search

Biomedical subjects

R L Goode

Publications and source records attributed to R L Goode.

At least 109 records · Page 6Linked to original sources
PubMed1983

Intraoperative iodine 125 implants. Their use in large tumors in the neck attached to the carotid artery.

Twenty-nine patients with large masses attached to the carotid artery underwent surgical resection, preservation of the artery, and intraoperative iodine 125 implantation via an absorbable suture. Eighteen were treated for recurrent neoplasms, having failed prior surgery and/or irradiation therapy. Eleven were treated primarily. With a minimum follow-up of one year, 76% were disease free in the implant volume and 62% were disease free in the entire neck. Distant metastases occurred in 45%. Mean survival was 15 months in the primary group (range, two to 50 months) and 12 months in the recurrent group (range, four to 26 months). This technique shows promise in providing local control without necessity for sacrifice of the carotid artery.

Aged↗
PubMed1983

Squamous cell carcinoma of the base of the tongue.

The squamous cell carcinomas of 119 patients treated between 1958 and 1980 were retrospectively reclassified according to the 1977 American Joint Committee for Cancer Staging-End Results Reporting guidelines. Analysis of the information was performed with an interactive computer program that allows the analysis of a large number of medical factors with numerous variables. The following factors show the statistically significant improved survival rates: well-differentiated histopathologic findings, small T-stage lesions, and clinically negative neck disease. Although the survival curve was similar in the planned combined therapy and radiation therapy groups, local control was statistically superior in the combined therapy group. A similar trend is seen in those patients who receive interstitial implants in addition to external beam therapy. A randomized prospective study is needed to determine the optimum mode of therapy.

Adult↗
PubMed1983

Lateral laryngeal suspension: a new procedure to minimize swallowing disorders following tongue base resection.

Fourteen patients who underwent composite resections for oropharynx and tongue base cancers had lateral laryngeal suspensions in order to improve postoperative swallowing ability, minimize the surgical defect, and decrease shifting of the mandible after composite resection. Eleven of these patients had significant base of tongue resections (30-90%) and 3 had oropharyngeal resections. Thirteen (93%) were able to eat by mouth, 14 patients (100%) had a normal airway, and 14 (100%) had intelligible speech.

Deglutition Disorders↗
PubMed1983

"How I do it"--otology and neurotology. A specific issue and its solution. Advantages of the T-tube for short and long-term middle ear ventilation.

The T-tube has several advantages that should be considered when selecting a ventilation tube. First, it remains in place much longer than the average tube; thus allowing the physician, rather than chance, to determine when the tube should be removed. Second, it can be removed painlessly without an anesthetic when indicated. Third, it does not have the problem of a high post-removal perforation rate such as seen with other long term tubes. Fourth, it can be easily modified to suit the needs of the patient and the physician.

Humans↗
PubMed1982

Treatment of fractures of the edentulous mandible.

The reduction and fixation techniques for treatment of fractures of the edentulous mandible are varied, although all the operative techniques are based on the fundamental principles of adequate bone fragment apposition and immobilization. The techniques include the following: (1) analgesia and soft diet, (2) closed reduction with splint fixation, (3) open reduction (intraoral or extraoral) with transosseous wire ligation, (4) percutaneous intramedullary pinning, (5) intraoral open reduction with bone graft and maxillomandibular fixation, (6) external splint fixation appliance, (7) extraoral open reduction and fixation with malleable mesh, and (8) extraoral open reduction and fixation with bone plating (metacarpal, lateral compression, and eccentric dynamic compression plate [EDCP]). We review the various modalities of therapy for this challenging problem, with the strengths and weaknesses of each technique. In addition, we discuss a relatively new method of fracture fixation in North America, the EDCP, and our experience using it to treat 17 fractures of the edentulous or nearly edentulous mandible, with a 94% bony healing rate.

Bone Transplantation↗
PubMed1982

Magnetic intranasal splints.

A magnet-containing silicone rubber intranasal splint is described for use following septoplasty. The splints hold the septal flaps in place by magnetic attraction and eliminate the need for packing. They produce minimal discomfort, are easily inserted and removed, and allow nasal breathing while in place.

Humans↗
PubMed1981

Differential interaction of antiestrogens with cytosol estrogen receptors.

Interaction of tamoxifen, trioxifene and LY117018 with cytosol-estrogen receptors from immature rat uteri was compared. Determination of relative binding affinity (RBA) by competition with [3H] estradiol under various assay conditions revealed that the RBA of LY117018 increased with temperature while that of trioxifene declined. Furthermore, the RBA values of tamoxifen and trioxifene observed after 24 h of incubation at 4 degrees C were significantly lower than those obtained with 1-h incubations. However RBA values obtained with 1- or 24-h incubations of LY117018 at 4 degrees C were similar. The complex formed by estradiol or LY117018 at 4 degrees was relatively stable for 24 h, while significant dissociation of tamoxifen and trioxifene was detected under these conditions. At 30 degrees C estradiol displayed a biphasic pattern of dissociation, but tamoxifen and trioxifene dissociated rapidly and little evidence of a stable phase was apparent. By contrast, the complex formed by LY117018 exhibited greater stability than that of estradiol at 30 degrees C. These results establish a relationship between shifts in competition curves (RBA) and rates of dissociation relative to estradiol; and clearly reveal that LY117018 has different binding characteristics than tamoxifen and trioxifene.

Animals↗
PubMed1981

Evidence for biological action of the antiestrogens LY117018 and tamoxifen by different mechanisms.

The influence of LY117018 and tamoxifen on established uterotropic influence of estradiol was examined in immature ovariectomized rats. When LY117018 was introduced on the fourth day of estradiol treatment, it regressed the uterotropic effect of estradiol. However, tamoxifen did not attenuate estradiol activity under these conditions. Injection of estradiol, commencing on the fourth day of LY117018 treatment, elicited no increase in uterine weight, while tamoxifen caused substantial uterotropic action in the presence of established, continuous LY117018 treatment. The uterotropic influence of tamoxifen also occurred when it was administered concomitantly with LY117018, and a similar result was observed following the injection of 4-hydroxytamoxifen with LY117018. These observations demonstrate that LY117018 can block or regress uterotropic effects of estradiol, but it cannot antagonize the action of tamoxifen or its hydroxylated metabolite. This suggests that these antiestrogens might act at separate sites or by different molecular mechanisms.

Animals↗
PubMed1981

Clinical studies with In-111 BLEDTA, a tumor-imaging conjugate of bleomycin with a bifunctional chelating agent.

Indium-111 BLEDTA, a bleomycin analog containing an EDTA group, was used for tumor imaging in 110 patients with cancer. Scans with In-111 BLEDTA agreed with biopsy results in 75 of 95 patients (79% accuracy). A positive scan was obtained in 71 of 88 patients with a positive biopsy (81% sensitivity). In 21 of 95 patients (22%), the scan revealed tumor sites that had not been detected. The main limitation of visualization was the size of the tumor (1.5--2.0 cm diameter was the smallest size seen). Background radioactivity in the liver, spleen, and bone marrow also made tumor detection in these areas more difficult. The cause of this background, and of false-positive uptake in sites of inflammation, is correlated with specific radiolabeling of polymorphonuclear leukocytes by In-111 BLEDTA. Means of eliminating this background are discussed.

Adult↗
PubMed1979

Squamous cell carcinoma of the soft palate.

We performed a retrospective study of 106 patients with carcinoma of the soft palate who were treated at two university hospitals. Computer analysis using a new interactive data base program called MING was made to determine Berkson-Gage survival and Gehan tests of statistical significance. Statistically significant associations with an increased survival included the following: smaller lesions, a clinically negative neck examination. well- and moderately well-differentiated histopathologic features, radiation therapy dose of less than or equal to 6,300 rads, absence of a simultaneous primary, and surgical salvage. No statistically significant differences were seen with age, sex, stage, or the number of days during which patients were treated with radiation therapy. There appears to be a need for a prospective, multi-institutional, randomized therapy study to solidify treatment policy. Consideration should be given to combine surgery-radiation vs radiation therapy alone.

Adult↗
PubMed1979

Radioactive suture in the treatment of head an neck cancer.

I-125 seeds in Vicryl suture have been used as a radioactive suture in 24 cases of advanced malignancy of the head and neck. Twelve cases had metastatic carcinoma attached to the internal or common carotid artery. The goal was to excise surgically as much tumor as possible, then implant any residual tumor with this radioactive suture which remains as a permanent implant (half-life of 60 days). This preliminary study shows that use of I-125 impregnated Vicryl suture in this manner appears to produce improved long-term palliation and may increase local cure rates.

Follow-Up Studies↗
PubMed1979

Eye protection in the paralyzed face.

All patients with a VIIth nerve paralysis with any limitation of closure of the eye should have in the office or out-patient clinic setting: 1. paper tarsorrhaphy of the upper or possibly lower lid; 2. artificial tears and/or ointment; and 3. glasses to protect the cornea from air currents. Kinetic and static surgical procedures are discussed. The kinetic procedures include facial nerve repair and grafting, VIIth-XIIth nerve anastamosis, muscle nerve block transplantation, transposition of nonparalyzed muscle and cross over. The principals of VIIth nerve repair and grafting and presented in the intracranial, internal auditory canal, labyrinthine, tympanomastoid and extratemporal sites. The static procedures include resection of redundant skin, fascia lata strip suspension, weakening of contralateral non-paralyzed musculature, and adjunctive procedures such as resection of ptotic melolabial fold, plication of parotid-masseteric fascia, dermal graft suspension, blepharoplasty, brow lift, canthoplasty, horizontal shortening of lower lid, fascial suspension of lower lip, McLaughlin tarsorrhaphy, and palpebral spring. Patient counseling is emphasized.

Blepharoptosis↗
PubMed1979

Effect of prophylactic antibiotics in radical head and neck surgery.

One hundred major head and neck operations performed on 77 patients were evaluated regarding the effectiveness of an aminoglycoside and cephalosporin antibiotic combination given prophylactically to prevent postoperative infection. The postoperative infection incidence was 6%, significantly lower than that reported in similar series where no antibiotics were used. The addition of the aminoglycoside did not appear to provide any additional protection compared with the use of cephalosporin alone.

Aminoglycosides↗
PubMed1978

The brow-lift operation in a man.

Various techniques of brow elevation, including their advantages and limitations, are discussed. Since there are no lines immediately above the eyebrow, the direct brow-lift operation results in a scar that cannot be camouflaged with makeup by a man. The approach via temporofrontal scalp produces limited and temporary brow elevation, and the scars may eventually become visible with hairline recession in men. A technique of the brow-lift operation in a man via the natural, horizontal forehead crease above the eyebrow has been found to be very effective. The complications have been minimal, the resulting scars have been unnoticeable.

Adult↗