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Biomedical subjects

S R Baker

Publications and source records attributed to S R Baker.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Complete microscopic controlled surgery for head and neck cancer.

Mohs surgery, as it has evolved since its inception by Mohs, is a technique for removing certain cancers using careful, precise microscopic marginal control. The contemporary technique using fresh tissue has enabled the application of Mohs surgery to the treatment of malignancies of the upper aerodigestive tract. Mohs surgery, once limited to large recurrent basal cell carcinomas, has expanded to include several cutaneous and noncutaneous neoplasms. With better understanding of the Mohs technique, its indications, applications, and advantages, an interdisciplinary approach to manage certain head and neck neoplasms is proposed.

Frozen Sections↗
PubMedDate not supplied

Periorbital cellulitis.

Periorbital cellulitis is a commonly occurring infectious process limited to the eyelids in the preseptal region. It occurs with greater frequency in the pediatric age group. It is important to distinguish this disease from orbital cellulitis, a potentially lethal infectious process involving the contents of the orbit. A retrospective study of clinical and laboratory data from 137 cases with orbital and periorbital cellulitis was performed. Periorbital cellulitis was documented in 98 cases (71%) in contrast to orbital cellulitis, which was noted in 39 (28%) patients. Sinusitis was the most frequently encountered predisposing factor for the development of periorbital cellulitis occurring in 29 patients. All patients with a diagnosis of periorbital cellulitis were hospitalized and received antibiotics, the majority (95%) receiving intravenous therapy. Hemophilus influenzae was the most frequently isolated pathogenic organism. It was necessary to operate on eight patients. Six patients underwent incision and drainage of an eyelid or periorbital abscess. A distinction between periorbital and orbital cellulitis is clarified. The separation of these entities on the basis of physical examination and radiographic studies is stressed.

Adolescent↗
PubMedDate not supplied

Prediction and control as determinants of behavioural uncertainty: effects on task performance and heart rate reactivity.

Control or control-belief is often viewed as being directly instrumental in facilitating coping mechanisms in aversive situations, and yet the empirical evidence for the beneficial effects of control is inconclusive. In this study we investigated the role of predictability in determining the effects of perceived control during an aversive reaction time task. Fifty-six subjects were allocated to one of four groups; predictable-control, predictable-no control, unpredictable-control, unpredictable-no control. In the predictable conditions, subjects could temporally predict the occurrence of an aversive noise. In the perceived control conditions, duration of the aversive tone was contingent on subject's performance. All subjects were matched in terms of the nature of the task and in the number and time of receipt of both the warning signal and noise. Heart rate reactivity and two performance parameters were measured, reaction time and performance increase. Both predictability and control-belief led to a reduction in heart rate reactivity, although they appeared to function independently and at different points in the sequence of events. That is, predictability or perceived control was sufficient to mitigate the effects of an aversive situation. Neither perception of control or predictability led to better task performance. These results are discussed in terms of behavioural uncertainty explanations.

Acoustic Stimulation↗
PubMedDate not supplied

Abdominal aortic aneurysm neck morphology: proposed classification system.

BACKGROUND: While aneurysm neck length, angulation and width have all been previously assessed in endovascular abdominal aortic aneurysm repair (EVAR), aneurysm neck shape has not been considered. AIMS: To analyse the influence of aneurysm neck morphology on outcome following EVAR. METHODS: Aneurysm neck morphology in 70 patients undergoing EVAR from April 2001 to May 2004 was determined using pre-operative CT scans and graft plans. Necks were classified as flared, parallel, irregular, conical, barrel or hourglass. End-points were death,Type I endoleak and graft migration. RESULTS: Forty-six per cent of necks were flared, 34% parallel, 9% irregular, 6% conical, 3% barrel and 3% hourglass. Mean follow-up was 20.2 months (range 4-35). There was one Type I endoleak and one graft migration. There were no aneurysm related deaths. CONCLUSIONS: Assessment of aneurysm neck morphology should be part of the routine preoperative workup for EVAR. A classification system of AAA necks is suggested to facilitate this.

Aortic Aneurysm, Abdominal↗
PubMedDate not supplied

Musings at the beginning of the hyper-CT era.

In the past decade, with the introduction and acceptance of helical and multidetector computed tomography (CT), CT has gained ascendancy as the preeminent imaging examination for most abdominal conditions. However, attention must now be directed toward the implications of dose consequent to CT studies. Multidetector CT has resulted in thinner and more slices per region of interest, more extensive studies as adjacent body regions can be assessed in one breath-hold, and more pediatric examinations. Dose per slice is greater with multidetector CT than with single-slice CT, and the number of examinations nationally has risen dramatically. These factors contribute to the radiation burden given to patients and the enhancement of risks for morbidity and mortality later in life.

Forecasting↗
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The free scapular flap for head and neck reconstruction.

The free scapular flap is a versatile flap for soft tissue and bony reconstruction of the head and neck. It has a very reliable blood supply and is easy to harvest. In this paper, we present our cumulative experience with the use of five cutaneous flaps and 31 osteocutaneous flaps.

Adult↗
PubMedDate not supplied

Carcinoma of the ethmoid sinus.

Cancer of the ethmoid sinus is a rare tumor in the head and neck, accounting for less than 1 per cent of all such malignancies. This paper examines squamous cell carcinoma arising in the ethmoid sinus, the most common form of ethmoidal malignancy in a series reviewed at the University of Michigan. Sixteen cases diagnosed between 1964 and 1974 (inclusive) were included in this study. Peak incidence of the disease occurred in the seventh decade of life. All patients had a minimum follow-up of at least five years. The patients had relatively common nasal complaints that unfortunately represented an unusual and frequently fatal disease. The symptoms of ethmoid sinus cancer are reviewed, and the many modalities of treatment that can be used are discussed. The problems of staging ethmoid sinus cancer are elucidated, and difficulties with the suggested classification systems are discussed. Ultimately, only 29 per cent of the patients survived five years.

Adolescent↗
PubMedDate not supplied

Evaluation and management of a carcinoma arising in a thyroglossal duct cyst.

Thyroglossal duct remnants are the most common congenital cystic lesions of the neck; however, a carcinoma arising in these structures is rare. Two new cases of a papillary adenocarcinoma arising in a thyroglossal duct cyst are presented. Preoperative evaluation, operative management, and postoperative care are discussed. Initial evaluation consisting of a thorough head and neck examination, palpation of the thyroid gland, thyroid function tests, and selective use of thyroid imaging is recommended. Removal of the cyst and tract in the manner described by Sistrunk is advocated. If an adenocarcinoma is found in the cyst and if a carcinoma is found in the thyroid gland or a thyroid scan reveals a nodule, a total thyroidectomy is recommended. A modified neck dissection and total thyroidectomy is advocated for cervical metastases. Postoperatively, thyroid suppression and long-term follow-up are encouraged. A squamous cell carcinoma arising in a thyroglossal duct remnant appears more aggressive and requires complete excision and, for confirmed cervical metastases, radical neck dissection and postoperative radiation therapy.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

Hearing loss from acute carbon monoxide intoxication.

A case of fluctuating sensorineural hearing loss from acute carbon monoxide (CO) poisoning with presentation of a U-shaped audiogram is reported. Acute CO intoxication seems to involve vestibular function more frequently than auditory function. Hearing loss is uncommon, but when present, may often display a U-shaped audiometric curve. Decrease in hearing sensitivity probably results from hypoxia to the cochlea, VIII nerve and brain stem nuclei. Fluctuation in hearing sensitivity may be an early manifestation of acute CO exposure, and requires periodic audiometric examination until the hearing has stabilized.

Acute Disease↗
PubMedDate not supplied

Ultrasonic analysis of head and neck neoplasms. Correlation with surgical findings.

Ultrasonography of head and neck neoplasms is useful in the preoperative evaluation of patients. Inflammatory masses demonstrate high reflectivity in a homogeneous pattern and have diffuse borders. Similarly, lipomas show medium to high reflectivity and have a homogeneous pattern, but are well outlined. Mixed tumors of the major salivary glands have a characteristic heterogeneous pattern and are well outlined. Malignant lesions demonstrate low reflectivity in a homogeneous or heterogeneous pattern and have poorly outlined or diffuse borders. Cysts of the head and neck are well outlined and devoid of interior echoes.

Adolescent↗
PubMedDate not supplied

Mucociliary flow in the canine frontal sinus.

The mucociliary flow in the frontal sinus of dogs is in a spiral pattern from medial to lateral. The final evacuation of mucus is through the ostium positioned anteriorly. Mucus flow rate is most rapid in the areas of the ostium and slowest in the area of the intersinus septum. Mucus flow patterns remain the same despite removing the intersinus septum and blocking one frontal sinus ostium. Mucociliary flow rate, however, appears to be diminished in the reoperated frontal sinus. Mucus does not appear to migrate readily across the intersinus septal areas when the septum has been removed and one nasofrontal duct is obstructed.

Animals↗
PubMedDate not supplied

Benign pleomorphic adenomas in children.

Benign pleomorphic adenomas of the salivary glands in children are rare. Reported are 30 patients under the age of 21 years presenting with this neoplasm. Twelve patients were first seen with recurrent or persistent tumor following previous attempts at removal. Retreatment resulted in control of the neoplasm in eight patients with follow-up from 5 to 24 years. Two additional patients have developed malignant degeneration of their neoplasms. All 18 previously untreated patients have remained free of recurrence. As with adults, the treatment of choice for benign pleomorphic adenomas of the parotid gland developing in children is parotidectomy with preservation of the facial nerve. Tumors arising in the submandibular gland are best treated by complete excision of the gland as well as the tumor.

Adenoma↗
PubMedDate not supplied

Risk factors in multiple carcinomas of the lip.

Certain risk factors appear to separate subjects with repeated primary carcinomas of the lip from the general population of patients with carcinoma of the lip. Factors that were found statistically significant in increasing the chance of recurrent carcinoma of the lip include outdoor occupations requiring prolonged exposure to sunlight or the use of tobacco on a regular basis. Significant risk factors of a clinical nature include a positive serologic reaction for syphilis; the presence of leukoplakia, hyperkeratosis, or actinic cheilitis; or the presence of a basal cell or squamous cell carcinoma of the facial skin.

Adult↗
PubMedDate not supplied

Carcinoma of the nasopharynx in childhood.

Squamous cell carcinoma of the nasopharynx is an uncommon disease in childhood. Ten patients under the age of 18 years with nasopharyngeal carcinoma are reviewed. The average patient age was 13 years and the average duration of symptoms was 18 weeks. Cervical mass (8/10) and hearing loss (4/10) were the most frequently encountered complaints. Three- and five-year determinate survival was 50% and 44% respectively. Bilateral cervical metastases or cranial nerve impairment from neoplasm offered a poor prognosis.

Adolescent↗