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Biomedical subjects

T A Garland

Publications and source records attributed to T A Garland.

10 recordsLinked to original sources
PubMed1989

Subclavian perivascular block: influence of location of paresthesia.

Subclavian perivascular block of the brachial plexus was used in 156 adult patients undergoing orthopedic hand and forearm surgery. The location of the elicited paresthesia prior to deposition of 30 ml of a solution containing 1% mepivacaine, 0.2% tetracaine and 1.200,000 epinephrine was recorded. Twenty minutes later the quality of the block in the distribution of the superior, middle and inferior trunks of the brachial plexus was evaluated. Anesthesia in each of the three trunks was compared with the three sites where the paresthesia was elicited (superior, middle, or inferior trunk). A middle trunk paresthesia was the most successful in producing surgical anesthesia of all three trunks. A superior trunk paresthesia was the paresthesia most often elicited. It resulted in a significantly lower incidence of inferior trunk anesthesia than did a middle or inferior trunk paresthesia. Complications included arterial puncture (25.6%), Horner's syndrome (64.1%), and recurrent laryngeal nerve block (1.3%), with no instances of symptomatic phrenic block or symptomatic pneumothorax.

Adult↗
PubMed1985

Terminal duct carcinoma of minor salivary glands. A nonpapillary subtype of polymorphous low-grade adenocarcinoma.

The clinicopathologic features of five terminal duct carcinomas arising in minor salivary glands are presented. These nonpapillary, low-grade adenocarcinomas are part of the spectrum of polymorphous low-grade adenocarcinoma. The patients ranged in age from 47 to 77 years. Symptoms were nonspecific and related to a mass that usually was present for several years. Histologically, the tumors had a ductal pattern with areas of solid and cribriform architecture. Cytologically, they were composed of uniform, cuboid cells with round to oval nuclei and fine chromatin. One patient developed a recurrence after 13 years, but none of the tumors has metastasized. One lesion in this series was studied ultrastructurally and demonstrated both glandular and pseudoglandular structures analogous to those of adenoid cystic carcinoma. Nonetheless, terminal duct carcinoma is cytologically distinctive from adenoid cystic carcinoma and appears to have a more favorable prognosis.

Adenocarcinoma↗
PubMed1984

Salivary duct carcinoma: an analysis of four cases with review of literature.

Salivary duct carcinoma (SDC) is a histologically distinctive neoplasm of the parotid gland. The criteria for the diagnosis of SDC are circumscribed epithelial nests having a papillary, cribriform, and/or solid architecture coupled with central necrosis. The infiltrating cancer can be papillary, resembling the intraductal component or have a nonspecific, undifferentiated pattern. The authors are presenting four cases and compare them with 11 other acceptable cases from the literature. The neoplasm occurs beyond the age of 50 (median 63 years) and has a dismal prognosis with nearly two-thirds of the patients developing distant metastases. All surviving patients have been treated with combined parotidectomy and radiotherapy.

Adenocarcinoma↗
PubMed1984

Low-grade papillary adenocarcinoma of palatal salivary gland origin.

The clinicopathologic features of five low-grade papillary adenocarcinomas of palatal salivary gland origin are presented and seven well-documented cases from the literature are reviewed. Patients in our series ranged in age from 30 to 77 years (median 48). Symptoms were nonspecific and related to a mass present for a long duration. Histologically, these were complex cystic, papillary, focally solid tumors that were partially encapsulated. Cytologically, they were composed of bland, predominantly cuboidal cells with eosinophilic or clear cytoplasm. Four tumors were initially considered to be benign mixed tumors, but long-term follow-up indicates that these are slowly growing, malignant neoplasms. Three patients developed solitary cervical lymph node metastases from 2 to 21 years after initial presentation. One tumor underwent an anaplastic transformation to solid adenocarcinoma, and this was from the only patient in our series who died with tumor. Low-grade papillary adenocarcinoma is a clinicopathologically distinctive salivary gland neoplasm, with histologic features unlike those of other papillary salivary gland tumors.

Adenocarcinoma↗
PubMed1984

Ductal cyst.

Explore the source record for details and available documents.

Aged↗
PubMed1983

Small cell undifferentiated carcinoma of the larynx. Report of two patients and review of 13 additional cases.

Two patients with small cell undifferentiated carcinoma of the larynx (SCUCL) are described and 13 additional well-documented cases are reviewed. SCUCL affects middle-aged and elderly smokers and has a 2:1 male predominance. Half the patients presented with cervical metastases, an additional 43% developed regional metastases, and 71% ultimately had distant metastases. Thyroid gland involvement occurred in 29% of cases. Ten of fourteen patients had died of their neoplasms (mean survival, 7.8 months). One was living with unresectable tumor. Three were clinically disease-free, 30, 15, and six months, respectively, after diagnosis. Following initial therapy, six patients had recurrent or persistent local tumor or regional metastases. None of them received both total laryngectomy and ipsilateral cervical lymphadenectomy. Four of the six patients had radiation, suggesting that radiotherapy was not always effective in the control of local or regional disease when used in lieu of more extensive surgery. Three patients received chemotherapy, in addition to other modes of treatment, and their mean survival compared favorably with the overall group. The tumor from one of the patients contained a squamous component, and, ultrastructurally, both neoplasms had squamous and neuroendocrine features.

Age Factors↗
PubMed1981

The neonate with adult-type autosomal dominant polycystic kidney disease.

A premature infant with severe respiratory distress syndrome was found to have bilaterally enlarged kidneys and normal renal function. Renal ultrasonography confirmed renal enlargement but revealed no hydronephrosis or cysts. Family history was consistent with autosomal dominant polycystic kidney disease (ADPKD), and renal ultrasonography in the mother revealed bilateral multiple cysts of which she was previously unaware. The infant died of respiratory failure and septicemia, and autopsy revealed multiple microscopic renal cysts characteristic of early ADPKD. This case, along with 16 other affected newborns previously reported, illustrates the difficulty and importance of diagnosing ADPKD in the neonate. It is anticipated that awareness of this unusual cause of renal enlargement in the newborn will result in earlier diagnosis and appropriate genetic counselling.

Female↗