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Biomedical subjects

W E Fee

Publications and source records attributed to W E Fee.

At least 73 records · Page 4Linked to original sources
PubMed1981

Planned approach to the management of malignant invasion of the carotid artery.

A planned approach to the evaluation and management of patients with tumor involvement of the cervical carotid artery is presented. Preoperative arteriography and determination of carotid back-pressure permitted a rational approach in these high risk patients. One patient found to have an extremely low carotid back-pressure was advised not to undergo carotid resection. Six patients with satisfactory carotid back-pressure tolerated carotid resection and reconstruction.

Blood Pressure↗
PubMed1981

Unsuspected esophageal foreign bodies in adults with upper airway obstruction.

Esophageal foreign bodies rarely cause respiratory distress in adults. While it is well known that upper airway obstruction can occur with esophageal foreign bodies in children, the otorlaryngologic literature mentions little of this problem in older patients. Two adults with airway obstruction from unsuspected esophageal foreign bodies are described, with emphasis on the problems of diagnosis and management. The possibility of an unsuspected esophageal foreign body should be kept in mind during the evaluation of respiratory distress in an adult, especially in one who is a poor historian or has a history of a psychiatric disorder. Early endoscopic removal in the treatment of choice, although esophagotomy may be required.

Adult↗
PubMed1980

Metastasis in head and neck cancer, 1979.

Metastatic spread of head and neck cancer signifies a grave change in prognosis for the patient. The presence or absence of detectable metastasis is valuable knowledge both in planning treatment and in predicting prognosis. Knowledge of the metastatic behavior patterns of such tumors, and of the diagnostic means of detecting metastasis, is essential. The available knowledge on this problem is comprehensively reviewed to present, in a single source, the requisite knowledge for any physician treating head and neck cancer. Metastatic spread is reviewed according to incidence, detection methods, anatomical sites, and correlation with characteristics of the primary tumor. Finally, methods of detecting metastasis are reviewed and a practical approach to patient evaluation recommended.

Bone Neoplasms↗
PubMed1980

Aminoglycoside ototoxicity in the human.

One hundred thirty-eight patient courses of tobramycin (tobra) and gentamicin (genta) were prospectively monitored for ototoxicity using weekly audiograms and electronystagmograms. Twice weekly drug serum levels and kidney function tests were determined. A pre, during, and post-therapy history was obtained and the results were analyzed to determine significant parameters of ototoxicity. Statistical analysis of the data was performed using SPSS on an IBM 370/3033 computer. Tobra showed less toxicity than genta but only the difference in vestibular toxicity was statistically significant. Significant associations with toxicity included the patient developing a high temperature, total dose, low hematocrit for tobra, high hematocrit for genta, high creatinine clearance with cochlear toxicity, high creatinine with nephrotoxicity, poor condition or critically ill, and duration of therapy greater than 10 days. Non-significant parameters included dose rate (mg/kg), serum levels, age, prior noise exposure, prior aminoglycosides, prior ear infections, non-aminoglycoside ototoxic drugs, underlying disease, or total number of high risks present. Ototoxicity was independent of nephrotoxicity.

Anti-Bacterial Agents↗
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

Tracheoesophageal space abscess.

Two cases of a newly described complication of endotracheal intubation are presented with a discussion of the pathophysiology, clinical symptoms, and treatment evaluation. Treated late, bilateral arytenoid fixation associated with subglottic stenosis is the eventual outcome. Reconstructive efforts in one patient have allowed decannulation two years after onset of his disease following bilateral arytenoidectomy. No reconstructive efforts were attempted in the second patient because of her basic underlying disease process. Early recognition is important and exploratory laryngotracheal-fissure advocated for suspected cases in order to perhaps decrease the devastating consequences of late treatment.

Abscess↗
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

Thyroid surgery: surgical and metabolic causes of hypocalcemia.

Patients undergoing radical surgical treatment of head and neck neoplasms often are seen with a history of cirrhotic liver disease, electrolyte abnormalities, and other stigma of chronic disease. Despite skillful thyroid surgical technique performed as an isolated procedure or in combination with other procedures such as laryngectomy, hypocalcemia can occur. Common causes of lowered serum calcium levels secondary to removal of parathyroid glands, blood transfusions, hypoalbuminemia, gastrointestinal malabsorption, and renal insufficiency are well known. Less well known is the recently elucidated role of dependence of calcium metabolism on magnesium. Recently, it has been well documented that alcoholism directly lowers serum magnesium levels in both human and animal models without prior liver disease or malabsorption. The fact that three mechanisms are needed to explain calcium homeostasis implies that the magnesium-calcium interdependence is not clearly understood.

Calcium↗
PubMed1978

24-hour infusion of cis-platinum in head and neck cancers.

Eighteen patients with advanced squamous cell cancer of the head and neck were treated with cis-diamminedichloroplatinum in a 24-hour infusion. The most frequent dose used was 80 mg/m2 repeated every three weeks. Six were treated preoperatively for Stage III or IV disease, and twelve were treated for recurrent disease. The overall response rate was 72% with one complete remission, greater than 50% regression in six patients, and 25--50% regression in six patients. Toxicity was minimal: creatinine greater than 2 in 6% of courses, leukopenia in 9%, anemia in 29%, vomiting in 76%, and documented minimal hearing loss in one patient. Plasma and urine platinum levels during infusion are presented. The dosage of 80 mg/m2 administered over 24 hours gives a response rate in head and neck cancers equivalent to that reported with higher doses given by rapid infusion, and toxicity is minimal.

Adult↗
PubMed1978

Temporal arterial ligation in head and neck surgery with absorbable sutures.

Temporary arterial ligation is a useful concept in head and neck surgery for situations dealing with potential recurrent hemorrhage or recurrent vascular neoplasms. In this study, several absorbable sutures, including plain gut, chromic gut, and polyglycolic acid were used to ligate the common carotid artery in dogs. Arterial patency was followed by serial selective arteriograms. Only polyglycolic acid sutures proved to be a reliable material to achieve transient arterial occlusion.

Absorption↗
PubMed1977

Rhomboid flap.

The rhomboid flap is a practical and efficient method of repairing small- to moderate-size surface defects of the head and neck. This flap has the advantage of combining the lateral shift and rotational methods of transfer that aid in the closure of the donor site as the flap is transposed. A description of this flap, the principle of its design, its clinical application, and potential pitfalls are presented.

Face↗
PubMed1976

Rhomboid flap principles and common variations.

The rhomboid flap was initially popularized by a Russian, Alexander Limberg, and modified by Claude Dufourmentel of Paris. Numerous variations on the flap have been proposed more recently by Webster and Gunter. This flap has found its way into the practice of most surgeons doing head and neck surgery, with its primary advantage being that it is an extremely simple flap operation to learn, with great versatility. The general principles and their clinical application are presented in order to increase proper utilization of the flap.

Humans↗