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Biomedical subjects

W J Goodwin

Publications and source records attributed to W J Goodwin.

At least 55 records · Page 3Linked to original sources
PubMed1985

Selenium inhibition of chemical carcinogenesis in the upper aerodigestive tract of hamsters.

Evidence suggests that ingestion of selenium compounds may inhibit carcinogenesis. We studied this in hamsters in which squamous cell carcinoma of the tongue was induced with 0.5% dimethylbenzanthracene (DMBA). Forty-five hamsters, divided into three groups of 15 each, were fed a low-selenium diet and the left lateral border of the tongue was painted with DMBA three times a week. Control animals were given deionized water, while water for animals in groups 1 and 2 contained 3 and 6 ppm selenium, respectively. All sufficiently long-lived animals developed leukoplakia of the tongue and floor of the mouth that progressed to dysplasia and papillary or ulcerative carcinoma. Carcinomas were seen less frequently on the palate and in the pyriform sinuses. Carcinoma metastasized to neck lymph nodes in two hamsters. Data indicate a 2-week delay in leukoplakia incidence for the selenium groups; a higher survival rate was also noted, although this was not statistically significant. We conclude that this model is similar to tobacco-induced squamous cell carcinoma of the upper aerodigestive tract in humans and that ingestion of supplemental selenium produces a modest inhibitory effect on leukoplakia.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1985

Sinusitis in intensive care unit patients.

The ultimate source of sepsis may be difficult to pinpoint in critically ill patients with multiple possible sources of iatrogenic infection. In the last year, we have been consulted with regard to several febrile intensive care unit patients in whom sinusitis was initially identified by computerized axial tomography done for other reasons. The questions are: 1. are the x-ray findings significant; 2. is this the cause of fever and sepsis; 3. how should the patient be treated for this problem; and 4. can this be prevented. In five patients, sepsis was clearly related to sinusitis. Treatment had included nasal tubes in all six patients, and in addition, five patients had received high doses of corticosteroids while intubated. The sixth patient was a diabetic. Etiology, diagnosis, and management are discussed in detail. We believe that prolonged nasal intubation should be avoided, particularly in patients with decreased resistance to infection. Initial treatment consists of removing intranasal tubes and the administration of broad spectrum or culture specific antibiotics. Surgery is indicated in the event of persistent sepsis or secondary complications. Computerized tomography is an excellent tool for diagnosis and following response to therapy.

Adult↗
PubMed1985

Orbital complications of ethmoiditis.

Orbital infections are due to sinusitis in 75 per cent of cases and the ethmoid sinus is the most likely culprit. Aggressive and timely treatment is crucial if permanent disability and death are to be prevented.

Abscess↗
PubMed1984

Reconstruction of the stenotic hypopharynx and cervical esophagus without total laryngectomy.

Reconstruction for severe stenosis of the hypopharynx, laryngeal inlet, and/or cervical esophagus is a challenging problem for the surgeon and his patient who want to avoid total laryngectomy. We reviewed the case records of eight patients and the relevant published literature in an effort to define the requirements for success and the causes of failure. A variety of surgical techniques were used. Seven of 8 patients eat a normal or near normal diet. Two of 4 patients, who sustained laryngeal damage at the time of initial injury, required total laryngectomy because of persistent aspiration. The 2 remaining patients and the 4 patients, who did not sustain laryngeal damage at the time of injury, speak with a good voice. Total laryngectomy should be reserved for those patient who cannot be rehabilitated following optimal reconstruction.

Adult↗
PubMed1983

Selenium and glutathione peroxidase levels in patients with epidermoid carcinoma of the oral cavity and oropharynx.

Selenium ingestion may inhibit carcinogenesis. Epidemiologic studies have shown that age-adjusted death rates for cancer at most head and neck sites are lower in states where the soil and forage crops contain higher levels of selenium. The mode of action is incompletely understood, but may be mediated through an increase in the activity of the selenium dependent, antioxidant enzyme glutathione peroxidase (GSH-Px). The authors studied blood selenium levels and blood and tissue GSH-Px activities in 50 patients with untreated cancer of the oral cavity and oropharynx. Mean erythrocyte selenium and glutathione peroxidase were significantly depressed when compared to age-matched controls. Mean plasma selenium, on the other hand, was significantly elevated in the cancer patient group. Data from subsets within the cancer patient group were also discussed. GSH-Px activity did not differ in tumor and adjacent normal tissue. The concept of chemoprevention of carcinogenesis with inhibitory chemical compounds is particularly apropos to head and neck cancer control. Further work is indicated to determine if ingestion of supplemental selenium corrects the abnormalities identified here, and what affect, if any, this would have on the development and behavior of squamous cell cancers in the upper aerodigestive tract.

Aged↗
PubMed1982

Presence of cellular retinol and retinoic acid-binding proteins in epidermoid carcinoma of the oral cavity and oropharynx.

Epidermoid carcinomas of the oral cavity and oropharynx from six patients were examined for the presence and amount of cellular retinol (CRBP) and cellular retinoic acid-binding (CRABP) proteins. In all cases adjacent, grossly normal tissue was similarly examined. For each example CRBP levels were significantly higher in tumor tissue compared to adjacent tissue. In four cases CRABP was significantly higher. This is of interest because retinol, retinoic acid and their analogs have been shown to inhibit the development of various epithelial tumors, and this inhibition is possibly mediated by these binding proteins.

Carcinoma, Squamous Cell↗
PubMed1982

Venous drainage of the lateral trapezius musculocutaneous island flap.

The transverse cervical artery (TCA) and the transverse cervical vein (TCV) form the dominant vascular pedicle for the lateral trapezius musculocutaneous island flap. The experience of others described previously leaves little doubt as to the reliability of this flap. The anatomy of the TCA is such that we have encountered no difficulty in maintaining arterial flow through wide arcs of flap transfer. The TCV, on the other hand, is variable, and maintaining venous drainage may be difficult. After reviewing the available literature and finding little detailed guidance, we studied the anatomy of the TCV in nine patients undergoing surgery and in six fresh cadavers.

Humans↗
PubMed1982

The role of high resolution computerized tomography and standardized ultrasound in the evaluation of orbital cellulitis.

We reviewed the records of 22 patients with orbital cellulitis to determine the value of high resolution computerized tomography (HRCT) and standardized ultrasound (US) in their management. In 13 patients, they demonstrated abscess formation and accurately defined its location and extent. The appearance of an abscess did not necessarily mandate immediate surgery. Three patients responded promptly to intensive antibiotic therapy and resolved despite a presumptive diagnosis of orbital abscess. The remaining 10 patients required surgical intervention and abscess formation was confirmed. In patients presenting with good visual acuity and some globe motion we recommended instituting intensive intravenous antibiotic therapy for 36 hours with close monitoring of visual acuity, avoiding surgery unless some impairment of vision is noted. The decision regarding surgery is then made on the time honored basis of response to therapy. Surgery is no necessary in those patients exhibiting prompt significant improvement in local inflammatory signs.

Abscess↗
PubMed1982

The current status of diagnosis and treatment of cancer of the larynx and hypopharynx.

We have reviewed current thoughts on the diagnosis and treatment of cancer of the larynx and hypopharynx. Early diagnosis remains the key to successful treatment providing high cure rates and optimal function. Combined therapy (surgery, irradiation, and possibly adjuvant chemotherapy) is preferred in more advanced stage III and IV disease. Partial laryngectomies are oncologically sound when applied in appropriately selected patients and, when total laryngectomy is required, a simple endoscopic procedure has improved the outlook for speech rehabilitation. Reconstruction following laryngopharyngectomy has been strengthened by the advent of the myocutaneous flaps, and gastropharyngeal anastomosis provides for adequate excision of cancers involving the esophagus and immediate restoration of function.

Follow-Up Studies↗
PubMed1982

Development of a large scale baboon breeding program.

A unique 6-acre corral facility and defined program for large-scale breeding of baboons, Papio sp, was developed. The colony produced approximatley 200 infants, with known biological characteristics, per year. This program served as a national resource, and provided domestically reared animals for biomedical research investigators in the United States.

Animal Husbandry↗
PubMed1981

Rare complications following ethmoidectomies: a report of eleven cases.

Intranasal ethmoidectomy is one of the most difficult operations to teach residents. An accurate knowledge of the regional topographic anatomy is of utmost importance. Friedman and Kerr reported complications of 1000 cases of consecutive intranasal ethmoidectomies performed at the Mayo Clinic from 1957 to 1972. The complication rate was 2.8%. Meningitis, cerebrospinal fluid rhinorrhea, loss of olfaction, and nasolacrimal duct obstruction were reported. No blindness, loss of occular motility, excision of brain tissue or intracranial vessel damage occurred in their series. We are reporting a series of 8 cases of very rare complications following intranasal ethmoidectomies: 1. Optic nerve damage resulting in total blindness (3 cases). 2. Loss of occular motility (2 cases). 3. Cerebrospinal fluid leak resulting in 8 episodes of pseudomonas meningitis and epidural abscess (1 case). 4. Cavernous sinus--internal carotid artery fistula (1 case). 5. Anterior cranial fossa brain damage resulting in death (1 case). These cases, which were either referred to us or came up for our review, are described in detail. A search of the world literature demonstrates a lack of emphasis on such complications. The pitfalls of intranasal ethmoidectomy are considered and ways to avoid such dreadful complications are discussed.

Adult↗
PubMed1981

Congenital choanal atresia.

Bilateral choanal atresia is a medical emergency. With good nursing care and close observation, surgery may be delayed until it is deemed safe and there is a good chance of success. Surgical treatment of unilateral atresia is better delayed to optimize the conditions for successful surgery. There are three surgical approaches for the correction of this anomaly: transnasal, transpalatal, and trans-septal. Each has advantages and disadvantages. The patient's age is an important consideration in the choice of the technique. Partial vomer removal minimizes the likelihood of restenosis. It is widely accepted that the transnasal microsurgical technique has improved the safety and success rate in infants and younger children. The transpalatal or trans-septal approach is preferred in older children and adults.

Airway Obstruction↗