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Biomedical subjects

B C Stack

Publications and source records attributed to B C Stack.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Digital vs 35-mm photography. To convert or not to convert?

OBJECTIVES: To compare the quality of images generated from a conventional 35-mm camera with those generated from various digital cameras; and to note the costs of the cameras and ease of use. DESIGN: A prospective, randomised, independent analysis of specific facial images taken with a 35-mm camera and 3 digital cameras by 3 facial plastic surgeons who were blinded to camera type. SETTING: An academic medical center. SUBJECTS: Thirteen volunteer subjects ranging from age 27 to 58 years. MAIN OUTCOME MEASURES: The overall quality, focus, distortion, trueness of color, resolution, contrast, and presence of shadows were evaluated for each image. Attributes were scored on an ordinal scale of 1 to 5. A 1-way analysis of variance was used to test whether the average scores across cameras were significantly different. Results using analysis of variance did not differ from the results using a nonparametric Kruskal-Wallis test. When significant differences were found, the Duncan multiple range test was used to group significantly different scores. RESULTS: The null hypothesis that there is no difference between photographs taken with the various cameras was rejected (P < .001) for each of the image attributes. The images produced by the 35-mm camera (Nikon 6006) had the best overall quality, followed by the Olympus D600L, Kodak DCS 315, and Olympus D320L digital cameras. Differences in individual attributes between several of the cameras in each category were statistically significant (P < .05). CONCLUSIONS: The 35-mm camera produced the best overall image quality and ranked first for each of the individual attributes analyzed in this study. The Olympus D600L digital camera placed second in overall quality, but there was no statistically significant difference in focus, distortion, and resolution compared with the images generated by the 35-mm camera. The Olympus D600L digital camera also ranked second in color, contrast, and shadow. The Kodak DCS 315 and D320L digital cameras finished well behind the 35-mm camera in most categories. Although the 35-mm photographs were superior to the digital images, the surgeon should also consider other factors before selecting a system for photodocumentation of surgical results.

Adult↗
PubMedDate not supplied

Cost considerations of converting to digital photography.

OBJECTIVES: To provide the practicing surgeon with data to make an informed economic decision regarding conversion from analog to digital photography. METHODS: A cost analysis of photography based on 35-mm vs digital platforms (low-, medium-, and high-cost hardware). RESULTS: Break-even thresholds for the investment in a digital platform of low, medium, and high costs were 3674, 15,789, and 34,000 images, respectively. CONCLUSION: Given the current excellent image quality and ongoing refinements in digital photography, a digital photography platform may be cost-effective for a busy facial plastic surgery practice.

Analog-Digital Conversion↗
PubMedDate not supplied

Epiglottic abscess.

BACKGROUND: Epiglottitis is more commonly seen in children less than 6 years of age, although this entity has also been well described among adults. A coalescence of infection of the epiglottis, or epiglottic abscess, has been infrequently reported in series of epiglottitis. Risk factors for epiglottic abscess include adult age at onset, diabetes, and the presence of a foreign body. METHODS: Case study. RESULTS: We present a case of a woman with a 4-day history of febrile illness, odynophagia, and an altered voice. Clinical examination and computed tomography (CT) demonstrated an epiglottic abscess. The patient underwent direct laryngoscopy, intubation, drainage of abscess, and intravenous antibiotics. CONCLUSIONS: The diagnosis of epiglottic abscess should be considered in adult patients initially seen with odynophagia and dysphonia. Principles of treatment include airway management, antibiotics, and surgical drainage.

Abscess↗
PubMedDate not supplied

Arytenoid subluxation from blunt laryngeal trauma.

Isolated arytenoid dislocation and subluxation are uncommon laryngeal injuries most often resulting from endotracheal intubation. However, these diagnoses must be entertained in all patients having sustained laryngeal trauma. Complaints of dysphonia, pain with phonation, or odynophagia in the setting of laryngeal trauma should include evaluation for possible arytenoid displacement after an airway is secured. Prolonged hoarseness or odynophagia after endotracheal intubation should alert the physician to the possibility of a cricoarytenoid joint injury. This represents the first reported case of isolated arytenoid injury resulting from blunt external trauma to the larynx. The patient had a stable airway without intervention, and the displaced joint spontaneously relocated with resolution of the cricoarytenoid edema and hemarthrosis. We propose that the cricoarytenoid joint was subluxed probably due to edema, hematoma, and/or cricoarytenoid hemarthrosis sustained from blunt laryngeal trauma. We furthermore propose that some cases of cricoarytenoid subluxation may be treated without operative intervention.

Adult↗
PubMedDate not supplied

Costal osteomyelitis after pectoralis major myocutaneous flap use in head and neck reconstruction.

Costal osteomyelitis and chondritis are rare complications of PMMF usage. They probably represent a secondary complication of a donor-site infection. This diagnosis must be considered in cases of PMMF donor-site infections, which fail to resolve with local wound care and antibiotics. Antibiotic coverage in these cases should be taylored to culture results, while having broad gram-positive activity. Workup of these patients should include CT and biopsy to rule out a neoplastic process.

Aged↗
PubMedDate not supplied

Single versus dual venous drainage of the radial forearm free flap.

PURPOSE: To compare single versus dual venous drainage of radial forearm free flaps (RFFF) and its impact on flap survival. DESIGN: A retrospective case series of 43 consecutive patients undergoing radial forearm free flap reconstruction for head and neck cancer defects, combined with a meta-analysis of 218 reported cases. SETTING: Two academic, tertiary referral medical centers. INTERVENTION: All 43 RFFF's were harvested and inset in a similar fashion. In 16 patients (group 1), two venous anastomoses were performed. In 27 patients (group 2) one anastomosis was created. The arterial anastomosis was similar in both groups. OUTCOME MEASURES: Clinically noted viability of the radial forearm free flap over the first 6 postoperative weeks. RESULTS: All 43 RFFFs maintained complete viability. No flap loss, complete or partial, was identified. Two patients in group 1 and one patient in group 2 developed postoperative pharyngocutaneous fistulae, but complete healing occurred with local wound care. One patient in group 2 developed a postoperative neck hematoma, which was evacuated with no insult to the free flap. Single venous anastomosis shortened operative time by 21 to 36 minutes. CONCLUSION: Though two venous anastomoses may provide a more fail-safe mechanism for adequate venous drainage, a single venous anastomosis employing a subcutaneous vein provides adequate drainage with reduced operative time and no additional morbidity. Meta-analysis statistically confirmed the equivalency of single and dual venous anastimoses (correction of amastimoses) with respect to flap survival.

Adult↗
PubMedDate not supplied

Simultaneous squamous cell carcinoma of the head and neck and reticuloendothelial malignancies.

BACKGROUND: Multiple primary neoplasms have been reported 4% to 26% of patients with a squamous cell carcinoma (SCC) of the head and neck. The vast majority of these second primaries are SCC and occur in the upper aerodigestive tract; however, head and neck SCC patients are also at higher risk for nonepidermoid neoplasms at any site. Reticuloendothelial malignancies (REM) have been reported in many patients that have SCC of the head and neck as well. METHODS: Retrospective case series of 5 advanced cases of SCC of the head and neck with synchronous REM. RESULTS: There was 40% mortality with 19.4 months mean follow-up. Fifty percent of the case had simultaneous cervical involvement with both processes. CONCLUSION: REM can occur simultaneously with SCC of the head and neck and confound staging of nodal status. Head and neck SCC patients are at increased risk for REM secondary to age and treatment factors.

Age Factors↗
PubMedDate not supplied

Overexpression of MPS antigens by squamous cell carcinomas of the head and neck: immunohistochemical and serological correlation with FDG positron emission tomography.

Survival from advanced primary or recurrent Squamous Cell Carcinoma (SCC) of the head and neck (H&N) is poor. More accurate detection of primary tumors and recurrence may provide ways to improve survival. No standard serum tumor marker is routinely used for surveillance of SCC-H&N. In this paper, we evaluated the performance characteristics of the MPS-H tumor marker test for the quantitative measurement of "MPS-H" heat-generated immunoreactive proteins and assessed the clinical utility of this marker in the detection and monitoring of SCC-H&N. In approximately 92% of the subjects having no evidence of SCC-H&N, the MPS-H levels were lower than 15 ng/mL. In 76% of patients having SCC-H&N at various stages (T1-T4), the MPS-H level was > 15 ng/mL (range: 20-200 ng/mL). In addition, we found a statistically significant correlation between PET positive cases and high MPS-H serum levels in SCC-H&N patients with recurrent disease. These results suggest that MPS-H may provide an initial screening test that would allow for selective PET imaging in these patients. Furthermore, we found that there was greater expression of MPS-1 in tumors of higher histological grades. Thus, in tumors with more histological aggressiveness there is more MPS-1, indicating the potential usefulness of this marker in prognosis for SSC-H&N. Considering the immunohistochemical, serological, and FDG-PET data presented here, and the compelling need to expedite the early diagnosis of primary and recurrent epithelial malignancies of the head and neck, we are further evaluating the system of MPS antigens in a large patient population as a tool for the early serologic and histologic diagnosis of SCC-H&N.

Adult↗