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Biomedical subjects

D A Jaques

Publications and source records attributed to D A Jaques.

13 recordsLinked to original sources
PubMed1991

Percutaneous endoscopic gastrostomy in patients with head and neck malignancies.

One hundred thirty-six percutaneous endoscopic gastrostomies (PEGs) were placed in 126 patients with head and neck malignancies. PEG was performed by the "push" technique described by Russell. There were 140 PEG attempts, with 136 successful placements (97%). Seven complications occurred related to tube placement (5% of placements). Complications encountered were prolonged ileus in one patient (1%), local skin wound infection in one patient (1%), and early tube dislodgment in five patients (4%). Three patients required laparotomy (2%). There were no episodes of aspiration and no deaths. Patients were followed up for an average of 11 months, with a mean duration of PEG tube placement of 6 1/2 months. Patients continued PEG feedings throughout the postoperative radiotherapy period and until oral intake was satisfactory. Acceptance of PEG feedings has been high. No patient required rehospitalization for nutritional support.

Enteral Nutrition↗
PubMed1979

Liposarcomas of the head and neck: a review of the literature and addition of four cases.

Liposarcomas of the head and neck are rare. There have been 25 previously reported patients in the literature. Four patients with head and neck liposarcomas, recently treated by the Head and Neck Surgery Service, Walter Reed Army Medical Center, are presented. Less than half of reported patients were noted to be living without evidence of disease. Prognosis generally corresponds to the cell type of the tumor. Intraoral, cheek and orbital tumors seem to have a worse prognosis compared to neck tumors. Wide local excision remains the treatment of choice. Advances in surgical techniques have allowed adequate therapy for most head and neck liposarcomas. Advanced lesions should be managed by conservative surgery and radical radiation therapy.

Adolescent↗
PubMed1978

Simultaneous recurrent multiple chemodectomas.

We report a case of concomitant, recurrent carotid body tumor and recurrent bilateral glomus jugulare tumors, with extensive intrajugular-venous extension. The patient's family history confirms the previously reported familial occurrence of chemodectomas. The value of preoperative angiographich evaluation is emphasized in establishing a diagnosis and formulating a therapeutic approach. Recurrence of chemodectomas after appropriate therapy, although unusual, was present in all three previously treated sites in this patient.

Adult↗
PubMed1978

Cervical presentation of thymic cysts.

Sixteen cases of cervical thymic cyst are added to the previously reported fifty-six cases. Seventy-five per cent of the patients were less than twenty years old. Eighty per cent complained of a painless mass preoperatively. The histologic diagnosis of cervical thymic cyst was made if thymic epithelial elements could be found adjacent to the cyst cavity; Hassall's corpuscles were usually present. Cholesterol granulomata could usually be identified. The theories of origin of cervical thymic cyst are discussed.

Adolescent↗
PubMed1978

The surgical management of recurrent parotitis.

Twenty-eight parotidectomies were carried out upon 26 patients with chronic parotitis. The lesion considered is chronic inflammation of the parotid gland associated with such intraglandular defects as sialadenitis secondary to ductal obstruction by calculi, cellular debris, stenosis or infiltrating lesions, that is, Mikulicz's or Sjögren's syndromes and sialoangiectasis, either primary or secondary to obstruction of the duct. Seventeen near total parotidectomies were done without significant complications or a recurrence of symptoms. Eleven superficial parotidectomies were performed in which symptoms recurred on the 12th postoperative day in one patient. No permanent weakness of the facial nerve occurred in any of the 28 parotidectomies. Based upon this experience, near total parotidectomy with removal of the parotid duct can be performed safely and should be the procedure of choice in patients with chronic, relapsing parotid sialadenitis.

Chronic Disease↗
PubMed1977

Squamous cell carcinoma of the buccal mucosa associated with chronic oral polyvinyl chloride exposure: report of a case.

The following case report describes a 22-year-old healthy man, non-smoker, non-drinker, who developed a squamous cell carcinoma of the buccal mucosa. The appearance of this unusual tumor in an unexpected clinical setting was unexplained until it was discovered that the patient had a lifetime habit of chewing plastic materials containing polyvinyl chloride (PVC). The extent and chronicity of his intense oral exposure to PVC is believed to be related to his subsequent development of an oral neoplasm. Attention is again focused on PVC as an important environmental toxin and carcinogenic agent. Clarification of the content of PVC in consumer products is urged. Physicians must remain aware of possible environmental carcinogens in patients presenting with unexpected or rare malignancies. Detection of such exposure may well prevent subsequent development of additional unexplained neoplasms.

Administration, Oral↗
PubMed1976

Ultrasound of the parotid gland.

Five cases of parotid gland masses were studied by ultrasound. Only retention cysts and true cysts of the parotid gland appear sonolucent at low and high gain settings. Benign and malignant tumor present as solid masses except for the Warthin's tumor which is sonolucent at lower gain settings but has a lattice of internal echoes at higher gain settings.

Adenolymphoma↗
PubMed1976

Parotid tumors in children.

Most salivary gland tumors, both benign and malignant, develop within the parotid glands. Although an overwhelming majority of tumors are reported in the adult population, the parotid glands are also the most frequently involved salivary glands in the pediatric age group. This study represents a combination of case material from the Armed Forces Institute of Pathology and our personal experiences. Of approximately 10,000 salivary gland lesions accessioned in all ages, only 124 tumors occurred in the parotid gland in children less than fifteen years old. There were ninety benign and thirty-four malignant lesions. The two most common benign masses were mixed tumors and vascular lesions. The most common malignancies were the mucoepidermoid and acinic cell carcinomas. We recommended that all solid tumors be removed by parotidectomy.

Adenocarcinoma↗
PubMed1975

Carcinoma of the oral cavity. An analysis of 478 cases.

Evaluation and analysis of 478 cases of carcinoma of the oral cavity treated from 1947 through 1970 shows a significant improvement in radiotherapy in the supervoltage (Co60) era. Survival in the early stages of disease (I and II) improved in the supervoltage era but not in the later stages of disease (III and IV). Results with combined therapy for advanced disease showed no significant difference from that of single mode therapy, whether with radiotherapy or with surgery in the supervoltage era.

Humans↗
PubMed1975

Chylothorax complicating radical neck dissection.

The third reported instance of chylothorax occurring after left radical neck dissection is presented and the literature reviewed. The pathogenesis appears to be lymphatic leakage in the neck with accumulation of chyle in the pleural space in spite of the absence of pneumothorax. The means for entry across an intact pleura is uncertain. The condition can be managed by conservative means consisting of adequate neck drainage and thoracentesis or chest tube drainage. A favorable outcome can be expected.

Carcinoma, Squamous Cell↗