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Biomedical subjects

D G Bowers

Publications and source records attributed to D G Bowers.

8 recordsLinked to original sources
PubMed1978

Adriamycin extravasation.

Adriamycin extravasation creates a severe tissue necrosis which is unusual, because it may not appear until several weeks later, and may continue to worsen for several months. As soon as the progressive nature of the tissue necrosis is established, we recommend that an early wide excision be performed in an attempt to remove the necrotic area and the surrounding tissues containing the extravasated drugs--before it has had an opportunity to diffuse even further. Adequate debridement requires removal of any adjacent tissue that is indurated, reddened, edematous, or pale. Skin grafts take poorly if there are small amounts of Adriamycin left in the tissue of the recipient site. Synergistic effects with radiotherapy, and continued systemic Adriamycin therapy, can aggravate or recall necrosis. The administration of more dilute solutions of Adriamycin may decrease the hazard of extravasation necrosis.

Doxorubicin↗
PubMed1978

Fibrinolytic activator activity in human neoplasms.

The results of this study suggest that many malignant tumors contain low levels of fibrinolytic activator activity. Evidence is presented to suggest that this low activity may be due to the presence of an inhibitor of fibrinolysis. The presence or absence of measurable fibrinolytic activator activity, and/or inhibitor in neoplastic growths may enable one to predict the probability of viable metastases to a distant site.

Anticoagulants↗
PubMed1977

Management of facial fractures.

Maxillofacial fractures are usually diagnosed easily by history, clinical findings, and standard roentgenograms. Emergency treatment centers around airway management; the conscious patient should be allowed to clear his own airway whenever possible. Treatment of lower and upper jaw fractures focuses on reducing the fragments so that dental occlusion is normal. Other midface fracture reductions require additional exact orbital rim alignment. Immobilization of fractures can require various combinations of intermaxillary fixation, interosseous wiring, suspensory wires from intraoral arch bars, transfacial Kirschner wires, occasional maxillary antral packs, and rare external fixation with headframes or external pins. Patients who may be comatose or seriously ill for several weeks should have a simple and safe compromise reduction and K-wire fixation done at the bedside. Management of blow-out fractures of the orbit and frontal sinus fractures is somewhat controversial. Naso-orbital central factial fractures are especially difficult to maintain in proper reduction. Listed are possible late postoperative complications after treatment of facial fractures.

Airway Obstruction↗
PubMed1976

Observations on the myth of "informed consent".

A series of 100 patients in a general plastic surgery population were interviewed by standard format to determine their retention rate of preoperative information given to them. An overall recall, or retention rate, of 35 percent was found.

Educational Status↗
PubMed1976

Cutaneous melanoma of the head and neck.

Melanoma of the head and neck, if diagnosed early and treated with aggressive appropriate surgical therapy, is potentially curable in up to 80 to 90 per cent of the cases. The use of microscopic staging by level of invasion and thickness of the tumor is helpful in determining the appropriate surgical procedure for the individual patient and is of prognostic significance. If possible, prophylactic incontinuity regional node dissection should be performed for melanomas of the head and neck that have invaded to Level III or deeper, especially those that are greater than 1.5 mm in thickness. The histological status of the regional nodes is beneficial both therapeutically and prognostically, in that patients who have negative nodes have a better prognosis than those with microscopically positive nodes. Also, these patients with microscopically positive nodes have a much better survival than those with macroscopically positive nodes. Melanoma of the head and neck should be treated very aggressively with wide excision of the primary tumor in order to prevent local recurrence and further spread of the disease. Since surgical treatment is the only effective curative measure for melanoma, all localized tumor in the region of the primary and solitary distant metastasis should be removed if possible. The adjunctive use of chemotherapy and immunotherapy when regional nodes are involved with melanoma is being studied and may be of some benefit. The combinations of surgical therapy, chemotherapy, immunotherapy, and radiotherapy offers the patient with advanced disease significant palliation, sometimes for prolonged periods. The treatment of head and neck melanoma is best summarized by the statement in the December 4, 1965 of The Lancet.-.29 "The surgeon who first operates on a malignant melanoma has a great responsibility. Prompt and competent action will give the patient a chance of survival better than in most other forms of cancer. The only additional operative surgical skill required is the ability to cut and apply split skin grafts. If he lacks confidence therein, let the surgeon refer the case at once and certainly before he has ruined, by niggling interference, the patient's chance of survival."

Adolescent↗
PubMed1976

Intraoral cancer of the minor salivary glands.

Intraoral minor salivary gland carcinomas are relatively uncommon. The glands are concentrated in the mucosa of the mouth but occur over a wide area in the head and neck region. Little is known about the etiologic factors responsible for these tumors. Histologically, most salivary gland tumors are similar to those occurring in the parotid gland, but are more likely to be malignant. The most common presentations is an asymptomatic submucosal mass on the palate in a patient in the fifth or sixth decade, although it can occur in any age group. Neck node metastases occur in about one fourth of these patients. Surgical resection is the treatment of choice; irradiation may be a useful adjunctive method of palliation. Multiple recurrences over a long period of time are the rule, with 5 year survival for all malignant lesions being 44.5 per cent. The survival decreases another 10 per cent for each succeeding 5-year period of follow-up.

Adolescent↗