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Biomedical subjects

E F Parker

Publications and source records attributed to E F Parker.

10 recordsLinked to original sources

Carcinoma of the esophagus. Long-term results.

Between 1940 and 1967, we treated 609 patients with primary carcinoma of the esophagus by three different methods. In the first group of 170 patients, surgical resection predominated. In the next 166 patients, radiation therapy was used as the primary method. In a third group (135 patients) and a fourth group (138 patients), radiation therapy was followed by resection in the operable cases. After comparing the results of the three methods, we believe that radiation therapy followed by resection produces the best results. Moreover, this approach is justified by the discovery of residual carcinoma in most surgical specimens from patients who have had radiation therapy.

Carcinoma, Squamous Cell

Dirofilaria immitis (dog heartworm) as a pulmonary lesion in humans.

Dirofilaria immitis, the dog heartworm, has been identified in the pulmonary granulomas of 5 patients from the greater Charleston area; this is the largest series of such cases from one medical center. The patients had no pulmonary symptoms. On roentgenogram the lesions were all about 2 cm in size, of uniform light opacity, and located near the pleural surface. Thoractomy was performed in each instance because of the possiblity of carcinoma. The association of granuloma formation, pulmonary infarct, and eosinophilic infiltration led to the suspicion of dirofilaria, which was confirmed in each case.

Adult

Carcinoma of the esophagus.

Life tables were computed from the Tumor Registry at the Medical University of South Carolina on 486 patients with histologically proven squamous cell carcinoma of the esophagus. The 5-yr follow-up was available in only 394 patients, or 81% of the total sample. For purposes of comparison with published literature, the traditional crude 5-yr survival percentages in the life-table analyses figures are presented. The life-table calculation utilizes all follow-up information available, in that patients observed for less than 5 yr still may contribute to the estimate of the true 5-yr survival rate in contrast to the past when all patients lost to follow-up were presumed to have died. In this method, patients not observed for the full time of the study are assumed to have had the same risk of dying as patients followed to the end of the fifth year experienced in their fifth-year analyses. The group with the most favorable prognosis in this series was that receiving preoperative irradiation. This operation. They were given 4,500 rads of supervoltage X ray over a period of 3 weeks prior to operation. The differences in surgical or radiation techniques employed by various reporters make comparative data difficult, if not impossible, to evaluate. Supervoltage irradiation has proved itself in some hands equal to surgery. A randomized prospective study would seem appropriate to conclude the best means of managing epidermoid carcinoma of the esophagus.

Age Factors

Effects of obstruction of cardiac lymphatics.

A study was undertaken in the dog to determine whether changes occurred in the lymphatics of the endocardium and myocardium of both ventricles after obstruction of the cardiac lymphatics. Other investigators have reported ventricular subendocardial hemorrhage, increased elastic and fibrous tissue in the left ventricle endocardium, and opacification of the mitral valve leaflets. In 14 experiments the ventricular walls were injected with India ink. The efferent cardiac lymphatics were followed to their termination in the cardiac lymph node or nodes. These nodes were excised, as were afferent and efferent lymphatic trunks. After 4 to 16 weeks, with the aid of extracorporeal circulation and oxygenation, biopsies were taken of the myocardium and endocardium of the ventricles of the beating heart. Six animals were used as control subjects. Grossly, there were no changes in the endocardium, myocardium, or valve leaflets. Light and electron microscopy demonstrated no fibrosis or elastosis, and no lymphatics were identifiable. We were unable to establish evidence of permanent changes as a result of obstruction of the lymphatics of the dog heart.

Animals

Effects of cardiac lymphatic obstruction on coronary arteries.

A study was undertaken to determine whether changes occurred in the coronary arteries of dogs after obstruction of the cardiac lymphatics. Other investigators have described changes in the walls of coronary arteries after cardiac lymphatic obstruction that caused compromise of the lumen. Adult mongrel dogs were subjected to an operation which occluded the cardiac lymphatics. Several days later, a second operation was done to remove specimens of the terminal branches of the coronary arteries. The specimens were studied by light and electron microscopy. There was no gross or microscopic evidence of altered morphology of the coronary arterial walls.

Animals