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Biomedical subjects

E T Mays

Publications and source records attributed to E T Mays.

At least 19 recordsLinked to original sources
PubMed1987

Steroid related neoplasia in human liver.

Prior to the early 1970's, benign liver neoplasms were among the rarest of tumors. The seemingly rapid increase, especially in young females ingesting oral contraceptives, as well as the catastrophic presentation of many of the tumors resulting from liver rupture and hemoperitoneum, stimulated studies by several investigators. In the Liver Tumor Registry at the University of Louisville, we have examined the histologic material, and finalized the data on 227 tumors, the majority in young women. With few exceptions, they had used oral contraceptives or were either pregnant or immediately post-partum and presumably in a hyperestrogenic state. There have been 82 hepatocellular adenomas (HCA), 105 cases of focal nodular hyperplasia (FNH), and 31 hepatocellular carcinomas. The hepatocellular carcinomas occurred in non-cirrhotic livers, and 14 of the 31 cases were of a distinct, but rare type, polygonal cell carcinoma with lamellar fibrosis. While it seems reasonable to believe steroids play a role in adenomas and in FNH it is less certain that they produce hepatocellular carcinomas since malignant liver tumors are not uncommon in this age group without the use of oral contraceptives. With an estimated 50 million women either currently using or who have used oral contraceptives the risk must be very slight.

Adenoma↗
PubMed1979

Hepatic artery ligation.

The use of hepatic artery ligation (HAL) in various clinical situations is illustrated by presenting a series of eight patients. The indications for HAL included ruptured hepatic tumors, spontaneous liver rupture, delayed hemorrhage after liver trauma, hematobilia, hepatic artery aneurysm, and hemorrhage after liver biopsy. Conventional methods of hemostasis had been used in some of these patients, but failed to control hemorrhage. The reasons for the relatively late adoption of hepatic artery ligation in treating liver hemorrhage are discussed and placed in proper prospective. Hepatic artery ligation has been shown to be such an effective method of controlling hemorrhage from the liver that other methods, such as packing and mass suture, which are unsafe and ineffective, should be abandoned. Major resection should be done only when an entire lobe of the liver is reduced to pulp or when exposure and repair of the retrohepatic vena cava are necessary.

Adult↗
PubMed1978

Selective management of post-traumatic obstructing intramural hematoma of the duodenum.

Fourteen patients with post-traumatic obstructing intramural duodenal hematoma were reviewed. Seven patients underwent exploration for associated injuries. Evacuation of the hematoma was performed in two patients. Of 12 patients treated by fasting, nasogastric decompression and parenteral fluid therapy, late obstruction of the duodenum developed in one patient, and operation was required. Criteria are discussed regarding evacuation of intramural hematoma of the duodenum found at celiotomy for associated injuries. In the typical patient with an isolated intramural hematoma in whom no other indications for operation are identified, aggressive nonoperative therapy is the preferred treatment.

Abdominal Injuries↗
PubMed1977

A clinicopathologic study of steroid-related liver tumors.

A registry of liver tumors was started in late 1973 in an attempt to assess the relationship of these tumors to oral contraceptives or to other environmental factors. This report is concerned with the pathological aspects and the possible pathogenesis of the first 101 tumors accessioned. There were 44 instances of focal nodular hyperplasia, 40 adenomas, four unclassified but probably benign tumors, and 13 hepatocellular carcinomas. Eighty-one patients took oral contraceptives; six were associated with pregnancy; three had taken estrogens for long periods of time; one had a thecoma; four never took sex steroids; and in five the history was unknown. Tumor rupture and intrahepatic hemorrhage were frequent complications. It is possible that the vascular lesions associated with focal nodular hyperplasia could play a part in their pathogenesis as well as with rupture. Foci of adenomatous hyperplasia may be related to the development of adenomas. The association of these tumors with sex steroids could be coincidental. The fact that none of the patients had cirrhosis of liver fibrosis, and that androgenic anabolic steroid therapy has been associated with hepatocellular carcinomas in males, suggests that further study of the problem is necessary.

Adenoma↗
PubMed1977

Selectivity in the management of hepatic trauma.

Retrospective review of 178 consecutive patients who sustained hepatic injuries confirms that selective application of hepatic artery ligation is an efficient means of definitive hemostasis. Only two of 20 immediate deaths resulted from hepatic parenchymal hemorrhage. Over-all mortality (20%) was not significantly increased where hepatic artery ligation was used. Sepsis was the most frequent complication after severe hepatic trauma.

Abdominal Injuries↗
PubMed1976

Hepatic changes in young women ingesting contraceptive steroids. Hepatic hemorrhage and primary hepatic tumors.

Primary hepatic tumors developed in 13 young women who had been ingesting contraceptive steroids. Nine tumors were benign, and four malignant. Six tumors ruptured spontaneously and caused life-threatening hemorrhage. Benign tumors were successfully resected in eight women. One woman died during hepatic resection for malignant hepatoma; in two other cases of hepatocellular carcinoma, tumors were nonresectable. In two patients, the tumor was left in situ after neoplasm had been excluded by biopsy. The increase of such tumors in women of childbearing age warrants the suspicion that these contraceptive steroid hormones play an etiologic role.

Adult↗
PubMed1976

Hepatic trauma.

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Adolescent↗
PubMed1976

Role of protein binding of cytotoxic anions in post-traumatic pulmonary insufficiency.

Anions of fatty acids infused intravenously into dogs clearly duplicate the clinical syndrome of post-traumatic pulmonary insufficiency (congestive atelectasis, shock lung, traumatic wet lung). Neutral fat embolized to the lungs is incapable of producing this syndrome within the time investigated. The incubation of fatty acid anions with human serum albumin before injection obviates the severe desaturation of blood and ultrastructure disruption caused by FAA alone.

Adolescent↗