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Biomedical subjects

G H Conner

Publications and source records attributed to G H Conner.

At least 19 recordsLinked to original sources
PubMed1987

Human papillomavirus type 16 in bowenoid papulosis, intraoral papillomas, and squamous cell carcinoma of the tongue.

A 33-year-old immunosuppressed man developed bowenoid papulosis on his genitalia, velvety papules and plaques in his mouth, and invasive squamous cell carcinoma of his tongue. All three lesions were positive for human papillomavirus type 16 (HPV-16). The case provides further circumstantial evidence for a role of HPV-16 in epithelial neoplasia. The possible roles of a second HPV infection and of immunosuppression are also discussed.

Adult↗
PubMed1985

A comparison of retention and complication rates of large-bore (Paparella II) and small-bore middle ear ventilating tubes.

Large-bore myringotomy tubes are usually reserved for the treatment of refractory middle ear effusion. Theoretically, they have an extended intubation time and a higher complication rate. There is, however, scant support of this in the literature. The duration of intubation, efficacy, and complication rates of the large-bore Paparella type II tube were compared with Paparella type I, Shepard, and Armstrong tubes. The study included 242 patients with 600 intubations. In addition, a subpopulation of patients receiving their initial intubation during this study was reviewed. Findings were similar for both groups. Paparella type II tubes had a prolonged period of intubation and a decreased reintubation rate when compared with the smaller bore tubes. Larger bore tubes had an increased complication rate when compared with the smaller bore tubes. Complications included occasional or frequent otorrhea and an increased rate of permanent perforation of the tympanic membrane. There was no instance of cholesteatoma formation secondary to intubation. Guidelines are presented for the use of the Paparella type II tube.

Adolescent↗
PubMed1984

Clinical experience with the silicone tracheal cannula in obstructive sleep apnea.

The surgical and postoperative course was evaluated in 20 patients with severe obstructive sleep apnea who underwent tracheostomy in which a silicone tracheal cannula was used. The cannula has been introduced recently by Dr. William Montgomery for use in a variety of clinical settings. Our findings indicate that the silicone tracheal cannula is a simple and reliable method of maintaining the tracheal airway in patients with severe sleep apnea. There were infrequent complications and a high degree of patient acceptance with this surgical procedure. Advantages of the silicone tracheal cannula include ease of insertion (especially in the often obese neck of the patient with sleep apnea), the inconspicuous nature of the cannula itself, the ease of care, and the maintenance of speech. Thus our clinical experience with this new tracheal cannula in the treatment of certain types of sleep-related breathing disorders indicates that it has a number of advantages as well as infrequent complications.

Adult↗
PubMed1983

Hydrops following perilymph fistula repair.

A series of 15 ears were explored for perilymph fistulas. Fifteen fistulas were found in 13 ears. Two cases are presented which developed hydrops-like symptoms only after closure of their fistulas. Closure of the other patients' fistulas was successful in relieving vertiginous symptoms, although hearing seldom improved. There were no significant complications of surgery. Fat failed as a graft material 4 of 10 times, whereas vein and perichondrium were not associated with recurrence of symptoms. The ENG-fistula test, as described by Daspit and associates, correctly predicted the presence or absence of a fistula in 7 of 8 ears tested. Hennebert's sign correctly predicted fistulae in 2 ears, and Hennebert's symptom was associated with proven fistulae in 9 of the 10 times it was present. Because of the low morbidity and the high success rate of surgery, a patient with a history suggestive of a perilymph fistula should have exploratory tympanotomy, particularly if the ENG-fistula test is positive.

Adult↗
PubMed1983

Benign osteoblastoma of the temporal bone.

Benign osteoblastoma is an uncommon tumor in the skull and particularly rare in the temporal bone. This article presents the clinical, radiologic, and pathologic findings of the fifth case known to involve the temporal bone, and only th second case limited to the temporal bone itself. Subtotal removal was performed following embolization of the tumor. The patient currently has no evidence of disease eighteen months following therapy. Benign osteoblastoma is rarely synchronously or metachronously associated with its malignant counterpart, osteosarcoma. Treatment should be conservative. Subtotal curettage is acceptable and often results in long-term resolution. Radiotherapy is not recommended unless the removal is incomplete and the consequences of local recurrence are serious, as in vertebral lesions. This lesion may be highly vascular, and preoperative embolization should be considered to minimize blood loss at surgery.

Adolescent↗
PubMed1982

The flat trachea: a cause of tracheal obstruction and its surgical management.

Tracheal obstruction requires aggressive evaluation to determine the cause and possible correction. An unusual presentation in an adult man with a primary tracheal malformation is described. Surgical reconstruction was performed, utilizing Erich dental arch bars for external stenting. The results were excellent. To our knowledge, the procedure discussed has not been described and may be applicable elsewhere in tracheal reconstructive procedures.

Humans↗
PubMed1982

Malignant external otitis: long-term (months) antimicrobial therapy.

Since Chandler's initial report in 1968 on "malignant external otitis" (MEO), this entity has been recognized in its earlier stages with increasing frequency. As a result of this, the availability of new antimicrobial agents, and the judicious use of surgery, there has been an improvement in the results of therapy. There remains, however, a subgroup of patients who continue to experience a significant mortality from this infection. A review and selected discussion of our experience with MEO from 1976 to 1979 is presented. Six patients have been diagnosed and successfully treated for MEO. They presented with problems ranging from severe otalgia to multiple cranial neuropathy. For the most part, therapy consisted of the now standard aminoglycoside and carbenicillin combination. Two of the patients were in the high mortality risk group. One of these patients developed an osteomyelitis which extended across the skull base resulting in bilateral cranial neuropathies. His therapy included surgery as well as long-term (months) outpatient treatment with tobramycin and carbenicillin with an excellent result. The second patient was treated similarly. The efficacy of this approach is discussed as well as the usefulness of radionuclide bone scanning in assessing the course and therapy of patients with MEO.

Aged↗
PubMed1982

Aerodigestive tract papillomatosis: bacille Calmette-Guérin (BCG) immunotherapy.

Aerodigestive tract papillomatosis (ADTP) remains a distinct challenge for the otolaryngologist. None of the myriads of therapies utilized to date offers a distinctly improved prognosis with less frequent clinical recurrences or absolute cure rates. Significant complications are avoided by withholding tracheotomy whenever possible and avoiding overly aggressive papilloma removal. Laser technology seems to offer a distinct benefit as regards the latter. Despite much activity in this area, little new knowledge has actually influenced the outcome of patients afflicted with papillomatosis. The disorder remains one of long-term morbidity in those acquiring it early in life and one with a significant rate of mortality for those with involvement of the lower airway. A review and selected discussion of our experience at The Milton S. Hershey Medical Center of The Pennsylvania State University with ADTP from 1974 to 1981 is presented. Nineteen patients ranging in age at the time of presentation from 1.5 to 68 years old have been diagnosed and treated. For the most part, therapy consisted of repeated microendoscopies with forceps removal of papillomas until recurrences ceased. However, in four adult patients with either rapidly recurring laryngeal and/or tracheobronchial papillomas, bacille Calmette-Guérin (BCG) immunotherapy has been administered. Two of these patients are evaluable for greater than 12 months. The rationale and efficacy of the treatment of a high risk group in this fashion are discussed.

Adolescent↗
PubMed1981

Basal cell adenoma of the major salivary glands. Report of a case with facial nerve encroachment.

Basal cell adenoma of the parotid gland showed histopathologic evidence of facial nerve encroachment. A review of the pertinent literature and a discussion of current concepts of histogenesis of the tumor indicate that a spectrum of benign to malignant forms of this unusual tumor may exist. The sparsely reported association of this tumor and its malignant variants to facial nerve pathology is discussed, and recommendations for treatment are made.

Adenoma↗
PubMed1980

Immunologic effects of experimental iodine toxicosis in young cattle.

A study was designed to evaluate effects of 4 dosage levels (0, 50, 250, or 1,250 mg) of daily iodine supplementation on cell-mediated and humoral immune mechanisms in 40 calves, 10 per group, for a 6-month period. Immune and inflammatory responses were measured by titers to brucella, leptospira, and infectious bovine rhinotracheitis virus vaccinations, by stimulation of lymphocyte mitoses with poke-weed, phytohemagglutinin (PHA), and conconavalin A mitogens, by intradermal PHA responses, by in vitro phagocytosis of Candida albicans by WBC, and by total WBC counts. Calves given 1,250 mg of iodine daily had significant (P = less than 0.05) decreases in persistence of antibody titers to brucella and leptospira organisms, in lymphocyte mitotic activity, in PHA injection induration, in phagocytosis by WBC, and in WBC counts. Calves fed iodine at 50 or 250 mg daily tended to have decreased leptospiral titers, lymphocyte mitoses, PHA injection induration, and in vitro phagocytosis by WBC compared with responses of controls. Seemingly, large amounts of dietary iodine interfere with titer maintenance to some antigens, with lymphocyte DNA synthesis, and with phagocytic activity of WBC.

Animals↗
PubMed1979

Tumor sterilization following high-dose pre-operative irradiation for advanced cancer of the larynx or pyriform sinus.

Twenty-two patients with advanced laryngeal cancer and 5 with advanced pyriform sinus cancer were given 51 Gy (5,100 rad) followed by surgical resection. In 10 (45%) of patients with laryngeal cancer, no tumor was found at the primary site pathologically; 15 (68%) had negative neck specimens. All of those with pyriform sinus cancer had positive specimens. Eighteen patients with laryngeal cancer are free of disease. In contrast, only 1 with pyriform sinus cancer is free of disease; 1 has had a local recurrence and 3 have had metastases. The data suggest that 51 Gy (5,100 rad) are insufficient to sterilize pyriform sinus cancer; higher doses together with adjuvant chemotherapy are needed.

Adult↗
PubMed1977

Orotracheal intubation in the newborn.

One hundred consecutive cases of orotracheal intubation in the premature and term newborn at the Hersehy Medical Center were studied retrospectively. The reason for intubation was for respiratory failure most commonly associated with hyaline membrane disease. The duration of intubation ranged from six hours to 63 days. Seventy-nine percent required intubation for more than 24 hours and 28 percent required intubation for more than one week. No tracheotomies were performed. There were 56 survivors, 50 of which were seen in follow-up examination at three, six or 18-month intervals. There were no cases of clinically evident upper airway damage or obstruction in this group. Post mortem examinations were carried out on 35 infants with tracheal necrosis found in one case. The authors feel that orotracheal intubation is superior to nasotracheal intubation and tracheotomy in this age group. This method of management should be carried out where there is adequate trained personnel and professional staff and equipment capable of proper orotracheal tube placement and management.

Follow-Up Studies↗
PubMed1977

Immune responses of the bovine fetus.

The bovine fetus is capable of mounting an antibody response when a bacterial antigen (killed Escherichia coli) or viral antigen (live reovirus) is deposited into the amniotic fluid. Time required for the fetus to respond to bacterial antigen given orally (amniotic fluid) is approximately 10 to 14 days and 8 to 10 days for viral antigen. Calves vaccinated prenatally with E. coli from 9 to 102 days before birth and deprived of colostrum survived oral challenge doses of viable E. coli which killed calves not vaccinated prenatally. One mechanism of protection was the local production of antibody in the gastrointestinal mucosa where immunofluorescent techniques showed immunoglobulins IgG, IgM, and anti-E. coli antibody in the duodenum, jejunum, and ileum as well as in the jejunal lymph node. Prenatal vaccination has been used in the field for prevention of colibacillosis. However, the occurrence of some stillbirths and premature births indicates the need for further research before there can be widespread field application of the technique.

Amniotic Fluid↗