PubMed Health⌕ Search

Biomedical subjects

G S Parker

Publications and source records attributed to G S Parker.

At least 19 recordsLinked to original sources
PubMed1992

Hematoma-induced flap necrosis and free radical scavengers.

Skin flap necrosis due to underlying hematoma can be devastating in reconstructive surgery. The production of free radicals in ischemic tissue and cellular damage caused by them have been well established. Deferoxamine, which is both an iron chelator and a free radical scavenger may have a dual benefit in the pharmacologic manipulation of necrosis in a flap jeopardized by hematoma. Past studies showing the importance of free radical scavengers in improving flap survival in hematoma-induced flap necrosis have used the rat model. The porcine model was used for this study because it is the animal model that most closely resembles human skin. A statistically significant benefit of deferoxamine in reducing necrosis of a skin flap induced by hematoma formation was found. Deferoxamine appears to be promising but requires further investigation before it can be optimally used in human applications.

Animals↗
PubMed1992

Subglottic and tracheal malignancies.

Subglottic and tracheal malignancies are the least frequently encountered laryngeal cancers. When these tumors are encountered, they have often reached advanced size prior to producing symptoms. Once symptoms are brought to the attention of the otolaryngologist, rapid and accurate diagnosis is essential to effect the earliest possible treatment and to minimize morbidity and mortality associated with this problem. Illustrative cases are presented including a highly unusual case that presented with cardiac-like chest pain. A review of the literature including the pertinent anatomy, pathophysiology, and methods of diagnosis and treatment is presented. Increased familiarity with this disease process and a high index of suspicion on the part of the otolaryngologist may lead to improved survival patterns in patients with these malignancies.

Adult↗
PubMed1991

Role of quinsy tonsillectomy in the management of peritonsillar abscess.

Peritonsillar abscess (PTA) is the most frequent complication of acute tonsillitis requiring surgical intervention. Debate continues concerning optimal therapy in terms of patient morbidity and cost-effectiveness. A retrospective study was performed on 45 tonsillectomies for PTA in military personnel from December 1986 through December 1988. Twenty-three quinsy (abscess) tonsillectomies and 22 interval tonsillectomies were identified. Parameters studied were age, sex, abscess location, interval prior to operation, blood loss, operative time, operative experience, and combined hospital and convalescent days for the two groups. Significant differences were noted between the quinsy and interval tonsillectomy groups concerning the average number of days hospitalized (3.0 versus 4.5) and their respective convalescent periods (10.3 versus 17.3). We conclude that quinsy tonsillectomy is the best management for PTA in a young work force when the optimal treatment choice is between interval or acute tonsillectomy.

Adolescent↗
PubMed1991

Indications for tonsillectomy and adenoidectomy.

Tonsillectomy and adenoidectomy are separate procedures that should be performed for distinct reasons. Studies now indicate that severe, recurrent pharyngitis responds well to tonsillectomy. According to separate recommendations from the American Medical Association and the American Academy of Pediatrics, patients are candidates for tonsillectomy if they have four or more episodes of pharyngitis a year. Recurrent otitis media and chronic otitis media are improved by adenoidectomy, although placement of pressure-equalizing tubes remains the preferred initial treatment for these conditions. Adenotonsillectomy improves severe upper airway obstruction (cor pulmonale and obstructive sleep apnea), as well as milder forms of airway obstruction (loud snoring). The effectiveness of these procedures in proposed indications, such as sinusitis and adenoiditis, is less well substantiated.

Adenoidectomy↗
PubMed1990

Metastasizing pleomorphic adenoma of the nasal septum.

Pleomorphic adenoma is the most common benign tumor of glandular tissue occurring in the head and neck region. There have been several reports of metastasis of this benign-appearing tumor from the salivary glands to distant sites, suggesting hematogenous spread and implantation. Although occurrence of pleomorphic adenoma on the nasal septum has been described, to our knowledge this is the first reported case of recurrent septal pleomorphic adenoma with histologically benign tissue in an enlarged metastatic ipsilateral submandibular lymph node, suggesting lymphatic spread. The literature concerning the subject is reviewed. Wide septal excision and modified neck dissection is the recommended treatment.

Adenoma, Pleomorphic↗
PubMed1990

Spontaneous cervical and mediastinal emphysema.

Subcutaneous cervical emphysema often appears as a result of surgery or trauma. However, when it occurs spontaneously, the patient may present with clinically impressive and dramatic features. The etiology is related to the rupture of terminal alveoli and dissection of air along the pulmonary vasculature. Exercise may contribute to the process by increases in intrathoracic pressure. Six cases of spontaneous cervical emphysema, all related to SCUBA diving training at a Naval facility, were recently seen at our institution. Proper management entails having a high index of suspicion for diagnosis, and then being able to identify potentially life-threatening complications.

Adult↗
PubMed1990

Adenoid cystic carcinoma of the trachea--a cause of pseudo-angina pectoris.

Primary tracheal tumors are rare. Typically slow growing, they present late in the course of disease, with obstructive respiratory symptoms. A 25-year-old man developed external substernal chest pain and pressure with dyspnea that were relieved with rest. Noninvasive evaluation identified a tracheal tumor, adenoid cystic carcinoma by biopsy, which was previously undescribed as a cause of pseudo-angina pectoris. The patient's evaluation, management, and 20-month follow-up are presented. A mechanism for the patient's noncardiac exertional chest pain is proposed. Previous experience with adenoid cystic carcinomas of the trachea is reviewed.

Adult↗
PubMed1989

Intracranial complications of sinusitis.

Sinusitis is a common problem that is routinely diagnosed and treated by most primary care physicians. Although most cases usually respond to appropriate therapy, some occasionally progress to the development of intracranial complications, including meningitis, osteomyelitis, epidural and subdural empyema, intracranial mucocele or polyps, and frank brain abscess. It is important to develop a rational approach to the diagnosis and treatment of these conditions. A high clinical index of suspicion must always be maintained, since symptoms are often masked by previous antibiotic therapy. Radiologic evaluation must always include computerized tomography (CT) for accurate diagnosis and surgical planning. Therapy includes surgical drainage and high doses of appropriate intravenous antibiotics. Cefuroxime and metronidazole provide excellent broad spectrum antibacterial coverage. Only early recognition and appropriate therapy can reduce the potential morbidity and mortality associated with these life-threatening complications.

Adult↗
PubMed1988

Burn scar carcinoma of the head and neck.

Carcinomas arising in burn scars are uncommon. Of the several hundred cases reported in the world's literature, 30% have been described in the head and neck region. Acute burn scar carcinoma, which occurs within one to two years of injury, is rare, while the chronic type, with an average latency of 35 years from injury to diagnosis, is much more common. Two cases of burn scar carcinoma are presented. Treatment is based on the histologic cell type (usually squamous cell or basal cell), in addition to the clinical stage. Adjuvant radiation therapy can often improve the results obtained with surgical excision alone. Proper initial treatment of burns, with early use of skin grafts, might curb the development of these potentially serious tumors.

Adult↗
PubMed1987

Post-tonsillectomy bleeding: an evaluation of risk factors.

While tonsillectomy is usually a safe operation, it is always accompanied by the risk of immediate postoperative bleeding. Despite continued efforts to eliminate this problem, it remains a persistent risk. In reviewing 775 consecutive cases of tonsillectomy, immediate postoperative bleeding occurred in 21 (2.7%). Diagnostic, demographic, hematologic, hemodynamic and surgical management factors were evaluated. The role of local anesthesia for tonsillectomy was also examined. Postoperative bleeders were more likely to have abnormal preoperative clotting studies, greater elevations of their mean postoperative blood pressures, and unusual surgical indications. Local anesthetic cases were shorter, had less intraoperative bleeding and were not associated with greater postoperative bleeding. We conclude that local anesthesia is safe and efficient and that identifiable factors are associated with primary post-tonsillectomy bleeding. An awareness of these factors can help identify potential postoperative bleeders.

Adolescent↗
PubMed1984

Eikenella corrodens. An emerging pathogen in head and neck infections.

Eikenella corrodens is a gram-negative, facultative anaerobe that exists as part of the normal oral flora. Its role as a pathogen in human infection has been disputed, but recently its pathogenic potential has been increasingly recognized. A review of the literature reveals the emergence of this organism as a pathogen in human infection. Specific microbiologic characteristics of this organism make it difficult to isolate and evaluate for antibiotic sensitivities. Infections produced by this bacteria are characteristically indolent in nature and are usually associated with oral contamination. Appropriate antibiotic therapy utilizes ampicillin or penicillin. Tetracycline is the drug of choice in the penicillin-allergic patient. Clindamycin resistance is a universal feature. A greater awareness of the pathogenic potential of E corrodens is essential for appropriate recognition and treatment.

Administration, Oral↗