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Biomedical subjects

J C Ross

Publications and source records attributed to J C Ross.

7 recordsLinked to original sources

Fine-needle aspiration in the diagnosis of salivary gland disorders in the community hospital setting.

From 1983 to 1988, 47 patients with salivary gland disorders were assessed with fine-needle aspiration (FNA) before surgery. The preoperative fine-needle diagnoses were then compared with the postoperative pathologic findings. In the same period, 63 patients from two other community hospitals who had been evaluated preoperatively with FNA were studied retrospectively. The overall sensitivity of FNA for salivary neoplasms was 80.6%. Fine-needle aspiration was more sensitive in identifying benign tumors (88.4%) than malignant neoplasms (58.3%) and was least sensitive in identifying nonneoplastic salivary diseases (35.3%). Pleomorphic adenomas were correctly identified preoperatively in 96.2% of cases, whereas for malignant neoplasms, the diagnostic accuracy was highest for mucoepidermoid carcinoma (50%). To demonstrate the strengths of FNA as a diagnostic tool, as well as to delineate its limitations, we present our 5-year experience. Our FNA results are similar to those reported by the major European and American referral centers. Because our medical centers are community based, our results may more accurately reflect those seen by otolaryngologists in private practice. To date, no evidence of tumor seeding along the FNA tract has been reported.

Biopsy, Needle

Ventricular dysphonia: a profile of 40 cases.

Ventricular dysphonia is a poorly understood disorder involving ventricular fold participation during phonation. A population of ventricular dysphonia patients was evaluated using phonatory function studies such as laryngovideostroboscopy, advanced acoustic analysis, and electroglottography to identify shared epidemiologic characteristics and to discuss possible neuromuscular mechanisms and causes. Forty patients with ventricular dysphonia were studied and epidemiologic, acoustic, and histologic data were analyzed. In almost all cases, the authors found abnormalities affecting the glottis caused by a related medical condition. The abnormalities included true vocal cord (TVC) aperiodicity in 100% of the patients, TVC asymmetry in 65%, a laryngeal mass or foreign body (usually Teflon) in 35%, TVC erythema or edema in 32.5%, and TVC bowing in 22.5%. Ventricular dysphonia seems to be primarily a compensatory mechanism for glottic dysfunction. Therapy is based on identifying and correcting the underlying abnormalities. Laryngovideostroboscopy is a particularly important tool in examining chronic dysphonia.

Adult

(Ludwig Guttmann)

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Anniversaries and Special Events

Clinical decision analysis. The hazard of using additional data.

Acquisition of laboratory data bearing on a clinical problem may make patient care worse rather than better. The hazards of obtaining new information, that go beyond the monetary costs and risks to physical well-being, are frequently not appreciated by physicians. In the complex and many-faceted practice of medicine, intuition, even when expressed by experienced clinicians, may lead to faulty judgments. Decision analysis gives a systematic exposition of clinical management, and lessens, if not eliminates, the influence of biased and unreliable intuition. With practice, most physicians could employ decision analysis to help solve moderately complicated problems at the bedside or in the office. Use of this tactic will make gaps in knowledge explicit, and may thereby stimulate investigations to ensure better clinical judgments in the future.

Clinical Laboratory Techniques

Division of the external urethral sphincter in the neuropathic bladder: a twenty years' review.

It is now twenty years since the authors first performed division of the external sphincter region in the treatment of the neuropathic bladder. Although a ten year report was published in 1967, it was decided to review all the patients at the end of the twenty year period. The rationale of the operation in the upper motor neurone lesion has been confirmed by modern investigative techniques, while it appears from recent work that the success of the procedure in the lower motor neurone case is due to division of plain muscle which is subjected to excessive sympathetic stimulation. It is the authors' firm conviction that long term catheterization, whether permanent or intermittent is a confession of failure and can be avoided in the vast majority of patients. The operation has proved of permanent benefit especially with the regard to the elimination of residual urine. Further, hydronephrosis, and renal infection and failure, are also benefited in many cases. These factors are of great importance in a condition in which late morbidity and mortality has been usually due to renal causes.

Humans

Production of parathyroid hormone by laryngeal cancer. Report of a case.

Nonparathyroid humoral hypercalcemia is becoming an increasingly more common problem associated with carcinoma. Carcinomas of the head and neck may elaborate parathormone or parathormone-like humors that in the absence of bone metastases, renal disease, parathytoid tumors, or secondary hyperparathyroidism may produce hypercalcemia, which if unrecognized, complicates and prevents the appropriate management of the patient. This report deals with the production of parathyroid hormone and the first reported case, to our knowledge, of carcinoma of the larynx associated with nonparathyroid hypercalcemia.

Carcinoma, Squamous Cell