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Biomedical subjects

J Carruthers

Publications and source records attributed to J Carruthers.

15 recordsLinked to original sources

Squamous cell carcinoma of the thyroid gland.

We present the clinical manifestations and details of treatment and outcome for eight patients with squamous cell cancer arising in the thyroid gland, which is a rare entity. All patients had advanced disease, with primary tumors invading adjacent structures (the trachea, esophagus, and major vessels). In two patients, pulmonary metastases were also present. Six patients died 6 months or less after diagnosis, five from the effects of local disease. Transient palliation was obtained in four patients who underwent partial excision (three patients) and radical radiotherapy (one patient). Two patients remained free of disease at last follow-up more than 4 years after gross total tumor resection and radical radiotherapy and were presumably cured. One patient treated by partial resection and radical radiotherapy died from other causes 17 months later. His disease status was unknown. Complete excision with postoperative radiotherapy may be curative, and debulking followed by external irradiation may provide short-term palliation. Patients with unresectable tumors are best managed by supportive measures only unless a truly effective chemotherapeutic regimen is developed for squamous cell cancer of the head and neck.

Adult

Botulinum toxin for benign essential blepharospasm, hemifacial spasm and age-related lower eyelid entropion.

Purified botulinum A exotoxin was used in the treatment of forty seven patients with benign essential blepharospasm, 11 patients with hemifacial spasm and 2 patients with age-related entropion. The treatment was effective in all three groups for an average of 3-4 months when symptoms recurred and repeated chemodenervation with toxin was needed. The commonest complication was transient ptosis with an overall frequency of 7.8%. This incidence increased to 11.1% with toxin doses higher than 25 units per orbicularis. The treatment was well accepted by the patients, who were subsequently able to return to pre-blepharospasm lifestyles.

Adult

Anterior segment ischemia treated with hyperbaric oxygen.

Anterior segment ischemia developed in a 62-year-old dysthyroid patient after two-muscle adjustable suture repair of vertical strabismus. Because of a quiescent pulmonary tuberculous focus he was not treated with systemic steroid therapy but rather with hyperbaric oxygen in the controlled environment of our hospital hyperbaric chamber. He tolerated this treatment well, and his acute symptoms almost completely resolved in 3 days. We believe this to be the first reported case of the use of hyperbaric oxygen in the management of anterior segment ischemia. We also believe it is the first reported case of anterior segment ischemia following surgery to two opposing, not contiguous, rectus muscles in dysthyroid ophthalmopathy.

Anterior Eye Segment

A pilot study on the use of botulinum toxin in spasmodic torticollis.

Dystonic torticollis has been treated with local injections of botulinum toxin in a single blind study of 12 patients. A significant decrease of abnormal movements was recorded, and pain improved. Further studies are desirable to define the optimum dosage and site for injections, and the long term effects of repeated injections.

Adult

Quantitative analysis of trace elements in human blood and plasma by energy dispersive X-ray fluorescence.

A photon excitation, secondary target x-ray fluorescence system was used to measure concentrations of Cu, Zn, Br and Rb in whole blood and plasma of healthy adults. The samples preparation method and calculated limits of detection of the technique are reported. Correlation statistics for elemental concentrations have been determined. Verification of the results for copper was performed using atomic absorption spectrophotometry.

Adult

Human albinism.

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Albinism

Acceptability of the cytopipette in screening for cervical cancer.

A randomized controlled trial was carried out in which the acceptability of screening for cervical carcinoma in situ by a postal 'do-it-yourself' method--the cytopipette--was compared with that of an invitation to attend a clinic or see a general practitioner for the conventional cervical scrape examination. In parallel with this, a sociological study of women who had been invited by both methods was undertaken in which information was obtained from responders and non-responders on attitudes to health care. The results show that, while the pipette was used by a greater proportion of women overall than the scrape examination, its acceptance by women most at risk of the disease is still not high. It is concluded that, taking into account the relative merits of the two methods as screening tests, as well as their acceptability and cost, the postal pipette may be useful in some circumstances, such as areas where clinical resources are limited, and as a second approach to women who have not taken up the offer of a scrape examination.

Adolescent