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Biomedical subjects

J D McMahon

Publications and source records attributed to J D McMahon.

At least 19 recordsLinked to original sources
PubMed2001

Incidence of cervical node involvement in metastatic cutaneous malignancy involving the parotid gland.

BACKGROUND: The parotid lymph nodes represent an important group of nodes at risk for metastatic involvement from cutaneous malignancies of the head and neck. When treating patients with metastatic disease in the parotid gland it has been our custom to also remove the lymph nodes of the neck on the basis that these nodes represent other nodal groups at risk for metastatic involvement. The aim of this study is to determine the incidence of cervical node involvement among patients with clinical metastatic SCC or melanoma of the parotid to determine whether treatment of the clinically negative neck is warranted. METHODS: The study group consists of 123 prospectively accessioned patients with clinical metastatic cutaneous squamous cell carcinoma (SCC) (n = 73) or melanoma (n = 50) involving the parotid gland and a minimum of 2 years of follow up, irrespective of the clinical status of the neck. RESULTS: Among 73 patients with metastatic SCC in the parotid, 19 (26%) had clinical neck involvement, and 16 of these were pathologically positive (84%). A total of 37 patients had elective neck dissections, and 13 were pathologically positive, which is an overall rate of 52% neck involvement among patients having neck dissection. Among 50 patients with metastatic melanoma in the parotid, 19 (38%) patients were initially seen with clinical neck disease, and all were pathologically positive. Among 31 patients with clinically negative necks, 26 had neck dissections and seven had positive nodes (27%). Overall, 58% of patients with melanoma who had a neck dissection had positive nodes. CONCLUSION: Patients with metastatic cutaneous SCC and melanoma involving the parotid gland had a high incidence of clinical (26% and 38%, respectively) and occult neck disease (35% and 27%). Treatment of the clinically negative neck in the presence of clinical metastatic parotid cancer should be considered to reduce the likelihood of failure in cervical nodes, to define the extent of disease, and to assist with patient selection for adjuvant therapy.

Aged↗
PubMed2000

The use of clinical criteria alone in the management of the clinically negative neck among patients with squamous cell carcinoma of the oral cavity and oropharynx.

BACKGROUND: Management of the clinically negative neck among patients with oral and oropharyngeal squamous cell carcinoma at the Royal Prince Alfred Hospital, Sydney, Australia has been based on the site and stage of the primary cancer, the likely incidence of microscopic nodal involvement, the treatment modality used for the primary cancer, and whether the neck will be entered during resection or reconstruction. This report analyzes the results of treatment when patients are allocated to either treatment or observation of the neck based on these clinical factors. METHODS: This is a prospectively documented series of 162 consecutively treated patients with squamous cell carcinoma of the oral cavity and oropharynx and clinically negative necks, treated by 1 surgeon (C.J.O.). There were 128 oral cavity and 34 oropharyngeal cancers clinically staged at T1 for 62 patients, T2 for 61, T3 for 16, and T4 for 23 patients. Management of the neck consisted of elective neck dissection (END) in 96 patients (12 bilateral), elective radiotherapy in 8, and observation in 58. Neck treatment correlated with the T stage in a statistically significant way. Forty-six patients underwent postoperative radiotherapy, which was directed to the neck in 22 patients because of pathological findings following neck dissection. Free-flap reconstruction was used in 90 patients. RESULTS: Metastatic squamous cell carcinoma was identified in 32 of 108 neck dissections (30%). There was 1 positive node in 15 necks, 2 positive nodes in 11 necks, and 3 or more positive nodes in 6 necks. Extracapsular spread was present in 8 of 32 positive END specimens (25%). Regional control rates in the neck at 3 years were 94% for END, 100% for elective radiotherapy, and 98% for patients initially observed and then treated by therapeutic neck dissection. Death with uncontrolled disease in the neck occurred in 4 of 96 patients (4%) after END and 1 of 58 patients (2%) after neck observation. Overall disease-specific survival was 83%, comprising an 86% rate for patients with pathologically negative necks and 68% if pathologically positive. Disease-specific survival was 86% at 3 years for patients having END, 67% following radiotherapy, and 94% for the observation group. CONCLUSIONS: Elective neck dissection was performed in most patients, and occult metastatic disease was found in nearly 30% of neck dissections. Observation was most frequently used for patients with early stage disease, and subsequent development of neck metastases was uncommon (9%) in this group. Selective treatment of the clinically negative neck based on the primary tumor site and stage led to a high rate of regional disease control in this series.

Adult↗
PubMed1989

Salary, education, and managerial-level differences of physical therapists in Maryland.

The purpose of this study was to determine whether differences existed between a random sample of male and female physical therapists on selected factors. These factors included salary, managerial level, number of courses taken in management or administration, years of work experience in physical therapy, and years of seniority in an organization. A self-reported questionnaire was sent to 400 licensed physical therapists in Maryland who were also American Physical Therapy Association members. Data were analyzed on the 244 respondents using chi-square tests, t tests, and critical ratios. Results showed that female physical therapists, when employed full time in Maryland as department managers, on average, earned significantly less than their male counterparts. A significant difference existed between male and female department managers for full-time work experience in physical therapy. Neither the number of management courses taken nor seniority in an organization were significantly different for male and female physical therapists, regardless of managerial level. Conclusions were that differences existed on several factors between male and female physical therapy department managers and that schools preparing physical therapists for entry into the profession should assess the need for management preparation.

Administrative Personnel↗
PubMed1987

Three applications of the Role Delineation Project 1985 Curriculum Framework.

Colleges are beginning to use the Role Delineation Project Curriculum Framework for curricular reform at the graduate and undergraduate levels. This paper describes the efforts of three universities to revise their curricula based on the Framework. At Towson State University, it is being used with other national and state standards to assess health educators. At the University of Alabama at Birmingham, it provided the structure by which the faculty determined the competence of exiting health majors. At the University of Georgia, it was used in strategic planning and graduate education restructuring. The Framework, while lacking material in certain professional development areas, provides the structure for departments to begin the process of health education curricula reform.

Curriculum↗
PubMed1984

Effects of hematoporphyrin (HPD) and a chemiluminescence system on the growth of transplanted tumors in C3H/HeJ mice.

Photoradiation therapy is emerging as a promising technique for combating cancer. Fundamentally, this approach consists of two steps: hematoporphyrin derivative (HPD) is used to selectively sensitize cancer cells to visible light; after an appropriate time interval, light is introduced into the tumor via a laser-fiber optic system to trigger the cytotoxic action of HPD. The present investigation was initiated to determine the therapeutic potential of HPD in combination with a chemiluminescent activator in treating mice which had been transplanted with tumors.

Animals↗