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Biomedical subjects

J H Whicker

Publications and source records attributed to J H Whicker.

17 recordsLinked to original sources

Spontaneous regression of a facial malignant melanoma.

We report a case of a head and neck melanoma fulfilling the criteria for spontaneous regression of the primary tumor. The melanoma originated within a pretragal nevus. Histological examination of the surgical specimen revealed regressive changes within the nevus but no demonstrable melanoma. This brings to a total of 14 the number of patients with documented regression of a primary melanoma.

Facial Neoplasms↗

Thin rubber sheeting in frontal sinus surgery: animal and clinical studies.

Closure of the nasofrontal communication is the most common cause of failure of nonobliterative external of nonobliterative external frontal sinus operations for chronic sinus disease. To determine whether silicone rubber sheeting or tubing might prevent closure, we designed animal experiments and conducted a clinical study. We enlarged the nasofrontal duct in dogs, inserted silicone rubber tubing or sheeting and assessed ductal patency grossly and microscopically. The tubes prevented epithelization and failed to prevent local osteoblastic reaction, fibroplasia, and scar formation. In contrast, sheeting permitted rapid mucosal regeneration, less osteoblastic activity, and less fibrosis. Our 16 patients with chronic sinus disease underwent a modified Lynch operation, with enlargement of the nasofrontal duct and stenting with rubber tubes or sheeting. The sheeting provided the best long-term result. In our experience, it raised the success rate of the classic Lynch external operation.

Adolescent↗

Mandibular osteotomy and lingual flaps. Use in patients with cancer of the tonsil area and tongue base.

The composite resection operation with sacrifice of a portion of the hemimandible is considered to be the fundamental operation for cancers in the posterior oral cavity. The mandible is resected for cancer control (to ease reconstruction) and perhaps for traditional reasons. Mandibular sacrifice is not always essential for oncologic resection. Access through the mandible is usually required for effective resection of cancers in this region. The lateral mandibular osteotomy approach provides this access in selected patients. The adjacent, remaining portion of the tongue provides 75 to 100 sq cm of thick pliable vascular mucosa that can be used for closing the defects after resection of the cancer in the posterior oral cavity. As much as one half of the tongue can be rotated. If certain precautions are taken, a viable flap can be assured even after radiation treatment or ligation of the ipsilateral lingual artery.

Carcinoma, Squamous Cell↗

Nasopulmonary reflex: evaluation in the nonparalyzed and paralyzed anesthetized dog.

Changes in the pulmonary mechanics of various animal species have been observed after nasal stimulation. In reviewing the methods of these studies, we found that often the respiratory patterns were not controlled well enough to permit conclusions about changes in resistance and compliance. To further investigate the possibility of a nasopulmonary reflex, we first studied the effect of nasal stimulation on pulmonary mechanics in anesthetized, nonparalyzed dogs. In this group of 35 dogs, we found that nasal stimulation typically produced marked changes in breathing patterns, a large transient increase (150%) in pulmonary airflow resistance, but no change in compliance. This response to nasal stimulation could be abolished by interrupting either the trigeminal or the vagus nerves. In an additional group of 12 anesthetized, paralyzed dogs, we found no changes in resistance or compliance after nasal stimulation. From this observation, we concluded that nasal stimulation produced changes in breathing patterns that led to alterations in resistance without an actual change in the intrinsic behavior of the pulmonary airways.

Airway Resistance↗