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Biomedical subjects

J R Hines

Publications and source records attributed to J R Hines.

18 recordsLinked to original sources
PubMed1992

Intravenous nitrogen mustard given immediately after mastectomy: possible effect on local recurrence.

A small group of patients with Stage I and II ductal breast carcinomas were treated with intravenous nitrogen mustard the day of mastectomy and the first two postoperative days. Long term follow-up revealed that only one patient developed isolated local recurrence, a rate much lower than usually reported. It is possible that early use of chemotherapy could reduce local recurrences in the recently traumatized tissue.

Breast Neoplasms↗
PubMed1992

Infiltrating syringomatous adenoma of the nipple.

Infiltrating syringomatous adenoma of the nipple is a distinct, benign clinical entity. It is similar histologically to a syringoma, a benign tumor originating in the ducts of the dermal sweat glands. When located in the nipple, this lesion has been mistaken for nipple duct adenoma or tubular carcinoma. Infiltrating syringomatous adenoma of the nipple is locally infiltrating but does not metastasize. Appropriate local management depends on an accurate diagnosis. Following is a case report, review of the literature, and therapeutic options for infiltrating syringomatous adenoma of the nipple.

Adenoma↗
PubMed1990

Parathyromatosis in hyperparathyroidism.

Recurrent hyperparathyroidism after parathyroidectomy may present a difficult diagnostic problem. A rare etiology is parathyromatosis (multiple nodules of hyperfunctioning parathyroid tissue scattered through the neck and mediastinum) due to spillage of otherwise benign parathyroid tissue during surgery. We present a case of recurrent hyperparathyroidism and parathyromatosis due to tissue spillage during surgical removal of probable double adenomas, a rare cause of primary hyperparathyroidism. Thus, parathyromatosis must be included in the differential diagnosis of recurrent or persistent hyperparathyroidism, distinguished from parathyroid carcinoma by histologic criteria. The surgeon must be careful of parathyroid spillage during surgery, even of benign tumors of the parathyroids.

Adenoma↗
PubMed1979

Experience with lobular carcinoma of the breast. Emphasis on recent aspects of management.

A total of 105 patients with lobular carcinoma of the breast were seen at two hospitals between 1966 and 1978. Mammography was found to be of limited value in the preoperative assessment of these patients. As reported by others, there was a high incidence of bilateral lobular neoplasia. In the patients with lobular carcinoma in situ for whom follow-up data were available, all were alive and well. In contrast to this, infiltrating lobular carcinoma was found to be as malignant a lesion as any other infiltrating breast cancer regardless of the operative procedure performed. These latter tumors were found to bind substantial levels of estrogen receptor proteins. From the information gained, it is suggested that early hormonal manipulation and/or chemotherapy may be advantageous in the patient with recurrent infiltrating lobular carcinoma in particular.

Adult↗
PubMed1979

Intracellular hyperthermia. A biophysical approach to cancer treatment via intracellular temperature and biophysical alterations.

This paper introduces a new multi-disciplinary "intracellular" biophysical treatment of cancer. The basic concept uses locally induced heat energy after tumor phagocytosis of submicron particles whose composition permits magnetic excitation. The key to this process is the utilization of the cancer cell membrane to contain the energy within the cancer cell. Any magnetic or electric dipole contained within or introduced into the cell, or that is capable of being produced by an external field, can be used. Submicron particles are colloidally suspended, injected intravenously and are phagocytized by cancer cells. Application of an external high frequency or pulsed electromagnetic field then raises the particles' temperature thus generating intracellular heat in precise increments. This results in selective thermal destruction of cancer cells with little effect on normal cells. Experimental evidence is presented showing tumor cell destruction in spontaneous mammary tumors in Sprague Dawley rats. In addition, we suggest that certain biophysical properties are altered within the cancer cells and could be used to enhance this effect. Specific radioisotopes or tumor specific antibodies bound to particles or chemotherapeutic microspheres increase cancer cell sensitivity and affinity for these particles. This "intracellular" treatment of cancer has a wide potential range of applications.

Animals↗
PubMed1977

Phytobezoar: a recurring abdominal problem.

Phytobezoars often follow gastric surgery for peptic ulcer disease. Billroth I resections have a high incidence of gastric bezoars, especially if accompanied by vagotomy. The larger opening of a Billroth II resection may result in intestinal bezoars with obstruction in the narrow terminal ileum. Gastric bezoars can be treated with enzymes or can be broken up by endoscopy; only rarely is operative removal required. Intestinal bezoars can be treated by long-tube and enzyme instillation but usually require laparotomy. If possible, the bolus should be milked into the cecum, but enterotomy or even resection may be required. Prevention is the best treatment and can be carried out by instructing patients who have had gastric surgery to avoid the fibrous portion of oranges and grapefruit and to avoid persimmons.

Adult↗
PubMed1977

Colostomy and colostomy closure.

A series of 181 adult patients subjected to colostomy was studied, almost all of whom had disease rather than injury. The complication rate was 28 per cent. One hundred of these patients had a subsequent colostomy closure with a complication rate of 17 per cent. Of the patients who had both procedures, 35 (35 per cent) had one or more significant complications. The causes and prevention of these complications are described.

Adult↗
PubMed1976

Cystosarcoma phyllodes metastatic to a brenner tumor of the ovary.

A patient had cytosarcoma phyllodes that developed metastases to bone and to a Brenner tumor of the ovary. The original breast tumor was reported as benign, but the patient died of metastases four months following mastectomy. The rapid growth in the ovary may have been due to estrogenic stroma in the Brenner tumor. This is the first report, to our knowledge, of cystosarcoma phyllodes metastasizing to another tumor.

Bone Neoplasms↗
PubMed1976

Scleroderma of the colon with obstruction: report of a case.

A case of a patient who had colonic obstruction caused by scleroderma is described. The obstruction initially was treated by means of a colostomy, and later subtotal colectomy was carried out. This is the fifth report of a patient with symptomatic colonic scleroderma successfully treated by colonic resection. A review of colonic scleroderma is included.

Adult↗
PubMed1976

Postbulbar peptic ulceration of the duodenum.

One hundred and twenty patients operated upon for peptic ulcer diathesis had intraluminal digital examination of the duodenum seeking post-bulbar ulcers. Twelve such ulcers were found, an incidence of 10 per cent. In six of these patients, the postbulbar ulcer was an unexpected finding, and in two patients, a second ulcer was present. A review of the patients with postbulbar ulcers revealed that these patients had severe ulcer symptoms that responded poorly to medical management. Our patients were treated by truncal vagotomy and an outlet procedure. In ten patients, the anterior duodenotomy was extended to include the stenotic area. A Jaboulay gastroduodenostomy was performed in one patient, and duodenoplasty with pyloroplasty in another patient. These 12 patients were observed from one to six years. There were no deaths. Two patients had temporary gastric atony and one patient had a dumping syndrome. Three patients have had possible recurrence of the ulcer, reoperation being required in one patient. It is possible that unrecognized postbulbar stenosis may be a cause of recurrent peptic ulcer following some surgical procedures. To recognize these ulcers, we believe that the duodenum should be inspected by intraluminal palpation in all patients operated upon for peptic ulcer disease.

Adult↗
PubMed1976

Double pyloroplasty and vagotomy for gastric ulcers.

A group of 31 patients with a variety of gastric ulcers were treated by vagotomy, biopsy, oversewing of bleeding points and a wide double pyloroplasty. On patient, a quadriplegic with multiple stress ulcers, rebled and had to undergo resection. He died a month later of progressive respiratory problems. A second quadriplegic died a month after a bleeding episode from myelitis and encephalitis resulting from a gunshot wound of the neck. He had no rebleeding. A third patient died two years after a gastric operation as a result of bronchial carcinoma. He had no recurrence of the ulcer problem. The remaining 28 patients were observed from six months to five years, an average of two and one-half years. There were no recurrences and only minimal untoward symptoms. It would appear that, for this period of observation, vagotomy with double pyloroplasty offers good treatment for patients with benign gastric ulcers.

Adult↗
PubMed1975

Nitrogen mustard as adjunctive chemotherapy for breast carcinoma.

A retrospective study is reported of 38 patients with breast carcinoma treated by radical mastectomy and a short course of nitrogen mustard. They were followed up for an average of 10 years. There were no serious untoward reactions to the drug. The 5- and 10-year correct survival rates were 71 and 71 per cent respectively. There would appear to be a renewal of interest in adjuvant chemotherapy for patients with breast carcinoma.

Adult↗
PubMed1975

Vagotomy and double pyloroplasty for peptic ulcer.

Seventy patients with peptic ulcers (55 duodenal and 15 gastric) were treated by truncal vagotomy and doulbe pyloroplasty during the past four years. Clinical and experimental data as presented lead us to believe that transecting the pylorus twice produces an incontinent pyloric sphincter and a larger gastric outlet than is found in other methods of pyloroplasty. This decreases gastric stasis and has led to a lower ulcer recurrence rate (1.5%). In addition the untoward postoperative sequelae are minimal. The 70 patients treated (for the most pare consecutive cases) exhibited the usual complications of peptic ulcer disease. Thirty-three had intractable pain, 23 bleeding (15 massive), 13 obstruction, and one acute perforation. There were no operative or postoperative deaths and the only serious postoperative complication was unrelated to the double pyloroplasty. During the followup period four patients have died of unrelated diseases. Of the remaining 66 patients one developed a probable recurrent peptic ulcer which has responded to medical management. Four patients have intermittent dumping, three have mild diarrhea and one has failed to gain weight, Constipation and weight gain are more common complaints. It would appear that vagotomy with double pyloroplasty is a safe and effective operation for peptic ulcers and that further clinical trials are warranted.

Humans↗
PubMedDate not supplied

Adenocarcinoma arising in a diverticular abscess of the colon: report of a case.

A case of a patient with adenocarcinoma in an abscess cavity that resulted from perforated diverticulitis of the descending colon is described. Serial barium-enema studies over a nine-year period show the diverticulosis, perforation, abscess cavity, and finally the adenocarcinoma in the abscess cavity. Although it is infrequent, the possibility of carcinoma must be considered in cases of patients who have unhealed pericolonic abscess cavities.

Abscess↗