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Biomedical subjects

J W Decker

Publications and source records attributed to J W Decker.

9 recordsLinked to original sources
PubMed1992

The external rhinoplasty approach for rhinologic surgery.

The technique of external rhinoplasty has enjoyed a renaissance over the last ten years, primarily for cosmetic and functional septorhinoplasty, and we have found this to be an effective method for nasal reconstruction. Moreover, we have recognized the versatility of this approach for a variety of rhinologic problems and have utilized it for transsphenoidal hypophysectomy, sphenoidotomy, unilateral choanal atresia, septal perforation, nasal valvuloplasty and rhinophyma. We describe our technique and the rationale for employing it. We conclude that the enhanced exposure provided by the cutaneous decortication of the nose facilitates surgery of both the soft tissues and the supportive architecture of the nose.

Dermatologic Surgical Procedures↗
PubMed1990

Predictive value of the Glasgow Coma Scale for tracheotomy in head-injured patients.

Patients with severe head trauma often require prolonged intubation and subsequent tracheotomy. The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify that subpopulation of trauma victims who will ultimately undergo tracheotomy. This retrospective study demonstrates through discriminant analysis that the likelihood of tracheotomy is significantly greater in patients with a GCS rating less than or equal to 7 than it is in patients with a GCS rating greater than 7 (p = .0001). Conversely, the presence of thoracoabdominal or maxillofacial injury is associated with but not predictive of eventual tracheotomy. In the hope of minimizing complications and enhancing the utilization of hospital resources, this study argues for early tracheotomy in patients with a GCS score less than or equal to 7 who do not undergo craniotomy and are otherwise stable.

Adolescent↗
PubMed1986

Advanced laryngeal cancer. Relevance of pathologic stage to survival and therapy.

Sixty-seven laryngectomies performed for stage III and stage IV laryngeal carcinoma were reviewed. Stage III disease was managed by surgery alone. Treatment of stage IV disease was divided equally between surgery only and surgery plus radiotherapy. Five-year survival rates by clinical stage were 73% for stage III and 39% for stage IV. Clinical underestimation of disease occurred in 25% of stage III lesions. Unrecognized cartilage invasion and nodal disease occurred with equal frequency. Survival rates computed on the basis of pathologic staging were 91% for stage III and 41% for stage IV. Patients with stage IV disease who were treated with surgery alone had a 28% survival rate, while those receiving both radiotherapy and surgery had a 56% survival rate. In our opinion, surgical pathologic staging more accurately predicts survival than does clinical staging. Surgery alone appears to be adequate therapy for pathologic stage III laryngeal cancer. Addition of radiotherapy significantly improves survival in stage IV disease.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

The effects of inflammatory bowel disease on adolescents.

Adolescence is a time of profound change for individuals. It is a period that witnesses biologic, social, and psychological change in the individual as well as role changes within the family and peer groups. Compounding these difficult transitions with the onset of inflammatory bowel disease leads to additional problems with adolescence adjustment. In the limited studies that have addressed the adolescent and inflammatory bowel disease, several key concepts emerge that point to ways for successfully dealing with these adolescent adjustment problems. Roy's Adaptation Model provides a foundation for identifying and selecting interventions in working with adolescents and chronic illness. A review of the literature finds the need for further study of the difficulties encountered by the changes of adolescence coupled with the onset of inflammatory bowel disease.

Adaptation, Psychological↗