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Biomedical subjects

M L Workman

Publications and source records attributed to M L Workman.

9 recordsLinked to original sources
PubMed1992

Malignant melanoma with evidence of maturation arising from a giant congenital nevocellular nevus.

The association between melanoma and giant congenital nevocellular nevus has been well documented, although controversy still exists regarding the precise incidence. The following patient report illustrates the excision of malignant melanoma arising from a giant congenital nevocellular nevus in a 4-month-old infant. The child had malignant melanoma with deep dermal involvement diagnosed by incisional biopsy with positive margins. She underwent subsequent en bloc resection of the original biopsy site and nevus. The reexcision specimen showed no evidence of malignancy. No adjuvant chemotherapy was used. The child is disease free at 5 years. It is possible that very young children (infants) with melanoma arising in a giant congenital nevocellular nevus may have a good prognosis.

Cell Transformation, Neoplastic↗
PubMed1992

Popliteal-based filleted lower leg musculocutaneous free-flap coverage of a hemipelvectomy defect.

A 33-year-old man suffered from locally recurrent malignant fibrous histiocytoma of his left thigh unresponsive to previous excision, radiation therapy, chemotherapy, and hyperthermic treatment. He underwent radical hemipelvectomy for cure. Because of extensive tumor involvement, a free flap consisting of his distal left leg based on the popliteal artery was utilized to close the defect. Both the tibia and fibula were removed from their periosteal sheaths, and the foot was excised from the flap. The popliteal artery and vein were anastomosed to the iliac vessels. The flap survived, and the patient was discharged home after physical rehabilitation. We suggest that uninvolved portions of the distal leg may be utilized as a free flap to successfully close hemipelvectomy defects in selected patients when conventional pedicle flaps are unavailable.

Adult↗
PubMed1992

Magnesium and phosphorus: the neglected electrolytes.

Magnesium and phosphorus normally are present in very low serum concentrations and usually are not included in common serum electrolyte laboratory studies. Though their normal serum concentrations are relatively low, both of these ionized minerals are necessary for many critical physiologic functions, and decreases in normal serum levels can have serious deleterious effects. Some of these effects, especially in myocardial tissues, may lead to permanent tissue damage. Hospitalized patients at greatest risk for developing hypomagnesemia or hypophosphatemia are trauma victims; individuals with poorly controlled diabetes mellitus, renal impairment, parathyroid dysfunction, or chronic alcoholism; and individuals who have been treated with antineoplastic agents.

Critical Illness↗
PubMed1992

Common electrolyte imbalances associated with malignancy.

More than one million Americans will be diagnosed with cancer during 1992, and 50% will be cured of their disease. Of those individuals not cured of the malignancy, survival time after diagnosis has increased tremendously compared to 1980. Because of advances in therapy and the increase in long-term survival, the presence of cancer patients in critical care units should no longer represent either a medical contradiction or an ethical dilemma when the condition requiring critical care is potentially reversible. Many of these individuals may become patients in critical care settings as a result of specific electrolyte imbalances caused by the malignant disease or treatment of malignancy. Although the imbalances often are temporary, they can be life-threatening without intervention. The most common temporary electrolyte imbalances associated with malignant conditions are hypercalcemia, hyperkalemia, and tumor lysis syndrome. Critical care nurses can contribute skill and knowledge in ameliorating these conditions so that the person with cancer can have better quality and longer survival time.

Adult↗
PubMed1990

Effects of steroids on postoperative nausea and vomiting.

The purpose of this study was to determine if the use of intraoperative steroids was effective in decreasing the incidence of postanesthetic nausea and vomiting and whether or not those complications were gender related. This retrospective study involved a chart review of 208 patients undergoing lumbar laminectomy at a large metropolitan hospital during a 10-month period in 1989-1990. Sixty-one patients met inclusion criteria and were accepted into the study. Of these, 34 patients had received an intraoperative steroid; 21 were male and 13 female. Twenty-seven patients did not receive intraoperative steroids; 17 were male and 13 female. Data collected included the number of pain medications and antiemetics used in the postoperative period, as well as the number of episodes of nausea and vomiting in the 24 hours following surgery. Results demonstrated that those patients who received intraoperative steroids were less likely to experience problems of nausea and vomiting than those who did not receive the drug. Requirements for postoperative pain medication were also reduced in the steroid group. Female patients in both groups were shown to have a greater incidence of nausea and vomiting than male patients.

Anesthesia↗
PubMed1985

Biologic characteristics of four Ewing's sarcomas.

Four Ewing's sarcomas were examined for chromosomal characteristics, growth in cell culture, tumorigenicity in nude mice, and presence of beta-adrenergic receptors. Three tumors were from untreated patients (one obtained directly from the patient and two after growth in nude mice) and one was a metastatic lesion obtained after treatment. All four tumors were diploid or near-diploid, with one or more structural rearrangements. In the metastatic lesion, 21 abnormalities were seen. No specific chromosome aberration was found to be common to all four tumors, although a t(1,16) was observed in two and a t(11;22) in two. Abnormalities involving chromosomes #1, #3, #11, #13, #16, and #22 were each found in two of four tumors. All four tumors were tumorigenic in nude mice; two grew well in cell culture, one of which became an established line, and all four expressed high concentrations of beta-adrenergic receptors.

Adolescent↗
PubMed1985

Cardiovascular and endocrine effects of potassium in spontaneously hypertensive rats.

Although potassium is known to lower blood pressure in a number of forms of experimental and human hypertension, the mechanism for this effect remains unclear. We studied several possible mechanisms for this effect in the spontaneously hypertensive rat (SHR). Fourteen-week-old SHR were given 0.5% KCl in the drinking water. This potassium supplement resulted in a 16-mmHg fall in mean arterial pressure and a 22% decrease in peripheral vascular resistance. Plasma potassium increased 0.4 meq/l, while muscle potassium was unchanged. Potassium supplementation resulted in no change in plasma renin activity, plasma aldosterone, or plasma norepinephrine. Urinary excretion of prostaglandin (PG) E2 and 6-keto-PGF1 alpha was also not altered by potassium supplementation. Potassium-supplemented SHR were found to have no difference in sodium excretion compared with control SHR, and plasma volume was similar in both groups. The pressor response to angiotensin II and norepinephrine was not substantially affected by potassium supplementation. Furthermore, baroreflex control of heart rate was not altered by potassium supplementation. Finally, potassium supplementation resulted in no change in mesenteric artery angiotensin II receptor number or receptor affinity. Therefore, although potassium lowers blood pressure in the SHR by decreasing peripheral vascular resistance, the mechanism of this effect on vascular resistance remains unknown.

Angiotensin II↗