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Biomedical subjects

N C Estes

Publications and source records attributed to N C Estes.

7 recordsLinked to original sources

Role of herniography in the diagnosis of occult hernias.

Twenty-two patients with groin or incisional pain and normal physical examinations underwent herniography. Eight patients were found to have 11 unsuspected hernias. Seven were direct, two indirect, and two incisional. Six of nine groin hernias were recurrent. Exploration confirmed the herniographic findings in all patients. Follow-up evaluation of patients undergoing herniorrhaphy revealed resolution of symptoms. Ten of the 14 patients with normal herniograms were asymptomatic 3 months after herniography. In these 22 patients, herniography resulted in a savings of $31,000. We conclude that herniography is cost-effective and useful in patients with abdominal wall pain of obscure etiology.

Adolescent

Autoantigens in breast cancer tissue.

Two antigens in specimens of human breast cancer have been identified as autoantigens. One antigen appears to be an IgG Fc fragment; the other, an IgG Fab fragment. Antibodies in sera of cancer patients directed against these antigens have also been identified. These autoantibodies occur in patients with breast cancer as well as other cancers, and rarely in patients with non-cancerous disease or in people screened in a detection center for breast diseases. The breast cancer patient found to have antibody directed against the IgG Fab antigen falls into a group that has improved two-year survival statistics over groups of patients who lack this antibody.

Antibodies, Neoplasm

Chylous ascites following abdominal aortic aneurysmectomy. Management with total parenteral hyperalimentation.

Chylous ascites may follow operative injury to retroperitoneal lymphatics. When possible, early reoperation has been advised. This report describes a patient with chylous ascites following emergency abdominal aortic aneurysmectomy. Because the patient was not a candidate for reoperation, total parenteral hyperalimentation was employed in management. This approach resulted in a successful outcome.

Aged

Aspects of fibrocystic disease of the breast. Treatment with danazol.

The differing aspects of fibrocystic disease are presented. The various histological components making up the breast account for the variegated presentation of symptoms and findings. Pain, tenderness and nodularity represent the greatest problem with the former two prompting the patient to seek relief. The latter symptom, nodularity, causes concern for patient and physician as such changes must be distinguished from those of carcinoma of the breast. Guidelines for and consideration of premalignant benign changes are briefly presented. Data from a clinical trial of danazol for the patients with fibrocystic disease are presented. The drug was highly effective in affording relief from pain and tenderness. Some diminution in nodularity was also seen. The impact of this drug on the problems associated with fibrocystic disease of the breast is discussed.

Adult

A transthoracic devascularization procedure for control of bleeding esophageal varices: preliminary report.

A procedure for control of variceal bleeding has been described which involves "devascularization" of the distal one third of the esophagus and upper one half of the stomach combined with a Nissen fundoplication performed through a left lateral thoracotomy and an incision in the left diaphragm. Transection of the truncal vagi is required to effectively de vascularize the distal esophagus and, thus, pyloromyotomy or pyloroplasty is added. Six patients who were moderately high risk candidates underwent this procedure for control for persistent hemorrhage; five of these patients were operated on within 48 hours of admission. There was one postoperative mortality. The five survivors have not rebled, and there has been no evidence of encephalopathy or progressive liver deterioration over a mean follow-up of thirteen months.

Adult