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Biomedical subjects

R S Cathcart

Publications and source records attributed to R S Cathcart.

At least 19 recordsLinked to original sources
PubMed1990

Augmentation mammaplasty by means of the transrectus route.

A new operative technique has been developed for augmentation mammaplasty. Through an inframammary incision, the anterior rectus sheath is entered, and the pocket is dissected in an entirely submuscular plane. We have performed this procedure in 112 patients to date. Complications have been few. The capsular contracture rate in 90 patients followed for greater than 1 year is 7 percent. The inframammary crease can be lowered using this technique, making mastopexy unnecessary in most patients with moderate ptosis.

Adult↗
PubMed1989

Preoperative and postoperative considerations in elective breast operations.

The number of young women undergoing elective breast operations is increasing rapidly. The lifetime breast cancer risk in the female population is 1 in 10. As this group ages, it is obvious that surgeons will encounter carcinoma of the breast in these patients more frequently. The surgical implications of breast cancer in these patients are discussed, and guidelines for preoperative and postoperative management in patients being considered for augmentation mammaplasty, mastopexy, and reduction mammaplasty are suggested.

Adult↗
PubMed1987

Nonreflux complications of hiatal hernia.

Patients with massive incarcerated hiatal hernia and no appreciable esophagitis present with a distinctly different clinical picture from those with hiatal hernia and reflux peptic esophagitis. In a recent review, 17 patients were encountered with this problem. The patients were often elderly and presented with the following grave complications: upper gastrointestinal obstruction; upper gastrointestinal bleeding, both acute and chronic, from gastric ulcerations; and perforated gastric ulcerations. In these patients, the surgical approach is better accomplished through the abdominal route. These patients should be distinguished from those with a shortened esophagus resulting from chronic reflux peptic esophagitis who often require thoracotomy for surgical correction.

Acute Disease↗
PubMed1984

Surgical treatment of intractable esophagitis.

An operative technique combining a 360-degree fundoplication which is stabilized by anchoring the gastroesophageal junction to the middle arcuate ligament was used in a series of 140 patients since 1973. The patients were evaluated 1 year or more after surgery with clinical and radiographic assessment, regardless of complaints. Clinical results have been good in 91%. There has been no operative mortality and minor transient morbidity. X-rays done at least 1 year after surgery were compared with results obtained in 88 patients who had a modification of Hill's posterior gastropexy performed during the earlier years of this experience. The incidence of x-ray abnormalities with the posterior gastropexy was reduced from 23.5% to 5% when fundoplication was used in combination with a posterior gastropexy. The anchorage of the esophagogastric junction to the middle arcuate ligament allows a relatively loose fundoplication and thereby has reduced the incidence of disabling gas-bloat. Stabilizing the fundoplication prevents the occurrence of other complications related to fundoplication such as disruption, migration, and obstruction. This technique avoids the use of sutures in the esophageal wall, thus reducing the potential for perforation, fistula, or injury to the vagus nerves.

Adolescent↗
PubMed1984

Should drains be used in routine cholecystectomy?

Retrospective analysis failed to demonstrate that drainage in routine cholecystectomy was associated with the reported incidence of wound complications. The overall complication rate was increased in those patients in whom drains were used. This is believed to be due to the patient selection rather than the use of drains in that the most difficult operative cases received drains. Those patients who did not have drainage did not experience related problems, but drains may diagnose and treat the occasional bile leak. Incidental appendectomy increased the incidence of wound infection.

Adolescent↗
PubMed1981

Surgical treatment of midgut nonrotation in the adult patient.

For a period of four years, five adult patients with nonrotation of the intestine and midgut volvulus have been treated. Two distinct clinical presentations were encountered. The chronic presentation is that of colicky abdominal pain, often present for many years, which is corrected by surgical intervention. The acute presentation with strangulation of the intestine may occur without pre-existing symptoms. Knowledge of this entity and a high index of suspicion are necessary for the diagnosis because massive gangrene of the intestine may result from a delay in treatment. Prophylactic surgical treatment in the asymptomatic patient is recommended to prevent this catastrophic occurrence.

Abdomen↗
PubMed1979

Treatment of cholelithiasis in patients with sickle cell anemia.

The incidence of cholelithiasis and surgical risk of cholecystectomy in patients with sickle cell anemia is reviewed. Records of all patients with sickle cell disease currently attending the Medical University of South Carolina Hematology Clinic were reviewed. An oral cholecystogram has been part of the initial evaluation for the past year. The records of 16 patients having cholecystectomy from 1968 to 1977 were reviewed with regard to diagnostic studies, preoperative preparation, morbidity, and mortality. When the status of the gallbladder is known, the incidence of cholelithiasis is 67%. The morbidity of elective cholecystectomy was high (37%); there was one death. Cholecystectomy is not recommended for the discovery of asymptomatic gallstones because of the relatively poor surgical risk and short life expectancy of these patients.

Adolescent↗
PubMed1975

Histochemical study of gastric mucosubstances after thermal injury: correlation with endoscopic evidence of acute gastroduodenal disease.

Gastroduodenoscopy with biopsy was performed in nine patients within 5 days after major thermal injury. Biopsies were evaluated by special histochemical techniques to visualize and differentiate cellular mucosubstances. Acute gastroduodenal lesions were encountered early and frequently in 78% of adult burn patients. The early occurrence, morphology, and histology of these lesions suggest that alterations in gastric mucosal blood flow may play an important etiologic role. A decreased production of gastric mucus does not appear to be an etiologic factor since acute gastric mucosal disease was encountered in most patients despite normal quantities of cellular mucosubstances.

Acute Disease↗
PubMed1974

Histochemical changes in gastric mucosubstances in patients with acute and chronic ulcer disease.

The several types of epithelial cells in human gastric mucosa produce different mucosubstances. The surface epithelium largely forms a neutral mucosubstance except that in about two-thirds of the specimens the deep foveolar cells produce a slight to moderate amount of a mucosubstance apparently containing sulfate esters and carboxyl groups. Mucous neck cells often exhibit a neutral mucosubstance but in about onehalf of the stomachs reveal a slight to moderate reactivity indicative of sulfated mucosubstance. Chief cells contain a sulfated mucosubstance with unique histochemical properties. Mast cells vary widely in prevalence but those in the gastric mucosa appear depleted of stored mucosubstances when compared with those in the gastric submucosa or the esophagus. The sulfated mucosubstance normally abundant in human as in canine chief cells appears consistently depleted in patients with stress ulcer or hemorrhagic gastritis. In addition, mucus often appears depleted in the surface epithelium and interstitial edema is present in the superficial mucosa of these patients. These findings appear consistent with the view that biosynthetic activity in chief cells and surface epithelial cells is impaired perhaps secondary to shock-induced circulatory changes in gastric mucosa of patients with stress ulcer or hemorrhagic gastritis.

Carboxylic Acids↗