Biomedical subjects

R W Gilbert

Publications and source records attributed to R W Gilbert.

30 records · Page 2Linked to original sources

PubMed1985

Augmentation in rhinoplasty--a personal view.

This paper presents a view on the use of various synthetic materials in rhinoplasty and the authors' preference for autologous bone as an augmentation material. The biology of bone transplantation as it applies to rhinoplasty is reviewed. Specific techniques for augmentation of the major saddle deformity are described, emphasizing the use of the external rhinoplasty approach for exposure as well as the authors' view that the dorsal graft should not extend beyond the cephalic border of the lower lateral cartilage. The senior author's experience with autologous bone as an augmentation material in 60 patients with major saddle deformities is reviewed. There were three patients whose grafts totally resorbed, and two cases of late graft fracture and displacement. The remaining patients had resorption graded as minor or insignificant. There were only two donor site complications--both wound seromas. Patients reviewed had been followed from one to 18 years.

Bone Transplantation↗

PubMed1985

Approach to naso-frontal-ethmoidal complex fractures.

Naso-fronto-ethmoidal complex fractures are infrequently encountered. The authors' approach to the management of the patient with this injury is presented emphasizing the importance of the adoption of a systematic approach to the evaluation of the patient with a maxillofacial injury. The frequency of associated injuries is stressed. The open reduction of this fracture and the use of interosseous fixation is recommended. The importance and technique of repair of the medial canthal ligaments is reviewed as well as the authors' preference for the use of the "open sky" exposure in most patients with this injury.

Ethmoid Bone↗

PubMed1985

Malignant schwannoma in the head and neck.

The authors' experience in dealing with three cases of malignant Schwannoma in the head and neck is outlined. The symptomatology of this tumor is discussed with its investigation and management. A correct diagnosis with a CT scan to delineate tumor extent is imperative. A wide surgical resection is the preferred method of treatment with postoperative irradiation of value for residual microscopic disease. The pernicious nature of this tumor often leads to a dismal outcome despite aggressive therapy.

Adult↗

PubMed1984

An approach to the posterior interosseous nerve.

An exposure of the posterior interosseous nerve has been described. We feel this exposure is simple, anatomic, and atraumatic and yet provides excellent visualization of the posterior interosseous nerve. In addition, proximal and distal exposure of the nerve is easily obtained. This exposure has been used in various clinical settings from trauma to compressive lesions. It has proved both effective and superior to any previously described exposures of the posterior interosseous nerve.

Dissection↗

PubMed1984

Refinement of the pectoralis major myocutaneous flap.

The pectoralis major myocutaneous flap has become the primary reconstructive flap in head and neck surgery. We have reviewed our experience and describe some modifications of incisions for elevation of this flap which will improve cosmetic results in both male and female patients. The technique for elevation of this flap is reviewed as well as some of the problem areas including the female with a large breast and the elevation of vascularized rib with the myocutaneous flap.

Female↗

PubMed1978

Epidural spinal cord compression from metastatic tumor: diagnosis and treatment.

The clinical findings in 130 conseucutive cases of spinal cord compression by metastatic extradural tumors were analyzed. These 130 patients were combined with a previous survey of 105 patients to compare the effectiveness of radiation therapy (RT) alone with that of surgical decompression followed by RT. Ambulation after treatment was considered a successful outcome. The most common primary tumors producing spinal cord compression were (in order) breast, lung, prostate, and kidney. In 68% of these tumors the thoracic region was involved. Pain was the primary symptom of 96% of the patients, while motor or sensory deficits (or both) were found in 82% of them. Therapy consisted of surgery and RT in 65 patients and RT alone in 170 patients. There were no differences in outcome between those treated by surgery combined with RT and those managed by RT alone. Patients with radiosensitive tumors and those ambulatory at the onset of treatment benefited whether treated by surgery or by RT. Seventy-five percent of living patients who improved from treatment remained ambulatory at 6 months, and approximately 50% of living patients were ambulatory at 1 year. We conclude that RT without decompressive laminectomy is as effective as decompressive laminectomy in treating epidural spinal cord compression from systemic cancer.

Adolescent↗

PubMed1976

Cellular immunity in rats with primary brain tumors: inhibition of macrophage migration by soluble extracts of avian sarcoma virus-induced tumors.

Rats bearing primary tumors of the brain induced by avian sarcoma virus (ASV) were studied with the migration-inhibition factor (MIF) assay for the presence of cell-mediated immunity to tumor-associated antigens. Astrocytomas and sarcomas of the brain were induced in 34 neonatal F344 rats by the intracerebral inoculation of Bratislava-77 ASV. At weekly intervals from 4 to 9 weeks after the inoculation with virus, peritoneal exudate cells (PEC) from rats bearing brain tumors were tested an an MIF assay against soluble and KCl-treated extracts of a syngeneic, ASV-induced sarcoma. Incubation of the PEC with a soluble extract of syngeneic liver or with a KCl extract of a syngeneic, chemically induced tumor served as controls. Of 14 rats tested against the soluble tumor extract, 6 (43%) had statistically significant inhibition of migration (P less than or equal to 0.05). Of 23 animals tested against the KCl extract, 16 (70%) had significant inhibition. Immunity to the KCl extract was significant in most rats at each period. Ten rats were tested against a KCl extract of a hamster ASV-induced tumor; 7 gad significant inhibition of migration. None of 3 tested against a soluble extract of a syngeneic, chemically induced tumor had significant inhibition. Rats bearing ASV-induced brain tumors displayed cell-mediated immunity to tumor-associated antigen or antigens of ASV-induced tumors, which could be solubilized.

Animals↗

PubMedDate not supplied

Correlation of tumor volume with local control in laryngeal carcinoma treated by radiotherapy.

An analysis of 37 patients with laryngeal carcinoma (T2 or greater) treated with radical radiotherapy, with surgery reserved for failure, was performed to determine if tumor volume, alone or in association with other prognostic factors, accurately predicted the probability of local control. Patient records were reviewed retrospectively and the following data extracted: age, sex, laryngeal region and number of sites involved by tumor, T and N categories, and success or failure of radiotherapy. Tumor volume for each patient was calculated from pretreatment computed tomograms by summing the products of the cross-sectional tumor area on each CT cut and the interval in millimeters between sequential CT cuts. The mean tumor volume for patients failing radiotherapy was 21.8 cm3, and the mean volume for patients primarily controlled by radiotherapy was 8.86 cm3. Tumor volume significantly predicted disease-free interval (p = .045) and outcome with radiotherapy (p = .02). The study suggests that tumor volume is a significant factor in determining the outcome of primary radiotherapy in advanced laryngeal carcinoma.

Adult↗

PubMedDate not supplied

Management of patients with long-term tracheotomies and aspiration.

The purpose of this study was to develop a management protocol for patients with long-term tracheotomies and aspiration, in order to develop clinical criteria for extubation and reduction of aspiration-related complications. We studied 39 patients with tracheotomies in place for over 3 months, 28 of whom completed management. Patients were classified according to degree of impairment and managed with the aims of avoiding aspiration and performing extubation whenever feasible. Criteria for choosing various management strategies are presented.

Adult↗

PubMedDate not supplied

Anodal block: can this occur during routine nerve conduction studies?

The median nerves of five normal subjects were electrically excited at the wrist with fine-tipped stimulating electrodes in a bipolar fashion. Compound sensory nerve action potentials (CSNAPs) were recorded from the index finger and compound muscle action potentials (CMAPs) from the thenar muscles. Both the cathode and the anode were positioned over the length of the nerve. Recordings were performed with different cathode-to-anode distances of 5, 10, 20, and in some cases, 30 mm. Just supramaximal CSNAPs and CMAPs were obtained initially with the cathode situated distal to the anode and then with the stimulus polarity reversed. There were no significant differences in the amplitude, duration, and morphology of the CSNAPs or CMAPs that were recorded by using different stimulus polarities. There was a consistent increase in the onset latency of the responses when the stimulus polarity was reversed (cathode located proximal to anode). This increase in latency was proportionate to the increase in distance from the cathode to the recording electrode. The effect of anodal block could not be observed from the above experiment.

Action Potentials↗

PubMedDate not supplied

Effect of calcium/phosphorus imbalance in the ration on flock performance in two broiler flocks in north Georgia.

Five- and six-day-old broilers from two flocks experiencing excessive mortality were submitted for necropsy. Rickets was diagnosed based on clinical signs of lameness and on gross and histopathologic lesions. Because of a confirmed feed mill error, these flocks had been fed a starter ration with a high calcium/phosphorus ratio (either 7.7:1 or 3.5:1). After debate concerning the profitability of salvaging the remaining birds in the affected flocks, the starter feed was replaced at 7 days of age. At processing, the affected flocks had weighted averages of body weight and feed conversion of 1.71 kg and 1.88, respectively; these averages compared favorably with the company averages of 1.72 kg and 1.87. The majority of the mortality in the affected flocks occurred during the first week. This case report demonstrates that it may be advantageous for a producer to salvage chicks that have been affected severely with rickets at less than 1 week of age.

Animal Feed↗

PubMedDate not supplied

Copper sulfate toxicosis in commercial laying hens.

A flock of 51-week-old leghorn hens experienced a 16% drop in egg production in a single week. The layer ration contained 1477 ppm copper from the addition of copper sulfate. Severe oral ulcers were present in the pharynx. Oral ulcers, reduced feed intake, and a drop in egg production occurred when a ration containing 1437 ppm copper was evaluated experimentally.

Animals↗