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Biomedical subjects

S W Gray

Publications and source records attributed to S W Gray.

At least 19 recordsLinked to original sources
PubMed1991

Cancer of bile duct with situs inversus.

We present a case of adenocarcinoma of the distal common bile duct in a 68-year-old woman with total situs inversus. Endoscopic retrograde cholangiopancreatography prior to surgery demonstrated segmental obstruction of the distal common bile duct. Obstructive jaundice was observed and the results of liver function studies were abnormal. All biopsy specimens obtained in the operating room were negative. The case met all the criteria of Child and Frey, but at the end of the procedure the tumor was found to involve the superior mesenteric vein, a factor not appreciated during the operative evaluation of the patient. The situs inversus did not produce any technical problems. The patient did not have any surgical complications, but she died 18 months later of the cancer.

Adenocarcinoma↗
PubMed1991

Smooth muscle tumors of the rectum and anus: a collective review of the world literature.

In this collective review, we have compiled all the reported cases of smooth muscle tumors of the rectum/anus in the world literature from 1959 to 1989. Our goal was to increase the data pool of smooth muscle tumors by adding these new data to that previously collected from 1881 to 1959. We increased the pool for leiomyomas from 89 to 148 and that for leiomyosarcomas from 54 to 215. By doing this, we hoped to make more accurate conclusions about smooth muscle tumors based on this increased data pool. Some interesting findings included three cases in small children that were found in our recent review: a 2-year-old with a leiomyoma and two small infants, aged 12 days and 36 days, with leiomyosarcomas. Again, the findings were probably consistent with an increased data pool. We were also able to find several more cases involving the anal region. We found the highest incidence of leiomyomas to have increased by a decade from the 40-49 year age group to the 50-59 year age group, while among leiomyosarcomas, there was about equal incidence among the 50-59 and 60-69 age groups. We doubt that these represent actual changes in the demographics, but rather that these latter findings are more accurate based on the greater quantity of cases available to us. As a further example, we found no appreciable sex difference; however, we did find more cases reported in females. From our increased data pool, we were able to find 16 more cases that were described as dumbbell-shaped, compared to one that was reported before 1959. Palpable mass, hemorrhage, and pain/discomfort continued as the most common symptoms reported at presentation. With regard to size, the majority of leiomyomas were found to be less than 5 cm in diameter, closely followed by those 5-9 cm. The majority of leiomyosarcomas were 5-9 centimeters at discovery. Most cases of leiomyoma were treated by excision, while most cases of leiomyosarcoma were treated by abdominoperineal resection, a finding consistent with old data. We hope that this paper thoroughly reviews pertinent information about leiomyomas and leiomyosarcomas of the rectum/anus and, in doing so, serves to refresh a few memories, stimulate others, and teach a few.

Adolescent↗
PubMed1991

The incidence and significance of the posterior gastric artery in human anatomy.

This study examines the incidence of the posterior gastric artery in a series of 75 adult cadavers. We clearly identified the posterior gastric artery in 36 (48%) cadavers as a 1- to 2-mm vessel arising from the cranial border of the splenic artery within 3 cm of the celiac trunk and coursing dorsally to the posterior parietal peritoneum where it forms a fold before supplying the upper part of the posterior gastric wall. Identifying this vessel is difficult during surgery that compromises vascular tributaries of the stomach, and the obscure course and high incidence of this vessel necessitates awareness that, in a 75-85% gastrectomy, the short gastric artery or branches of the left gastric artery should be preserved since the posterior gastric artery will be sacrificed in 13% of these cases.

Arteries↗
PubMed1990

Effect of visuomotor rehearsal with videotaped modeling on racquetball performance of beginning players.

This investigation was designed to assess the effect of visuomotor behavior rehearsal (VMBR) with videotaped modeling on racquetball performance of beginning players. 24 male students in beginning racquetball class were randomly assigned to either VMBR with videotape modeling or relaxation and imagery (no modeling) condition for a 2-wk. training period. All subjects were pre- and posttested on forehand and backhand racquetball skill tests. Analysis indicated an effect for forehand shooting, with those given visuomotor behavior rehearsal with videotaped model exhibiting better performance than the relaxation and imagery group, but no effect for backhand shooting.

Adolescent↗
PubMed1990

Malignant fibrous histiocytoma of the pancreas.

Malignant fibrous histiocytoma (MFH) is a well-recognized soft-tissue sarcoma; however, its presentation as a primary neoplasm of the pancreas is unusual. We report a rare case of primary MFH of the pancreas treated with wide local excision and postoperative chemotherapy. Three cases of MFH of the pancreas have previously been reported in the world literature. The natural history of MFH of the pancreas cannot be summarized due to the rarity of the tumor. It appears, however, that the behavior of this tumor parallels the behavior of retroperitoneal MFH in terms of aggressiveness and poor prognosis.

Combined Modality Therapy↗
PubMed1989

The duodenum. Part 1: History, embryogenesis, and histologic and physiologic features.

Long before the Christian era, the duodenum was named and its function in controlling gastric emptying was conjectured. It received almost no further attention until the Eighteenth century when its relation to the bile and pancreatic ducts became know. The embryogenesis of the duodenum and the histological features of the organ are described as well as the gross movements that explain the mature relations of the duodenum to the surrounding structures. The "sphincters" of the duodenum are mentioned and evaluated.

Anatomy↗
PubMed1989

The duodenum. Surgical anatomy.

The second part of this monograph on the duodenum describes the muscular and mucosal changes observed at the gastroduodenal junction. The structure of the duodenal wall and details of the intramural portion of the common bile and pancreatic ducts are described, together with the surgical anatomy of the four parts of the duodenum. The arterial supply, the venous and lymphatic drainage, and the innervations are described from the surgeon's point of view.

Ampulla of Vater↗
PubMed1989

The duodenum. Part 3: Pathology.

Duodenal pathology includes various developmental malformations and acquired lesions. This report provides brief descriptions of various congenital anomalies of the duodenum, including stenosis and atresia, annular pancreas and ectopic duodenal pancreatic tissue, megaduodenum, duodenal diverticula, preduodenal portal vein, and paraduodenal fossae. Acquired lesions, such as duodenal ulcer, tumors, vascular compression, and duodenal trauma are also described.

Duodenal Diseases↗
PubMed1989

The duodenum. Part 4: Surgery.

This is the last part of our efforts to present, if possible, the duodenum in toto as an anatomical and surgical entity. For all practical purposes, Part 4 is a short presentation of the anatomy involved in mobilization and exposure of the duodenum from a surgical standpoint with specific applications. A table with most of the anatomical complications of duodenal surgery is also included.

Duodenum↗
PubMed1987

Apudomas.

Apudomas are neoplasms known to produce many biologically active amines. Some of these tumors have been known for 70 years, but over the last 15 years a wealth of new knowledge has been obtained. This study reports experience with apudomas over an 8-year period (1975-1983) at The Piedmont Hospital. There were 159 tumors with the potential for producing various ectopic hormones as well as biologically active amines, including 112 oat cell carcinomas, 37 carcinoid tumors, 4 paragangliomas, 2 pancreatic islet cell tumors, 2 medullary thyroid carcinomas, 1 pituitary adenoma, and 1 pinealocytoma. Of the 112 oat cell carcinomas, only 2 per cent had hormone-related symptoms. Of the carcinoid tumors, 12 were found in the appendix, 9 in the small intestine, 9 in the lungs, 4 in the colon and 2 in the rectum. Nineteen of the 37 carcinoids had hormone-related symptoms but none had a classic carcinoid syndrome. A third group of apudomas included several of relative rarity, the paragangliomas, the medullary thyroid carcinomas, the pancreatic islet cell tumors, pituitary adenomas, and pinealocytomas. Of this latter group, only the pancreatic islet cell tumors had symptomatology that could be related to ectopic hormone production.

Adenoma, Islet Cell↗