Biomedical subjects

T L Stokes

Publications and source records attributed to T L Stokes.

12 recordsLinked to original sources

PubMed1979

Granular cell myoblastoma of the head and neck: review of the literature and 10 year experience.

The literature on granular cell myoblastoma (Abrikossoff's tumor) is reviewed and 16 new cases are presented. The etiology of this tumor remains uncertain, although a neurogenic origin appears likely. Individual tumors are usually small, nodular, and nonulcerating. There appeared to be no predilection for either sex in our series, and most tumors occurred between the third and sixth decades of life. Pseudoepitheliomatous hyperplasia is frequently associated with granular cell myoblastoma, and this combination must be distinguished from squamous cell carcinoma. Wide local excision, the treatment of choice, should be curative, although the incidence of multicentricity may exceed 15%. Thus, despite the usually benign nature of granular cell myoblastoma, its propensity for local invasion, multicentricity, and associated pseudoepitheliomatous hyperplasia should alert surgeons to its potential hazards, to the probability of recurrence if it is only marginally excised, and to the possible later development of similar lesions.

Adolescent↗

PubMed1979

Preventing disruption of abdominal wounds.

The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedation, cutting of viscera, and a residual cross-hatched scar. Nevertheless, we believe that use of the technic is amply justified by the prevention of abdominal wound disruption, ease in visualization of the wound, ease in providing equal distribution of wound tension and periodic adjustment of it, and in reapproximation of superficial tissues in the event of wound breakdown, as well as in the elimination of need for any external supportive device. The existence of a voluminous literature on the placing, making, and closing of abdominal incisions suggests that no single ideal method exists. Major disruption of abdominal wounds continues to be a serious problem, despite the infrequency of its occurrence. The use of through-and-through semirigid silver wire retention sutures with adjustable tension as a complement to the routine layered closure can prevent disruption of abdominal wounds while causing only minor complications.

Abdominal Injuries↗

PubMed1978

Cholecystohepatic duct.

Review of embryologic and surgical literature emphasizes the great variability in biliary ducts. Major cholecystohepatic ducts are rare, although accessory bile ducts are common. A rare case of intrahepatic junction of right and left hepatic ducts providing drainage through a single cholecystohepatic duct is presented. Chlolecystectomy and primary anastomosis of hepatic ducts and duodenum was successful. We know of no report of a precisely similar case. Awareness of the possibility of these anomalies should increase their reported incidence and decrease the severe morbidity and mortality attending failure of recognition.

Aged↗

PubMed1978

Pelvic lipomatosis.

Although usually in the domain of the urologist, pelvic lipomatosis sometimes first may present to the general surgeon. Often called perivesical lipomatosis, this process of unknown etiology has been defined as a nonmalignant overgrowth of normal fatty tissue limited primarily to the perirectal and perivesical spaces in the pelvis. Typically it occurs in middle-aged, nonobese, men presenting with dysuria and sometimes with suprapubic fullness. High position of the prostate may be noted on rectal examination. Urinary tract roentgenograms show a high, gourd-shaped bladder with the surrounding radiolucency of fatty tissues. Elongation of the urethra usually makes cystoscopy difficult. Sigmoidoscopy and barium enema may reveal extrinsic pressure on the rectum. Pelvic venography rarely shows external venous compression; arteriography does not suggest neoplastic vessels. Fat metabolism studies are of little value. The absence of adequate cleavage planes renders direct surgical management difficult. The frequently progressive lower ureteral obstruction eventually may require urinary diversion. Four biopsy-proved cases from the Eastern Virginia Medical School Hospitals are reported, and the 57 previous cases from the literature are reviewed.

Adult↗

PubMed1976