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Biomedical subjects

W E Powers

Publications and source records attributed to W E Powers.

At least 19 recordsLinked to original sources
PubMed1991

Eye metastasis from carcinoma of the breast: diagnosis, radiation treatment and results.

The experience at the Gershenson Radiation Oncology Center of 32 cases of metastases to the eye or orbit from breast cancer are presented with a review of the literature. The 32 patients were referred for radiation therapy in the period of 1980-1991. Eighteen patients had metastasis to the choroid, 2 patients had involvement of other parts of the eye (anterior chamber +/- choroid), and 11 patients had orbital metastasis. In one patient, the diffuse nature of the disease prevents subsite assignment. Ten of the patients with eye metastases also had brain or meningeal metastases (8 patients concurrent with eye metastases). Four of the 32 patients had bilateral choroidal metastases. A complete course of radiation therapy was delivered to 28 patients, one patient was not treated and 3 patients received only partial treatment because of general deterioration due to other widespread metastases from breast cancer. Of 21 evaluable patients, 15 had definite improvement. There was no progression of the eye metastases in the other 6 patients. The rest (7 patients) were lost to detailed follow-up of the response of the eye metastases. Four patients are still alive without any severe long-term side-effects. The diagnosis, treatment and outcome is presented with a review of the literature. The importance of emergency treatment for rapidly progressing lesions is stressed as well as the need for detailed treatment planning, careful delivery of daily treatments with a high degree of reproducibility and precision to prevent possible damage to sensitive normal structures.

Adult↗
PubMed1989

Transmission measurements in multi-rod arrays: a design study for a multi-rod collimator.

The results of transmission measurements for neutrons, cobalt-60 gamma-rays, and 10 and 15 MV photons made with close-packed arrays of tungsten rods are presented. These results indicate that tungsten rod arrays of reasonable thickness can provide for primary or secondary collimation of all these radiation beams. Development work on a collimation system utilizing the multi-rod concept which is capable of producing irregularly shaped fields and suitable for use in photon or neutron radiation therapy is described.

Humans↗
PubMed1979

Irradiation alone or in combination with surgery in stage IB and IIA carcinoma of the uterine cervix: A nonrandomized comparison.

This is a report of a nonrandomized comparison of treatment results of 244 patients with stage IB carcinoma of the uterine cervix treated by radiation alone and 92 treated with preoperative radiation and surgery and 77 patients with stage IIA treated by radiation alone and 24 treated with a combination of radiation and surgery. The techniques of irradiation and types of operation are described in detail. The five-year tumor free actuarial survival for the patients with stage IB treated either with irradiation alone or combined with surgery was approximately 85% and the ten-year survival, 78%. For stage IIA the tumor free actuarial five-year survival without tumor was 73% and for ten years, 60%. In the 244 patients treated with radiation alone, there were ten central failures (4%) usually combined with distant metastasis. Further, 16 of these patients (6.5%) developed parametrial recurrence, in all but one instance associated with distant metastasis. In the 92 patients with stage IB treated with combined therapy, there were three local recurrences (3.8%), two of them combined with parametrial failures and six parametrial recurrences (6.5%), all of them concomitant with distant metastasis. Of the 77 patients with stage IIA treated by irradiation alone, there was one central recurrence alone and five local and parametrial recurrences, all of them associated with periaortic nodes or distant metastasis. Four additional patients had parametrial recurrences only concurrent with distant metastasis. Of the 24 patients treated with irradiation and surgery, there were two parametrial recurrences combined with distant metastasis (8.2%). There was no significant difference in the survival or recurrence rate of the patients treated with either method. In the group treated with combined therapy, patients with stage IB who showed evidence of microscopic residual tumor after irradiation had a failure rate of approximately 42% (8/18) in contrast to only 8.6% (6/70) in those with negative specimens. In stage IIA there were three failures in eight patients with residual tumor in the specimen in contrast to only two of 16 with negative specimens (12.5%). Major complications were comparable in both groups (radiation alone approximately 8.7% and irradiation combined with surgery approximately 14%), the difference is not statistically significant. The most frequent minor complication in patients treated with radiation alone was vaginal fibrosis (30 patients--9%) or vaginal vault necrosis (10 patients--3%).

Adenocarcinoma↗
PubMed1979

Clinical importance of directional statistics for electrocardiographic differentiation of smoking habits.

Statistical methods for the analysis of directional data are of relatively recent origin and have not been generally applied in clinical investigations where they are appropriate. This study compares spherical means and standard deviations for directional polarcardiographic variables with the linear means and standard deviations of the same variables for a typical industrial cohort of male white collar workers. Normal subjects were classified by smoking status and by independent clinical evidence of the presence of CHD, and both directional and linear statistics are applied to compare the PCG variables in these groups. Directional statistics more accurately define the spherical means and variances of heart vectors and thereby permit more reliable differentiation of directions, or angles to aid diagnosis.

Adult↗
PubMed1979

Measuring the quality of medical care: a beginning.

Quality of medical care is fundamental; however, the recognition of quality is a complex task. The Patterns of Care Study is examining radiotherapeutic care in cancer throughout the United States, using a new methodology which can be applied to other medical disciplines. The system is described and illustrated as applied to the management of carcinoma of the cervix. Considerable variations in treatment have been identified. These variations can be studied and, where necessary, modified by appropriate educational programs; thus, the quality of medical care can be improved.

Decision Making↗
PubMed1978

Carcinoma of the pyriform sinus. An analysis of treatment results and patterns of failure.

A retrospective review of 169 patients with carcinoma of the pyriform sinus was accomplished for a ten-year-period from 1964 to 1974. Of the 169, 80 (47%) were treated with low dose preoperative radiation and partial laryngopharyngectomy (PLP), 57 (34%) were treated with radiation and total laryngectomy-partial pharyngectomy (TLP), and 32 (19%) were treated with palliative radiation, surgery or chemotherapy. Act,arial five-year-survival was 31% for all cases, 59% for the PLP group, 21% for the TLP group and 4% for the palliation group. Eighty to 90% of the relapses occurred within two years. The primary and/or nodal failure rates were 23, 37 and 78%, respectively for the PLP, TLP and palliation groups while the distant metastasis rates were 15, 37 and 34% for the three groups. Sites of failure differed for the three groups with a relatively high rate of contralateral neck metastases (23%) in the TLP group and an overwhelming number of primary and ipsilateral failures (78%) in the palliation group. Retreatment of failures resulted in few salvages (15%) and a significant number of fatal complications (26%). The cause of death was tumor related in most cases.

Carcinoma, Squamous Cell↗
PubMed1978

Noise pollution.

Explore the source record for details and available documents.

Humans↗
PubMed1977

Pseudoblocks and portal localization.

A new method of rapid simulation including design, verification and patient marking for shaped fields is described. This system utilizes a "pseudoblock" constructed from the Styrofoam components of the Cerrobend blocking system. The procedure is precise; errors in block aperture or patient positioning can readily be seen and corrected before the block is cast. In addition, the use of the pseudoblock does not significantly increase the time the patient spends in the simulator on his initial visit.

Humans↗
PubMed1976

Non-randomized comparison of preoperative irradiation and surgery versus irradiation alone in the management of carcinoma of the tonsil.

This is a non-randomized comparison of 98 patients with epidermoid carcinoma of the tonsil treated by preoperative irradiation and surgery and 97 patients receiving irradiation alone. Patients treated with preoperative irradiation received, in most instances, 3,000 rads tumor dose in three weeks through ipsilateral portals, followed within two to six weeks after completion of therapy by an en bloc tumor resection and radical neck dissection. The group treated with irradiation alone received tumor doses in the range of 5,500-6,500 rads in six weeks. No significant difference was noted in the survival yielded by either treatment modality. Both treatment modalities were equally effective in controlling the tumor in the metastatic ipsilateral lymph nodes. In selected cases, a combination of both modalitites may offer better results, but this remains to be proved.

Carcinoma, Squamous Cell↗
PubMed1975

Prognostic significance of endometrial extension from primary carcinoma of the uterinecervix.

This is a retrospective analysis of 302 patients with histologically confirmed primary carcinoma of the cervix on whom a dilatation and curettage was performed during the initial workup. The prognostic significance of endometrial extension of the tumor was investigated. Four different types of specimen were identified: 1) endometrial extension of cervical carcinoma; 2) cervical carcinoma in the currettings only; 3) a mixture of normal endometrium and and epidermoid carcinoma in the curettings; 4) no cervical carcinoma noted (negative D&C). The patients were staged according to the FIGO classification. Patients with Stage I carcinoma and positive D&Cs showed significantly lower 3-5 year survival rates (50-60 percent), as opposed to those with D&C.

Adenocarcinoma↗
PubMed1975

Development of a plastic surgical teaching service in a women's correctional institution.

A plastic surgical teaching service has been organized at a women's correctional institution to provide a previously unrecognized medical need and to serve a valuable educational function for our residents in training. A total of 177 surgical candidates demonstrating a wide range of reconstructive problems including tattoos, scars, keloids, neoplasms of the skin and hands, deformities of the face and breasts, and numerous disabilities of the hands were identified among 241 inmates requesting examination. Thus far, 116 operative procedures have been performed on 101 patients. Patient acceptance has been high, and the support of prison authorities has been enthusiastic. Persistent efforts to convince legislators of the wisdom of supporting this program financially have only been partially successful and will require further accumulation of sociologic data bearing on the rehabilitative potential of the detained patient with a correctable deformity. Meanwhile, residents in training gain maturity as they provide a very "private" type of service for what has traditionally been considered a very "public" population of patients.

Consumer Behavior↗