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Biomedical subjects

W G Edwards

Publications and source records attributed to W G Edwards.

14 recordsLinked to original sources
PubMed1998

Carcinoma of the bladder in renal transplant patients. A case report and collective review of cases.

Bladder malignancy in the renal transplant recipient is an infrequent occurrence. The 11 previously reported cases reflect an aggressive tumor growth with invasion, requiring partial or complete cystectomy with or without conduit diversion. We report an additional case in a 40-yr-old woman with a living related renal transplant, who experienced rapid progression of her tumor over 3 wk from initial hematuria to a pelvic mass involving the anterior bladder. Her allograft ureter and native ureters, as well as her left iliac vein, became obstructed with tumor in another 2 wk. Biopsy showed poorly differentiated, invasive transitional carcinoma. Attempted resection was abandoned because of finding tumor involvement in most of the pelvis. Chemotherapy was not attempted. She died 2 wk after her attempted resection from tumor burden. Our report presents a collective review of these previously reported 11 cases plus our case. These bladder tumors demonstrate a rapid progression of invasive disease and respond poorly to chemotherapy. There is a possible association of bladder tumors with cyclophosphamide immunosuppression. An aggressive surgical approach should be followed, especially since these tumors present in a younger age group.

Adult↗
PubMed1980

Hemodialysis encephalopathy with osteomalacic fractures and muscle weakness.

The hemodialysis unit at Columbia, South Carolina, opened in April, 1974. By June of 1977, 7 patients had died from dialysis encephalopathy, and 16 of the 51 surviving patients showed speech disorders, fits, and myoclonic jerks. Pathologic fractures were seen in 22 patients. Bone histomorphometry showed severe osteomalacia with minimal, if any, osteitis fibrosa, and serum alkaline phosphatase activity was normal. The mean serum aluminum concentration in 33 random patients was elevated at 83.5 microgram/liter (control group, 13.9 microgram/liter, P less than 0.001). The mean bone aluminum concentration in 4 patients who died from this syndrome was 307 ppm of bone ash (normal, less than 10 ppm). Dialysis fluid aluminum was high at 140 microgram/liter. Purification of the dialysis fluid with a water softener, reverse osmosis and a deionizer and abandoning extra-strength Basaljel resulted in a notable clinical and EEG improvement. None of 81 new patients who started hemodialysis between July of 1977 and July of 1979 after the change in treatment have developed any such symptoms. A syndrome of hemodialysis encephalopathy accompanied by pathologic osteomalacic fractures is described. Recovery is possible. The syndrome was eradicated after purification of the dialysis fluid.

Aged↗
PubMed1980

Functional middle ear reconstruction: experience with prostheses and tissue graft.

The transmission of sound to the internal ear passes across the tympanic membrane to vibrate the ossicle chain formed by the malleus, incus and stapes. Movements of the stapes footplate set up complex wave formation within the cochlear fluids to excite the sensory nerve endings of the organ of Corti. Microsurgery for the relief of middle ear deafness has been progressively developed since 1946 and is concerned with the restoration of this collection of sound by an intact flexible ear drum and transmission of oscillation across the middle ear by a free, mobile chain of ossicles. Otosclerosis is a deafness of genetic origin caused by bony overgrowth immobilizing the stapes footplate and is treated with a 95% success rate by selective stapedectomy and fenestration of the footplate. A prosthesis or one limb of the stapes is attached on to the incus and inserted into the fenestration, often with the use of using a tissue graft as a sealing membrane. Over twenty years' experience has originated many differing contours and materials for the stapes prosthesis--in scale some 4 mm or 5 mm in length and 0.3 mm to 0.8 mm in diameter--which will be illustrated and discussed. These prostheses lie deep within a healthy tympanic cavity, and it is most exceptional for a prosthesis to detach or extrude. In our large series subsequent reexploration usually reveals a prosthesis sheathed in mucosa without visible foreign body reaction.

Ear Ossicles↗
PubMed1979

Advanced head and neck cancer treated by combined radiotherapy and VBM cytotoxic regimen--four-year results.

The 4-year results of treatment of advanced squamous cell cancer of the head and neck regions by radiotherapy combined with a cytotoxic regimen VBM (Vincristine, Bleomycin, Methotrexate) given synchronously are compared with those obtained with radiotherapy alone in similar patients. There was a statistically significant improvement in the results of the combined treatment at four years in terms of crude survival rate (56.1% v. 24.5%) and disease free survival rate (56.5% v. 21.8%). Both groups are examined for general prognostic features which might account for the difference. In the absence of such features it must be concluded that the addition of VBM to radiotherapy had produced a marked therapeutic improvement.

Bleomycin↗
PubMed1978

Postpartum cytomegalovirus infection. A hazard of multiple transfusions.

A patient whose postpartum course included the defibrination syndrome and Bacteroides septicemia developed recurrent high fever. Cytomegalovirus infection was suspected on the basis of the clinical features and a history of massive blood transfusion, and was confirmed by subsequent observations. Recognition of this disease and its typically benign course averts the need for extensive diagnostic procedures, exploration, and empiric drug therapy trials.

Adult↗
PubMed1977

Method for improved protein separation in human and animal sera.

A method of improved protein separation in human and animal sera on columns of diethylaminoethyl cellulose is described. The improvement in protein separation is achieved by employing suitably modified elution gradients, the construction of which is described. A comparison with other work shows that improved resolution has been achieved over shorter elution times.

Animals↗
PubMedDate not supplied

The versatility of the basic microscope system in otolaryngology.

The operating microscope is now an essential tool for a large number of surgical procedures in a wide range of disciplines. At many medical centers, the optical equipment is often shared by surgeons from several disciplines. The expansion of microsurgical interest will continue to be interdisciplinary in the future, and this will call for microscope systems that are sufficiently versatile, both optically and mechanically, to meet the needs of surgery on a wide variety of anatomic structures. The development of the current range of microsurgical procedures in otolaryngology is presented to illustrate the concept of versatility by demonstrating the expansion of microsurgical technique to many regions of the head and neck. The key to this versatility has been the interchangeable objective lens system (200-400 mm), which allows a working distance appropriate to the depth of the various surgical approaches and which also allows the free transfer of microsurgical skills and instrumentation to new procedures.

Diagnostic Techniques, Surgical↗