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1. New Frontiers in Aortic Therapy: Focus on Current Trials and Devices in Transcatheter Aortic Valve Replacement

Author

Jacob T. Gutsche, Aris Sophocles, David B. Jones, Saif Anwaruddin, John G.T. Augoustides, Nimesh D. Desai, Sy-Yeu S. Chern, Elizabeth K. Walsh, Stuart J. Weiss, and Prakash A. Patel

Subjects
medicine.medical_specialty, Transcatheter aortic, Patient risk, medicine.medical_treatment, Prosthesis Design, Transcatheter Aortic Valve Replacement, Valve replacement, Internal medicine, medicine, Humans, In patient, Clinical Trials as Topic, business.industry, Aortic Valve Stenosis, Perioperative, medicine.disease, Surgery, Stenosis, Treatment Outcome, Anesthesiology and Pain Medicine, Heart Valve Prosthesis, Aortic valve stenosis, Cardiology, Cardiology and Cardiovascular Medicine, business, Edwards sapien
Abstract

The first decade of clinical experience with transcatheter aortic valve replacement since 2002 saw the development of 2 main valve systems, namely the Edwards Sapien balloon-expandable valve series and the Medtronic self-expanding CoreValve. These 2 valve platforms now have achieved commercial approval and application worldwide in patients with severe aortic stenosis whose perioperative risk for surgical intervention is high or extreme. In the second decade of transcatheter aortic valve replacement, clinical experience and refinements in valve design have resulted in clinical drift towards lower patient risk cohorts. There are currently 2 major trials, PARTNER II and SURTAVI, that are both evaluating the role of transcatheter aortic valve replacement in intermediate-risk patient cohorts. The results from these landmark trials may usher in a new clinical paradigm for transcatheter aortic valve replacement in its second decade.

Published
2015
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2. The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights From 2014

Author

Lourdes Al-Ghofaily, John G.T. Augoustides, Sy Yeu S. Chern, Michael Andritsos, George Silvay, Hynek Riha, Kamrouz Ghadimi, Gurmukh Sahota, Frederick C. Cobey, Michael Fabbro, Prakash A. Patel, Sophia T Cisler, Elizabeth A. Valentine, Harish Ramakrishna, Emily K. Gordon, Jacob T. Gutsche, Aris Sophocles, and Stuart J. Weiss

Subjects
Aortic arch, medicine.drug_mechanism_of_action, medicine.medical_treatment, Factor Xa Inhibitor, Left atrial appendage occlusion, Dabigatran, medicine.artery, medicine, Humans, Anesthesia, Stroke, Clinical Trials as Topic, Aspirin, biology, business.industry, Atrial fibrillation, medicine.disease, Troponin, Anesthesiology and Pain Medicine, Cardiovascular Diseases, Practice Guidelines as Topic, biology.protein, Cardiology and Cardiovascular Medicine, business, medicine.drug
Published
2015
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3. Translating versus nontranslating cervical plates

Author

Zachary L. McBeth, Scott Golembeski, Vikas V. Patel, Emily M. Lindley, Aris Sophocles, and Evalina L. Burger

Subjects
musculoskeletal diseases, Orthodontics, Cobb angle, Lordosis, business.industry, Radiography, Radiographic Films, Load sharing, Anterior cervical discectomy and fusion, General Medicine, musculoskeletal system, medicine.disease, Medicine, Displacement (orthopedic surgery), business, Increased lordosis
Abstract

Several anterior cervical plating systems recently have been designed to allow for controlled movement between fused vertebrae to increase load sharing across an interbody graft. The purpose of this study was to determine whether dynamic translating cervical plates are associated with improved radiographic outcomes as compared with variable-angle screw plates in patients undergoing anterior cervical discectomy and fusion (ACDF). We retrospectively reviewed medical records and postoperative radiographic films (3, 6, and 12 months) of patients who underwent single and multilevel ACDF using either dynamic translating or variable-angle plates. Data were analyzed relative to mean displacement of vertebrae, number of vertebrae fused, fusion status, and Cobb angle. Of the 50 patients in this study, 24 received translating plates and 26 received variable-angle plates. Radiographic outcomes were similar between the two groups when looking at mean displacement of vertebrae, number of vertebrae fused, and fusion status. We observed a higher rate of Cobb angle change greater than 3° with translating plates. Additionally, we observed a trend toward loss of lordosis in the translating group and increased lordosis in the variable-angle group. Our study failed to confirm our hypothesis that translating plates are associated with higher fusion rates than variable-angle plates. A higher rate of Cobb angle change along with a decrease in mean Cobb angle was observed in the translating group. Loss of lordosis in the translating group may suggest a negative impact with these plates, including less ideal alignment of the spine.

Published
2013
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4. Challenges After the First Decade of Transcatheter Aortic Valve Replacement: Focus on Vascular Complications, Stroke, and Paravalvular Leak

Author

Kamrouz Ghadimi, John G.T. Augoustides, Prakash A. Patel, Christopher Reidy, Harish Ramakrishna, and Aris Sophocles

Subjects
Cardiac Catheterization, medicine.medical_specialty, medicine.medical_treatment, Pseudoaneurysm, Postoperative Complications, Valve replacement, Aortic Valve Annulus, Internal medicine, medicine, Humans, Vascular Diseases, Cardiac skeleton, Stroke, Heart Valve Prosthesis Implantation, business.industry, valvular heart disease, Atrial fibrillation, Embolic Protection Devices, medicine.disease, Surgery, Treatment Outcome, Anesthesiology and Pain Medicine, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Transcatheter aortic valve replacement (TAVR) is entering its second decade. Three major clinical challenges have emerged from the first decade of experience: vascular complications, stroke, and paravalvular leak (PVL). Major vascular complications remain common and independently predict major bleeding, transfusion, renal failure, and mortality. Although women are more prone to vascular complications, overall they have better survival than men. Further predictors of major vascular complications include heavily diseased femoral arteries and operator experience. Strategies to minimize vascular complications include a multimodal approach and sleeker delivery systems. Although cerebral embolism is very common during TAVR, it mostly is asymptomatic. Major stroke independently predicts prolonged recovery and increased mortality. Identified stroke predictors include functional disability, previous stroke, a transapical approach, and atrial fibrillation. Embolic protection devices are in development to mitigate the risk of embolic stroke after TAVR. PVL is common and significantly decreases survival. Undersizing of the valve prosthesis can be minimized with 3-dimensional imaging by computed tomography or echocardiography to describe the elliptic aortic annulus accurately. The formal grading of PVL severity in TAVR is based on its percentage of the circumferential extent of the aortic valve annulus. Further emerging management strategies for PVL include a repositionable valve prosthesis and transcatheter plugging. The first decade of TAVR has ushered in a new paradigm for the multidisciplinary management of valvular heart disease. The second decade likely will build on this wave of initial success with further significant innovations.

Published
2013
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5. The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2012

Author

Bernard J. Lane, Kamrouz Ghadimi, Michael Andritsos, John G.T. Augoustides, Harish Ramakrishna, Prakash A. Patel, Christopher Reidy, Aris Sophocles, and Hynek Riha

Subjects
Teamwork, business.industry, media_common.quotation_subject, medicine.medical_treatment, Specialty, Percutaneous coronary intervention, Coronary Artery Disease, Perioperative, Thoracic Surgical Procedures, medicine.disease, Subspecialty, Coronary artery disease, Patient safety, Coronary artery bypass surgery, Postoperative Complications, Anesthesiology and Pain Medicine, Anesthesia, medicine, Humans, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures, media_common
Abstract

Cardiothoracic and vascular critical care has emerged as a subspecialty due to procedural breakthroughs, an aging population, and a multidisciplinary collaboration. This subspecialty now has a dedicated professional society, recently published guidelines, and plans for standardized certification. This paradigm shift represents a major collaboration opportunity for our specialty. The rise of evidence-based perioperative practice has produced a culture of large trials in our specialty to search for solutions to the challenging outcome questions. Besides the growth in the development of evidence, the consensus conference format and postpublication peer review have both emerged as effective processes for identifying the most relevant high-quality evidence. The quest for best perioperative practice has highlighted the importance of teamwork at all phases of care with respect to transitions in care, blood component transfusion, and research misconduct. The emergence of ultrasound as a standard for central vascular access also has been emphasized in recent multisociety guidelines. There also has been a paradigm shift in the management of patients with coronary artery disease. Recent guidelines have emphasized the roles of the cardiac anesthesiologist and the interventional cardiologist as part of the heart team approach. Major recent trials in comparative effectiveness have challenged the advantages of percutaneous coronary intervention, off-pump coronary artery bypass surgery, and intra-aortic balloon counterpulsation. The year 2012 has witnessed the emergence of new paradigms of care in our specialty with the emphasis on teamwork, safety, and quality. These processes will further improve perioperative outcome.

Published
2013
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6. Reducing Perioperative Mortality with the Intra-Aortic Balloon Pump

Author

Aris Sophocles, George Silvay, John G.T. Augoustides, and Emily J. MacKay

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Diastole, Perioperative, Balloon, Balloon inflation, medicine.anatomical_structure, Ventricle, Internal medicine, medicine, Coronary perfusion pressure, Cardiology, Systole, business, Intra-aortic balloon pump
Abstract

The intra-aortic balloon pump (IABP) enhances myocardial performance by minimizing oxygen supply/demand mismatch [1–6]. Balloon inflation during diastole enhances myocardial oxygen delivery due to increased diastolic coronary perfusion pressure [4–6]. Balloon deflation just prior to systole reduces myocardial oxygen demand by unloading the left ventricle [4–6]. Recent evidence has identified the IABP as a therapeutic modality that may reduce perioperative mortality due to these myocardial benefits [1–3].

Published
2016
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7. Transition of Care in the Cardiothoracic Intensive Care Unit: A Review of Handoffs in Perioperative Cardiothoracic and Vascular Practice

Author

John G.T. Augoustides, Michael Fabbro, Jesse Raiten, Sy Yeu S. Chern, Jacob T. Gutsche, Lourdes Al-Ghofaily, Aris Sophocles, Benjamin A. Kohl, and Meghan B. Lane-Fall

Subjects
medicine.medical_specialty, business.industry, Patient Handoff, Perioperative, Transitional Care, Intensive care unit, Perioperative Care, law.invention, Intensive Care Units, Anesthesiology and Pain Medicine, law, Critical care nursing, Perioperative care, medicine, Humans, Transitional care, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published
2015

8. Postoperative amnesia in a patient undergoing general anesthesia for electro-physiologic (EP) catheter ablation of an irritable atrial focus

Author

Aris, Sophocles, Linda, Chen, David, Lin, and Renyu, Liu

Subjects
Article
Abstract

This case report describes the anesthetic management of a 67-year-old who underwent a catheter based pulmonary vein isolation (PVI) of long-standing, persistent atrial fibrillation. When the patient awoke from the 6.5 hour procedure, he was found to have a transient retrograde and anterograde amnesia that persisted for 18–24 hours postoperatively. This is a unique instance of global amnesia following a cardiac ablation procedure under prolonged general anesthesia. This case study highlights important topics in postoperative cognitive deficits including the differential diagnosis, risk factors, and strategies for optimizing patient outcomes in high risk procedures.

Published
2014

10. Manual Vacuum Aspiration for First-Trimester Abortion

Author

John M. Westfall, Sarah Ellis, Holly Burggraf, and Aris Sophocles

Subjects
Adult, medicine.medical_specialty, Colorado, Adolescent, Vacuum, medicine.medical_treatment, Uterine perforation, Abortion, Medical Records, Pregnancy, medicine, Humans, First trimester abortion, Retrospective Studies, Vacuum aspiration, Primary Health Care, Obstetrics, business.industry, Abortion, Induced, General Medicine, medicine.disease, Pregnancy Trimester, First, Inhalation, Products of conception, Gestation, Female, business, Pelvic Infection
Abstract

OBJECTIVE To assess the safety and effectiveness of manual vacuum aspiration for abortion in a primary care office setting. DESIGN Retrospective chart audit. SETTING Private family practice office. PATIENTS A total of 1769 consecutive women who obtained an abortion in this office between January 1, 1993, and December 31, 1995, for whom 1677 medical charts were available for review. MAIN OUTCOME MEASURES Rate of complete abortion, estimated blood loss, and rate of complications. Complications included early complications of uterine perforation, cervical injury, and hospitalization, and late complications of pelvic infection and retained products of conception. RESULTS Overall, manual vacuum aspiration was 99.5% effective in terminating pregnancy through 12 weeks of gestation. There were no major complications, and the minor complications of retained products of conception and infection were easily treated. CONCLUSION Manual vacuum aspiration performed in a primary care office setting is safe and effective in terminating pregnancy through the end of the 10th week of gestation.

Published
1998
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11. Reducing Perioperative Mortality with Intra-Aortic Balloon Counterpulsation (IABP)

Author

Aris Sophocles, George Silvay, and John G.T. Augoustides

Subjects
medicine.medical_specialty, business.industry, Cardiogenic shock, medicine.medical_treatment, Diastole, Percutaneous coronary intervention, Perioperative, medicine.disease, Balloon, medicine.anatomical_structure, Ventricle, Internal medicine, medicine, Cardiology, Coronary perfusion pressure, Systole, business
Abstract

Recent international consensus has identified intra-aortic balloon counterpulsation (IABP) as a therapeutic modality that may reduce perioperative mortality [Landoni et al. (Acta Anesthesiol Scand 55:259-66, 2011), Landoni et al. (J Cardiothorac Vasc Anesth 26:764-72, 2012)]. The therapeutic benefit of IABP stems from its improvement of left ventricular performance by minimizing oxygen supply/demand mismatch [Peura et al. (Circulation 126:2648-67, 2012)]. Balloon inflation during diastole enhances coronary perfusion pressure to boost myocardial oxygen delivery. Balloon deflation just prior to systole reduces myocardial oxygen demand by unloading the left ventricle.

Published
2013
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12. Perioperative conduction disturbances after transcatheter aortic valve replacement

Author

John G.T. Augoustides, Jacob T. Gutsche, Kamrouz Ghadimi, Aris Sophocles, Prakash A. Patel, Wilson Y. Szeto, and Saif Anwaruddin

Subjects
medicine.medical_specialty, Cardiac Catheterization, Heart block, medicine.medical_treatment, Valve replacement, Heart Conduction System, Internal medicine, Atrial Fibrillation, medicine, Humans, Cardiac skeleton, Intraoperative Complications, Heart Valve Prosthesis Implantation, business.industry, Atrial fibrillation, Perioperative, Right bundle branch block, medicine.disease, Clinical trial, Anesthesiology and Pain Medicine, Heart Block, Aortic Valve, Cardiology, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract

Cardiac conduction disturbances after transcatheter aortic valve replacement (TAVR) are common and important. The risk factors and outcome effects of atrial fibrillation after TAVR recently have been appreciated. The paucity of clinical trials has resulted in the absence of clinical guidelines for the management of this important arrhythmia in this high-risk patient population. Given this evidence gap and clinical necessity, it is likely that clinical trials in the near future will be designed and implemented to address these issues. Prompt recognition and proper management of atrioventricular block remain essential in the management of patients undergoing TAVR, because heart block of all types is common and may require permanent pacemaker implantation. The current evidence base has described the incidence, risk factors, and current outcomes of this conduction disturbance in detail. As the practice of TAVR evolves and novel valve prostheses are developed, a focus on minimizing damage to the cardiac conductive system remains paramount. It remains to be seen how the next generation of TAVR prostheses will affect the incidence, risk factors, and clinical outcomes of associated conduction disturbances.

Published
2013

15. Blalock-Taussig Shunt (BTS)

Author

Aris Sophocles and Mark Twite

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Medicine, Blalock–Taussig shunt, business, Surgery
Published
2011
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16. Contributors

Author

Sanjib Adhikary, Jorge Aguilar, Charles Ahere, Moustafa Ahmed, Jane C. Ahn, Shamsuddin Akhtar, David B. Albert, Nasrin N. Aldawoodi, John T. Algren, Gracie Almeida-Chen, David Amar, Zirka H. Anastasian, Stephen Aniskevich, Solomon Aronson, Harendra Arora, Amit Asopa, Joshua H. Atkins, John G. Augoustides, Mohammad Fareed Azam, Catherine R. Bachman, Douglas R. Bacon, Andrew D. Badley, Emily Baird, Alethia Baldwin, Ryan Ball, Amir Baluch, David Bandola, Shawn Banks, Paul G. Barash, Kathleen E. Barrett, Shawn T. Beaman, Jonathan C. Beathe, Christopher D. Beatie, W. Scott Beattie, Perry S. Bechtle, G. Richard Benzinger, Lauren Berkow, Jeffrey M. Berman, Wendy K. Bernstein, Arnold J. Berry, Frederic Berry, Ulrike Berth, Walter Bethune, Sumita Bhambhani, Shobana Bharadwaj, Neil Bhatt, Frederic T. Billings, Wendy B. Binstock, David J. Birnbach, Michael Bishop, Stephanie Black, Mary A. Blanchette, James M. Blum, Krishna Boddu, Lara Bonasera, Richard L. Boortz-Marx, Cecil O. Borel, Gregory H. Botz, Charles D. Boucek, William Bradford, Jason C. Brainard, Michelle Braunfeld, Ferne R. Braveman, Caridad Bravo-Fernandez, Peter H. Breen, Marjorie Brennan, Tricia Brentjens, Megan A. Brockel, Jay B. Brodsky, Todd A. Bromberg, Adam J. Broussard, Chris Broussard, Carmen Labrie-Brown, Robert H. Brown, Charles S. Brudney, Sorin J. Brull, Claude Brunson, Trent Bryson, Jacob M. Buchowski, Stefan Budac, Zachary D. Bush, John Butterworth, Lisbeysi Calo, Christopher Canlas, Ayana Cannon, Shawn M. Cantie, Lisa Caplan, Marco Caruso, Davide Cattano, Charles B. Cauldwell, Laura Cavallone, Maurizio Cereda, Thomas M. Chalifoux, Susan Chan, Theodore G. Cheek, Alexander Chen, Samuel A. Cherry, Albert T. Cheung, Grace L. Chien, Peter T. Choi, Christopher Ciarallo, Franklyn Cladis, Anthony J. Clapcich, Richard B. Clark, Mindy Cohen, Neal H. Cohen, Robert I. Cohen, Stephan J. Cohn, Aisling Conran, Richard I. Cook, Randall F. Coombs, David M. Corda, Daniel Cormican, Darren Cousin, Vincent S. Cowell, Lyndsey Cox, Paula A. Craigo, Richard C. Cross, Roy F. Cucchiara, William H. Daily, Gaurang Dalal, Priti Dalal, Michael Danekas, Ahmed M. Darwish, Ribal Darwish, Suanne M. Daves, Kathleen Davis, Peter J. Davis, Bracken J. De Witt, Ellise Delphin, Seema Deshpande, Dawn P. Desiderio, Tricia Desvarieux, Laura K. Diaz, Christian Diez, Sanjay Dixit, Meenakshi Dogra, Karen B. Domino, Kathryn Dorhauer, Todd Dorman, Don D. Doussan, James Duke, Ann C. Duncan, Frank W. Dupont, Andrew Dziewit, L. Jane Easdown, R. Blaine Easley, Thomas J. Ebert, David M. Eckmann, Talmage D. Egan, Seth Eisdorfer, Nabil M. Elkassabany, Ryan P. Ellender, Logan S. Emory, Monique Espinosa, Lucinda L. Everett, Nauder Faraday, James J. Fehr, James M. Feld, Lynn A. Fenton, Laura H. Ferguson, Matthew Fiegel, Aaron M. Fields, Gordon N. Finlayson, Alan Finley, Gregory W. Fischer, Gary Fiskum, Molly Fitzpatrick, Russell Flatto, Lee A. Fleisher, Ronda Flower, Annette G. Folgueras, Patrick J. Forte, Joseph F. Foss, Charles J. Fox, William R. Furman, Robert Gaiser, David R. Gambling, Scott Gardiner, Matthew L. Garvey, Abraham C. Gaupp, Steven Gayer, Jeremy M. Geiduschek, Frank Gencorelli, Eric Gewirtz, Ghaleb A. Ghani, Charles P. Gibbs, Jeremy L. Gibson, Lori Gilbert, Kevin J. Gingrich, Gregory Ginsburg, Christopher Giordano, Christine E. Goepfert, Hernando Gomez, Santiago Gomez, Alanna E. Goodman, Stephanie R. Goodman, Alexandru Gottlieb, Ori Gottlieb, Allan Gottschalk, Basavana Gouda Goudra, Harry J. Gould, Nikolaus Gravenstein, Megan Graybill, William J. Greeley, Patrick Guffey, Ala Sami Haddadin, John G. Hagen, Karim Abdel Hakim, Michael Hall, N. James Halliday, Raafat S. Hannallah, Jeremy Hansen, C. William Hanson, Charles B. Hantler, Andrew P. Harris, Jonathan Hastie, Henry A. Hawney, Stephen O. Heard, James E. Heavner, James G. Hecker, Elizabeth A. Hein, Eugenie Heitmiller, Mark Helfaer, Lori B. Heller, Andrew Hemphill, Adrian Hendrickse, Frederick A. Hensley, Ian A. Herrick, Douglas Hester, Eric J. Heyer, Michael S. Higgins, Roberta Hines, Charles W. Hogue, Kenneth J. Holroyd, Natalie F. Holt, Simon J. Howell, Faisal Huda, Keith E. Hude, Hayden R. Hughes, James M. Hunter, Brad J. Hymel, James W. Ibinson, Karen E. Iles, Robert M. Insoft, Shiroh Isono, Yulia Ivashkov, Bozena R. Jachna, Anna Jankowska, Norah Janosy, Arun L. Jayaraman, Nathalia Jimenez, Judy G. Johnson, Lyndia Jones, Edmund H. Jooste, Zeev N. Kain, Maudy Kalangie, Philip L. Kalarickal, Ihab Kamel, Mia Kang, Ivan Kangrga, Ravish Kapoor, Helen W. Karl, Christopher Karsanac, Swaminathan Karthik, Jeffrey A. Katz, Alan Kaye, Adam M. Kaye, A. Murat Kaynar, Nancy B. Kenepp, Miklos D. Kertai, Mary A. Keyes, Sarah Khan, Swapnil Khoche, David Y. Kim, Jerry H. Kim, Kimberly M. King, Jeffrey Kirsch, Matthew A. Klopman, Paul R. Knight, Donald D. Koblin, W. Andrew Kofke, Vincent J. Kopp, Joseph R. Koveleskie, Courtney Kowalczyk, Valeriy V. Kozmenko, Kaylyn Krummen, Sapna R. Kudchadkar, Nathan Kudrick, Adrienne Kung, C. Dean Kurth, Robert Kyle, J. Lance LaFleur, Jason G. Lai, Kirk Lalwani, William L. Lanier, Dawn M. Larson, Richard M. Layman, Chris C. Lee, Mark J. Lema, W. Casey Lenox, Jacqueline M. Leung, Roy C. Levitt, Jerrold H. Levy, J. Lance Lichtor, Charles Lin, Sharon L. Lin, Karen S. Lindeman, Lesley Lirette, Ronald S. Litman, Qianjin Liu, Renyu Liu, Wen-Shin Liu, Justin Lockman, Stanley L. Loftness, Martin J. London, Philip D. Lumb, M. Concetta Lupa, Anne Marie Lynn, Devi Mahendran, Jeffrey Mako, Anuj Malhotra, Vinod Malhotra, Andrew M. Malinow, Mark G. Mandabach, Dennis T. Mangano, Sobia Mansoor, Inna Maranets, Jonathan B. Mark, Sinisa Markovic, H. Michael Marsh, Choendal Martin, Nicole D. Martin, Douglas Martz, Veronica A. Matei, Letha Mathews, Lynne G. Maxwell, Philip McArdle, John P. McCarren, Brenda C. McClain, Brian McClure, William A. McDade, Kathryn E. McGoldrick, Brian J. McGrath, Gregory L. McHugh, David McIlroy, Jason McKeown, Thomas M. McLoughlin, R. Yan McRae, William L. Meadow, Sameer Menda, William T. Merritt, David G. Metro, Berend Mets, Hosni Mikhaeil, David W. Miller, Jessica Miller, Mohammed Minhaj, Marek A. Mirski, Nanhi Mitter, Alexander J.C. Mittnacht, Raj K. Modak, Pierre Moine, Constance L. Monitto, Richard C. Month, Richard E. Moon, Laurel E. Moore, Roger A. Moore, Thomas A. Moore, Debra E. Morrison, Jonathan Moss, John R. Moyers, Jesse J. Muir, Adam J. Munson-Young, Stanley Muravchick, John M. Murkin, Peter Nagele, Peter A. Nagi, Daniel A. Nahrwold, Michael L. Nahrwold, Madhavi Naik, Manchula Navaratnam, Stephan P. Nebbia, Priscilla Nelson, Thai T. Nguyen, Viet Nguyen, Stavroula Nikolaidis, Zoulfira Nisnevitch, Dolores B. Njoku, Mary J. Njoku, Edward J. Norris, Omonele O. Nwokolo, Daniel Nyhan, William T. O'Byrne, Edward A. Ochroch, Andrew Oken, Nathan Orgain, Nancy E. Oriol, Pedro Orozco, Andreas M. Ostermeier, Andranik Ovassapian, Mehmet S. Ozcan, Ira Padnos, Sheela S. Pai, Nirvik Pal, Dhamodaran Palaniappan, Susan K. Palmer, Howard D. Palte, Wei Pan, Oliver Panzer, Sibi Pappachan, Anthony Passannante, Dennis A. Patel, Dilipkumar K. Patel, Kirit M. Patel, Samir Patel, Shalin Patel, Sanup Pathak, Minda L. Patt, Ronald W. Pauldine, Olga Pawelek, Tim Pawelek, Kiarash Paydar, Ronald G. Pearl, Christine Peeters-Asdourian, Padmavathi R. Perela, Charise T. Petrovitch, Patricia H. Petrozza, Dennis Phillips, Mark C. Phillips, Christine Piefer, Edgar J. Pierre, S. William Pinson, Evan G. Pivalizza, Raymond M. Planinsic, Don Poldermans, Joel M. Pomerantz, Jason E. Pope, Wanda M. Popescu, Vivian H. Porche, Jahan Porhomayon, Dmitry Portnoy, Corinne K. Postle, Paul J. Primeaux, Donald S. Prough, Ferenc Puskas, Carlos A. Puyo, Forrest Quiggle, Mary Rabb, Bronwyn R. Rae, Muhammad B. Rafique, Jesse M. Raiten, Arvind Rajagopal, Srinivasan Rajagopal, Gaurav Rajpal, Chandra Ramamoorthy, Ira J. Rampil, James G. Ramsay, James A. Ramsey, Vidya N. Rao, Joana Ratsiu, Selina Read, Ronjeet Reddy, Leila L. Reduque, David L. Reich, Karene Ricketts, Cameron Ricks, Bernhard Riedel, Jyotsna Rimal, Joseph Rinehart, James M. Riopelle, Stacey A. Rizza, Amy C. Robertson, Stephen Robinson, Peter Rock, Yillam F. Rodriguez-Blanco, Michael F. Roizen, Daniel M. Roke, Ryan Romeo, Joseph Rosa, David A. Rosen, Kathleen Rosen, Stanley H. Rosenbaum, Andrew D. Rosenberg, Andrew L. Rosenberg, Henry Rosenberg, Meg A. Rosenblatt, Steven Roth, Brian Rothman, Justin L. Rountree, Matthew J. Rowan, Marc Rozner, Ryan Rubin, Stephen M. Rupp, W. John Russell, Thomas A. Russo, Alecia L. Sabartinelli, Tetsuro Sakai, Orlando J. Salinas, Paul L. Samm, Jibin Samuel, Tor Sandven, Ted J. Sanford, Joshua W. Sappenfield, Ponnusamy Saravanan, Subramanian Sathishkumar, R. Alexander Schlichter, Eric Schnell, David L. Schreibman, Armin Schubert, Peter Schulman, Todd A. Schultz, Alan Jay Schwartz, Jamie McElrath Schwartz, Jeffrey J. Schwartz, Benjamin K. Scott, Joseph L. Seltzer, Tamas Seres, Daniel I. Sessler, Navil F. Sethna, Amar Setty, Paul W. Shabaz, Pranav Shah, Saroj Mukesh Shah, Milad Sharifpour, Joanne Shay, Jay Shepherd, Jeffrey S. Shiffrin, Marina Shindell, Daniel Siker, Richard Silverman, Brett A. Simon, Nina Singh, Ashish C. Sinha, Robert N. Sladen, Kieran A. Slevin, Tod B. Sloan, Kathleen Smith, Timothy E. Smith, Victoria Smoot, Denis Snegovskikh, Betsy Ellen Soifer, Molly Solorzano, James M. Sonner, Aris Sophocles, James A. Sparrow, Joan Spiegel, Bruce D. Spiess, Ramprasad Sripada, Stanley W. Stead, Joshua D. Stearns, Kelly Stees, Clinton Steffey, Christopher Stemland, John Stene, Christopher T. Stephens, Tracey L. Stierer, O. Jameson Stokes, Bryant W. Stolp, David F. Stowe, Ted Strickland, Suzanne Strom, Erin A. Sullivan, Michele Sumler, Dajin Sun, Lena Sun, Esther Sung, Veronica C. Swanson, Judit Szolnoki, Joe Talarico, Gee Mei Tan, Darryl T. Tang, Paul Tarasi, René Tempelhoff, John E. Tetzlaff, Alisa C. Thorne, Arlyne Thung, Vasanti Tilak, Kate Tobin, Joseph R. Tobin, Michael J. Tobin, R. David Todd, Matthew Tomlinson, Thomas J. Toung, Lien B. Tran, Minh Chau Joe Tran, Kevin K. Tremper, Sanyo Tsai, George S. Tseng, Kenneth J. Tuman, Avery Tung, Cynthia Tung, Rebecca Twersky, Mark Twite, John A. Ulatowski, Michael Urban, Manuel C. Vallejo, Andrea Vannucci, Albert J. Varon, Anasuya Vasudevan, Susheela Viswanathan, Alexander A. Vitin, Wolfgang Voelckel, Ann Walia, Russell T. Wall, Terrence Wallace, Shu-Ming Wang, David C. Warltier, Lucy Waskell, Scott Watkins, Denise Wedel, Stuart J. Weiss, Charles Weissman, Nathaen Weitzel, Gregory Weller, Gina Whitney, Robert A. Whittington, Danny Wilkerson, Nancy C. Wilkes, Michael Williams, Jimmy Windsor, Bernard Wittels, Gregory A. Wolff, Andrew K. Wong, Stacie N. Woods, A.J. Wright, Zheng Xie, Christopher C. Young, Ian Yuan, Francine S. Yudkowitz, James R. Zaidan, Paul Zanaboni, Warren M. Zapol, Angela Zimmerman, and Maurice S. Zwass

Published
2011
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19. Laryngeal papilloma showing changes of Bowen's disease and angiosarcoma

Author

Thomas K. Rathmell and Aris Sophocles

Subjects
Larynx, Pathology, medicine.medical_specialty, Hemangiosarcoma, Vocal Cords, Polyps, Carcinosarcoma, Medicine, Humans, Angiosarcoma, Laryngeal Neoplasms, Aged, Bowen's disease, Papilloma, business.industry, Soft tissue, General Medicine, Laryngeal Neoplasm, medicine.disease, Prognosis, medicine.anatomical_structure, Otorhinolaryngology, Carcinoma, Squamous Cell, Surgery, Female, business, Spindle cell carcinoma
Abstract

PAPILLARY lesions of the larynx usually are designated as benign papillomas, singer's nodes, papillary granulomas, or papillary carcinomas. Sometimes the terms carcinosarcoma, pseudocarcinoma, or spindle cell carcinoma enter into the discussion of the histological interpretation of laryngeal neoplasms. Tumors in this area may constitute difficult interpretative problems for the histopathologist as well as therapeutic enigmas for the clinician. In the past 40 years approximately 54 laryngeal sarcomas have been reported in the English literature: characteristically these have been polypoid lesions with little tendency to deep infiltration into the adjacent soft tissue. Most arose in the true vocal cord and enlarged slowly. Twenty-six of these neoplasms were diagnosed as fibrosarcomas, seven as malignant lymphomas, five as chondrosarcomas, and the remainder as rhabdomyosarcomas, angiosarcomas, osteogenic sarcomas, leiomyosarcomas, or sarcomas of an undetermined type. 1 Report of a Case An 82-year-old white woman complaining of hoarseness of about two months' duration and who

Published
1969

20. Medical Problems in Alpine Sliding

Author

Douglas Minton and Aris Sophocles

Subjects
Orthodontics, medicine.medical_specialty, Lumbar, Allergic reaction, business.industry, medicine, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, business, Surgery, Rubbing
Abstract

In brief: Very few injuries resulted from use of the Breckenridge Alpine Slide from 1979 through 1982. Virtually all injuries resulted from sleds sliding out of their troughs or from one sled colliding with another. One patient sustained a fracture of two lumbar transverse processes and a renal contusion when she was hit from behind by a sled, and another patient developed a severe allergic reaction 30 minutes after sustaining an abrasion from rubbing against the slide trough. Stationing people at the bottom of the slides and having adrenalin, Benadryl, and adequately trained medical personnel available will help prevent or lessen these problems.

Published
1983
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