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Biomedical subjects

A Blitzer

Publications and source records attributed to A Blitzer.

At least 91 records · Page 5Linked to original sources
PubMed1979

Rhinocerebral mucormycosis: premortem diagnosis and therapy.

The diagnosis of rhinocerebral mucormycosis is most often made at autopsy. We report a series of nine patients in whom the diagnosis was established premortem. Six of the patients had underlying diabetes mellitus and three had acute leukemia. Facial or ocular pain was the complaint found in all patients, and frequently was the initial symptom. The diagnosis was established by examination and culture of infected tissue obtained by biopsy. In seven patients, identification of hyphal elements in smears of biopsy material allowed the immediate institution of amphotericin B therapy. Four of the seven patients treated with amphotericin B survived. All surviving patients had underlying diabetes mellitus and had undergone surgical debridement. Early diagnosis leading to immediate institution of appropriate therapy is most important for survival of patients with mucormycosis.

Acute Disease↗
PubMed1978

Tympanic neurectomy and chorda tympanectomy for the control of drooling.

Seventeen patients suffered from drooling that either occurred as a sequelae of extensive head and neck cancer resections or was due to neurological disorders. In these patients, a tympanic neurectomy and/or chorda tympanectomy was performed in an attempt to eliminate the drooling. The conditions in five of 12 (41%) patients with head and neck cancer were improved following such surgery. Two of four children with cerebral palsy initially had a good result. However, the long-term follow-up of the patients demonstrated that the drooling recurred. An additional patient suffering from bulbar weakness and drooling owing to a cerevrobascular accident had less problems with salivary secretions. The results were relatively disappointing; there are several possible explanations for this.

Adolescent↗
PubMed1977

Malignant fibrous histiocytoma of the head and neck.

Review of the literature reveals of 29 cases of fibrous histiocytoma of the deep structures of the head and neck. Three additional cases are reported: a multicentric case involving the submandibular gland with metastases to the lungs; and intraosseous tumor of the mandible locally invasive; and a submental tumor which rapidly recurred after simple excision. A metastatic potential of 22% is established. The historm, nomenclature, histopathology and clinical features are reviewed. The value of electron microscopy and tissue culture in arriving at the current diagnosis are stressed. Wide excision is the treatment of choice.

Adolescent↗
PubMed1976

Tuberculous peritonitis. A case report and review.

A 32-year old Dominican woman with signs and symptoms of an acute abdomen, was found to have tuberculous peritonitis. Our experience with this patient is presented along with a review of the literature. Population shifts may bring about an increased number of cases in this country. Awareness of this entity will avoid unnecessary diagnostic errors and laparotomy. The surgeon should also be versed in the total management and be prepared to handle the surgical complications of the disease.

Abdomen, Acute↗
PubMedDate not supplied

Sleeping position and sleep apnea syndrome.

Four patients who were evaluated for hypersomnia-sleep apnea syndrome were found in all-night sleep studies to have obstructive or mixed apneas related to their sleeping positions. All four were available for comprehensive follow-up and were subsequently restudied while avoiding the supine position. Supine, prone, and lateral decubitus apnea indices were calculated for each patient for each night. The supine sleeping position was associated with significantly more apneas than the non-supine positions. Keeping these patients off their backs when they slept was effective treatment. Additionally, when results of surgical or pharmacologic treatments of apnea are evaluated, positional apnea indices should be considered.

Follow-Up Studies↗
PubMedDate not supplied

Collagenase activity in squamous cell carcinoma of the human parotid gland.

A collagenase obtained from a single squamous cell carcinoma of human parotid gland was purified to homogeneity by procedures including precipitation with ammonium sulfate, gel filtration, ion-exchange chromatography with DEAE-cellulose, and extraction from polyacrylamide gel after electrophoresis. The parotid tumor collagenase had a molecular weight of approximately 68,000 and appeared similar to other mammalian collagenases in many respects such as action on collagen and response to common collagenase inhibitors. Analysis of specimens of various human parotid gland tumors revealed that the levels of collagenase activity were higher in squamous cell carcinoma than in nonsquamous tumors. A high level of collagenase activity from squamous cell carcinoma suggests that collagenase may promote local connective tissue destruction associated with tumor invasion and lymph node metastasis.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Electromyographic findings in focal laryngeal dystonia (spastic dysphonia).

Spastic dysphonia is a clinical speech disorder characterized by spasms of the laryngeal muscles during phonation, producing a broken pattern of speech sometimes termed laryngeal stuttering. Fourteen patients with the diagnosis of spastic dysphonia based on voice quality were referred for evaluation; detailed clinical and electrophysiologic evaluations were performed. Laryngeal electromyographic (EMG) testing failed to demonstrate any spontaneous activity in the 14 patients tested. Seven patients (50%) had normal number and amplitude of motor unit potentials. Four of these had disparate amplitudes when compared with the other side, and two had complex motor unit potentials. The other seven patients (50%) had abnormal findings, including three patients with abnormally increased amplitude. Two patients had asynchronous activity characteristic of a tremor disorder. One patient had synchronous bursts of activity also affecting the diaphragm, later diagnosed as pyramidal and extrapyramidal disease. One patient had bursts of activity, and later presented with diffuse myoclonus. Laryngeal EMG therefore seemed to be a more precise way of evaluating patients presenting with a tremulous voice pattern termed spastic dysphonia. Clinical observation and EMG data demonstrated that spastic dysphonia is not a "spastic" disease. We identified patients with tremor (2), pyramidal and extrapyramidal disease (1), and myoclonic disorders (1). The remainder of the patients had clinical and EMG findings consistent with dystonia, a neurologic disorder characterized by abnormal, often action-induced, involuntary movements or uncontrolled spasms. We classify these patients as having "focal laryngeal dystonia" when the disorder occurs in isolation. It may also present as a component of a generalized dystonic syndrome.

Adult↗
PubMedDate not supplied

Collagenase in human head and neck tumors and rat tumors and fibroblasts in monolayer cultures.

Invasive tumors must release collagenase to break down the surrounding host connective tissues. The cellular origin of this enzyme is still unclear. We used anticollagenase antibodies to localize collagenase in the human head and neck tumor and rat tumor tissues. Collagenase appeared to be localized in the tumor connective tissue stroma but not in tumor cells. The rat skin fibroblasts in monolayer culture treated with the rat tumor cell-conditioned medium demonstrated marked extranuclear and particulate staining. Fibroblasts without treatment showed no staining. Tumor cells in the culture also showed no staining. Assay of culture media demonstrated that only fibroblasts with the addition of the tumor cell-conditioned medium produced collagenase. These findings suggest the following: collagenase is produced by fibroblasts which are harbored in the connective tissue stroma, but not by tumor cells; cellular interaction between tumor cells and fibroblasts appears to be involved in breakdown of the host connective tissue for tumor cell invasion; and tumor cells release soluble factors which stimulate production of collagenase by fibroblasts.

Animals↗
PubMedDate not supplied

Evaluation of tympanic neurectomy and chorda tympanectomy surgery.

Thirty patients were treated by tympanic neurectomy, chorda tympanectomy, or both for a variety of conditions. Out of six patients with gustatory sweating treated by tympanic neurectomy, two patients were relieved of symptoms, two were improved, and two remained unchanged. In five cases of benign recurrent painful parotid swelling, only two patients noted improvement in symptoms. Seventeen patients suffered from drooling. Out of 12 postresection head and neck patients, 5 (41%) were improved following such surgery. Two of four cerebral palsy children initially had a good result. However, the long term follow-up of the patients demonstrated that the drooling recurred. An additional patient who suffered from drooling caused by bulbar weakness following a cerebrovascular accident had fewer problems with salivary secretions postoperatively. The pertinent anatomy and pathophysiology is outlined. The possible reasons for the relatively disappointing results achieved are discussed.

Adult↗
PubMedDate not supplied

Thyroid carcinoma in a patient with a coexisting functional adenoma.

Fourteen case reports have been published in which "hot" nodules have been documented as carcinoma, with or without coexisting adenomas. The diagnosis of these lesions is difficult, since hot nodules usually represent benign disease. These carcinomas are not functional, but represent coexistence of a functional area or a malignant degeneration. Hot nodule carcinomas should be suspected in high-risk patients. A euthyroid, 31-year-old woman who, as a teenager, had radiotherapy for acne is reported. She was followed up with yearly scans for a hot nodule in the right lower lobe of her thyroid. When she was 36, a node was discovered in the right side of her neck, and carcinoma was suspected. Surgical excision revealed a papillary-follicular carcinoma adjacent to an adenoma with metastases to regional lymph nodes.

Adenocarcinoma↗
PubMedDate not supplied

Granular cell tumors of the larynx.

Granular cell tumors of the larynx are uncommon lesions. Only 15 were identified at the Columbia-Presbyterian Medical Center, New York, during the past 45 years. These tumors produce hoarseness usually and are identified as small keratotic, polypoid, or sessile nodules involving the glottic region (most often posterior glottis, arytenoid, or vocal process). These lesions can usually satisfactorily be treated by endoscopic excision. On histologic examination, pseudoepitheliomatous hyperplasia is frequently seen and may be misinterpreted as squamous cell carcinoma.

Adult↗
PubMedDate not supplied

Collagenase and protease activities in head and neck tumors.

An analysis of specimens of 43 head and neck tumors revealed that collagenase and protease activities paralleled each other and varied according to the anatomic site; highest activities were in tongues and tonsils, which are known to have low five-year survival rates. The greatest differences in both enzyme activities were observed in the studies of histologic patterns and tumor differentiation. The ulcerated tumors with inflammatory infiltrates having high enzyme activities suggest that collagenase and protease may be derived from inflammatory cells.

Carcinoma, Squamous Cell↗