Biomedical subjects
A M Cooperman
Publications and source records attributed to A M Cooperman.
Ovarian suppression and breast cancer.
Castration by radiation or oophorectomy may cause regression of tumor metastasis. Patients who will benefit are those whose estrophile protein concentration in breast tissue is high. The use of castration as an early adjunctive method (prophylactic castration) delays the onset of recurrence, although it may take 10 to 15 years to verify these observations. Difficulty in analyzing these data is due to the smallness of the sample, and the frequent use of hormones in control patients. Effective castration may be observed with radiation or surgery. The choice is dependent on the patient's wishes and the need for an immediate effect. Combination therapy with steroids, chemotherapy, or adrenalectomy may potentiate the effect of castration. Premenopausal castration may markedly decrease the incidence of new breast cancers, particularly when followed for 20 or more years.
The rhomboid flap and partial mastectomy.
The use of a rhomboid flap in segmented breast resection is described. This reconstructive technique allows large areas of the breast to be resected with minimal deformity and nipple-areola displacement.
Watery diarrhea syndrome. Two unusual cases and further evidence that VIP is a humoral mediator.
Two unusual cases of the watery diarrhea syndrome are presented. In one patient an adrenal medullary tumor, a pheochromocytoma that produced vasoactive intestinal polypeptide (VIP) was excised with total relief of symptoms. The second patient a 65-year-old man with abrupt onset of massive watery diarrhea that led to acidosis and coma was symptomatically controlled for one year on 10 mg/day of prednisone. Elevated levels of VIP returned to normal after prednisone therapy was started. A benign islet cell tumor not localized by angiography was removed by distal pancreatic resection. Tissue levels of VIP were markedly elevated. VIP is a humoral mediator of the water diarrhea syndrome. Both benign and malignant pancreatic and extrapancreatic tumors may cause the watery diarrhea syndrome. Steroids may cause symptomatic relief of the diarrhea by lowering peptide levels to normal. The term watery diarrhea syndrome may be more accurate than the pancreatic cholera syndrome.
Computed tomography of the gallbladder.
Computed tomography (CT) was used to study 79 patients with suspected gallbladder disease. First and second generation scanners were used to determine the efficacy of CT in detecting cholecystitis or cholelithiasis. Manifestations of gallbladder disease such as hydrops, opaque and nonopaque gallstones, chronic cholecystitis with thickened inflammatory walls, and secondary liver abscesses can be easily detected. It is a useful technique for individuals in whom the gallbladder has failed to opacity on oral cholecystography. The scanning method is described, and estimates of reliability are given including its accuracy, limitations, and place in the management of gallbladder disease, especially cholelithiasis. When conventional radiographic examinations or ultrasound fail to give definitive diagnostic information, CT can be a useful alternative with an overall diagnostic accuracy greater than 80%.
Villous adenoma of the ampulla of Vater. An unusual cause of biliary colic and obstructive jaundice.
An unusual case of biliary obstruction caused by a benign villous adenoma of the ampulla of Vater is reported and the literature reviewed. Of the reported cases, 75% have jaundice or symptoms of cholecystitis. Rarely, gastrointestinal bleeding or pancreatic duct obstruction is a presenting symptom. The tumors are frequently small and can be overlooked. Operative treatment varies from excision of the tumor to pancreatoduodenal resection depending on histological evaluation, intraoperative findings, and the surgeon's philosophy.
Computed tomography: an aid to the abdominal surgeon.
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Computed tomography and abdominal diseases: a valuable diagnostic aid?
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Local spectral analysis in the visual cortex.
On the basis of experimental evidence presented earlier a model of local spectral analysis of the image performed by the complex receptive fields of the visual cortex has been proposed. An essential feature of the model is that the generalized piece-wise Fourier transform is performed not over the image luminance function but over the logarithm contrast function resulted from analysis of the image by the round receptive fields of the preceding levels. Such an assumption removes a number of experimental objections offered against the hypothesis of two-dimensional Fourier transform in the visual system. The consequences from the piece-wise expansion in a series of basic functions have been considered and among them: the channel frequency characteristics which can have more than one maximum; the possibility of describing the image by a limited number of channels with overlapping frequency characteristics; the existence of mechanisms for estimation of phase shift between frequencies.
Use of transcutaneous electrical stimulation in the control of postoperative pain.
Perception and relief of pain were studied in a varied group of fifty patients who had undergone laparotomy with upper abdominal midline incisions. Twenty-six patients were supplied with functioning transcutaneous electrical stimulators. Twenty-four received nonfunctioning machines. The controls were randomized by a nurse not otherwise involved in this study. Only seventeen of the total study group were judged failures and six of the patients had been receiving preoperative narcotics. Patient response was very favorable and pain relief was good to excellent, especially in one group with working stimulators (p is less than 0.008). Patients with known malignant disease did not respond as well as those with benign disease although anxiety may have been an important factor here. Use of the transcutaneous electrical stimulator would seem particularly worthwhile for patients undergoing elective abdominal operations for benign disease with no history of narcotic usage. Briefing the patient preoperatively on the potential value of transcutaneous electrical stimulation as a method of pain relief may improve end-results.
Computed tomography: a valuable aid to the abdominal surgeon.
The application of computed tomography (CT) for diseases of the liver, pancreas, kidney, and retroperitoneum has been described. The diagnostic accuracy of CT when compared with angiography, radioisotope scanning, endoscopic pancreatography, and transhepatic cholangiography is now being studied prospectively. The attractive features of CT include low risk, wide applicability, noninvasive technics, high diagnostic accuracy, and patient acceptance.
Composite stimuli are detected by grating detectors rather than by line detectors.
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CT detection and aspiration of abdominal abscesses.
Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.
Transcatheter vasopressin infusion therapy in the management of acute gastrointestinal bleeding.
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Toxic megacolon--unusual complication of pseudomembranous colitis.
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Effect of lipid calories on weight gain, nitrogen balance, liver weight, and composition in total parenteral nutrition (TPN).
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