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Biomedical subjects

A Neuman

Publications and source records attributed to A Neuman.

At least 37 records · Page 2Linked to original sources

Lipomatosis of the scalp and macrocephaly.

In summary, a case of macrocephaly and lipomatosis of the scalp and forehead has been presented. The phenotypic and clinical features found in our patient are in accordance with previous reports. The differential diagnosis with other hamartoneoplastic syndromes has been evaluated and discarded, concluding that the present report is in accordance with Bannayan-Zonana syndrome. However, as in other inherited traits, finding a genetic test to diagnose this entity remains a challenge.

Child, Preschool↗

Melanoma of the scalp: the invisible killer.

A series of 20 patients (15 men and 5 women) suffering from malignant melanoma of the scalp is reported. Their epidemiologic data and outcome are described. The ages ranged from 48 to 78 years (mean 63 years). Analysis of the cases demonstrated that lesions occurring posterior to the tragal line (in hair-bearing area) have the worst prognosis. The 5-year survival rate was poor; 12 patients died within this period. Two representative cases are described, and the preventable aspects of the disease are emphasized.

Aged↗

Dual-isotope myocardial imaging: feasibility, advantages and limitations. Preliminary report on 231 consecutive patients.

Two hundred and thirty-one patients underwent dual-isotope myocardial imaging (rest thallium-201 followed by stress technetium-99m sestamibi). The feasibility of the procedure was excellent: camera scheduling flexibility was improved and the duration of the procedure was less than that of a classical stress-redistribution procedure. Interpretation of defects due to image attenuation was facilitated by the different attenuation properties of 201Tl and 99mTc-sestamibi in 11 of 19 patients. 201Tl cross-over on 99mTc was found to be 15% +/- 3% with doses of 201Tl and 99mTc-sestamibi of 3 and 10 mCi, respectively, and 7% +/- 2% with doses of 3 and 20 mCi. This protocol should preferentially be reserved for patients with a history of myocardial infarction and/or a basal left ventricular dysfunction, in whom assessment of myocardial viability is of major interest. Extensive clinical validation of the dual-isotope procedure is required and optimal acquisition and reconstruction parameters should be established.

Adult↗

Terrorist bombing with a 'Molotov cocktail' inside travelling cars: an old weapon for a new burn syndrome?

The 'Molotov cocktail' terrorist weapon which is thrown into a travelling car has given a new type of injury to people who sustain massive smoke inhalation together with disfiguring burns of face, thighs, hands and chest, and post-traumatic psychological disorder. The combination of petrol ignition with the synthetic fumes inside the care is a unique occurrence with a high morbidity and mortality which is difficult to treat and to manage. We propose to show that the combination of all the above components can be defined as the 'Molotov cocktail' burn syndrome.

Adolescent↗

Cyclosporin A treatment failed to extend skin allograft survival in two burn patients.

Prolongation of skin allograft survival by immunosuppression of burn casualties has been reported sporadically during the past two decades. Recently cyclosporin A (CycA) has been used effectively for such an indication. We report here two paediatric patients with extensive burns (85-95 per cent BSA) treated with fresh, family-related skin allografts that were rejected during CycA treatment after 14-18 days. One of these children survived while the other died with candida sepsis.

Burns↗

The inframammary midline triangle in reduction mammaplasty: the renewal of an old idea.

The junction between the inframammary and vertical suture lines after reduction mammaplasty is a weak point well known to plastic surgeons. This junction is prone to either necrosis or disruption, or both, in some cases. A small triangle of skin left in that location may prevent this problem. This is done routinely in all the cases of McKissock reduction mammaplasty, but it could be employed in any other techniques as well. The cosmetic appearance is good. The method, which is not new and has been used in the past, has been found very helpful and is described here along with its advantages.

Breast↗

The use of sandpaper in chemical peeling combined with dermabrasion of the face.

The combined use of chemical peel and dermabrasion of the face was widely accepted since the first reports of DuPont and Horton. We present a refinement of this combined method by introducing the use of a simple diathermy head cleaner (Surgikos, Inc) as a safer method of face abrasion. This disposable device, available at every surgical theater allows a better control of the abrasive tool, permits a more accurate depth of the abrasion, and reduces the incidence of unexpected complications in this combined technique.

Chemexfoliation↗

Signal processing for hearing impairment.

Four noise reduction methods for use in sensory aids for hearing impairment were evaluated. These include a two-microphone adaptive noise canceller, short-term Wiener filtering, a transformed spectrum subtraction technique, and sinusoidal modelling. The largest improvements in speech recognition were obtained with the two-microphone adaptive noise canceller in a moderately reverberant room. Significant improvements were also obtained for short-term Wiener filtering for some hearing-impaired subjects. The transformed spectrum-subtraction technique failed to improve performance as the front-end of a hearing aid, but yielded improvements in performance as a preprocessor for the Nucleus Cochlear Implant. Sinusoidal modelling resulted in significant improvements in signal-to-noise ratio, but without a corresponding improvement in speech intelligibility.

Acoustic Stimulation↗

Case study: full thickness chemical burn of the abdomen and chest.

An 81 year old patient, suffering from Alzheimer's disease sustained a full thickness HCI Acid burn of her abdomen and chest wall due to leakage of gastric content from her gastrostomy feeding tube. The controversial management of such a patient is discussed and early surgical treatment is recommended.

Abdominal Injuries↗

[A decade of experience in craniofacial surgery].

Our craniofacial surgery team includes experts from the following fields: plastic surgery, neurosurgery, ophthalmology, genetics, neurology, orthodontics, pedodontics, facial rehabilitation, psychiatry, social work, anesthesiology and intensive care. Craniofacial surgery became to a large extent pediatric surgery, following evidence that careful, early surgery does not impair growth and that development following surgery is almost normal. The malformations that were repaired included those of the Crouzon and Apert syndromes, requiring frontal remodelling and advancement of the middle third of the facial skeleton; hypertelorism in which orbits were moved to the midline; large craniofacial clefts in which the hemiface from either side was moved to the midline; and different types of craniostenosis in which frontal advancement and remodelling with reconstruction of the vault was performed. The series consisted of 78 patients who presented between 1979-1989. 3 illustrative cases are described.

Craniofacial Dysostosis↗

Comparison of N-acetylcysteine and mesna as uroprotectors with ifosfamide combination chemotherapy in refractory germ cell tumors.

From January 1983 through August 1988, 318 consecutive patients with refractory germ cell neoplasms were treated with ifosfamide-containing combination chemotherapy. The patients received ifosfamide at 1.2 gm/m2/day with cis-platin 20 mg/m2/day for 5 days and etoposide 75 mg/m2/day for 5 days or vinblastine 0.11 mg/kg on days 1 and 2 for each cycle. Of 277 evaluable patients, NAC was used as an uroprotector in the initial 86 patients while the latter 191 consecutive patients received mesna to reduce urothelial toxicity. Dosages of NAC was 2.0 gm po q 6 hr and for mesna 120 mg/m2 IV push prior to ifosfamide and then 1200 mg/m2/day as continuous infusion of 5 consecutive days. All patients received 3.0 liters of normal saline per day. The number of courses of chemotherapy given in the two groups were similar. Twenty-four of the 86 patients (27.9%) receiving NAC developed hematuria (13 patients - grade 1, 4 patients - grade 2, and 7 patients - grade 3 toxicity). While 8 out of 191 (4.2%) mesna patients developed hematuria (6 - grade 1 and 2 - grade 3) (p < 0.0001). The incidence of severity of renal toxicity was similar in the two groups. Ifosfamide dosage was reduced solely for urothelial toxicity in 11 patients receiving NAC compared with none of the patients receiving mesna (p < 0.0001). Chemotherapy response was similar in the two groups. In conclusion, mesna provides better urothelial protection from ifosfamide-induced toxicity than NAC and allows better maintenance of the drug dosage.

Acetylcysteine↗

Phosphorous pentachloride chemical burn--a slowly healing injury.

A 51-year-old chemical engineer sustained phosphorous pentachloride partial skin thickness burns over 20 per cent of his body surface area. Although macroscopically and microscopically the wound seemed to be superficial, the course of clinical healing of this injury was very slow and painful. Retrospectively this burn should have been treated by early excision and grafting.

Accidents, Occupational↗