Search PubMed⌕ Search

Biomedical subjects

B E Hirsch

Publications and source records attributed to B E Hirsch.

At least 73 records · Page 4Linked to original sources
PubMed1991

Structural biomechanics of the foot bones.

The structure of the tarsal and metatarsal bones reflects the functional demands placed on them. Their shape and the arrangement of compact and trabecular bone within them help them resist the normal forces of everyday life. When the limits of their strength are exceeded, failure can occur.

Biomechanical Phenomena↗
PubMed1991

Metastatic atrial myxoma to the temporal bone: case report.

A 25-year-old male underwent right mastoid surgery for removal of a soft tissue mass. At age 29 a left cardiac atrial myxoma was excised. At age 34 an expanding right supra-auricular mass with extension into the middle and posterior fossa necessitated total temporal bone resection. Pathology proved to be myxoma. Retrospective review of tissue obtained from the initial mastoid procedure was also myxoma. The temporal bone lesion was considered to be persistent and metastatic atrial myxoma. A review of atrial myxomas and this most unusual metastatic presentation is discussed.

Adult↗
PubMed1990

Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings.

An accepted staging system for squamous cell carcinoma of the external auditory meatus is currently lacking and would permit accurate comparison of treatment strategies and results for patients with this unusual neoplasm. In order to develop such a staging system we reviewed the prognostic variables and the accuracy of radiographic diagnosis in 39 patients undergoing temporal bone resection for squamous carcinoma of the external auditory meatus. Predictors of poor survival were extensive tumor involvement, facial nerve paralysis, middle ear involvement, and cervical or periparotid lymphadenopathy. In a comparison of 12 specific anatomic sites, computed tomography was found to be an accurate indicator of histopathologically proven tumor invasion. On the basis of this clinical radiographic-histopathologic analysis, we propose a TNM staging system for external auditory meatus carcinoma utilizing preoperative computed tomography and physical examination. This system fulfills the requirements of the American Joint Committee on Cancer that a staging system should provide a sound basis for therapeutic planning for cancer patients by describing the survival and resultant treatment of different patient groups in comparable form.

Aged↗
PubMed1989

Posterior nasal packing. Are intravenous antibiotics really necessary?

The use of antimicrobial prophylaxis in the presence of posterior nasal packing for the treatment of posterior epistaxis remains controversial. Twenty patients were prospectively randomized into this placebo-controlled, double-masked pilot study to receive either placebo or cefazolin sodium. Antibiotic-impregnated posterior gauze packing was employed in all patients. No infectious complications were noted in either group. The packings from the patients in the placebo group were foul smelling and heavily colonized with gram-negative bacteria while the packings from the antibiotic group were odor-free and lightly colonized with gram-positive organisms. This preliminary study suggests the usefulness of antimicrobial prophylaxis for preventing complications from posterior nasal packing, although a larger sample size will be needed to decrease the type II (beta) error.

Adult↗
PubMed1989

Cardiac myxoma metastatic to the temporal bone.

Two metastases from an atrial myxoma occurred in the right common carotid artery distribution of a 34-year-old man. One metastasis caused the phenomenon of intracranial pseudoaneurysm in a distal branch of the middle cerebral artery. The other resulted in the unusual radiographic appearance of a tremendous, "bubbly" expansion of the temporal bone.

Adult↗
PubMed1989

Squamous cell carcinoma of the external auditory meatus (canal).

A retrospective study of 35 patients with squamous cell carcinoma of the external auditory meatus treated at the Eye and Ear Hospital of the University of Pittsburgh was performed. The standard treatment was a temporal bone resection that corresponded to the extent of the lesion, followed by postoperative radiation therapy. The tumor extensions, symptoms, treatments, survival rates, and prognostic variables were reviewed. Overall, 12 of 35 patients survived. Lesions limited to the external auditory meatus with no erosion had excellent prognoses. Survival in intermediate lesions with bony erosion or middle ear involvement was related to the status of surgical margins after partial or subtotal temporal bone resections. Extensive lesions that involved the surrounding soft tissue or dura had poor prognoses. The survival value of total temporal bone resection remains unproved.

Aged↗
PubMed1989

Three-dimensional reconstruction of the foot from computed tomography scans.

Recently developed computer programs create a new type of image from the sections created in computed tomography. These images look like actual photographs of internal structures. The authors describe the process of three-dimensional reconstruction in nonmathematical terms, and provide examples of its use in imaging the bones of the foot. They demonstrate the technique's ability to resolve small details, and its usefulness in displaying articular surfaces.

Computer Graphics↗
PubMed1988

Nasopharyngeal teratoma involving the temporal bone.

Teratoma is the most common nasopharyngeal tumor in neonates. The tumor is usually limited to the oropharynx and is manifest by stridor and respiratory distress. Complete excision affects a cure. An unusual case of nasopharyngeal teratoma extending into the temporal bone, causing facial paralysis and conductive hearing loss, in addition to stridor, is presented. Stridor was relieved by transoral partial excision shortly after birth. Complete removal of the tumor by way of a subtemporal and infratemporal fossa approach was performed at 14 months of age. The defect was filled with a rectus abdominis muscle graft with microvascular anastomoses. The facial nerve was reconstructed secondarily with a sural nerve graft. The patient has no recurrence tumor and has good facial function at 30 months. This case demonstrates the first known case of facial paralysis due to nasopharyngeal teratoma. The surgical approach for tumor removal: lateral infratemporal fossa dissection, and the method of reconstruction: free rectus abdominis muscle flap with microvascular anastomoses, had so far not been described in a patient this young.

Humans↗
PubMed1987

The origins and function of the interosseous muscles of the foot.

The dorsal and plantar interosseous muscles of the foot arise, not only from the metatarsal bones, but also from ligamentous tissue proximal to the tarsometatarsal joints. The interossei also take origin from the fascia of adjacent muscles, and the first dorsal interosseous muscle usually arises in part from a slip of the peroneus longus tendon. A means may thus exist to ensure that the interossei contract in a coordinated manner. Their positions and time of contraction during the gait cycle imply a possible role as stabilisers of the forefoot, rendering the tarsometatarsal joints rigid when weight is carried on the ball of the foot.

Dissection↗
PubMed1985

Adult supraglottitis.

Hospital records from 1974 through 1983 contained the cases of 20 patients over 18 years old admitted with supraglottitis (epiglottitis). Most patients presented with pharyngitis and odynophagia, and were diagnosed by laryngoscopy and neck radiographs. Four patients required tracheostomies, and one was nasotracheally intubated because of impending airway obstruction. Visualization of the hypopharynx was often necessary for diagnosis and in accordance with previously reported cases, did not precipitate airway obstruction. Adults without respiratory distress can be treated in the intensive care unit with inhaled mist, antibiotics, and corticosteroids, and such patients usually recover in a few days. Tracheostomy is being supplanted by nasotracheal intubation as the preferred means of securing an endangered airway.

Adult↗
PubMed1984

Anomalous contrahentes muscles in human feet.

Anomalous muscles were found in the third layer of plantar musculature in 2 human feet. Although they occupied the approximate position of m. adductor hallucis caput obliquum , they were larger than that muscle and showed more extensive insertions. In one specimen the muscle inserted into the areas of the metatarsophalangeal joint capsules of the first and second toes. In the second specimen the insertion was into the metatarsophalangeal joint capsules of the 4 medial toes. The m. adductor hallucis caput transversum was missing in both feet. Both muscles were supplied by ramus profundus n. plantaris lateralis. The location and innervation of these unusual muscles indicates that they are contrahentes .

Foot↗