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Biomedical subjects

D Weissberg

Publications and source records attributed to D Weissberg.

At least 55 records · Page 3Linked to original sources
PubMed1990

Technical aids in surgery. Two muscle-sparing thoracotomies--techniques and indications.

Two types of muscle-sparing thoracotomies are described. They have been used over the past 11 years in 396 patients. These incisions are ideal for wedge resections, biopsies, exploratory thoracotomies, excisions of emphysematous blebs, decortications, and a variety of other operations, including pulmonary resections in selected patients. They provide entirely adequate exposure, while minimising the trauma of thoracotomy.

Humans↗
PubMed1990

Cholecystostomy as a definitive operation.

Cholecystostomy for decompression and drainage of the biliary tree is indicated when the elderly, poor risk patient with destructive inflammatory process in the gallbladder is unable to tolerate a more extensive operation. Cholecystostomy is often criticized as an inferior operation, because it provides some palliation but leaves the patient with most problems unattended. To re-evaluate the role of cholecystostomy in the management of acute disease of the gallbladder, we reviewed our experience with it. During the years 1974 to 1987, 37 patients underwent a cholecystostomy. Patients ranged in age from 58 to 90 years, with an average age of 69 years. Twenty-eight patients had acute destructive cholecystitis, usually complicated by perforation, peritonitis or ascending cholangitis. Five had severe pancreatitis; three, cholelithiasis, and one patient, carcinoma of the bladder. Twenty-seven of the 37 patients had severe systemic disease and were critically ill. At the operation, calculi were extracted and the gallbladder and abscess were drained. Two patients died, yielding a mortality rate of 5.4 per cent. Tube cholangiography was done in 33 patients. Although residual stones were demonstrated in seven patients, the stones were removed electively at a later date under much more favorable conditions. None of the 35 survivors had symptoms of disease of the gallbladder during the follow-up period, which ranged from one to 12 years. Cholecystostomy is a curative operation indicated in critically ill and elderly patients for whom extensive operation is a prohibitive risk.

Acute Disease↗
PubMed1988

Effects of upper dorsal sympathectomy on esophageal motility in humans.

To evaluate the role of the sympathetic nervous system in modulating esophageal motility, esophageal manometry was performed on two groups of patients who underwent upper dorsal sympathectomy for relief of palmar hyperhydrosis. In six patients sympathectomy was done by the supraclavicular approach, with removal of T2 and T3 ganglia. Manometry was performed before the operation and three weeks after it. In seven other patients sympathectomy was done by the axillary approach, with removal of T2-T4 ganglia. Manometry in this group was performed 28.4 +/- 22.4 months after the operation. Fifteen individuals with an intact sympathetic system served as controls. Manometric parameters evaluated were esophageal contraction amplitude and duration and lower esophageal sphincter pressure. The difference between the results obtained in the pre- and postoperative periods in the first group was not statistically significant. The differences between the two patient groups and between the patient groups and the control group were not statistically significant either. We conclude that upper dorsal sympathectomy does not affect esophageal motility in man.

Adolescent↗
PubMed1988

Traumatic perforations of the esophagus.

Over the past 15 years nine patients with traumatic mechanical perforations of the esophagus have been treated. Seven perforations were iatrogenic, two were accidental. One patient treated conservatively did well. Two patients were operated on without delay. Their hospitalization was short and they had no complications. Six patients were referred to surgery after a delay ranging from 5 days to 17 days from the time of perforation. Their hospitalization ranged from 9 to 113 days, averaging 62.7 days. Complications were common and two patients died. In order to assure survival of patients with esophageal perforation, early aggressive treatment is essential in nearly all instances. In an occasional patient with a small and clean perforation at the esophageal inlet, conservative treatment may be justified.

Adolescent↗
PubMed1987

Foreign bodies in the tracheobronchial tree.

Between 1972 and 1984, we treated 66 patients with foreign bodies (FBs) in the tracheobronhial tree. Twenty-six patients (39.4 percent) were between one and two years old; 52 (78.8 percent) were under age ten. Forty-four FBs (67 percent) were fruit and vegetable seeds and nuts. Soft organic material (meat, cucumber peels) was found in four patients, chicken bones in six, pins and needles in six, other nonorganic materials (toys, stone, broken thermometer) in six. In 55 patients, the FB was removed at bronchoscopy; three patients coughed up the FB shortly after bronchoscopy. Eight patients were operated on because the impacted FB could not be removed at repeat bronchoscopy trials. In this group, the FB was removed through a bronchotomy in two patients, but in six, pulmonary resection was necessary because of severe bronchiectasis (FBs had been impacted from ten months to 12 years). Stiff bronchoscope was used in all patients. In several cases, the flexible bronchoscope was used initially but proved inadequate. There were three complications, two related to hypoxia, but no deaths. Infants and little children should be prevented from reaching peanuts and seeds. When presence of a FB is suspected, and in children with unresolving pneumonic process, early bronchoscopy is mandatory. Expert anesthesia is essential, and hypoxia must be avoided.

Adolescent↗
PubMed1987

Fine-needle aspiration biopsy in diagnosis of pulmonary masses.

Fine-needle aspiration biopsy (FNAB) is a diagnostic method indicated in patients with pulmonary lesions that cannot be reached with a bronchoscope and when cytologic examinations of the sputum are persistently negative. Cells are aspirated under fluoroscopic control and stained using the Papanicolaou method for cytologic examination. Results are available within hours, and the material can be used for other studies. Between 1975 and 1984, the authors performed 845 FNABs in 342 patients. Diagnosis was established in 306 patients, or 89.5 per cent. Malignant neoplasm was diagnosed in 284 instances, benign disease in 22. In 176 patients with malignant tumors, the diagnosis was based on FNAB exclusively. In 108 patients who were operated on, the results of FNAB matched histology in 97 per cent. The aspiration specimen was inadequate in 36 patients, most of whom had diffuse lung disease. The incidence of complications was extremely low. FNAB is safe and reliable. It is recommended for use in clinical workup of undiagnosed pulmonary masses. FNAB enables rational planning of treatment when other diagnostic methods fail. The authors do not recommend FNAB for use in cases of diffuse pulmonary disease.

Adult↗
PubMed1986

The use of talc for pleurodesis in the treatment of resistant empyema.

The use of talc in the infected pleural space has not been reported previously. Five patients who had empyema of the pleura in the fibrinopurulent stage and did not respond to treatment with tube drainage and antibiotics were treated by talc insufflation to stimulate pleural adhesions. Pleurodesis was achieved in all 5 patients, with complete recovery from empyema. No untoward effects were observed. These results suggest that talc pleurodesis may be an acceptable solution to the problem of empyema resistant to other methods of treatment.

Adult↗
PubMed1986

Incorporation of a new radioactive compound, 4+Sn-117m DTPA, into normal and burred rat femurs.

The physical characteristics of a new tin radiopharmaceutical, 4+Sn-117m diethylenetriamine-pentaacetic acid (DTPA), may make this compound appropriate for orthopedic therapeutic application. The physical and biologic half-lives of this tracer are 14 and 7.8 days, respectively. The decay scheme consists of short-range tissue destroying beta, conversion, and Auger electrons, and a 159-keV gamma ray. Significantly, this compound has a high degree of affinity for newly calcified bone at the site of experimental burr holes in contrast to the adjacent bone marrow. Radioactive skeletal retention was one-half of whole body retention.

Animals↗
PubMed1985

The relationship of the double crush to carpal tunnel syndrome (an analysis of 1,000 cases of carpal tunnel syndrome).

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton's Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.

Adolescent↗