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Biomedical subjects

G Weinstein

Publications and source records attributed to G Weinstein.

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

Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma.

The partial horizontal supracricoid laryngectomy with cricohyoidoepiglottopexy consists of resection of the whole thyroid cartilage and paraglottic space. The cricoid cartilage, the hyoid bone, most of the epiglottis, and at least one arytenoid cartilage are conserved. Thirty-six patients with squamous cell carcinoma of the glottis who underwent this procedure from 1974 through 1986 are presented. All 36 recovered physiologic deglutition and phonation. None required a permanent tracheotomy. The 3-year actuarial survival rate was 86.5%. The local recurrence rate was 5.5%. The indications for the procedure are carcinomas of the glottis that 1) spread beyond the confines of the membranous portion of the true vocal cord or 2) present with limitation of true vocal cord mobility. The procedure is presented as a useful alternative to radiotherapy, partial vertical laryngectomy, and total laryngectomy in select cases of glottic carcinoma.

Adult↗
PubMed1990

Supracricoid laryngectomy with cricohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas.

The partial horizontal supracricoid laryngectomy with cricohyoidopexy consists of resection of the whole thyroid cartilage and paraglottic space, as well as the epiglottis and the whole pre-epiglottic space. The cricoid cartilage, the hyoid bone, and at least one arytenoid cartilage are spared. Sixty-eight patients with squamous cell carcinoma of the supraglottis who underwent this procedure during the period from 1974 through 1986 are presented. Conventional horizontal supraglottic laryngectomy was contraindicated in all cases. All but three patients (95.4%) recovered physiologic deglutition, and none required a permanent tracheostomy. The 3-year actuarial survival rate was 71.4%. No local recurrences were encountered. The indications for the procedure are carcinomas of the supraglottis that 1. involve the glottis and anterior commissure, 2. invade the ventricle, 3. present with a marked limitation of true vocal cord mobility (transglottic lesions), and 4. invade the thyroid cartilage. The procedure is presented as a useful alternative to radiation therapy, horizontal supraglottic laryngectomy, and total laryngectomy in select cases of supraglottic carcinoma.

Adult↗
PubMed1990

Thermophysiologic anthropometry of the face in Homo sapiens.

Standard clinical thermographic practice has been to regard a side-to-side skin surface temperature difference of 0.5 degrees C or greater as indicative of a clinically significant disorder when such a difference is observed for the contralateral sides of the face. Prior to this time this standard relied upon empiric observation and cumulative experience. This paper provides the first published documentation clearly supportive of this long-standing clinical practice.

Cephalometry↗
PubMed1985

Clobetasol propionate versus fluocinonide creams in psoriasis and eczema.

A double-blind, parallel comparison was made of the short-term efficacy and safety of three times daily regimens of 0.05% clobetasol propionate cream and 0.05% fluocinonide cream in 114 adolescent and adult patients with psoriasis and 113 with eczema. After 2 weeks of topical applications, patients were assessed according to (1) investigators' overall judgment of clinical response, (2) degree of severity of specific signs and symptoms, and (3) patients' evaluation of improvement. In all three response categories in psoriasis, and in two of three in eczema, clobetasol was statistically significantly superior to fluocinonide (p less than 0.05-p less than 0.001). Healing commenced more rapidly with clobetasol and there was no indication of tachyphylaxis. In contrast, the healing rate with fluocinonide slowed noticeably after the first week, and there was a greater tendency to relapse following fluocinonide treatment. Both regimens were safe: drug-related side effects were generally mild and occurred most commonly with fluocinonide therapy in eczema patients. Overall, drug-related effects occurred in 4% of patients receiving clobetasol and 12% receiving fluocinonide (p less than 0.05). Transient morning plasma cortisol reductions below 5 micrograms/dl occurred in 6% of clobetasol-treated patients, reverting to normal within 1 week of the end of treatment.

Administration, Topical↗
PubMed1984

Response of psoriasis to red laser light (630 nm) following systemic injection of hematoporphyrin derivative.

Systemically injected hematoporphyrin derivative (HPD) in combination with red laser light (630 nm) was used to treat a patient with intraepithelial neoplasia of the vulva. Since the patient had psoriasis in the mons pubis area this region also was exposed to the red light. The psoriasis treatment area was divided into two regions receiving 40 and 20 J/cm2. Both psoriatic zones responded vigorously to the HPD + light treatment, forming eschars by 1 week postirradiation. All three treatment zones (the neoplastic area and the two psoriatic areas) underwent normal reepithelialization by 17 days.

Adult↗
PubMed1982

Anxiety and mitral valve prolapse syndrome.

The diagnosis of Mitral Valve Prolapse Syndrome (MVPS), even though symptomatically similar to anxiety neurosis, may prompt pharmacological treatment only, neglecting any underlying emotional problems. If only a dichotomy were considered, one diagnosis might be seen as mutually exclusive of the other. A case history is presented illustrating features of both clinical syndromes. We consider the interaction of both etiologies, as well as the possibility of both being unrelated and coincidental. As physiological factors are explored when the diagnosis of anxiety neurosis is considered, so should psychological factors be examined with MVPS.

Adult↗
PubMed1982

Surgical management of complete atrioventricular canal.

Successful correction of complete atrioventricular (AV) canal depends on accurate assessment of surgical anatomy and preservation of valve tissue to avoid postoperative valvular insufficiency. From 1975 to 1980 there were 68 patients aged 2 months to 17 years (median age 12 months) who underwent correction for the complete form of AV canal. Forty-six percent had associated anomalies which included patent ductus arteriosus, right aortic arch, pulmonic stenosis, and ostium secundum defect. Two types of repairs were employed: group I-Teflon patch closure of the ventricular septal defect (VSD) by division of the common leaflets into mitral and tricuspid components: Group II-Teflon patch closure of the VSD without division of common leaflets by fashioning the patch between the chordae tendineae and under the common leaflets. The atrial septal defect component was closed separately with pericardium or Teflon. Overall mortality is related to presence of (1) elevated pulmonary vascular resistance (Wood units greater than 4), (2) prior palliative operations, or (3) associated cardiovascular anomalies. Repair of complete AV canal without splitting the common leaflets preserves valve tissue. The act of splitting the common leaflets and reattaching the mitral and tricuspid components to the VSD patch by necessity sacrifices valve tissue. Although this may not be significant in older children, it becomes important in infants, for the sacrificed valve tissue comprises a greater proportion of the whole. Moreover, patch disruption of the reattached mitral and tricuspid components can be avoided if the common leaflets are not split.

Adolescent↗
PubMed1981

New model of a scaling dermatosis: induction of hyperproliferation in hairless mice with eicosa-5,8,11-trienoic acid.

The present studies have demonstrated that topical application of a low concentration of eicosa-5,8,11-trienoic acid (a 20:3,n9 fatty acid previously reported to inhibit competitively the activity of the sheep vesicular cyclooxygenase) to skin of normal fed hairless mice produced severe scaly dermatosis which is characterized by marked hyperplasia and acanthosis of the epidermal layer. The precise mechanism of this induction of scaly dermatosis is presently unclear. It is nonetheless interesting that the treatment of skin with similar concentrations of other unsaturated fatty acids produced no visible or histologic effects. Furthermore, endogenous levels of arachidonic acid in epidermal phospholipid and triglyceride fractions were shown to increase significantly (p < 0.01) in skin treated with the 20:3,n9 fatty acid while the endogenous level of PGE2 in the same tissue decreased markedly. This latter observation is consistent at least in part, with a previous report from this laboratory in which the 20:3,n9 fatty acid inhibited in vitro the activity of the sheep vesicular cyclooxygenase (the rate limiting enzyme in the transformation of arachidonic acid into the prostaglandin endoperoxides) although the increase in arachidonic acid may also reflect an increased incorporation of this fatty acid into the epidermal lipids by the hyperproliferative tissue. Evaluation of the proliferative status of 20:3,n9 fatty acid-treated skin showed a significant increase (p < 0.01) in labeling and mitotic indices. The use of this potentially endogenous fatty acid may be a useful tool for further investigations of hyperproliferative skin diseases where dietary deficiency of essential fatty acids does not exist.

8,11,14-Eicosatrienoic Acid↗
PubMed1980

Cell proliferation patterns in human malignant melanoma, in vivo.

Cell kinetics were studied, in vivo, in 19 patients with metastatic melanoma by autoradiographic technics. Multiple tumor labeling indices (L.I.) were determined with intralesional H3-TdR in 19 patients and were correlated with the presence of melanin. Serial biopsies were obtained to derive percent labeled mitoses (PLM) curves for 9 individual patients. Duration of the S and G2 phases were calculated using 50 and 37% intercepts from the PLM curves, as well as by two computerized cell-cycle analysis programs, and the results were compared. Tumor L.I.s were found to be reproducible for distant metastases of similar size in the same patient. Tumor L.I.s had a bimodal distribution for the 19 patients examined. The two significantly distinct subgroups had L.I.s of 18.2 +/- 3.4% and 6.7 +/- 2.1%. The presence of melanin correlated with the higher L.I. subgroup. The difference in L.I. may reflect a higher growth fraction or a shorter germinative cycle in melanotic tumors. However, the presence of melanin did not correlate with a change in the duration of S or G2 phases. The sum of Ts and Tg2 was approximately 24 hours, regardless of the analytic method. These kinetic parameters are being monitored during chemotherapy for prognostic indicators.

Autoradiography↗
PubMed1980

Innominate artery-coronary artery bypass graft in a patient with calcific aortitis.

Calcification of the ascending thoracic aorta may make aortic cross-clamping dangerous and aorta-coronary artery bypass grafting impossible. A patient with a severely calcified ascending aorta owing to syphilitic aortitis presented such a problem. Sequential saphenous vein grafting was done to three coronary arteries, the proximal anastomosis being made to the noncalcified innominate artery. This technique may offer a practical solution to this problem.

Aged↗
PubMed1975

Anomalous right ventricular muscle bundle. Repair through the right atrium.

Anomalous muscle bundles within the right ventricle may cause obstruction to blood flow at the level of the outflow tract. This condition is usually associated with a ventricular septal defect. Although complete correction is usually approached through a right ventriculotomy, the anatomic configuration makes repair through a right atriotomy more suitable. The advantages of this approach are discussed and a case report is presented.

Angiocardiography↗