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Biomedical subjects

L D Leffall

Publications and source records attributed to L D Leffall.

At least 37 records · Page 2Linked to original sources
PubMed1988

Intraoperative radiotherapy for patients with carcinoma of the pancreas. The Howard University Hospital experience, 1978-1986.

During the period from 1978 to 1986, 106 patients were diagnosed with carcinoma of the pancreas; 30 of these patients were excluded from this study. Of the remaining 76 patients, 40 did not receive intraoperative radiotherapy (IORT) and were used as the nonrandomized control group for the 36 patients who did receive IORT after histologic confirmation of carcinoma of the pancreas. The records of 35 patients were available for review. The group receiving IORT ranged in ages from 43 to 89 years (20 males and 15 females). Seventeen patients had distant metastatic disease. The primary was located in the head of the pancreas in 32 and the body in three. No patient in this group had a curative resection. All patients were treated by a combination of biliary and gastric bypass prior to or concurrent with IORT. IORT was begun only after obtaining a histologic diagnosis and prior to the completion of any anastomosis. Necrotizing pancreatitis occurred in the treated group. There was no statistically significant difference in the survival of the nonrandomized control and treated groups.

Adult↗
PubMed1988

Colorectal cancer in young black patients.

A higher percentage of young black patients are discovered with a more advanced stage of colorectal cancer than is reported for white patients. To evalute this phenomenon, various prognostic factors in young colorectal cancer patients at Howard University Hospital were studied.

Adenocarcinoma, Mucinous↗
PubMed1986

Chylothorax: an omnipresent reality in thoracic surgical procedures.

Loss of integrity of the thoracic duct will produce a chylous thoracic effusion. latrogenic chylothorax occurring during an intrathoracic surgical procedure in the vicinity of the thoracic duct is an omnipresent reality. The fluid is characteristically milky in appearance, sterile, and high in fat content.There seems to be a general agreement that initial management be conservative, namely, dietary control and adequate drainage. The success of conservative management will depend on collateral lymphatic channels developing. If conservative measures fail, thoracotomy for ligation of the duct is indicated. When to terminate nonoperative therapy and opt for operative is controversial.

Carcinoma, Squamous Cell↗
PubMed1985

The effect of citrate and polyamines on human benign prostate in organ culture.

A technique for short-term cultivation of slices of human benign prostate tissue in an organ culture environment is described. Minimum essential medium utilized was supplemented with 10 percent fetal bovine serum and 25 mg/mL of citrate, spermine, and spermidine. Spermine in the presence of testosterone in the culture medium induced morphological changes, enhancing the morphology of the tissue. The epithelium was well preserved morphologically. Citrate or spermidine together with testosterone does not enhance any morphological change. After seven days of culture, necrosis was developed. The spent culture medium showed a pattern of prostatic acid phosphatase production. When treated with spermine, the maximum level was reached at four days, after which it decreased. With spermidine or citrate, the maximum level is reached at two days of culture. Tissue β-glucuronidase activity was enhanced by either spermidine, spermine, or citrate together with testosterone. The biochemical studies suggested that explants of human benign prostate can be well maintained in organ culture for a few days.

Citrates↗
PubMed1985

Superior mesenteric vein thrombosis: a case report.

Superior mesenteric vein thrombosis is an abdominal emergency that is rarely diagnosed early. Abdominal pain, vomiting, fever, and hematochezia are the characteristic presenting complaints. Tenderness, distension, and diminished intestinal sounds were the prominent abdominal physical findings in this case and were often associated with tachycardia and hypotension. This is a case that demonstrates all the nonspecifics, and one in which the patient survived beyond all others reported in the literature to date.

Humans↗
PubMed1984

Sclerosing lobular hyperplasia manifesting as a palpable mass of the breast in young black women.

Sclerosing lobular hyperplasia is defined as a lesion of the breast characterized solely by prominent hyperplasia of the lobules and sclerosis of the intralobular stroma. The extra-lobular connective tissue may or may not be fibrosed. To ascertain the frequency of this condition, the histologic sections of all benign breast lesions diagnosed at Howard University Hospital between January 1, 1980, and June 30, 1982, were reviewed. The patient population of the hospital is almost entirely black. Among a total of 590 benign breast lesions, 18 cases of sclerosing lobular hyperplasia were found. The mean age of the patients was 28.3 years. The patients generally complained of a painless or slightly tender lump in the breast, of one or two month's duration. The masses appeared finely nodular and varied in size from 0.8 X 1.2 cm to 3.5 X 5.0 cm. Some microscopic sections from patients with sclerosing lobular hyperplasia revealed incipient (lobule-sized) fibroadenoma. On re-examination of the available sections of 101 fibroadenomas, 47 (46.5 per cent) were found to be surrounded by breast tissue exhibiting focal sclerosing lobular hyperplasia. Apparently, sclerosing lobular hyperplasia is often overgrown by fibroadenoma, and the presenting symptoms are those of the dominant tumor rather than those of the preceding condition.

Adenofibroma↗
PubMed1983

Surgery for colorectal carcinoma.

An adequate operation for colorectal carcinoma involves removal of the primary tumor and wide excision of the mesentery with its contained regional lymph nodes and lymphovascular pathways. Enker and DeCosse state that radical resection, i.e., total mesenteric lymphadenectomy encompassing the origins of the complete arterial blood supply to an affected bowel segment has proved to be a rewarding operation in terms of survival in cancer patients. In patients with positive lymph nodes, radical resection is associated with twice the five-year survival rate achieved by more limited operations that spare the root of the mesentery. Details of the various surgical approaches to the resection of colorectal cancer are presented.

Colonic Neoplasms↗
PubMed1983

Penetrating neck wounds.

Over a 15 year period 120 patients with neck injuries that penetrated the platysma were studied. Appropriate treatment was initiated in the emergency room. Sixty-one patients underwent exploration and 59 were observed. Two of the observed patients later required delayed operation. In 9.2 percent of the patients, two or more injuries were present within the neck, whereas in 30 percent the neck injury was only one of many bodily injuries. Length of hospital stay for the operative group of patients was 9 days and for the nonoperative group 5 days. There was one death. The complication rates in the operative and nonoperative groups were 2.5 and 1.7 percent, respectively. The major structures injured were within the venous system. The neck injuries were classified according to three zones defined by Saletta and Jones and their co-workers [4,5]. The majority were Zone II injuries. Our morbidity and mortality rates are slightly lower than those reported in most series. This review supports the concept that therapy for penetrating injuries to the neck should be individualized.

Adolescent↗
PubMed1983

A follow-up study on familial polyposis coli in black patients.

We have updated our experience concerning eight families (24 patients) with FPC, 11 of whom had FPC with carcinoma and 13, FPC only. The importance of biopsy to prove the presence of an adenoma (tubular, villous or tubulovillous) was emphasized. Although we prefer total colectomy with ileorectal anastomosis as definitive treatment, total proctocolectomy also has been recommended. The value of careful follow-up examination to detect carcinoma in the retained rectal segment and the periampullary region has been stressed. No racial differences were noted.

Adenocarcinoma↗
PubMed1981

Is there a genetic basis for the differences in cancer incidence between Afro-Americans and Euro-Americans?

The data of the Third National Cancer Survey show for many cancer types, large differences in cancer incidence between Euro-Americans and Afro-Americans.(1) As in other racial studies, it is difficult to separate environmental and genetic factors. For the cancers which are more frequent among Afro-Americans, environmental factors seem to be primarily responsible. However, among the cancers less frequent in Afro-Americans, there are some for which the racial differences have a genetic basis. This is clearly the case for skin and lip cancers caused by the ultraviolet B of the sun. Genetic factors are probably also responsible for the racial differences in the incidence of malignant melanomas, testis cancers, astrocytomas, and Ewing's sarcomas. Perhaps there is also a genetic basis for some of the racial differences in the incidence of malignant lymphomas and leukemias. For all these cancers, Afro-Americans are less susceptible. The only cancer to which Afro-Americans appear more susceptible on the basis of genetic makeup, is fibrosarcoma. This is in accord with the high frequency of keloids, a benign counterpart of fibrosarcoma in Afro-Americans.

Africa↗