Search PubMed⌕ Search

Biomedical subjects

L Rosen

Publications and source records attributed to L Rosen.

At least 109 records · Page 6Linked to original sources
PubMed1986

V-Y advancement for anal ectropion.

A V-Y advancement flap modified for anorectal use in reconstructive surgery for anal ectropion is described. The underlying external sphincter serves a dual function as the pivotal point for flap advancement and as the vascular pedicle to the dermal-subdermal plexus supplying the flap. This ensures viability and restores function to the newly created anus.

Anal Canal↗
PubMed1986

Follow-up on a prospective study of continuous hepatic perfusion with implantable pump.

Continuous chemotherapy for hepatic metastases secondary to carcinoma of the colon and/or rectum was delivered via implantable pump in 20 patients. This is a follow-up to a preliminary report published in January 1985. Pumps were placed by a single surgeon in a community hospital; there was no mortality and minimal morbidity. Follow-up of these patients revealed a significant long-term complication rate secondary to effects of chemotherapy. Nine patients were alive at the cutoff date of this report; mean follow-up was 16 months. Eleven patients have died following implantation, with a mean survival of 14 months. Statistical analyses demonstrated increased survival rates for those patients whose tumors were poorly differentiated when compared with those with moderately differentiated or well-differentiated tumors. The objective response of liver metastases was overwhelmingly positive, as judged by CT scan and serial CEA levels. The significant rehospitalization rate for complications and the marginal increase in survival, however, have discouraged implantation of the pump at our institution.

Aged↗
PubMed1986

Nephrocolic fistula.

A patient with nephrocolic fistula secondary to perinephric abscess was treated successfully with nephrectomy, colonic resection, and colocolostomy.

Abscess↗
PubMed1986

Management of anorectal horseshoe abscess and fistula.

Over a 10-year period 69 patients were treated consecutively for posterior and anterior horseshoe abscesses and fistulas. Fifty-nine patients had posterior and ten had anterior abscesses or fistulas. There were 52 patients with acute abscess. Treatment consisted of incision and drainage, incision and drainage with primary fistulotomy, incision and drainage with primary fistulotomy and counter-drainage, and incision and drainage with insertion of seton. Seventeen patients with chronic fistulas were treated by primary fistulotomy with curettage, or incision and drainage with insertion of seton. Patients were followed from three months to ten years with a mean follow-up of three years. No incidences of incontinence were reported in this series. The overall rate of recurrence was 18 percent, and included only patients with posterior abscesses and fistulas. Recurrence was related to the failure to maintain prolonged drainage in the midline after primary fistulotomy. The use of seton for delayed fistulotomy appears to promote wound drainage and precludes premature wound closure. More liberal use of the seton in the treatment of horseshoe abscesses and fistulas is advocated.

Abscess↗
PubMed1986

Rationale for medical or surgical therapy in anal incontinence.

Seventy patients with anal incontinence referred to a colorectal service over a two-year period were evaluated and treated. In each case, a comprehensive history and physical examination as well as anal manometry were performed. Anorectal angle measurement was done when indicated. Patients were separated into groups of the four major causes of incontinence: 1) external/internal sphincter dysfunction, 2) puborectalis and anorectal angle, 3) alterations in rectal compliance, and 4) sensory deficits. Treatment was dictated by categorization of the patients. All patients were followed for a minimum of one year and, with the exception of patients with profound sensory loss, each believed that their symptoms had decreased substantially, enabling them to return to normal occupational and social activities.

Anal Canal↗
PubMed1986

Bowen's disease, Paget's disease, and malignant melanoma in situ.

The histologic differential diagnosis of skin lesions characterized by large, atypical, clear cells in the epidermis includes Bowen's disease, Paget's disease (mammary and extramammary), malignant melanoma in situ (pagetoid precancerous melanosis), mycosis fungoides, Spitz nevus, and artifact. Our experience with these lesions indicates that these diseases can be differentiated immunohistologically by the standard peroxidase-antiperoxidase technique, using antibodies directed against keratin (KER), carcinoembryonic antigen (CEA), and S-100 protein (S-100). Based on a study of 11 cases of Bowen's disease, eight cases of Paget's disease, and nine cases of malignant melanoma in situ, we conclude that the atypical clear cells of Bowen's disease stain only with antibodies to KER; those of Paget's disease, exclusively with antibodies to CEA; and those of malignant melanoma in situ, with antibodies to S-100. Additionally, we report a case in which clinical and histologic findings suggested Bowen's disease, but immunohistologic findings supported the diagnosis of Paget's disease.

Adult↗
PubMed1986

Retrorectal tumor: is biopsy risky?

A 55-year-old white man with an extensive retrorectal tumor died after transrectal needle biopsy. The indications and methods for biopsy of tumors in this location are controversial and are not well delineated in the literature. When resection seems unlikely or risky, or if a neoplasm is suspected which could be treated by nonsurgical means, biopsy is indicated. Antibiotics with aerobic and anaerobic coverage should be given prophylactically. When CT scan or sigmoidoscopic findings suggest a necrotic tumor, the transrectal approach should be avoided.

Biopsy↗
PubMed1986

Experimental vertical transmission of Saint Louis encephalitis virus by Florida mosquitoes.

Vertical transmission of St. Louis encephalitis (SLE) virus to F1 larval progeny was demonstrated in 8 species of mosquitoes which occur in Florida: Culex quinquefasciatus, Cx. nigripalpus, Cx. salinarius, Cx. restuans, Cx. opisthopus, Anopheles quadrimaculatus, An. albimanus, and Aedes taeniorhynchus. Relatively high rates of such transmission were observed in Ae. taeniorhynchus and vertical transmission to F1 adult progeny and venereal transmission from males to females also were demonstrated with this species. Larval rearing temperature affected transstadial transmission of the virus in Ae. taeniorhynchus, especially to the adult stage. Such transmission was observed with a larval rearing temperature of 18 degrees C but not at 27 degrees C. Because of the abundance and distribution of Ae. taeniorhynchus in Florida, and the relatively high rates of vertical transmission of SLE virus observed in the present experiments, this mosquito species warrants further investigation as a possible overwintering host for the virus in that locality.

Aedes↗
PubMed1986

Dengue in Greece in 1927 and 1928 and the pathogenesis of dengue hemorrhagic fever: new data and a different conclusion.

A massive outbreak of dengue, with a high incidence of hemorrhagic manifestations and a high death rate, occurred in Athens and neighboring areas of Greece in 1927 and 1928. For many years it was believed that the episode had been caused by dengue type 1 virus. Recently, it was claimed that dengue type 2 virus also was present in Athens in 1928, and this report is cited in support of the hypotheses that dengue hemorrhagic fever is almost always the result of sequential infection with different dengue serotypes and that infection with dengue type 2 following dengue type 1 is particularly pathogenic. In the present study of 258 Greek residents born from 1914 to 1938, it was also found that dengue type 2 had occurred in Greece--but after 1928. No evidence was found that that virus had occurred in the country during, or within 13 years before, the 1927-1928 epidemic.

Aged↗
PubMed1986

[Pathogenesis of hemorrhagic dengue: critical discussion of current hypotheses].

The major hypotheses which have been advanced to explain the pathogenesis of "dengue hemorrhagic fever" are reviewed. Because of the difficulty in applying the definition of "dengue hemorrhagic fever" proposed by the World Health Organization, most of the discussion deals only with the most severe form of dengue, "dengue shock syndrome", which may or may not be a subset of "dengue hemorrhagic fever". It is not clear if it is the virus or the host that plays the predominant role in the pathogenesis of the dengue shock syndrome. More specifically, there is considerable difference of opinion as to whether or not a prior dengue infection with a heterologous dengue serotype constitutes a risk factor for the development of the syndrome. The evidence cited in favor of the latter concept is discussed from a critical point of view.

Dengue↗
PubMed1986

Management of anal incontinence.

Anal incontinence can be attributed to anatomic and physiologic alterations in the external sphincter, internal sphincter and puborectalis muscle. Altered compliance or changes in the sensory threshold are contributing factors. In addition to history and physical examination, anal manometry and radiologic examination of the anorectal angle are helpful in determining the exact causative factors. Depending on the cause, either medical therapy or surgical repair can control anal incontinence.

Anal Canal↗