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Biomedical subjects

L Rosenfeld

Publications and source records attributed to L Rosenfeld.

At least 73 records · Page 4Linked to original sources

Malignant secondary parotid tumors.

Malignant secondary parotid neoplasms are uncommon. Among 545 malignant parotid tumors, we found 52 (9%) that did not arise primarily in the parotid gland. Lymphomas or tumors of hematopoietic origin were excluded from this study. All patients had a parotid mass (two bilateral), one third of which were painful; 20% had facial nerve weakness. Fifty-four surgical procedures were performed on 51 patients. Radical neck dissection was done for deeply invasive or highly malignant tumors. Adjunctive radiotherapy was administered postoperatively for cutaneous squamous cell carcinoma, while chemotherapy was given for lung and breast carcinoma and melanoma. Follow-up, obtained in 51 of 52 patients, averaged five years.

Adolescent↗

Surgical experience with hyperparathyroidism.

This is a retrospective analytic review of 208 patients with hyperparathyroidism studied and treated at Vanderbilt University Hospital from 1935 to 1980. Follow-up in these patients has been completed to date or to death in a great majority of patients. Results indicate the value of excision of isolated adenomas and of subtotal parathyroidectomy for primary and secondary hyperplasia.

Adenoma↗

Long-term experience with childhood thyroid carcinoma.

Twenty patients with well-differentiated thyroid carcinoma, 20 yr of age or younger have been treated at Vanderbilt University Hospital. The young patient with thyroid carcinoma frequently presents with far-advanced disease but enjoys an improved survival. Preoperative scintiscanning is useful in the evaluation of patients with childhood thyroid carcinoma. A new noninvasive scan is described and appears to be promising in the preoperative differentiation between benign and malignant thyroid lesions in children and young adults. There is a high instance of nodal metastases, but long-term follow-up would indicate that lobectomy and modified neck dissection are sufficient for most patients. However, total thyroidectomy can be performed safely in those patients with disease in both lobes. Additionalally, frozen section diagnoses were found to be helpful in diagnosing and staging thyroid carcinoma.

Adenocarcinoma↗

Esthesioneuroblastoma. Case report.

We present a case of esthesioneuroblastoma, and we emphasize the importance of considering this tumor in the differential diagnosis of primary intranasal carcinomas. Although the tumor is uncommon, we feel that many cases have been misdiagnosed histologically. The typical history in these patients is one of intermittent recurring epistaxis or nasal destruction and frequently, at the time of the initial examination, the tumor has reached a considerable size with evidence of local invasion.

Diagnosis, Differential↗

Transitory cerebral microvascular blockade after cardiopulmonary bypass.

Dogs were submitted to cardiopulmonary bypass (CPB) carried out under conditions calculated to generate large numbers of microbubbles and microemboli. On the day following the procedure the dogs showed evidence of neurological damage including impaired consciousness and ataxia. These abnormalities largely cleared within a week. When the animals were sacrificed at intervals after the procedure, the cerebral microvasculature was demonstrated by injecting a suspension a lamp black into the carotid artery. This revealed that multiple filling defects were present in the microcirculation of the brain immmediately after CPB and for two days thereafter. However, by seven days the microvascular blockade had disappeared, and the vascular blockade had disappeared, and the vascular pattern of the brain had returned to normal. Neuropathological findings were sparse and restricted to the cerebellum. This study suggests that the transient neurological syndromes that sometimes follow cardiopulmonary bypass for heart surgery may be due to a transient microvascular blockade, perhaps by microbubbles and microparticles.

Animals↗

Carcinoma of the thyroid with description of a new scanning technic.

A statistical analysis of 193 patients with thyroid carcinoma encountered at Vanderbilt University Hospital from 1925 to 1974 is reported, from which the following conclusions are drawn: (1) Papillary thyroid carcinoma is an extremely favorable lesion that when grossly limited to one thyroid lobe can usually be managed successfully by ipsolateral total lobectomy. (2) Cervical lymph node enlargement in patients with papillary carcinoma requires lymph node dissection. When feasible, the spinal accessory nerve should be preserved. (3) Failure to cure papillary and follicular thyroid carcinoma is influenced by advanced age, inadequate local extirpation, and unresectability of the carcinoma. (4) Prophylactic lymph node dissection is rarely indicated in the treatment of follicular carcinoma. A new isotope scanning procedure, developed at Vanderbilt University Hospital, promises to be helpful in preoperatively differentiating benign from malignant solitary thyroid nodules.

Adenocarcinoma↗

Salivary gland carcinoma of the palate.

Results of a detailed study of the clinical features, histology, management, and prognosis of palatal carcinoma of salivary origin in 30 patients are presented. These were compared to a larger series of salivary carcinoma at other sites, and to the known behavior of epidermoid carcinoma of the palate. The prognosis was significantly better for lesions of the palate. Results of treatment were also much better for these salivary gland lesions than for epidermoid carcinoma of the palate. The frequent occurrence and seemingly greater malignancy of adenoid cystic carcinoma at this anatomic site are stressed. Several patients with primary bone involvement survived, but local recurrence in the maxilla carried a graver prognosis. There was no definite indication that radiotherapy altered the course of the disease, and nothing to suggest that prophylactic neck dissection is of value. On the basis of the evidence presented, there is little to justify more radical excision than the clinical extent of the lesion would indicate, with the probable exception of adenoid cystic carcinoma, where a more aggressive approach may well prevent death from cancer.

Adult↗