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Biomedical subjects

M Deutsch

Publications and source records attributed to M Deutsch.

At least 253 records · Page 14Linked to original sources
PubMed1985

Stereotactic interstitial brachytherapy--current concepts and concerns in twenty patients.

Recent advances in imaging and stereotactic techniques have resulted in wider application of interstitial brachytherapy (IBT) for brain tumors. The advantages of brachytherapy alone or in combination with teletherapy have been detailed, and may be responsible for increasing survival time. We report the preliminary results of 20 patients who underwent CT stereotactic IBT for malignant brain tumors. Despite both old and recent evidence about the efficacy of IBT, concerns remain about the proper grade neoplasm, the target, the dose, and the timing for treatment. Current usage of IBT should be limited to centers with both stereotactic and radiotherapeutic expertise, and where the risks and benefits are being investigated.

Adult↗
PubMed1985

Experimental coronary angioplasty using a UV-Excimer laser.

Both conventional Argon- and NdYAG-lasers in continuous wave or pulsed application and far ultraviolet laser radiation are able to cause a loss of substance of biologic tissue. The thermic and ablative effects of NdYAG-lasers and UV-Excimer lasers at the wavelengths of 193 nm (ArF) and 248 mm (KrF) on inconspicuous and atherosclerotic human and animal coronary vessels were compared by histologic and, in some cases, by scanning electron microscopic examinations. Whereas common lasers generally produce thermal injuries of the surroundings, pulsed far ultra-violet radiation is characterized by a lack of thermic damage. The UV-radiation in vitro cleaned precise defects of substance, and assessable tissue-removing effects were found. These results were influenced by the wavelength used. In general, the removing effect was good in normal and atherosclerotic tissue, whereas massive calcification was very resistant. Excimer lasers seem to be preferable for ablation of atherosclerotic tissue, but still there is a great number of technical problems to be solved until use in the clinical setting can be justified.

Journal Article↗
PubMed1985

Uterus duplex with a unilaterally imperforate vagina--diagnosis and treatment. Report of two cases and review of the literature.

Severe cyclic dysmenorrhoea in a young woman with a unilateral abdominopelvic mass terminating in a purpuric bulge in the lateral vaginal wall, and resulting in renal agenesis ipsilateral to the pelvic mass, suggests uterus didelphys with unilaterally imperforate vagina. A report of two cases, their diagnostic and therapeutic approach and review of the literature are presented.

Abnormalities, Multiple↗
PubMed1984

[Surgical measures in the postinfarct phase].

Even though the majority of patients with myocardial infarctions demonstrate an uncomplicated course which does not need any kind of surgical intervention, there is a distinct number of patients with a ventricular aneurysm complicated by congestive heart failure or refractory arrhythmias or a perforated ventricular septum or a mitral insufficiency due to papillary muscle dysfunction or rupture, representing a life-threatening condition with an urgent need for surgical correction. The clinic, hemodynamic and surgical therapy are discussed.

Blood Vessel Prosthesis↗
PubMed1984

[Paroxysmal brain stem ischemia in a combination of thoracic outlet syndrome with contralateral subclavian steal syndrome].

Mechanical irritation of the right subclavian artery in the scalenus region and stenosis of the contralateral subclavian artery in combination with hypoplasia of the vertebral artery led to recurrent neurological symptoms in a 41 year-old female patient. Sudden loss of consciousness, episodes of dizziness, vomiting and paraesthesiae occurred as a result of manoeuvres involving turning the head and lifting the right arm. A significant blood pressure difference between both arms and a stenotic bruit were found. Angiography revealed the "subclavian steal syndrome" with stenosis of the left subclavian artery and hypoplasia of the left vertebral artery. On operation of the right scalenus region an atypically angled origin of the right vertebral artery was detected. After dissection of the scalenus anticus muscle and-in a second step-transaxillary resection of the first rib the patient has remained symptom-free for the past 24 months.

Adult↗
PubMed1984

The impact of myelography on the treatment results for medulloblastoma.

Two series of newly diagnosed patients with medulloblastoma are compared in terms of survival, relapse-free survival, and sites of relapse. Patients in series I were all diagnosed and treated prior to 1974 and did not have the benefit of myelography and CSF cytology for staging. All patients treated after 1974 had myelography and most had CSF cytology studies prior to radiotherapy. In addition, patients in the latter series were all followed with CT scanning. Improved survival and relapse-free survival rates were seen in the series II patients. Approximately 30% of the staged patients have had abnormal myelograms. It is suggested that involved portions of the cord be treated with higher doses than the usual prophylactic doses. The better results seen in the series II patients are probably due in part to a combination of adequate staging with radiation doses to the neuraxis based on the staging, close followup with CT scanning, and aggressive re-treatment of relapses.

Adolescent↗
PubMed1984

Increased alpha-fetoprotein levels in mixed mesodermal tumor of the ovary.

2 Cases of mixed mesodermal tumor of the ovary with elevated peripheral levels of alpha-fetoprotein (alpha-FP) were studied. The morphology of these tumors is presented. The finding of hyaline droplets of alpha-FP is of special interest. The histogenesis of the tumor was reappraised in light of the increased level of the marker.

Aged↗
PubMed1983

Germ cell tumors complicated by pneumothorax.

Spontaneous pneumothorax is an unusual consequence of pulmonary metastases. This complication occurs mainly in children and adolescents with primary osseous sarcomas and is extremely rare in patients with pulmonary metastases secondary to carcinomas. Germ cell tumors have a proclivity to metastasize to the lung, but few instances of pneumothorax have been recorded. The authors present 3 cases of pneumothorax secondary to pulmonary metastases from germ cell tumors, both gonadal and extragonadal in type.

Adult↗
PubMed1983

Validation of the SCM-test for the diagnosis of cancer.

The basic aspects of the SCM-test are summarized. A derivation of the fluorescence intensity vs time curve is given as well as that of the polarization as a function of time. These curves are found to be in excellent agreement with the experimental results. The test is applied to the lymphocytes of twenty-six healthy individuals and of thirty-three cancer patients. No false negative results were obtained. Seven cancer patients were found to be negative after various intervals from the removal of the tumour. The most important technical difficulties and pitfalls are discussed in order to facilitate the reproduction of the test by other researchers.

Cytoplasm↗
PubMed1983

Therapeutic implications of an intraoral malignancy complicated by Darier-White's disease.

A 69-year-old white male with a long history of severe Darier-White's disease presented with an extensive intraoral malignancy. High dose external supervoltage radiotherapy (Cobalt-60) to the tumour caused remarkable clearing of the hyperkeratotic lesions involving the overlying skin. Subsequently, surgical resection of the tumour with staged reconstruction of the jaw was carried out. The presence of the skin disorder did not adversely affect the surgical procedure nor the subsequent wound healing. Darier-White's disease, therefore, should not be a deterrent to radical radiotherapy and/or surgery for concomitant malignancy.

Aged↗
PubMed1983

Myelography and cytology for staging very young children with medulloblastoma.

Children under 5 years of age with medulloblastoma reportedly have a worse prognosis than older patients. Twenty-four patients under 5 years of age who completed radiotherapy are reviewed. Eleven were diagnosed after 1974 and were prospectively staged for dissemination with myelography and cerebral spinal fluid (CSF) cytology. Thirteen patients were treated before 1974 and without prior myelography or cytology studies. Six of 11 staged patients had abnormal myelograms and one additional patient had malignant cells in the CSF. Thus, only 4/11 staged patients were without evidence of dissemination. Seven of the 11 staged patients are alive and well at least 29 months from diagnosis. All four patients without evidence of dissemination at diagnosis are alive. Of six patients with initial cord involvement, three are alive. The one patient with a positive cytology died. Four of 13 unstaged patients are alive and well. There was no difference in survival between patients under 5 years of age and those over 5 years of age for either series of patients. Children under 5 years of age, when compared to older children, were more likely to have cord involvement at diagnosis. The optimum radiation dose to the cord in children without evidence of dissemination is unknown. Four long-term survivors received less than or equal to 2600 rad to the cord.

Brain Neoplasms↗
PubMed1982

Radiotherapy for primary brain tumors in very young children.

Ninety-one children younger than age five years have been treated with radiotherapy for primary intracranial tumors. Patients with cerebellar astrocytomas and optic chiasm gliomas did relatively well, whereas brain stem tumors, extensive posterior fossa tumors and cerebral gliomas had a poor prognosis. Medulloblastomas, ependymomas, and midbrain tumors were of intermediate prognosis. There was no definite correlation between age at diagnosis and survival, although patients over 24 months of age seemed to do slightly better. Tumor doses of at least 4000 rad seem necessary for any likelihood of control. Of 63 children diagnosed over five years ago, 27 (43%) survived at least five years. The majority of long-term survivors are leading normal lives, although many have mild impairments.

Astrocytoma↗
PubMed1982

Acute lymphocytic leukemia of the ovary: the value of sonography.

Leukemic involvement of ovary has been found in up to 30% of patients with acute lymphocytic leukemia (ALL) at autopsy, but is rarely found clinically. Since the ovary may be a sanctuary for ALL to reseed the marrow, early clinical detection of ovarian involvement is important. The use of sonography in evaluating the ovary is suggested as part of the management routine in ALL. It can be used prior to cessation of chemotherapy and on subsequent follow-up to assess the state of the ovary. A case is presented in which a young woman with ALL in remission developed a pelvic mass, documented by ultrasound, subsequently shown to represent leukemic infiltration of the ovary.

Adult↗
PubMed1982

Radiotherapy for cerebral metastases in children.

Twelve children with cerebral metastases from non-lymphomatous primary tumors are reviewed. Eleven were treated with radiotherapy and four are alive without clinical or radiographic evidence of intracranial tumor 2-7 1/2 years later. Three of the four survivors are free of neurologic impairments. Eight patients died within two months of detection of cerebral metastases. There were no obvious differences between those patients who survived and those who did not, concerning the primary tumor, age at diagnosis, duration of symptoms or the interval from the primary to the cerebral metastases. All survivors are male.

Adolescent↗
PubMed1981

Findings from NSABP Protocol No. B-04: comparison of radical mastectomy with alternative treatments. II. The clinical and biologic significance of medial-central breast cancers.

Findings from 1665 women with primary breast cancer, treated at 34 NSABP institutions in Canada and the United States, have failed to demonstrate that patients with medial-central tumors had a greater probability of developing distant metastases or dying than did those with lateral tumors despite the greater incidence of internal mammary (IM) node involvement when tumors are medial-central in location. A comparison of patients with similar clinical nodal status and tumor location who were treated either by radical mastectomy (RM) or by total mastectomy plus radiation therapy (TM + RT) failed to indicate that radiation of IM nodes reduced the probability of distant treatment failure (TF) or mortality. When findings from patients having equivalent clinical nodal status and tumor location treated by TM alone or TM + RT were compared, it was found that the addition of RT failed to alter the probability of the occurrence of a distant TF or of death. This was despite the fact that in the nonradiated group two putative sources of further tumor spread, i.e., positive axillary and IM nodes, were left unremoved and untreated. The findings provide further insight into the biologic significance of the positive lymph node and confirm our prior contention that positive regional lymph nodes are indicators of a host-tumor relationship which permits the development of metastases and that they are not important investigators of distant disease.

Axilla↗