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Biomedical subjects

M Deutsch

Publications and source records attributed to M Deutsch.

At least 271 records · Page 15Linked to original sources
PubMed1980

The value of myelography in the management of childhood medulloblastoma.

Sixteen children with newly diagnosed medulloblastomas underwent myelography prior to radiotherapy. None had clinical evidence suggesting spinal cord involvement. Seven patients (43%) were discovered to have unsuspected metastases involving the cord. Cerebrospinal fluid (CSF) cytology results were inaccurate in predicting spinal cord involvement. Additional radiation was administered to the demonstrated lesions. Thirteen children (81%) are alive and well 7-53 months (average 26) from completion of therapy. One of nine children with a normal myelogram initially, and two of seven with initial spinal cord involvement have relapsed.

Adolescent↗
PubMed1980

A typology of divorcing couples: implications for mediation and the divorce process.

An experimental mediation procedure for the negotiation of divorce settlement agreements was studied through the intensive analysis of nine completed mediation cases. The audio recordings of mediation sessions and postdivorce interviews with both of the former marital partners provided the material on which the analysis is based. Five additional couples, drawn from a similar population but who used the traditional adversarial system, provided a comparative perspective. High levels of prenegotiation conflict and nonmutuality of the decision to divorce were negatively related to attitudes toward mediation and behavior during negotiations. The report focuses on four distinctive patterns of divorce decision-making. The typology is based on three primary dimensions: degree of ambivalence; frequency and openness of communication; and level and overtness of conflict. Couples exhibiting the enmeshed and autistic patterns of divorce were the most difficult for mediators to work with and had the poorest postdivorce adjustment; couples exhibiting the direct and disengaged conflict patterns fared better, both in mediation and in the postdivorce period. The potential importance of intercouple differences for the divorce mediation process and postdivorce adjustment are considered.

Adult↗
PubMed1980

Carcinomas of the anterior tonsillar pillar and the soft palate--uvula: treatment by radiation therapy.

Sixty-six patients with carcinomas of the anterior tonsillar pillar and/or soft palate-uvula underwent radiation therapy. Three methods were used: (a) conventional fractionation, (b) a combination of conventional fractionation and radon seed implant, and (c) split course therapy in which two one-week courses were separated by two weeks rest. On time, dose, and fractionation (TDF) factor analysis, no significant difference in the success of tumor control was found between the methods. The determinate disease-free survival at two years was 82.4% for T1, 62.5% for T2, and 56.3% for T3--4 lesions; for the whole group, the two- and five-year determinate values were 67.3% and 59.4%, respectively.

Adult↗
PubMed1979

[Myocardial revascularization in threatening extension of myocardial infarction (author's transl)].

Myocardial revascularization was performed in 13 patients between two and 14 days following initial infarction because of impending re-infarction. The diagnosis of impending re-infarction was made on the basis of the following criteria: myocardial infarction; repeated stenocardia despite medical treatment; renewed ST-T changes in the ECG. The intra-aortic balloon pump was installed in 7 patients for haemodynamic reasons (shock, massively raised pressure in the pulmonary artery). 12 patients survived the surgical intervention and were eventually discharged free of stenocardia. The presented findings suggest that surgical intervention in impending re-infarction appears of value in those cases which have not been satisfactorily controlled by conventional medical treatment.

Adult↗
PubMed1979

[Surgery of extracranial carotid artery occlusion (author's transl)].

A report is given on the results achieved in 197 procedures undertaken for extracranial cerebrovascular insufficiency in 186 patients. Patch angioplasty of the common carotid and internal carotid artery were performed in 162 cases, whilst in 30 patients kinking or looping of the internal carotid artery was corrected by means of arteriopexy, segmental resection of the common carotid artery or by means of reimplantation of the transected internal artery proximal to its origin. Neurological deficits with incomplete recovery were observed in 2 cases (1%). The mortality rate was 3%.

Arterial Occlusive Diseases↗
PubMed1979

[The research programme "Artificial Heart" at the 2nd Department of Surgery, University of Vienna: a ten year review (author's transl)].

The experimental and clinical results are presented of the research programme "Artificial Heart" carried out by the 2nd Department of Surgery, University of Vienna. In particular, an assessment of the clinical experience in 177 patients with the intra-aortic balloon pump is documented and it is concluded that only limited cardiac support is possible by this pump. In view of this fact more efficient methods of mechanical circulatory support, such as the interaortic auxilliary ventricle, the aortic "Windkessel" ventricle with guiding balloon, and two types of ventriculo-aortic bypass ventricle were tested with regard to their haemodynamic and long-time efficacy. The transatrio-aortic auxilliary ventricle (E-LVAD) was also clinically tested in 11 patients. In conclusion the problems of total mechanical heart replacement are discussed.

Animals↗
PubMed1979

[Femoro-crural reconstruction in preference to amputation (author's transl)].

22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results. The operative technique is described in detail and the speical problems of this group of patients and the particular difficulties of this technically sophisticated bypass procedure are discussed.

Adult↗
PubMed1979

Radiation treatment of orbital lymphoid hyperplasia.

Ten patients with biopsy-proved lymphoid hyperplasia (pseudotumor) of the orbit were treated with radiation therapy individed sose ranging from 2,500 to 3,000 rads. Five of the ten patients had prior treatment with corticosteroids in high dosages with only partial or no response. All ten patients had clinical resolution of the lymphoid hyperplasia orbital mass within three weeks following radiation therapy. A follow-up period of six months to five years has demonstrated no recurrences. There were no discernible complications from the radiation therapy. We believe that radiation therapy should be considered as a primary treatment of benign lymphoid hyperplasia of the orbit.

Aged↗
PubMed1979

Cancer of the breast. Radiation therapy.

There are many questions that have to be answered concerning the role of radiotherapy in the management of primary breast cancer. Hopefully, prospective clinical trials will provide some answers, but more basic research into the biology of breast cancer and the host-tumor relationship will be needed. There are indications that radiotherapy alone, or following minimal extirpative surgery in selected cases, may be as effective for control of breast cancer as conventional mastectomies. The role of radiotherapy following segmental mastectomy, with or without axillary dissection, needs to be clarified. The possibility exists that high LET (linear energy transfer) radiation such as neutron or pi meson beams may provide better local control than conventional radiation. Thus, it may be possible to treat effectively all primary breast cancers with such radiations and obviate the need for any type of mastectomy. It remains to be demonstrated whether adjuvant chemotherapy is as effective as radiotherapy in preventing chest wall and regional node recurrences. If it is not, there may be a place for both adjuvant chemotherapy and radiotherapy in the treatment of operable cancer of the breast. Likewise, effective chemotherapy combined with radiotherapy may increase the local and regional control achieved with radiotherapy alone and make more primary lesions suitable for treatment without mastectomy. Meyer (1970) recently called attention to the leukopenia and cellualr immune deficiency produced by irradiation to the thorax and mediastinum. Further study is necessary to define exactly how much immunosuppression results from radiotherapy, its clinical significance and what can be done to avoid or counter it. If Stjervsward's thesis (1974) concerning the deleterious effects of radiotherapy on survival is correct, then it is of great importance to identify those patients most likely to be adversely affected by radiotherapy. Conversely, it may be possible in the future to identify a subgroup of patients who would not be adversely affected by radiation and who would be most likely to benefit from it.

Breast Neoplasms↗
PubMed1978

Cancer of the nasopharynx in children.

The authors present 15 children with cancer of the nasopharynx. Of seven patients with primary epidermoid carcinomas, only two are alive and well. Only one of four patients with a primary soft tissue sarcoma is alive and well. Two of four patients with lymphoma of the nasopharynx are alive and well. All deaths were due to uncontrolled distant metastases. Only one patient (rhabdomyosarcoma) died with uncontrolled local disease. Radiotherapy to the primary and neck is recommended for all children with primary malignancy of the nasopharynx. Adjuvant chemotherapy may also be of value for all patients regardless of histopathology.

Adolescent↗
PubMed1978

[Surgical therapy of postinfarct tachyarrhythmia (author's transl)].

Thirteen patients with ventricular tachyarrhythmias after myocardial infarction underwent surgery at the heart wall or at the coronary vessels. Ten of these patients had an aneurysm of the anterior wall or akinesia of the anterior wall which in some cases was associated with stenosis of the right coronary artery or of the circumflex artery. One patient showed an isolated stenosis of the right coronary artery. One patient died from recurrent ventricular fibrillation during hospitalization, another patient died from reinfarction 4 months later. All the other patients could be discharged and were improved significantly.

Female↗
PubMed1978

Clinical application of the ellipsoid left heart assist device.

The ellipsoid left heart assist device (E-LVAD) was implanted in eight patients suffering from intraoperative heart failure. It was not possible to remove these patients from extracorporeal circulation following an intracardiac procedure; therefore, implantation of the E-LVAD was performed during extracorporeal circulation. The inflow connector was pushed forward from a purse-string suture on the right superior pulmonary vein, across the mitral valve and into the left ventricle. The outflow connector was joined to the ascending aorta. In two patients, the artificial heart chamber was removed after complete recovery of the circulation; these patients, however, later died. In six other patients, untreatable right heart failure developed and these patients died with the pump in place. It is concluded, therefore, that the right heart must also be mechanically supported during postoperative heart failure.

Adult↗
PubMed1978

Orthogonal fields: variations in dose vs. gap size for treatment of the central nervous system.

Variations in dose at the junction at the lower end of two lateral skull portals and the upper end of a posterior spinal portal used for irradiation of the central nervous system (CNS) were studied using 60Co and 6 MV linear accelerator radiation. The relationship between dose and gap size was measured via film dosimetry. Small variations in gap size resulted in large variations in dose (+/- 40%) at the junction. These variations in dose were more pronounced for the 6 MV accelerator than for the 60Co, but the volume of high and low dose tended to be smaller with the 6 MV linear accelerator.

Central Nervous System Diseases↗