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Biomedical subjects

M F Tenholder

Publications and source records attributed to M F Tenholder.

62 records · Page 4Linked to original sources
PubMed1984

Pulmonary artery malformation syndrome.

We present a case to illustrate that pulmonary artery malformation is a potential diagnosis in patients with nonresolving perfusion defects. The diagnosis can usually be made by the history, physical examination, chest roentgenogram, and ventilation-perfusion scanning. If the patient's clinical symptoms are inconsistent with the scan, then pulmonary angiography is warranted. Pleuritic chest pain, hypoxemia, and a perfusion defect are nonspecific and should not be interpreted as indicative of pulmonary embolism but only that it has not been ruled out. Anticoagulation is risky because these patients are already at increased risk for pulmonary hemorrhage and hemoptysis.

Adult↗
PubMed1984

Computed tomographic scanning of the brain in initial staging of bronchogenic carcinoma.

Hematogenous dissemination to the brain occurs frequently with bronchogenic carcinoma ( BGCA ). Advocates of computed tomographic (CT) scanning have proposed the use of CT scanning of the brain as a screening procedure to exclude metastasis. To establish CT's appropriate role, we have retrospectively reviewed patients who had CT scanning of the brain during the initial staging and evaluation of BGCA . Clinical factors indicative of metastatic disease, both organ-specific and nonorgan -specific, were extracted from the history, physical, and laboratory data. Eighty-nine patients were studied. Sixteen patients had abnormal CT scans of the brain (18 percent). Only nine of the 16 had evidence of central nervous system (CNS) disease on history or physical examination. All 16 patients had strong clinical indications of disseminated disease. With completely normal clinical examinations, no abnormal CT scans were identified. Among patients with three or more clinical abnormalities present, an abnormal CT scan occurred in 37.5 percent (12 of 32). The clinical examination is a sensitive indicator of metastatic CNS disease as identified by the CT scan. Both organ-specific and nonorgan -specific findings are important indicators of CNS metastatis .

Adult↗
PubMed1982

Endobronchial metastatic plasmacytoma.

Plasmacytomas are rare tumors and an endobronchial presentation has not been previously described. A 64-year-old white woman with metastatic involvement by plasmacytoma is presented. A review of the literature indicates the difficulty in distinguishing this lesion from benign plasma cell tumors of the lung and the prolonged follow-up often necessary to reveal metastatic behavior. Careful observation in this case led to the demonstration of metastatic lung and endobronchial lesions without the development of abnormal proteinuria or overt myeloma. The literature would suggest a key role for radiation therapy in treatment. The role of chemotherapy remains to be defined.

Bronchial Neoplasms↗
PubMed1980

Bullous emphysema. Progressive incremental exercise testing to evaluate candidates for bullectomy.

Various tests of both function and anatomy have been used in patients being considered for surgical resection of giant pulmonary bullae. A young patient had an excellent response to removal of a large bulla in the right lung. In addition to roentgenographic evaluation, ventilation perfusion scanning, and routine preoperative pulmonary function studies, we performed progressive incremental exercise testing to determine both preoperative and postoperative ventilatory and cardiac measurements. We feel that progressive incremental exercise pulmonary function adds another dimension to the selection and follow-up of patients being considered for operative bullectomy.

Adult↗
PubMed1980

Pulmonary infiltrates in leukemia.

We reviewed the inpatient records of 139 adult patients with leukemia to determine the incidence of opportunistic infections in immunocompromised patients and the pattern of roentgenographic involvement of such infections. There were 98 parenchymal infiltrates identified, including 43 episodes of local disease and 55 episodes of diffuse disease. The causes of the infiltrates were determined from biopsies of tissue and autopsies whenever possible. If roentgenographic resolution after therapy with an antibiotic or diuretic agent was documented, the cause was considered determined; however, this did not identify a specific bacterial or viral agent. Parenchymal infiltrates (17 episodes) appearing in the period before treatment or within 72 hours of initiating therapy were not opportunistic. Local disease during treatment was infectious in 23 (74 percent) of 31 cases and was bacterial in 20 (87 percent) of 23 cases. Opportunistic organisms caused only 13 percent of the local infectious episodes. Diffuse disease was noninfectious in 26 (65 percent) of 40 episodes; while in the 14 episodes of infectious disease identified, 13 (93 percent) were caused by opportunistic organisms. We conclude that procedures for biopsy to document opportunistic infection are of little value in local or diffuse disease before treatment, are of modest value in local disease during treatment, and are of greatest value in diffuse disease during treatment if little clinical evidence for noninfectious causes exists.

Acute Disease↗