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M Nissenbaum

Publications and source records attributed to M Nissenbaum.

At least 19 recordsLinked to original sources
PubMed1997

Relative displacement resistance of standard and low-profile bone plates in experimental mandibular angle fractures.

OBJECTIVE: The purpose of the study was to compare the resistance to displacement of low-profile and standard titanium bone plate with an experimental mandibular angle fracture model. STUDY DESIGN: A jig was used to produce standard horizontally and vertically unfavorable mandibular angle fractures in 24 healthy baboon hemimandibles. Each hemimandible was immobilized with either a standard or a low-profile titanium bone plate with a Champy unicortical technique. The resistance to displacement was measured in a tensile-testing machine, and results were analyzed with a three-way analysis of variance. RESULTS: Mean (SD) forces required to displace the fractures were standard plate 68.7 (22.8) kg and low-profile plate 46.5 (24.6) kg. CONCLUSIONS: The standard plates provided significantly more resistance to displacement, and 75% of the low-profile plates fractured through a screwhole.

Animals↗
PubMed1996

Familial florid cemento-osseous dysplasia--a case report and review of the literature.

Cemento-osseous dysplasia is a fairly common lesion of the jaws originating from the elements of the periodontal ligament. Most lesions do not have a hereditary basis, however a few familial cases have been documented. This is the first report of the florid form of cemento-osseous dysplasia in an African family. The mother, son and one daughter exhibited multiple sclerotic cemental masses of the jaws with large tumour-like swellings in the symphyseal area of the mandible. In the case of the mother the lesions had become infected. The familial form of cemento-osseous dysplasia differs from the non-hereditary type in that the lesions present in children, all cases are florid in nature, there is no predilection for black females, the rate of growth appears to be more rapid and the symphyseal area of the mandible is most severely affected. The mode of transmission appears to be autosomal dominant with variable phenotypic expression.

Adolescent↗
PubMed1990

Prognostic significance of cholestatic alcoholic hepatitis. VA Cooperative Study Group #119.

Tissue cholestasis is a histologic feature in some patients with alcoholic liver disease, but its significance is unknown. We studied prospectively the clinical, laboratory, and histologic findings of 306 chronic male alcoholics in whom liver tissue was available. Tissue cholestasis permitted identification of two groups: group I, absent or mild cholestasis (239 patients), and group II, moderate to severe cholestasis (67 patients). Statistical evaluation was performed by Student's t test and regression analyses. In patients with tissue cholestasis, 97% had elevated serum cholylglycine levels, while only 61% had significant jaundice (serum bilirubin greater than 5 mg/dl). In patients without tissue cholestasis, 66% had elevated serum cholylglycine and 13.5% jaundice. Highly significant statistical correlations (P less than 0.0001) were found between cholestasis and malnutrition, prothrombin time, AST, alkaline phosphatase, bilirubin, Maddrey's discriminant function, serum cholylglycine level, albumin, and histologic severity score. In group I, 54% survived 60 months versus 22% in group II (P less than 0.0001). Highly significant statistical correlations (P less than 0.0001) were noted between serum cholylglycine levels and the parameters enumerated earlier, but not with survival. We conclude that tissue cholestasis is a highly significant prognostic indicator of outcome in alcoholic hepatitis and is more consistently associated with bile salt retention than jaundice.

Cholestasis, Intrahepatic↗
PubMed1990

Giant lateral neck swellings.

Four patients with extremely large lateral neck swellings are described. In the discussion the controversy about using radiotherapy: (i) to make an 'inoperable tumour operable', and (ii) to 'sterilise the operative field' is considered. It is concluded that modern radiotherapeutic techniques probably satisfy these requirements.

Adolescent↗
PubMed1988

Lack of a significant independent effect of race on survival in breast cancer.

In an analysis of 2033 patients with breast cancer from two population groups presenting to the Combined Breast Clinic of the Johannesburg and Hillbrow Hospitals, black patients were found to present with more advanced stage disease (P much less than 0.0001) and to have a poorer prognosis within each stage than whites (P less than 0.005- less than 0.001). Intrastage inhomogeniety was indicated by the finding that black patients had significantly more advanced T and N categories within stage grouping as compared to white patients (P = 0.013-P less than .001). A multivariate analysis controlling for age, T and N in nonmetastatic showed that when these factors were taken into consideration there was no significant independent effect of race on survival. The data indicate that the poorer prognosis which has been previously reported for black patients probably results from intrastage variability of disease bulk, supporting the use of the TNM rather that the stage grouping system for prognostication. Age differences also were evident when the two population groups were compared, with breast cancer in blacks appearing to present at an earlier age. Further analysis showed that these age differences were related to the age structure of the two populations and that breast cancer probably does not occur at a younger age in black subjects. Ethnic origin, does not appear to play a significant independent role in the prognosis of breast cancer in women.

Adult↗
PubMed1988

Bypass surgery for unresectable oesophageal cancer: early and late results in 124 cases.

The early and late results of bypass surgery in 124 patients with unresectable oesophageal cancer are reported. Patients were grouped according to the extent of disease: group A, tumour localized to the oesophagus where severe pulmonary disease contra-indicated oesophagectomy (n = 9); group B, tumour less than or equal to 10 cm in length with mediastinal invasion (n = 81); group C, tumour greater than 10 cm in length with mediastinal invasion and/or fixed malignant lymph nodes (n = 33). Extent of disease was not recorded in one patient. The operative mortality was 4 per cent but 9 other patients died in hospital (hospital mortality, 11 per cent). Mortality was increased in patients undergoing colon bypass and in those with a large tumour load but these differences failed to reach statistical significance. The most frequent complication was neck sepsis, secondary to leakage from the proximal end of the excluded oesophagus. Eighty-nine per cent of the survivors could eat a normal, unrestricted diet on discharge and eighty-two per cent of survivors had complete and lasting relief from dysphagia. Median survival after bypass was 5 months but survival was significantly improved by radiotherapy to the tumour (P less than 0.001). Gastric bypass with radiotherapy is indicated in patients with extra-oesophageal spread of malignancy and in patients with tumours localized to the oesophagus who are unfit for resection. Bypass surgery may be contra-indicated in patients with a primary tumour greater than 10 cm in length and/or fixed lymph node metastases because mortality is increased and survival after operation is short.

Adult↗
PubMed1986

Treatment of metastatic and recurrent cervix cancer with chemotherapy: a randomised trial comparing hydroxyurea with cisdiamminedichloro-platinum plus methotrexate.

In a randomised trial comparing single-agent chemotherapy (hydroxyurea) to combination chemotherapy in advanced cervix cancer, response was seen in 57% (including 13% CR) of patients receiving the combination (DDP + MTX) regimen. Responding patients survived significantly longer (11 months) than either those receiving hydroxyurea or those not responding to combination chemotherapy (4 months). Two patients remain in complete remission for 14+ and 17+ months.

Actuarial Analysis↗
PubMed1986

Pregnancy after radiation therapy for carcinoma of the cervix.

A successful pregnancy after intracavitary radiation therapy for carcinoma of the cervix is described. An additional 13 similar cases from the literature are reviewed. The possible reasons for the occurrence of these pregnancies despite irradiation to the ovaries, cervical canal and endometrium are discussed. The fact is emphasized that no genetic damage to the child was expected.

Adenocarcinoma↗
PubMed1985

Unusual skeletal metastases in carcinoma of the cervix.

In a series of 1347 patients with carcinoma of the cervix, 62 or 4.6% had metastatic spread to the bones. Bone metastasis correlated with more advanced disease, occurring in 39.1% of patients with Stage II disease. The role of isotope bone scanning and of the radiographic skeletal survey in the investigation of carcinoma of the cervix is considered. Eight patients having unusual radiographic appearances of skeletal metastases are discussed.

Adult↗
PubMed1984

High-dose weekly fractionation radiotherapy in advanced cancer of the uterine cervix.

A trial comparing two different radiotherapy techniques and schedules in the treatment of 83 patients with advanced cancer of the uterine cervix (stage IIIB) employing external irradiation alone is described. The one technique, used routinely in this department, employed a conventional daily fractionation schedule while the other used a high-dose weekly fractionation regimen. The techniques are described. The aim of the trial was to compare the efficacy and morbidity of these two methods of treatment. Dose distribution curves in cross-section and midsagittal planes are shown and calculations or equivalent doses at various selected points using Ellis's nominal single-dose formula are tabulated. The 2-year survival figures were 33% for the daily fractionation technique and 22% for the weekly regimen. Serious late complication rates were 6% for the daily regimen and 22% for the weekly schedule. These differences are not statistically significant. Late complication rates in the weekly fractionation regimen appeared to be lower than figures quoted by other authors. Local control within the irradiated volume was better in the group treated by the daily fractionation method.

Adolescent↗
PubMed1984

Radiotherapy and surgery in the management of stage IB and IIA carcinoma of the cervix.

Ninety-two consecutive patients with stages IB and IIA carcinoma of the cervix were treated by one of two regimens: pre-operative intracavitary caesium-137 followed by a Wertheim hysterectomy (group 1) or staging laparotomy with biopsy of suspicious lymph nodes (group 2) (if there was no evidence of tumour on examination of a frozen section of the lymph nodes a Wertheim hysterectomy was performed, but if a tumour was present the abdomen was closed and a course of radical irradiation given). When there was evidence of extracervical spread on examination of the specimen after the Wertheim hysterectomy, postoperative irradiation was given. It was found that clinical staging had been incorrect in 38,5% of patients thought to have stage IB disease and in 71,4% of those thought to have stage IIA disease. The actuarial survival curves showed no significant statistical difference between group 1 and group 2. When examination of the operative specimen showed tumour invasion of the parametrium only, the disease was well controlled by postoperative irradiation (all 7 such patients survived). On the other hand, when there was evidence of tumour invasion of pelvic lymph nodes the 4-year survival rate fell to 31% (4 out of 13 patients), despite the use of postoperative irradiation.

Adult↗
PubMed1984

Late metastases of ovarian carcinoma. A case report.

In cases of ovarian carcinoma distant metastases are rarely discovered before local spread has become evident. This article reports an unusual case in which renal metastases appeared 9 years after the initial diagnosis of epithelial ovarian carcinoma. A discussion of the histological features of the tumour and the spread of ovarian carcinoma is included.

Adult↗
PubMed1984

Treatment of advanced head and neck cancer: multiple daily dose fractionated radiation therapy and sequential multimodal treatment approach.

Fifty-eight patients with advanced head and neck cancer were entered into a randomised trial comparing chemotherapy (DDP + bleomycin) alone, multiple daily fractionated radiation therapy, and multimodality therapy consisting of chemotherapy plus multiple fractionated radiation therapy. Multimodal therapy gave a significantly higher response rate (69%) than either single-treatment modality. The use of a multiple daily dose fractionation allowed radiation therapy to be completed over 10 treatment days, and the addition of chemotherapy to the radiation treatment did not significantly increase toxicity. Patients receiving multimodal therapy also survived significantly longer (median 50 weeks) than those receiving single-modality therapy (median 24 weeks).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Class IIA ring avulsion injuries: an absolute indication for microvascular repair.

The class II ring avulsion category, includes those patients in whom only digital arteries are damaged but all other structures are intact and functional (here labeled class IIA). Current literature suggests this is a rare lesion. Seven patients with this specific injury in whom the affected digits were nonviable are reported. Four of the seven were misdiagnosed on initial emergency room evaluation. Two did not seek additional medical attention and the condition progressed to necrosis and amputation. The other two, who sought additional treatment because of progressive ischemia, and three additional patients who were correctly diagnosed on initial examination underwent simple digital arterial repair. All digits operated on survived and demonstrated near normal function. Since failure to operate results in digital loss, this is an absolute indication for microvascular repair.

Adult↗