Anterior approach for removal of spinal angiolipoma. A case report.
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Hemangioma↗
Biomedical subjects
P Lebensart
Publications and source records attributed to P Lebensart.
Hepatic intraarterial antibiotic therapy for resistant hepatic abscesses.
Liver abscesses present a severe problematic medical entity. The traditional treatment modality consists of surgical drainage, which cannot be accomplished in all circumstances. Other modes of therapy include systemic antibiotics or percutaneous catheter drainage under ultrasonography or computerized tomography. Despite new treatment regimes liver abscesses, to date, are a potentially lethal disease, with a mortality rate of about 50%. We report an innovative approach of high dosage intrahepatic arterial antibiotic infusion for the therapy of hepatic abscesses, which are resistant to conventional treatments. A patient who underwent mastectomy for breast carcinoma, developed liver metastases one year later. She was prescribed systemic chemotherapy for one year, but no antitumor response was evident. Since ther was no evidence for extra-hepatic metastases, intraarterial hepatic chemotherapy was instituted, using an Infusaid (Mi-400) implantable pump. Marked regression of liver metastases was observed. Therapy was withheld after 19 months because of biliary sclerosis development. At this stage, the patient developed liver abscesses, which were resistant to systemic antibiotic therapy. Intraarterial antibiotic therapy, using the implantable pump, was initiated. Following the treatment, a marked improvement in the patients' clinical condition was recorded and shrinkage of the abscesses was evident by ultrasonography. The patient was free of symptoms for three months, when she was readmitted with evidence of terminal metastatic disease and sepsis. It is suggested that intrahepatic arterial antibiotic therapy is an additional mode of treatment for patients with persistent liver abscesses which fail to respond to conventional treatment.
Adult↗
Screening for prostate cancer.
In an attempt to detect prostate cancer when the tumor is still confined to the prostate, a screening program was established. We studied the efficacy of digital rectal examination (DRE) and serum prostate-specific antigen (PSA) in the early detection of prostate cancer. One thousand men aged 50-75 years underwent DRE and serum PSA determination. Transrectal ultrasound-guided biopsies were obtained in each case of a suspicious DRE. Six systematic biopsies were performed if the PSA level was > 10 ng/ml, even if DRE and transrectal ultrasonography revealed no areas suspicious of cancer. A suspicious DRE was noted in 11.5% of the subjects; 16% had elevated levels of serum PSA (> 4 ng/ml) and 3.9% had serum PSA > 10 ng/ml. Biopsies were obtained from 90 patients, of which 31 were positive for prostate cancer. The cancer detection rate was 2.2% for DRE, 2.0% for PSA > 10 ng/ml, and 3.1% for the two methods combined. Clinical staging revealed that in 29 of the 31 patients with prostate cancer, the tumor was confined to the prostate: Stage A in 9 cases and stage B in 20 cases. Only two patients had clinically advanced cancer, and 22 patients underwent radical prostatectomy. Pathological examination disclosed biologically significant tumors in 91% of the cases in terms of tumor volume and grade. Although there is little evidence that screening will result in the reduction of the disease-specific mortality rate, early detection of prostate cancer by DRE, serum PSA, and transrectal ultrasound should be encouraged.
Aged↗