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Biomedical subjects

R Kaufman

Publications and source records attributed to R Kaufman.

84 records · Page 5Linked to original sources

Responsiveness to endocrine manipulations in breast cancer after "prophylactic" castration.

Two hundred and one cases of premenopausal women with breast cancer who underwent prophylactic castration with subsequent recurrence were review to ascertain the degree of responsiveness of these patients to subsequent endocrine manipulation. We show that the standard endocrine manipulations, particularly the major ablations, retain a fair degree of activity in this group. There is a suggestion that the longer the castration-recurrence interval, the higher the chance of a response, but the difference is significant only for osseous-dominant disease. As in other patient groups, responders to subsequent endocrine manipulations live longer than nonresponders.

Adrenal Cortex Hormones↗

Glioblastoma multiforme metastatic to the neck.

Glioblastoma multiforme, a rapidly growing intracranial neoplasm, rarely metastasizes unless operated upon, and even after surgical exposure metastasis is uncommon unless the patient is a long-term survivor. The most likely site of metastasis is the cervical lymph nodes. A patient developed a rapidly expanding cervical metastasis a year after surgery and irradiation for the primary. The 6-cm neck mass responded dramatically to radiation therapy and lomustine. The patient is clinically without evidence of progression of disease 20 months after the initial diagnosis, and there is no palpable recurrence in the neck. It is recommended that the patient who has a cervical mass and a history of surgically treated glioblastoma multiforme undergo a careful otolaryngologic examination prior to open biopsy. In general, such a patient can be spared an extensive "unknown primary" evaluation before biopsy.

Adult↗

The frequency of cricopharyngeal dysfunction on videofluoroscopic swallowing studies in patients with dysphagia.

PURPOSE: Dysphagia associated with cricopharyngeal dysfunction (CPD) is of particular interest to the otolaryngologist because it may respond to cricopharyngeal myotomy. There is a wide variation in the reported incidence of cricopharyngeal dysfunction in patients with dysphagia. This can be attributed to the different populations being studied, the lack of uniform criteria for diagnosis, and to different techniques used to evaluate patients. We have reviewed videofluoroscopic swallowing studies (VSS) conducted on 443 consecutive patients with complaints of dysphagia to identify the incidence of cricopharyngeal dysfunction. PATIENTS AND METHODS: The patient population consists of 443 veterans with complaints of dysphagia who were evaluated by videofluoroscopic swallowing studies at the Department of Veterans Affairs Medical Center, East Orange, NJ, between November 1988 and March 1993. RESULTS: Cricopharyngeal dysfunction was diagnosed radiologically as the appearance of a shelf in the posterior column of barium at the level of the cricoid cartilage. It was identified in 10 of 177 (5.7%) patients with neurological disorders, in 7 of 142 (4.9%) patients with head and neck or esophageal tumors, and in 11 of 124 (8.9%) patients with other medical problems. CONCLUSION: These results do not support the notion that cricopharyngeal dysfunction is an important factor in a significant proportion of patients with dysphagia. It is recognized that videofluoroscopy may not always detect cricopharyngeal dysfunction and that better criteria for identifying this entity are needed.

Adult↗

Sequential genital infections by herpes simplex viruses types 1 and 2: restriction nuclease analyses of viruses from recurrent infections.

Virus isolated from a woman presenting with the first symptomatic episode of genital herpes was identified as herpes simplex virus type 1 (HSV-1) by restriction nuclease fingerprinting. Testing for IgM antibody to HSV indicated that the patient had recently contracted a new HSV infection. Virus microneutralization and the micro-solid phase radioimmunometric test for IgG, however, showed that the patient had had prior infection with herpes simplex virus type 2 (HSV-2); thus the HSV-1 infection was acquired despite the presence of antibody to HSV-2. Genital herpes recurred about four, seven, and nine months after the HSV-1 infection. Isolates from the latter three episodes all were of an identical strain of HSV-2 and were not recombinants or a mixture of the viruses. The data show that two distinctly different herpes simplex viruses can initiate genital infections in one individual and suggest that HSV-2 is more likely to recur than HSV-1.

Adult↗

Spine duplication.

Spinal column duplication in association with other vertebral, gastrointestinal, and genitourinary tract anomalies is reported in a female infant. An embryologic explanation is postulated, in which the combination of anomalies is attributed to a single embryologic insult occurring the latter half of the third week of gestation.

Abnormalities, Multiple↗

Eating disorder history in women with obsessive compulsive disorder.

This study examined the frequency of eating disorders in women with obsessive compulsive disorder (OCD). Letters were sent to area psychiatrists asking them to refer patients diagnosed with OCD to a research study. Subjects completed the Yale Brown Obsessive Compulsive Scale and a survey including history of eating disorders. Thirty-one women participated in the study. Forty-two percent (N = 13) had a past or current history of an eating disorder: 26% anorexia nervosa alone (N = 8); 3% bulimia nervosa alone (N = 1); and 13% both anorexia and bulimia (N = 4). Our study found a higher percentage of history of eating disorders than expected. Perhaps specifically asking about history of weight loss, binging, and vomiting allowed for fuller disclosure of eating disorders than other studies that relied on retrospective chart review or limited the survey to current eating symptoms. A past history of eating disorder may be more common than previously believed and may frequently precede the diagnosis of OCD.

Anorexia Nervosa↗