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Biomedical subjects

A Kantor

Publications and source records attributed to A Kantor.

18 recordsLinked to original sources
PubMed1995

Femoral torsion after interlocked nailing of unstable femoral fractures.

OBJECTIVE: The determination of rotation of the femur during intramedullary nailing procedures can be difficult, particularly when the fracture pattern does not lend itself to interdigitation. We studied 22 patients who had isolated femur fractures treated by closed intramedullary nailing to determine the degree of malrotation introduced at the time of surgery. DESIGN AND METHODS: Anteversion of the affected and normal femora was determined by a standard computed tomography (CT) torsion study. The range of motion of the hip was measured in the prone position. Foot progression angles (FPAs) were measured in 14 patients who were fully ambulatory for at least 6 months. MAIN RESULTS: The average malrotation of the fractured femur was 16 degrees (4 to 61 degrees). The median malrotation was 14 degrees. The differences in CT-measured anteversion (delta A), FPA (delta FPA), internal rotation (delta IR), and external rotation (delta ER) between the affected and normal sides were determined. Linear regression was used to analyze delta A with delta FPA, delta IR, and delta ER. Changes in internal and external rotation as determined by physical exam had a stronger correlation with delta A than did delta FPA. This indicates that malrotation of the femur is accommodated for during gait. CONCLUSIONS: Based on this data, we found that anteversion of the normal femur can be determined in the operating room using the image intensifier and can be duplicated on the fractured side using the described technique in cases where comminution prevents fragmentational alignment. This method has been used for 12 patients in a prospective trial, and malrotation has been kept to under 10 degrees in all cases.

Adult↗
PubMed1995

Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis.

OBJECTIVES: The aims of this study were to determine if angiographic findings can be used to predict successful nonoperative therapy of splenic injury and to determine if coil embolization of the proximal splenic artery provides effective hemostasis. METHODS: Splenic injuries detected by diagnostic imaging between 1981 and 1993 at a level I trauma center were prospectively collected and retrospectively reviewed after management by protocol that used diagnostic peritoneal lavage, computed tomography (CT), angiography, transcatheter embolization, and laparotomy. Computed tomography was performed initially or after positive diagnostic peritoneal lavage. Angiography was performed urgently in stabilized patients with CT-diagnosed splenic injuries. Patients without angiographic extravasation were treated by bed rest alone; those with angiographic extravasation underwent coil embolization of the proximal splenic artery followed by bed rest. RESULTS: Patients (172) with blunt splenic injury are the subject of this study. Twenty-two patients were initially managed operatively because of associated injuries or disease (11 patients) or because the surgeon was unwilling to attempt nonoperative therapy (11 patients) and underwent splenectomy (17 patients) or splenorrhaphy (5 patients). One hundred fifty of 172 consecutive patients (87%) with CT-diagnosed splenic injury were stable enough to be considered for nonoperative management. Eighty-seven of the 90 patients managed by bed rest alone, and 56 of 60 patients treated by splenic artery occlusion and bed rest had a successful outcome. Overall splenic salvage was 88%. It was 97% among those managed nonoperatively, including 61 grade III and grade IV splenic injuries. Sixty percent of patients received no blood transfusions. Three of 150 patients treated nonoperatively underwent delayed splenectomy for infarction (one patient) or splenic infection (two patients). CONCLUSIONS: (1) Hemodynamically stable patients with splenic injuries of all grades and no other indications for laparotomy can often be managed nonoperatively, especially when the injury is further characterized by arteriography. (2) The absence of contrast extravasation on splenic arteriography seems to be a reliable predictor of successful nonoperative management. We suggest its use to triage CT-diagnosed splenic injuries to bed rest or intervention. (3) Coil embolization of the proximal splenic artery is an effective method of hemostasis in stabilized patients with splenic injury. It expands the number of patients who can be managed nonoperatively.

Adolescent↗
PubMed1994

Radiation therapy in epidemic, AIDS-related Kaposi's sarcoma in southern Africa.

AIMS AND BACKGROUND: Acquired Immunodeficiency Syndrome (AIDS) associated Kaposi's Sarcoma (EKS) is widely spread in the Southern African Region. No large studies concerning the role of radiation therapy in the Southern African variant of EKS have been reported to date. METHODS: Over a 10 year period (1982-1992) 25 patients with EKS (disseminated skin involvement) were treated primarily with radiation therapy at the Johannesburg General Hospital. Radiation fields were individually tailored to the extent of the disease. Total administered doses ranged between 8-12 Gy (single fraction) to 24-30 Gy fractionated over 2-3 weeks. RESULTS: Overall response and symptomatic relief rates were 72% and 80%, respectively. Toxicity was mild and manageable. CONCLUSIONS: Our retrospective analysis supports the use of radiation therapy for the Southern African type of EKS.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Radiation therapy in an elderly African population with Kaposi's sarcoma.

There are no published studies on the efficacy of modern radiation therapy in elderly populations with the endemic African type of Kaposi's sarcoma (AKS). The present retrospective analysis of 20 elderly AKS patients treated by radiotherapy attempts to supply information relevant to the older age group. It demonstrates that excellent symptomatic relief with minimal side effects can be attained and suggests that the role of radiotherapy as the treatment of choice in this particular group should be emphasized.

Africa↗
PubMed1994

Malignant lymphoma with primary cardiac manifestations: a case report.

This case report describes a 29-year-old black patient presenting with right heart failure secondary to massive lymphomatous cardiac involvement. Additional sites of involvement included mesenteric lymph nodes and the small bowel. Malignant lymphoma with primary cardiac manifestations is very rare and follows an aggressive course. The importance of early diagnosis and commencement of immediate therapy is emphasized.

Adult↗
PubMed1994

Classical Kaposi's sarcoma in Caucasians in Africa--experience at the Johannesburg Hospital (1978-1992).

The data are scant concerning classical Kaposi's sarcoma (CKS) among the Caucasian population of Africa. A description of the clinical features of 15 such patients, treated and followed up at the Johannesburg General Hospital over a 14-year period (1978-1992) is presented. All patients were negative for the human immunodeficiency virus. After a mean follow-up of 50 months (range: 7-168 months), 2 patients are alive with absent or minimal disease; 1 patient is alive with stable disease and 1 has active disease involving his extremities. Three patients were lost to follow-up but had minimal or no disease when last seen. Five patients died of unrelated causes but also had minimal or no disease at their last visit. One patient died of sepsis related to active KS. Only two patients died of progressive KS. No alterations in humoral or cellular immunity were demonstrated in 2 patients with persistent disease. Four (27%) patients developed lymphoproliferative disorders including non-Hodgkin's lymphoma, Waldenström's macroglobulinemia, Hodgkin's disease and Castleman's disease (angiofollicular lymph node hyperplasia) preceding or following the diagnosis of CKS. These data confirm the indolent nature and good outcome of the classical form of Kaposi's sarcoma among Caucasians in the southern African region. The marked association between CKS and lymphoproliferative disorders warrants a long-term awareness and continued monitoring for these complications.

Adult↗
PubMed1989

The role of interventional radiology in the management of genitourinary trauma.

The role of the radiologist in the management of urologic disease has changed dramatically in the last 10 years with the introduction of new imaging methods and the evolution of the angiographic catheter into a therapeutic instrument. The authors review the diagnostic options in genitourinary trauma, the indications for and techniques of transcatheter arterial embolization for renal and other retroperitoneal hemorrhage, and nonvascular interventions such as antegrade nephrostomy, stenting of urethral disruptions, percutaneous bladder drainage, and drainage of abscesses, hematomas, and urinomas.

Embolization, Therapeutic↗
PubMed1987

Percutaneous insertion of the Kimray-Greenfield filter: incidence of femoral vein thrombosis.

Venograms were obtained in 17 patients 5-8 days after percutaneous dilatation of the common femoral vein for insertion of the Kimray-Greenfield inferior vena cava filter. The venograms showed thrombosis of the common femoral vein in seven (41%) of the 17 patients, four of whom were symptomatic. Common femoral vein thrombosis can have serious clinical sequelae. The possibility of this complication should be considered before inserting the filter percutaneously via the femoral vein.

Femoral Vein↗
PubMed1985

Bladder cancer risk and pipes, cigars, and smokeless tobacco.

Interview data from 2982 patients with bladder cancer and 5782 controls selected from the general population were used to assess the effects of non-cigarette tobacco use on bladder cancer risk. Compared to men who had never smoked, those who had smoked pipes but not cigars or cigarettes had a relative risk estimated at 1.23 (95% confidence interval [CI] = 0.75-2.00). Those who smoked cigars but not pipes or cigarettes were estimated to have a relative risk of 1.33 (95% CI = 0.92-1.94). Little evidence of dose response was observed. The excess relative risk to pipe smokers was limited to those who inhaled deeply.

Adult↗
PubMedDate not supplied

Ectopic supernumerary kidney: another cause of a pelvic mass.

Ectopic supernumerary pelvic kidney is a rare cause of a pelvic mass in the adolescent populations. We present a case of an ectopic supernumerary pelvic kidney, found incidentally, on a computed axial tomographic (CT) examination.

Adolescent↗
PubMedDate not supplied

Epidemic AIDS-related Kaposi's sarcoma in southern Africa: experience at the Johannesburg General Hospital (1980-1990).

Epidemic acquired immune deficiency syndrome-related Kaposi's sarcoma (AKS) in tropical and southern Africa is a highly varied neoplastic disease, characterized by multifocal mucocutaneous, lymphatic and visceral involvement. It follows a clinical course similar to AKS in Europe and the USA. However, lack of adequate medical facilities in many African countries hampers successful palliation of this fatal disease. In this retrospective analysis, we summarize our experience with 52 patients with AKS treated at Johannesburg General Hospital, South Africa, between 1980 and 1990. Radiation therapy can provide good to excellent palliation with only minimal side-effects, producing a lesser impact on the haematological and immunological system than chemotherapy.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Malrotation of the bowel: malalignment of the superior mesenteric artery-vein complex shown by CT and MR.

A malposition of the superior mesenteric vein on cross-sectional imaging was seen in four adult patients with malrotation of the bowel and is diagnostic of this entity. This sign should be looked for on CT or magnetic resonance to explain ill defined symptomatology and to define who may be at risk for future complications. We also define a "pseudo-superior mesenteric artery-vein sign" due to mass displacement of the pancreas, which must be distinguished from true malrotation.

Adult↗