PubMed Health⌕ Search

Biomedical subjects

H L Levine

Publications and source records attributed to H L Levine.

17 recordsLinked to original sources
PubMed1992

Factors influencing survival in ethmoid sinus cancer.

Nineteen patients with primary ethmoid sinus malignancies were treated at the Cleveland (Ohio) Clinic Foundation between 1976 and 1989. Pathologic diagnoses included adenocarcinoma (eight), sarcoma (four), squamous cell carcinoma (three), mucoepidermoid carcinoma (two), adenoid cystic carcinoma (one), and undifferentiated carcinoma (one). All patients underwent surgical resection: 13 had craniofacial resection, four had craniofacial resection/orbital exenteration, one had radical ethmoidectomy/maxillectomy/orbital exenteration, and one had transantral ethmoidectomy. Twelve patients had combined treatment with radiation therapy. Ten patients were alive with no evidence of disease. A trend toward improved prognosis is associated with negative surgical margins. Preservation of the globe was not associated with local recurrence at this site. A poor prognosis was noted with involvement of the dura, brain, nasopharynx, or sphenoid sinus.

Adenocarcinoma↗
PubMed1979

Paired-ion reversed-phase high-pressure liquid chromatographic assay of pentobarbital-pyrilamine suppositories.

The assay of suppositories containing pentobarbital and/or pyrilamine in a water-soluble polyethylene glycol base by high-pressure liquid chromatography is described. No extraction is required. The suppository is dissolved in the mobile phase. This solution is diluted with an internal standard stock solution containing phenobarbital. Chromatographic conditions include a C18 bonded microporous silica column and a mobile phase of 65% 4 x 10(-3) M n-butyl sodium sulfonate in 1% acetic acid and 35% acetonitrile. The procedure using commercial products gave results comparable to those obtained by GLC.

Aminopyridines↗
PubMed1979

Hypopharyngeal diverticulum and the cricopharyngeus muscle: a posterior surgical approach.

Hypopharyngeal diverticulum and dysphagia due to cricopharyngeus muscle dysfunction are a continuing challenge to the head and neck surgeon. The ability to completely transect the cricopharyngeus muscle is generally agreed to be the key to successful relief of symptoms, and--to an even greater extent--to prevention of recurrence. In the past, the most significant complications arising from such surgery have been recurrent laryngeal nerve injury and recurrent diverticulum or cricopharyngeus spasm. Both of these problems have been prevented by a modified surgical approach which takes advantage of the relatively bloodless retropharyngeal space. The logic of this posterior approach to the cricopharyngeus, from an anatomic standpoint, coupled with the good visualization and relatively bloodless field when approaching the muscle, suggests that it might be a suitable substitute for the more common lateral approach if continued long-term experience in larger number of cases does not lead to significant complications.

Diverticulum↗
PubMed1979

Left-to-right transfer of language dominance: a case study.

Partial recovery from aphasia was documented in an individual rendered hemiplegic and globally aphasic by embolic infarction in the distribution of the left middle cerebral artery. Computed tomography showed total destruction of the classical left hemisphere language areas, indicating that the right hemisphere was responsible for the improved linguistic function. This observation is consistent with right hemisphere language capacity demonstrated after left hemispherectomy or commissurotomy. Right hemisphere language function may underlie much of the recovery from aphasia after injury of the left hemisphere.

Aphasia↗
PubMed1979

Myelographic evaluation of nontraumatic spinal canal obstruction: a new approach.

A new technique simplifies the evaluation of the spinal canal above obstructing lesions encountered during myelography via the lumbar route. After the demonstration of a block with 2--4 ml Pantopaque, a second injection of 2--4 ml Pantopaque is made through the lumbar needle with the patient in 45 degree Trendelenberg (or any degree necessary to keep the initial contast bolus against the inferior margin of the obstruction). In all 10 cases in this series, the second injection easily displaced contrast around and above obstructions that could not be overcome by gravity thereby obviating a lateral cervical or cisternal puncture. No technical failures of complications were encountered. The method is not recommended in cases of traumatic spinal canal obstruction.

Adult↗
PubMed1979

Relapsing polychondritis--report of ten cases.

Relapsing polychondritis is a rare disease of unknown etiology. There are approximately 211 reported cases in the world literature. This is a report of ten cases from the Cleveland Clinic Foundation. McAdam's diagnostic criteria for R.P. were reviewed and modified. For diagnosis, all patients had to have 1. at least three or more diagnostic criteria, histologic confirmation not necessary; 2. one or more of McAdam's signs with positive histologic confirmation; or 3. chondritis in two or more separate anatomic locations with response to steroids and/or Dapsone. Chondritis of the auricles (9/10 patients) and arthropathy (8/10 patients) are the most common presenting signs. Chondritis was also seen in the nose (6/10) and the upper respiratory tract involving the larynx and trachea (4/10). Cochlear and vestibular damage and ocular inflammation were each seen in 5/10 patients. Patients were treated with steroids and/or Dapsone. Both drugs were reliable in abating episodes of activity and in decreasing recurrences. These results further support Dapsone as an alternate form of treatment for RP.

Adolescent↗
PubMed1978

Obstructive hydrocephalus secondary to an ectatic basilar artery.

A 57 year-old white hypertensive male presented with a five-month history of progressive dementia and a clinical picture suggestive of normal pressure hydrocephalus. A CT scan and vertebral angiogram demonstrated an ectatic basilar artery obstructing the posterior third ventricle; the resulting hydrocephalus was relieved by a ventriculo-peritoneal shunt and the patient's symptoms resolved completely.

Basilar Artery↗
PubMed1977

Pharyngeal reconstruction after laryngectomy.

A method of pharyngeal reconstruction following laryngectomy is described. In 44 successive laryngectomies using this technique, no postoperative pharyngocutaneous fistulas occurred. Ten of the patients had received full courses of radiation therapy prior to the surgical procedure and had recurrent carcinomas. Other reports have noted that laryngectomy following full courses of "unplanned preoperative" radiation therapy is usually associated with a high incidence of postoperative pharyngeal fistula. The pharyngeal fistula problem, and the pharyngeal repair that was used in our series, are discussed. The pharynx was closed carefully in three layers with fine, absorbable sutures, and a submucosal inverting technique was used for the important mucous membrane closure. Tube feedings were used for two weeks after surgery. A high incidence of pharyngocutaneous fistula after laryngectomy in the irradiated patient can be prevented.

Carcinoma, Squamous Cell↗
PubMed1977

Carotid--cavernous fistula--iatrogenic carotid--cavernous fistula due to thrombectomy with a Fogarty catheter.

Removal of thrombus from a totally occluded internal carotid artery with a patent siphon by means of a balloon-tipped Fogarty catheter has been an acceptable technique. There have, however, been five reported cases of carotid-cavernous fistula following this procedure (Barker et al., 1968; Davie and Richardson, 1967; Motarjeme and Keifer, 1973; Newton and Potts, 1974). The purpose of this report is to add a sixth case to the literature and to suggest that this surgical method be abandoned.

Arteriovenous Fistula↗
PubMed1975

The neuroradiologic evaluation of "optic neuritis".

Optic neuritis, even when clinically typical, cannot be diagnosed with certainty because mass lesions compressing the anterior visual pathways may mimic it. The radiologist is in a position to assist in identifying such lesions or in ruling them out and thus preventing surgical exploration. While every patient in whom the diagnosis of optic neuritis is entertained should have plain roentgenograms of skull, orbits and optic canals, we have developed a schema for detailed neuroradiologic investigation based on clinical and plain roentgenographic findings. A classification of such lesions by location is illustrated.

Adolescent↗
PubMedDate not supplied

Recurrent layngeal nerve section for spasmodic dysphonia.

Spasmodic dysphonia is a severe disorder of phonation accompanied by extreme tension of the entire phonatory system. The expressive functions of speech such as laughter, singing, and whispering are much less affected if at all. Psychotherapy, speech therapy, stimulant and psychotropic drugs, hypnotism and acupuncture have all been tried as treatment without success. In 1976, Dedo reported 34 patients who were managed with recurrent laryngeal nerve section for spasmodic dysphonia. All of these patients had marked improvement in voice with relief of spasticity. Twenty-two patients with documented spasmodic dysphonia present for at least one year have been managed at the Cleveland Clinic since Dedo's report. None of them had any improvement with conventional voice therapy and were subjected, therefore, to recurrent laryngeal nerve section.

Humans↗
PubMedDate not supplied

Diagnosis of juvenile nasopharyngeal angiofibroma by computed tomography.

Juvenile nasopharyngeal angiofibroma is a highly vascular neoplasms that tends to spread in the various fissures and foraminia of the nasopharynz. Polytomography and angiography have added greatly to the diagnosis and management of this tumor through accurate preoperative assessment. Computed tomography has given an additional sophisticated, precise method for evaluating the extent of juvenile nasopharyngeal angiofibroma. Computed tomography shows, in detail, the extension of the tumor into the pterygopalatine fossa with widening of the pterygopalatine fossa and anterior bowing of the posterior wall of the maxillary sinus. With this correct information about tumor location, surgical or radiation treatment can be appropriately planned, with a probable improvement of cure rates and reduction of recurrences.

Histiocytoma, Benign Fibrous↗