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Biomedical subjects

I Cohn

Publications and source records attributed to I Cohn.

At least 55 records · Page 3Linked to original sources
PubMed1977

The National Pancreatic Cancer Project: an update.

Cancer of the pancreas is now the fourth most common cause of cancer-related death in the United States. The diagnosis of this disease is difficult and the therapeutic results are discouraging. Recognizing these factors, the National Cancer Institute has funded the National Pancreatic Cancer Project as of 1 January 1975, in an attempt to stimulate new and more active research in this field at both the basic and the clinical levels. Some of the work that has already been funded by the project is outlined as a means of familiarizing a larger number of people with the activities of this particular National Organ Site Program.

Animals↗
PubMed1977

Review of abdominoperineal resections for cancer.

One hundred eighty-six consecutive abdominoperineal resections for primary carcinoma of the anus, rectum, or sigmoid colon performed at Charity Hospital of Louisiana at New Orleans between January 1, 1963 and December 31, 1974 were reviewed. The operative mortality was 16 per cent. Complications during the same hospitalization occurred in 70 percent of the patients. Although most of the complications were minor, 22 percent did require some form of surgical intervention. Twenty-nine percent of the patients who were discharged developed late mechanical or cancer-caused complications which required surgical correction. A history of congestive heart failure or a significant weight loss were the most consistent preoperative findings in the operative mortality group. The overall five year survival rate was 25 percent. White females with no history of weight loss had the best long-term prognosis. Better survival in white patients can be accounted for by the less advanced lesions in these patients. No such difference between male and female patients could be demonstrated. Better selection of surgical candidates with alternate forms of therapy for poor risk patients have probably been the most significant factors in decreasing the operative mortality from 21 percent in the first six years of the study to 9 percent in the last six years. Primary closure of the perineal wound would appear to be of value in decreasing operative morbidity.

Abdomen↗
PubMed1976

Cancer of the pancreas: detection and diagnosis.

Since cancer of the pancreas is now the fourth most common cause of death from cancer in the United States, and since the signs and symptoms of this disease are such poor indicators of its presence, other more effective diagnostic methods must be utilized in an attempt to lower the mortality of pancreatic cancer. The newer studies which appear to hold some promise include endoscopy alone and in combination with pancreatography, selective and superselective angiography with or without pharmacologic assistance, and various forms of scanning. Resolution of some of the problems associated with the technique of biopsy and immunologic studies may make these studies of greater value. A clearer distinction between cancer arising in the pancreas itself from those lesions arising in the ampullary area will be of great value in clarifying both thinking and therapeutic approaches to the problem. Activation of the National Pancreatic Cancer Project and some other ongoing multi-institutional cooperative studies should do much to stimulate further advances in our knowledge about pancreatic cancer.

Angiography↗
PubMed1976

Diagnosis and management of blunt abdominal trauma.

The records of 437 patients with blunt abdominal trauma admitted to Charity Hospital, New Orleans, from 1967-1973 have been reviewed and computer-analyzed. There was an 80% increase in the incidence of blunt abdominal trauma when compared with the preceding 15-year experience. Forty-three per cent of all the patients presented with no specific complaint or sign of injury. Blunt abdominal injury was usually diagnosed preoperatively using conventional methods including history, physical examination, and routine laboratory tests and x-rays. Abdominal paracentesis via a Potter needle had an 86% accuracy. The incidence and management of specific organ injuries with associated morbidity and mortality have been discussed. Mortality and morbidity continue to be significant in blunt abdominal trauma. Isolated abdominal injuries rarely (5%) resulted in death, even though abdominal injuries accounted for 41% of all deaths. Associated injuries, especially head injury, greatly increased the risk. The insidious nature of blunt abdominal injury is borne out by the fact that more than one-third of the "asymptomatic" patients had an abdominal organ injured. A high index of suspicion and an adequate observation period therefore are mandatory for proper care of patients subjected to blunt trauma.

Abdominal Injuries↗
PubMed1976

Parotid neoplasms: a report of 250 cases and review of the literature.

A 25-year experience with parotid tumors was reviewed. From a total of 250 neoplasms, 173 were histologically benign and 77 were malignant. Benign mixed tumors accounted for 59% of all lesions. Clinical parameters used to diagnose parotid neoplasms were found to be unreliable in determining whether a given tumor was benign or malignant. The mean age for malignant lesions was 10 years greater than for benign lesions. The phenomenon of malignant transformation of a benign tumor was considered in four patients. Complete surgical excision is the safest and preferred method for diagnosis. Preoperative needle or incisional biopsy are associated with a high degree of local recurrence. The appropriate management of any parotid tumor is predicated on special histological type. Local excision or enucleation no longer have a place in the surgical management of benign parotid tumors. Postoperative tumor recurrence and morbidity are directly related to awareness of surgical anatomy and pursuit of correct surgical techniques for adequate resection. The five-year recurrence rate for 102 benign mixed tumors was 6%. Recurrence in malignant tumors varied with specific histological types but was generally high. Five-year survival for all malignant parotid tumors was 48%.

Adolescent↗
PubMed1976

Tetanus: 2,449 cases in 68 years at Charity Hospital.

The 68-year Charity Hospital experience with tetanus has been reviewed with particular emphasis on the past 8 years. There were 2,449 cases treated at Charity Hospital from 1906 through 1974. The mortality rate has remained high. There were 24 cases in the past 8 years, with a 58% case fatality rate. Clues to our high mortality rate could be: 1) many cases with a short period of onset, 2) none of our 24 cases received treatment at time of injury, and 3) there were more severe cases, as judged by the high rate of need for tracheostomy. The method of management emphasizes: 1) wound care, 2) neutralization of the toxin, 3) antibiotic therapy, 4) supportive measures including good nursing care with control of convulsions and seizures, and 5) completion of active immunization. Prophylaxis is stressed, with particular emphasis on wound debridement and toxoid. The decreasing incidence of the disease is encouraging, probably related directly to proper immunization. However, the mortality rate remains high and the solution to the problem of tetanus is still prophylaxis. Epidemiologic considerations were discussed with particular emphasis on tetanus in the five Gulf States, the South in general, and the decreasing incidence in endemic areas.

Adolescent↗
PubMed1975

Stability of normal human fecal flora during a chemically defined, low residue liquid diet.

Ten adult male volunteers (medical students) subsisted for seven days upon a chemically defined, low residue liquid diet, and consumed 1200-1800 calories per day. All stools were collected; three were cultured within the hour-a prediet stool, one collected on the seventh day, and a postdiet stool. Specimens were diluted anaerobically, and anaerobic cultures were streaked upon plates of prereduced agar media and incubated in Brewer jars. During the low residue diet, total fecal mass was relatively small and each subject passed only two or three stools. The mean reduction in daily fecal output was 70%. Mean counts of total aerobes were 10-7/gm throughout the study, and mean counts of total anaerobes were 10-10/gm. There was no overgrowth by opportunistic bacteria or fungi. The low residue food did not alter fecal flora; there was neither disappearance nor reduction of any bacterial group.

Adult↗