PubMed Health⌕ Search

Biomedical subjects

L S Shuman

Publications and source records attributed to L S Shuman.

9 recordsLinked to original sources
PubMed1985

Complications of colonic interposition.

The roentgenographic and surgical experience with 44 patients treated with colon interpositions was examined. Forty-two of these patients had carcinoma of the esophagus. Staged therapy consisted of mediastinal irradiation, colonic interposition, and total esophagectomy. The more common complications related to luminal patency and conduit integrity. A total of 29.5% developed anastomotic narrowing due to postoperative edema. Anastomotic leaks arose only at the proximal anastomosis and had an incidence rate of 31.8%. Thirty-four percent had fistulous tracts originating in the reconstructed upper gastrointestinal tract. In eighty percent of the patients with leaks or fistulae, their defects healed spontaneously or with simple drainage. Strictures were encountered in 59.1%, and there were 5 instances of colonic graft ischemia. The mortality directly related to surgery was 6.8%. Ischemia, particularly at the cervical anastomosis, is probably the most common cause of complications. Radiographic evaluation is recommended using a single contrast barium examination unless gross extravasation is expected.

Adenocarcinoma↗
PubMed1985

Biliary catheter drainage complicated by hemobilia: treatment by balloon embolotherapy.

Seventeen patients experienced severe hemobilia following percutaneous (nine patients) or surgical (eight patients) placement of biliary drainage catheters. Fourteen patients bled early after catheter placement (0.5-32 weeks; mean, 5.4 weeks) and three bled late during long-term biliary drainage (1.1-3.6 years; mean, 2 years). Hepatic angiography demonstrated the source of bleeding in 15 (88%) patients (hepatic artery pseudoaneurysm in ten, hepatic artery-portal vein fistula in four, varix along the tube tract in one) but showed no source of bleeding in two. Thirteen patients with hemobilia were treated with embolotherapy, using detachable balloons in 12. The advantages of this technique included the ability to flow-direct the balloon without selective catheterization; the ability to test-inflate the balloon at the site of the aneurysm or fistula during angiographic study and adjust its position before detachment; and preservation of the hepatic artery proximal and distal to the inflated balloon, thus preserving hepatic function following embolization.

Adult↗
PubMed1984

Radiation-induced pulmonary change: CT findings.

Four patterns of radiation change in the lung were identified in 53 computed tomographic studies of 41 patients at various times following completion of radiotherapy. (a) The homogeneous pattern shows slight increase in density uniformly involving irradiated portions of lung and is believed to represent a diffuse, minimal radiation pneumonitis. (b) Patchy consolidation is contained within irradiated lung but does not conform to the shape of the radiation field. It is analogous to radiation pneumonitis seen on chest radiographs. (c) Discrete consolidation that conforms to the radiation portal but does not uniformly involve it has several possible analogues. (d) Solid consolidation totally involves the irradiated lung and contains ectatic bronchi within it. This finding is analogous to radiation fibrosis. The temporal sequence and dose relationships of these appearances are discussed and related to those seen with conventional studies.

Adolescent↗
PubMed1982

Intra-arterial chemotherapy of malignant fibrous histiocytoma of the pelvis.

In 3 cases of malignant fibrous histiocytoma of the bony pelvis, intra-arterial chemotherapy was followed by surgical resection when possible in an attempt to control local disease without unacceptable deformity and treat undetected systemic metastases. Cis-diamminedichloroplatinum (CDDP) and a combination of intra-arterial doxorubicin, 5-(dimethyltriazeno)imidazole-4-carboxamide, and intravenous cyclophosphamide (CYADIC) were used. In 2 patients who underwent surgical resection, no viable tumor cells were found. The third patient did not respond to these or other forms of treatment. The patients treated with resection have shown no evidence of local recurrence at 24 and 9 months, respectively.

Adult↗
PubMed1981

Pneumonia in hairy-cell leukemia.

Hairy-cell leukemia (HCL) is an unusual malignant hematologic disorder involving splenomegaly, pancytopenia, and circulating mononuclear cells with prominent cytoplasmic projections. As in most forms of leukemia, the risk of pulmonary infection by normal pathogens and opportunistic invaders alike is high. HCL may be associated with granulomatous infections of the lung, especially mycobacterioses. Of the authors' series of 33 patients, 9 had a fungal or mycobacterial infection, including 5 atypical mycobacterial species. Five of the 6 patients with mycobacterioses and 1 of the 3 with fungal pneumonia survived the infection with appropriate therapy. Granulomatous infections, particularly mycobacterioses, should be seriously considered in the differential diagnosis of pulmonary parenchymal disease in a patient with HCl.

Adult↗
PubMedDate not supplied

Alteration in starch microsphere degradation following contrast angiography in the dog kidney.

Six adult mongrel dogs received bilateral sequential renal arterial injections of degradable starch microspheres following preadministration arteriograms. Renal arterial flow was measured using electromagnetic flow probes, and microspheres were administered until flow was blocked completely. One kidney in each dog was subjected to immediate postembolization arteriography, while the contralateral kidney served as a control. In the control kidneys, arterial flow returned to 90-95% of baseline within 30 minutes of embolization, and angiography at this time revealed a normal nephrogram. Blood flow in the kidneys that received postembolization arteriography returned to only 60-65% of baseline, even when followed up to 1 hour. Angiography at this time revealed persistent defects in the nephrogram. The effect of heparin, Renografin-60, and distilled deionized water on amylase activity was evaluated in vitro. No change in enzyme activity was noted.

Angiography↗