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Biomedical subjects

M D Nathan

Publications and source records attributed to M D Nathan.

12 recordsLinked to original sources
PubMed1982

Accuracy of cardiac output, oxygen uptake, and arteriovenous oxygen difference at rest, during exercise, and after vasodilator therapy in patients with severe, chronic heart failure.

Measurement of cardiac output, arteriovenous oxygen difference, and oxygen uptake in patients with heart failure may be subject to technical and biologic inaccuracies. We measured these 3 variables in 16 patients with chronic heart failure at rest and during exercise. When cardiac output was measured by thermodilution and compared with values calculated by the Fick principle, there was a significant correlation at rest (r = 0.91, p less than 0.001) and at exercise (r = 0.93, p less than 0.001). When the arteriovenous oxygen difference was measured by spectrophotometry of arterial and mixed venous samples and compared with values calculated by the Fick principle, there was a significant correlation at rest (r = 0.80, p less than 0.01) and at exercise (r = 0.76, p less than 0.01). When oxygen uptake was measured from expired gas analysis and compared with values calculated by the Fick principle, there was a significant correlation at rest (r = 0.84, p less than 0.01) and at exercise (r = 0.94, p less than 0.001). In addition, 10 patients received vasodilator treatment which increased cardiac output and decreased the arteriovenous oxygen difference at rest and exercise. There was no significant difference between measured and calculated values for the 3 variables under those additional conditions. It is concluded that despite technical and biologic difficulties, cardiac output, arteriovenous oxygen difference, and oxygen uptake, when calculated from Fick's principle, yield results equivalent to direct measurement.

Adult↗
PubMed1982

Prosthetic rehabilitation of extensive facial defects.

Patients with extensive surgical defects of the palate, orbit, or nose are difficult to rehabilitate. Prosthetic rehabilitation in these areas often shortens hospitalization, speeds recovery, and reduces medical expenses. Specific factors in planning treatment are directed toward successful prosthetic rehabilitation, using a team approach, careful patient selection, and specific surgical principles keyed to each facial region.

Female↗
PubMed1982

Entomophthorales infection of the maxillofacial region.

Phycomycosis infections caused by the fungi Rhizopus and Mucor are commonly termed mucormycosis. Mucormycosis infections exhibit a rapidly progressive course characterized by angioinvasion and necrosis. The rhinocerebral form has been described thoroughly in the literature. However, there exists another order of Phycomycetes, the Entomophthorales, which rarely cause clinical disease. Their infection is indolent and is associated with granulomatous inflammation and a protracted clinical course. Presented here is a rare case of suspected Canidiobolus coronato infection occurring in the maxillofacial region of a previously healthy male. The authors believe this to be the first reported case occurring in the United States. Because of the poorly documented natural history of this infection and the patient's relative intolerance to parenteral antifungal therapy, a multidisciplinary therapeutic approach was designed. It consisted of long-term, low-dosage amphotericin-B, hyperbaric oxygen and sequential surgical debridements. This unusual disease entity must now be considered in the differential diagnosis of granulomatous disorders of the head and neck.

Amphotericin B↗
PubMed1981

Transsphenoidal surgery on the pituitary.

Transseptal transsphenoidal hypophysectomy has evolved into a low mortality/morbidity procedure in properly selected patients. Preoperative evaluation is becoming increasingly accurate with the rapid advances in computerized axial tomography. With the lowering of operative morbidity, indications for the transsphenoidal approaches to the sella are broadening. Caution must be used when approaching pituitary tumors with extensive suprasellar components by the transsphenoidal route.

Adolescent↗
PubMed1980

Intractable hiccups. (singultus).

Intractable hiccups (singultus) is an uncommon disorder with various etiologies. The majority of reported studies of intractable hiccups has claimed ipsilateral spasm of the hemidiaphragm based solely on clinical or radiographic evidence. A case of intractable hiccups is presented. Documentation of normal phrenic nerve latencies with bilateral synchronous firing of anterior scalene, intercostal muscles and bilateral hemidiaphragm involvement is presented. This combination of muscle group involvement supports the concept of a "supraspinal hiccup center." A systematic trial of chemotherapeutic agents described as effective against hiccups was employed. Relief lasting for three to four week periods has been obtained by the intravenous administration of a specially prepared sterile solution of methylphenidate. The nerve pathways pertinent to hiccup are discussed. The etiology of intractable hiccups and the various treatment modalities are presented.

Brain Stem↗
PubMed1975

Stevens-Johnson syndrome: Twenty-three cases and their otolaryngologic significance.

Stevens-Johnson syndrome is a symptom complex characterized by mucosal, ocular, and cutaneous lesions. Prodromal symptoms of upper respiratory infection or pharyngitis are most common. These are followed by target lesions of skin, sloughing of musous membranes, and ocular inflammation. Twenty-three cases are presented. Most patients (61 percent) were between 10 and 39 years of age. Relapses occurred in three patients. Five patients developed pneumonia, and there were two fatalities. Over one-half of the patients had serious ocular complications. The etiology of this syndrome is uncertain. Multiple allergic factors, drugs (especially long-acting sulfonamides), and infectious agents (most recently mycoplasma pneumoniae) have been implicated. This study does not support any single cause. The use of systemic steroids is generally accepted by most authors. The death rate in this study (10 percent) is essentially unchanged from early reports on patients without steroid therapy. The complications rate directly attributable to steroids is significant in this study group. The major complications of this syndrome are ocular. Aggressive topical management of ocular inflammation is required; however, the morbidity rate remains high despite these measures. The otolaryngologist should be aware of this syndrome as the early symptoms, and the acute complications may require his awareness of the natural and treated courses of this disease.

Adolescent↗
PubMedDate not supplied

Computerized axial tomography in the assessment of thyroid cartilage invasion by laryngeal carcinoma: a prospective study.

The purpose of this study was to assess the value of computerized axial tomography (CAT) in canine larynges that exhibit controlled surgical defects, and in 18 patients with biopsy-proved epidermoid carcinoma of the larynx who were studied prospectively. Five canine larynges with sequential surgical defects of 0 mm, 5 mm, 10 mm, and 15 mm were studied by CAT in order to evaluate our ability to identify defects in the thyroid cartilage. A 5-mm collimator with overlapping sections at 3-mm intervals and a 13-mm collimator with 5-mm overlapping sections were both used for each stage of the experiment. Results show significantly improved resolution with the 5-mm collimator compared with the 13-mm unit. In the human study group, results demonstrated excellent (100%) soft-tissue tumor site correlation. It appears from this study that we still lack a highly reliable radiographic technique for evaluating preoperatively with accuracy the integrity of the thyroid cartilage in the patient with carcinoma of the larynx.

Animals↗