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M Nissenbaum

Publications and source records attributed to M Nissenbaum.

8 recordsLinked to original sources
PubMed1990

Prognostic significance of cholestatic alcoholic hepatitis. VA Cooperative Study Group #119.

Tissue cholestasis is a histologic feature in some patients with alcoholic liver disease, but its significance is unknown. We studied prospectively the clinical, laboratory, and histologic findings of 306 chronic male alcoholics in whom liver tissue was available. Tissue cholestasis permitted identification of two groups: group I, absent or mild cholestasis (239 patients), and group II, moderate to severe cholestasis (67 patients). Statistical evaluation was performed by Student's t test and regression analyses. In patients with tissue cholestasis, 97% had elevated serum cholylglycine levels, while only 61% had significant jaundice (serum bilirubin greater than 5 mg/dl). In patients without tissue cholestasis, 66% had elevated serum cholylglycine and 13.5% jaundice. Highly significant statistical correlations (P less than 0.0001) were found between cholestasis and malnutrition, prothrombin time, AST, alkaline phosphatase, bilirubin, Maddrey's discriminant function, serum cholylglycine level, albumin, and histologic severity score. In group I, 54% survived 60 months versus 22% in group II (P less than 0.0001). Highly significant statistical correlations (P less than 0.0001) were noted between serum cholylglycine levels and the parameters enumerated earlier, but not with survival. We conclude that tissue cholestasis is a highly significant prognostic indicator of outcome in alcoholic hepatitis and is more consistently associated with bile salt retention than jaundice.

Cholestasis, Intrahepatic↗
PubMed1990

Giant lateral neck swellings.

Four patients with extremely large lateral neck swellings are described. In the discussion the controversy about using radiotherapy: (i) to make an 'inoperable tumour operable', and (ii) to 'sterilise the operative field' is considered. It is concluded that modern radiotherapeutic techniques probably satisfy these requirements.

Adolescent↗
PubMed1988

Bypass surgery for unresectable oesophageal cancer: early and late results in 124 cases.

The early and late results of bypass surgery in 124 patients with unresectable oesophageal cancer are reported. Patients were grouped according to the extent of disease: group A, tumour localized to the oesophagus where severe pulmonary disease contra-indicated oesophagectomy (n = 9); group B, tumour less than or equal to 10 cm in length with mediastinal invasion (n = 81); group C, tumour greater than 10 cm in length with mediastinal invasion and/or fixed malignant lymph nodes (n = 33). Extent of disease was not recorded in one patient. The operative mortality was 4 per cent but 9 other patients died in hospital (hospital mortality, 11 per cent). Mortality was increased in patients undergoing colon bypass and in those with a large tumour load but these differences failed to reach statistical significance. The most frequent complication was neck sepsis, secondary to leakage from the proximal end of the excluded oesophagus. Eighty-nine per cent of the survivors could eat a normal, unrestricted diet on discharge and eighty-two per cent of survivors had complete and lasting relief from dysphagia. Median survival after bypass was 5 months but survival was significantly improved by radiotherapy to the tumour (P less than 0.001). Gastric bypass with radiotherapy is indicated in patients with extra-oesophageal spread of malignancy and in patients with tumours localized to the oesophagus who are unfit for resection. Bypass surgery may be contra-indicated in patients with a primary tumour greater than 10 cm in length and/or fixed lymph node metastases because mortality is increased and survival after operation is short.

Adult↗
PubMed1977

Thanatophoric dwarfism. Two case reports and survey of the literature.

Thanatophoric dwarfism is a severe form of short-limbed dwarfism in which cardiorespiratory failure uniformly results in death in the neonatal period. Its radiographic features include markedly flattened vertebral bodies with a typical U-shaped deformity, a flat squat pelvis, and short, bowed extremities with flaring and irregularity of the metaphyses. These characteristic features distinguish this entity from the two other most commonly confused congenital short-limbed forms of dwarism--achondroplasia and achondrogenesis. The distinctions are discussed in the text.

Achondroplasia↗
PubMedDate not supplied

Clear-cell carcinoma of the lung metastatic to the hamate: a case report.

Metastatic lesions of the hand are uncommon. A report of a solitary metastasis to the hamate seems not to have appeared previously in the literature. A 46-year-old factory worker presented a rare tumor, clear-cell carcinom of the lung, metastasizing to an unusual location, the hamate. The symptoms simulated sympathetic dystrophy and diagnosis was delayed because of the late appearance of radiographic changes over 6 months after symptoms first appeared. Early bone scanning in patients with chronic pain may provide useful information prior to the appearance of X-ray changes.

Adenocarcinoma↗
PubMedDate not supplied

Neurotrophic arthropathy of the shoulder secondary to tuberculous arachnoiditis: a case report.

A rapidly progressive neurotrophic arthropathy of the shoulder was noted in a 44-year-old man with tuberculous adhesive arachnoiditis. Difficulty in making the diagnosis of adhesive arachnoiditis was encountered because of the variable and confusing neurologic manifestations until a cisternal myelogram was performed and this previously unreported relationship established.

Arachnoiditis↗