Biomedical subjects

R R Shaw

Publications and source records attributed to R R Shaw.

15 recordsLinked to original sources

PubMed1989

Hartmann on adaptation: an incomparable or incomprehensible legacy?

Hartmann's essay sets forth ideas of incomparable value as well as incomprehensible density. While he developed many important concepts which have far-ranging clinical utility even today, his attempt to extend psychoanalysis into a general psychology back-fired because it separated psychoanalytic concepts from analytic data. Because of his lack of clinical material or anecdotal illustration, Hartmann's theoretical scaffolding has been frequently misunderstood and misapplied. This paper re-examines Hartmann's essay in light of current clinical and metapsychological issues, and illustrates some of his more important ideas.

Adaptation, Psychological↗

PubMed1984

Pancoast's tumor.

Until 1956, surgical attempts to remove a Pancoast tumor had proven futile, since the neoplasm invades the endothoracic lymphatics, the sympathetic chain, intercostal nerves, ribs, bodies of the vertebrae, and subclavian vessels. In 1956, a man believed to have a nonresectable tumor received 3,000 rads over the upper right chest. Three weeks later, his superior sulcus tumor had shrunk to one-half its original size. At operation, en bloc resection of portions of the upper three ribs, along with the upper lobe of the lung, was accomplished. The patient is alive 27 years later and has only minor complications. Several other patients were successfully treated with this combined therapy, although those with distant metastases, supraclavicular tumefaction, obvious erosion of the transverse processes, extensive involvement of the brachial plexus, and vena caval obstruction are not suitable candidates for this approach.

Combined Modality Therapy↗

PubMed1981

Pulsatile sternal tumor: report of three cases and a review of the literature.

At our institution, 3 patients with pulsatile sternal tumor have been seen. Although ascending aortic aneurysm frequently is high on the list of differential diagnoses, the likelihood that this tumor is metastatic from either a primary renal or thyroid neoplasm is overwhelming. Of the 15 patients reported, 11 had metastases from a primary renal cell carcinoma, including all 3 of our patients. There were 2 patients with primary myeloma, the only histologically proved primary pulsatile sternal tumor. From the surgical standpoint, only the patient with metastatic renal cell carcinoma has a chance of cure. With the recent report of 2 5-year survivors and our own experience of 1 patient with a long asymptomatic interval following resection of the primary kidney tumor and the secondary sternal metastasis, the attitude of hopelessness for these patients should be challenged and an aggressive approach considered.

Adult↗

PubMed1980