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Biomedical subjects

S M Bloom

Publications and source records attributed to S M Bloom.

At least 19 recordsLinked to original sources
PubMed1996

Lung cancer in patients with bullous disease.

There have been sporadic reports in the literature of an association between bullous disease of the lung and lung cancer; however, we believe that this clinical association is not well recognized. We present six cases in which bullous disease of the lung and lung cancer coexisted, and review the available literature on the topic. Five of the patients were males, the mean age of presentation was 42 yr (range: 32 to 62 yr), and all of the patients were smokers. Histologically the tumors in all six patients were non-small-cell carcinomas. The significantly younger age of these patients with lung cancer and bullous disease as compared with those reported in the literature with lung cancer but without bullous disease suggests that the association between these two processes is more than just coincidental. The utility of plain radiography and computerized tomography (CT) of the chest in screening patients with bullous disease for lung cancer is discussed.

Adult↗
PubMed1995

Laser indirect ophthalmoscope photocoagulation and scleral depression for rhegmatogenous retinal detachment.

BACKGROUND: Transconjunctival cryotherapy or laser photocoagulation with simultaneous Eisner funnel scleral depression has been used to treat selected cases of rhegmatogenous retinal detachment. There are no studies to date reporting the use of the laser indirect ophthalmoscope coupled with scleral depression for treating retinal detachment. METHODS: 16 consecutive patients (18 retinal detachments in 17 eyes) were enrolled in a prospective, uncontrolled clinical trial using the laser indirect ophthalmoscope with scleral depression as the sole treatment for retinal detachment. The region immediately surrounding the break where subretinal fluid was present was directly treated rather than demarcated. All patients were treated with local anesthesia in an outpatient setting. RESULTS: Complete retinal reattachment was initially achieved in 14 (78%) of 18 eyes after scleral depression and laser alone. Significant postoperative complications of scleral depression with laser indirect ophthalmoscope photocoagulation included macular pucker (2 eyes), late recurrent rhegmatogenous retinal detachment without proliferative vitreoretinopathy (1 eye), and late recurrent rhegmatogenous retinal detachment with proliferative vitreoretinopathy (2 eyes). Failure of initial treatment to flatten the retina, late recurrent retinal detachment, macular pucker, or proliferative vitreoretinopathy led to scleral buckling and/or vitrectomy in 6 (86%) of the 7 eyes with clinical detachment and 3 (30%) of the 10 eyes with localized detachment. Final retinal reattachment at the last follow-up examination was achieved in all 17 eyes with subsequent surgical procedures. CONCLUSION: Although scleral depression with laser indirect ophthalmoscope photocoagulation is a noninvasive outpatient surgical procedure that is capable of flattening selected retinal detachments, its use cannot be recommended because of the relatively high rate of postoperative complications requiring further surgical procedures.

Adult↗
PubMed1994

External argon laser choroidotomy versus needle drainage technique in primary scleral buckle procedures. A prospective randomized study.

PURPOSE: To compare the rates of intraoperative and postoperative complications of external argon laser choroidotomy and needle drainage techniques during scleral buckle procedures for primary retinal detachment. METHODS: A group of 175 patients undergoing scleral buckling for primary retinal detachment was randomly assigned to undergo either external argon laser choroidotomy or needle drainage. Complications associated with drainage of subretinal fluid were categorized as retinal break, retinal incarceration, or hemorrhage (dot, < or = 1 disc diameter [DD], or > 1 DD), and recorded during surgery and 24 hours after surgery. RESULTS: In the group that underwent laser choroidotomy, 12 (13%) of 92 patients had complications, including 4 dot hemorrhages, 3 hemorrhages 1 DD or smaller, 3 hemorrhages larger than 1 DD, 1 retinal incarceration, and 1 suprachoroidal hemorrhage. In the group that underwent needle drainage, 13 (16%) of 81 patients had complications, including 3 dot hemorrhages, 4 hemorrhages 1 DD or smaller, 5 hemorrhages larger than 1 DD, and 1 suprachoroidal hemorrhage. No significant difference was noted between the two groups in the incidence of complications (P = 0.657). CONCLUSION: External argon laser choroidotomy and needle choroidotomy are comparable, safe, and effective ways to drain subretinal fluid during scleral buckle surgery.

Body Fluids↗
PubMed1993

Choroidal malignant melanoma.

Choroidal nevi are found on routine fundus evaluations in 1% to 2% of patients. It is felt that these usually benign lesions are the precursors of choroidal malignant melanomas. The incidence of choroidal malignant melanoma in the United States is approximately 6 cases per 1 million persons per year. Diagnosis is multifactorial, based on the tumor's funduscopic, angiographic, and ultrasonographic appearance. Once a melanoma is diagnosed in a patient, a complete metastatic workup is performed. A small tumor is observed for change. Medium-sized tumors are treated with radioactive plaque therapy, external beam radiation, or enucleation. Large tumors are treated with enucleation with or without external beam radiation. Studies are underway to establish the optimum form of treatment.

Choroid Neoplasms↗
PubMed1992

Lenticular burns following argon panretinal photocoagulation.

Photocoagulation burns of the crystalline lens are a rare complication of posterior segment laser surgery. These burns occur more commonly in eyes with cataracts and with small, high-power, long-duration argon blue-green burns. We describe the first occurrence of lenticular burns caused by a fractured laser fibre optic cord.

Diabetic Retinopathy↗
PubMed1992

Chest roentgenographic abnormalities in IL-2 recipients. Incidence and correlation with clinical parameters.

The chest roentgenograms of 54 patients receiving high dose interleukin-2 with or without lymphokine-activated killer cell therapy for advanced cancer were retrospectively reviewed. Thirty-nine patients (72 percent) developed chest roentgenographic abnormalities consisting of pleural effusions, 28 (52 percent); diffuse infiltrates (pulmonary edema), 22 (41 percent); and focal infiltrates, 12 (22 percent). These abnormalities resolved in 30 of 39 (77 percent) patients by four weeks after therapy. Simple pleural effusions were the only residual roentgenographic abnormalities seen and were present primarily in patients receiving IL-2 by bolus intravenous injection (8 of 28) (29 percent) as compared to continuous intravenous infusion (1 of 24) (4 percent) (p = 0.03). Only roentgenographic evidence of pulmonary edema appeared to correlate with the degree of clinical pulmonary toxicity (p = 0.001). The development of chest roentgenographic abnormalities correlated with the administration of IL-2 solely by bolus intravenous injection (p = 0.04), a pretreatment FEV1 of less than 3 L (p = 0.04), and treatment associated bacteremia (p = 0.09), but not with prior therapy, the presence of pulmonary metastases or the degree of systemic capillary leak as measured by percentage of weight gain during therapy. Although the roentgenographic abnormalities did not relate to the number of LAK cells received, two patients developed sudden onset of dyspnea and chest roentgenographic evidence of pulmonary edema shortly after the first LAK cell administration, implying that a direct cause-and-effect relationship exists in some patients. Possible mechanisms for these IL-2 related chest roentgenographic abnormalities and pulmonary toxicity in general are discussed.

Adult↗
PubMed1991

Photocoagulation for serous detachment of the macula secondary to retinal astrocytoma.

Retinal astrocytomas are rare, usually asymptomatic, hamartomatous retinal tumors that are most commonly seen in patients with tuberous sclerosis. Serous detachment of the macula is a rare complication of retinal astrocytomas. The first successful treatment with laser photocoagulation of two eyes (two patients) with decreased vision due to a serous detachment of the macula from a retinal astrocytoma is described. Laser photocoagulation should be considered for retinal astrocytomas causing persistent or increasing exudation that is threatening the macula or causing visual loss.

Adolescent↗
PubMed1991

A simple method for practicing unimanual pars plana vitrectomy with the binocular indirect ophthalmoscope.

Bimanual vitrectomy has become the method of choice for performing closed vitrectomy. In certain situations, visualization is improved by using indirect ophthalmoscopy to see the vitrectomy instrument. A simple method using a +20.00-diopter condensing lens is described as a means of practicing the initially difficult unimanual technique, which requires working in an inverted operative field.

Fundus Oculi↗
PubMed1990

Scleral fixation suture for dislocated posterior chamber intraocular lens.

The posterior dislocation of an intraocular lens is a serious complication of extracapsular cataract extraction with implantation of a posterior chamber intraocular lens. We describe a method of repositioning and suturing such a lens, using pars plana techniques. The method we recommend has several advantages over previously described methods, including the use of radially oriented scleral fixation sutures.

Aged↗
PubMed1983

Chronic erosive gastritis--a recently recognized disorder.

We have reviewed the clinical manifestations, endoscopic findings, pathology, and upper gastrointestinal x-rays in 10 patients with chronic erosive gastritis, a disorder that was rarely recognized before the use of double-contrast upper gastrointestinal radiology and endoscopy. The characteristic x-ray appearance is that of a series of 3 to 11-mm nodules, some with central collections of barium, that are distributed along rugal folds and usually extend into the antrum. The endoscopic appearance is similar: small erythematous nodules with shallow central erosions. The pathology differs from that seen in peptic ulcer disease. There are few polymorphonuclear leukocytes and a predominance of plasma cells in the inflammatory infiltrate. Seven of our patients presented with epigastric pain similar to that of peptic ulcer disease; four of these also had anorexia and weight loss. In two other patients anorexia and weight loss were the only symptoms. One patient was asymptomatic. All nine symptomatic patients responded to antacid treatment. However, repeat x-rays demonstrated persistence of the nodules, although the central erosions usually disappeared. The etiology is unknown. Chronic erosive gastritis appears to be a distinct entity different from peptic ulcer disease.

Adult↗
PubMed1983

Chronic erosive gastritis resulting in cachexia.

Nine patients are reported who presented with severe weight loss of up to 13.6 kg (30 lb) as a result of chronic erosive gastritis. In many the cachexia was sufficient to prompt a search for malignancy but no other lesion was found. The importance of the radiological pursuit of this diagnosis is emphasised. Illustrative case histories are presented.

Adult↗
PubMed1982

Chronic erosive gastritis--clinical and radiological features.

Chronic erosive gastritis has been regarded as an unusual, ill-defined condition of unknown etiology. We report a retrospective study of 40 patients in whom this diagnosis was made relating radiologic findings to patients' age, symptomatology and possible etiologic factors. The condition is more common than previously suspected and requires careful technique combining double contrast and graded compression to demonstrate fine mucosal abnormalities. The radiologic appearance is of mucosal mounds measuring 3-11 mm in diameter with central barium collections and numbering from 3-27 per examination. Antral involvement occurred in 90% of patients, with diffuse involvement of both antrum and body in 58%. Several linear erosions measuring up to 15 mm in length were also demonstrated. Chronic erosive gastritis is most severe and symptomatic between 40 and 60 years, becoming sub-clinical in the elderly. Symptoms mimic those of a peptic ulcer or gastric neoplasm and are more severe the more extensive the disease. Gastric irritants, virus infection and Crohn's disease were possible etiologic factors in some patients in this study.

Adult↗