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Biomedical subjects

S Zimbler

Publications and source records attributed to S Zimbler.

At least 19 recordsLinked to original sources
PubMed1988

Metastatic sweat gland carcinoma in an adolescent: a case report.

Sweat gland carcinomas are rare tumors that metastasize frequently. The diagnosis is seldom suspected prior to histologic examination. A long interval between onset of the disease and diagnosis is characteristic of the disorder. The benign clinical and histologic appearance of some of these tumors can obscure their full malignant potential. This report illustrates an unusual instance of sweat gland carcinoma metastatic to bone carcinoma in an adolescent. This case stresses the necessity for those involved in the care of the foot to be familiar with a condition of this type.

Adenocarcinoma↗
PubMed1988

Segmental spinal dysgenesis.

Segmental spinal dysgenesis is characterized by focal agenesis or dysgenesis of the lumbar or thoracolumbar spine, with focal abnormality of the underlying spinal cord and nerve roots. Children are symptomatic at birth with lower limb deformities and neurological deficits that may be segmental. Myelography and computed tomography disclose hypoplastic or absent vertebrae and atrophic or absent neural elements adjacent to the bony deformity; the spinal column distal to the abnormality may be partially bifid, but is otherwise normal. Spinal ultrasonography was a helpful diagnostic adjunct in one patient. Surgery may be helpful in decompressing partially functioning spinal cord or nerve roots, but may exaggerate the tendency toward spinal instability. The embryology of this abnormality is not clear, but two children had other anomalies suggesting a spinal dysraphic syndrome, and its cause is probably related to a segmental maldevelopment of the neural tube.

Female↗
PubMed1986

Dermoid tumors occurring at the site of previous myelomeningocele repair.

Four children with previously repaired myelomeningoceles presented toward the end of the first decade or early in the second decade of life with deteriorating lower-extremity and bladder function. Myelography and computerized tomography scanning demonstrated irregular filling defects at the area of the myelomeningocele repair, and surgical exploration disclosed dermoid tumors that were adherent to the placode and adjacent roots. Dermoid tumors should be considered in the differential diagnosis of neurological deterioration in children with a repaired myelomeningocele.

Adolescent↗
PubMed1986

Osteoid osteoma of the cervical spine.

Osteoid osteoma is a benign tumor of bone that occurs in children and adolescents, particularly in the femur and tibia. Osteoid osteoma of the spine accounts for approximately 10% of these lesions. There frequently is a delay in diagnosis because of its difficult visual appearance. Pain in the spine occurring at night that is relieved by aspirin, or painful scoliosis, should alert the physician to the possibility of its presence. Bone scan and tomograms are essential in making the diagnosis. Complete surgical excision of the lesion is the procedure of choice for immediate, lasting pain relief.

Cervical Vertebrae↗
PubMed1985

A plan of management and treatment results in the arthrogrypotic hip.

In a retrospective review of 52 hips in 26 patients with arthrogryposis, 65% of all hips studied were affected by the disorder; 46.6% of the patients were independent ambulators, 33.3% required some type of bracing for ambulation, and 20% were confined to a wheelchair. Based on the results of the authors' treatment as determined by a functional hip score, the authors recommend a one-stage open reduction, varus shortening femoral derotational osteotomy for all unilateral hip dislocations and those bilateral hip dislocations that have a less severe generalized involvement. They also recommend an aggressive traction program with appropriate soft-tissue releases during the neonatal period for patients with subluxation and/or marked limitation of motion of the hip.

Adolescent↗
PubMed1981

Air embolism as a complication of hip arthrography.

As an aid to correctly placing the needle tip within the hip joint during arthrography, injection of small amounts of air has been used to outline the joint space. Over a period of seven years, air embolus has been noted in three pediatric patients, twice with minor symptoms, and once with cardiac arrest. Even small amounts of air (less than 5 cc) injected accidentally intravenously may cause dangerous complications in small infants. If this technique is to be used, it is recommended that small amounts of carbon dioxide or oxygen be used instead of air.

Child, Preschool↗
PubMed1980

Recurrent subluxation and dislocation of the patella in association with athletic injuries.

Seventy-one patients with 81 operations for correction of patellar instability are reviewed. Follow-up was for at least five years. The various preoperative symptoms, signs, and radiographic findings are presented. Two types of patellar instability become clear. One type is usually bilateral and secondary to general ligamentous laxity. A second type, usually unilateral with distinct physical findings, is secondary to trauma. The operative technique and results of surgery and physical therapy are discussed. A new rational approach to the operative treatment of recurrent subluxation and dislocation of the patella is proposed. The operative procedure would depend on the Q angle. For a Q angle of less than 14 degrees, a proximal realignment is sufficient. For a Q angle greater than 14 degrees, a distal realignment would be necessary in addition.

Athletic Injuries↗
PubMed1978

Adjuvant treatment of osteogenic sarcoma with high-dose cyclophosphamide.

Six patients with osteosarcoma and no evidence of metastases received postoperative adjuvant chemotherapy with high-dose cyclophosphamide (25 mg/kg iv every other day for five doses). Three of these patients are alive without evidence of disease at 2 1/2, 3, and 5 years following diagnosis. The regimen was tolerable in terms of toxicity. Cyclophosphamide in high doses may be effective adjuvant therapy in some patients with osteosarcoma.

Bone Neoplasms↗
PubMed1976

Foot deformities.

A list of syndromes that include foot deformities as part of the clinical presentation has been compiled and subdivided into a descriptive classification. A brief discussion is presented of the embryology of the foot as it pertains to and helps explain the etiology of these various anomalies. Variations in the treatment of arthrogryposis multiplex congenita and ring constrictions are described. Finally, unique foot configurations are documented, which if seen should alert the clinician to consider the diagnosis of a specific syndrome.

Abnormalities, Drug-Induced↗
PubMed1976

Birth defects involving the spine.

There is a multiplicity of birth defects of the spine occurring as isolated anomalies or as aspects of multifaceted syndromes. The clinical significance of these anomalies varies from the asymptomatic to the life threatening. Symptoms and signs may present at birth or not until years later. The optimal clinical result for the patient requires a careful history and physical examination, appropriate routine and specialized roentgenograms, laboratory data, and a high index of suspicion for signs or symptoms of neurological dysfunction. When the diagnosis is made, conservative or surgical treatment may be instituted as appropriate.

Atlanto-Occipital Joint↗
PubMed1976

Comprehensive health care clinic for hemophiliacs.

One hundred hemophiliacs were examined at a formal comprehensive health care clinic. Sixty-eight percent had abnormal results of liver function tests, and 26% had spleens that were palpable. Measurement of range of motion of knees, ankles, hips, shoulders, and elbows showed a high incidence of hemophilic arthropathy and established a precise baseline by which to judge efficacy of therapy. Results of dental examination disclosed a 14% incidence of multiple severe caries, which is an incidence lower than that of the population as a whole. Examples of inadequate dosage of replacement therapy (16%) and chronic delay in application of self-therapy (14%) were discovered. An 8% incidence of hypertension was noted; prior experience suggests that the combination of hypertension and hemophilia may be lethal. Other clinical and laboratory data also illustrate the importance of a periodic, formally structured, comprehensive examination of hemophiliacs.

Adolescent↗