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Biomedical subjects

A Mashiah

Publications and source records attributed to A Mashiah.

At least 19 recordsLinked to original sources

Estrogen and progesterone receptors in normal and varicose saphenous veins.

The presence of estrogen and progesterone receptors was investigated in the walls of normal and varicose veins. Cryostat sections from the saphenous veins of 29 normal individuals, and varicose and normal vein segments of 32 patients with varicose veins, were stained with anti-estrogen or anti-progesterone receptor antibodies. Nuclear stain intensity was scored by three independent observers. Receptors to both hormones were detected in the nuclear regions of the intima and media in females and males. In the adventitia, estrogen and the progesterone receptors were found only in nuclei of the vasa vasorum. Estrogen receptor levels were lower in non-varicose segments of varicose veins compared with normal veins. In varicose segments, estrogen receptors were more abundant than in the non-varicose parts of the same vein, especially in females. Similarly, progesterone receptor levels in the non-varicose portions were higher in females. These gender differences may be related to hormonal action. However, these differences may also be age related. These findings may be related to the involvement of sex-hormones in varicosis, by mechanisms as yet unknown.

Adult↗

Estrogen, progesterone and testosterone receptors in human fetal cartilaginous tissue: immunohistochemical studies.

Computerized image analysis was used to study the distribution in cartilage of receptors to estrogen, progesterone, and testosterone during human fetal development. We have examined three histologically distinct cell groups (hypertrophic, proliferating, and reserve zones) in long bones, vertebrae, and trachea from 19 fetuses. Comparisons were made across gender and gestational age. Contrasting with controls, we examined the density of receptors, the size of the nuclear area in which the receptors were detected, the number of hormone receptor-bearing cells, and the total receptor quantity per sample. We found that estrogen, progesterone, and testosterone receptors were detected in the nuclei of all cell types, in both female and male embryonic cartilaginous tissue. Gender differences were small and inconsistent. Changes associated with gestational age depicted a pattern of hormone receptor manifestation, shifting from the immature cell types to more differentiated cells. This was evident from the receptor densities and from the cellular area in which receptors were sighted. These dynamics are accompanied by a general increase in receptor content per sample, brought about by the concomitant increase in receptor containing area size and cell number. The increase in receptor levels seems to reflect the maturation and growth of the fetal skeleton.

Cartilage↗

Collagen subtype pattern in normal and varicose saphenous veins in humans.

Our present study was to determine the collagen subtype pattern in the greater saphenous vein of the lower limb, obtained from 21 normal (macroscopically and ultrastructurally non-varicose vein segments from non-varicose subjects) and 37 varicose subjects, and to compare affected (macroscopically and ultrastructurally varicose segments from varicose veins) vs. non-affected (macroscopically and ultrastructurally non-varicose segments from varicose veins) segments (16). After elastase pretreatment and partial pepsin digestion, types I, III & V collagens (CI, CIII, CV) were extracted selectively by differential salt precipitation and measured quantitatively in samples obtained from normal and varicose saphenous veins-either affected or unaffected segments. Significant elevations of water (p < 0.05) and collagen type I [CI] (p < 0.01) content in varicose veins (both affected and unaffected segments) as compared with normal saphenous veins were observed. The collagen type III (CIII) and collagen type V (CV) content of varicose veins were found to be slightly reduced as compared to normal veins and consequently the CI/(CIII+CV) ratio in varicose veins increased significantly (p < 0.02) as compared to normal veins. Elevation of the CI/(CIII+CV) ratio in varicose veins may cause considerable weakening of the venous wall, further supporting the "weak wall" theory of varicose vein etiology.

Case-Control Studies↗

Hyperinsulinemia in colon, stomach and breast cancer patients.

The objective of this study was to collect more information on the intricate relationship between the presence of a tumor, insulin status and blood lipids. We selected non-obese subjects suffering from colon, stomach and breast cancer and determined the concentration of fasting insulin, glucose, cholesterol, and triglycerides in blood before (BS) and after surgery (AS). Controls were healthy non-obese subjects. Insulin was also measured in tumors and non-cancerous tissues from the same organ. BS insulin and glucose (with the exception of glucose in colon patients) were significantly higher than the controls and fell to almost normal levels at AS. Serum cholesterol and triglycerides levels were reduced in stomach patients, BS and AS and cholesterol in colon patients BS. Tumors had 1.9-3.0 times as much insulin, or insulin-like substances, as control tissues. These results are consistent with our previous studies showing hyperinsulinemia in the presence of a tumor.

Breast Neoplasms↗

Recurrent mucinous adenocarcinoma of the ovary presenting as an inguino-labial hernia.

We report a case of a 65-year-old woman who nine years previously had undergone total abdominal hysterectomy and bilateral salpingoophorectomy for a large ovarian cyst. During surgery the cyst had ruptured and some mucinous material had been spilled intraabdominally. Histopathological studies demonstrated the cyst to be a mucinous adenocarcinoma of low malignant potential. Appendectomy had also been performed due to an enlarged appendix, which proved to be a mucocoele. The patient had been lost to subsequent follow-up. Her current presenting symptom was a giant inguino-labial hernia of 25 cm diameter with two small skin perforations leaking a gelatinous discharge. Subsequent laparotomy and inguinal exploration have disclosed herniated small intestine with an attached metastatic multicystic mucinous adenocarcinoma. This case represents a case of borderline mucinous adeno-carcinoma-pseudomyxoma peritonei recurring in a unique pattern as a huge inguino-labial hernia, and serves to emphasize the possible consequences of spillage of ovarian cyst contents during surgery.

Adenocarcinoma, Mucinous↗

Phenol lumbar sympathetic block in diabetic lower limb ischemia.

BACKGROUND: Patients with arteriosclerotic peripheral vascular disease and lower limb ischemia have painful ulceration or incipient gangrene of the lower limb with intractable rest pain. The arteriosclerotic changes may preclude any surgery other than amputation. METHODS: We examined whether chemical sympathectomy could relieve pain, arrest gangrene and postpone amputation, even in diabetic patients. RESULTS: Phenol lumbar sympathectomy was performed on 373 patients, of whom 226 (60.6%) were diabetic. Over 24-120 months of follow-up, 219 patients (58.7%) experienced total relief from pain and healing of gangrenous ulcers, although the treatment was unsuccessful in 154 patients. A favorable result was marked in diabetic patients who had rest pain and in non-diabetic patients who had digital gangrene or digital ulcers. Age and sex did not affect the results but heavy smoking did. CONCLUSION: Phenol sympathectomy should be considered as an alternative to surgical sympathectomy. Furthermore, the technique may be a precursor to and even an alternative to amputation in patients who have diabetes and advanced arteriosclerosis of the lower limb.

Adult↗

The scanning electron microscope in the pathology of varicose veins.

We studied varices of the lower limb by scanning electron microscope (SEM) in 29 women who had undergone surgery under local anesthesia for symptomatic varicose veins. Their ages ranged between 19 and 42 years (average 30). They were all diagnosed as having incompetence of the valve at the saphenofemoral junction. The surgical procedure was high ligation of the long saphenous vein, excision of the upper portion of the vein and multiple excision of all the varices along the leg through several tiny incisions. Segments of the removed varices and the upper portion of the long saphenous vein were prepared and studied by the Jeol scanning electron microscope (Japan, model 355c). We found no changes in the intima or adventitia and no changes in any of the upper valves of the saphenous vein; however, varying degrees of thinning of the media of the venous wall were seen, which coincided with the areas of varicose dilatation between areas that retained their normal configuration. Our study therefore supports the "weak vein wall" theory concerning the etiology of varicose veins, and confirms that surgery for varicose veins of the lower limb must concentrate on removal of the varices themselves. Since these often lie outside the long saphenous vein, routine stripping is neither advisable nor effective.

Adult↗

Carotid surgery under local anesthesia in the elderly.

Carotid endarterectomy in 39 elderly patients was carried out under local anesthesia and neuroleptic analgesia. There were no deaths within 30 days. Two patients required an intraoperative shunt because of signs of ischemic changes (aphasia, motor changes) during two-minute test cross-clamping. In two patients, transient vocal cord paresis was observed, and seven patients (18%) experienced immediate postoperative hypertension. Our results support the contention that in awake elderly patients the need for an intraoperative shunt can be accurately assessed by simple neurological monitoring. Carotid surgery under local anesthesia and neuroleptic analgesia appears to be a safe procedure, and is especially recommended for elderly patients with hypertension, diabetes mellitus or ischemic heart disease.

Aged↗

Sheep bronchoalveolar carcinoma: tissue associated protein complex (TAPC) in normal lung tissue and in the tumor differed quantitatively.

Sheep lungs experimentally and naturally affected by bronchoalveolar carcinoma were washed out exhaustively of soluble components by phosphate-buffered saline, pH 7.4 (PBS), followed by glycine buffer, pH 2.8 (GB), and then again by 1M KCl followed by PBS. The tissue matrix (TM) of the tumor-free region and the tumor-affected tissue were analysed separately by sodium dodecyl sulfate (SDS) polyacrylamide electrophoresis. Normal lung tissues obtained from normal sheep served as controls. Several protein fractions and fragments, identified in both the normal and the tumorous lung, have the molecular weight (MW) of 130,000-228,000, as compared with the major soluble tissue associated protein having MW of 70,000. Coomassie blue staining used in the SDS polyacrylamide system and alkaline phosphatase immunoreaction used in the Enzyme Linked Immunosorbant Assay (ELISA) showed tenfold increased concentration of the TAPC in the TM of the tumor tissue and in the blood of tumor-affected animals, respectively. Total concentration of the TAPC in the serum of tumor-affected animals was higher than in the normal. Immunofluorescent antibody test (IAT) detected the TAPC in the cytoplasm of tumor as well as in normal lung cells, and the study suggested that the TAPC reaches the peripheral blood during tissue destruction occurring at the tumor site, as observed by light and electron microscopy (LM and EM). The concentration of each of the TAPC fractions was higher in the tumor-affected sheep lung as compared with normal sheep lung. Antibodies prepared against the TAPC fractions were toxic to sheep lung cells in tissue culture. Tumor cells were more susceptible.

Adenocarcinoma, Bronchiolo-Alveolar↗

Cryosurgery for life-threatening bleeding hemorrhoids in the elderly.

Forty-three elderly patients with massive bleeding of hemorrhoidal varices were treated by cryosurgery at a single outpatient session, using nitrous oxide gas, without premedication or anesthesia. The results were excellent in all but one patient, who had ulcerative colitis and required another session of cryotherapy following a recurrence of bleeding. There was no morbidity and no mortality. The patients have remained free of symptoms over follow-up periods ranging from two to five years. The authors believe that cryosurgery is the treatment of choice and indeed may sometimes be life-saving for elderly, poor-risk patients who are unfit for general anesthesia and surgical hemorrhoidectomy.

Aged↗

The rabbit as an animal model for haemoperfusion: surgical preparation and use.

In this paper the authors describe the surgical procedure to prepare rabbits for haemoperfusion experiments. The carotid artery and jugular vein are cannulated and a simple shunt device inserted to maintain patency of the vessels over a period of time. The cannulas and shunt remain patent and free of infection for some months. Specially designed outflow and inflow extracorporeal tubing sets minimize blood volume outside the body of the rabbit. The authors also illustrate the efficacy of this system in haemoperfusion trials to remove specific antibodies. Recently a system was described to remove mercury from the bloodstream of poisoned animals. The rabbit is a useful experimental animal for this type of haemoperfusion trial.

Animals↗

Specific removal of digoxin by hemoperfusion through agarose polyacrolein microsphere polyacrolein microsphere beads-antidigoxin antibodies (APAMB-AD).

The efficacy of a new, biocompatible, specific immunosorbent for hemoperfusive removal of digoxin is described. The sorbent contains antidigoxin antibodies covalently bound to polyacrolein microspheres, 0.2 mu diam. Thousands of microspheres are matrix-encapsulated in crosslinked agarose to form beads of 500 to 800 mu diam. Digoxin intoxicated dogs showed heart block, ventricular and atrial tachycardia and extended runs of PVCs. During hemoperfusion the abnormal ECG abated; at 2 h of hemoperfusion the ECG tracings returned to normal. Up to 25% of the total digoxin burden was removed. The numbers of the blood cells and the content of a battery of relevant soluble components of the blood remained constant. Dogs were alive and well after the hemoperfusion. Non hemoperfused dogs, which received antiarrythmic agents, did not survive the intoxication. This is the first report of a practical hemoperfusive system for the specific removal of digoxin from whole blood.

Acrolein↗