Biomedical subjects
Publications and source records attributed to A Shai.
A 24-year-old man developed slow-growing lesions on subungual and plantar areas that appeared a few weeks after returning from a trip to South America. The diagnosis of tungiasis was established by microscopic examination of a lesion. Tungiasis is rarely seen in non-endemic areas.
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We conducted a retrospective study to characterize the clinical course, microbiologic spectrum, and risk factors for endocarditis and for associated mortality in a large series of patients with documented pacemaker endocarditis. Using a computerized search through the medical records of 10 major hospitals in Israel from 1982 to 1992, and carefully reviewing the charts, we identified 44 patients with pacemaker endocarditis. The cases were categorized as definite (n = 25), probable (n = 12), or possible (n = 7) infective endocarditis based on strict case definition. Fever and chills were the most common symptoms. Increased ESR, leukocytosis, microscopic hematuria, and anemia were the most common laboratory findings. A relatively high proportion of the patients were diabetic. The most common source of endocarditis was infection acquired by the placement procedure or infection of the pacemaker pouch. Demographic, clinical, and laboratory features were similar to those of endocarditis patients of a similar age range without pacemakers, although the frequency of fever and chills was higher in our patients than in those patients and splenomegaly, vascular embolic phenomena, and new or changing murmurs were rare in our patients. The major pathogens were Staphylococcus aureus and Staphylococcus epidermidis, similar to other series of pacemaker-associated bacteremia and similar to the microbiologic findings of early prosthetic-valve endocarditis. However, this microbiologic profile is different from that of native-valve endocarditis. Although the present series did not show a statistically significant advantage to electrode removal over conservative treatment, when analyzed together with pooled data from other studies, it suggests that the surgical approach is preferable.(ABSTRACT TRUNCATED AT 250 WORDS)
BACKGROUND: Spontaneous regression of malignant melanoma is characterized by a partial or complete disappearance of the neoplasm. Partial regression of melanoma has been documented in large series, but complete regression is reported as occurring only sporadically. OBJECTIVE: To describe a case of metastatic malignant melanoma where the primary lesion underwent spontaneous and complete regression and to review the literature pertaining to regression of melanoma. METHODS: The patient was examined clinically. Wide excision of the skin with the lesion was performed as well as left inguinal lymph node dissection. RESULTS: Histologic examination of the lesion revealed complete regression of malignant melanoma. Examination of the lymph node dissected from the adjacent inguinal area revealed matastatic melanoma. CONCLUSIONS: Greater attention should be devoted to identification of regression in melanoma, clinically and histologically, evaluating the prognostic implications which regression might indicate.
Lichen planus-like or lichenoid eruptions from certain drugs and compounds can closely mimic idiopathic lichen planus. The patient's history and physical examination histopathologic criteria, and certain tests can assist in the differentiation between a lichenoid drug eruption and idiopathic lichen planus and in the identification of the offending drug.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Transition from solar keratosis (SK) to squamous cell carcinoma (SCC) is well known and vastly documented. The possible relation between SK and basal cell carcinoma (BCC) is rarely mentioned in the dermatopathological literature. In order to identify the characteristics of the relation between SK and BCC, 40 slides of the head and neck regions in which both SK and BCC had been diagnosed, were retrieved from a collection in the Institute of Pathology of Beilinson Medical Center, seen between 1984 and 1994. Gradual and continuous transition between SK and BCC was found in 15 (37.5%) of these 40 slides. In order to estimate the prevalence of this phenomenon, 73 additional slides, which had been diagnosed as BCC of the head and neck, were re-examined. Atypia of the spinous layer, as an initial marker for the development of SK, was sought in each slide. Revision revealed spinous layer atypia in 26 (35.6%) slides, in addition to the previously diagnosed BCC. In seven (9.6%) the transition between atypical spinous cells and BCC was gradual and continuous. A gradual and continuous transition between SK and BCC can be explained by the presence of pluripotent stem cells in the epidermis. Stem cells, following malignant transformation, may differentiate in different directions, resulting in both SK and BCC.