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Biomedical subjects

E Azizi

Publications and source records attributed to E Azizi.

At least 37 records · Page 2Linked to original sources

Regional hyperthermic perfusion with cisplatin following surgery for malignant melanoma of the extremities.

BACKGROUND: The study was undertaken to review our experience in the treatment of extremity melanoma with hyperthermic isolated limb perfusion (HILP), using cisplatin as the chemotherapeutic agent. We also evaluated the best timing for regional lymph node dissection in relation to the perfusion. PATIENTS AND METHODS: Sixty patients with advanced malignant melanoma of the limbs were treated with HILP used mainly as an adjuvant treatment. There were 56 lower- and 4 upper-limb HILPs. Cisplatin was used at a dose of 20 mg/L of limb volume. Temperature at the tumor site was 39 degrees C to 40 degrees C. Postoperative complications, disease-free period, and time to recurrence were recorded. RESULTS: There were no deaths related to the procedure. Forty-seven percent of the patients developed local complications; most complications were minor and resolved within 60 days. The local complication rate was higher when HILP was performed shortly after or simultaneously with regional lymph node dissection. None of the patients had systemic complications. Mean survival time from treatment was 87.2 months. Currently, 35 patients (58%) are alive and free of disease 52.7 +/- 22.5 months after HILP. Twelve patients (20%) are alive with recurrent disease, of which 5 recurred locally. The average time (+/- standard error of the mean) to recurrence was 24.5 +/- 13.8 months after perfusion. CONCLUSIONS: HILP with cisplatin is a relatively safe procedure, which seems to increase locoregional control of advanced malignant melanoma of the extremity. Separating the timing of lymph node dissection from HILP by 6 to 8 weeks reduces the complication rate.

Aged↗

Familial cutaneous malignant melanoma and tumors of the nervous system. A hereditary cancer syndrome.

BACKGROUND: Excessive risk of cutaneous melanoma as a second cancer has been associated with benign or malignant tumors of the nervous system. Cutaneous melanoma and nervous system tumors may independently aggregate in families. There are, however, no previous reports of increased likelihood of tumors of the nervous system in families of patients with cutaneous melanoma or--of cutaneous melanoma in families with tumors of the nervous system. METHODS: The occurrence of nervous system tumors as second cancers was examined in a series of 904 patients with cutaneous melanoma and/or their family members. RESULTS: Fifteen families with 17 members with cutaneous melanoma from this series had one or more additional relatives with tumors of the nervous system, including astrocytoma, medulloblastoma, glioblastoma multiforme, ependymoma, glioma, meningioma, and acoustic neurilemmoma. Another subgroup of 10 patients with cutaneous melanoma had either a meningioma (n = 9) or acoustic neurilemmoma (n = 1) as a second tumor. The pattern of atypical melanocytic nevi occurring in the majority (20/25) of cutaneous melanoma patients in our series and in additional first degree relatives of 9 of 11 of the affected families, has been previously associated with the Familial Atypical Multiple Mole-Melanoma syndrome. CONCLUSIONS: This unusual familial and personal occurrence of tumors, showing differentiation toward tissues of the neural crest, neuroepithelium, and/or mesenchymal derivation, supports a putative association with a hereditary cancer susceptibility trait.

Adolescent↗

Total abdominal perfusion (TAP) in the treatment of abdominal metastatic melanoma.

Total abdominal perfusion (TAP) is a recently described technique in which the abdominal organs are isolated from the systemic circulation and perfused by means of an external pump. Administering chemotherapy into the circuit provides higher locoregional drug exposure with lower systemic toxicity. Two patients with melanoma metastatic to the abdomen were treated using this technique. The first patient suffered from intractable upper gastrointestinal bleeding due to unresectable melanoma metastasis of the duodenum. He underwent TAP with melphalan and cisplatinum. His bleeding stopped and the tumor regressed. The patient's response lasted for 6 months. The second patient had an unresectable liver metastasis. She underwent TAP with melphalan and DTIC, resulting in a complete response with disappearance of the liver mass, which lasted until her death in 13 months. Our conclusion is that TAP should be considered as a technique for regional chemotherapy, which may be used in the treatment of unresectable metastatic melanoma of the abdomen.

Abdominal Neoplasms↗

Vitiligo- and melanoma-associated hypopigmentation: a similar appearance but a different mechanism.

The significance of the association between the appearance of hypopigmentation in patients with melanoma and the prognosis is still not clear. It was postulated that, in melanoma, an immune response is responsible for the destruction of the malignant as well as the normal pigmented cells, and that the eventual development of vitiligo-like patches in melanoma patients improves their prognosis. We studied the level of anti-melanoma antibodies in the sera of patients with melanoma with hypopigmentation and compared it to the titer in patients with melanoma only, to the titer of patients with vitiligo, and to that of healthy subjects. Only IgG-type antibodies were found in the sera of patients with vitiligo, with melanoma, or with melanoma with hypopigmentation. No significant differences in the titer of anti-melanoma antibodies could be found between the patients with melanoma when subgrouped according to the initial stage and the status of the disease at the time when the test was carried out. Statistically significantly (P < 0.001) higher titers of antibodies were detected in the sera of patients with vitiligo in comparison to the lower titers in the other groups. Our results point to a similar immunobiological status, which probably does not give any advantage to patients with melanoma with hypopigmentation compared to patients without it. The appearance of hypopigmentary plaques in melanoma patients should be regarded, in our opinion, as a concomitant immunological phenomenon of the disease.

Adolescent↗

Vitiligo autoantibodies are effective against melanoma.

BACKGROUND: Vitiligo is a dermatologic disease characterized by local, dispersed, or diffuse white patches on the skin. The disease is defined as an autoimmune disorder because autoantibodies against membranal components of melanocytes are found in the patients' sera. The current study examined whether the autoantibodies reacting with the normal melanocytes could be a potent therapy against melanoma cells. METHODS: The three in vitro assays used to determine the antibody reactivities using a mouse melanoma cell line B-16-F10 and M-14 human melanoma cells as targets are as follows: enzyme-linked immunosorbent assay (ELISA), proliferation assay, and morphologic examination in the presence of antibodies purified from sera of patients with vitiligo. In the in vivo studies, experimental melanoma was intravenously induced in C57BL/6J mice, and the mice were treated by daily intraperitoneal injections with purified immunoglobulin G (IgG) fraction derived either from patients with vitiligo or from healthy subjects. RESULTS: The binding of IgG derived from patients with vitiligo was demonstrated by ELISA: Exposure of melanoma cells to the vitiligo autoantibodies was followed by inhibition of their proliferation capacity. In addition, morphologic alterations exemplified by detachment of the cells from their solid support associated with melanin release were observed in the B-16-F10 cells. Less metastatic foci developed in the lungs of the mice treated with the purified IgG fraction from the sera of patients with vitiligo compared with those treated with purified IgG fraction from healthy subjects. CONCLUSIONS: The results of this study point to the presence of anti-melanoma autoantibodies in the sera of patients with localized and diffuse vitiligo. These antibodies have a destructive effect on melanoma cells in vitro and in vivo.

Animals↗

Renal artery stenosis secondary to neurofibromatosis in children: detection by Doppler ultrasound.

Renal artery stenosis was diagnosed in two adolescents with neurofibromatosis using Doppler ultrasound. The diagnosis was confirmed by angiography. The renal vascular lesion in neurofibromatosis usually affects the proximal segment of the artery, which is the part most optimally visualized by ultrasound. We suggest that Doppler ultrasound of the renal arteries may be a useful technique in the investigation of hypertensive children with neurofibromatosis.

Adolescent↗

Chorea as a manifestation of rheumatic fever--a 30-year survey (1960-1990).

Sydenham chorea, a major manifestation of acute rheumatic fever, has been the most common form of acquired chorea during childhood. Despite the recent dramatic decline in both incidence and severity of rheumatic fever in our area, the frequency of carditis was unchanged. This study investigated retrospectively the incidence of chorea in the last three decades (1960-1990) in our area. During the 30 years of the survey, 28 patients with Sydenham chorea were treated in our centre of whom 10 were seen between 1960-1970, 17 between 1970-1980, and only one patient between 1980-1990.

Acute Disease↗

A 15-year study of the role of Aeromonas spp. in gastroenteritis in hospitalised children.

During a 15-year period, 146 strains of Aeromonas spp. were isolated from 32810 faecal specimens from 13,820 hospitalised patients up to 13 years of age. These isolates constituted 4% of all the pathogenic bacterial strains cultured. For the years 1978-1988, the files of children with gastro-enteritis revealed 81 whose faeces yielded Aeromonas spp. Most of them (94%) were < 3 years of age, 78% < 1 year old. The peak incidence was at 2-6 months, involving severe morbidity including dehydration and vomiting with acidaemia and azotaemia; the mean duration of illness and length of hospitalisation at this age were longer than at other ages. Bloody diarrhoea was found in 7% of the children. Almost all the strains of Aeromonas were resistant to ampicillin. We conclude that Aeromonas spp. are of aetiological significance in gastro-enteritis in small children; culture for this pathogen should be routine in the bacteriological examination of faeces.

Aeromonas↗

Brainstem auditory evoked potentials in familial dysautonomia.

The brainstem function of eight children with familial dysautonomia was investigated by brainstem auditory evoked potentials and compared with that of age-matched healthy control children. All median latencies of waves III and V in the study group were significantly higher than those of the control children. Brain transmission times of waves I-III and I-V were significantly prolonged in the study group compared with the control group. These results provide additional objective support for the assumption that the brainstem function of children with familial dysautonomia is affected by this disease.

Adolescent↗

[Skin cancer risk of Israeli workers exposed to sunlight].

To assess the number and types of workers occupationally overexposed to sunlight, we interviewed a national sample of 450 employers in occupational categories involving outdoor work and 5000 of their workers. The workers were assigned to 5 overall risk levels, according to combinations of skin sensitivity to ultraviolet radiation (UVR), total weekly hours of outdoor occupational sun-exposure between 0800 and 1400, and percent of skin surface exposed during outdoor work in the summer. Based on this information it was estimated that out of a total of 379,000 Israeli workers in outdoor occupations, 167,000 (44%) are at increased risk for skin cancer (risk levels 1-3) due to occupational exposure to solar UVR. Their estimated lifetime skin cancer risk is 1.5- to 20-fold higher than that of workers at low or minimal risk levels (4-5). The characteristics of those interviewed with regard to occupation, duration of solar exposure, demographic traits, geographic location, degree of risk awareness and protective measures undertaken, provide a data base for effective intervention to reduce the hazards of occupational solar exposure in Israel. We estimate that an appropriate preventive program may reduce skin cancer in Israeli men to half its current rate.

Humans↗

The recovery from ultraviolet radiation-induced erythema and melanoma risk factors: a case-control study.

The proportion of subjects recovering from skin erythema induced by a single ultraviolet radiation challenge of 6 times the minimal erythema dose during a 3-week period was lower in 47 patients with stage I cutaneous melanoma than in 48 healthy control subjects with similar risk factors of increased sensitivity to ultraviolet radiation (p = 0.045). This difference indicates that the patients with melanoma were more susceptible to prolonged ultraviolet radiation-induced skin damage than the control subjects. Prolonged erythema response was significantly associated in the melanoma group with decreased minimal erythema doses (odds ratio [OR] = 11.3) and with the presence of freckles (OR = 5.5), and was associated in the control group with light eye color (OR = 5.8). Prolonged ultraviolet radiation-induced erythema is neither a unique feature of melanoma patients nor a useful marker for identifying risk groups for cutaneous melanoma.

Adult↗

Acute gastroenteritis due to double infection with enteropathogenic Escherichia coli or Salmonella and another bacterial pathogen.

Two enteric bacterial pathogens were concomitantly isolated from the feces of 18 infants less than 6 months of age admitted to the Assaf Harofeh Medical Center over a 7-year period. In all but two patients stool cultures grew enteropathogenic Escherichia coli, six of serogroup 0119. The other organisms cultured were Shigella, Salmonella, Campylobacter jejuni and Aeromonas hydrophila. The usual clinical presentation was diarrhea, dehydration and vomiting of acute onset, and low grade fever. Patients with gastroenteritis due to a single agent compared with multiple pathogens had a milder course of disease, a milder degree of dehydration and acidosis, a lesser need for i.v. fluid treatment and shorter hospitalization.

Academic Medical Centers↗

Neurogenic bladder due to herpes zoster infection in an infant.

A case is presented of Herpes zoster (HZ) infection in a 2.5-month-old infant with the added complication of a neurogenic bladder. The patient's mother suffered from varicella during the 18th week of pregnancy. The patient had a typical herpetic rash at the age of 2.5 months, and developed constipation and a neurogenic bladder. While the constipation improved, bladder atonicity led to hydroureters necessitating bilateral ureterostomies. Urinary tract involvement of HZ is well known in adults and is reversible. To our knowledge this is the first report of such a complication of HZ infection in infants.

Chickenpox↗

Chorea associated with systemic lupus erythematosus in children. A case report.

In the past most cases of childhood chorea were related to rheumatic fever and were treated appropriately. With the decrease in the incidence of rheumatic fever less common etiologies of chorea should be investigated. This report demonstrates the difficulties of distinguishing between chorea associated with rheumatic fever and chorea associated with systemic lupus erythematosus.

Child↗