Biomedical subjects
Publications and source records attributed to G Amir.
Four very-low-birth-weight infants developed localized intestinal perforations after enteral administration of indomethacin. The clinical picture and histologic findings were unlike those seen in necrotizing enterocolitis.
A rare extraskeletal soft-tissue chondrosarcoma of the foot occurred in a 50-year-old man. Adequate en-bloc excision or amputation was the indicated method of treatment.
A patient with nonfunctional paraganglioma situated adjacent to the pancreas is presented. The clinical picture, the laboratory studies, as well as the gross appearance of the tumor and a frozen section at operation were not diagnostic. Internal drainage of the cystic tumor, assumed to be a pseudocyst of the pancreas, was done. Excision was performed when the diagnosis was histologically and ultrastructurally established. The microscopic and the electron microscopic features of this rare neoplasm are discussed. Excision of the tumor is recommended as the treatment of choice because of the malignant potential that does not correlate well with the histological appearance.
Reassessment of the pathological slides of 31 Israeli patients confirmed the initial diagnosis of uterine sarcoma in 28 cases. The review diagnosis of the histological subcategory was not always identical with the original one. The most common tumor (32.1%) was mixed heterologous sarcoma. Abnormal bleeding was the most common symptom and a presumed myomatous uterus the most common clinical finding. Although almost half the patients were diagnosed in Stage I, the overall survival was 26%. Survival was influenced by both the stage at diagnosis and the histological category.
The prognostic value of the tumor markers CYFRA 21-1, tissue polypeptide specific antigen (TPS) and carcinoembryonic antigen (CEA) was investigated in three histologic subtypes of non-small cell lung cancer. Pretreatment serum marker levels were measured in 38 patients with adenocarcinoma (AC), in 43 patients with squamous cell carcinoma (SQC) and in 35 patients with large cell carcinoma (LCC). Univariate analysis in AC showed significant lower survival of patients with elevated levels of TPS, CYFRA 21-1 and CEA. In LCC, elevated levels of TPS and CEA were found to predict lower survival, while in SQC--only TPS was a predictor. A multivariate analysis of survival identified CEA (Relative Risk-5.5; p = 0.004), CYFRA 21-1 (RR-3.4; p = 0.008) and TPS (RR-3.0; p = 0.02) as independent prognostic factors in AC. In SQC, only TPS (RR-2.3; p = 0.03) was such a factor whereas in LC--none of the markers studied retained statistical significance. Thereafter, the combinations of the two strongest prognostic factors in the AC group--CEA and CYFRA 21-1 were explored to divide this group into subsets with different prognosis. In cases where both markers were positive, the relative risk of death was 10.5 times higher as compared to cases where both markers were negative (p = 0.002).
A simple alternative for microsurgical anastomosis of the fallopian tube is presented. The anastomosis is composed of a single continuous suture (8-0 nylon) extending through the serosa and muscularis, avoiding the mucosa. Experimentally this technique was performed on the uterine horns of 30 female rats and compared with the conventional interrupted suture technique on 30 additional female rats. Patency was established histologically in 100% of operated horns in both groups, with an average nidation index of 0.7 in the study group as compared with 0.6 in the conventional technique group. The results indicate that this simple method of anastomosis, which reduces operative time significantly, does not affect patency or nidation index in this model as compared with the conventional interrupted suture technique. It may, therefore, be a suitable procedure for anastomosis of equal-sized segments of the fallopian tubes, especially in cases of reversal of sterilization.
A 38-year-old woman with megakaryoblastic chronic myelocytic leukemia (CML) crisis developed recurrent episodes of severe hypercalcemia, manifested by nausea and vomiting and later by dyspnea and hypoxia. The levels of serum parathyroid hormone and serum and urine cyclic AMP were normal. Autopsy revealed widespread metastatic calcifications in various organs, including the lungs. The case suggests that hypercalcemia complicating blast crisis of CML is not related to blast cell phenotype, can cause severe pulmonary malfunction, and is a terminal event. The hypercalcemia most probably resulted from bone resorption, either directly by the megakaryoblasts or by secretion of osteolytic substances.
A case of giant mammary hamartoma is presented. Macroscopically the tumor resembled giant fibroadenoma and cystosarcoma phylloides. Histological criteria for diagnosis include encapsulation, preservation of lobular integrity and the presence of adipose tissue. The radiological picture is described and the differential diagnosis discussed.