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Biomedical subjects

G Marshak

Publications and source records attributed to G Marshak.

At least 19 recordsLinked to original sources
PubMed1995

Vocal cord palsy: possible late complication of radiotherapy for head and neck cancer.

Cranial nerve palsies are uncommon complications of radiotherapy for head and neck cancer. A review of the literature reveals that cranial nerve damage after radiotherapy has been reported for the optic, oculomotor, trigeminal, abducens, cochlear, vagus, spinal accessory, and hypoglossal nerves. The hypoglossal nerve appears to be the most commonly affected, and the recurrent laryngeal nerve is seldom involved. The case histories of three patients who developed vocal cord palsy from 21 to 34 years after a course of curative or postoperative radiotherapy for carcinoma of the head and neck are presented. Two patients had bilateral palsy, and in the third patient, bilateral damage cannot be excluded. Physical examination and radiographic investigations on admission and on follow-up did not demonstrate any evidence of tumor recurrence, cervical or distant metastases, or second primary tumors. The distinction between irradiation-induced palsy and that due to malignancies is emphasized.

Adolescent↗
PubMed1994

T1 glottic carcinoma involving the anterior commissure.

This study reviews the records of 56 patients with early glottic carcinoma involving the anterior commissure (T1N0M0) who were treated between 1958 and 1988 at Beilinson Medical Center. Five- and 10-year survival rates were 82% and 60%, respectively. Most failures were local (15 patients). In addition, three patients who were treatment failures had neck lesions (regional failure) and one had lung lesions (distant metastases). All 56 patients received irradiation as the only mode of initial treatment. The effectiveness of irradiation for anterior commissure lesions is therefore evaluated. The study supports previous reports suggesting that glottic carcinoma involving the anterior commissure is associated with a high rate of treatment failure.

Adult↗
PubMed1992

Long-term follow-up of the effectiveness and safety of inferior turbinectomy.

The long-term effectiveness and safety of inferior turbinectomy were assessed in 186 patients who were interviewed and examined 10 to 15 years after surgery (mean 12.3 years). Relief of nasal obstruction was reported by 82 percent of the patients; rhinoscopy showed wide, clean nasal airways in 88 percent. Rhinorrhea was still a problem for 34 percent of patients, and 19 percent were receiving medical treatment for this symptom. Smell acuity had improved in 52 percent of the patients. Before turbinectomy, 32 patients had suffered from bronchial asthma; postoperatively, there was an improvement in 16, and no change in 13; 3 patients reported exacerbation of asthmatic attacks. Atrophic changes of the nasal mucosa and chronic purulent infection were not observed in any of the patients.

Adolescent↗
PubMed1991

Needle aspiration and pressure sutures for auricular pseudocyst.

Auricular pseudocyst is an asymptomatic cystic swelling of the upper portion of the auricle. Various therapeutic approaches have been employed with variable success. We report our results with nine patients treated by needle aspiration and bolstered pressure sutures applied over both aspects of the cyst for 1 week. Treatment resulted in complete resolution with no recurrence of the lesion in any of the patients. This procedure is simple, does not require an operating room setting, and is more comfortable and more acceptable aesthetically by the patient.

Cysts↗
PubMed1990

Experience with the Wilkie procedure for sialorrhea.

Sialorrhea (drooling) is most commonly seen in children with cerebral palsy or mental retardation. Surgical procedures for the control of sialorrhea include salivary gland excision, parasympathetic nerve section, and salivary duct ligation and/or rerouting. Eighteen children between the ages of 5 and 17 years underwent bilateral submandibular gland excision and rerouting of Stensen's duct (Wilkie procedure). All children had severe drooling associated with cerebral palsy or mental retardation. Follow-up at 7 years showed satisfactory control of sialorrhea in 16 of 18 patients (89%). There was one major complication: xerostomia. Our results indicate that submandibular gland excision together with parotid duct retropositioning provides effective control of sialorrhea in most cases. Unfavorable head and mandibular posturing seemed to cause persistent sialorrhea in one case.

Adolescent↗
PubMed1989

Olfactory function following late repair of choanal atresia.

Results of olfactory function tests (threshold determination and odor identification) in three cases of bilateral and one case of unilateral choanal atresia are reported. All four patients underwent successful repair of choanal atresia at relatively advanced ages (8 to 31 years). Test results showed that patients who had suffered from bilateral atresia had permanent olfactory deficits, while the patient who had suffered from unilateral atresia appeared to have normal olfactory acuity. Although these results should be interpreted with caution due to the small number of cases examined, they suggest the possibility that early sensory exposure might be needed for the normal development of central olfactory functions in analogy to the visual system.

Adolescent↗
PubMed1989

Clinical and pathological features of non-Hodgkin's lymphoma of the tonsil. Review of the literature and report of 10 cases.

Ten patients with tonsillar lymphomas diagnosed and treated in our hematology unit from 1979 to 1986 are reported. The heterogeneous histology at presentation, the aggressiveness of the histologic types during relapse, and the relatively low incidence of gastrointestinal tract involvement are discussed. A review of the literature is presented. In view of the better survival rate obtained with chemotherapy or combined chemo- and radiotherapy, we confirm that lymphomas of the tonsil should be aggressively treated, regardless of the staging. Among our 10 cases, 2 are of special interest since they progressed into highly malignant disorders: B-acute lymphoblastic leukemia and Burkitt's lymphoma.

Adult↗
PubMed1988

Peritonsillar abscess. A prospective evaluation of outpatient management by needle aspiration.

Outpatient management of peritonsillar abscess by needle aspiration and oral antibiotic therapy was evaluated for its effectiveness in providing rapid symptom relief and cure and in preventing recurrence. Between 1984 and 1987, 124 patients with peritonsillar infection were treated in our department, and 115 were included in this prospective study. Needle aspiration was not carried out in 11 patients because of young age, noncooperation, or severe trismus. The other 104 patients underwent permucosal aspiration and were followed up for periods of four months to three years. Of these, findings of aspiration were positive in 75 (72%). Only nine (12%) of the 75 patients with positive aspirates had to be hospitalized. In 64 (85%) of the 75 patients, the abscess resolved without further therapy. Aspiration of pus, along with oral administration of antibiotics, thus appears to be a reasonable alternative to incision and drainage or "hot" tonsillectomy in patients with peritonsillar abscess. This conservative approach obviates the need for hospital admission in most patients, thus enabling a significant cost reduction.

Adolescent↗
PubMed1987

Myringoplasty in the pediatric population.

The long-term results of myringoplasty in children, including closure of perforation and hearing improvement, were reviewed in relation to age, condition of the operated-on ear, and condition of the untreated ear. The overall success rate in 155 operations evaluated one year postoperatively was 79%. Children in the 5- to 8-year-old age group had a success rate comparable to that of older (9- to 12-year-old) children (77.7% vs 80.4%). Where graft failure occurred, it was usually within one year of surgery. The outcome of surgery could not be related to the presence or absence of chronic otitis media in the untreated ear, the status of the operated-on ear (whether dry or discharging), or the performance of adenoidectomy before myringoplasty. Results of postoperative hearing, analyzed by calculating the postoperative air-bone gap and by speech audiometry, were similar in the two age groups. It is concluded that myringoplasty has a good chance of success in children, regardless of age.

Audiometry, Pure-Tone↗
PubMed1987

Cytokeratin polypeptides expression in different epithelial elements of human salivary glands.

Immunofluorescent labeling of human salivary glands was carried out with a battery of monoclonal antibodies reactive with specific cytokeratin polypeptides. All the epithelial elements of the glands were positively labelled by a broad-spectrum cytokeratin antibody (KG 8.13) and by antibody Ks 18.18, which reacts with cytokeratin No. 18 exclusively. Labelling of frozen sections with antibody KM 4.62, which is reactive with the 40 Kd (No. 19) cytokeratin, was confined to the ductal system and apparently absent from the acini. Antibody KA-1, reactive with polypeptides 4, 5 and 6 stained both the myoepithelial cells and the basal cells of the large ducts. Antibody KS 8.58, however, reacted with the basal cells exclusively. It is thus proposed that the combined use of the various monoclonal antibodies may provide a most useful probe in studies on epithelial cell diversity in normal salivary glands as well as in pathological disorders of that gland.

Child↗
PubMed1987

Malignant melanomas of female urethra.

Primary melanoma of the female urethra is extremely rare. Treatment by surgery, radiation, and chemotherapy has been uniformly ineffective. We herein report on 2 patients with primary malignant melanoma of the urethra treated with immunotherapy and chemotherapy. The first patient died four years after the initial diagnosis, and the second died after two years. Chemo-immunotherapy may be considered as an additional, palliative form of treatment in the management of primary melanoma of the female urethra, but cystourethrectomy should be the initial form of treatment.

Aged↗
PubMed1987

Modulation of intermediate-filament expression in developing cochlear epithelium.

The present study was designed to characterize the expression and distribution of intermediate filaments (IFs) in the diverse cellular elements of inner-ear epithelium in guinea pig and man. Using immunofluorescence microscopy with a battery of IF-specific monoclonal antibodies, we show that the epithelium of the otocyst expresses cytokeratin (CK) polypeptides typical of simple epithelia. Cells in the early otic ganglion were also positively labelled for cytokeratins, suggesting that they are of otocystic epithelial origin. Cytokeratin distribution was largely homogeneous in the early cochlear duct as the epithelium differentiated, differences in the distribution of cytokeratin between the various cell types became detectable. Characteristically, cochlear hair cells became devoid of cytokeratin labelling, and remained unlabelled with antibodies specific for all other IF classes. The neural tissue of the inner ear was also devoid of cytokeratins and was typically positive for neurofilaments. Vimentin IFs were abundant in the mesenchymal tissues around the membranous labyrinth. Desmin and glial fibrillary acidic protein were not detectable in the cochlea. The apparent absence of all IFs from the cochlear hair cells in both guinea pig and man, as revealed by immunofluorescence and electron microscopy, and the possible significance of their absence for cochlear physiology, are discussed.

Animals↗
PubMed1987

Cytokeratin polypeptides in normal and metaplastic human salivary gland epithelia.

Immunofluorescent and immunoperoxidase labelling of normal and metaplastic human submandibular salivary glands with a battery of cytokeratin-specific monoclonal antibodies was carried out. Labelling with a broad spectrum cytokeratin antibody (KG 8.13), as well as with antibody to cytokeratin polypeptide No. 18 (Ks 18.18) was observed in all the epithelial elements of the gland. Polypeptide No. 19, however, was present in ductal cells only, sparing the acini and the associated myoepithelium. Antibody KS 8.58, specific for cytokeratins Nos. 13 and 16, selectively labelled basal cells along the large ducts. Examination of squamous metaplasia associated with chronic suppurative sialadenitis indicated that the metaplastic cells display the same cytokeratin profile as the normal ductal cells and are not labelled with antibodies KS 8.58 and KK 8.60 which usually stain normal and pathological stratified epithelia. The significance of these observations for the histogenesis of normal salivary glands, as well as for the development of the metaplastic process, is discussed.

Antibodies, Monoclonal↗
PubMed1987

Cytokeratin polypeptide expression during the histogenesis of guinea pig submandibular salivary gland.

The present study was directed towards the characterization of cell-specific histogenetic markers for the various epithelial elements of the adult and the developing guinea pig submandibular salivary gland. We have employed immunofluorescent labelling using three cytokeratin monoclonal antibodies, for which the polypeptide specificities towards guinea pig cytokeratins were determined. All the epithelial elements of the adult gland were positively labelled with two monoclonal antibodies, namely KG 8.13 ('broad spectrum' anti-cytokeratin) and antibody Ks B.18 (reactive with a simple cytokeratin-specific polypeptide of 49 X 10(3) Mr). Antibody KS 8.58 (reactive with a guinea pig cytokeratin polypeptide of 50 X 10(3) Mr) labelled the basal cells of the large ducts, as well as the myoepithelium. During development of the gland, the submandibular anlage and its primary and secondary branches with their terminal buds, were uniformly labelled with the three antibodies; however, the cytokeratin polypeptides reactive with antibody KS 8.58, which were apparently expressed in all cells of the developing ducts, gradually disappear from most of the ductal cells, starting at about 6 weeks of gestation, and remain only in the basal or reserve cells of the large ducts and the myoepithelium. These observations support the notion that the basal cells retain at least some of the properties of the embryonic glandular epithelium and could be considered as pluripotent reserve cells which may function as progenitors for other epithelial elements in the salivary glands epithelia.

Animals↗
PubMed1987

Distinctive immunohistochemical labeling of epithelial and mesenchymal elements in laryngeal pseudosarcoma.

A laryngeal squamous cell carcinoma in situ with an underlying spindle cell nodule (pseudosarcoma) was immunohistochemically labeled with antibodies to tissue-specific intermediate filament proteins, including desmin, vimentin, and cytokeratin. Two distinct populations of cells were found within the lesion: cytokeratin-positive cells, corresponding to the carcinomatous component of the tumor, and vimentin-positive spindle cells in the subepithelial nodule. In view of the strict specificity of antivimentin and anticytokeratin for cells of mesenchymal and epithelial origin, respectively, it is proposed that the two components of the pseudosarcoma in our case are not morphologic variants of the same tumor, and that the subepithelial nodule represents a mesenchymal lesion. These results can, however, not be extrapolated to other cases since in some the spindle cell component may represent metaplastic epithelial cells. In view of the difficulties encountered in reaching a correct diagnosis in these lesions, it is recommended to use intermediate filament typing to elucidate the nature of the spindle cells in this controversial tumor.

Carcinoma in Situ↗
PubMed1986

Changes in olfactory acuity induced by total inferior turbinectomy.

The short-term and long-term effects of total inferior turbinectomy on smell acuity was assessed in two groups of patients. Olfactory thresholds were determined by a three-way forced-choice method, using four odorants. Resection of obstructive inferior turbinates resulted in a decrease in olfactory thresholds in 22 of 24 tested patients. No deleterious effect on smell acuity was observed in 16 patients tested 2 1/2 years or more after surgery. Subjective assessment of olfactory acuity is unreliable. It is our intention to focus attention on an aspect of intranasal surgery not frequently reported.

Adolescent↗