Biomedical subjects

Haim Golan

Publications and source records attributed to Haim Golan.

6 recordsLinked to original sources

PubMed2006

99mTc-methylene diphosphonate single photon emission tomography of the knees: intensity of uptake and its correlation with arthroscopic findings.

OBJECTIVE: To examine whether single photon emission computed tomography (SPECT) can determine the severity of knee pathology, based on intensity of uptake and, therefore, possibly substituting this technique for more invasive and expensive diagnostic procedures, such as arthroscopy, in certain patient populations. METHODS: The study results of patients referred for knee SPECT followed by an arthroscopy at our institution were evaluated retrospectively. The scintigraphic and arthroscopic findings for the menisci and femoral condyles were each graded on a numeric scale. One numeric scale corresponded to the level of uptake in the SPECT and the other to the severity of the pathology visualized at arthroscopy. Statistical correlation between both scales, representing the SPECT and arthroscopy findings, was performed. RESULTS: Forty-one patients were included in the study. A positive and statistically significant correlation was found between the intensity of uptake on the SPECT and the severity of the arthroscopic findings in the menisci and medial femoral condyle. CONCLUSION: The degree of uptake in the knee, as determined by SPECT, positively correlates with the severity of pathology seen at arthroscopy. The data can potentially be used to assist in decision-making before proceeding to surgery, especially where there is severe pathology that may be less amenable to arthroscopic therapy.

Adolescent↗

PubMed2005

Persistent BBB disruption may underlie alpha interferon-induced seizures.

Generalized seizures during Interferon-alpha (IFN-alpha) therapy have been repeatedly described in about 1%-4% of patients. However, the mechanisms underlying IFN-alpha induced seizures are not known. We describe a patient who developed partial and secondary generalized seizures during IFN-alpha therapy while displaying a focal disruption of her blood-brain barrier (BBB) corresponding with pathological electroencephalography (EEG). To test our hypothesis that IFN-alpha induces seizure activity, we exposed rat somatosensory cortices to clinically relevant concentrations of IFN-alpha in the acute in-vitro slice preparation or in-vivo. While acute exposure did not induce epileptic activity, recordings from slices exposed to IFN-alpha in-vivo one week prior to recordings revealed pronounced epileptiform activity in > 80% of the slices. We propose that cortical exposure to IFN-alpha leads to the generation of an epileptic cortex, which explains the weeks of latency in patients from initial treatment to seizures, and stressing the importance of identifying possible BBB disruption among high-risk patients administered peripherally acting drugs.

Action Potentials↗

PubMed2005

FDG-PET imaging in Merkel cell carcinoma - value of head-to-toe scan.

A 63-year-old man was diagnosed with metastatic MCC. Preliminary staging PET scan with 18F-FDG was not done at the time of diagnosis. After completion of chemo- and radiotherapy, the patient underwent a CT scan of the area from the maxilla to the ischium; no evidence of disease was noted. Clinically, the patient was considered to be in remission. The CT scan was followed by head-to-toe FDG-PET scanning which revealed foci of metastatic disease in the right mid- thigh and left proximal calf. This case demonstrates the added value of head-to-toe FDG-PET for the detection of distant metastases in MCC.

Carcinoma, Merkel Cell↗

PubMed2004

[Comparison between D-dimer levels and lung scan in patients with suspected pulmonary embolism].

Pulmonary embolism (PE) is a critical situation that requires prompt diagnosis and treatment. Lately, the use of D-Dimer (DD) blood level test was recommended when PE is suspected. The goal of this work was to evaluate the association between DD levels and the results of lung scan in patients with suspected PE. 84 patients who were admitted due to suspected PE and met the inclusion criteria of having both DD test and lung scan within less than 7 days apart, were included in our study (age = 76 +/- 14, females = 58, males = 26). Comparison of lung scan results, DD level and diagnosis of PE at discharge was carried out. The subjects were classified into 2 groups according to the DD levels: group A = DD > or = 250 ng/mL--abnormal test, group B = DD < 250 ng/mL--normal test. Group A includes 67 patients, of which 29 (43%) were diagnosed as PE. In these subgroup lung scan showed high Probability (HP) for PE in 19 (66%), medium probability (MP) in 9 (31%) and low probability (LP) in 1 (3%). From the 38 (57%) patients who were not diagnosed with PE (non-PE), 5 (13%) had HP lung scan, 4 (11%) MP and 29 (76%) LP. Group B includes 17 patients, in which only one (6%) had diagnosed with PE and the rest (n = 16, 94%) had no PE. Of the latter subgroup 15 (94%) had LP lung scan and one MP scan. The one patient who was diagnosed with PE had a HP lung scan that was also confirmed with CT-angiography. DD and lung scan had similar sensitivity (96.7%) and high negative predictive value (NPV = 94.1% and 97.8% accordingly) for PE. On the other hand DD specificity is much lower (29.6%) in comparison to lung scan (81.5%). The results of this work support the use of DD test prior to lung scan, in order to rule out PE with relatively high probability.

Aged↗

PubMedDate not supplied

Focal cortical dysfunction and blood-brain barrier disruption in patients with Postconcussion syndrome.

Postconcussion syndrome (PCS) refers to symptoms and signs commonly occurring after mild head injury. The pathogenesis of PCS is unknown. The authors quantitatively analyzed EEG recordings, localized brain sources for abnormal activity, and correlated it with imaging studies. Data from 17 patients with neurologic symptomatology consistent with ICD-10 criteria for PCS was analyzed. Normalized quantitative EEG (QEEG) revealed significantly higher power in the delta band and lower power in the alpha band compared with matched controls. The generators for the abnormal rhythms were focally localized in neocortical regions. Brain computerized tomography and/or MRI did not reveal focal abnormality at the time of diagnosis. Single photon emission computed tomography (SPECT) after 99mTc-ethylcysteinate dimer administration showed a focal reduction in perfusion in 85% (n = 11) of the patients, and abnormal blood-brain barrier (BBB) after 99mTc-diethylenetriaminepentaacetic acid administration in 73% (n = 8). In 75% of these patients, low-resolution brain electromagnetic tomography analysis showed that the generators for abnormal rhythms were closely related to the anatomic location of the BBB lesion. These data point to focal cortical dysfunction in conjunction with BBB disruption and hypoperfusion as a possible mechanism of pathogenesis in at least some PCS patients, and offer QEEG and SPECT as important tools in evaluating these patients.

Adolescent↗

PubMedDate not supplied

Cutaneous lymphomas and association to sex hormones.

Male gender is interpreted as a risk factor for developing mycosis fungoides and perhaps other cutaneous and extracutaneous lymphomas. In this review the authors examine epidemiologic, clinical, pathologic, and molecular data in an effort to understand whether and to what extent gender or sex hormones are involved in the pathogenesis of lymphoproliferative disorders.

Carcinogens↗