Biomedical subjects
J Sidi
Publications and source records attributed to J Sidi.
Detection of specific IgA antibodies to varicella zoster virus in serum of patients with Ramsay Hunt syndrome.
Varicella zoster virus (VZV)-specific IgG and IgA antibody titers were determined in serial serum samples of 23 patients with Ramsay Hunt syndrome by the immunoperoxidase assay. Varicella zoster virus-specific IgG antibodies were found in the first serum samples of all the patients. In 80% of 20 patients in whom a serum sample was available within 5 days after the onset of the disease. VZV-specific IgA antibodies were detected. The second serum sample was VZV-specific IgA-positive in all of the patients. While all the healthy age- and sex-matched control subjects had VZV-specific IgG antibodies, VZV-specific IgA antibodies were detected in a low titer (dilution = 2) in only three of the subjects. By using VZV-specific IgA antibody titers greater than or equal to 2 and greater than or equal to 4 by the immunoperoxidase assay as a "cutoff" for younger and older patients with Ramsay Hunt syndrome, respectively, an early diagnosis of the disease can be obtained in 89% of the younger and in 64% of the older patients by a single serum sample.
Rapid percutaneous tracheostomy.
We describe a new method of performing percutaneous tracheostomy rapidly and safely using a specialized instrument kit. The technique permits the safe insertion of a full-sized 7.0 (ID) or 7.5 mm (ID) cuffed cannula into the trachea within 1-2 min, through the membranous second intercartilagenous space. Animal studies have demonstrated a superior healing process compared to that seen after conventional tracheostomy techniques.
Percutaneous tracheostomy--a new method.
A rapid method of definitive low tracheostomy utilizing an original instrument kit and percutaneous approach is described. Through a horizontal, shallow (1.5-cm) skin incision in the neck, a 12-ga needle is introduced into the tracheal lumen. A flexible metal guidewire is gently introduced through the needle, which is then removed. A specially designed percutaneous tracheostomy tool slides over the guidewire into the trachea; by squeezing its handles, the intercartilaginous space is enlarged, securing the placement of a cuffed tracheal cannula. After extensive and successful investigation in both cadaver and animal trials, the procedure was carried out in 80 patients who had a variety of underlying diseases, without serious complications. Of these 80 patients, 33 required airway control after neurosurgical interventions or after severe head trauma, 23 had percutaneous tracheostomy performed before radical excision for head and neck cancer, and the remaining 24 suffered from severe cardiorespiratory problems. Twenty-nine procedures were performed in the operating theater, and 51 procedures were carried out at the patient's bedside in the ICU, ED, or in the ward. There was no infection at the stoma site, and late healing was remarkable. It should be strongly emphasized that in the majority of our patients the procedure was carried out safely at the bedside. This resolved the logistic problem of moving very sick ICU patients (who are sometimes on high PEEP levels) to the OR. Although our experience is totally restricted to elective situations, we do postulate that it could be as effective in a variety of urgent situations.
[Hyperthermia and treatment of cancers].
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Giant cementoblastoma simulating a peridental infection.
A case of giant cementoblastoma of the maxilla in a young female is reported. An unusual painful swelling of the gingivolabial area led to an initial misdiagnosis of a peridental infection and consequently to inappropriate treatment.
Carcinoma in situ of the vocal cords: a retrospective study.
Between the years 1960 and 1981, 21 patients with the diagnosis of carcinoma in situ of the vocal cords were treated in the ENT department of Beilinson Medical Center. All 21 patients received initial irradiation therapy, identical to patients with invasive squamous cell carcinoma--7200 rads Co60 tumour dose. No patient died as a result of tumour. One patient had local recurrence of invasive carcinoma after 3 years and subsequently underwent total laryngectomy. One patient died after 15 years as a result of myocardial infarction. It is important to mention that 20 patients (95.2%) were free of tumour during a follow-up of 4-25 years (mean 11 years). This study shows that radiotherapy is a highly effective method of management for carcinoma in situ of the glottic region.
An analysis of staging systems for carcinoma of the maxillary sinus.
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Clinical experiences with carcinoma of the maxillary sinus.
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Laryngeal carcinoma in patients 40 years of age and younger.
Between 1950 and 1985, 570 patients with squamous cell carcinoma of the larynx were diagnosed and treated in the Otolaryngology Department of the Beilinson Medical Center. Of these, 20 patients (2.8%) were aged 40 years or younger. Twelve patients (60%) had glottic carcinoma in Stage I (T1N0M0) when initially diagnosed, one patient had supraglottic carcinoma in Stage I (T1N0M0) and seven patients (35%) had laryngeal carcinoma in Stage II (T2N0M0) and III (T3N0M0). Patients with T1N0M0 received only radiotherapy. Three patients with T2N0M0 underwent total laryngectomy and also received postoperative radiotherapy. Four patients with the tumor in T3N0M0 received pre-operative and postoperative radiotherapy in addition to total laryngectomy. The 5-year survival rate for T1N0M0 and T2N0M0 was 100% and for T3N0M0 66%. Although a high percentage of the young patients presented for treatment with advanced disease, the survival rate compared the same or favorably with rates in older patients. This supports the concept of aggressive treatment when there is a recurrence or second primary, particularly because it is well tolerated in the young age group who do not exhibit many of the conventional risk factors and therefore, have a better prognosis.
[Squamous cell skin carcinoma of the head and neck].
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Ossified segments of the stylohyoid ligament. A case of radiological misdiagnosis.
An ossified segment of the stylohyoid ligament was misdiagnosed as a foreign body.
Anaplastic thyroid carcinoma metastatic to the tonsil.
We describe a 65-year-old woman who presented with a left tonsillar tumour. Biopsy revealed metastatic anaplastic cell carcinoma of the thyroid. Metastatic tumours are rare in the tonsils. This case, to the best of our knowledge, is the first in which the thyroid was the primary site.
Hemangioma of the zygoma.
Hemangioma of the zygomatic bone is an extreme rarity. Six cases have been reported in the English literature. These reports and the 2 new patients presented here constitute the basis for our data. Clinical, histopathological, therapeutic, and reconstructive considerations are discussed.
Complete cricotracheal separation following blunt trauma to the neck.
We report a case of complete cricotracheal transection with wide separation of the ends, a rare injury. Because of the good general and respiratory condition of the patient on admission, the pathognomonic signs of laryngeal injury were not noticed, causing an unnecessary delay in treatment. Deteriorating respiratory status with progressing cervical subcutaneous emphysema brought up the diagnosis of laryngotracheal injury. Treatment was immediate and included tracheotomy and primary end-to-end anastomosis.
Carcinoma of the nasopharynx. An analysis of 91 cases and a comparison of differing treatment approaches.
Ninety-one patients with malignant epithelial tumors of the nasopharynx seen in our department from 1970 to 1982 were evaluated. The 5- and 10-year actuarial survival rates were 62.0% and 42.0%, respectively. Patients seen from 1970 to 1979 were treated by radiotherapy to the primary site and upper neck, the lower neck being irradiated only in instances of massive disease. Those treated from 1980 to 1982 received elective irradiation of the whole neck, as well as adjuvant chemotherapy (consisting of cyclophosphamide, methotrexate, and either 5-fluorouracil or bleomycin) for 6 to 12 months after completion of radiotherapy. Comparison of 3-year actuarial survival (61.4% versus 83.3%) and disease-free survival (49.7 versus 77.0%) rates show significantly improved results (P less than 0.05) for those receiving combined therapy. In addition, significantly fewer (P less than 0.05) distant metastases appeared in the combined therapy group at 18 months. A retrospective analysis comparing those patients who received full-neck irradiation and adjuvant chemotherapy with those who received full-neck irradiation alone showed a significantly improved survival (P less than 0.02) and disease-free survival (P less than 0.05) for those patients with undifferentiated carcinomas, including lymphoepitheliomas, who received adjuvant chemotherapy.
Hurthle cell carcinoma of the thyroid gland. A tumor of moderate malignancy.
Hurthle cell carcinoma is a rare thyroid cancer histologically related to the well-differentiated malignancies of the thyroid gland. This report presents the evaluation of 30 years experience in treating 17 patients (out of 549 thyroid cancer patients) with Hurthle cell carcinoma. All 17 patients were treated surgically. Six patients (35.3%) died of their thyroid disease. Survival rates for 10 and 15 years were 63.7% and 25%, respectively. These rates are above those of high-grade malignancies and below those of low-grade malignancies of the thyroid gland. Nonsurgical treatment, including radioactive iodine therapy, is disappointing; thus, initial radical surgery is recommended as the treatment of choice.
[Coexistence of Hashimoto's disease and thyroid carcinoma].
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