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Biomedical subjects

M Glezerman

Publications and source records attributed to M Glezerman.

At least 37 records · Page 2Linked to original sources

Cervical cancer in Jewish women.

Because of the known low incidence rate of cervical cancer in Jewish women, less than appropriate attention has been focused on this type of malignancy in Jewesses. We have summarized our experience with 144 cases of cervical cancer diagnosed during 25 years in South Israel. In recent years a remarkable, although not statistically significant, increase in the number of patients with cervical cancer could be observed. Only two of ten patients were diagnosed at preinvasive stage. In contrast with previous reports we did not find women of Asian and African origin to be overrepresented, but patients from these origins were more often diagnosed at a higher stage than were patients of European origin. Adenocarcinoma accounts for almost 19% of the cervical cancer in premenopausal women. A very low rate of early detection of cervical cancer and a trend of rising incidence of cervical cancer in Jewish women urgently require a reevaluation of health care policy. Large-scale screening programs, perhaps initially in defined high-risk groups are needed.

Adenocarcinoma

Synchronous carcinomas of endometrium and ovary.

Five cases of synchronous carcinomas of uterine endometrium and ovary are reported. All uterine cancers were typical endometrial adenocarcinomas. Among the ovarian cancers, four were serous papillary cystadenocarcinomas and one was an endometrioid carcinoma. There is much controversy with respect to staging and management of such cases since these tumors may represent either two synchronously occurring primaries or a single primary with metastases. It is suggested that when each tumor is confined within the limits of its tissue of origin the tumors may be considered as two separate primaries and surgery may be less aggressive. When there is evidence that at least one tumor is spreading to adjacent tissues and organs the question of two separate primaries or one metastatic tumor becomes academic only and aggressive surgical treatment with adjuvant chemotherapy is indicated.

Adenocarcinoma

Proliferating trichilemmal tumor of the vulva. Case report and review of the literature.

A case of proliferating trichilemmal tumor, otherwise known as pilar tumor, occurring in the dermis of the left labium majus of a 65-year-old woman, is presented. To our knowledge, this is the second reported case of such a tumor occurring in this location. The origin of this neoplasm, the reasons for its rarity at this site, and the range of its biological behavior are discussed in relation to the clinical manifestations of this case.

Aged

Placebo-controlled trial of topical interferon in labial and genital herpes.

The efficacy of topical interferon-beta (IFN-beta) treatment was assessed in 25 patients with herpes of the lips or genitals who completed a 2-year follow-up in a double-blind placebo-controlled trial. IFN-beta gel (10(5) U/g) 4 times daily (about 2 x 10(4) U) applied locally during eruptions (about 10 days) reduced the mean number of recurrences (p less than 0.007) and the duration of eruptions (p less than 0.007): in the placebo group these indices did not change significantly. Reduction of symptoms and severity was noted in 11 of 12 patients on IFN-beta and in only 1 on placebo. No important side-effects were recorded. Topical IFN-beta may therefore be advantageous as a time-limited local treatment of recurrent herpes simplex virus infections of the genitals and lips.

Administration, Topical

Results of in vitro fertilization in women with antisperm antibodies in serum, cervical mucus, and follicular fluid.

This study was undertaken to investigate the presence of antisperm antibodies (ASA) in serum, cervical mucus, and follicular fluid (FF) of women undergoing in vitro fertilization and embryo transfer (IVF-ET). IgG and IgA ASA directed mostly against sperm head were found at similar concentrations in serum, cervical mucus, and FF of 2 of 34 patients. Ninety-one percent fertilization and 100% cleavage rates, respectively, were observed in one of the two patients. No fertilization occurred in the second patient. In both women, in vitro sperm penetration tests revealed hostile mucus and repeated postcoital tests were poor. It is concluded that the sperm-cervical mucus penetration test and mucus ASA measurements are useful in establishing the diagnosis of immunological infertility.

Adult

Involvement of the spleen in ovarian adenosquamous carcinoma.

Classification of ovarian tumors according to FIGO does not take into account involvement of spleen. A patient who appears to be the first reported case of widespread carcinoma of the ovary with involvement of the splenic parenchyma is presented.

Adenocarcinoma

Acid phosphatase levels in follicular fluids following induction of ovulation in in vitro fertilization patients.

Considerable evidence indicates that changes in acid phosphatase (AP) activity at the ovarian level play a role in the process of ovulation. In this study the concentrations of AP were determined in follicular fluids collected from follicles of 52 women at the time of laparoscopy performed in connection with an in vitro fertilization program. In each of the 52 women at least one ovum was harvested. Of the 52 ova, 28 cleaved in vitro, while in 24 ova cleavage was not seen. Levels of AP in follicular fluids of women whose ova did not cleave were significantly lower than those found in follicular fluids of women with at least one ovum undergoing cleavage: 0.45 +/- 0.14 (SE) and 4.78 +/- 0.37 Bess Lowry Units (BLU), respectively. Comparison of AP levels in follicular fluids of women who conceived (5) and women whose ova cleaved, but in whom pregnancy was not achieved (23), did not reveal significant differences: 5.87 +/- 1.29 and 4.55 +/- 0.35 BLU, respectively. Moreover, the enzyme level was typical for a woman and not for a follicle. Fluids of two different follicles of the same woman, when one ovum cleaved and one did not, showed similar AP levels. AP levels were high in all samples follicles of women in whom at least one ovum cleaved. These findings indicate that the presence of certain levels of acid phosphatase represents an important, albeit not the sole, condition for ovum maturation. Moreover, the follicular fluid levels of AP could serve as an indicator of proper timing of the follicular puncture in relation to the human chorionic gonadotropin injection (or the luteinizing hormone peak).

Acid Phosphatase

Bilateral ovarian involvement as the only manifestation of malignant lymphoma.

A 16-year-old girl presented with a large pelvic mass. At laparotomy, bilateral ovarian tumors were disclosed and bilateral salpingo-oophorectomy was performed. No evidence of extra-ovarian disease was found. Histopathological examination and histochemical immunoperoxidase studies demonstrated the tumors to be malignant lymphoma of the lymphoblastic type. The patient had radiotherapy and systemic chemotherapy and more than 10 years later she is alive with no evidence of recurrent disease. The rarity of ovarian involvement as the initial manifestation of malignant lymphoma is discussed. The question of whether this patient represents a case of a primary ovarian malignant lymphoma or merely represents a case of ovarian initial manifestation of an occult generalized disease cannot be answered.

Adolescent

The setting-up of an ambulatory urologic-gynecologic service. Management of patients and results.

An ambulatory set-up is presented which comprises a simple armamentarium for management of women complaining of urinary stress incontinence. Since history appeared to be not sufficiently reliable for management of patients, diagnosis was based mainly on cystomanometry and radiology. Of 58 women who have completed at least six months of follow-up, 11 had been diagnosed as suffering from detrusor instability (DI) and 47 from genuine stress incontinence (SI). Treatment was medical in the former group and surgical in the latter. Significant or complete relief of symptoms was reported in 91% of the former group and in 81% in the latter.

Adult

Evaluation of reliability of history in women complaining of urinary stress incontinence.

It was the aim of this study to evaluate critically the value of history in patients complaining of urinary stress incontinence. Diagnosis was established mainly by radiologic and cystomanometric assessment. History included 21 symptoms subdivided into various items. Only 3 symptoms were proven significant in distinguishing between various diagnostic groups. Assessment of stress incontinence should be regarded as incomplete without other means of evaluation in addition to history.

Adult

Choriocarcinoma associated with undetectable levels of human chorionic gonadotropin.

A case of choriocarcinoma is presented which developed during close follow-up for hydatidiform mole. Serum levels of beta subunits of human chorionic gonadotropin (beta-HCG) were assessed by radioimmunoassay (RIA) before, during, and after diagnosis of choriocarcinoma and remained below the sensitivity level of the assay. To our knowledge, this is the fourth reported case where choriocarcinoma was not associated with the presence of elevated beta-HCG levels.

Adult

Steroid receptors in a granulosa cell tumor (GCT) in an infant with precocious puberty.

A granulosa theca cell tumor was found in a 10-month-old girl with precocious puberty. Steroid hormone receptors were measured in fractionated tumor cells. Estrogen and progesterone receptors were measured in the cytosol, and estrogen receptors were measured in the nuclear fraction of the tumor. Although high affinity (Kd 0.4 nM) progesterone receptors were present in the cytosol of this tumor-54 fmole/mg protein-no cytosolic estradiol receptors could be detected; however, these receptors were found to be tightly bound to the nuclear fraction of the tumor. The nuclear protein had lower apparent Kd for the hormones-5.4 nM. This tumor produced and released various steroid hormones. The plasma steroid levels before removal of the tumor were 1,200 pg/ml for estradiol, 350 pg/ml for testosterone, and 5 ng/ml for progesterone. All these steroid hormones declined postoperatively to undetectable levels, with total remission of pubertal signs. Plasma-dehydroepiandrosterone, prolactin, and gonadotropin levels were in the normal range before and after surgery. These results suggest that cytosolic progesterone receptor as an estrogenic marker and/or nuclear estrogen receptors may predict the hormonal dependency of these estrogen-producing tumors.

Cell Nucleus