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Biomedical subjects

M Michowitz

Publications and source records attributed to M Michowitz.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Anterior resection with colo-anal anastomosis for low rectal cancer].

Between May 1989 and April 1993 we treated 108 patients, aged 44-82 years, for rectal cancer. Of them, 7 men and 2 women underwent anterior resection with colo-anal anastomosis. In this group the average distance of the tumor from the anal verge was 6 cm. Follow-up ranged from 12-48 months. There was no operative mortality. Perioperative morbidity included wound infection in 1 patient and pelvic sepsis in another; temporary disturbances in micturition occurred in 4; 1 developed an anastomotic stricture and another intestinal obstruction; 1 died of systemic spread; another was reoperated and salvaged, but had a local recurrence 3 years after the first operation. Continence was achieved in 6, while 3 had minor impairment of control. Frank incontinence did not occur. We believe that anterior resection with colo-anal anastomosis in low rectal cancer avoids a permanent colostomy, while meeting oncological and functional criteria. We advocate this procedure in selected patients with low rectal cancer.

Adult↗
PubMed1994

[Subdural empyema complicating sinusitis].

Paranasal sinusitis complicated by subdural empyema (SDE) in a 14-year-old boy is described. He presented with fever, headache and vomiting. X-rays revealed left maxillary and bilateral frontal sinusitis. While in the emergency room he had seizures; CT-scan showed an air leak adjacent to the right frontal sinus. Despite intravenous antibiotics, left hemiparesis developed and repeat CT showed interhemispheric SDE. Frontal craniotomy was performed and a large amount of purulent material was drained. Recovery followed 4 weeks of intravenous antibiotic treatment without neurologic sequelae. SDE is a rare complication of paranasal sinusitis and constitutes approximately 20% of all localized intracranial infections. Clinical features include fever, headache, vomiting, convulsions and neurologic deficits. Modern imaging methods and combined surgical and antibiotic treatment have lowered mortality to 5-10%. A high index of suspicion is important for early diagnosis and successful treatment.

Adolescent↗
PubMed1994

[Surgical treatment of thoracic esophageal diverticula].

Symptomatic pulsion or "true" diverticula of the lower and mid-esophagus (thoracic esophagus) are relatively rare. Associated motility disorders occur in most patients with epi-phrenic diverticula. These functional and obstructive disturbances should be looked for, diagnosed and treated. Surgical intervention such as diverticulectomy might prevent respiratory and nutritional complications and give significant relief of symptoms. We describe our experience in the surgical treatment of a 67-year-old man and 2 women, aged 69 and 73, respectively, with symptomatic thoracic diverticula.

Aged↗
PubMed1994

[Large simple liver cyst treated laparoscopically].

Simple liver cysts of various sizes are present in 1% of the population. Most are found incidentally and require no treatment. However, in a few the cyst is symptomatic and requires surgery: celiotomy and unroofing of the cyst. A 64-year-old woman with a symptomatic, simple cyst of the liver underwent laparoscopic surgery. After an uneventful course she was discharged on the 3rd postoperative day. Simple liver cysts can be safely treated by laparoscopic surgery.

Cysts↗
PubMed1994

Drug resistance and its counteraction by cyclosporin A in function of metastatic potential in the Lewis lung carcinoma system.

Tumor progression (TP) is often accompanied by evolution of drug resistant clones. Decreased intracellular accumulation of cytotoxic agents is probably the major mechanism of drug resistance. In the present study, we tried to examine the possibility to overcome the resistance to adriamycin (ADR) treatment, by cyclosporin A (CS) in two models of TP in the Lewis lung carcinoma (3LL) system. The first model consisted in the comparison of primary tumor cells (3LL-PT) to metastatic cells (3LL-MT) and the second consisted in comparison of lung metastases of the highly malignant variant D122 to those of the parental 3LL tumor. Cyclosporin had a weak augmenting effect on ADR uptake, in the two more malignant cell variants and no influence on the 3LL-PT cells, according to FACS analysis. Cytofluorometry also showed practically no effect of CS on cell size, unlike the effect of other chemosensitizers, such as membrane active agents. In order to find out whether CS counteracts resistance to ADR despite the fact that it does not increase cytotoxic agent uptake, we examined its effect on in vitro proliferative capacity of the 3LL-PT cells. CS in combination with ADR had a more pronounced effect, as compared to single treatments on cell proliferation. The low effect of CS on ADR uptake according to FACS analysis, and by contrast, its efficiency to overcome resistance to ADR according to the in vitro growth results, suggest that the mechanism of the CS action as a chemosensitizer is not related to the p-glycoprotein (P-G-P), known to be overexpressed in the typical multidrug-resistance (MDR) phenotype. A better understanding of the complexity of MDR mechanisms may contribute to the design of new modalities to overcome this phenomenon, which still limits effectiveness of cancer cure, to the early stages of the disease.

Animals↗
PubMed1993

[Pharyngo-gastric anastomosis following pharyngo-laryngo-esophagectomy for cancer].

Cancer of the hypopharynx and cervical esophagus usually presents in an advanced stage. Treatment is therefore aggressive and involves a combination of surgery and radiotherapy. Pharyngo-laryngo-esophagectomy, gastric pull-up and pharyngo-gastric anastomosis has become the method of choice for extensive tumors in the past decade. 3 men, aged 51, 51 and 74, respectively, who had extensive cancer of the hypopharynx and cervical esophagus and underwent this procedure are described. 2 made full, rapid recoveries without complications, but in the third, there were postoperative complications due to severe chronic lung disease. Proper selection of patients may reduce considerably the morbidity and mortality of this surgical procedure.

Aged↗
PubMed1992

[Surgery for complete rectal prolapse in adults].

Surgery for complete rectal prolapse was performed in 17 women and 3 men between November 1986 and April 1991. An abdominal approach with posterior rectopexy was used in 17. The Thiersch procedure of anal narrowing was performed in 3 high risk patients. All recovered without major complications. Urinary tract infection developed in 15% and postoperative fecal impaction in 10%. Anal continence improved in 70% of those previously incontinent. There was no recurrence of complete rectal prolapse during follow-up. All patients rated the operative results as either good or very good.

Adult↗
PubMed1992

Effect of a membrane-active agent on uptake of adriamycin in Lewis lung carcinoma cells derived from 'primary' and 'metastatic' growths.

The treatment of metastatic growth still constitutes a challenge for cancer research. Tumor progression is often accompanied by a loss in sensitivity to previously efficient drugs. Decreased intracellular accumulation of cytotoxic agents is probably the major reason for drug resistance, although other mechanisms have also been described. Properties of the cell membrane have been shown to determine the metastatic phenotype. This cellular organelle is also responsible for the multiple drug resistance phenomenon. Membrane-active agents may increase cell permeability to drugs, counteracting thereby drug resistance. In the present study the effect of the nonionic detergent Tween 80 on sensitivity to adriamycin (ADR) of cells derived from Lewis lung carcinoma 'primary tumors' (PT)-the local growth following subcutaneous inoculation - and 'metastatic tumors' (MT) - lung tumors which develop following intravenous injection - was compared. Flow cytometry analysis demonstrated several differences between cells derived from the PT and the MT: (1) single ADR treatment showed that MT cells possessed a lower percentage of a high ADR permeability subpopulation than PT cells; (2) a dose-dependent shift to a higher ADR accumulating population was seen in the presence of Tween 80 for both cell types. However, the increase in percentage of high ADR permeability cells was more pronounced in MT (up to x4.7) than in PT (up to x1.3) cells. This differential effect of the membrane-acting agent was evident at various ADR (10-50 micrograms) and Tween 80 (0.1-0.4%) concentrations. The present results corroborate previous data obtained in our group in another tumor progression model, AKR lymphoma.

Animals↗
PubMed1992

Solcoderm as alternative conservative treatment for acute anal fissure: a controlled clinical study.

Acute anal fissure is a common malady that results in morbidity. If a patient is not responsive to conservative treatment, the current recommended treatments are either anal dilatation or lateral internal sphincterotomy. Both operations promise relatively good results, but the recurrence rates are about 16 per cent and 7 per cent, respectively. This fact, together with possible postoperative complications and costs, justifies trying conservative treatment before referring patients for surgery. The authors treated a study group of 25 patients with a topical application of Solcoderm. Another group of 25 patients concurrently treated with the usual conservative treatment served as the control group. Analysis of the early and late results proved Solcoderm to be simple to use, safe, without systemic side effects, cost-effective, and with statistically significant better outcome. Consequently, the authors believe that this method of treatment is justified in cases of acute and fissure and should be attempted before operation.

Acetates↗
PubMed1992

Differential metastatic capacity of three AKR lymphoma variants.

The comprehension of tumour progression has advanced due to the use of various models, the most rewarding being probably the study of malignancy variants derived from the same tumour. In the present study the biological behaviours of three AKR lymphoma variants were compared. The three variants, TAU-33, TAU-38 and TAU-39, differed markedly in biological behaviour. The TAU-39 variant formed very large 'primary tumours', TAU-33 produced local growths of intermediate size, and TAU-38 formed small s.c. tumours. However, the metastatic potentials of the variants were inversely related to their ability to produce local tumours. According to various parameters (spread to organs, cachexia and mice mortality rate), the variant of highest metastatic potential was TAU-38, the one of intermediate ability TAU-33 and the TAU-39 had the least aggressive behaviour. A lack of difference in invasive capacity as well as a similar ranking of malignancy by both s.c. and i.v. inoculation indicate a differential behaviour in late metastasis phase. Tumour progression models may contribute to a better understanding of this threatening process and to testing of new treatment modalities suitable for cancer at different stages.

Animals↗
PubMed1991

Differential sensitivity to hyperthermia of the F1 and F10 B16 melanoma variants.

The currently available antitumoral therapeutic modalities are most often inefficient against metastatic disease. The metastatic phenotype has been shown to be largely determined by cell membrane properties. The cell membrane could therefore be considered as a possible target for antimetastatic drugs. In the present study we examined the effect of hyperthermia (the antitumoral effect of which is based, at least partly, on an action on the cell membrane) on the F1 and F10 variants of B16 melanoma. Cells of the more malignant variant, F10, were found to be markedly more sensitive to hyperthermic treatment than those of the less malignant one, F1. One hour in-vitro treatment by supranormal temperatures (ranging from 40 to 46 degrees C) resulted in a differential effect with regard to both proliferating capacity of the cells in vitro and tumorigenic ability following inoculation to mice. Our present results in the B16 melanoma corroborate data obtained by us in another tumour system, the AKR lymphoma. Study of the effect of membrane-acting agents on tumour variants differing in degree of malignancy might result in the finding of antitumoral agents efficient against advanced cancer.

Animals↗
PubMed1990

AKR lymphoma malignancy variants differing at late phase of metastasis.

The biological behavior of two AKR lymphoma variants, the TAU-39 and TAU-38, of low (LM) and high (HM) malignancy, respectively, has previously been described. In the present study an attempt was made to determine the phase in the metastatic process in which these variants differ. Two types of findings suggest that the two variants differ in the late phase of the process; (a) no difference in the degree of invasiveness of the primary tumor to the surrounding tissues has been found between the two variants, both being highly invasive; (b) comparison of malignant behavior in the "spontaneous metastasis" versus the "experimental metastasis" tests showed a similar ranking of malignancy of the two variants.

Animals↗
PubMed1990

Change in the role of the spleen from protective to harmful following tumor progression in AKR lymphoma.

Tumor progression has been reported to be often accompanied by a loss of sensitivity to various elements of the immune system. In the present study, three variants of malignancy of AKR lymphoma were compared as to the host reaction they elicit. Splenectomy caused an acceleration of growth of the low-metastasizing tumor, slightly inhibited the growth of the tumor of intermediate malignancy and significantly inhibited the development of the high-metastasizing lymphoma. These results suggest that splenic elements exert an inhibitory effect on the low-metastasizing tumor and a growth-stimulatory effect on the more malignant ones. While decreased sensitivity to various host defense mechanisms following tumor progression has been amply documented, the present study shows a more severe phenomenon: increased malignancy can be accompanied by a deviation of the host immune reaction from tumor growth inhibition to growth stimulation.

Animals↗
PubMed1989

Brown-bowel syndrome.

Extensive brownish discoloration of the small bowel is rare and has been described mainly in association with malabsorption disorders. It is related to deficiency of the fat soluble vitamin E. Vitamin E is an antioxidant substance that prevents peroxidation of unsaturated fatty acids. Vitamin E deficiency may result in oxidized lipids, which when polymerized with polysaccharides form the brown, PAS-positive pigment termed ceroid or lipofuscin. The deposition of pigmented granules in the effected tissues accounts for the brownish discoloration. We present three patients ultimately found to have "brown bowel syndrome (BBS)," in which the symptoms, preoperative findings, and respective diagnoses were different. In all three patients, serum Vitamin E levels were found to be extremely low.

Aged↗
PubMed1988

Abdominal operations without nasogastric tube decompression of the gastrointestinal tract.

The routine use of nasogastric (NG) drainage during and after abdominal surgery was examined. One hundred and fifty patients who underwent various abdominal operations with a Levine tube served as a control group (retrospective group). The tubeless study group (prospective group) of 150 patients was randomly and blindly divided into three equal subgroups. Subgroup A patients were operated on without any NG tube. The tube in subgroup B patients was inserted after induction of anesthesia and removed one hour after the operation. The tube in subgroup C was inserted as in subgroup B, but was taken out 12 hours after the operation. The total number of complications in the intubated group was significantly higher than in the tubeless group (P less than 0.01). High temperature, atelectasis and miscellaneous complications were more frequent in the control group than in the study group (P less than 0.01). Other complications such as nausea, vomiting, bronchopneumonia, and gastric dilatation, as well as the resolution of the postoperative ileus and hospital stay, were not of statistical significance. Fewer miscellaneous complications (P less than 0.05) and less patient discomfort were found in subgroup A than in the other tubeless subgroups. Complications in the study group were easily controlled by conservative treatment and no serious complications resulted. Therefore, the routine use of NG suction as adjunctive therapy following abdominal operations is not advocated by this study.

Abdomen↗
PubMed1987

Effect of splenectomy on treatment of Lewis lung carcinoma by an immunomodulatory polysaccharide and a cytotoxic agent.

The effect of the spleen on the efficiency of chemotherapy (cyclophosphamide) and immunotherapy (the polysaccharide levan) of C57BL mice bearing the Lewis lung carcinoma was studied. The development of Lewis lung carcinoma caused a gradual splenomegaly in the C57BL mice. Splenectomy did not, however, affect tumor growth in the nontreated host. Levan induced a pronounced splenomegaly. Splenectomy reduced markedly the antitumoral effect of the polysaccharide. These results indicate that spleen elements participate in the inhibitory activity of levan. By contrast, splenectomy had no effect on the efficiency of treatment of cyclophosphamide.

Adjuvants, Immunologic↗
PubMed1987

Relationship of nuclear appearance to stromal invasion in human breast cancer.

Two biopsies of intraductal and invasive lobular carcinoma of the breast and 11 biopsies of intraductal and invasive carcinoma of the breast were examined by automated micromensurative techniques for mean nuclear area of carcinoma cells in intraductal and in invasive compartments. The nuclei of invasive carcinoma cells tended to be smaller when they invaded stroma as single cells or as "thin strands" than when they invaded as part of large sheets of cells. Cells in direct apposition with the stroma usually had smaller nuclei than cells which were found centrally in large confluent sheets of cells. Intraduct carcinoma cells approached, in size, invasive cells which formed confluent sheets, rather than cancer cells which invaded as single cells. The nuclei of cells which invaded in small groups were usually darker than those of cells in confluent sheets, which were usually more vesicular.

Adult↗