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Biomedical subjects

N Freidin

Publications and source records attributed to N Freidin.

15 recordsLinked to original sources
PubMed1995

Intermediate and high-grade gastric non-Hodgkin's lymphoma: a prospective study of non-surgical treatment with primary chemotherapy, with or without radiotherapy.

The role of surgery as initial treatment in gastric lymphoma remains controversial. We have prospectively evaluated a stomach conservation strategy in histologically aggressive gastric lymphoma, using primary adriamycin-containing chemotherapy, followed by involved-field radiotherapy in patients with limited disease. Twenty-six patients (median age 69 years) were entered in this study; 15 had stage I disease, 7 had stage II disease and 4 had stage IV disease. The chemotherapy combinations were CHOP (18 patients) and ProMACE/MOPP (8 patients). Radiotherapy was given to 11 patients. Of the 24 patients evaluated for response, 18 (75%) achieved endoscopically-confirmed complete response and 4 (17%) partial response. During follow-up (median 22 months), none of the complete responders developed recurrent lymphoma. Gastric resection was performed in 1/26 patients who did not respond to primary chemotherapy. There were no cases of perforation, but three patients (12%) developed acute gastro-intestinal bleeding a few days after the onset of chemotherapy, one of whom required a surgical devascularization procedure. There was no treatment-related mortality. These data further support the non-surgical approach in histologically aggressive gastric lymphoma, using primary chemotherapy with or without radiation therapy.

Adult↗
PubMed1991

Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis.

Nocturnal gastro-oesophageal reflux may be important in the pathogenesis of reflux oesophagitis. This study aimed to determine whether: (1) gastro-oesophageal reflux occurs during sleep in patients with reflux oesophagitis and, if so, to explore the mechanism, and (2) the sleep pattern of patients with oesophagitis is different from that of control subjects. After a standard evening meal, simultaneous manometric, oesophageal pH, and polysomnographic recordings were obtained in 11 patients with endoscopic oesophagitis and 11 control subjects. Patients with gastrooesophageal reflux disease had significantly more total reflux episodes throughout the nocturnal monitoring period than control subjects (105 v 6). Ninety two of 105 episodes of gastro-oesophageal reflux in patients occurred during the awake state and 10 during sleep stage II. A number of reflux episodes occurred during brief periods of arousal from the various sleep stages. Of the 105 reflux events recorded in patients, 42 were induced by transient lower oesophageal sphincter relaxation, 20 by stress reflux, 22 by free reflux mechanisms, and in 21 the mechanism was unclear. The sleep pattern and the time spent in each sleep stage was not different between the two groups. It is concluded that the awake state is crucial for the occurrence of nocturnal reflux episodes in normal subjects as well as in patients with reflux oesophagitis and that the difference between the frequency of gastro-oesophageal reflux between normal subjects and patients cannot be explained by different sleep patterns.

Adult↗
PubMed1991

Does body posture affect the incidence and mechanism of gastro-oesophageal reflux?

We studied eight patients with gastro-oesophageal reflux disease to compare the frequency and mechanism of reflux in the upright and supine positions. Simultaneous oesophageal manometry and pH studies were performed on two separate days in each subject in the fasting and postprandial periods. The frequency of reflux tended to be higher in the upright position. The most prevalent mechanism of reflux in either position was transient relaxation of the lower oesophageal sphincter. The frequency of transient lower oesophageal sphincter relaxation was higher in the upright than in the supine position. There was no difference in the total reflux time, acid clearance time, and number of reflux episodes lasting longer than five minutes in the two positions. We suggest that daytime reflux (upright) may be as important as night time (supine) reflux in the pathogenesis of reflux oesophagitis and needs to be considered when treating patients with reflux disease.

Adult↗
PubMed1989

The hypertensive lower esophageal sphincter. Manometric and clinical aspects.

Controversy exists as to whether the hypertensive lower esophageal sphincter (HLES) represents a clinical motility disorder of the esophagus or is merely the right-sided expression of a normal distribution curve. In the present study we describe 16 patients with HLES, defined as a lower esophageal sphincter (LES) pressure of greater than or equal to 40 mm Hg (mean + 3 SD of controls) with normal peristalsis. All of the patients suffered from chest pain and nine from dysphagia. Delayed bolus transit at the gastroesophageal junction was demonstrated in four patients by radiography. Manometric studies showed that during swallowing the LES residual pressures were significantly greater (9.2 +/- 5.0 mm Hg) than observed in normal controls (1.8 +/- 2.2 mmHg) (mean +/- 1 SD). However, the percent LES relaxation in patients did not differ significantly from controls. Clinical improvement was associated with pharmacological or mechanical reduction of resting LES pressure with an accompanying fall in the nadir pressure. These observations suggest that HLES may have clinical and pathophysiological significance and that evidence for the entity should be sought during manometric studies in the clinical laboratory.

Adult↗
PubMed1989

Segmental high amplitude peristaltic contractions in the distal esophagus.

High amplitude peristaltic contractions in the distal esophagus ("nutcracker esophagus") is the most common manometric disorder seen in patients with noncardiac chest pain. Although this abnormality is found in the distal esophagus, the definition regarding its precise level in the esophagus is unclear. A careful analysis of 99 consecutive manometric tracings performed during a 1-yr period revealed that in patients with noncardiac chest pain and/or dysphagia, the location of the abnormal esophageal contractions varied: 1) in 11 patients the esophageal contractions were abnormal at 2 cm, as well as 7 cm, above the lower esophageal sphincter (LES); 2) the abnormality was limited to the 2-cm location above the LES in six patients; and 3) was confined to the 7-cm location above the LES in five patients. If the conventional criteria of averaging the distal esophageal contraction amplitudes at 2 and 7 cm above the LES were adopted, six of the 11 patients with segmental esophageal contraction abnormality would not have been identified. We suggest that, by inspection of each location of the distal esophagus separately, localized high amplitude contractions can be identified, and the distal 2 cm segment of the esophagus should be routinely included in the manometric evaluation.

Adult↗
PubMed1985

Recurrent intraabdominal abscess caused by Salmonella paratyphi C.

We describe a patient who suffered from recurrent intraabdominal abscesses. The last two of the three abscesses were certainly caused by Salmonella paratyphi C. The time interval between the first and the second abscess was 25 years, and that between the second and the third abscess was 20 years. Single infection with this microorganism is very rare in Israel, with only four known cases in the last 20 years. The annual frequency in the United States is 0 to 2 cases per year. In recent years, this infection has also been very rare in other parts of the world. Our case is unique as it recurred two or three times. The infection was probably dormant for a very long time. During the dormant years, the patient was clinically healthy. To our knowledge a recurrent infection with this microorganism has not previously been reported in the literature.

Abdomen↗
PubMed1984

Pancoast's syndrome in multiple myeloma.

A 74-year-old patient developed IgG multiple myeloma. 7 months later a right Pancoast's syndrome was observed. Computerized tomography established the extrapleural origin of the tumor. Fine needle aspiration revealed pathological plasma cells. Partial reduction of plasmacytoma was noted following radiotherapy, but the patient succumbed to pneumonia. Autopsy confirmed that a plasmacytoma caused the Pancoast's syndrome. The importance of early diagnosis and accurate therapy of this rare manifestation of multiple myeloma is discussed.

Aged↗
PubMed1977

Transmission and scanning electron microscopy study on plasma cell leukemia.

The peripheral blood cells of a patient with acute plasma cell leukemia were examined with transmission (TEM) and scanning (SEM) electron microscopes. The TEM features of the immature plasma cells comprised lobulated and irregulary shaped nuclei, with scanty heterochromating and bizarre nucleoli, parallel arrays of endoplasmic reticulum, cytoplasmic fibrils and numerous polymorphic mitochondria. SEM examination of the cells showed long, thin irregular ruffles, or round blebs on the cell surface, with appearance different from this observed on other types of leukemia. A remarkable clinical and hematological remission was achieved with administration of melphalan and steroids.

Acute Disease↗
PubMed1977

Hypercalcaemia, hyperphosphataemia and cytoplasmic inclusions in a patient with chronic lymphocytic leukaemia.

The history of a patient with chronic lymphocytic leukaemia (CLL), known for ten years, is presented. During the terminal stage of the disease, she developed hypercalcaemia and hyperphosphataemia. The peripheral blood and lymph node lymphocytes contained crystalline inclusions in the dilated cisterns of the endoplasmic reticulum. The possible mechanism of hypercalcaemia and hyperphosphataemia and the significance of the crystalline inclusion are discussed.

Aged↗
PubMedDate not supplied

The presence of hepatic intramitochondrial crystalline inclusions in routine liver biopsies.

Electron microscope examination of the liver biopsies of 33 patients revealed the presence of intramitochondrial crystalline inclusions (IMCI) in ten of them. Three patients suffered from iron deficiency anemia, porphyria, and malignant melanoma, conditions not reported to be associated with IMCI. Comparison of the clinical and laboratory findings of patients with and without IMCI did not show significant difference, or a clue for clarifying the nature of this phenomenon. Although these inclusions were reported in normal individuals, the possibility that they are the result of liver damage is not excluded.

Adult↗