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Biomedical subjects

N Walach

Publications and source records attributed to N Walach.

50 records · Page 3Linked to original sources
PubMed1976

The effect of radiation therapy on lymphocyte subpopulations in cancer patients.

The proportion of T and B lymphocytes in the peripheral blood was determined in patients with either mammary cancer or with various pelvic malignancies. In cancer patients studied prior to irradiation the level of cells forming either E-rosettes or EAC'-rosettes was similar to that found among healthy controls. Radiation therapy resulted in a striking lymphopenia. The level of cells with T-cell markers was diminished to a greater extent than the level of cells with B-cell markers. The relative proportion of T-cells forming high affinity E-rosettes was not reduced following radiation, so that it can be concluded that radiation affects predominantly the subpopulation of T-cells which do not form high affinity E-rosettes. Irradiation of the pelvic area resulted in a more rapid reduction of the level of T lymphocytes than irradiation of the mediastinum, although the final relative proportions of the cells were similar in both groups of patients. The results of the present study suggest that the reduction of the level of T lymphocytes following irradiation results from its effect on the lymphocytes in the major blood vessels, and that radiation of the thymus is not a prerequisite for this phenomenon.

B-Lymphocytes↗
PubMed1975

Cancer of the thyroid following radium application to the neck.

A young patient, suffering from thyroid carcinoma 24 years after radium treatment of the neck, is presented. The cancer appeared in the area which has been irradiated. In the present case, the thyroid was exposed to a relatively low dose of radiation. The importance of ionizing radiation and its carcinogenic effect in the juvenile thyroid are discussed.

Adult↗
PubMedDate not supplied

Leukocyte alkaline phosphatase and carcinoembryonic antigen in lung cancer patients.

Leukocyte alkaline phosphatase (LAP) scores in peripheral blood and plasma carcinoembryonic antigen (CEA) levels were determined in 58 lung cancer patients and compared with those of 22 healthy persons, who served as controls. In the control group we found LAP scores of 54 +/- 28 and CEA levels of 4 +/- 3 ng/ml. The 97.7% confidence intervals are: LAP score < 110 and CEA level < 10. In the patients with limited lung cancer we found LAP scores of 152.4 +/- 36.7 and CEA levels of 22.7 +/- 48 ng/ml. The 97.7% confidence intervals are: LAP score > 78.6 and CEA level > 0. In the patients with extensive lung cancer we found LAP scores of 272 +/- 49 and CEA levels of 47.5 +/- 80.4 ng/ml. The 97.7% confidence intervals are: LAP score > 174 and CEA level > 0. The sensitivity of each marker is discussed, here as percent of false-negative results, denoted PFN, and meaning that with a chosen threshold for the marker level, only PFN% of the patients with a given condition (e.g. extensive lung cancer) might have a marker level less than the chosen threshold and could therefore be assumed healthy. The sensitivity of the LAP score is 0.05% PFN for the group of patients with extensive lung cancer, and we conclude that indeed LAP score < 110 indicates a very low probability of having extensive malignancy. The sensitivity of the CEA level is 32% PFN. The sensitivity of the LAP score to limited lung cancer is 12% PFN for the group of patients with that condition compared with 40% of CEA. The specificities of both LAP score and CEA levels, expressed as percent of false-positive results in the control group, are fair (2.3%), provided that the common conditions, other than cancer, that elevate LAP score and/or CEA levels are well known and can be eliminated by the physician. It is concluded that the LAP score is considerably more useful than the CEA level as a marker for extensive lung cancer.

Adenocarcinoma↗
PubMedDate not supplied

Leukocyte alkaline phosphatase as a probable predictor of the metastatic state in breast and colon cancer patients.

Leukocyte alkaline phosphatase (LAP) score in peripheral blood was determined in 45 new cancer patients, 30 with breast cancer and 15 with colorectal cancer, with nonmetastatic disease. The LAP scores were performed immediately after diagnosis or surgery, and later at intervals of 1-3 months, until clinical detection of metastases. The preliminary data presented here show that there may be some utility in measuring LAP score in patients with solid tumors on a serial basis to detect evidence of metastatic disease prior to its clinical recognition. In 22 out of 30 breast cancer patients and 11 out of 15 colon cancer patients, there were 'alarming signals' of metastases (defined in this study) in the data taken before the checkup in which metastases were diagnosed by other methods. We conclude that LAP scores should be introduced into routine checkup of breast and colon cancer patients and could be a helpful nonspecific additional element in detecting earlier metastatic disease during the follow-up of a patient. As an extrapolation from this study we suggest that work should be undertaken to explore the possibility that a sudden rise of LAP score in an otherwise healthy person, who has no known reason for an elevated LAP score, might be the very first measurable sign of cancer.

Alkaline Phosphatase↗
PubMedDate not supplied

Clinical determinants of long-term survival in patients with glioblastoma multiforme.

Repeated reports of more than ten years postoperative survival in patients with glioblastoma multiforme (GM) have appeared in the literature over the last decades. Authors have tried to identify the clinical, therapeutic and histological features determining long-term survival. We present two patients in whom, after radical removal of the tumor followed by conventional radiation, there has been no recurrence for at least ten years. The young age of the patients and the radical surgical approach were in accordance with previous reports of long-term survival. Nevertheless, one tumor originated from the thalamus, a location considered to be of unfavorable prognosis. We therefore further discuss the value of clinical signs as determinants in the prognosis of GM.

Adolescent↗
PubMedDate not supplied

Meningiomas after radiotherapy for tinea capitis--still no history.

AIMS AND BACKGROUND: To review the clinical, radiological and histological findings of 19 patients with radiation-induced intracranial meningiomas treated at our neurosurgical department between 1981 and 1996. METHOD: The records of 18 patients with intracranial meningiomas who underwent low-dose radiation for tinea capitis in childhood, and of one patient irradiated for pituitary adenoma, were analyzed in respect of the previously reported features of postradiation meningiomas. RESULTS: The mean age of the patients with low-dose radiation-induced meningiomas was 58 years and the mean shortest onset latency was 48 years. The male to female ratio was 1.1:1. Forty-seven percent of patients presented with mental changes and/or focal neurological signs, 21% with signs of increased intracranial pressure and 26% with seizures. Calvarial location of the meningiomas was found in 54% of patients and in one patient the tumor arose from the skull base. Multiple tumors were present in 15% of patients and 29% of the meningiomas displayed malignant features on histological examination. A significantly lower meningioma recurrence rate was found in our series compared to the recurrence rate in the reported series of postradiation meningiomas. Five patients had a history of a second neoplasm other than meningioma. CONCLUSION: Our series of low-dose radiation-induced meningiomas represents one of the largest of its kind in the English literature. The patients did not differ substantially in sex ratio, tumor localization, multiplicity and histological features from the previously reported postradiation meningioma patients, except for the significantly lower tumor recurrence rate. It would seem that over the next years we will be further witnessing the deleterious effects of low-dose radiation administered in childhood.

Adult↗
PubMedDate not supplied

Leukocyte alkaline phosphatase, CA15-3, CA125, and CEA in cancer patients.

Peripheral blood leukocyte alkaline phosphatase (LAP) scores and CA15-3, CA125, and CEA levels in plasma were measured in 57 patients with metastatic breast, ovarian, and colorectal cancer, respectively, and in 79 patients with the same types of nonmetastatic cancer. The mean LAP scores of the metastatic cancer patients (261, 272 and 275 for breast, ovary and colon, respectively) were significantly higher than those of the nonmetastatic cancer group (70, 68 and 57, respectively). There was no overlap between the 95% confidence intervals of the two groups (i.e., metastatic versus nonmetastatic), and no patient known to be metastatic had a LAP score within the normal range. The mean levels of other markers in the metastatic patients (CA15-3, 63.4 mu/ml; CA125, 104.8 mu/ml; and CEA, 51.8 ng/ml for metastatic breast, ovarian, and colon cancer, respectively) were also higher than in the nonmetastatic patients (CA15-3, 24 mu/ml; CA125, 25.3 mu/ml; and CEA, 5.8 ng/ml for nonmetastatic breast, ovarian, and colon cancer, respectively). However, the 95% confidence intervals of the nonmetastatic and the metastatic patients overlapped so that there were false-negatives and/or false-positives when the other markers were used. We therefore conclude that the addition of the LAP score to conventional cancer markers could be helpful for the diagnosis of recurrence and follow-up of cancer patients and suggest that our results be confirmed by further studies on a larger series of patients.

Adult↗
PubMedDate not supplied

Skilled nursing facilities as a setting for comprehensive care of older people with advanced cancer: a model of care in the post oncologic stage.

METHODS: We surveyed the elderly cancer patients admitted to the Skilled Nursing Wards of Shmuel Harofe Hospital, Geriatric Medical Center, during a 5-year period. RESULTS: The 304 elderly patients admitted with advanced cancer represented 16% of the skilled nursing patients admitted during this period. Their average time of survival was 4.2 months, ranging from 9.1 for breast cancer to 1.8 months for gastric cancer. Ninety-five percent were severely dysfunctional, and all had a high rate of medical complications. CONCLUSIONS: Our study reveals the benefits of a skilled nursing system that provides comprehensive care, flexibility, and continuity of care at a difficult and demanding stage of this illness. This model functions at reasonable cost, and we recommend it for the care of elderly patients with advanced cancer in the post oncologic stage.

Journal Article↗