Biomedical subjects

R Gal

Publications and source records attributed to R Gal.

At least 19 recordsLinked to original sources

PubMed1998

Echocardiography in the diagnostic evaluation of syncope.

To assess the role of echocardiography in patients with syncope, we studied 439 consecutive adults who were referred over a 7-year period. Of all patients, 251 (57.2%) were women, who were generally younger than male referrals. All 439 patients had interpretable echocardiographic studies. Results showed that of patients younger than 40 years of age, 72.8% had scans that were normal and 18.5% had mitral valve prolapse (MVP). All (other) patients in this age group with abnormal echocardiographic findings (8.7%) had either abnormal physical findings over the heart, an abnormal electrocardiogram, or an abnormal chest radiograph. In patients 60 years old and older, 29.6% had scans interpreted as normal and 4.6% had MVP (approximately half of these patients had at least moderate mitral regurgitation). The study demonstrates that patients younger than 40 years of age with syncope are likely to have a normal Doppler echocardiography or MVP without significant mitral regurgitation. Thus additional abnormal findings (e.g., heart murmur, abnormal electrocardiogram, or abnormal chest radiograph) may be needed before the patient is referred to the echocardiography laboratory.

Adolescent↗

PubMed1998

Oropharyngeal fatty infiltration in obstructive sleep apnea patients: a histologic study.

It has been suggested that due to fatty infiltration, obstructive sleep apnea (OSA) patients have a narrower pharyngeal airway than normal persons. To identify potential fatty infiltration of pharyngeal tissues that may contribute to OSA, a histologic study of the distal soft palate was performed. Histologic sections of 46 oropharyngeal specimens were evaluated. This included 25 overweight OSA patients (25/31), 6 normal-weight OSA patients (6/31), and a control group of 15 healthy (non-OSA) individuals. A semiquantitative analysis of the fatty tissue was performed. In all 31 OSA patients an excess of fatty infiltration was found in the histologic oropharyngeal specimens in comparison to the control group. No correlation was found between the pharyngeal fatty infiltration degree, the body mass index, and the apnea index. Irrespective of their body weight, in none of the patients without OSA was excessive fatty infiltration seen. It is suggested that excessive pharyngeal fatty infiltration plays a role in upper airway obstruction in OSA and that it can be associated with the development of apnea.

Adipose Tissue↗

PubMed1998

Skin surface proteolytic activity. Partial characterization and identification.

Skin surface proteolytic activity in the living animal was determined by a sensitive, non-invasive methodology developed in our laboratory. A non-leaky well was constructed on the shaved back of an anesthetized guinea pig. The well contained the reaction mixture including the substrate 125I-S-carboxymethylated insulin B-chain (ICMI). The proteolytic activity was shown to be time-dependent. The activity was strongly inhibited by pepstatin A, indicating the involvement of aspartic proteinase(s) such as cathepsin D and/or E. Pretreatment of the skin with propylene glycol blocked the proteolytic activity. The present study demonstrates the presence of proteolytic activity located on skin surface using a unique, non-invasive method for in situ proteinase determination in the living animal.

Animals↗

PubMed1998

Diagnostic value of AgNOR staining in thyroid cytology.

OBJECTIVE: To determine the value of the argyrophil nucleolar organizer region (AgNOR) technique on scrape cytology of thyroid lesions. STUDY DESIGN: AgNOR counts were evaluated in smears of 70 thyroid lesions that were sent for frozen section and included 15 cases of follicular adenoma, 10 cases of follicular carcinoma, 13 cases of papillary carcinoma, 23 cases of nodular goiter and 9 cases of Hashimoto's thyroiditis. Forty-one slides out of 70 were freshly prepared, and 29 slides had been previously stained with hematoxylin and eosin and then destained with alcohol. The number of AgNOR dots was recorded for 50 cells, and the mean number was calculated. RESULTS: The mean AgNOR counts were statistically significantly higher in malignant lesions in comparison to benign lesions. CONCLUSION: AgNOR staining could be of use in cytologic material from thyroid lesions.

Adenocarcinoma, Follicular↗

PubMed1997

Lymph node-revealing solution: simple new method for detecting minute lymph nodes in colon carcinoma.

PURPOSE: Detection of metastatic lymph nodes in colon cancer is essential for determining stage and, thus, therapeutic modalities. However, very small lymph nodes can easily be missed during routine examination. The aim of this study is to describe a new and easy technique for detecting tiny nodes in colonic specimens. METHODS: Thirty problematic cases, in which an unsatisfactory number of lymph nodes was found by the traditional method, were investigated. The entire mesocolonic fat was immersed for six hours in a lymph node-revealing solution (LNRS) composed of various traditional fixatives and fatty solvents. After six hours, the lymph nodes stood out as white, chalky nodules on the background of yellow fat. They were then excised, processed. and stained. RESULTS: Total number of lymph nodes found by the traditional method in the 30 cases was 88. After LNRS, 258 additional lymph nodes, measuring from 0.5 to 7 mm in largest diameter, were found. Of the 12 cases in which no lymph nodes were found by the traditional method, 8 became N0 and 4 became N1. Of the 14 cases first classified as N0, 4 became N1; of the 4 classified at first as N1, 2 became N2 after LNRS. Upstaging from Dukes B to C occurred in eight cases. Quality of the sections and histochemical and immunohistochemical stains after LNRS was similar to that of formalin-fixed tissues. CONCLUSIONS: LNRS is an easy, rapid, and inexpensive technique for detecting very small lymph nodes. These may contain metastases, a fact that changes the stage of disease and influences the mode of therapy.

Acetic Acid↗

PubMed1997

Noninvasive procedure for in situ determination of skin surface aspartic proteinase activity in animals; implications for human skin.

The present study demonstrated a noninvasive procedure for in situ determination of stratum corneum aspartic proteinase in the living animal. A non-leaky well, containing [125I]S-carboxymethylated insulin B-chain (ICMI) as a substrate, was constructed on the shaved back of anesthetized guinea pigs and rats. The enzymatic activity was determined by measuring the radiolabeled trichloroacetic acid soluble material. We demonstrated pepstatin-sensitive proteinase activity bound to the skin surface indicating the involvement of aspartic proteinase(s) such as cathepsin D and/or E. Aged rats had about six fold lower activity than young animals. The proteinase activity was inhibited by the alkylating agent mechlorethamine and by the cosmetic propylene glycol. A similar procedure was carried out with intact human skin pieces obtained during plastic surgery. The activity was inhibited by antihuman cathepsin D antibodies. Cathepsin D was immunohistochemically localized in the corneal and granular layers of the epidermis. Skin surface aspartic proteinase/cathepsin D activity may serve as a marker for skin aging or for certain skin disorders leading to a new approach to their medical treatments.

Aging↗

PubMed1997

The clinical and histological features of transitional cell carcinoma of the bladder with microcysts: analysis of 12 cases.

OBJECTIVE: To describe the clinical course and histological features of transitional cell carcinoma (TCC) of the bladder with microcysts. PATIENTS AND METHODS: Among 940 patients with bladder TCC diagnosed at our institution during a 5 year period. 12 (1.2%; eight men and four women, mean age 71.1 years, range 52-85) were diagnosed histologically as having microcystic TCC. Sections of the tumours were stained with haematoxylin and eosin, periodic acid-Schiff and Alcian blue and clinical data obtained from the patients' records. RESULTS: Of the 12 patients with bladder TCC with microcysts, three had tumours confined to the epithelium, six had tumour invasion of the lamina propria and three had muscle invasion. One patient had low-grade TCC and 11 had high-grade TCC; six patients had a second primary tumour; three had a colon carcinoma, one a villous adenoma of the caecum, one a locally advanced carcinoma of the prostate and the last a squamous cell carcinoma of the uterine cervix. CONCLUSIONS: Microcystic TCC was associated with high-stage and high-grade bladder tumours and with other primary tumours, especially of the colon. Screening these patients for asymptomatic tumours of the colon is suggested.

Aged↗

PubMed1997

Lymph-node revealing solution: a new method for detecting minute lymph nodes in cystectomy specimens.

OBJECTIVE: To describe the use of a new lymph-node revealing solution (LNRS) for detecting lymph node involvement in total cystectomy specimens from patients with locally confined invasive transitional cell carcinoma (TCC) of the bladder, and to compare the results obtained with those using the conventional method (palpation and sectioning perivesical fat) that may fail to detect very small lymph nodes. MATERIALS AND METHODS: Of 12 cystectomy specimens obtained from patients with TCC, six in which 0-3 metastatic nodes were identified by the conventional method were further investigated using LNRS. The revealing solution comprised 95% ethanol, diethyl ether, glacial acetic acid and buffered formalin (65:20:5:10 v/v) prepared under a fume-hood. After evaluation using the conventional method, the specimens were immersed for 6-12 h in the solution, washed under running tap water and the adipose tissue sectioned at intervals of 2-3 mm. Lymph nodes were identified as white, chalky nodules against the background of yellow fat. The number of the lymph nodes identified by conventional and the LNRS methods was recorded and classified according the TNM system. RESULT: Twenty-two lymph nodes were detected by the conventional method, of which four were positive for tumour metastasis. Using the LNRS, an additional 21 nodes were identified among which 12 were positive. The mean size of the lymph nodes detected by the conventional and LNRS methods was 7.96 mm and 3.81 mm, respectively. The stage of three patients was increased (Nx to N2, N0 to N2 and N1 to N2) and therefore two of these patients received adjuvant chemotherapy. CONCLUSIONS: LNRS significantly enhanced the yield of normal and metastatic nodes of cystectomy specimens and may identify smaller nodes. The LNRS method allows a more accurate staging with better assessment of the prognosis and need for adjuvant therapy.

Carcinoma, Transitional Cell↗

PubMed1997

Detection of serum amyloid A-derived proteins in formalin-fixed paraffin-embedded tissues: reliability of the method and expansion of its spectrum.

To further assess the reliability of the Shtrasburg method for detection of amyloid A in formalin-fixed, paraffin-embedded tissues and to expand the spectrum of the amyloid proteins analyzed by this method, we studied formalin-fixed, paraffin-embedded amyloid-containing tissues obtained from patients with the following types of amyloidosis: amyloid A, light chain, transthyretin, calcitonin, beta2 microglobulin, and senile seminal vesicle. The tissue samples were deparaffinized, processed, and subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the Western blot technique. Only specimens from patients with amyloid A amyloidosis gave protein bands: a single 8.5-kd band in lanes of all tissues studied, except thyroid tissue, which displayed two bands of about 5 and 10 kd. Other types of amyloid failed to show any protein band. These findings suggest that the Shtrasburg method is sensitive, specific, and reliable and may have an important role in the diagnosis of amyloidosis.

Amyloidosis↗

PubMed1997

Lymph node revealing solution: a new method for detection of minute axillary lymph nodes in breast cancer specimens.

The staging and prognosis of patients with breast cancer is related to the presence or absence of axillary lymph node involvement. However, in some cases no lymph nodes or too small a number of lymph nodes are revealed by the traditional method of palpating and sectioning the axillary fat. In the present study we demonstrate the usefulness of the lymph node revealing solution (LNRS) in breast cancer. Specimens from 13 patients, in whom <10 lymph nodes were identified in the axilla by the traditional method, were included in the study. After excising the lymph nodes by the traditional method, axillary tissue was immersed in LNRS for 6-12 hours. Additional lymph nodes, which stood out as white chalky nodules, were excised and processed as usual. The LNRS increased the mean number of nodes per case from 6.0+/-2.5 found by the traditional method to 12.54+/-4.61 nodes per case (p < 0.01). The size of the nodes identified by the LNRS was significantly smaller (p < 0.01) than those detected by the traditional method. The LNRS changed the lymph node stage of the disease in four of the studied cases (30%). LNRS seems to be the technique of choice for detection of axillary lymph nodes in cases where the number of detected lymph nodes by the traditional method is too small for accurate staging.

Axilla↗

PubMed1997

Functional intestinal hypomotility in association with neuronal damage in a dog.

A young, crossbred dog with a 13-month history of progressively worsening, recurrent episodes of vomiting, anorexia, depression and dehydration was diagnosed as having a functional hypomotility disorder of the small intestines. During hospitalisation, the dog's condition improved only when total parenteral nutrition was administered. When fed orally, the dog developed severe gastric dilatation. Intestinal motility was minimal, but was induced by neostigmine. Post mortem findings included dilatation of the duodenum and progressive narrowing of the small bowel up to the ileum. Histopathology revealed various grades of neuronal degeneration and necrosis of the myenteric plexuses throughout the small intestine. Microscopic changes resembled those reported in dysautonomia, but were limited to small intestinal myenteric plexuses. A localised congenital neuronal defect causing a lack of parasympathetic tone is suspected.

Animals↗

PubMed1997

Lead toxicosis in a captive bottlenose dolphin (Tursiops truncatus) consequent to ingestion of air gun pellets.

A captive bottlenose dolphin (Tursiops truncatus) in a dolphinarium in Tel Aviv, Israel, had signs of anorexia, weight loss and a reluctance to train over a 4-week period in June 1995 and died shortly thereafter. On necropsy, it had an enlarged, yellow discolored liver, and about 55 air gun pellets in the second stomach. The pellets were composed of 40% lead. Samples of liver and kidney cortex contained 3.6 and 4.2 micrograms/g lead, respectively. There was hemosiderosis in the liver and kidneys, status spongiosus in the brain, and vacuolization in the optic nerve; acid-fast intranuclear inclusion bodies were seen in the kidneys. We propose that chronic lead toxicosis had been induced after the gradual dissolution of the lead-based pellets in the acid environment of the stomach.

Animals↗

PubMed1996

Cost-saving approach to normal technetium-99m sestamibi myocardial perfusion scan.

We conducted a 1-year follow-up of 116 patients with normal poststress technetium-99m sestamibi without images at rest. Although 2 patients with proven coronary artery disease needed cardiac intervention, no patient suffered cardiac mortality or myocardial infarction, suggesting that early interpretation of normal poststress images without images at rest may imply an excellent prognosis for at least 1 year.

Coronary Disease↗

PubMed1996

[Head and neck sarcoma].

We reviewed patients with primary soft tissue and bone sarcomas treated in our department. Malignant tumors arising in somatic, connective, soft tissues, especially those of the head and neck, are uncommon and few reports have been published. Between 1980 and 1995 15 patients with head and neck sarcoma were seen. The major sites involved included: paranasal sinuses and orbits (2 patients), neck (4) and 1 each in the forehead, temporal region, mandible, parapharyngeal space, tongue, hypopharynx, larynx, cervico-mediastinal region and nasal cavity. Follow-up ranged from 1-16 years. The youngest patient was a 12-year-old male. Rhabdomyosarcoma, one of the most common mesenchymal tumors found in the head and neck, especially in children, was excluded from our study because of its different clinical behavior and its chemosensitivity, unlike other sarcomas. Most of our patients were treated with wide-field resection; 12 received postoperative radiation, and 3 combined surgery and chemotherapy. Wide excision with negative margins is considered an important, positive, prognostic factor, as the extent and adequacy of excision largely determines survival and the incidence of local recurrence. All our patients underwent initial, wide, local excision of the lesion. Our observations strongly suggest that wide resection is the most effective means of therapy for sarcoma of the head and neck. Radical neck dissection was not only performed for manifest regional neck metastases, but was also used for completing the enlarged, wide-excisions of liposarcomas. The worst survival was in patients with osteosarcoma, angiosarcoma and fibrosarcoma, with an absolute 5-year survival of 60% (9/15).

Adult↗

PubMed1996

The protective role of the immunomodulator AS101 against chemotherapy-induced alopecia studies on human and animal models.

The immunomodulator AS101 has been demonstrated to exhibit radioprotective and chemoprotective effects in mice. Following phase-I studies, preliminary results from phase-II clinical trials on non-small-cell-lung-cancer patients showed a reduction in the severity of alopecia in patients treated with AS101 in combination with chemotherapy. To further substantiate these findings, the present study was extended to include 58 patients treated either with the optimal dose of 3 mg/m2 AS101 combined with carboplatin and VP-16, or with chemotherapy alone. As compared with patients treated with chemotherapy alone, there was a significant decrease in the level of alopecia in patients receiving the combined therapy. The newly developed rat model was used to elucidate the protective mechanism involved in this effect. We show that significant prevention of chemotherapy-induced alopecia is obtained in rats treated with Ara-C combined with AS101, administered i.p. or s.c. or applied topically to the dorsal skin. We show that this protection by AS101 is mediated by macrophage-derived factors induced by AS101. Protection by AS101 can be ascribed, at least in part, to IL-1, since treatment of rats with IL-1 RA largely abrogated the protective effect of AS101. Moreover, we demonstrate that in humans there is an inverse correlation between the grade of alopecia and the increase in IL-1 alpha. In addition, protection by AS101 could be related to PGE2 secretion, since injection of indomethacin before treatment with AS101 and Ara-C partly abrogated the protective effect of AS101. To assess the ability of AS101 to protect against chemotherapy-induced alopecia, phase-II clinical trials have been initiated with cancer patients suffering from various malignancies.

Alopecia↗

PubMed1996

Tumor angiogenesis as a prognostic factor in early oral tongue cancer.

OBJECTIVE: To evaluate the relationship between tumor angiogenesis and the subsequent development of cervical node metastases in patients with stage 1 carcinoma of the oral tongue. METHODS: The study group consisted of 25 patients with T1 carcinoma with no evidence of neck disease at presentation. Paraffin blocks from 10 patients, in whom neck node metastases were found shortly after surgery, were stained for factor VIII and compared with those from 10 randomly chosen patients in whom no evidence of recurrent disease was observed during prolonged followup. Microvessels were counted in each group. RESULTS: The microvessel counts correlated with metastatic disease. The mean +/- SD count was 103.41 +/- 40.72 per X 250 field in the patients with positive lymph node metastases and 50.03 +/- 13.74 per X 250 field in those with no lymph node metastases during follow-up (P < or = .05). CONCLUSIONS: The number of microvessels per X 250 field in the area of most intensive neovascularization in early oral tongue carcinoma may be an independent predictor of nodal metastases. Assessment of tumor angiogenesis may therefore prove valuable in selecting patients with early oral tongue carcinoma for aggressive therapy.

Humans↗

PubMed1996

Extent of victimization, traumatic stress symptoms, and adjustment of terrorist assault survivors: a long-term follow-up.

This paper examines the long-term impact of a terrorist attack on adolescents; this attack involved the seizure of over one hundred hostages, most of them adolescents, and the focus here is on the relationships between the extent of victimization and long-term outcomes. The study was based on in-depth interviews and a battery of questionnaires administered to the survivors 17 years after the event. The findings indicated that very intense victimization, particularly in terms of physical injury, had the strongest effect on long-term adjustment in comparison to moderate or minimal victimization in the same trauma.

Adaptation, Psychological↗

PubMed1996

The residual ovary syndrome: a 20-year experience.

OBJECTIVE: To address the controversy of ovarian preservation during a hysterectomy for benign indications by using our experience with residual ovary syndrome (ROS). STUDY DESIGN: Over a period of 20 years, 2561 hysterectomies (during which one or both ovaries were preserved) were performed at the Golda Medical Center, Israel. A retrospective, quasi, case-control analysis was undertaken. RESULTS: The incidence of ROS was 2.85%. While chronic pelvic pain was the principle indication for subsequent reexploration in 52 patients (71.3%), an asymptomatic pelvic mass noted during routine follow-up examination accounted for 24.6% of operations for ROS. The majority (75.4%) of patients underwent surgery during the first 10 years, while the highest incidence occurred within the first 5 years (46.6%). Furthermore, histological examination revealed functional cysts, benign neoplasm and ovarian carcinoma in 50.7%, 42.6% and 12.3% of the cases, respectively (in nine patients more than one pathology was observed). CONCLUSIONS: Since ROS was found to occur in 1/35 women who had undergone previous hysterectomies mainly due to physiologic ovarian function and benign cyst formation, but not malignancy, we believe that routine oophorectomy is justified in premenopausal women over 45 years of age. However, the final decision to perform elective oophorectomy at the time of hysterectomy for benign disease should be established on an individual basis, taking into consideration age, individual and family risk factors, the patient's preference and ability to ensure long-term compliance to exogenous hormone replacement therapy.

Adult↗