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Biomedical subjects

R Pfefferman

Publications and source records attributed to R Pfefferman.

16 recordsLinked to original sources
PubMed1998

The role of the soluble p53 antigen and its autoantibodies as markers for diagnosis of colon cancer: a comparative study.

The role of various serological tumor markers, p53 soluble antigen and its autoantibodies, was evaluated for the detection of colon cancer in humans. An HPLC technique was used to measure serum levels of both forms of p53 protein after their partial isolation on gel fiberglass affinity chromatography columns. Tumor-associated proteins (TAP) in the form of either antigens or autoantibodies were about 4% of the total protein isolated from the serum of colon cancer patients. The absolute amount of each of the two types of TAP was also similar: 14.69 2.88 and 18.29 3.85 mg ml-1, respectively. The amount of p53 autoantibodies was higher than those of p53 antigen, but the difference was not significant: 9.35 3.48 and 6. 19 3.87 mg/ml, respectively (p>0.05). A good correlation was found between the total amount of tumor-associated antigens (TAA) and the amount of p53 antigen (r=0.69), total amount of IgG and the amount of p53 autoantibodies (r=0.46), and between both forms of p53 protein (r=0.46). A high coefficient of regression was found between the total amount of TAA and the amount of p53 antigen (b=2.4). Relationships between Duke's stage in colon cancer and the serum levels of p53 protein were weak: 0.33 and -0.32 for p53 antigen and its autoantibodies, respectively. Serum determination of p53 autoantibodies has no advantage over the determination of p53 antigen. Both forms of p53 protein can be isolated with extremely high accuracy for the pathological diagnosis of cancer (87-93%). Specificity of the method was proved using of commercial p53 PAb OD1: the GFG columns with this antibody were able to isolate the same proteins which were isolated by GFG columns with anti-p53 IgG. Moreover, the isolation of p53 protein was performed with higher effectiveness using the GFG columns with entrapped anti-p53 IgG than those columns with commercial DO1 PAb.

Autoantibodies↗
PubMed1996

[Amplification of protooncogenes and expression of the HER2/neu oncogene in invasive breast cancer].

The protooncogene HER2/neu was analyzed in 27 women with invasive breast cancer and in 26 with benign breast conditions. Gene amplification was found in 3 patients, 1 in stage 3 and 2 in stage 4. In 3 patients in stage 2 overexpression of protein was found. Although amplification of the gene was found to be a significant predictor of clinical outcome (p < 0.05), high expression of the gene did not correlate with prognosis. In women with benign breast conditions there were no alterations of HER2/neu amplification may become a molecular marker in some malignancies. It should be noted that since few tumors show amplification, examination of a small series may not reveal clinical association with these alterations. Therefore, our conclusions require confirmation on a larger scale with long-term clinical follow-up.

Biomarkers, Tumor↗
PubMed1996

Acute appendicitis: diagnosis by transvaginal sonography.

We present a case of a female patient with right lower quadrant abdominal pain, in whom transvaginal ultrasound facilitated the diagnosis of acute appendicitis. The insertion of the appendix into the cecum was demonstrated with direct continuity between the cecal lumen and the appendix. The inflamed appendix was in close proximity to the right ovary and was distinguished by a thick edematous wall and fluid in the lumen. This combination of findings may comprise a new sonographic sign for the diagnosis of acute appendicitis, particularly when performed by transvaginal sonography.

Abdominal Pain↗
PubMed1996

Comparative study of the role of serum levels of p53 antigen and its tumor cell concentration in colon cancer detection.

The role of serum levels of p53 antigen in detection of colon cancer was studied in different groups of cancer and noncancer patients and was compared with the results of immunohistochemical analyses. The p53 antigen was isolated from the human serum as a cytoplasmic fraction using the recently described new type of columns for affinity chromatography, gel fiberglass columns (Zusman and Zusman, 1995). Its concentration was detected by high performance liquid chromatography. The serum level of the p53 antigen significantly increased in cancer patients (3.6 mg ml(-1)) as compared to its concentration in patients with benign tumors (1.7 mg ml(-1)) or in patients with noncancer disorders (0.49 mg ml(-1)), and this was found to be a result of higher concentration of p53 protein in tumor cells. Coefficient of correlation between cellular concentration of p53 protein and its serum level was 0.44 in noncancer lesions and 0.48 in cancer patients. Serum levels of p53 antigen was shown to be highly active either in patients with noncancer lesions or in patients with cancer (r = 0.46 and 0.51 respectively), whereas the cell determination of p53 protein was effective only among noncancer patients (r = 0.61) but not in cancer patients (r = 0.22). The findings suggests that serum determination of p53 antigen can perhaps reveal this oncoprotein already in the early stages of cancer or even predict the putative development of cancer. The possibility to use the serum-levels of p53 antigen in the follow up patients with chronic diseases and to detect transformation of these diseases into cancer, or monitoring former cancer patients in order to detect as early as possible the incidence of recurrent cancer is discussed.

Antigens, Neoplasm↗
PubMed1995

[Combined intrapleural and low epidural anesthesia for upper abdominal surgery].

Intrapleural administration of local anesthetics to achieve postoperative analgesia was recently described by Kvalheim and Reiestad. It has been stated that the intrapleural technique provides analgesia, but not surgical anesthesia. However, this method has been used recently for anesthesia during minor surgical procedures. We describe the use of combined, bilateral intrapleural and low epidural anesthesia in a woman with severe impairment of cardiopulmonary function who underwent combined splenectomy and cholecystectomy.

Abdomen↗
PubMed1992

Delayed operation for acute pancreatitis.

A retrospective study of 72 patients with acute biliary pancreatitis admitted to our department between 1982 and 1988 was carried out to evaluate our policy of delaying surgery in such cases. Of the 57 patients who underwent surgery, 17 were operated upon within 1 to 14 days of admission ("early operation"), and 40 patients were managed conservatively and readmitted for elective surgery about 6 weeks after resolution of the acute attack. Higher mortality and morbidity rates were observed in the "early operation" group (18% and 18% compared to 0% and 10%, respectively, P < 0.05). However, all deaths occurred in septic patients over the age of 70 who were operated on due to failure of maximal intensive medical therapy. Advanced age and early operation were found to be significant predictors of hospital mortality (P < 0.01). The two groups had similar mean hospital stay; 12 patients (30%) suffered an attack while waiting for elective surgery, however in only 3 (8%) the second attack occurred within 4 weeks of discharge from hospital. We conclude that a "delayed" operation for biliary pancreatitis is an acceptable option, and that recurrent attacks of acute pancreatitis in the time interval before the operation are avoidable if the operation is performed within 6 weeks of the initial acute attack.

Acute Disease↗
PubMed1989

[Ectopic spleen syndrome].

2 women with ectopic spleen are described. Because of the broad spectrum of clinical presentations, a high index of suspicion is needed to reach a correct diagnosis before the appearance of complications, which may be fatal. Diagnosis is usually possible by noninvasive means. Because of the high incidence of complications, splenectomy is recommended, even in asymptomatic cases.

Adult↗
PubMed1989

[Retroperitoneal desmoid tumor and familial polyposis coli].

A 43-year-old woman with familial polyposis coli (FPC) and adenocarcinoma of the rectosigmoid was treated by total colectomy, mucosal proctectomy and construction of an ileal pouch with ileoanal anastomosis. A year after operation she developed a huge retroperitoneal desmoid tumor which on exploratory laparotomy was found to be nonresectable. A 21-month course of indomethacin followed by tamoxifen failed to induce regression of the tumor. Desmoid tumors appear in 3.5-29.0% of patients with FPC, mostly after colectomy. This possibility must be considered in the differential diagnosis of recurrent carcinoma of the colon. The preferred treatment of abdominal and retroperitoneal desmoid tumors is conservative, and includes the use of non-steroidal antiinflammatory drugs, ascorbic acid and tamoxifen.

Adenomatous Polyposis Coli↗
PubMed1986

Complement-dependent lysis of Erhlich ascites tumor cells by human serum (ascitolysin) is lowered in cancer patients and raised in pregnant women.

Normal human serum has been shown to contain IgM antibodies that are lytic to Ehrlich ascites tumor cells in the presence of complement. We call this activity ascitolysin (AL). Using a 51Cr release assay, the AL titers of 164 normal sera, 211 sera from patients with non-malignant disease, 62 sera from 25 pregnant women and 170 sera from cancer patients were estimated. The patient sera were taken preoperatively, and were assigned to the cancer or non-cancer group after histological diagnosis. In normals, higher titers were found in sera of A and O blood groups but not B and AB. The difference was due to a fraction absorbed by B red blood cells. Sera from untreated cancer patients showed significantly reduced titers when compared to normal, benign tumor, chronic and other non-malignant disease groups. In pregnancy, titers were positively correlated with duration and remained elevated for at least 6 weeks post partum. About 30% of AL activity was absorbed by the free galactose groups of agarose. This fraction was significantly lower in untreated cancer patients. Anti-T antigen antibodies do not contribute to AL levels. Galactophilic blocking factors were also found; eight times more frequently in cancer sera than in normals. The non-absorbed fraction was also lower in cancer sera. The data suggest that AL antibodies may be directed against human oncofetal antigens.

ABO Blood-Group System↗
PubMed1977

Ocular complications after renal transplantation.

The ocular complications in 78 renal transplant patients were evaluated. Fifty-eight (74%) showed some ocular abnormality. Forty-one patients (53%) were found to have various degrees of cataracts. The duration of hemodialysis, the age of the patients, and daily dosage of prednisone did not seem to influence the development of cataracts. Correlation was found between the total dosage of prednisone and the cataract formation. Mild and moderated hypertensive fundus changes were found in 15 patients. Severe progression of diabetic retinopathy was observed in 2 diabetic patients. For the first time focal hemorrhagic necrosis of the eyelid as a result of cryptococcus septicemia was noted. Other ocular complications include one case of ocular hypertension and one case of herpetic keratitis. Although the incidence of ocular complications was high, the severity of ocular pathology seemed to be relatively mild.

Adolescent↗
PubMed1972

Observations on the effect of thymectomy on chemical carcinogenesis in the hamster cheek pouch.

The effects of thymectomy and sham operation on 9,10-dimethyl-1,2-benzanthracene (DMBA) induced tumours of the hamster cheek pouch were studied in Syrian golden hamsters. The incidence of carcinomata and papillomata with intra-epithelial carcinoma (atypical papillomata) in these animals was compared with that in control animals treated with DMBA alone, without surgical intervention.In 32 non-operated control animals, the average tumour yield after 12 weeks' DMBA application was 2·13 carcinomata and 1·22 atypical papillomata per treated pouch. In 14 animals thymectomized at the age of 2 weeks, the tumour yield was 0·21 and 0·36, respectively, and in 10 animals thymectomized when adult, it was 0 and 0·1 respectively. In 9 animals sham operated on at the age of 2 weeks, an average of 1·56 carcinomata and 1·22 atypical papillomata were found, but in 13 animals which were sham operated when adult, the tumour yield was 0·54 and 0·15 per treated pouch, respectively.The results suggest that the time of thymectomy in relation to DMBA treatment may be of importance and that thymectomy, when performed in 2-week old hamsters, inhibits DMBA tumourigenesis. The major effect of thymectomy performed in adult hamsters appears to be related to stress following surgery.

Age Factors↗
PubMedDate not supplied

The role of blood levels of soluble 53 kDa protein and CEA in monitoring colon cancer patients.

BACKGROUND: The usefulness of determining blood levels of the soluble p53 antigen and CEA was evaluated with respect to the monitoring colon cancer patients. METHODS: HPLC (high performance liquid chromatography) was used to measure serum levels of the soluble 53 kDa protein (s53) after its partial isolation on gel fiberglass affinity chromatography columns. RESULTS: The blood of cancer patients before tumor removal contained a high amount of s53 protein which did not change significantly over several subsequent months (4.5 and 4.7 mg/ml, respectively). The average serum level of CEA was relatively low but with extremely high deviations (48 +/- 128 ng/ml). In patients with recurrent cancer and metastases, the serum concentrations of the s53 protein and CEA remained at high levels and their changes during the period studied were not significant (3.9 +/- 3.5 and 6.1 +/- 2.9 for s53; 56.5 +/- 148.5 and 209.9 +/- 867.3 for CEA). Disease progression was accompanied by slight increase in the serum levels of the s53 protein (3.5 +/- 2.2 and 7.6 +/- 4.6) or CEA (143.3 +/- 98.5 and 244.9 +/- 873.8). Despite the absence of statistically significant changes in the serum levels of the s53 protein in different groups of patients, on an individual basis such changes could be detected and could be of diagnostic value. CONCLUSIONS: Findings suggest that HPLC determinations of blood levels of the s53 protein can be a useful means of monitoring cancer patients only if tumor removal is complete and the patient exhibits a subsequent sharp decrease in the p53 protein serum level. In such cases, a following increase in the serum level of the p53 protein reflects the initiation of a new neoplastic formation which can then be detected a few months earlier than by any other available method. However, if the patient's immune system reacts weakly to the operation and the blood concentration of the s53 protein remains high, neither CEA nor s53 levels can be used for monitoring purposes.

Biomarkers, Tumor↗
PubMedDate not supplied

Parkinson syndrome. A significant risk factor in the patient with acute surgical disorder.

Ten Parkinsonic patients presenting with acute surgical disease were studied to determine the effects of both conditions on each other and the patient's outcome. Severe motion and communication disturbances led, invariably, to a delay in seeking medical assistance, with most of the patients' presenting symptoms and signs being non-specific and misleading. As a result half the patients presented already in a state of septic shock, and a correct preoperative diagnosis could be achieved in three patients only. The functional status significantly deteriorated in six patients, in four of whom a prolonged rehabilitation course was necessary. Although there was no immediate perioperative mortality, morbidity was significant as 50% and 100% major "surgery-related" and "Parkinson-related" complications accordingly. It is concluded that the coexistence of acute surgical disease with Parkinson syndrome has a profound adverse effect on the patient's outcome. High index of suspicion, early mobilisation, intense physiotherapy and early resumption of the anti-Parkinson drugs are the key points in the management of these patients.

Aged↗
PubMedDate not supplied

Carcinoma of pancreas associated with the 5q-syndrome.

A female patient with the 5q-syndrome (refractory macrocytic anemia with deletion of the long arm of No. 5 chromosome) was followed-up for a period of 33 months and developed a carcinoma of pancreas. Until death she showed no signs of leukemic transformation. This association has not been described, and the genetic predisposition of 5q-patients to malignancies is discussed.

Adenocarcinoma↗