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Biomedical subjects

R Tadmor

Publications and source records attributed to R Tadmor.

At least 19 recordsLinked to original sources
PubMed1992

The management of pediatric brain tumors in a tertiary center.

Between January 1982 and January 1990, 120 newly diagnosed pediatric patients were treated at The Chaim Sheba Medical Center. Sixty three (52.5%) tumors arose in the posterior fossa and 57 (47.5%) appeared supratentorially. A wide variety of histologic subtypes was seen, each requiring tumor-specific treatment. The modern imaging techniques-CT and MRI-offered better planning of operation, treatment and follow up. All children with highly malignant tumors were treated with combination chemotherapy besides the 'conventional radiotherapy'. Since 1987 the "eight in one day" protocol has been used extensively pre- and post-irradiation. Five-year survival, varied significantly according to tumor type, location and stage. The average delay from presentation of symptoms to diagnosis was 6 months. A multidisciplinary approach has been used in the treatment, rehabilitation and follow-up of these children. In this study, the results of treatment are presented and the role of chemotherapy is discussed.

Adolescent↗
PubMed1992

Malignant prolactinoma.

Malignant prolactinoma is a rare entity and only a few cases have been published. The diagnostic criteria and the clinical course remain unclear. We present a case of malignant prolactinoma in a woman with a 30-year duration of the disease. In the terminal stage of the disease the prolactinoma metastasized to the left eye, the prolactin level reaching 196000 mU/l. Bromocriptine in high doses was not effective. The response to pergolide was good in the first two years of treatment; thereafter an escape effect was observed. The patient died in a comatose state. A review of previously published cases follows.

Bromocriptine↗
PubMed1990

Pineal germinoma with unilateral blindness. Seeding of germinoma cells in optic nerve sheath.

A 13-year-old boy presented with blindness and loss of the papillomacular bundle in the left eye, bilateral papilledema sparing the area of axonal loss, and Parinaud's syndrome. Computerized tomography (CT) revealed an enlarged kinked left optic nerve and enlarged optic canal as well as a tumor in the pineal area producing hydrocephalus. Magnetic resonance (MR) scans showed multiple spinal metastases. The histological diagnosis was germinoma. On completion of four courses of chemotherapy with cis-platin, vinblastine, and bleomycin, repeated CT of orbita and MR imaging of the spine demonstrated the disappearance of the tumor surrounding the left optic nerve and of the spinal metastases. This is believed to be the first case report of seeding of germinoma into the perioptic arachnoid space.

Adolescent↗
PubMed1989

Hypofractionated radiation therapy and concurrent cisplatin in malignant cerebral gliomas. Rapid palliation in low performance status patients.

Twenty-eight patients with high-grade cerebral gliomas (16 biopsy-proven and 12 diagnosed clinically and by computed tomography scan) were treated with altered fraction radiation and concomitant cisplatin (C-DDP). Twenty cases (Groups IA and IB) whose Karnofsky performance status (KPS) was 60% or less received hypofractionation and C-DDP. All these patients had received high-dose Decadron (Merck Sharp & Dohme, West Point, PA), and their conditions were not improving or progressively deteriorating. The first 11 patients (Group IA) received from 600 cGy twice weekly to 3600 cGy over 3 weeks combined with C-DDP IV at 40 mg/M2 every 2 weeks for two courses. The nine subsequent patients (Group IB) received from 600 cGy weekly to 3600 cGy over 5 to 6 weeks with C-DDP IV at 40 mg/M2 every 1 to 2 weeks for four courses. The target volume in all cases was confined to the tumor as defined on computed tomography (CT) scan with a 2 cm to 3 cm margin. The C-DDP at 40 mg/M2 was administered immediately (within 5 minutes after radiation). Eight cases (Group II) with a KPS of more than 60% were treated with hyperfractionation, i.e., from 200 cGy twice daily to 4800 cGy in just under 3 weeks. The C-DDP was administered every 2 weeks for a total of two courses, as for Group IA. In Group I, 15 of 20 (75%) patients experienced rapid improvement in their performance status, which usually becoming evident within 1 to 2 weeks from the initiation of treatment, and progressed over time. Four patients with a KPS of 10% improved their KPS to over 60%. This regimen was both well tolerated and logistically very convenient both for the patients and attending staff. Follow-up CT scans in three of 16 evaluable patients in the hypofractionated group showed complete tumor resolution. Median survival for Group IA was 7 months, for Group IB was 12 months, and overall was eight months. The Group II median survival was 9 months. This experience suggests that hypofractionated radiation in combination with C-DDP may offer rapid palliation with improvement in functional status in severely compromised patients with malignant glioma.

Adult↗
PubMed1989

High incidence of primary cerebral lymphoma in tumor-induced central neurogenic hyperventilation.

An awake patient presented with central neurogenic hyperventilation induced by a cerebral tumor. Corticosteroid therapy and brain irradiation while the patient was anesthetized and respiration controlled under pancuronium-induced respiratory paralysis were followed by tumor regression and resolution of hyperventilation. Recurrence of tumor 6 weeks later was not accompanied by recurrence of hyperventilation. Cytologic study of cerebrospinal fluid revealed B-cell lymphoma. This patient brings to 10 the number of cases recorded with tumor-induced central neurogenic hyperventilation. Five of the eight patients with known tumor histology had a primary cerebral lymphoma, a rare neoplasm that comprises only 1% of all intracranial neoplasms. The disproportionately high frequency of central neurogenic hyperventilation in patients with cerebral lymphoma has therapeutic implications that are briefly reviewed.

Adrenal Cortex Hormones↗
PubMed1989

MR demonstration of spontaneous acute epidural hematoma of the thoracic spine.

Two patients with spontaneous epidural hematoma of the thoracic spine are presented. The magnetic resonance (MR) examination performed within the first hours following the onset of symptoms demonstrated an epidural elongated lesion impinging on the spinal cord, compatible with hematoma. In one of the patients this finding was surgically confirmed. The second patient improved under steroid treatment. The MR findings were highly suggestive of the pathological nature of the lesion. The MR examination should replace other diagnostic procedures, such as computerised tomography (CT) and myelography.

Acute Disease↗
PubMed1989

Magnetic resonance imaging in patients with progressive myelopathy following spinal surgery.

Thirty one patients with insidious progressive myelopathy 2 to 8 years following surgery of the cervical spine were subjected to magnetic resonance imaging (MRI). In 15 patients operated on for vascular malformations or intramedullary tumours, syringomyelia and cystic lesions of the spinal cord were shown. Seven of these patients also showed a combination of a recurrent tumour and spinal atrophy. Out of 16 patients who had surgery for herniated disc or spinal stenosis of the cervical spine, four had syringomyelia and 12 had spinal cord atrophy. There was no syringomyelia in the 12 patients submitted to MRI prior to surgery.

Adolescent↗
PubMed1989

Delayed nonhemorrhagic encephalopathy following mild head trauma. Case report.

Delayed nonhemorrhagic encephalopathy following mild head trauma is a rare condition with an unknown etiology. The few cases reported in the literature are in young adults, all of them in the era before computerized tomography (CT) became available, and all had a devastating clinical course with multifocal ischemia or necrotic lesions found at autopsy. A case is presented of a young man with this syndrome who survived the acute encephalopathic phase with severe residual neurological deficits. Repeat CT scans during and following the acute phase as well as magnetic resonance imaging showed diffuse multifocal lesions compatible with ischemic changes and demyelination in the "watershed" areas of the brain.

Adult↗
PubMed1988

Disappearance of quadriparesis due to a huge cervicothoracic aneurysmal bone cyst.

A young man who had suffered from rheumatoid arthritis developed a huge cervicothoracic aneurysmal bone cyst and progressive quadriparesis. Complete recovery occurred after "incomplete therapy," which consisted of an open biopsy and a small dose of irradiation. This tumor was observed and characterized as a blood-filled cyst excavated from the bone. Because of the controversy in the literature over the benefit of surgery vs. irradiation, this report emphasizes the fact that even "partial" treatment may beneficially affect this tumor.

Adolescent↗
PubMed1988

Brain dysfunction in primary ciliary dyskinesia?

To identify possible altered flow of cerebrospinal fluid due to defective ependymal ciliary motion, 8 subjects, including 6 with Kartagener's syndrome (KS), 1 with primary ciliary dyskinesia (PCD) and 1 with situs inversus were studied by computerized tomography (CT) examination of the brain and paranasal sinuses and had their nasal cilia studied by in vitro ciliary beat frequency (CBF) analysis. Five of the 6 patients with KS and the one with PCD had abnormal CBF (slowed or absent), while the CBF of 1 KS patient and the subject with situs inversus was normal. CT evaluation of the brains of all subjects was normal. Sinus examinations of the 7 patients with KS and PCD revealed mucosal thickening. We conclude that slowed or absent ciliary activity as measured in vitro is not associated with brain abnormalities as demonstrated by CT examination.

Adolescent↗
PubMed1987

Percutaneous discectomy of the lumbar spine.

Ten patients with clinical and radiological evidence of herniated discs at lower lumbar levels were treated with partial discectomy by a lateral percutaneous approach. Eight patients had complete relief from radicular pain and were discharged within four days. They returned to normal daily activity within one month.

Adolescent↗
PubMed1987

The role of three dimension computerized imaging in hand surgery.

Three-dimensional computerized imaging is a new modality of radiological imaging. This new technique transforms the two-dimensional slices of bi-plane CT into a three-dimensional picture by a computer's monitor adjusted to the system. This system enables the physician to rotate the angle of viewing of the desired region to any desired angle. Moreover, this system can delete certain features of different densities from the picture, such as silicone implants, thus improving visualization. Our preliminary results using this technique are presented. The advantages, pitfalls, and suggested future applications of this new technique in hand surgery are discussed.

Adolescent↗
PubMed1987

Intermittent priapism in spinal canal stenosis.

A case of spontaneous intermittent priapism in a patient with spinal canal stenosis is presented. Erection, as well as intermittent neurogenic claudication and urinary incontinence were provoked by physical exertion, mainly walking. The symptoms completely resolved after decompressive lumbar laminectomy.

Aged↗