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T Siegal

Publications and source records attributed to T Siegal.

At least 73 records · Page 4Linked to original sources
PubMed1984

CNS involvement by non-Hodgkin's lymphoma. Response to a standard therapeutic protocol.

Treatment results of 31 episodes of CNS involvement by malignant lymphoma diagnosed in 24 patients were studied. Leptomeningeal involvement occurred in 16 patients, intracerebral invasion in eight patients, and epidural cord compression in seven patients. Twelve patients with leptomeningeal involvement treated with intraventricular methotrexate sodium achieved complete CSF remission and ten patients' conditions improved neurologically. Five of the patients with epidural cord compression were ambulatory following treatment. Complete resolution of intracerebral lymphoma was documented by computed tomographic scan in four patients. The overall median survival was nine months, eight months for leptomeningeal involvement, five months for intracerebral lymphoma, and 12 months for patients with cord compression. Our results suggest that all forms of CNS lymphoma usually respond well to therapy, life span is prolonged, and is free of CNS disease until patients die of uncontrolled systemic lymphoma.

Adolescent↗
PubMed1983

Fresh and cryopreserved fetal bones replacing massive bone loss in rats.

Cartilaginous fetal bones from rat preserved by deep freezing procedures were compared to comparable fresh bones with regard to the following parameters: chemical composition, water and uronic acid contents; cell viability measured by the rate of proteoglycan synthesis; mineralization-ossification status by calcium binding; matrix integrity by the release of uronic acid containing substances; and biological activity as transplants inducing the formation of bone. The transplanted material was chemically analyzed and checked for its rate of proteoglycan synthesis. The quality of the formed bone was similar whether isogeneic or allogeneic, fresh or cryopreserved bone was employed as transplant material. Evidently those various fetal bones may be of clinical value whenever the need for replacement of massive bone loss arises. Although the viability and the cartilaginous nature of the graft are critical, the isogeneity and freshness are of a quantitative advantage only. These biochemical observations were confirmed by roentgenological and histological evaluations of the grafts. An optimal cryopreserving procedure and tests for examining bone candidates for successful grafting are described.

Animals↗
PubMed1983

Successful chemotherapy of recurrent intracranial germinoma with spinal metastases.

A recurrent CNS germinoma with subependymal and spinal metastases was treated by combination of cis-platinum, bleomycin, and vinblastine, resulting in disappearance of intracranial and spinal tumor. Second intracranial relapse responded again to the same combination chemotherapy. Response of spinal metastases to this combination chemotherapy has not been reported previously.

Adult↗
PubMed1983

Massive hemorrhagic necrosis of the spinal cord in metastatic cord compression.

A fusiform longitudinal hemorrhagic necrosis of the spinal cord is described in a patient with spinal cord compression caused by metastases from an adenocarcinoma of the prostate. The lesion extended from the D3 down to L2 level with maximal involvement of the D7-D8 segments. The shape, location, and distribution of the lesion and its prominent hemorrhagic component corresponded to Jellinger's category of cylindrical liquefaction necrosis, probably due to venous obstruction. The multiple thrombi found in epidural veins supported such a pathogenic mechanism, which although extremely rare has been reported previously in five cases.

Adenocarcinoma↗
PubMed1982

Solitary dural plasmacytoma with conspicuous cytoplasmic inclusions.

A solitary intracranial plasmacytoma originated from the left parietal meninges of a 67-year-old woman; the patient had a four-month history of generalized seizures. Immunoelectrophoresis, performed nine months after surgery, revealed a monoclonal IgG band in the cerebrospinal fluid (CSF) but not in the blood. A peculiar feature of the tumor cells was the presence of abundant hyaline, eosinophilic cytoplasmic inclusions. Ultrastructurally, these inclusions consisted of electron-dense floccular material within distended cisterns of endoplasmic reticulum (ER). These ultrastructural features resemble "thesaurocytes" originally described by Paraskevas et al. in IgA myeloma. Tumors composed mainly of such inclusion-bearing cells are extremely rare. Only a fraction of the tumor cells stained positively for IgG with the immunoperoxidase technique; most inclusion-bearing cells did not stain. It is therefore unlikely that the electron-dense material is stored immunoglobulins.

Cytoplasm↗
PubMed1982

Anterior decompression of the spine for metastatic epidural cord compression: a promising avenue of therapy?

Most metastatic epidural tumors arise in a vertebral body and invade the anterior epidural space. Therefore, it is logical to decompress the spine anteriorly and not by traditional laminectomy. Surgical decompression is indicated if relapse occurs after radiotherapy and further radiation cannot be administered, if there is neurological deterioration during radiotherapy, and when histological diagnosis of the primary tumor is lacking. This pilot study consists of eleven consecutive anterior decompressions of the spine performed in nine patients. In seven instances other treatment modalities had been exhausted, and in four patients a tissue diagnosis was lacking. Before operation eight of the patients were nonambulatory, four of them paraplegic. Following decompression all but one patient became ambulatory. At operation the main bulk of the compressing tumor was found anterior or anterolateral to the cord. Spine stabilization was done when stability was a problem. Wound infection in one patient was the only postoperative complication. The encouraging outcome of our management prompts us to suggest that anterior decompression of the spine should be considered more often in metastatic compression of the cord and cauda equina.

Cauda Equina↗
PubMed1982

Periodic ataxia: an unusual non-familial variation with paroxysmal EEG features.

A 19-year-old youth suffered from periodic attacks of ataxia and dysarthria. Abnormally high IgG and IgA levels were found in the CSF. The length of the episodes of ataxia, absence of family history and the presence of generalised paroxysmal features in the EEG constitute a combination which is not believed to have been recorded previously. Carbamazepine was ineffective but temporary clinical and electroencephalographic improvement followed the administration of ACTH. Acetazolamide therapy has resulted in prolonged remissions from attacks.

Adult↗
PubMed1980

Spinal meningeal uptake of technetium-99m methylene diphosphonate in meningeal seeding by malignant lymphoma.

Definite diagnosis of meningeal seeding by systemic cancer relies on the presence of malignant cells in the cerebrospinal fluid (CSF). In the absence of such cells in the CSF, only two other tests strongly suggest the diagnosis--a CT scan and a myelogram. We report a case in which the diagnosis was strongly suggested by an unusual uptake of Tc-99m methylene diphosphonate by the leptomeninges during a skeletal scan and later established by the presence of malignant cells in the CSF. We believe that radionuclide scan may be an additional diagnostic test in some cases with meningeal seeding by systemic cancer. We therefore are extending our studies to validate this possibility.

Aged↗
PubMed1980

Osteotomy of the hip in children: posterior approach.

The posterior approach for varus rotational osteotomy of the hip with the patient prone is relatively bloodless, provides excellent visualization of the osteotomy site, and facilitates insertion of internal fixation devices. We performed this operation on 100 hips in fifty-nine patients. All but one of the osteotomies healed within eight weeks and there was one infection.

Adolescent↗
PubMed1979

Fetal bone grafts do not elicit allograft rejection because of protecting anti-Ia alloantibodies. Implications to the immune survival of fetuses in allogeneic mothers.

In a previous study we showed that allografts of BN fetal bone, unlike allografts of adult bone, are not rejected by allogeneic recipients of the Lewis strain in spite of the existence of major histocompatibility complex (MHC) incompatibility between donors and hosts. In the present study, we analyzed the relationships existing between the host and fetal tissue that determine graft survival. We found that (1) the fetal BN graft, unlike adult grafts, induces in Lewis recipients a vigorous humoral response consisting mainly in the production of IgG antibody that seems to be directed against antigens of Ia-like specificities. (2) The BN rats are genetically defective in their capacity to respond to determinants and thus are not capable of producing anti-Ia antibodies; in accordance, Lewis fetal bone grafts are rejected by the BN recipients. (3) Chondrocytes isolated from fetal mouse bones do express Ia antigenic determinants. We suggest that the survival of an allogeneic fetal graft in an immunologically intact recipient depends on an active and selective immune response directed against the Ia components associated with the MHC on the embryonic and fetal cells. On the basis of these notions, we propose that the capacity of Ia determinants expressed on cells of the embryo, to elicit anti-Ia and IgG alloantibodies in the pregnant mother, determines the capacity of the embryo to escape rejection by the histoincompatible mother.

Animals↗
PubMed1978

Clinical and laboratory aspects of disseminated intravascular coagulation (DIC): a study of 118 cases.

The medical records of 118 cases who met laboratory criteria of DIC were studied. The most frequent etiologies were: Generalized infection (39.8%), trauma (16.9%), malignancy (6.8%) and surgical cases (6.8%). The main clinical manifestations which appeared to be related solely to DIC were (in a decreasing order of frequency): Bleeding (64.4%), renal dysfunction (24.6%), liver dysfunction (18.6%), respiratory dysfunction (16.1%), shock (14.4%), thromboembolic phenonmena (6.8%) and central nervous system involvement (1.7%). In 26 patients none of these manifestations were observed. In patients with infection, liver and renal dysfunction were frequent and respiratory dysfunction rare, whereas in trauma cases, liver and renal dysfunctions were rare and respiratory dysfunction frequent. This variability indicates that the clinical manifestations are affected not only by the process of intravascular coagulation but also by the underlying clinical disorders. The most impaired coagulation tests were prothrombin time, partial thromboplastin time, platelet count and thrombin time. The degree of abnormality of these coagulation tests was found to be related to the extensiveness of organ involvement. The mortality (overall 54.7%) increased independently with age, with the number of clinical manifestations and with the degree of abnormality of the above-mentioned four most impaired coagulation tests. In addition, older patients were more likely to have an increased number of clinical manifestations and more impaired coagulation tests. Mortality was similar in the various etiologies except for trauma patients in whom it was lower (30%).

Adolescent↗
PubMed1977

Methotrexate treatment in dermatomyositis.

Two patients with dermatomyositis were treated with methotrexate, given intravenously. They were unresponsive to corticosteroids. The patients were bedridden and paralysed and one seemed to be in the terminal phase of the disease. The response to courses of methotrexate treatment was satisfactory and sustained over a 2-year follow-up period; muscle enzyme studies indicate that the muscle disease is no longer active. Although steroid therapy alone may be effective, its usefulness is unpredictable and may lead to dependence and undesirable side effects. Our experience with these two patients suggests that a combination of the two drugs may be justified as initial treatment in severe cases.

Aspartate Aminotransferases↗