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Y Ben David

Publications and source records attributed to Y Ben David.

At least 19 recordsLinked to original sources

Effect of BRCA mutations on the length of survival in epithelial ovarian tumors.

PURPOSE: To study the role of BRCA mutations in ovarian cancer survival. PATIENTS AND METHODS: Blood samples and specimens of ovarian tumors (whenever blood samples were not available) at the time of the primary surgery were obtained in the course of a nationwide case-control study of women with ovarian cancer in Israel. The three common BRCA mutations in Israel (185delAG, 5382insC, and 6174delT) were analyzed with a multiplex polymerase chain reaction to amplify the exons containing the three mutations using fluor-labeled primers in a single reaction. Because each mutation is a small insertion or deletion, they can be detected as length polymorphisms. Patients were followed for up to 5 years (range, 20 to 64 months). Statistical analysis was performed using the Kaplan-Meier method and the log-rank test. Stepwise Cox regression analysis was used for determination of independent prognostic factors. RESULTS: This report is based on 896 blood or tumor specimens analyzed for the presence of the BRCA mutations. Of these, 234 women (26.1%) were found to be positive. A significant difference in survival pattern was found between BRCA1/BRCA2 carriers and noncarriers among the women with invasive ovarian cancer (median survival, 53.4 months v. 37.8 months; 3-year survival, 65.8% v. 51.9%, respectively). These differences were independent of age at diagnosis or stage of the disease. CONCLUSION: Our data indicate that the survival of patients with ovarian cancer is affected by BRCA germline mutation, at least in the early years after diagnosis.

Case-Control Studies↗

[Laparoscopy as part of the evaluation and management of ovarian and cervix neoplasms].

INTRODUCTION: Surgery is the treatment of choice in most early stages of cervical cancer and advanced stages of ovarian cancer. Failing to preoperatively diagnose para-aortic and parametrial metastases in cervical cancer or a non-resectable, ovarian cancer, may results in a superfluous laparotomy. AIM: To evaluate the advantage of using laparoscopy in cervical and ovarian cancer. PATIENTS AND METHODS: Study population includes patients with ovarian or cervical cancer referred between 1997-1999. A CT scan and a trans-vaginal sonography were used to detect involvement of pelvic and para-aortic lymph nodes, parametrium and other metastases. In patients with cervical cancer, para-aortic lymph node dissection was laparoscopically performed. When para-aortic nodes were negative and parametrium was clear, radical hysterectomy and pelvic lymph nodes dissection was conducted through laparotomy. When para-aortic lymph nodes or parametrium were positive, patients were referred for radiation therapy. In ovarian cancer patients, the upper abdomen and the pelvis were examined laparoscopically to evaluate the possibility of optimal debulking surgery. Staging was done for patients who were not candidates for optimal debulking surgery and second debulking surgery was considered. RESULTS: Nine patients with stage 1b-11a cervical cancer were included. Preoperatively, 2 of them were suspected for lymph node involvement. Following laparoscopy one was confirmed to have para-aortic lymph node involvement and the other did not. In the remaining 8 patients, one was found to have parametrial involvement and laparotomy was avoided, while the rest were treated surgically. Eighteen ovarian cancer patients were included in this study. Laparoscopy revealed an extensive disease in 7 patients and therefore staging laparoscopy was completed. In the remaining 11 patients, laparotomy was performed, operable disease was found and complete debulking surgery was conducted. In only one patient of the 11 complete debulking surgeries was not possible. CONCLUSIONS: In accordance with the experience and skills of the surgical team, we propose utilizing laparoscopy in cases where laparotomy may be avoided.

Female↗

No association of the I1307K APC allele with ovarian cancer risk in Ashkenazi Jews.

Familial adenomatous polyposis is a dominantly inherited colon cancer syndrome associated with germ-line mutations in the APC tumor suppressor gene. An APC gene sequence alteration, the I1307K allele, occurs in 6% of the Ashkenazi Jewish population and is reported to double the risk for colorectal cancer. We screened a population of 190 Ashkenazi women who were diagnosed with epithelial ovarian carcinoma for the I1307K variant and measured the effect of this allele on the risk for cancer development in their first-degree relatives. We identified the I1307K allele in 7.9% (15 of 190) of our ovarian cancer cases. The average age of ovarian cancer diagnosis in carriers of the I1307K allele (57.5 years) was not statistically different than the age for noncarriers (56.4 years; P = 0.70). Among the 1087 first-degree relatives, there were 23 cases of colorectal cancer; 3 of 100 relatives of probands with the I1307K allele (3.0%) had a history of colorectal cancer versus 20 of 987 relatives of probands without the I1307K allele (2.1%; relative risk, 1.48; 95% confidence interval, 0.45-4.88; P = 0.462). Relatives of the I1307K carriers had a risk of 38.0% for developing any cancer to age 80, similar to the risk for relatives of noncarriers of the I1307K allele (42.1%; P = 0.86). The average age of diagnosis of cancer of any type was not different between relatives of carriers (59.0 years) and noncarriers (60.4 years). In the Ashkenazi Jewish population, the I1307K allele is unlikely to increase the risk of ovarian cancer or of cancer in general.

Biomarkers, Tumor↗

Pain assessment: a pilot study in an Israeli bone marrow transplant unit.

The incidence and quality of pain experienced by nine patients during the first phase of the bone marrow transplant (BMT) was assessed in an Israeli BMT Unit. Reports of 215 separate episodes of pain were collected, which included the quality, intensity, and different locations of pain reported by the patient and medical staff. It was found that patients experienced on an average five anatomically identifiable pains daily for a period of > 11 days. In addition, although nurses recorded these episodes of pain more frequently than physicians did (47 versus 33%), there was still a discrepancy between the nurses' and the patients' reporting. This pilot study highlights the need for a larger study to be conducted in the area.

Adult↗

Brain stem auditory evoked potentials: effects of ovarian steroids correlated with increased incidence of Bell's palsy in pregnancy.

To investigate the effect of ovarian steroids on the brain stem during changes of estrogen and progesterone blood levels, we recorded brain stem auditory evoked potentials with increased stimulus rates from 26 women treated for sterility by menotropins (Pergonal and Metrodin). These women were divided into three groups according to their estrogen and progesterone blood levels. The brain stem auditory evoked potential results revealed a significant delay of peak III only, with an increased stimulus rate in the group with the highest estrogen level. Estrogen may cause a brain stem synaptic impairment, presumably because of ischemic changes, and thus also may be responsible for a higher incidence of Bell's palsy during pregnancy.

Adult↗

The safety of nitrofurantoin during the first trimester of pregnancy: meta-analysis.

Asymptomatic bacteriuria is common during pregnancy and may adversely affect both the mother and her fetus. Nitrofurantoin (NF) has been long recognized as an effective agent in both nonpregnant and pregnant women suffering from urinary tract infections. This meta-analysis was conducted in order to evaluate the safety of NF ingested during early pregnancy. Of twenty-two studies, only four met the inclusion criteria and their analysis could not demonstrate any significant correlation between NF ingestion and fetal malformation. The pooled odds ratio was 1.29 with 95% confidence interval 0.25-6.57. Although the number and quality of the studies included are limited, we thought it important to present the existing data. More extensive controlled studies are urgently needed in order to increase the significance of our study.

Adult↗

Does the anteroposterior diameter of the bony spinal canal reflect its size? An anatomical study.

Nine anatomical parameters that may have a relation to the spinal canal size were directly measured in each of 594 cervical and lumbar vertebrae from young adult cadaver skeletons. The anteroposterior diameter of the spinal canal was the only parameter which could be statistically correlated with its cross-sectional area (P less than 0.05), and hence justifies the accepted practice of its use as an indicator of bony spinal canal size.

Humans↗

Bilateral perilymph fistula in an adult.

Sudden hearing loss is a symptom caused by a variety of diseases, among them also a perilymph fistula. The occurrence of bilateral perilymph fistula is rare, and was reported only associated with head trauma. A case of a bilateral perilymph fistula, without head trauma in an adult construction worker is reported. To the best of our knowledge this is the first bilateral case caused by physical effort to be reported in the literature.

Audiometry↗

Toxic effects of cisplatin alone and in combination with gentamicin in stria vascularis of guinea pigs.

The toxic effects on the stria vascularis of treatment with cisplatin alone and combined with the aminoglycoside antibiotic, gentamicin, were studied in guinea pigs. The toxicity induced in albino and pigmented guinea pigs was investigated morphologically with light and transmission electron microscopy, and functionally by brainstem-evoked response audiometry. The results of hearing thresholds were variable, ranging from no change in one ear in some of the animals to a hearing loss of 20 dB in one or both ears when treated with low-dose cisplatin alone or in combination with gentamicin. Bilateral deafness resulted from high-dose cisplatin combined with gentamicin. The combined treatment produced prominent structural damage in the stria vascularis. The results should be considered when aminoglycoside therapy is required in conjunction with cisplatin.

Animals↗

Inactivation of the p53 oncogene by internal deletion or retroviral integration in erythroleukemic cell lines induced by Friend leukemia virus.

The p53 gene is rearranged in a high proportion of erythroleukemic cell lines derived from the spleens of mice infected with Friend leukemia virus. These rearrangements result in either the synthesis of a truncated protein or the inactivation of the p53 gene. Here we have molecularly characterized the rearrangements in two murine erythroleukemic cell lines induced by Friend leukemia virus, DP20-1 and CB3, that contain a rearranged p53 gene and fail to express p53 protein. The rearrangement in the DP20-1 cell line is due to the insertion of Friend spleen focus-forming provirus (SFFV) in the 3' end of the p53 gene in intron sequences between exons 9 and 10. Transfection of molecular clones of this SFFV provirus into NIH3T3 cells results in the generation of infectious virus as determined by its ability, in the presence of helper virus, to induce rapid splenomegaly and polycythemia when injected into adult DBA/2J mice. Insertion of SFFV in DP20-1 cells resulted in the expression of an aberrant 2.9 kb RNA species. Analysis of a molecular clone of the rearranged p53 gene in a second cell line, CB3, revealed that the p53 gene in this clone has sustained a large deletion within the p53 gene resulting in the loss of coding sequences between exons 4 and 8. The 5' end of the deletion originates within exon 4 and extends 3' to within the eighth intron. The significance of these findings with regard to the multi-stage nature of Friend virus induced erythroleukemia is discussed.

Animals↗

A highly leukemogenic radiation leukemia virus isolate is a thymotropic, immunosuppressive retrovirus with a unique RNA structure.

Clones of N-, B- and NB-fibrotropic viruses were isolated from weakly (D-RadLV) and strongly (A-RadLV) leukomogenic RadLV preparations. A highly leukemogenic, thymotropic virus (TV) was isolated by ex-vivo infection of thymocytes with A-RadLV. This virus could not be isolated from D-RadLV. Two-dimensional fingerprint analysis suggested that TV recombines unique RNA sequences with RNA genomic material derived from a B-tropic endogenous virus. C57BL/6 (B6) mice injected with B- or NB-fibrotropic clones, but not with TV or N-tropic viral clones, developed reactive T lymphocytes (Tr), capable of differentiating into anti-tumor cytotoxic cells. The N-tropic virus isolates were non-immunogenic in B6 mice whereas the TV isolate induced suppressor T lymphocytes (Ts) that abrogated a potential Tr response. These results suggest that emergence of highly leukemogenic RadLV involves activation of endogenous fibrotropic virus which is immunogenic in its natural host strain (B6). This virus can further recombine with other retroviral genetic sequences, resulting in a suppressogenic and thymotropic, highly leukemogenic virus.

Animals↗

Left ventricular function during physiological cardiac pacing: relation to rate, pacing mode, and underlying myocardial disease.

The hemodynamic effects of cardiac pacing at different rates and in different modes were studied in 21 patients who were candidates for permanent pacemaker implantation. Nine of these had primary conduction disturbances (PCD), ten had ischemic heart disease (IHD), seven with additional cardiac failure (CHF), and two had hypertrophic cardiomyopathy (HCM). In patients with PCD, atrial (AOO) and AV sequential (DVI) pacing did not change systolic blood pressure and pulse pressure but ventricular (VVI) pacing caused a progressive fall in these measurements, especially as heart rate increased. Ventricular volume and stroke volume (counts) derived from radionuclide ventriculography (RVG) decreased progressively with higher pacing rates, especially during VVI pacing. Cardiac output was maintained during VVI pacing by the increase in heart rate; during AOO and DVI pacing, cardiac output increased. Similar but more marked differences were observed in patients with IHD and CHF and the changes were even greater in the patients with HCM. Left ventricular (LV) ejection fraction changed little with increasing heart rate in PCD but decreased progressively with the onset of ischemia in IHD and CHF. There was no difference in ejection fraction in the different pacing modes. Graphs related to LV contractility (end-systolic pressure-volume relations) showed that AOO pacing produced the highest and VVI pacing produced the lowest curves of myocardial contractility in all patient groups, except that at higher rates the AOO curve shifted down again in patients with IHD and CHF, presumably with the onset of myocardial ischemia. This study showed that physiological pacing produced the best hemodynamic results in all patient groups. Higher pacing rates should be avoided in patients with ischemic heart disease while VVI pacing should not be used in patients with HCM. Blood pressure and RVG studies during temporary pacing are useful in selecting the optimal pacing system in an individual patient when the clinical choice is not clear.

Bradycardia↗

Feasibility of pre-hospital fibrinolytic therapy in acute myocardial infarction.

Intravenous streptokinase (STK) was given in the field by a physician-staffed mobile intensive care ambulance to 13 patients. Patients waited 33 +/- 17 minutes to call the ambulance, arrival time was 5 +/- 3 minutes, and a further work-up time of 32 +/- 8 minutes elapsed. The average time from the onset of pain until administration of STK was 66.7 minutes. Patients were transferred to hospital without important side effects or complications. Eleven of 12 of the infarction-related arteries were patent on subsequent coronary angiography. Three patients had minor hematomas and two had microscopic hematuria. This pilot study shows that intravenous STK can be given with relative ease and safety at home by an experienced physician capable of treating any complications.

Adult↗

A simple prognostic index for hospitalized geriatric patients. A prospective study of 70 patients.

A simple prognostic index for hospitalized geriatric patients is reported herein. Seven parameters including: mobility, sphincter control, mental competence, feeding ability, presence of pressure sores, medical condition and family state were recorded in 70 patients. The sum of the scores of all parameters constituted the prognostic index. At the end of 3 months the patients were divided into two groups: 18 patients who were discharged (group 1) and 52 patients who were still hospitalized (35 cases) or had died (17 cases) (group 2). The mean index for group 1 was 14.9 +/- 3.2 (mean +/- SD), while that for group 2 was 23.5 +/- 4.3 (p less than 0.00001). Eighty-three percent of the patients in group 1 and only 8% of those in group 2 had scored lower than 17. Thus, the score of 17 or more had a prognostic sensitivity of 92% and a specificity of 83%. The predictive value of indices of 17 or more was 94%. The index described offers therefore a simple and relatively accurate tool for the assessment of the prognosis of elderly patients.

Aged↗

Effect of sustained release isosorbide dinitrate on exercise performance.

The duration of action and hemodynamic mechanisms of isosorbide dinitrate in a sustained release formula (ISDSR) were examined over a 24-hour period. 20 patients with effort angina pectoris were divided randomly into two groups, one group received a single dose of 40 mg ISDSR (at 07.30 h) and the other, two doses of 40 mg ISDSR (at 07.30 and 13.30 h). Every patient had four exercise tests on the first (placebo) day and second (ISDSR) day and a single test on the third (placebo) day. Effort tolerance was improved significantly (p less than 0.05) with ISDSR and this lasted for more than 10 h. The double product was compared to ISDSR. Improvement was achieved by a decrease in blood pressure and an increase in heart rate. There were no signs of increased ischemia (ST segment depression) with the prolongation of exercise time. The antianginal and hemodynamic effects of ISDSR were more pronounced in the patients who received two doses of ISDSR. Thus, ISDSR improved effort tolerance for a prolonged period by inducing a sustained decrease of blood pressure and increase in heart rate in patients with effort-induced angina pectoris.

Adult↗