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Y Finkelstein

Publications and source records attributed to Y Finkelstein.

At least 55 records · Page 3Linked to original sources
PubMed1998

Immunohistochemical analysis of p27/kip1 expression in thyroid carcinoma.

Cyclin-dependent kinase inhibitors, including the protein product of the p27/kip1 gene, play an important role in cell-cycle regulation. Loss of p27 expression was reported in a number of neoplasms and shown to be an independent prognostic factor in colorectal, lung, and breast carcinoma By immunohistochemical analysis, we investigated p27/kip1 expression, using a polyclonal antibody, in a series of 87 benign and malignant thyroid neoplasms. We correlated its expression with the Ki-67 labeling index and other prognostic factors. All of the thyroid neoplasms examined exhibited significantly lower p27 expression than did normal thyroid tissue (P < .001). Poorly differentiated carcinomas had the lowest p27 staining frequency of all carcinomas examined. p27 staining frequency of the papillary carcinomas was significantly lower than that of the follicular carcinomas (P < .001). This difference could not be attributed solely to the inverse correlation between the staining patterns of p27 and Ki-67, which was reported for other neoplasms, because there was no significant difference between the Ki-67 labeling indices of these two groups. The follicular variant of papillary carcinoma had a significantly higher p27 staining frequency (P = .05) than did classical papillary carcinoma. We saw no significant difference in the p27 staining frequencies between minimally and widely invasive follicular carcinomas nor between localized and nonlocalized papillary carcinoma. In summary, the p27 immunostaining pattern of thyroid neoplasms is related to neoplastic transformation and varies according to tumor phenotype. It seems, however, to have limited routine diagnostic or prognostic significance in thyroid neoplasia.

Adenocarcinoma, Follicular↗
PubMed1997

Uvulopalatopharyngoplasty vs laser-assisted uvulopalatoplasty. Anatomical considerations.

OBJECTIVE: To assess and compare anatomical changes in the velopharynx produced by conventional uvulopalatopharyngoplasty and by laser-assisted uvulopalatoplasty. DESIGN: A before-after trial of patients who underwent conventional or laser-assisted palatal surgical procedures. PATIENTS AND INTERVENTIONS: A total of 174 patients (157 men and 17 women; age range, 22-71 years; mean age, 48 years) who were suffering from heavy snoring (n = 16) or obstructive sleep apnea. The first 100 consecutive patients underwent conventional uvulopalatopharyngoplasty, and the remaining 74 underwent 1 of 2 surgical variations of laser-assisted uvulopalatoplasty. MAIN OUTCOME MEASURES: Preoperative and postoperative examinations included peroral photographs of the oropharynx and nasopharyngoscopic examination of the velopharyngeal valve. In 10 randomly selected patients, postoperative lateral and frontal cephalometric radiographs, enhanced with contrast media, were compared with routine preoperative radiographs. RESULTS: Uvulopalatopharyngoplasty results in an enlargement of the oropharynx and an increased velopharyngeal air space. Laser-assisted uvulopalatoplasty, by producing a raw surface, involves circumferential scarring, the severity of which depends on the velopharyngeal axial configuration; therefore, it can result in a diminished velopharyngeal air space and decreased distensibility. CONCLUSIONS: From an anatomical viewpoint, laser-assisted surgery of the palate is significantly inferior to conventional uvulopalatopharyngoplasty and may even be deleterious. The results of preoperative and postoperative polysomnographic comparisons in patients who undergo laser-assisted operations should be evaluated to determine whether future laser-assisted surgery is an adequate option, even for snoring as an isolated symptom.

Female↗
PubMed1997

A new classification for pericarditis associated with meningococcal infection.

UNLABELLED: Acute meningococcal pericarditis is a rare clinical disorder. Our review of the literature disclosed that current classifications are confusing since they fail to differentiate between two distinct criteria: time and causality. We suggest a new classification of the various states of meningococcal pericarditis on the basis of the pathophysiological process: disseminated meningococcal disease with pericarditis (purulent, culture-positive, associated with meningococcal bacteraemia); isolated meningococcal pericarditis (purulent, culture-positive but without signs of meningeal or other clinical systemic involvement); and reactive meningococcal pericarditis (immunological, late-onset, culture-negative, resembling post-viral pericarditis). It is essential that clinicians recognize the various states of the disease, since they differ in natural history, treatment and prognosis. CONCLUSION: From personal experience and a literature review it emerges that meningococcal pericarditis should be classified as: (1) Pericarditis as local manifestation of disseminated meningococcal disease; (2) isolated meningococcal pericarditis; (3) reactive (immunopathic) meningococcal pericarditis.

Adolescent↗
PubMed1997

Narrow-band red light phototherapy in perennial allergic rhinitis and nasal polyposis.

BACKGROUND: Allergic rhinitis and nasal polyposis are common nasal diseases, but the available treatment modalities have only limited success. OBJECTIVE: To assess the therapeutic effect of low-energy narrow-band red light phototherapy on nasal clinical symptoms of allergic rhinitis and nasal polyposis. METHODS: In a double-blind randomized prospective study, 50 patients with allergic rhinitis and 10 with nasal polyposis received intranasal illumination at 660 nm for 4.4 minutes three times a day for 14 days (total dose 6 joules per day). Twenty-nine rhinitic patients and one patient with polyposis received equivalent sham illumination as placebo. Evaluation was based on symptom scores and a clinical assessment that included pre-treatment and post-treatment videotaped rigid and flexible nasendoscopy. RESULTS: Following treatment, improvement of symptoms was reported by 72% of the allergic rhinitis patients and objective improvement was endoscopically demonstrated in 70% of them as compared with 24% and 3%, respectively, in the placebo group. These differences were significant. No improvement was obtained in any of the patients with polyposis. CONCLUSIONS: Allergic rhinitis, if uncomplicated by polyps or chronic sinusitis, can be effectively treated by narrow-band red light illumination of the nasal mucosa at 660 nm, with marked alleviation of clinical symptoms. Whenever possible, candidates for phototherapy should be selected by endoscopic examination.

Adolescent↗
PubMed1997

Patterns of hearing loss in non-explosive blast injury of the ear.

A prospective study of hearing loss in 120 cases with non-explosive blast injury of the ear, gathered over a six-year period, is presented. Thirty-three (27.5 per cent) patients had normal hearing, 57 (47.5 per cent) conductive hearing loss, 29 (24.2 per cent) mixed loss and one (0.8 per cent) had pure sensorineural loss. The severity of conductive hearing loss correlated with the size of the eardrum perforation; only a marginal difference was found between water and air pressure injuries, with respect to this type of hearing loss. Of all locations, perforations involving the posterior-inferior quadrant of the eardrum were associated with the largest air-bone gap. Audiometric assessment revealed that none of the patients suffered ossicular chain damage. Three patterns of sensorineural hearing loss were identified: a dip at a single frequency, two separate dips, and abnormality of bone conduction in several adjacent high frequencies. Involvement of several frequencies was associated with a more severe hearing loss than a dip in a single frequency. Healing of the perforation was always accompanied by closure of the air-bone gap, while the recovery of the sensorineural hearing loss was less favourable.

Adolescent↗
PubMed1997

Characterization of smoking-induced nasopharyngeal lymphoid hyperplasia.

The frequency of smoking-induced nasopharyngeal lymphoid hyperplasia in heavy smokers and its potential clinical implications are still unknown. Precise criteria to differentiate this entity from other types of nasopharyngeal lymphoid hyperplasia are needed. A prospective clinicopathological study of smoking-induced nasopharyngeal lymphoid hyperplasia was conducted in 17 heavy smokers. Ten nonsmoking patients, five of them with chronic sinusitis, three with adult-onset adenoid hypertrophy, and two children with adenoidal hypertrophy served as a control group. Both in smokers and in nonsmokers, lymphocytic infiltration of the mucosa was characterized immunohistochemically as T cells. In smokers, semithin (1 micron) sections revealed deformed and migrating cytotoxic lymphocytes in the nasopharyngeal mucosa. The lymphocytes were attached to epithelial, ciliated, and goblet cells, resulting in cell damage. Transmission electron microscopy of biopsies from smokers revealed emperipolesis, characterized by mucosal invasion and epithelial cell damage by an unusual population of migrating T lymphocytes that penetrate them. These findings confirm a direct effect of smoking on the nasopharyngeal lymphoid tissue, which forms part of the immune system. It is concluded that the diagnostic evaluation and therapeutic approach of heavy smokers with otological and airway symptoms should be based on thorough endoscopic examination of the nasopharynx. When the diagnosis is not clear-cut, selective tele-endoscopic biopsy and electron microscopic examination are recommended. This entity should be added to the list of known clinical manifestations of the smoking habit.

Adenoids↗
PubMed1997

Anti-Ro (SSA) and anti-La (SSB) antibodies and complete congenital heart block.

Complete congenital heart block (CCHB) is the most severe manifestation of neonatal lupus syndrome, associated with a mortality rate of up to 31%. It is caused by irreversible damage to the cardiac conduction system due to the transplacental passage of maternal antibodies to the fetus. Anti-Ro (SSA) and anti-La (SSB) antibodies are usually detected in sera of mothers of children with prenatally diagnosed CCHB and in cardiac tissues of affected newborns. Their pathogeneic role in the development of CCHB has been established in several studies. When CCHB is detected during pregnancy, careful monitoring and delivery are needed before heart failure is developed. Treatment strategies are debatable and may include prophylactic therapy for high-risk pregnant women and a combination of intrauterine plasmapheresis with plasma exchange or with corticosteroids. Pacemaker insertion is required in most infants during the first three months of life. Assays for anti-Ro (SSA) and anti-La (SSB) antibodies should be performed on sera of pregnant women with SLE and newborns with CCHB.

Antibodies↗
PubMed1996

The mechanism of monensin-mediated cation exchange based on real time measurements.

Monensin is an ionophore that supports an electroneutral ion exchange across the lipid bilayer. Because of this, under steady-state conditions, no electric signals accompany its reactions. Using the Laser Induced Proton Pulse as a synchronizing event we selectively acidify one face of a black lipid membrane impregnated by monensin. The short perturbation temporarily upsets the acid-base equilibrium on one face of the membrane, causing a transient cycle of ion exchange. Under such conditions the molecular events could be discerned as a transient electric polarization of the membrane lasting approx. 200 microseconds. The proton-driven chemical reactions that lead to the electric signals had been reconstructed by numeric integration of differential rate equations which constitute a maximalistic description of the multi equilibria nature of the system (Gutman, M. and Nachliel, E. (1989) Electrochim. Acta 34, 1801-1806). The analysis of the reactions reveals that the ionic selectivity of the monensin (H+ > Na+ > K+) is due to more than one term. Besides the well established different affinity for the various cations, the selectivity is also derived from a large difference in the rates of cross membranal diffusivities (MoH > MoNa > MoK), which have never been detected before. (v) Quantitative analysis of the membrane's crossing rates of the three neutral complexes reveals a major role of the membranal dipolar field in regulating ion transport. The diffusion of MoH, which has no dipole moment, is hindered only by the viscose drag. On the other hand, the dipolar complexes (MoNa and MoK) are delayed by dipole-dipole interaction with the membrane. (vi) Comparison of the calculated dipoles with those estimated for the crystalline conformation of the [MoNa(H2O)2] and [MoK(H2O)2] complexes reveals that the MoNa may exist in the membrane at its crystal configuration, while the MoK definitely attains a structure having a dipole moment larger than in the crystal.

Arylsulfonates↗
PubMed1996

The functional role of the adenoids in speech.

Illustrative cases are presented showing a variety of interrelationships between the adenoids and the activity of the velopharyngeal valve in speech. The cases presented were selected from a group of 1000 patients referred because of suspected velopharyngeal diseases. When appropriate, complete velopharyngeal assessment was made including otolaryngological speech and hearing examination, polysomnography, nasendoscopy, multiview videofluoroscopy and cephalometry. New observations are described which further elucidate the mechanism by which the adenoids may change the mechanism of velopharyngeal valving and consequently speech patterns. In conclusion, procedures involving the adenoids and tonsils and surgical correction of velopharyngeal valve abnormalities to improve respiratory function must be performed in a manner which ensures preservation of normal speech activity. Similarly, surgical correction of velopharyngeal valve abnormalities to improve speech activity must preserve its respiratory function. The velopharyngeal valve and the adeno-tonsils must be considered together whenever diagnosis and a therapeutic intervention of either of them is considered. A clinical method for patient evaluation, patient management and the development of a rational therapeutic approach is presented.

Adenoids↗
PubMed1996

The enigma of parkinsonism in chronic borderline mercury intoxication, resolved by challenge with penicillamine.

A 47 year old female dentist suffered from hemiparkinsonism which had started eighteen months earlier and was manifested mainly by resting tremor and cogwheel rigidity. A baseline quantitative urinary mercury excretion was 46 micrograms/day. The patient was treated with chelating agent d-penicillamine for a week. Chelation therapy resulted in clinical improvement of parkinsonism and in dynamic changes in daily urinary mercury excretion with a prompt increase to 79 micrograms/day, a subsequent decline followed by increase in the mercury urinary excretion. After a week chelation therapy was stopped. During a follow-up period of five years, the neurological status remained unchanged after the initial penicillamine-induced improvement. This case may be evidence, therefore, of a rare clinical variant of elemental mercury intoxication associated with parkinsonism, in the absence of most classical neuropsychiatric signs of chronic mercurialism.

Chelating Agents↗
PubMed1995

Can obstructive sleep apnoea be a complication of uvulopalatopharyngoplasty?

UNLABELLED: Polysomnography is currently used for diagnosis, evaluation and selection of therapy in patients with obstructive sleep apnoea (OSA), but clinically successful uvulopalatopharyngoplasty (UPPP) is not necessarily reflected by post-operative improvement of polysomnographic recordings. Post-operative polysomnography may suggest deterioration of pre-existing OSA or, in snorers, de-novo precipitation of OSA. Thus, if polysomnography is a reliable indicator of OSA, then OSA may be a post-operative risk of UPPP. THE AIMS OF OUR STUDY WERE: (i) to assess the possible deleterious effect of UPPP on sleep patterns; (ii) to further define the role of cardioisotope scanning in the evaluation of OSA; (iii) to assess the reliability of polysomnography given the clinical and cardiosotope scan findings. Symptoms, polysomnography and radionuclide ventriculography were prospectively compared pre- and post-operatively in 41 patients undergoing UPPP. In 12 patients (29 per cent), there were disparate results between pre- or post-operative polysomnography and the clinical and/or radionuclide ventriculography, as follows: In four of 16 patients with abnormal pre-operative ventricular performance, there was pre-operative symptomatology of severe OSA and a bedmate's reports of apnoeic episodes. This was in contrast to normal or near normal sleep apnoea recordings. In eight patients, post-operative improvement of symptoms was reported, despite deterioration of post-operative polysomnographic recordings. In these patients the post-operative improvement of symptoms was also reflected by improved ventricular performance. Worsening of ventricular performance was not demonstrated in any patient. In conclusion, UPPP does not induce OSA. Polysomnography may underestimate or even misdiagnose cases of OSA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗