Is a ventilation-perfusion mismatch in a lung scan always a sign of pulmonary embolism? A propós a case of Takayasu's arteritis.
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Adult↗
Biomedical subjects
Y Horn
Publications and source records attributed to Y Horn.
Acute tumor lysis syndrome induced by high-dose corticosteroids in a patient with chronic lymphatic leukemia.
Acute tumor lysis syndrome (TLS) has been reported in hematological malignancies, such as aggressive non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and rarely, in other malignancies (solid tumors) in association with the administration of cytotoxic therapy. We report a case of a patient with chronic lymphatic leukemia (CLL) who developed autoimmune hemolytic anemia treated by high dose corticosteroids and, following this treatment, developed acute tumor lysis syndrome. Only one similar case has been reported recently. Clinicians should be aware that corticosteroids alone may produce this potentially life-threatening complication.
Acute Disease↗
A quantitative morphometric study of the kinetics of tissue regeneration after administration of cisplatin.
The effect of the anti-neoplastic drug cisplatin was investigated on several rat tissues using a novel computerized morphometric image analysis system. The rats were sacrificed in pre-determined intervals, ranging from 1 to 36 days after drug administration, and their liver, kidneys and external ears were sampled and sectioned. Tritiated thymidine was injected into each rat 1 h prior to sacrifice to enable autoradiographical explorations. All sections were histomorphometrically studied by a computerized system. The kidneys of the experimental group revealed increased tubular diameters, especially in the corticomedular region. In the ears, decreases of the mean epithelial thickness, in the mean number of nuclei and in the mean nuclear surface were observed. The thickness of the connective tissue also decreased significantly by the end of the first week and returned to its normal size later on. No changes were detected in the ear cartilage. In the liver, no morphometrical differences were noticed in the hepatocyte density, Kupffer cell density or nuclear area. The nuclei of the hepatocytes and Kupffer cells retained a constant ratio to the total number of cells throughout the whole experiment. Liver autoradiography revealed that the hepatocyte and Kupffer cell labelling indexes after cisplatin administration were significantly higher than those of the control group, indicating enhanced replication of cells and increased synthesis of DNA, which in turn is accumulated in the nuclei and turn the cells into polyploids. In addition, the mean radius of the liver acini after cisplatin was diminished, followed by a significant reduction in the size of the progenitor compartment. It is concluded that while the kidneys are the organs most affected by cisplatin, the progenitor compartment of the liver is heavily affected as well. Computerized morphometry was demonstrated as a highly reproducible and accurate quantitative method for evaluation of histopathological changes in various mammalian tissues.
Animals↗
Long-term follow-up of patients with superficial transitional cell carcinoma of the urinary bladder treated by intravesical mitomycin C.
Prophylactic intravesical chemotherapy (IVC) reduces recurrence rates of superficial transitional cell carcinoma (TCC) of the urinary bladder. The patient cohort existed of 86 individuals (stage TaN0M0 or T1N0M0) superficial carcinoma of various grades of malignancy. Following initial transuretheral resection or diagnostic cystoscopy, mitomycin C (MMC), 20 mg dissolved in 50 ml saline, was instilled intravesically by catheter over 1 hr at 2-week intervals, initially and then four more times followed by diagnostic cystoscopy (one course = 12 weeks). Two similar courses were administered thereafter for a total period of 36 weeks. For patients in remission, installations continued in monthly fractionations for 9 more months (cystoscopy every 3 months) and then at 2-month intervals for 12 more months (cystoscopy every 6 months). When cystoscopy revealed recurrence, IVC was repeated from the beginning. No symptoms of MMC-related toxicity were observed. Cystoscopic follow-up evaluations showed a complete response rate of 84% at 3 years and 81% at 5 years after initial therapy. Twenty-seven patients who had not responded to previous treatment with other drugs responded to MMC.
Administration, Intravesical↗
The potential carcinogenic hazards of electromagnetic radiation: a review.
The purpose of this review is to summarize the experience gained thus far on the potential health hazards of electromagnetic radiation. Far less information is available in the medical literature on this kind of radiation than on ionizing radiation, which has been recognized as a health hazard long ago. Increased rates of cancer morbidity and mortality have been noted in populations exposed to ionizing radiation, and international quantitative safety criteria have been established. Electromagnetic radiation (radiofrequency levels between several hundred kilohertz and 300 GHz) is not an infrequent phenomenon. The literature consists mainly of epidemiological studies out of which grew the assumption that this kind of radiation may be carcinogenic. However, only limited data are available on electromagnetic radiation as a potential cancer inducer. A review of the literature does not demonstrate a direct and clear linkage between electromagnetic radiation and the occurrence of malignant tumors, but much more research and clarification are necessary before reaching any conclusions.
Animals↗
Nutritional risk factors and breast cancer in Jewish and Arab women.
Based on a lower reported incidence of breast cancer in the Arab population in Israel, nutritional levels were evaluated in a case-control study of 33 Jewish and 10 Arab patients with breast cancer all matched with a first-degree family-related control. Demographic, gynecologic, obstetric, anthropometric, genetically tumor-related, and nutritional data were ascertained through interviews, tests, and questionnaires. Food consumption, calories, protein, fat, and fiber intake, and anthropomorphic measures were calculated. The following results were obtained: 1. Calories of food consumption were significantly higher in Jewish and Arab patients than in their controls. 2. Jewish patients consumed significantly higher levels of monounsaturated fat; Arab patients consumed significantly higher levels of dietary fiber. 3. Animal protein intake was elevated in patients of both ethnic origins as compared with controls. 4. Vegetable fat and monounsaturated fatty acids were elevated in Arab patients as compared with Jewish patients. 5. Body weight of both Arab and Jewish patients was not significantly higher when compared with their controls. 6. Energy consumption and obesity were higher in breast cancer patients than in the controls. This supporting evidence suggests an association between obesity and breast cancer occurrence.
Adult↗
Characteristics of cancer patients under the age of 20 at medical centers in Israel and the West Bank: a preliminary study.
This paper describes the demographic experience on 373 young cancer patients (less than 20 years of age) at two oncology centers initiated in Israel by one medical team in 1975-1977. These units are the Assaf Harofeh Medical Center (AHMC), which predominantly serves a Jewish population (103 cases); and the West Bank Cancer Unit (WBCU), which provides similar care services to the Arab population of the West Bank (270 cases). The two centers have the unique feature of serving two populations residing in close relationship but still differing in many cultural and socioeconomic characteristics. The Arab patients at WBCU tended to be younger than the Jewish children at AHMC. The five most common diagnostic sites for both AHMC and WBCU included hematopoietic system, bones and joints, soft tissue, urinary tract, and brain and nervous system, although not in the same order of occurrence. These tumor sites accounted for approximately 80% of the cases at each center. The experience with WBCU patients was also compared with data for all Jews in Israel. This comparison identified for both sexes combined statistically significant differences in relative frequency of tumors of soft tissue, eye and orbit, brain and nervous system, and thyroid gland. If confirmed by additional data, reasons for the suggested excess risks should be pursued through more definitive epidemiological studies.
Adolescent↗
The combined effect of small volume hypertonic saline and normal saline solutions in uncontrolled hemorrhagic shock.
Recently, small volume hypertonic saline solution (HTS) has been suggested for treatment of trauma casualties. Previously, we reported that small volume HTS treatment of uncontrolled hemorrhagic shock (UCHS) leads to increased bleeding, hemodynamic deterioration and early mortality. In the present study, large volume normal saline solution (NS) combined with small volume HTS was used to treat UCHS in rats. The rats were randomly assorted into four groups. Group 1 (n = 9) included rats in which UCHS induced by 12 per cent resection of the tail was untreated; group 2 (n = 8) consisted of those in which UCHS was treated after 15 minutes with 41.5 milliliters per kilogram of sodium chloride, 0.9 per cent (NS); group 3 (n = 7) included rats in which UCHS was treated with 5 milliliters per kilogram sodium chloride, 7.5 per cent (HTS); and group 4 (n = 9) included rats in which UCHS was treated by a combination of HTS and NS. In group 1, resection of the tail was followed by bleeding of 4.9 +/- 0.3 milliliters in 15 minutes, a decrease in mean arterial pressure (MAP) from 105 +/- 5 to 51 +/- 3 torr (p less than 0.001) and pulse rate from 377 +/- 9 to 305 +/- 22 beats per minute (p less than 0.05). Further loss of blood after 30 minutes was 0.5 +/- 0.2 milliliters, MAP rose to 58 +/- 6 torr (p less than 0.05) with the death of two rats. Infusion of NS in group 2 was followed by further bleeding of 3.3 +/- 1.0 milliliters (p less than 0.01) and rise in MAP to 76 +/- 9 after 30 minutes. Infusion of HTS in group 3 was followed by bleeding of 1.9 +/- 0.3 milliliters (p less than 0.05) and fall in MAP to 57 +/- 14 torr (p less than 0.05). Continued loss of blood in this group resulted in further fall in MAP to 36 +/- 11 torr (p less than 0.01) with death of 71 per cent (p less than 0.01) of the rats in four hours. Combined HTS and NS infusion in group 4 was followed by bleeding of 2.0 +/- 0.4 milliliters (p less than 0.05) and an increase in MAP to 93.0 +/- 3.0 torr (p less than 0.005) after 30 minutes with the death of only one animal in four hours. Total loss of blood in the three treated groups was similar and significantly higher than in the untreated group.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗
Cancer patterns at medical centers in Israel and the West Bank.
This paper describes the oncological experience on 7,216 patients at two cancer units initiated by one medical team in 1975-1977 at Assaf Harofeh Medical Center in Israel (predominantly serving a Jewish population, 4,671 cases) and at the West Bank Cancer Unit (WBCU), which serves an Arab population (2,545 cases). The two centers have the unique feature of serving two populations residing in close geographic proximity but differing in many cultural and socioeconomic characteristics. Data from the ongoing cancer registries in these two centers are summarized and compare the demographic characteristics of the two study groups, anatomic sites of cancer, methods of diagnosis and extent of disease. The findings at the two centers suggest the presence of different risk factors influencing the site distributions of cancers seen in the two populations served. Among the findings, significantly higher (p less than 0.05) estimated relative risks for cancers of the digestive and urinary-genital systems are observed in each sex group at AHMC than at WBCU. Alternatively, the estimated risk of head and neck cancers was significantly higher among both males and females at WBCU compared with their counterparts at AHMC. Differences in risk were also noted for a number of specific anatomic sites of cancer.
Age Factors↗
Efficacy of intravesical mitomycin C in the treatment of superficial transitional cell carcinoma of the urinary bladder.
We treated 47 patients with recurrent transitional cell carcinoma of the bladder with intravesical chemotherapy. Twenty milligrams of mitomycin C per treatment was introduced 7 days after transurethral resection (TUR) or diagnostic cystoscopy, and was repeated at 2-week intervals for five times followed again by cystoscopy. Two more similar courses were administered for a total of 36 weeks. Clinical data revealed no toxicity-related symptoms. Cystoscopic follow-up showed a gradual decline in the presence of tumor to a complete response rate of 87.1% at 36 weeks. Thirteen patients who were previously treatment failures with other drugs responded to mitomycin C.
Administration, Intravesical↗
Urinary polyamine levels in cancer patients treated with D,L-alpha-difluoromethylornithine, an inhibitor of polyamine biosynthesis.
The polyamine biosynthesis inhibitor D,L-alpha-Difluoromethylornithine hydrochloride monohydrate (DFMO) has cytostatic and cytotoxic effects against various human tumor cell lines in vitro. We measured levels of the polyamines putrescine and spermidine in the urine of cancer patients undergoing "conventional" chemotherapy in a two-arm randomized phase I-II study with and without additional DFMO administered orally at a dose of 1.7 g/sq.m. t.i.d. The study group included 38 patients with carcinoma of the breast, stomach, prostate, or female genital organs or metastatic carcinoma of unknown origin. A control group of 32 patients with similar malignancies received "conventional" chemotherapy without DFMO. Polyamine levels were determined periodically in the urine of all patients. In DFMO-treated patients, a significant decrease in putrescine and spermidine levels was observed after 3 weeks of DFMO therapy (the first time point evaluated) that usually persisted throughout the course of treatment. Significant differences in polyamine levels between DFMO-treated and control patients were observed for patients in remission. Less significant differences were noted, however, for patients with static or progressive disease between DFMO-treated and control groups. DFMO activity appears to be reflected by a long-term decrease in urinary polyamine levels.
Antineoplastic Combined Chemotherapy Protocols↗
Simultaneous occurrence of systemic lupus erythematosus and coeliac disease-like features.
Involvement of the gastrointestinal tract in systemic lupus erythematosus is well documented but small intestinal malabsorption is a rare event. We report a 27 year old woman with systemic lupus erythematosus who had malabsorption and coeliac-like changes on intestinal biopsy. This is the eighth reported case of this association the significance of which is discussed.
Adult↗
Nutritional monitoring and counselling for cancer patients during chemotherapy.
The objective of the study was to try to monitor the nutritional status of cancer patients during chemotherapeutic treatment. Concomitantly with chemotherapeutic treatment administered to patients with cancer of the gastrointestinal tract and metastatic carcinoma of unknown origin, levels of carotene, retinol, thiamine, riboflavin, pyridoxine, iron, total protein and hemoglobin were measured in the blood periodically. In addition, anthropometric studies were performed and the nutritional status was established. A total of 19 patients were subject for final evaluation. These patients formed 3 groups according to their nutritional status (good, medium, poor). The effect of chemotherapy was correlated to the nutritional status at 3 different periods of chemotherapy. Most patients with good clinical status maintained the initial nutritional status. Half of the patients with medium nutritional status improved clinically during therapy, and patients initially with poor nutritional status further deteriorated. The levels of most vitamins decreased to a certain degree during therapy and returned to initial values thereafter. Our impression is that cancer patients might benefit from intensive ongoing personal nutritional monitoring and counselling. The results presented have a preliminary meaning because of the small number of patients included in this study.
Adult↗
Malabsorption and systemic lupus erythematosus.
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Celiac Disease↗
[Primary meningococcal pericarditis--a rare expression of a common infection].
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Humans↗
Detection of genotoxic substances in cancer patients receiving antineoplastic drugs.
A short-term bacterial mutation test, the SOS Chromotest, has been used to detect the excretion in urine of genotoxic metabolites of antineoplastic drugs administered to cancer patients. In this test, the damage to the DNA of the test bacteria is expressed by the production of beta-galactosidase, which can be quantitatively assessed and is proportional to the concentration of the drug. Kinetic curves of excretion for adriamycin, bleomycin, dacarbazine, cis-platinum and vincristine and their mixtures have been constructed from standard curves relating the intensity of the beta-galactosidase response to the concentration of drugs dissolved in normal urine. Comparative data on extraction and concentration of the drugs from urine or serum by means of selective resin or silica columns are presented.
Adenocarcinoma↗
Breast cancer at medical centers in Israel, the West Bank, and the United States.
A comparison is made of the characteristics of female breast cancer patients, their diseases, and treatment practices in medical centers in Israel and the West Bank of the Jordan River. This experience is further compared with tumor registry data from a major medical center in the United States. Differences are found in the age distributions of patients, marital status, parity, stage of disease at diagnosis, delay between onset of symptoms and diagnosis as well as between diagnosis and treatment. Some of these observations reflect differences in population characteristics, sociocultural practices and local attitudes toward disease, its diagnosis and management.
Adult↗
Effect of multiple applications of Bitupal on squamous stratified epithelium in rats.
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Animals↗