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Biomedical subjects

Y Lieberman

Publications and source records attributed to Y Lieberman.

At least 55 records · Page 3Linked to original sources
PubMed1980

Increased risk of lung cancer in patients with chondromatous hamartoma.

Fifty-two patients with chondromatous hamartoma of the lung (CHL) operated upon in one medical center in Israel during the years 1960 to 1975 were followed through the end of 1976 for occurrence of malignancy. In 51 patients, the operation followed the finding of a coin lesion in a routine chest x-ray film (32 cases) or an x-ray film taken due to symptoms related to the chest (19 cases). In one case, it followed a cytologic diagnosis of bronchogenic carcinoma. Four cases of carcinoma of the lung were observed in this group, three of them 2 to 10 years after the CHL was first observed; in the fourth the CHL was found during an operation for lung cancer. All four lung cancers were located in the same lobe as and in proximity to the CHL. Since hamartomas were randomly distributed among the lobes, this spatial association is highly significant (p = 0.0016). The risk of lung cancer in CHL patients was estimated to be 6.3 times higher than the age-sex-ethnic adjusted rate expected for the general Israeli population. No increased risk for malignancies of other sites was found.

Adult↗
PubMed1979

Resectional surgery in the treatment of primary carcinoma of the lung with mediastinal lymph node metastases.

Between 1966 and 1970 we reviewed 46 consecutive patients undergoing resection for primary carcinoma of the lung, in whom mediastinal lymph node metastases were found at operation. There was one operative death. Five of the remaining 45 patients survived five years--one of 10 cases of large cell carcinoma, one of 19 cases of adenocarcinoma, and three of 12 cases of epidermoid carcinoma. We believe that mediastinal lymph node metastases are not per se a contraindication to resection of epidermoid carcinoma of the lung.

Adenocarcinoma↗
PubMed1979

The influence of cell type and lymph node metastases on survival of patients with carcinoma of the lung undergoing thoracotomy.

We studied 202 cases of bronchogenic carcinoma treated surgically between January 1, 1966 and December 31, 1970. Over all, adenocarcinoma was the most common cell type (36.1 per cent). Of 151 patients whose carcinomas were successfully resected, and who lived for at least 30 days postoperatively, 88 had lymph nodes free of cancer. Not surprisingly, 5-year survival was related to lymph node metatases and cell type. The best over-all 5-year survival rate was for large cell carcinoma; it was 52.0 per cent without nodal involvement. Similar figures for epidermoid carcinoma were 29.0 per cent over all, and 26.3 per cent without lymph node involvement; for adenocarcinoma, 19.3 per cent over all, and 32.0 per cent without nodal involvement. For the entire group of 151 patients, the 5-year survival rate was 27.8 per cent over all, and 36.4 per cent without nodal metastases. Among resected patients with mediastinal lymph nodes positive for cancer, the 5-year survival rates were 1 of 10 patients with large cell carcinoma, 1 of 19 patients with adenocarcinoma, and 3 of 12 patients with epidermoid carcinoma. This suggests that in patients with epidermoid carcinoma, the presence of mediastinal lymph node metastases is not, in itself, an absolute contraindication to resectional therapy.

Adenocarcinoma↗
PubMed1977

The human coronary microcirculation: an electron microscopic study.

The ultrastructure of the terminal vascular bed of human coronary arteries was studied in the myocardial tissue obtained at surgery from different locations in the heart in five patients. The following vessels were identified: (1) Arterioles; slender and prolonged endothelial cells, flat nuclei and two to three layers of smooth muscle cells. (2) Precapillary sphincters: short endothelial cells, large nuclei bulging into the lumen, close myoendothelial junctions and a single layer of circular smooth muscle. (3) Capillaries: composed of one or more slender endothelial cells. (4) Venules: flat endothelial cells and nuclei, no muscular layer, rich collagen tissue. The function of these structures is believed to be as follows: the arterioles are the smallest blood-distributing arteries in the heart. The precapillary sphincters control blood flow to the capillaries; pressor substances present in the blood are picked up by endothelial cells, pass rapidly through the myoendothelial junctions and cause contractions of the smooth circular muscle layer; the bulging nuclei of endothelial cells then passively obstruct the lumen almost completely. The main exchange of gases and nourishing substances takes place in the capillaries. We postulate that in some pathologic conditions, abnormal constriction of the sphincters may cause diminished flow and be the basis for some well defined or unclear ischemic events.

Coronary Circulation↗
PubMed1976

Pulmonary hydatid embolization. Report on 2 operated cases and review of published reports.

Two patients with pulmonary hydatid embolization are described and commented upon in the light of 43 similar published cases. The diagnosis was strongly suspected from the medical history and the chest x-ray films and supported by angiocardiography. The angiocardiographic features of this condition have not been described previously in detail. They include amputation and filling defects of pulmonary artery branches, which are typically located proximal to a rounded tumour-like opacity seen on the plain x-ray film. Both patients underwent successful embolectomy.

Adult↗
PubMed1976

Left ventricular aneurysm of unusual aetiology: report of two cases.

Two young patients aged 14 and 25 with left ventricular aneurysms are described. In both, a clinical picture initiated by attacks of supraventricular tachycardia led to the discovery of the condition. In the first patient the clinical picture clearly suggested a traumatic aetiology. In the second, the angiographic and histological findings strongly favoured a congenital origin. Both patients underwent successful aneurysmectomy. The literature on the incidence and aetiology of traumatic or congenital ventricular aneurysms is discussed.

Adolescent↗
PubMed1976

Chordal rupture: a common complication of myxomatous degeneration of the mitral valve.

In two patients with a clinical picture of acute mitral insufficiency, the presence of chordal rupture secondary to myxomatous degeneration of the mitral valve was disclosed during surgery. There was no evidence of previous rheumatic valvulitis, subacute bacterial endocarditis or other etiologies. It appears from the literature and from the cases described that ruptured chorda tendinea is a not uncommon complication of myxomatous transformation of the mitral valve. While this fact has been mentioned in anatomophological reports, clinicians are less aware of the association. In the absence of supportive evidence for a rheumatic or arteriosclerotic etiology, a clinical picture of acute mitral insufficiency should suggest ruptured chorda tendinea secondary to myxomatous degeneration of the mitral apparatus. This is particularly true in older patients, especially among those followed for a midsystolic click-late systolic murmur or an apical pansystolic murmur of pure mitral regurgitation.

Aged↗
PubMed1976

Left ventricular aneurysmectomy for refractory tachyarrhythmias: report in 11 postinfarction patients.

Between January 1970 and August 1974, eleven postinfarction patients underwent left ventricular aneurysmectomy for refractory tachyarrhythmias. Ten suffered from ventricular tachycardias and one from supraventricular tachycardia. All had localized aneurysms and normal contractions of the surrounding myocardium on angiocardiography. None suffered from significant angina, congestive heart failure or papillary muscle dysfunction. The diagnosis was first suspected at fluoroscopy, the latter being in our opinion a most reliable screening method for the recognition of these cases. There was one hospital death after surgery. The remaining ten patients are now free from further arrhythmic attacks for a follow-up period between fourteen months to five and a half years. These results confirm that in some carefully selected postinfarction patients, left ventricular aneurysmectomy without concomittant aortocoronary bypass may result in the elimination of medically intractable tachyarrhythmias.

Aged↗
PubMed1975

Dissecting aneurysm of thoracic aorta: reappraisal of radiologic diagnosis.

In a series of 24 cases of acute dissecting aneurysm of the aorta (not including Marfan's disease) the diagnosis was usually suspected on the basis of the clinical picture and plain chest roentgenograms. The most consistent clinical sign was severe pain. Absent pulses and a neurological deficit were each noted in only five patients. In many cases there was no correlation between the clinical picture and the type or the extent of the dissection. Widening of the aortic arch and obliteration of the aortic knob with displacement of the trachea to the right are the most common signs in plain chest roentgenograms. A barium swallow examination in these cases reveals an elongated compression and displacement of the esophagus by the aortic arch. Calcification in the area of the aortic arch is the exception rather than the rule in dissecting aneurysms. Angiography is essential for the definitive diagnosis of dissecting aneurysms. The diagnosis is based on the demonstration of two channels, either by the presence of a linear radiolucency separating the two lumens, or by differences in flow that present as delayed opacification or delayed washout. If only the true lumen is opacified, widening of the outer extraluminal border of the aorta or narrowing of the lumen indicates the presence of a dissection. Abnormal catheter recoil and position were helpful in only two cases, and are not informative when the false lumen is catheterized. Failure to visualize main aortic branches was not always due to involvement by the dissection. It can also be caused by reduced flow due to severe proximal compression of the main lumen. The exact location of the intimal tears is usually not demonstrated unless additional injections are made in the area assumed to contain the tear. If only the false lumen is opacified in the ascending aorta, this can be recognized by the demonstration of a blind end, by failure to visualize the sinuses of Valsalva, from flattening of the medial border of the opacified channel, and from delayed washout in the blind end.

Aged↗