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Y Shargal

Publications and source records attributed to Y Shargal.

5 recordsLinked to original sources

[Limited axillary thoracotomy for recurrent spontaneous pneumothorax].

Recurrent spontaneous pneumothorax often requires surgical intervention. Recently, less invasive thoracic surgical techniques, such as video-assisted thoracoscopy (VAT) and limited axillary thoracotomy (LAT), have been developed and used for different thoracic procedures. We describe our results with limited axillary thoracotomy, as compared with those of video-assisted thoracoscopy as reported in the literature. From October 1994 to May 1996, 14 patients with recurrent spontaneous pneumothorax, aged 16-33 years, underwent limited axillary thoracotomy, resection of blebs and apical pleurectomy, using multifire GIA 80 staplers (Auto Suture Inc.). There were no complications or recurrences during 5-17 months of follow-up. Mean operative time was 52.2 minutes and mean hospital stay 2.3 days postoperatively. Full activity was regained within 12.1 days. In comparison with over 75 cases of VAT from the literature, LAT is safe and offers the potential benefits of decreased operative time, hospital stay and cost.

Adolescent↗

Early experience in lung transplantation.

Lung transplantation is becoming an acceptable mode of therapy worldwide for the end-stage lung disease. We present our initial experience with the first 10 consecutive lung transplant patients at Hadassah University Hospital. There were 5 males and 5 females with an age range 27 to 59 years. Eight patients underwent single lung transplantation, one patient had double lung transplantation and one had heart-lung transplantation. Indications were: pulmonary fibrosis in 4, emphysema in 4, cystic fibrosis in 1, and cystic bronchiectasis in 1. Two patients had primary graft failure (1 death). Nine patients had a serious infection after transplantation (1 death). Four patients developed airway complications including dehiscence of bronchial anastomosis (1 death), bronchial stenosis requiring placement of a stent in 2 patients, and pneumothorax in 1 patient. One patient required tracheostomy. One patient died of massive brain infarction secondary to pulmonary venous thrombosis and embolization. Six patients are intermediate-term survivors, with a follow-up period of 4-24 months. Four of them had at least one episode of rejection each. In all survivors pulmonary functions and quality of life improved and they do not need supplemental oxygen. We conclude that lung transplantation is a viable option for end-stage lung disease. Better selection of patients and perhaps improved immunosuppression agents will further improve outcome in lung transplantation. Shortage of donor supply is currently the limiting factor in successful lung transplantation in Israel.

Adult↗

[Uveal malignant melanoma in Israel (1970-1989)].

The treatment of uveal melanoma is controversial. In retrospective survival studies no therapeutic method was found to be superior. A few risk factors were found to influence survival, without relation to the method of treatment. The main ones were size of tumor, anterior location, and age of patient. In the present study all cases of uveal melanoma treated between 1970-1989 were reviewed retrospectively and 135 of the 182 cases were included in the study. There was no relationship between method of treatment (irradiation vs enucleation) and survival, nor did any clinical risk factor influence survival. Thus, whenever possible, conservative treatment should be used in order to save the eye. Further investigation on a larger group of patients is needed.

Eye Enucleation↗

PC-10 immunostaining of proliferating cell nuclear antigen in posterior uveal melanoma. Enucleation versus enucleation postirradiation groups.

PURPOSE: It is difficult to assess the viability of uveal melanoma after radiotherapy treatment. The purpose of the current study is to investigate PC-10 monoclonal antibody of proliferating cell nuclear antigen as a possible marker for cell proliferation and tumor viability in conventionally processed histologic preparations of uveal melanoma irradiated by brachytherapy as well as in nonirradiated melanomas. METHODS: Thirteen enucleated eyes with posterior uveal melanoma that were treated by brachytherapy (cobalt 60 or ruthenium 106 radioactive plaques) were included in this study. Thirteen enucleated eyes of the same size with nonirradiated posterior uveal melanoma served as controls. The tumors were stained with PC-10 monoclonal antibody to proliferating cell nuclear antigen. All clinical and histologic data of the tumors were recorded and analyzed. RESULTS: Five of the irradiated tumors showed positive staining with PC-10, although with a low score. Four of these tumors showed regrowth, and the fifth tumor was treated with a low-irradiation dose (5500 rad). In the nonirradiated tumor group, nine were positive for PC-10 staining, with a higher score. Significant correlation was found in this group between the PC-10 score and the mitotic figure count, but not with other prognostic factors. In three of four tumors that caused metastatic death, the PC-10 staining was positive and had a high score. CONCLUSIONS: PC-10 immunostaining is a simple, reproducible method that can be applicable to conventionally processed histologic preparations. It clearly shows that cellular proliferation activity in nonirradiated and irradiated uveal melanomas. Based on the small number of cases reported herein, it seems that the PC-10 score can correlate with prognosis, but further studies should be performed.

Adult↗