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Biomedical subjects

Z Dreznick

Publications and source records attributed to Z Dreznick.

6 recordsLinked to original sources

Inhibition of primary colon carcinoma growth and liver metastasis by the A3 adenosine receptor agonist CF101.

Adenosine is a purine nucleoside that acts as a regulatory molecule by binding to specific G-protein-coupled A1, A(2A), A(2B), and A3 cell surface receptors. We have recently demonstrated that adenosine inhibits tumour cell growth and concomitantly stimulates bone marrow cell proliferation via activation of the A3 adenosine receptor (A3AR). In the present study, we show that a synthetic agonist to the A3AR, CF101, at the low nanomolar concentration range, inhibits HCT-116 human colon carcinoma cell growth. This effect was reversed by the selective A3AR antagonist MRS1523, demonstrating the specificity of the response. CF101 (given orally) was efficacious in inhibiting the development of primary tumours in xenograft and syngeneic models in which mice were inoculated subcutaneously with human HCT-116 or murine CT-26 colon carcinoma cells, respectively. Moreover, CF101 suppressed (50%, P<0.01) colon cancer liver metastases in syngeneic mice inoculated to the spleen with CT-26 cells. The mechanism of action entailed upregulation of interleukin-12 production in the CF101-treated groups and potentiation of NK cell activity. In the HCT-116 xenograft model in which a combined therapy of CF101 and 5-fluorouracyl (5-FU) was examined, an additive antitumour effect was demonstrated. Moreover, CF101 prevented the 5-FU-induced myelotoxicity, resulting in normal values of white blood cell and neutrophil counts. We conclude that the A3AR agonist CF101, a small orally bioavailable molecule, exerts systemic anticancer, antimetastatic, and myeloprotective effects in colon carcinoma-bearing mice, and may serve as an adjuvant treatment to enhance the chemotherapeutic index and prevent myelotoxicity.

Adenosine↗

Complications of rubber band ligation of symptomatic internal hemorrhoids.

In a prospective study, 512 patients undergoing hemorrhoidal band ligation over a seven-year period were followed up to focus on complications. Thirteen patients (2.5 percent) were hospitalized: six with delayed massive rectal bleeding, three with urinary retention, pain, and fever (one developed perianal abscess), and three others with severe pain due to prolapsed thrombotic hemorrhoids (one developed difficulty in urination). One patient developed perianal abscess and perianal fistula two months after ligation. Twenty-four patients (4.6 percent) suffered from minor complications: 11 patients had painful thrombosed hemorrhoids; five experienced slippage of bands; three had mild bleeding; two developed band-related mucosal ulcer; one experienced each time, after two subsequent ligations, priapism lasting several hours; and difficulty in urination and tender induration above the dentate line occurred in two other patients. Rubber band ligation is, in effect, a miniature hemorrhoidectomy and has been considered, until recent reports of fatalities associated with this procedure, as an effective, safe, and efficient method of treating symptomatic second-degree and third-degree hemorrhoids. We conclude that the ability to handle complications that occur secondary to the rubber band ligation and, thereby, prevent sepsis and the low rate of major complications in our study justify reliance on this method of treating symptomatic hemorrhoids.

Female↗

Ileostomy with the EEA stapler.

The EEA instrument was used to perform ileostomy in three patients. Two female patients with complications of Crohn's colitis underwent total colectomy and proctocolectomy, respectively. The first patient was operated upon because of toxic megacolon and the second patient for severe perianal disease. A third male patient underwent total colectomy for severe ulcerative colitis that failed to respond to medical therapy. In all patients, ileocutaneous anastomosis was performed with the EEA stapler (ILS, Ethicon). No serious complications were observed except for slight retraction of the ileostomy in one patient after he had gained 22 pounds.

Colectomy↗

Calculus in 16-year-old cadaveric kidney transplant: a unique case and literature review.

Calculi are rare in transplanted kidneys with an incidence of 0.1-0.2% of all urological complications. The clinical presentation of an obstructing stone is different from that seen in nontransplant patients and can be easily mistaken for rejection. Ultrasonography and renogram may fail to detect it. Steroid therapy, the treatment of choice for acute rejection, may improve renal functions albeit obstruction. An obstruction ureteral stone in a 16-year-old cadaveric kidney transplant was mistaken for acute rejection. Steroid therapy improved renal function for a short time, but then anuria recurred. Failing treatment, the kidney was considered lost and hemodialysis was started. Spontaneous passage of a stone and improved renal functions clarified the picture. The literature regarding kidney transplant stones is reviewed.

Adolescent↗

Parathyroid localization. Sonographic-surgical correlation.

Sonographic localization of enlarged parathyroid gland was performed in 37 patients suspected of hyperparathyroidism who underwent surgical exploration of the neck. Nine of those patients were clinically asymptomatic. Most of the others presented with urolithiasis. The sonograms were obtained by conventional and high resolution realtime (10 mHz). Of the 37 patients, 31 patients had a single adenoma, three patients had two adenomas, and two patients had hyperplasia. Analysis of the results has shown accuracy of 84 per cent. The sensitivity of the procedure was 79.5 per cent and the specificity was 98 per cent. The exact side and location of the enlarged parathyroid in relation to the thyroid gland was predicted in 91 per cent. The false-negative cases were due to abnormal location (gland in mediastinum or incorporated within the thyroid). The false-positive findings were all colloid cysts located at the periphery of the thyroid parenchyma. Preoperative confirmation and localization of enlarged parathyroid glands facilitated the decision for surgical intervention, especially in hypercalcemic asymptomatic patients and in high operative risk patients. The duration of operation and postoperative complications were significantly reduced.

Adolescent↗