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Biomedical subjects

Zvi Halpern

Publications and source records attributed to Zvi Halpern.

2 recordsLinked to original sources

Sentinel node mapping for gastric cancer.

BACKGROUND: Sentinel lymph node mapping is the standard of care for patients with malignant melanoma and breast cancer. Recently, SLN mapping was introduced to the field of gastric cancer. OBJECTIVES: To evaluate SLN mapping in patients with gastric cancer. METHODS: In 43 patients with gastric cancer, open intraoperative subserosal dye injection in four opposing peritumoral points was used. Ten minutes following dye injection, stained LNs were located, marked and examined postoperatively from the surgical specimen. RESULTS: SLN mapping was performed in 43 patients with gastric cancer; 782 lymph nodes were harvested and evaluated. SLNs were stained in 34 of the patients (79.1%) with a mean of 2.85 SLNs per patient. The false negative rate was 20.9%, the positive predictive value 100%, the negative predictive value 78.6% and the sensitivity 86.9%. CONCLUSIONS: SLN mapping in patients with gastric cancer is feasible and easy to perform. SLN mapping may mainly affect the extent of lymph node dissection, and to a lesser degree gastric resection. However, more data are needed.

Adult↗

Quick parathormone assay in the surgical management of hyperparathyroidism.

BACKGROUND: Among the various new technologies in the field of parathyroid surgery is intraoperative quick parathormone measurements. OBJECTIVES: To evaluate the contribution of QPTH measurements during parathyroidectomy to the achievement of higher success rates. METHODS: QPTH assay using Immulite Turbo Intact PTH was measured in 32 patients undergoing parathyroidectomy: 30 for primary and 2 for secondary hyperparathyroidism. QPTH levels were measured at time 0 minutes (before incision) and at 10, 20, and 30 minutes after excision of the hyperfunctioning gland. Only a drop of 60% or more from the 0' level was considered to be a positive result. RESULTS: The mean QPTH level at time 0' for PHPT patients was 38.12 +/- 25.15 pmol/L (range 9.1-118 pmol/L). At 10 minutes post-excision of the hyperfunctioning gland (or glands), QPTH dropped by a mean of 73.80% to 9.89 +/- 18.78 pmol/L. CONCLUSIONS: Intraoperative QPTH level measurement is helpful in parathyroid surgery. A drop of 60% or more from 0' level indicates a successful procedure, and further exploration should be avoided.

Adenoma↗