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Biomedical subjects

A Halevy

Publications and source records attributed to A Halevy.

At least 91 records · Page 5Linked to original sources
PubMed1988

Ultrasound, CT, and MRI comparison in primary and secondary tumors of the liver.

Thirty-five patients with surgically removed or percutaneous biopsy-proven tumors were examined by ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). This retrospective study describes the appearance of the primary tumors and metastases and compares the sensitivity and specificity of the 3 imaging methods. Ultrasound, CT, and MRI examinations as well as clinical, operative, and/or histologic data were available for all 35 patients. Paramagnetic contrast agent gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) was used in 23 patients and a short TI inversion recovery MRI sequence was used in 23 patients, in addition to various spin echo MRI sequences. Thirteen patients were examined using both Gd-DTPA and the short TI inversion recovery sequence. Our comparative study--based on the following criteria: detection, size, location of the tumor, and portal vein involvement and bile duct dilatation--demonstrated an advantage of MRI over ultrasound in 16 of 35 cases, equal results in 17 of 35 cases and a disadvantage of MRI compared to ultrasound in 2 of 35 cases. With the identical criteria, MRI proved to be more informative than CT in 10 of 35 cases, equal in 21 of 35 cases, and less informative in 4 of 35 cases.

Adolescent↗
PubMed1988

Frozen saphenous vein allografts for constructing vascular access for hemodialysis.

Frozen saphenous vein allografts were used in seven patients to construct vascular access for hemodialysis. In five patients the allografts connected the brachial artery to the axillary vein, and in two, the radial artery to the basilic vein. Five allografts functioned for periods varying from 6 to 20 months, one is still functioning after 3 years, and one graft occluded immediately following surgery. The availability of this biological material, the ease of its preparation, the very low cost, and the satisfactory graft survival, call for further evaluation of this method for complex vascular access problems in patients on chronic hemodialysis.

Adult↗
PubMed1987

Major hepatic resection for colorectal liver metastases.

A 6 1/2 year experience in the management of hepatic colorectal metastases in a specialist unit is reviewed. During the period studied, 48 patients were referred of whom only 24 actually came to resection. There were two in-hospital deaths, at 20 and 60 days, and six patients had non-fatal complications. Although the extent of resection was greater than in most reported series (13 right hepatectomies and 6 extended right hepatectomies), the results of resection were broadly the same as those of others, with a median survival of 30 months and 2 and 3 year survivals of 50 and 44 per cent respectively. A number of factors which others have considered to be of prognostic significance were examined. Tumour clearance was the only important prognostic indicator, where a 5 mm clear margin between the tumour and cut surface produced a significant difference in survival. It is suggested that a much larger number of patients in the UK with hepatic colorectal metastases might be considered for resection.

Colonic Neoplasms↗
PubMed1987

Emergency subtotal colectomy for obstructing carcinoma of the left colon.

Eight patients with obstructing carcinoma of the left colon underwent emergency subtotal colectomy and ileosigmoidostomy or ileoproctostomy. Based on the results obtained by us and those reported in the literature, it is our opinion that emergency subtotal colectomy with primary ileocolonic anastomosis should be considered as the procedure of choice for patients with obstructing carcinoma of the left colon.

Aged↗
PubMed1987

Primary adenocarcinoma of the appendix: report of five cases and review of the literature.

Five patients with primary adenocarcinoma of the appendix are reported. All patients presented with symptoms resembling those of acute appendicitis or periappendicular abscess. In none of them was malignancy suspected prior to operation. It is advisable that every patient above 50 years of age presenting with symptoms of appendicitis undergo laparotomy, thus enabling a better exploration of the cecal region. If an appendiceal mass is present and frozen section shows malignancy, a right hemicolectomy should be performed. The prognosis of adenocarcinoma of the appendix is dismal as most patients present with an advanced stage of the disease.

Adenocarcinoma↗
PubMed1987

Anterior rectus sheath repair for inguinal hernia.

Fifty-four patients over the age of 40, with direct inguinal hernias were studied. Thirty-two of them underwent operation with the anterior rectus sheath flap, and 22 patients in whom the hernias were repaired by the method described by Bassini served as the control group. We could not demonstrate any significant difference between the two groups in regard to length of hospital stay, complications, and recurrence rate. There was only one recurrence in the rectus flap group. Anterior rectus sheath repair proved to be easy to perform and comfortable for the patient.

Abdominal Muscles↗
PubMed1987

Magnetic resonance imaging of the solitary hepatic mass: direct correlation with pathology and computed tomography.

Magnetic resonance images (MRI) of the liver were obtained using a combination of short time inversion recovery (STIR) and spin echo (SE) sequences. These were correlated with comparable tissue slices generated from resected specimens obtained at partial hepatectomy. All 10 cases appeared to have solitary masses on contrast enhanced computed tomography (CT). Histological examination revealed five primary tumours (two hepatocellular carcinomas, two haemangiomas and one cholangiocarcinoma) and five metastatic tumours. The STIR images demonstrated a high signal intensity in all areas of viable tumour involvement and reduced signal intensity in regions of confluent necrosis with superimposed haemorrhage or calcification. This sequence also demonstrated additional areas of high signal intensity adjacent to several lesions which were not visible on CT. Microscopy of these regions in the specimens demonstrated no tumour involvement or steatosis and their precise cause remains obscure. All the lesions demonstrated on the CT images were visible on MRI and no additional lesions were discovered on detailed microscopical examination of the specimens. Delineation of the extent of the cholangiocarcinoma was a problem with both techniques. MRI showed no major advantage over CT except for a higher contrast of the lesion compared with normal liver and also a better delineation of the tumour mass.

Adenoma, Bile Duct↗
PubMed1987

Sigmoid volvulus in adolescence.

Sigmoid volvulus in young adults is rare. It usually presents as chronic recurrent attacks of abdominal pain. The diagnosis is usually delayed because of a low level of suspicion. We present the case of a 17-year-old girl with recurrent episodes of sigmoid volvulus, to illustrate the problem.

Adolescent↗
PubMed1987

Benign biliary strictures: a proposed combined surgical and radiological management.

A combined surgical and radiological approach to the management of complex biliary strictures is described. Radiological access for stricture dilatation or stone extraction is created at the time of surgery either by insertion of a transhepatic U-tube or superficial fixation of the afferent limb of the Roux-en-Y loop. Each of seven patients treated in this way had multiple complicating factors known to adversely affect the outcome of operative repair. Five of the seven have had an excellent outcome at a median follow-up of 15 months (mean 21 months, range 2-39 months).

Adult↗
PubMed1987

Diagnosis of carcinoma of the breast by fine needle aspiration cytology.

During a six year period, 1,953 fine needle aspiration cytologies (FNAC) were performed for lumps of the breast. Of these, 355 were diagnosed as carcinoma of the breast. The FNAC was performed on an outpatient basis and the pathologic interpretation was available within 30 to 60 minutes. The treatment strategy was always guided by the clinical impression of the physician. If the results of a suspected mass were negative on FNAC, biopsy was performed and histologic study gave the final diagnosis. There were no false-positive results and only 6 per cent were false-negative findings diagnosed later by open biopsy. The over-all accuracy rate was 90 per cent plus 4 per cent diagnosed on cytologic examination as "suspicious" and which proved to be malignant. Based upon our accumulated results, simplicity of performing the test, its low cost, the extremely low morbidity, the immediate response and, above all, an over-all high accuracy rate, we conclude that FNAC is a highly recommended method for the diagnosis of carcinoma of the breast.

Adult↗
PubMed1986

Perforated diverticulitis of the transverse colon.

A case of localized, perforated diverticulitis of the transverse colon in a 45-year-old woman is presented. Preoperatively, this rare disease is indistinguishable from other acute surgical conditions, and often is mistaken for carcinoma at laparotomy. This report increases awareness of this unusual condition, and emphasizes the clinical, diagnostic, and therapeutic implications. Case reports described in the literature are reviewed.

Adult↗
PubMed1986

Familial retrocaecal appendicitis.

Four members of the same family operated on for acute retrocaecal appendicitis are reported. It is suggested that they provide further support for the hypothesis that an hereditary factor might be involved in the pathogenesis of acute appendicitis.

Acute Disease↗
PubMed1986

[Treatment of sudden deafness with xantinolnicotinate (Complamin) in increasing dosage].

Twenty-nine patients affected by typical unilateral sudden hearing loss were treated with Xantinolnicotinate (Complamin) by a 21 days infusion of 1.5 g-30 g in 500 ml NaCl 0.9% followed by 3 months 1,000 mg sustained release tablets t.i.d. An improvement in hearing was achieved in 90.5% of the cases and in 52% returned to normal. Tinnitus improved in 92% of cases and resolved completely in 54%. The results of speech and sound audiograms correlated well, and showed significant recovery in the first 3 weeks. The infusion therapy was terminated prematurely in 4 patients because of near normalization of hearing (maximum dosage: 15 g Complamin). Adverse reactions only occurred during the infusion therapy. For ethical and therapeutic reasons a placebo control group was not included. To compensate for this the audiograms of impaired and 'normal' ears were compared. The changes in hearing and tinnitus are therefore to be regarded as the result of spontaneous remission and drug efficacy.

Adolescent↗