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Biomedical subjects

C Chaimoff

Publications and source records attributed to C Chaimoff.

At least 19 recordsLinked to original sources

[Unusual presentation of malignant melanoma of the small intestine].

2 patients with unusual presentations of malignant melanoma involving the small intestine, a 75-year-old woman and a 78-year-old man, are described. One underwent laparotomy for diagnosis and removal of a retroperitoneal mass, with no preoperative evidence of the primary disease. The other underwent emergency laparotomy for small bowel obstruction due to intussusception, which was found to result from a metastatic melanoma. A melanoma had been completely resected from the patient's thigh a month previously, but full investigation before the operation for intussusception failed to establish the diagnosis. Malignant melanoma tends to spread to the small intestine, but tumors of this organ are very rare. Preoperative diagnosis is important since it may improve the outcome of surgical intervention, as well as the prognosis in general.

Aged

[Complications of laparoscopic cholecystectomy].

92% of our first 60 laparoscopic cholecystectomies were successful. Postoperative complications included fever in 10 cases (17%), urinary retention in 5 (8%), intraabdominal abscess in 2 (3%), biliary leakage in 1 (2%) and unexplained abdominal pain in 10 (17%). Although laparoscopic cholecystectomy has obvious advantages, it also has major as well as minor complications.

Abdominal Pain

The use of oncofetal ferritin-bearing lymphocytes as a marker for the screening, diagnosis, and follow-up of patients with early breast malignancy screening of 3400 women.

The potential of using a blood test enumerating oncofetal ferritin-bearing lymphocytes (FBL) as a biomarker for early breast cancer was further explored. Nine hundred women attending a high-risk breast cancer clinic and 2500 normal-risk women were physically examined and their blood drawn for FBL determination using a newly developed radioimmunoassay. The FBL test results were compared to clinically or histopathologically diagnosed breast disease and to known breast cancer risk factors. A gradual increase in the mean FBL ratio was seen from normal risk disease-free women to those with in situ or early stage breast cancer. The percentage of women with positive FBL was 13.6% for the normal risk group, 19% and 25.7% for clinically and histopathologically diagnosed benign breast disease, respectively, and 100, 77.8, and 66.7% for in situ, Stage I, and Stage II breast cancer, respectively. In locally advanced disease (Stage III) the percentage of positive women was only 17.2%. It was further found that a negative FBL result in known breast cancer patients at Stage I, II of the disease was a bad prognostic marker indicating a shorter disease-free survival. The follow-up of patients after surgery by periodical clinical examination and the FBL test revealed that the positive FBL was declining after removal of the precancerous or malignant tumor and that it was highly sensitive (100%) in predicting tumor development and recurrence. Using a logistic regression analysis, an FBL-positive test indicated a significant association with risk of early breast cancer (odds ratio = 2.9; 95% confidence interval = 1.4-5.8). Being a measure of the immune response the positive FBL was associated with early breast cancer and good prognosis. Since patients with locally advanced cancer and poor prognosis were FBL negative but such patients were shown to have increased serum ferritin levels. It is suggested to use the FBL and serum ferritin assays for screening and diagnosis of breast cancer.

Antigens, Neoplasm

[Calcific retropharyngeal tendinitis].

Calcific retropharyngeal tendinitis is a rare clinical entity of which we found only 31 published cases. We present a 45-year-old woman who suffered from severe pain and difficulty in swallowing. The course was benign and recovery was spontaneous. The main problem is the differential diagnosis between benign and malignant diseases that occur in the retropharyngeal area and in the intraspinal space.

Calcinosis

New approach to surgical treatment of ulcerative colitis and polyposis coli without pelvic pouch. Experimental study in dogs.

A new method for the surgical treatment of ulcerative colitis and polyposis coli is described. Instead of preparing a pelvic pouch, the natural rectal pouch stripped of the diseased mucosa was used experimentally in dogs. The undisturbed muscular cuff of the rectum (12 cm from the anal verge) was covered by healthy vascularized mucosa of small bowel in such a manner that the dog could use its rectum as usual before surgery. The results are encouraging. The rectal reservoir is spared, with its sensitivity, continence and motor activity covered by healthy mucosa. The dogs thrived.

Adenomatous Polyposis Coli

Use of a Silastic sheet for widening the abdominal cavity in the surgical treatment of diaphragmatic hernia.

Five newborns were operated on in our department by using a Silastic prosthesis to widen the abdominal cavity. The surprising postoperative course that prevented the need of recurrent surgical interventions is described. From the fifth day, some opacity appeared beneath the Silastic sheet. The wound began to contract and during 1 month all the layers of the abdominal wall regenerated. The Silastic sheet was rejected and the skin closed spontaneously. We obtained the desired result, ie, to close the abdomen and all its layers without stretching the abdominal wall, and without respiratory assistance or temporary closure of the skin and subsequent intervention for completion of the repair. We believe that in these four patients with congenital diaphragmatic hernia, this method prevented increased pressure in the abdomen and the need for respiratory assistance.

Abdominal Muscles

Esophageal transection with automatic stapler device for bleeding esophageal varices. Case report and review of the literature.

The EEA stapler offers a relative easy technique for the control of severe bleeding from esophageal varices. Two cases are reported in which this technique in combination with proximal gastric devascularization and splenectomy was found to be superior to the performance of portosystemic shunt in emergency cases. The results of portocaval shunts created during severe bleeding from esophageal varices are not satisfactory because of the high mortality rate varying between 36% and 47% (1, 2) and the development of postoperative encephalopathy. For these reasons the tendency today, in cases of severe bleeding from esophageal varices where conservative treatment was unsuccessful, is that the surgeon should attack the bleeding area itself (3). Support for this opinion may be found in the publications of Sugiura and Futagawa (4, 5) and of Koyama et al. (6) about their long-term good results obtained after esophageal transection for bleeding esophageal varices.

Adult