Search PubMed⌕ Search

Biomedical subjects

E Shiloni

Publications and source records attributed to E Shiloni.

80 records · Page 5Linked to original sources
PubMed1979

Acute blunt traumatic rupture of the diaphragm in a child.

Diaphragmatic rupture due to blunt trauma is rare in childhood. The possibility of such injury must be borne in mind whenever blunt abdominal and chest trauma is encountered. This paper reports a case of diaphragmatic rupture in a child with multiple injuries sustained in a road accident.

Accidents, Traffic↗
PubMedDate not supplied

High-resolution ultrasonography: highly sensitive, specific technique for preoperative localization of parathyroid adenoma in the absence of multinodular thyroid disease.

The objective of this prospective study was to evaluate the role of preoperative ultrasonography (US) for parathyroid lesion localization in patients with primary hyperparathyroidism (PHPT) prior to initial surgery. Fifty-two consecutive patients with PHPT, diagnosed in our institution within a period of 2 years, were referred for preoperative US and subsequently for bilateral surgical neck exploration. The combination of a confirmatory pathologic report and normalization of blood calcium concentration for a period of at least 3 months was considered an operative success. In 50 patients (96.2%) a single parathyroid adenoma was excised, and in one patient (1.9%) hyperplasia of three glands was found at surgery. In the one surgical failure, no parathyroid pathology was identified in the neck; therefore the operative success in this series was 98%. The sensitivity of preoperative US was 83% with a specificity of 100%. In the absence of thyroid multinodular disease (MND), the sensitivity of preoperative US increased to 90%, whereas in patients with MND the sensitivity was only 64%. Our findings support the notion that patients with PHPT should be investigated with US before initial surgery. Bilateral surgical exploration is warranted in patients with MND. In the absence of such thyroid pathology, an US finding positive for adenoma should allow the surgeon to perform unilateral neck exploration only, with consequent reduction of operation time and postoperative complications.

Adenoma↗
PubMedDate not supplied

Therapy of advanced solid tumors in mice using chemotherapy in combination with interleukin-2 with and without lymphokine-activated killer cells.

Adoptive immunotherapy with LAK-cells in conjunction with high-dose IL-2 has recently been introduced in the treatment of patients with advanced cancer. This therapeutic modality has thus far proved to be of limited efficacy, severe toxicity and entails complicated logistics. Our present study is aimed at establishing a model system to test for increasing efficacy and reducing toxicity by using AIT cojointly with chemotherapy. Mice implanted i.v. or i.p. with weakly immunogenic tumors (M109 lung carcinoma, MCA-105 sarcoma) were treated 7 to 20 days after tumor inoculation with or without CTX, with and without recombinant human IL-2, and with and without syngeneic/allogeneic LAK-cells. Whereas IL-2 or IL-2 + LAK-cells without CTX was largely ineffective, and CTX alone cured 0 to 20% of the animals with an i.p. tumor and only slightly reduced pulmonary tumor mass, the combination of CTX + IL-2 cured 50 to 80% of the mice bearing i.p. tumors and reduced pulmonary tumor growth by greater than or equal to 80%. The combination of CTX + IL-2 + LAK-cells proved no more beneficial than CTX + IL-2 without LAK-cells. Also relevant were the observations that murine LAK-cells are transiently sensitive to moderate doses of CTX (greater than or equal to 100 mg/kg body weight) and X-irradiation (greater than equal to 400 rad), and that administration of IL-2 by the i.v. or i.p. route variously affects LAK-cell activation in different tissues and eradication of growths localized at different sites. With the regimens used, no signs of toxicity were detected. It is proposed that instillation of IL-2 (and perhaps of additional immunostimulating cytokines as well) as an adjunct to chemotherapy (or chemoradiotherapy), each given at a subtoxic dose, is both safe and effective in the treatment of metastatic advanced tumors, and that the additional administration of LAK-cells may not be required.

Adenocarcinoma↗
PubMedDate not supplied

"Delayed rupture of the spleen" or delayed diagnosis of the splenic injury?

Splenic rupture is the most frequent intraabdominal injury following blunt abdominal trauma. Massive hemorrhage commonly occurs from injuries to this friable vascular organ. The mortality rate from simple splenic rupture is 1%. Delayed diagnosis of a ruptured spleen increases the rate to 10%. During 1964-79, 293 patients underwent splenectomy for blunt splenic injury, of whom 278 were operated on within 24 h. All had typical signs of splenic lacerations with intraperitoneal bleeding from the time of injury. Fifteen patients were operated on more than 48 h after sustaining the injury. A detailed analysis of these 15 patients revealed that in only three did the evidence support delayed hemorrhage following traumatic rupture of the spleen. In the other 12 patients, there was a delay in recognition of the intraabdominal injury, almost entirely the result of "diagnostic error." Careful clinical inquiry and peritoneal lavage are the mainstays of early diagnosis and therapy and should help to eliminate any delay in the diagnosis of a ruptured spleen.

Adolescent↗
PubMedDate not supplied

Degenerative lumbar spinal stenosis.

Advanced degenerative multilevel disk disease of the lumbar spine with resultant spinal stenosis may lead to neurogenic intermittent claudication, which closely mimics claudication due to aortofemoral disease. Narrowing of the lumbar spinal canal, the lateral recesses and intervertebral foramina secondary to degenerative disk disease is brought about by hypertrophy of laminae, facet joints and ligamentum flavum, descent of the pedicles, posterior bony ridging and occasional disk herniation. The symptoms are elicited by lumbar lordosis and are relieved by lumbar flexion. Five patients with degenerative lumbar stenosis are presented. Decompressive laminectomy yields satisfying results, regardless of the advanced age of some of the patients, and allows normal ambulation.

Aged↗