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Biomedical subjects

H Gutman

Publications and source records attributed to H Gutman.

At least 55 records · Page 3Linked to original sources
PubMed1988

Changing trends in surgery for benign gallbladder disease.

Hospital charts and notes of 2181 consecutive cholecystectomies performed between 1969 and 1984 were computer analyzed. They were divided into three categories of patients operated on 5, 10, and 15 yr ago. The trends of change throughout this period were as follows: 1) The population operated on in the last 5 yr is older, the proportion of males, especially over 70-80 yr old, and diabetics, is growing constantly. 2) The frequency of acalculous cholecystitis and gangrenous changes increase; the same is true for common bile duct pathology and positive bile cultures. 3) There is a marked decrease in hospitalization time, postoperatively, without significant increase in rate of wound infection and thromboembolic phenomena, or mortality. It seems that there is no change in the frequency of gallstone-related pancreatitis and perforations of gallbladder. The same is disappointingly true for positive choledochal exploration index. We think that the subcostal approach, with rational prophylactic and therapeutic antibiotic regimen, contribute to the shortening of hospitalization time and the fixed rates of wound infection and herniae in scar. Prophylactic heparin given subcutaneously seems to avoid possible thromboembolic phenomena.

Acute Disease↗
PubMed1986

Primary leiomyosarcoma of the right common iliac artery--a rare finding and a cause of occlusive vascular disorder.

A case of primary intraluminal leiomyosarcoma of the right common iliac artery that presented itself by intermittent claudication is described. The diagnosis was established only postoperatively, based on examination of the endarterectomy specimen. No other primary tumor was found in the postoperative investigation and the patient received no further treatment. A review of the literature attests to the rarity of the diagnosis and the uncertainty regarding the mode of treatment.

Arterial Occlusive Diseases↗
PubMed1986

Diagnostic ultrasound of scrotum.

Ultrasound is a proved, safe diagnostic procedure. Its efficacy in the evaluation of 54 cases of scrotal pathology is reviewed. Ultrasound was 100 per cent accurate in the evaluation of hydroceles, hematoceles, and paratesticular masses, but less informative in testicular abscesses (80%) and epididymo-orchitis (77%).

Abscess↗
PubMed1986

Inflammatory fibroid polyp of the jejunum causing intussusception.

A case of inflammatory fibroid polyp of the jejunum is presented. This is the seventh case of this type of polyp in the jejunum and, to the best of our knowledge, the first one producing jejunojejunal intussusception. Symptoms of the inflammatory fibroid polyp in this part of the intestine are usually those of intermittent obstruction or intussusception, as in our patient. The treatment is surgical excision of the polyp.

Female↗
PubMed1986

Macrophage migration inhibition factor test in breast tumors.

Thirty women with breast lumps who attended our outpatient clinic were randomly chosen for this study. The breast tumors were benign in 8 and malignant in 22 patients. Ten healthy women constituted a control group. In 15 of the 22 patients (68%) with malignant lesions, the migration inhibition factor (MIF) test was positive. Only one of the patients with benign lumps had a positive reaction. The MIF test was negative in all women in the healthy control group. It seems reasonable to conclude that the human cell-mediated immunity system is affected by the presence of breast cancer, and that the MIF test aids in the differentiation between benign and malignant breast tumors and has a sensitivity of at least 70%. The test may be of value in the postoperative follow-up of patients with breast cancer.

Adult↗
PubMed1986

Primary duodenal carcinoid with malignant carcinoid syndrome: a case report.

Primary duodenal carcinoid causing a malignant carcinoid syndrome is rare. Herein a case is reported. In view of this case and a review of the literature, the carcinoid syndrome is almost pathognomonic of massive liver metastasis or involvement of organs whose venous drainage is not through the portal system. The right upper quadrant abdominal pains accompanied by symptoms that resemble even part of the carcinoid syndrome should initiate the investigational process including proximal gastrointestinal endoscopy to avoid delay in diagnosis of duodenal carcinoid.

Carcinoid Tumor↗
PubMed1985

Postoperative course and rehabilitation achievements of colostomates.

Forty colostomates (mean age, 61.5 years) were examined and interviewed 3 to 174 months (mean, 47.5 months) after creation of their colostomies, to try to determine their rehabilitation achievements after leaving the hospital. All patients had permanent colostomies, most of them after Miles' operation for carcinoma of the rectum. Most patients leave the hospital distressed and unprepared for independent life. They lack confidence and urgently need the help of the community health services, which repeatedly disappoint them. Patients are not aware of the anticipated problems and available agencies that offer support. They have irregular bowel habits, discharge of gas and unpleasant odor, as well as diminished sexual and social life. Irregularity of bowel habits seems to be the most difficult unresolved problem and is the main cause for social handicap, a handicap which is exacerbated by various commonly occurring surgical complications.

Adaptation, Psychological↗
PubMed1984

Ureteral obstruction by shotgun pellet seven years after injury.

Ureteral obstruction by an extrinsic object is rare. We herein report a case of renal colic caused by a shotgun pellet lodged in the ureter seven years after the injury. Computerized tomography scan and antegrade pyelogram demonstration were obtained.

Abdominal Injuries↗
PubMed1984

Ruptured anastomotic pseudoaneurysms after prosthetic vascular graft bypass procedures.

Pseudoaneurysms of prosthetic vascular grafts are a well-recognized phenomenon. In the past year we treated four patients with ruptured pseudoaneurysms, each of whom originally underwent surgery after March 1981. The main etiological factors were infection and mismatching between the physical characteristics of the prosthetic graft and the host artery. Once this diagnosis is suspected, pseudoaneurysms should be treated as an emergency. They should be resected, a new extraanatomical bypass constructed, and the wound left open.

Aged↗
PubMed1981

Effects of anesthetics on water permeability and lipid metabolism in Acholeplasma laidlawii membranes.

The addition of tetracaine and diethyl ether to Acholeplasma laidlawii at concentrations commonly used for local anesthesia did not affect water permeability over the cell membrane, as measured by a pulsed magnetic field gradient NMR method. However, A. laidlawii changed its membrane lipid composition upon treatment with these anesthetics. Both tetracaine and diethyl ether addition resulted in a decrease in the molar ratio between the major membrane glucolipids, monoglucosyldiacylglycerol and diglucosyldiacylglycerol. The ratio between saturated and unsaturated acyl chains did not change. The results are in accordance with our proposal that A. laidlawii regulates its lipid composition in order to maintain optimal packing stability in the membrane (Wieslander, A., Christiansson, A., Rilfors. L. and Lindblom, G. (1980) Biochemistry 19, 3650--3655). Introduction of anesthetics into the hydrophobic region of a bilayer is likely to affect the lipid packing. A membrane which contains lipids like monoglucosyldiacylglycerol, which forms a reversed hexagonal phase, will be destabilized unless the amounts of such lipids are reduced. The membrane concentration of anesthetics was estimated to one molecule per 12--15 lipid molecules. The fact that A. laidlawii regulates its lipid composition as a response to these concentrations, despite their negligible effect on water permeability, indicates a high sensitivity of this regulatory system.

Acholeplasma laidlawii↗
PubMedDate not supplied

Cancer of the anus (review).

Cancers of the anus differ in their histology, anatomical location, response to therapy and prognosis. Epidermoid cancers have turned out to be one of the tumors most responsive to multimodality treatment, for which radical surgery is no longer the primary modality of choice.

Anus Neoplasms↗
PubMedDate not supplied

Toxicity of adjuvant high-dose interferon-alpha-2b in patients with cutaneous melanoma at high risk of recurrence.

Interferon-alpha-2b (INF-alpha-2b) has been approved by the FDA as adjuvant treatment for patients with melanoma at high risk of recurrence. INF-alpha-2b is administered at 20 MU/m2/day IV, 5 days per week for 4 weeks, and then 10 MU/m2/day SC, three times weekly for 48 weeks. We investigated the toxicity of this protocol in 30 patients between June 1996 and February 1998. An intensive toxicity evaluation program was developed to monitor side effects. During both induction and maintenance phases, 60% of patients required a dose delay and/or reduction. Twenty percent were unable to complete the treatment plan, and 53% tolerated at least 80% of the scheduled dose. The frequently reported toxicity during induction included constitutional symptoms, myelosuppression, and hepatotoxicity. All were reversible on cessation of treatment or dose modification. During maintenance, toxicity included thyroid dysfunction, hypertriglyceridemia, retinopathy and a combination of mood disturbances, memory loss, cognitive slowing and impaired executive function. Administration of high-dose INF-alpha-2b is feasible, with close patient monitoring.

Adolescent↗
PubMedDate not supplied

Laryngeal carcinoma--epidemiological and clinical features: experience of the Rabin Medical Center in Israel.

We sought to compare the epidemiological and clinical features of patients with carcinoma of the larynx treated at a major Israeli tertiary facility with other series in the literature. The charts of 361 consecutive patients from 1974 to 1995 were reviewed. Our population was distinguished from other series by a low rate of alcohol abuse (12%), high incidence of second malignancies in sites other than the upper aerodigestive tract (53%) and high rate of early-stage tumors (82%). Overall 5-year survival and local control rates were 88% and 85%, respectively. Our study suggests that the low alcohol consumption and high proportion of early-stage tumors at diagnosis, characteristic of the Israeli population of patients with laryngeal carcinoma, may explain, in part, the relatively high survival and local control rates.

Adolescent↗