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Biomedical subjects

H Kashtan

Publications and source records attributed to H Kashtan.

At least 73 records · Page 4Linked to original sources
PubMed1988

Epitheloid hemangiomatosis mistaken for carcinomatosis.

We present a unique case of intra and extra-peritoneal epitheloid hemangioma which was mistaken for diffused carcinomatosis, representing a clinical-pathological problem, and emphasizing the unpredictable behaviour of this tumour. We are dealing with epitheloid vascular tumours, and briefly touch on the differential diagnosis, the principle of biological, pathological and clinical behaviour. Knowledge of this entity would provide an accurate diagnosis and would hence improve dealing with the problem. The conclusion is that this group of Histiocytoid-epitheloid vascular lesions have varying biological potential and this unusual functional state represents a large spectrum of cells, from normal to neoplastic endothelium.

Abdominal Neoplasms↗
PubMed1988

Prevention and treatment of urinary retention and infection after surgical treatment of the colon and rectum with alpha adrenergic blockers.

In a retrospective study, 153 male patients who underwent surgical treatment of the colon and rectum presented with complaints indicating obstruction of the prostate gland and clear indications for preoperative administration of alpha-blockers. Between the years 1982 and 1984, the alpha-blocker phenoxybenzamine hydrochloride (PB-HCl) was prohibited from use by the Ministry of Health because of suspicions of its carcinogenic properties. This enabled a comparative study between two groups of patients. Seventy-five patients (group 2a1) were prohibited from receiving PB-HCl. Urinary retention occurred in 54.7 per cent and urinary tract infection in 65.3 per cent. Seventy-eight patients (group 2a2) were administered PB-HCl. In this group of patients, urinary retention occurred in 19.2 per cent and urinary tract infection in 15.4 per cent. Forty-one patients with urinary retention of group 2a1 who were not administered PB-HCl were compared with 50 patients with urinary retention (group 3) who received PB-HCl. Spontaneous relief was observed in 21.9 and 76.0 per cent, respectively. PB-HCl was shown to be extremely effective, both as a preventative and therapeutic agent, when complaints indicating the prostate gland are present in patients undergoing surgical treatment of the colon and rectum.

Adrenergic alpha-Antagonists↗
PubMed1988

An analysis of the biomechanical mechanism of tibial stress fractures among Israeli infantry recruits. A prospective study.

The biomechanical mechanism of tibial diaphyseal stress fractures was studied prospectively in a group of 286 Israeli recruits. Before training each recruit had roentgenograms taken of his tibiae. Measurements of total tibial and cortical widths in the anteroposterior (AP) and mediolateral planes were made on these roentgenograms at two levels: at the point of the narrowest tibial width on AP roentgenograms (Level 1) and at the point of the narrowest width on lateral roentgenograms (Level 2). The tibial cross section was idealized as an eccentric ellipse within an ellipse, and on the basis of measurements taken from the roentgenograms, the cross-sectional area (compression strength), area moments of inertia about AP and mediolateral axes of bending (bending strength), and the area polar moment of inertia (torsional strength) were calculated for each cross section. During the course of 14 weeks of training, 20% of the recruits sustained tibial diaphyseal stress fractures, all of which were along the medial cortex. Using stepwise logistic regression analysis the tibia's bending strength along an AP axis of bedding at Level 2 was found to be the most significant factor determining whether or not a recruit would develop a tibial stress fracture.

Adult↗
PubMed1987

Right and left colon carcinoma: a retrospective comparative study.

We studied 347 patients with primary colorectal carcinoma treated by surgery during 1973-1983: 64 (18.2%) with right colon carcinoma, 158 (45.7%) with left colon carcinoma, 14 (4.2%) with transverse colon carcinoma, and 110 (31.9%) with rectal carcinoma. We compared the right-sided carcinoma (RSC) and left-sided carcinoma (LSC) groups. Obstruction was found in 17.2% of RSC compared with 20.3% LSC patients (P greater than 0.05). Advanced disease (Dukes stages C and D) was found in 34.4% on the right and 47.8% on the left side (P = 0.01). Crude 5-year survival rate, by life table method, was 71% on the right and 66% on the left side (P greater than 0.05); this difference became significant (P = 0.03) when Dukes stage B patients were compared. We conclude that patients with RSC are not diagnosed, as is commonly believed, at advanced stages of the disease. We found that the 5-year survival rate of RSC patients was the same or, occasionally, better than that of LSC patients.

Actuarial Analysis↗
PubMed1987

Stress fractures and tibial bone width. A risk factor.

A prospective study of 295 infantry recruits has shown that the mediolateral width of the tibia measured radiographically at each of three different levels in the bone had a statistically significant correlation with the total incidence of stress fractures as well as with those in the tibia alone or the femur alone. A narrow tibial width was shown to be a risk factor, but cortical thickness was not found to be significant.

Femoral Fractures↗
PubMed1987

Clinical significance of nonfocal scintigraphic findings in suspected tibial stress fractures.

The clinical significance of nonfocal increased uptake on skeletal scintigraphy in suspected tibial stress fractures is controversial, because it may represent either bone reaction to stress or a stress fracture in evolution. The scintigraphic evolution of areas of abnormal tibial activity, graded according to a 1 to 4 rating system and their corresponding clinical courses, were analyzed in 27 military recruits, as part of a prospective study. Disappearance of pain correlated with scintigraphic healing and increased pain with progression to stress fracture. Decreased or persistent pain had equivocal scintigraphic correlation. Eight of 14 nondiscrete scintigraphic lesions disappeared in spite of continuous training by the recruits; four such lesions, however, progressed to stress fractures. This uncertainty of progression suggests that military recruits and people training for sports who have such scintigraphic activity should have a brief rest period and proper monitoring before resuming training.

Adolescent↗
PubMed1987

External rotation of the hip. A predictor of risk for stress fractures.

External rotation of the hip was found to have a statistically significant correlation with the incidence of stress fractures, in a prospective study among Israeli infantry recruits of possible anthropomorphic predictors of risk for stress fractures. Soldiers in whom hip external rotation was greater than 65 degrees were at a higher risk for tibial and total stress fractures than those with external rotations of less than 65 degrees. The mean hip external rotation in this study of 57 degrees +/- 9.3 degrees was higher than in statistics reported in the American literature. The existence of a larger subpopulation with hip external rotation greater than 65 degrees may partially explain why the reported incidence of stress fractures in the Israeli army is higher than that of the American army.

Adolescent↗
PubMed1986

Prophylactic oophorectomy in premenopausal women with stage II breast carcinoma.

Prophylactic oophorectomy, as an additional treatment for stage II breast cancer, is controversial. In a retrospective study, a group of 37 premenopausal women with stage II infiltrating duct carcinoma and one to three positive axillary lymph node involvement after modified radical mastectomy and bilateral oophorectomy were compared to a matched group of 34 women treated by modified radical mastectomy only. Prophylactic oophorectomy prolonged the disease free interval significantly as compared to the control group. However, it did not prolong survival. This raises the question whether the prolongation of survival achieved by late oophorectomy in women with advanced breast cancer is preferable to an improvement in quality of life resulting from longer disease free intervals.

Actuarial Analysis↗
PubMed1986

Recurrent spontaneous perforation of the colon.

A 58-year-old man with recurrent spontaneous perforations of the colon is reported. The first two events were of the sigmoid colon, and a sigmoidectomy was performed after the second perforation. The third spontaneous perforation had occurred in the transverse colon, however, although a patent sigmoid colostomy was present. Neither primary colonic pathology nor elevated intraluminal pressure were found, which means that the cause and pathogenesis of these perforations are unknown. Six months later, a subtotal colectomy with ileo-sigmoid anastomosis was performed with an apparent satisfactory result.

Colonic Diseases↗
PubMed1986

Stress fractures of the medial femoral condyle.

Three military recruits who presented with medial joint line pain and positive Appley grinding tests were found on the basis of scintigrams plus arthroscopy and/or arthrogram to have no intra-articular pathology, but rather medial femoral condyle stress fractures. The importance of the differential diagnosis is emphasized.

Adolescent↗
PubMed1986

Recurrent stress fractures in military recruits. One-year follow-up of 66 recruits.

Of 66 recruits who sustained stress fractures during basic training and returned to training after a period of rest, seven (10.6%) suffered recurrent fractures within one year. None of the recurrences was at the original anatomical site. All of the recruits with recurrent stress fractures had had at least one of their initial stress fractures in the femur. This suggests that a femoral stress fracture carries a high risk of recurrence at other sites.

Adult↗
PubMed1986

Effect of intense physical activity on the bone-mineral content in the lower limbs of young adults.

The effect of intense physical training on the bone-mineral content of young adults who are unaccustomed to physical activity has not yet been established. In this study, 268 male recruits, eighteen to twenty-one years old, were evaluated before and after fourteen weeks of strenuous physical training. The bone-mineral content of both legs at the level of the distal third of the tibia in each individual was measured using single-beam photon absorptiometry. The subjects started their training with equal values for bone-mineral content in both legs. During the training period, the average bone-mineral content of the left leg increased by 11.1 per cent and that of the right leg, by 5.2 per cent. In the group of subjects who did not complete the training course, mainly because they incurred stress fractures, the increase in bone-mineral content was significantly less than the increase in those who completed the program. This study indicated that in young adults a high level of loading of bone results in either a stress fracture or a rapid increase in bone-mineral content.

Adolescent↗
PubMed1986

Medial tibial pain. A prospective study of its cause among military recruits.

In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.

Fractures, Bone↗
PubMed1985

A prospective study of the effect of a shock-absorbing orthotic device on the incidence of stress fractures in military recruits.

In a prospective study of stress fractures the hypothesis that a shock-absorbing orthotic device worn within military boots could lessen the incidence of stress fractures was tested. The incidence of metatarsal, tibial, and femoral stress fractures was lower in the orthotic group, but only the latter difference was statistically significant. The time of onset and the location of stress fractures between orthotic and nonorthotic users did not differ. These findings suggest that the incidence of femoral stress fractures, which are the most dangerous type of stress fracture because of their high risk of developing into displaced fractures, can be reduced by an orthotic device.

Fractures, Bone↗
PubMed1985

The normal range of subtalar inversion and eversion in young males as measured by three different techniques.

In a prospective study, 272 males aged 18 to 20 had goniometric measurement of their subtalar inversion and eversion by three different methods. Placing the ankle in dorsiflexion while performing the measurements decreased the mean inversion from 32 to 22 degrees but had little effect on eversion. The neutral position of the subtalar joint was found to have a mean value of 3 degrees of varus from the midpoint of the tibia. The technique for measuring subtalar motion as described by the Committee for the Study of Joint Motion of the American Academy of Orthopaedic Surgeons has less subjective variables than the other two methods used in this study. Its use is therefore recommended if comparisons are to be made between series.

Adolescent↗