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Biomedical subjects

H Levavi

Publications and source records attributed to H Levavi.

36 records · Page 2Linked to original sources
PubMed1994

An evaluation of lateral and medial transposition of the ovaries out of radiation fields.

BACKGROUND: Transposition of the ovaries is practiced in young women before possible radiation to the pelvic fields. In patients with carcinoma of the uterine cervix (Ca cervix), the ovaries are transposed laterally (LOT), whereas in patients with Hodgkin's disease (HD), they are usually transposed medially (MOT). Nevertheless, not all transposed ovaries are successfully protected. METHODS: Computed tomography was performed in 16 patients (7 Ca cervix and 9 HD) after ovarian transposition. The location of all identified ovaries was depicted on diagrams of the respective radiation fields for evaluation of the efficacy of LOT or MOT in relocating the ovaries out of these fields. RESULTS: All 13 ovaries transposed laterally were easily identified by CT, as compared with only 13 of 18 ovaries transposed medially (P = 0.2). Eleven of the 13 ovaries that underwent lateral transposition (6 of 7 patients) were located outside the radiation field. In contrast, only 3 of 13 identified ovaries in the medially transposed group were completely outside the radiation field (P = 0.005). Of the remainder, six were completely within the radiation field, and four were at least partially within the radiation field. CONCLUSIONS: Although LOT achieves its purpose in patients with Ca cervix, the use of MOT in patients with HD should be revised to achieve better protection of the ovaries from the effects of radiation. The authors suggest that LOT is preferred over MOT also in patients with HD if radiation of the pelvic lymph nodes is planned.

Adult↗
PubMed1994

Translocation of bacteria due to direct mucosal damage caused by Gastrografin. An experimental study in newborn rats.

A study was carried out on 40 newborn rats to determine the effect of Gastrografin (a hyperosmolar solution, 1700 mosm/liter) on the gastrointestinal tract. All the newborns received an inoculum of Klebsiella bacteria to the gastrointestinal tract. Thirty received, in addition to maternal milk, a feeding of Gastrografin twice daily. The Gastrografin was found to cause severe and irreversible damage to the mucosa of the small intestine, causing the death of 24 rats less than a week after start of the experiment. The 10 rats who received no Gastrografin and served as controls showed no signs of disease or damage to the intestinal tract. Cultures taken from the peritoneal cavity after sacrifice were all positive for Klebsiella in the Gastrografin group (30 rats) and negative in the controls (10 rats). This study has therefore demonstrated that severe damage to the small intestine mucosa will lower the intestinal barrier and lead to transmural translocation of bacteria into the peritoneal cavity.

Animals↗
PubMed1994

Ovarian tumors in women over 70.

OBJECTIVES: To discuss and evaluate the management of ovarian masses in women over 70. METHODS: The nature of adnexal masses and the outcome of surgical intervention in 38 women over 70 was reviewed. RESULTS: There were seven cases of malignant ovarian tumors in our series of 38 patients reviewed. The most frequent presenting sign was abdominal pain (11 cases). The presence of an adnexal mass was suspected on the basis of routine gynecologic examination in 8 cases, whereas by routine ultrasound scan in 30 patients. Postoperative complications were rare. CONCLUSIONS: It is suggested that in all postmenopausal women routine yearly pelvic examination and ultrasound scan is advisable. Furthermore, in view of our favorable results in recent years, we feel that surgical intervention is justified in all cases of adnexal tumors in the woman over 70.

Age Factors↗
PubMed1994

[Large loop transformation zone excision in premalignant cervical lesions].

Colposcopic expertise is necessary in cases of cervical intraepithelial neoplasia (CIN) to avoid conservative treatment of microinvasive and invasive lesions. Large loop excision of the transformation zone (LLETZ) enables the pathologist to examine the entire tumor, and especially its margins. We describe this method and its indications, and review the results of our first 100 cases (mean age 28 years, range 19-46). Indications for LLETZ were biopsy findings of CIN III or of a large CIN II, a lesion entering the endocervical canal, and recurrent CIN after CO2-laser treatment. The procedure was performed under local anesthesia in 93 patients; complications were minimal (8 cases of bleeding requiring local tamponade). In 14% marginal involvement was found, but in only 4 was re-treatment necessary during follow-up of 12-33 months. Only 3 developed recurrent CIN, which was again treated by LLETZ. The cure rate of the initial treatment was 97%. This ablative, nondestructive method is easy to perform, requires only local anesthesia, has few, mild complications and gives an accurate histopathological result, including information on margins. The procedure is becoming the method of choice for treating high-grade and recurrent CIN.

Adult↗
PubMed1993

"Hook effect" in complete hydatidiform molar pregnancy: a falsely low level of beta-HCG.

BACKGROUND: In some cases of gestational trophoblastic disease, a large amount of serum beta-hCG may lead to the high-dose "hook effect" with falsely low serum levels, creating misdiagnosis or delay in diagnosis and therapeutic hazards to the patient. CASES: In two cases of the hook effect in complete hydatidiform mole, ultrasonographic scan showed intrauterine echogenic material, whereas diluted serum specimens gave very high levels of beta-hCG (1,600,000 and 2,225,000 mIU/mL). CONCLUSION: The possibility of a method-dependent hook effect must be considered. Early recognition of falsely low values of beta-hCG can allow correction to the true values by various methods, such as serum dilution before the radioimmunometric method.

Adult↗
PubMed1992

A cell line with unusual characteristics from an ovarian carcinoma patient: modulation of sensitivity to antitumour drugs.

A cell line (GZL-8) was established by cloning from ascitic fluid of an untreated ovarian carcinoma patient. The cells grew rapidly, accumulated lipids and showed chromosomal alterations. One of the marker chromosomes showed characteristics of a Y-like chromosome. This unusual finding was confirmed by DNA hybridisation using specific probes to the Y chromosome. The cells stained with fluorescent antibodies to desmoplakin and cytokeratins 8, 18, 19, and weakly with vimentin but not with desmin. The presence of epithelial membrane antigen, human milk fat globulin, alpha-lactalbumin, alpha-fetoprotein, placental alkaline phosphatase and oestrogen receptor-related antigen was demonstrated by indirect immunoperoxidase staining, but no CA-125 antigen could be detected. The cells showed positive reaction with antibodies to P-glycoprotein. The function of the P-glycoprotein transport system was demonstrated by the rhodamine-123 release test. The cells were initially responsive to doxorubicin, and to high concentrations of cisplatin. Growth inhibition by doxorubicin, especially at low doses was enhanced by the addition of verapamil or tamoxifen. This was shown by the soft agar clonogenic assay, by direct cell counting and by the MTT reducing test. Our results show that combination between drug and sensitivity modulators may be of potential clinical value in ovarian cancer.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1990

Transvaginal sonography in postmenopausal women.

Transvaginal sonography (TVS) is a recent addition to the diagnostic techniques available for the evaluation of the female pelvis. Our experience in over 200 cases of postmenopausal women is the subject of this synoptic review. Using this technique in 60 women, we were able to detect endometrial changes such as endometrial carcinoma or adenomatous hyperplasia in 81% and in a group of 19 patients myometrial invasion in 84%. Fibroids of different sizes and locations could be recognized, some of them with signs of cystic degenerations. In 48 postmenopausal women, TVS was used to follow the morphologic changes in the endometrium stimulated by hormone replacement therapy. Histological features of the endometrium were in close correlation with the sonographic patterns obtained. Ultrasound evaluation has been suggested as a possible screening tool for early changes in ovarian size and morphology. Fifty patients were evaluated for the effectiveness of TVS to detect ovarian pathology. The sensitivity and specificity were 83% and 100%, the same as that of gross examination of the ovary at the time of surgery. It seems that TVS is a reliable tool in the detection of early changes in the postmenopausal ovary, but further evaluation in a large population is necessary to assess the usefulness of TVS as a routine screening tool for early ovarian carcinoma. Twenty-nine postmenopausal women with unilateral simple cysts (diameter less than or equal to 5 cm) were identified. All exhibited benign histopathologic changes. We conclude that small (less than 5 cm) postmenopausal cysts have a low incidence of malignancy and could be followed by TVS without immediate surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Surgery in postmenopausal women--the value of transvaginal sonography.

Transvaginal sonography is a recent addition to the diagnostic techniques available for the evaluation of the female pelvis. Transvaginal sonography is performed with a high-frequency transducer placed in the vagina where it is in close anatomic proximity to the pelvic structures. The procedure overcomes difficulties in imaging obese patients, those with a large amount of bowel gas, and those with inadequate bladder filling. Our experience in over 200 cases of postmenopausal women is the subject of this review. This technique has been employed to detect ovarian and adnexal abnormalities, endometrial changes (hyperplasia and endometrial carcinoma), myometrial invasion, fibroids, adnexal torsion and free fluid in the rectouterine fossa. The results suggest that transvaginal sonography has considerable advantages in the evaluation of pelvic structures in postmenopausal women prior to planned surgical exploration.

Adnexal Diseases↗
PubMed1989

Sodium butyrate enhances the activities of membranal enzymes and increases drug sensitivity in a cell line from ascitic fluid of an ovarian carcinoma patient.

The effect of sodium butyrate was examined on the growth and phenotypic expression of a cell line derived from the ascitic fluid of an untreated patient with ovarian carcinoma. The chemical inducer of differentiation, sodium butyrate, markedly enhances the activity of the membrane-bound glycoprotein enzymes, alkaline phosphatase and gamma-glutamyl transpeptidase. The alkaline phosphatase corresponds to placental Regan type. Sodium butyrate (1 mM) alone has only a small inhibitory effect on cell growth. However, it was shown to potentiate the anti-proliferative effect of Adriamycin and to render the cells sensitive to cis-platinum.

Alkaline Phosphatase↗
PubMed1989

The protracted effect of o,p'-DDD in Cushing's disease and its impact on adrenal morphogenesis of young human embryo.

We hereby present a patient with Cushing's disease who became pregnant while being treated with o,p'-DDD and underwent a therapeutic abortion in view of the known embryotoxicity and placental transfer of this drug. Biopsy of adipose tissue in this patient showed it to be the storage site of considerable quantities of o,p'-DDD. Serum levels of o,p'-DDD determined in this patient initially four months after withdrawal of treatment and in another similar case three months after withdrawal were about 20 times higher than those found in untreated patients and reached control values only about 20 months later. Repeated evaluation of plasma and urinary free cortisol failed to reveal any correlation with the serum levels of o,p'-DDD, suggesting that the drug blood values cannot be used as a reliable indicator of the therapeutic effect on the adrenal gland. The histopathological examination of the embryo, aged about 42 days, revealed a dysmorphogenic event in the cortical primordia characterized by pycnotic sympathoblasts. It is suggested that such a toxic effect of o,p'-DDD on the embryonic cortical cells may act indirectly, affecting the viability of the migrating sympathoblasts.

Abortion, Therapeutic↗
PubMed1984

Intramuscular human interferon-beta injections in treatment of condylomata acuminata.

A two-part study was done to assess the value of human fibroblast interferon (IFN-beta) in the treatment of condylomata acuminata. The first part was an open study of different IFN-beta preparations, which showed that intramuscular injection was the most suitable mode of administration of IFN-beta. In the double-blind placebo section 22 patients were given injections of 2 X 10(6) units IFN-beta or placebo for 10 consecutive days and followed up for 3 months. In 9 of the 11 in the IFN-beta group and 2 in the placebo group lesions disappeared from about 5 weeks after completion of the course of injections. After 3 months 8 of the non-responders were given a course of IFN-beta and all responded to treatment. None of those who had responded has had a recurrence, the disease-free period now being 12 months. Changes in (2'-5')oligo A synthetase levels in white blood cells confirm that intramuscular injections of IFN-beta produce a systemic response.

2',5'-Oligoadenylate Synthetase↗
PubMed1984

Treatment of pruritus vulvae by means of CO2 laser.

Five women with intractable pruritus vulvae, in whom standard therapy had failed to cure the condition, were treated by CO2 laser beam application. Results at one year were good in one patient and excellent in four.

Adult↗
PubMedDate not supplied

Hereditary ovarian cancer.

Hereditary ovarian cancer occurs rarely in the general population but may appear in up to 85% of the offspring of affected women. Pedigree analysis remains the main diagnostic tool. Aberrations of BRCA-1 gene, located on 17q12-21, are considered to be the reason for the genetic expression of ovarian cancer. Hereditary ovarian cancer is characterized by bilateralism, usually stage III, at operative diagnosis, mostly serous cystadenocarcinoma type and relatively early age at onset. Hence, early follow-up is recommended in high risk patients. Prophylactic removal of the uterus and the adnexae is indicated in patients at risk.

Female↗