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Biomedical subjects

I Avinoach

Publications and source records attributed to I Avinoach.

At least 19 recordsLinked to original sources
PubMed2006

Skin biopsy for assessment of autonomic denervation in Parkinson's disease.

Autonomic dysfunction in Parkinson's disease (PD) is considered a late complication of the disease or an adverse effect of anti-parkinsonian medications. Morphological changes are demonstrated only by postmortem examination. The study objective was to evaluate peripheral autonomic neural involvement in PD using punch skin biopsy. The study sample included 22 patients (mean age 50 +/- 7.7 years, mean disease duration 5.3 +/- 3.8 years) and 19 controls. Four-millimeter skin biopsies were immunohistochemically stained with anti-PGP 9.5 antibody. Autonomic innervation of the blood vessels, sweat glands, and erector pili muscles was assessed and rated from 0 (normal) to 2 (severe). Cutaneous autonomic innervation was decreased in patients compared to controls. Semi quantitative analysis demonstrated reduced autonomic innervation of the blood vessels (1.0 +/- 0.8 vs. 0.42 +/- 0.8 in controls; p < 0.02), of sweat glands (0.95 +/- 0.67 vs. 0.47 +/- 0.61; p < 0.02) and of the erector pili muscles (1.06 +/- 0.55 vs 0.21 +/- 0.42; p < 0.001). This method demonstrates that the peripheral autonomic system is affected in PD at early stage of the disease and that autonomic involvement in PD may be more prevalent than previously thought.

Adult↗
PubMed2002

Spontaneous regression of retroperitoneal metastases from a primary pure anaplastic seminoma: a case report.

Spontaneous regression of pure seminoma metastases is a rare phenomenon, with only a few cases reported to date. To the best of our knowledge, this is the first report of regression of anaplastic pure seminoma metastases located in the retroperitoneum. We present a 27-year-old man, a marihuana smoker, with metastatic pure anaplastic seminoma in the high retroperitoneal lymph nodes. After orchiectomy, his metastases regressed with no medication. Several mechanisms are suggested to explain this phenomenon, which still remains elusive.

Adult↗
PubMed2002

p53 expression in tissue adjacent to endometrial carcinoma.

OBJECTIVE: Since several investigations did not demonstrate the presence of altered p53 in endometrial hyperplasias, it has been concluded that these alterations constitute a relatively late event in endometrial carcinoma. The aim of the present study was to assess the presence of p53 in the tissue adjacent to endometrial carcinoma in attempt to elucidate the relationship between these tissues. METHODS: New slides were prepared from paraffin-embeded tissue blocks of 49 endometrial endometrioid carcinoma hysterectomy specimens so that in each case tumor tissue and adjacent uninvolved endometrium were represented. Immunohistochemical staining for p53 detection was then performed. RESULTS: In 43 of the 49 hysterectomy specimens evaluated, the tissue adjacent to the endometrial carcinoma was non hyperplastic and in six it was hyperplastic. Positive immunohistochemical staining was found in 22 (44.9%) of endometrial carcinomas and in eight (16.3%) of the adjacent tissues. A statistically significant higher percentage of hyperplastic adjacent tissues than non-hyperplastic adjacent tissues were immunohistochemically p53 positive (50.0% vs 11.3%; p = 0.047). CONCLUSIONS: Our findings may indicate that p53 alterations are not necessarily a late event in endometrial endometrioid carcinogenesis. Since a large proportion of tissues adjacent to endometrial carcinoma do not show p53 alterations, other early cellular events may also play a role.

Adult↗
PubMed2001

A tattoo and localized lymphadenopathy: a case report.

We report the case of a left inguinal lymph node enlargement in a young man. A tattoo was present in close proximity to the lymph node and had preceded its enlargement by several years. The lymph node was removed surgically, and pathologic examination showed it to contain dark pigment material characteristic of a tattoo. The clinical significance of this finding is discussed, and the relationship of tattoo lymphadenopathy to inflammatory skin reactions and to dermatopathic lymphadenopathy is considered.

Adult↗
PubMed2000

Davener's dermatosis: a variant of friction hypermelanosis.

BACKGROUND: As part of our clinical experience we encountered a group of patients from a specific population with a similar peculiar pigmentation over the lower dorsal spine. OBJECTIVE: We investigated these patients to see whether we could determine a common origin. METHODS: Patients meeting the inclusion criteria underwent detailed history and complete physical examination; biopsy specimens from 3 patients were studied. RESULTS: All 13 patients were full-time male students at Orthodox Jewish Talmudic seminaries (Yeshivas). The lesion consisted of an elongated, vertical, midline, hyperpigmented patch with indistinct borders, which was distributed along the skin overlying the bony protuberances of the inferior thoracic and lumbar vertebrae. It was often unrecognized by the patients. Mean body mass index was lower than that for the general population. Histologic study showed a marked diffuse hyperkeratosis and hyperplastic epidermis with diffuse hyperpigmentation. We attributed the phenomenon to friction from the rigid backrests against the cutaneous surface of the lower back generated by the characteristic swaying activity that traditionally accompanies Torah study or "davening" (praying) and termed it Davener's dermatosis. CONCLUSION: We believe this phenomenon represents a new form of benign friction hypermelanosis. This report highlights the importance of a thorough history in patients presenting with pigmented lesions.

Adolescent↗
PubMed2000

Tungiasis.

A 24-year-old man developed slow-growing lesions on subungual and plantar areas that appeared a few weeks after returning from a trip to South America. The diagnosis of tungiasis was established by microscopic examination of a lesion. Tungiasis is rarely seen in non-endemic areas.

Adult↗
PubMed1999

Stewart-Treves syndrome in a patient with elephantiasis.

Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis.

Chronic Disease↗
PubMed1999

Preparation of a diagnostic antigen of human melanoma based on lymphocyte activation as measured by intracellular fluorescein fluorescence polarization.

The intracellular fluorescein fluorescence polarization (IFFP) test indicates that peripheral blood lymphocytes (PBL) of cancer patients display stimulatory sensitivity to a short incubation with specific tumor protein extracts. In this work, a human lymphocyte activation melanoma antigen (LAMA) was purified from supernatant of a human melanoma cell line (L1M1), which could specifically stimulate lymphocytes of melanoma patients. The results showed a significant stimulation of lymphocytes from healthy donors after incubation with phytohaemagglutinin (PHA), while no stimulation was observed after incubation with LAMA. On the other hand, lymphocytes from melanoma patients showed a significant stimulation with LAMA, while generally showing minor or no stimulation with PHA. Melanoma specificity of LAMA was demonstrated by no response in lymphocytes from patients of lung, colon, or breast cancer. The purified fraction is therefore considered to be a shared tissue-specific antigen which may be useful in immunodiagnosis and immunotherapy of melanoma.

Antigens, Neoplasm↗
PubMed1999

Pigmented purpuric dermatosis (Schamberg's purpura) in an infant.

Purpura in an infant is usually an alarming sign of a systemic (infectious, hematologic-oncologic or immunologic) disease. Chronic purpuric dermatoses have not been reported in infants and, therefore, are not considered in the differential diagnosis of purpuras in this age. We report on a female infant with progressive purpura who underwent extensive laboratory investigations to rule out a systemic disease. Based on the laboratory findings and clinical course, the diagnosis of Schamberg's purpura was established.

Diagnosis, Differential↗
PubMed1998

Lupus vulgaris complicated by metastatic squamous cell carcinoma.

A 47-year-old Bedouin man presented with an ulcerated nodule of several months' duration on the nape of the neck. The nodule developed on an asymptomatic, slowly growing plaque which appeared during childhood. Physical examination revealed two erythematous plaques covering the posterior and right lateral aspects of the neck. The border of the plaques was soft, circinate, with a reddish-brown color, while the center was slightly erythematous and atrophic. An ulcerated nodule measuring 2 cm was seen on one of the plaques. Physical examination was unremarkable with no lymphadenopathy. Laboratory tests, including complete blood cell count, erythrocyte sedimentation rate (ESR), and routine chemistry tests, were all within normal limits. Chest X-ray showed a small calcified perihilar lymph node. The Mantoux test was positive with erythema and induration of 15 mm after 48 h. Biopsy from a plaque showed extensive diffuse granulomatous infiltration throughout the dermis with epithelioid and Langhans giant cells surrounded by mononuclear inflammatory cells. No caseation necrosis was present. Ziehl-Neelsen, periodic acid-Schiff (PAS), and Giemsa stains were negative. Polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis and atypical mycobacteria from a skin sample was also negative. Fresh tissue cultures yielded M. tuberculosis after 6 weeks. A biopsy specimen from the ulcerated nodule demonstrated islands of atypical malignant squamous cells invading the dermis, which were compatible with moderately differentiated squamous cell carcinoma (SCC). The ulcerated nodule was completely excised, and treatment for tuberculosis was initiated with a combination of isoniazid, rifampicin, and pyrazinamide. Within 3 months of therapy, the patient's lesions resolved, leaving only slightly atrophic hypopigmented scars. A month after the treatment's initiation, an enlarged cervical lymph node was noted showing metastatic SCC on histologic examination. The patient underwent neck dissection and radiation therapy without evidence of any further metastases.

Carcinoma, Squamous Cell↗
PubMed1998

Leukocytoclastic vasculitis induced by low-dose methotrexate: in vitro evidence for an immunologic mechanism.

The rare occurrence of methotrexate (MTX)-induced vasculitis has been associated mainly with high or intermediate MTX doses. We report herein a case of cutaneous leukocytoclastic vasculitis (LCV) following treatment with low-dose oral MTX (7.5 mg/week) for rheumatoid arthritis. The histological findings of a cutaneous lesion were consistent with drug-induced vasculitis. The clinical and histological findings, including the temporal relationship between MTX intake and the onset of vasculitis, and the results of withdrawal and rechallenge tests, suggest a causal relationship, and indicate a drug-induced LCV due to MTX. The role of MTX in the induction of the vasculitis was further supported by a positive mast cell degranulation (MCD) test.

Aged↗
PubMed1997

Leukocytoclastic vasculitis--correlation between different histologic stages and direct immunofluorescence results.

BACKGROUND: Leukocytoclastic vasculitis is a well-known clinico-pathologic entity. A good correlation between clinical and direct immunofluorescence (DIF) findings has been shown only in the early stages of vasculitis. Our purpose was to determine the correlation between different stages of vasculitis, etiology of vasculitis, and DIF findings. METHODS: Histologic and DIF studies were performed and evaluated from 40 patients with leukocytoclastic vasculitis. RESULTS: Thirty-seven out of 40 patients (92%) showed positive DIF findings in the blood vessel walls. Eight patients were in the early stage of vasculitis and exhibited deposits mainly of fibrinogen, C3, and IgM. Seventeen patients were at the fully developed vasculitis stage and showed albumin, fibrinogen, and IgG deposits. Fifteen patients were in the late stage of vasculitis and showed deposits of mainly fibrinogen and C3 in the blood vessel walls. CONCLUSIONS: The present study demonstrates that DIF examination is a very sensitive test in the diagnosis of vasculitis, and can be used in all stages of vasculitis and not only in the early stages as has been shown in previous studies.

Adult↗
PubMed1997

Cutaneous necrotizing vasculitis associated with hepatitis A virus infection.

Hepatitis A virus has been recognized as an etiologic factor of cutaneous necrotizing vasculitis in only 2 adult cases. We describe a 2-year-old Bedouin girl who developed cutaneous necrotizing vasculitis during the acute phase of hepatitis A infection. The cutaneous punch biopsy from an ecchymotic lesion revealed microscopic findings of a necrotizing vasculitis process involving the superficial and deep blood vessel plexuses. Fibrin thrombi were present in the lumen of a few blood vessels. She was treated with 2 mg/kg/day, tapered during 5 weeks. Serum liver enzymes returned to the normal range within 6 weeks of the first presenting symptom. A few skin scars were noted in previously necrotic areas. Hepatitis A is one of many viruses that may be an etiologic factor in development of cutaneous necrotizing vasculitis in children.

Acute Disease↗