Biomedical subjects
Publications and source records attributed to J J Bubis.
Spinal intradural ependymal cysts are extremely rare. The case presented is the sixth reported in the literature. The symptoms are consistent clinically and radiologically with a spinal intradural space-occupying lesion. The cyst wall is lined with both ciliated and nonciliated cells, resting directly on connective tissue. The exact embryonal origin of these cysts is obscure.
A case of an asymptomatic solitary pulmonary nodule which proved to be due to sarcoidosis, is described. Only an excisional biopsy can establish the diagnosis. Sarcoidosis, although rare, must be added to the differential diagnosis of asymptomatic solitary pulmonary nodule.
The first two cases of trabecular carcinoma of the skin reported in Israel are presented. On light microscopy, the tumors demonstrated a distinctive trabecular pattern, with cords of tumor cells embedded in the connective tissue stroma in the dermis. Dense-core neurosecretory granules, in association with formed desmosomes, were demonstrated by electron microscopy. This tumor may be misdiagnosed as lymphoma or metastatic anaplastic carcinoma, and awareness of its distinctive morphological features is necessary in order to arrive at the correct diagnosis.
An aneurysmal bone cyst (ABC) is an uncommon benign bone lesion that principally occurs in long bones and in the vertebral column. The appearance of ABC in carpal bones is very rare. We report a case of ABC that occurred in the hamate bone.
Cutaneous T cell lymphoma first presenting at the tumor stage is described in three patients, including one with the rarely reported granulomatous mycosis fungoides. The rapid progression and resistance to the currently available treatment modalities seem to characterize this unique form of lymphoma.
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The importance of obtaining an intraoperative diagnosis and measurement of thickness of a malignant melanoma has emerged since the change in the surgical approach towards thin melanomas (0.75 mm). In experienced centers, both diagnosis and thickness, can be established on frozen section. Eighty-four pigmented lesions were examined on frozen section. Thirty of 31 were correctly diagnosed as malignant melanomas. The one not diagnosed was a regressing melanoma. The frozen section diagnosis of a regressing melanoma is difficult, and this should be deferred until paraffin sections are examined. In 29 consecutive skin melanomas thickness was measured on frozen section and was found to be 0.1-0.4 mm more than that measured on paraffin sections of the same specimens. It is therefore suggested that tumors measuring up to 0.85 mm on frozen section should be included in the group of thin melanoma.
Carpal tunnel syndrome is a result of median nerve compression within the carpal canal. Factors associated with the appearance of carpal tunnel syndrome can be related to the bony architecture of the carpal canal, to its contents and to systemic disease. The purpose of this work is to see if changes in the elasticity of the transverse carpal ligament may cause carpal tunnel syndrome.
In the past few years a change has been noticed in the behavior of cutaneous malignant melanoma, with higher cure and survival rates. A retrospective review of all cases of primary cutaneous malignant melanoma during the years 1970-1979 in Chaim Sheba Medical Center reveals a possible explanation for this. The microscopic findings were reevaluated, diagnosis confirmed, and thickness of the tumor measured in millimeters. The number of cases diagnosed rose from eight in 1970 to 45 in 1979. A constant rise in number of thin melanomas (less than 0.75 mm in depth) was noticed. The percentage of thin melanoma rose from 11.1% of all melanomas in 1970 to 57.7% in 1979. Greater public and medical awareness of the danger of pigmented cutaneous lesions has probably triggered an earlier diagnosis of melanoma. Each suspected lesion is completely excised with a 1-cm free margin. No further excision is undertaken if a thin melanoma is diagnosed (excluding the more malignant regressing melanoma) on frozen section. Of the patients seen in 1979, 57% were spared wide excision and general anesthesia.
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Hemisplenectomy was performed in mongrel dogs using a hand held CO2 laser. Cutting and hemostasis were performed by a laser beam with a high concentration power--about 6kW/mm2--at the focal spot, and residual bleeding was controlled by using a defocused beam. The cutting action was improved by temporary closing of the arterial vessels and by injecting adrenaline into the splenic artery to produce a relatively dry surface. The surgical procedure was free of mortality or morbidity. Histological studies revealed a brand of fibrous tissue at the cut surface, without apparent abnormalities in the splenic parenchyma beneath the section. Activity of the residual half spleen was shown by postoperative technetium scan and by the fact that Howell-Jolly bodies appeared in peripheral blood only after resection of the remaining half spleen.
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Nitrocellulose discs, untreated or immersed in paraffin oil or in Vespa orientalis venom, were inserted s.c. in mice. Similarly treated mice were given daily i.v. injections of levan. The discs were extracted, defibrinated, stained and the cells attached were counted. Paraffin oil and venom increased the number of monocytes on the discs. Treatment with levan reduced the number of polymorphs and giant cells, but increased the number of monocytes. Thus levan, which inhibits transendothelial migration of polymorphs, enhances the migration of monocytes.
Between 1966 and 1970 we reviewed 46 consecutive patients undergoing resection for primary carcinoma of the lung, in whom mediastinal lymph node metastases were found at operation. There was one operative death. Five of the remaining 45 patients survived five years--one of 10 cases of large cell carcinoma, one of 19 cases of adenocarcinoma, and three of 12 cases of epidermoid carcinoma. We believe that mediastinal lymph node metastases are not per se a contraindication to resection of epidermoid carcinoma of the lung.
We studied 202 cases of bronchogenic carcinoma treated surgically between January 1, 1966 and December 31, 1970. Over all, adenocarcinoma was the most common cell type (36.1 per cent). Of 151 patients whose carcinomas were successfully resected, and who lived for at least 30 days postoperatively, 88 had lymph nodes free of cancer. Not surprisingly, 5-year survival was related to lymph node metatases and cell type. The best over-all 5-year survival rate was for large cell carcinoma; it was 52.0 per cent without nodal involvement. Similar figures for epidermoid carcinoma were 29.0 per cent over all, and 26.3 per cent without lymph node involvement; for adenocarcinoma, 19.3 per cent over all, and 32.0 per cent without nodal involvement. For the entire group of 151 patients, the 5-year survival rate was 27.8 per cent over all, and 36.4 per cent without nodal metastases. Among resected patients with mediastinal lymph nodes positive for cancer, the 5-year survival rates were 1 of 10 patients with large cell carcinoma, 1 of 19 patients with adenocarcinoma, and 3 of 12 patients with epidermoid carcinoma. This suggests that in patients with epidermoid carcinoma, the presence of mediastinal lymph node metastases is not, in itself, an absolute contraindication to resectional therapy.
Mineralized dead cells were found in infarcted areas in the cerebella of three chicks killed in the healing stage of nutritional encephalopathy. The mineral depostis were found in vacuoles and consisted of radially packed threads and spicules, concentric laminated structures and centrally located amorphous masses. The cells in which these deposits were found were positively identified as astrocytes and macrophages. The presence of such deposits in neurons was suspected but not proven.
Fifteen mongrel dogs underwent a left lateral non-anatomical partial hepatectomy using a carbon dioxide laser, diathermy or a surgical scalpel. An original prototype of a compact hand-held laser was used and its effects were compared with those of the other two instruments. An improved dry cat surface was achieved by placing a rubber snare proximal to the planned incision. While no significant differences in the blood loss or in the operating time were found among the experimental groups, the laser beam sealed vessels of up to about 6 mm in diameter without any complementary suture ligatures, which were needed in the other groups. Histological studies revealed less tissue trauma in the sections performed by the laser and only slight secondary inflammatory reaction.