Search PubMed⌕ Search

Biomedical subjects

J Shvero

Publications and source records attributed to J Shvero.

36 records · Page 2Linked to original sources

Squamous cell carcinoma of the oral tongue.

Between 1958 and 1983 at Beilinson Medical Center, Petah Tiqva, Israel, 75 patients were diagnosed as having squamous cell carcinoma of the body of the tongue. Of these, 42 were male and 33 female and the average age at the time of diagnosis was 61.6 years. 29.33% were in clinical stage I, 36% in stage II, 26.67% in stage III and 8% in stage IV. Fifteen patients underwent only surgery, nine received only irradiation and 51 received combined treatment. The 5-year survival rate was 68.3% with a significant difference between that for stage I (90%) and stage II (83.7%) and that for stages III and IV (43.07% and 0%, respectively) (P less than 0.001). Among the 24 with recurrence of the malignancy, 20 died despite treatment and four patients died of causes unrelated to the malignancy. From this experience it was concluded that local excision of the tumor should be performed only in stage I patients and that in stage II patients prophylactic treatment of the neck (neck dissection and irradiation) should be undertaken because of the high incidence of occult metastases.

Adult↗

Oral ofloxacin as treatment of malignant external otitis: a study of 17 cases.

Seventeen patients with malignant external otitis were treated with oral ofloxacin. Their mean age was 69 years. Seven of the patients were diabetic. Pseudomonas aeruginosa, sensitive to ofloxacin (Kirby-Bauer method, inhibition zone greater than or equal to 22 mm), was isolated from the external auditory canal in all patients. Ofloxacin (200 mg b.i.d.) was given to the patients for 12 to 39 days. Two patients also received additional parenteral antibiotic therapy. Subjective and objective improvement occurred in all patients during treatment, and complete resolution was documented in all patients, with one exception. Only one patient suffered recurrence 2 weeks after discontinuation of antimicrobial therapy. The results of our study suggest that oral ofloxacin is an effective treatment for malignant external otitis caused by Pseudomonas aeruginosa.

Aged↗

Stapedotomy technique and results: ten years' experience and comparative study with stapedectomy.

Fifty of the 810 patients who underwent stapedotomy for otosclerosis from 1969 through 1988 were randomly chosen for follow-up of at least 5 years. Most of the patients (65%) had follow-up of 10 years after stapedotomy, but another 50 patients who underwent stapedectomy had follow-ups of longer than 10 years. In 50 patients, stapedectomy under local anesthesia was performed by removal of the footplate of the stapes, using an endaural incision, and covering the oval window with Gelfoam. In the other 50 patients, stapedotomy was performed under general anesthesia, using an endopreauricular incision, making a small hole in the footplate, and covering the hole only with blood from the surgical area. Although both groups showed improvement in hearing after the operation, the air-bone gap in the stapedotomy group was significantly better than that in the stapedectomy group. The use of the endopreauricular incision under general anesthesia was preferable to endaural incision under local anesthesia because the operative field was wider, more convenient for the surgeon, and conducive to patient safety. There were no significant complications in either group.

Adult↗

Granulocytic sarcoma (chloroma) of the temporal bone.

A case of granulocytic sarcoma (chloroma) of the temporal bone in a male child is presented. The diagnosis was confirmed by electron microscopic and histologic findings. The patient presented with otologic and neurological manifestations. CAT scan was at first normal but after some months a mass was apparent in the apex of the petrous bone and a manifestation of preleukemia appeared.

Child, Preschool↗

[Malignant lymphoma of the larynx].

Primary localized laryngeal lymphoma is rare. The presenting symptoms are hoarseness of long duration and increasing dyspnea. Clinical and histological diagnosis is difficult and in some cases repeated biopsies are needed for conclusive diagnosis. Radiotherapy appears to be the treatment of choice for the disease. As in addition there may be head, neck or distant localizations, there should be a complete clinical evaluation before treatment, including lymphangiography, IV pyelography, liver and spleen scans, and total body CT scan. Although in a significant number of cases laryngeal lymphoma has been cured or has remained a localized disease, it is very likely that in some cases additional treatment for the tumor at other sites may be required. Lifelong follow-up and careful periodic evaluation by experts is imperative.

Humans↗

Anaplastic thyroid carcinoma. A clinical, histologic, and immunohistochemical study.

Twenty-six cases of anaplastic thyroid tumor were investigated and reclassified using immunoperoxidase techniques. Sections of the neoplasms were stained immunohistologically for the following thyroid associated antigens: (1) thyroglobulin, which shows a positive reaction with follicular cells of the thyroid; (2) calcitonin, which is positive in medullary carcinoma of the thyroid; and (3) leucocyte common antigen (LC), which identifies lymphomata and Factor VIII-related antigen for hemangioendothelioma. Using these methods, five cases were reclassified. Three cases were identified as lymphomata, one case was reclassified as medullary carcinoma of the thyroid, and one case was identified as hemangioendothelioma. Eleven cases were confirmed to be anaplastic carcinoma of the thyroid and ten cases were negative for all the antigens tested. There was a significant difference in the survival of the groups of patients mentioned above. Prognostic data support the suggestion that immunohistochemical methods should be used for the precise classification of anaplastic carcinoma. In this way, tumors such as malignant lymphoma and medullary carcinoma, which resemble anaplastic carcinoma histologically but have a better prognosis, can be identified. This is important for planning surgical procedures and choosing chemotherapy and/or radiotherapy.

Adult↗

Carcinoma in situ of the vocal cords: a retrospective study.

Between the years 1960 and 1981, 21 patients with the diagnosis of carcinoma in situ of the vocal cords were treated in the ENT department of Beilinson Medical Center. All 21 patients received initial irradiation therapy, identical to patients with invasive squamous cell carcinoma--7200 rads Co60 tumour dose. No patient died as a result of tumour. One patient had local recurrence of invasive carcinoma after 3 years and subsequently underwent total laryngectomy. One patient died after 15 years as a result of myocardial infarction. It is important to mention that 20 patients (95.2%) were free of tumour during a follow-up of 4-25 years (mean 11 years). This study shows that radiotherapy is a highly effective method of management for carcinoma in situ of the glottic region.

Adult↗

Laryngeal carcinoma in patients 40 years of age and younger.

Between 1950 and 1985, 570 patients with squamous cell carcinoma of the larynx were diagnosed and treated in the Otolaryngology Department of the Beilinson Medical Center. Of these, 20 patients (2.8%) were aged 40 years or younger. Twelve patients (60%) had glottic carcinoma in Stage I (T1N0M0) when initially diagnosed, one patient had supraglottic carcinoma in Stage I (T1N0M0) and seven patients (35%) had laryngeal carcinoma in Stage II (T2N0M0) and III (T3N0M0). Patients with T1N0M0 received only radiotherapy. Three patients with T2N0M0 underwent total laryngectomy and also received postoperative radiotherapy. Four patients with the tumor in T3N0M0 received pre-operative and postoperative radiotherapy in addition to total laryngectomy. The 5-year survival rate for T1N0M0 and T2N0M0 was 100% and for T3N0M0 66%. Although a high percentage of the young patients presented for treatment with advanced disease, the survival rate compared the same or favorably with rates in older patients. This supports the concept of aggressive treatment when there is a recurrence or second primary, particularly because it is well tolerated in the young age group who do not exhibit many of the conventional risk factors and therefore, have a better prognosis.

Adolescent↗

Heterotopic salivary tissue and branchial sinuses.

Heterotopic salivary tissue and branchial sinuses occur not infrequently (Goodman et al., 1981; Stingle and Priebe, 1974), caused probably by heteroplasia within remnants of the second cleft (Stingle, 1974). Bilateral lesions which presented clinically as branchial cleft sinuses have been removed from a patient's neck; both of them proved to be branchial cleft sinuses with elements of salivary tissue. The paper describes salivary tissue and branchial sinuses along the anterior border of the sternocleidomastoid muscle on both sides of the neck and bilateral preauricular fistulae occurring in a boy and probably in his sister.

Branchial Region↗

Clear cell carcinoma of the thyroid gland.

Clear cell carcinoma is a rare variant of thyroid cancer, histologically related to the well-differentiated thyroid malignancies. The purpose of this paper is to discuss data collected from the English literature and to present three additional cases. In two of the three cases presented, thyroglobulin levels were extremely high after thyroid ablation. Both cases presented metastasis to lung and bone with significant I131 uptake. It seems that, when compared to the well-differentiated carcinomas of the thyroid gland, clear cell carcinoma has a more aggressive clinical course. Initial radical surgery is the treatment of choice for this kind of neoplasm and I131 should always be considered for the treatment of its metastasis.

Adenocarcinoma↗

Well-differentiated thyroid carcinoma.

PURPOSE: This study presents our experience with 728 patients treated in our department for well-differentiated thyroid carcinoma between 1954-1994. MATERIALS AND METHODS: The retrospective evaluation of the prognostic implications of the clinical and pathological findings was performed. Age, sex, histological variants, tumor size, and locoregional and distant spread were evaluated as risk factors in relation to the prognosis. RESULTS: During follow-up, which ranged from 1 to 31 years, 125 locoregional and/or distant metastases developed (17.2% of the patients), 87 of which occurred in the first 10 years after initial therapy. Thirty-two patients with papillary cancer and 20 with follicular cancer died of causes related to malignancy of the thyroid. CONCLUSION: The experience gained in our department has led us to adopt an aggressive approach in the treatment of patients with well-differentiated carcinoma of the thyroid gland.

Adenocarcinoma, Follicular↗

Objective and subjective nasal airflow.

PURPOSE: This study was designed to assess whether a correlation exists between the rhinomanometric measurement of nasal resistance, nasal airflow, and the subjective sensation of airflow. MATERIALS AND METHODS: Sixteen patients with recurrent maxillary sinusitis were examined before and after uncinectomy during functional endoscopic sinus surgery. Subjective nasal sensation of airflow was assessed by means of a visual scale before and after uncinectomy. Rhinomanometry was performed three times for every patient: before anesthesia, and before and after uncinectomy. The subjective nasal sensation of airflow was compared with the nasal airflow and resistance to flow as measured by rhinomanometry. RESULTS: Rhinomanometric measurements were almost the same before and after uncinectomy, with no significant difference, whereas patients reported a significant improvement in nasal airflow. CONCLUSION: Rhinomanometric measurements of nasal airflow and resistance often have no correlation to the patients's sensation of airflow. However, because it is the patients' ultimate concern to breathe more comfortably, the rhinomanometer has little clinical value.

Airway Resistance↗

Computer-assisted image analysis of small cell lymphoma of the thyroid gland. Comparison of nuclear parameters of small lymphocytes in lymphomas and Hashimoto's thyroiditis.

The nuclear parameters of the small lymphocytes in nine cases of small cell lymphomas of the thyroid gland and 17 cases of Hashimoto's thyroiditis were assessed by computer-assisted image analysis. The nuclear area, maximal, minimal and averaged Ferret diameters, perimeter, regularity factor and elongation factor were gauged. Statistically, the nuclear area was ascertained to be the optimum descriptor discriminating between small neoplastic and reactive lymphocytes. Application of a novel variable, combining a nuclear area cut-off value of 14 microm2 with a nuclear averaged Ferret diameter cut-off value of 4.5 micron, allows for the distinction - with a high degree of sensitivity and specificity - between small neoplastic lymphocytes in thyroidal lymphomas and the reactive lymphocytes in Hashimoto's thyroiditis.

Adult↗

Respiratory distress due to diffuse cervical hyperostosis.

Cervical spondylosis and ankylosing hyperostosis of the cervical vertebrae are common findings. Although these hypertrophic changes can be completely asymptomatic, it is known that dysphagia may occur occasionally in the presence of massive cervical hyperostosis. Laryngotracheal symptoms due to cervical hyperostosis are less frequent and may be managed initially as tumors of the esophagus, trachea, or thyroid gland. The management of two severe cases of dyspnea due to cervical ankylosing hyperostosis are discussed.

Aged↗

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↗

Histological changes in the cervical lymph nodes after radiotherapy.

Radiotherapy to the neck is frequently employed in the treatment of malignancies, sometimes alone and sometimes before or after surgery or with or without chemotherapy. We checked the histopathological changes in the neck after radiotherapy, dividing the changes into two groups. One with short-term changes between six months to one year, and the second group with long-term changes after more than six years. We compared these two groups with a control group without radiotherapy. The changes in the long-term group were more pronounced than in the short-term group, with more stromal fibrosis, vascular changes, and specially lymph nodes smaller than one centimeter. Thus, bigger lymph nodes (more then one centimeter) are more radiosensitive and become smaller after six years.

Adult↗