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Biomedical subjects

K Segal

Publications and source records attributed to K Segal.

At least 37 records · Page 2Linked to original sources
PubMed1995

Vocal cord palsy: possible late complication of radiotherapy for head and neck cancer.

Cranial nerve palsies are uncommon complications of radiotherapy for head and neck cancer. A review of the literature reveals that cranial nerve damage after radiotherapy has been reported for the optic, oculomotor, trigeminal, abducens, cochlear, vagus, spinal accessory, and hypoglossal nerves. The hypoglossal nerve appears to be the most commonly affected, and the recurrent laryngeal nerve is seldom involved. The case histories of three patients who developed vocal cord palsy from 21 to 34 years after a course of curative or postoperative radiotherapy for carcinoma of the head and neck are presented. Two patients had bilateral palsy, and in the third patient, bilateral damage cannot be excluded. Physical examination and radiographic investigations on admission and on follow-up did not demonstrate any evidence of tumor recurrence, cervical or distant metastases, or second primary tumors. The distinction between irradiation-induced palsy and that due to malignancies is emphasized.

Adolescent↗
PubMed1994

[Thyroidal oxyphilic tumors].

Treatment of thyroidal oxyphilic (Hurthle cell) tumors is controversial due to difficulties in grading tumor malignancy. We classify these tumors into 3 histological subtypes: adenomas, atypical adenomas, and carcinomas. The purpose of this study was to find out whether this classification is a useful criterion for determination of the extent of surgery. Our retrospective study included 5 cases of adenoma, 2 of atypical adenoma and 13 of carcinoma. All histological specimens were revised and were stained immunohistochemically for thyroglobulin. All specimens were positive for thyroglobulin; staining for factor VIII was performed in cases in which the tumor had penetrated into blood vessels. Hemithyroidectomy was used for typical adenomas, while atypical adenomas were treated as carcinomas and total thyroidectomy was performed. 5 patients were treated with radioactive iodine. Taking into account the clinical results, we conclude that histological subtype is a useful guide for proper surgical management. Hemithyroidectomy is proper therapy for adenomas. The management of atypical adenomas was not determined as all were treated as carcinomas.

Adenoma↗
PubMed1994

Early glottic carcinoma involving the anterior commissure.

Between 1958 and 1990 67 patients with an early glottic carcinoma involving the anterior commissure were treated by radiotherapy. Excluding three with carcinoma in situ, 64 had a T1N0M0 squamous cell carcinoma; in eight of these (12.5%) the tumour was only located in the anterior commissure, in 45 (70.3%) it also involved one vocal cord and in 11 (17.2%) both vocal cords. The overall 5-year survival rate was 85%. For those with only anterior commissure involvement it was 60%, with involvement of one vocal cord and the anterior commissure it was 89% and with involvement of both vocal cords 82%. The 3-year recurrence rate was 58% for patients with involvement of only the anterior commissure, 24% with involvement also of one vocal cord, and 45% for those with involvement of both vocal cords. It was found that in cases of early glottic carcinoma, involving the anterior commissure and treated by radiotherapy, the prognosis for recurrence and survival was poorest when the carcinoma was only located in the anterior commissure, and it was concluded that this group of patients deserves special consideration.

Carcinoma, Squamous Cell↗
PubMed1994

T1 glottic carcinoma involving the anterior commissure.

This study reviews the records of 56 patients with early glottic carcinoma involving the anterior commissure (T1N0M0) who were treated between 1958 and 1988 at Beilinson Medical Center. Five- and 10-year survival rates were 82% and 60%, respectively. Most failures were local (15 patients). In addition, three patients who were treatment failures had neck lesions (regional failure) and one had lung lesions (distant metastases). All 56 patients received irradiation as the only mode of initial treatment. The effectiveness of irradiation for anterior commissure lesions is therefore evaluated. The study supports previous reports suggesting that glottic carcinoma involving the anterior commissure is associated with a high rate of treatment failure.

Adult↗
PubMed1994

Serum thyroglobulin and iodine-131 whole-body scan in the diagnosis and assessment of treatment for metastatic differentiated thyroid carcinoma.

UNLABELLED: Because of the limitations of periodic 131I whole-body scans, including suspension of substitution therapy, questionable sensitivity and low yield in detecting metastases in patients who have undergone thyroidectomy, serum thyroglobulin and 131I whole-body scans were evaluated for sensitivity in detecting local, regional or distant metastases in 261 patients with differentiated thyroid carcinoma after total thyroidectomy and ablation. METHODS: A noncompetitive immunoradiometric assay was used for serum thyroglobulin determination. An 131I whole-body scan was obtained after replacement therapy had been suspended for 6 wk or when TSH reached levels higher than 50 microU/ml. In patients who underwent radiological procedures with iodinated contrast media, the waiting period before the 131I whole-body scan was no less than 10 wk. RESULTS: Of the 58 patients with proven metastases who were followed for 12 yr (mean 7 +/- 3.3 yr), 51 (88.4%) had high serum thyroglobulin assays performed while under full replacement therapy and 32 (55%) showed clear 131I whole-body scan localization. There were no instances of positive whole-body scans and negative serum thyroglobulin. CONCLUSION: In patients treated with 131I, serum thyroglobulin assay was an excellent method to assess treatment. Patients with metastatic disease and negative whole-body scans with or without serum thyroglobulin exhibited a trend toward higher mortality. This trend may also indicate that the lack of 131I trapping and low thyroglobulin is a sign of metabolic dedifferentiation of otherwise histologically differentiated thyroid tumors.

Adenocarcinoma, Follicular↗
PubMed1993

Malignant external otitis in nondiabetic patients.

The purpose of this study is to point out that contrary to traditional belief, there is a small but significant group of nondiabetic patients with malignant external otitis. Thirty patients with a diagnosis of malignant external otitis were treated and followed up at the Department of Otolaryngology-Head and Neck Surgery, Beilinson Medical Center, between 1987 and 1991. Nine of these patients did not have clinical or laboratory evidence of diabetes. This study analyzes this group and concludes that the diagnosis of malignant external otitis should be considered by the treating physician in nondiabetic patients presenting with a Pseudomonas aeruginosa infection of the external ear canal. Severe pain and edematous closure of the canal, together with typical granulation tissue and failure to respond to medical treatment, are specific characteristics of this group.

Aged↗
PubMed1993

Anaplastic carcinoma of the thyroid.

A review of 48 cases of anaplastic cell carcinoma of the thyroid gland treated in the Department of E.N.T. of Beilinson Medical Center revealed more than 90% of the patients to be over 50 years of age. Twenty-five percent of the patients showed, histologically, areas of transition from differentiated carcinoma (either papillary or follicular) into anaplastic carcinoma. The patients were treated by surgery and/or irradiation and/or chemotherapy. Twenty-seven patients underwent subtotal or total thyroidectomy and 21 patients underwent biopsy or partial thyroidectomy. The survival rate was very poor, two-year survival rate was 28%. Twenty-eight of the patients (58%) died within one year of diagnosis.

Adult↗
PubMed1993

Metastatic malignant melanoma of the tongue.

The tongue is an unusual site for metastases of cutaneous malignant melanoma. A review of the literature revealed only 16 such cases. The discovery of metastases in the tongue usually indicates widespread dissemination of the melanoma and a terminal phase of the disease. Two patients with metastatic malignant melanoma of the tongue are presented. The primary tumors were excised 10 and four years respectively prior to the discovery of the lingual metastases. In one of the patients the lingual metastasis was the first evidence of a disseminated stage of the disease. The histopathological differentiation between primary and secondary melanoma of the tongue is discussed. Such differentiation may have an important therapeutic implication.

Female↗
PubMed1993

Minimal middle ear effusion: an indication for ventilation tubes in infants with protracted vomiting.

We have lately treated six infants hospitalized in our hospital for persistent vomiting and failure to thrive with no overt explanation for their condition. Examination of the ears of these infants revealed various degrees of serous otitis media. They all had myringostomies and insertion of ventilation tubes after which they stopped vomiting and gained in weight. We wish to revive the often overlooked association between protracted vomiting and middle ear effusion. It seems that minimal degrees of middle ear effusion may cause vomiting and patients with this condition may benefit from ventilation tubes.

Failure to Thrive↗
PubMed1992

[Thyroid carcinoma in children and adolescents].

Of the 720 patients with thyroid cancer we saw from 1953 to 1989, 49 were younger than 20 years at diagnosis, and the female/male ratio was 4.4:1. The histologic type was papillary in 34, follicular in 14 and medullary in 1. Initial treatment in 41 was total or near-total thyroidectomy, and in 8 hemithyroidectomy. 23 underwent neck dissection in addition to thyroidectomy. 49% of those who underwent total thyroidectomy had foci of bilateral thyroid carcinoma on serial histological section. Local and distant relapse of thyroid carcinoma occurred in 4 of the 8 who underwent hemithyroidectomy, but in only 1 of the 41 who underwent total thyroidectomy. Our recommendations include total thyroidectomy, radioiodine therapy, and modified neck dissection when neck metastases are presented.

Adenocarcinoma↗
PubMed1991

Intravascular papillary endothelial hyperplasia in the maxillary sinus. A benign lesion that may be mistaken for angiosarcoma.

Intravascular papillary endothelial hyperplasia is a vascular benign lesion bearing some similarities to malignant angiosarcoma. To the best of our knowledge, it has never been described within the paranasal sinuses. A case of such a lesion within the maxillary sinus appearing in a 17-year-old boy who presented with unilateral facial pains and proptosis is reported. The lesion, despite its benign nature, extended to the ethmoidal cells and nasal cavity and pressed the floor of the orbit. Clinically and histopathologically it may be mistaken for an angiosarcoma. An awareness of this similarity and the features in which it differs from angiosarcoma will prevent incorrect diagnosis and inappropriate treatment.

Adolescent↗
PubMed1991

Carcinoma of the lip: observations on its frequency in females.

Seventy-three patients with lip carcinoma were treated from 1970 to 1988 in the Otolaryngology Department of the Beilinson Medical Center. The most common histological type was squamous cell carcinoma which occurred in 68 patients; four tumours were basal cell carcinoma and one acinic cell carcinoma. Carcinoma of the lip is more frequent in males. Nevertheless, the frequency of carcinoma in females in our series was substantially higher than the average reported in the literature. Forty-nine patients were treated surgically and 24 patients were treated by irradiation. Analysis of the results among those treated by surgery and those treated by irradiation shows a difference in tumour local control which was statistically significant (p = 0.025). Surgical treatment is recommended because of the advantage of tumour margin assessment, avoidance of radiotherapy complications and rapid rehabilitation. Two rare cases of carcinoma of the lip in young patients (age under 20 years) are presented.

Adolescent↗
PubMed1991

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↗
PubMed1990

[Malignant skin neoplasms].

Malignant skin neoplasms of the auricle and peri-auricular region constitute only 6% of all skin cancers. However, rates of recurrence and metastasis are higher than for other cutaneous malignancies. Of 81 patients with malignant skin neoplasms of the auricle, 53.1% had basal cell carcinoma, 39.5% squamous cell carcinoma and 7.4% malignant melanoma. The neoplasms were 4 times more common in men (more than in other series), and more common in those of Ashkenazi origin (75% of the patients) and in the elderly (peak incidence in the 7th decade). All patients were treated surgically, and 21 were also irradiated. In 4 with cervical metastases neck dissection was performed. The recurrence rate for all neoplasms was 12.4% and the rate of metastases to regional lymph nodes from squamous cell carcinoma, 12.5%. There was a marked correlation between positive margins after surgical excision and rates of recurrence and regional metastases. Malignant skin neoplasms of the auricle should be regarded as high risk lesions which often recur and/or metastasize. Therefore, it is recommended to excise the tumors adequately so as to get negative margins, and to follow-up with careful, frequent evaluation.

Adolescent↗
PubMed1990

[Mandibular metastases from colonic adenocarcinoma].

Metastases to the mandible are very rare and account for only 1% of all oral tumors. The most common primary in such cases is the breast. Only 20 cases of metastases to the mandible of tumors of the large bowel have been reported. We present the case of a 59-year-old woman with metastatic disease of the mandible in whom the primary tumor was an adenocarcinoma of the sigmoid. Metastases to the oral cavity and mandible should be included in the differential diagnosis of gingival or mandibular lesions in a patient with a previous or current malignancy.

Adenocarcinoma↗
PubMed1990

Acute effects of exercise on food intake in obese and nonobese women.

The animal model of exercise-induced anorexia was employed in humans to develop a laboratory paradigm for studying the acute effect of exercise on food intake. Each of nine obese and nine nonobese women exercised either strenuously (90 W) or moderately (30 W) on a cycle ergometer for 40 min or rested in the laboratory on each of 3 nonconsecutive days. Intake of a liquefied test meal (1.04 kcal/g) eaten 15 min after exercise was significantly less after the strenuous (620 g) than after the moderate (754 g) exercise in the nonobese women but was no different after the two conditions (532 g after strenuous, 581 g after moderate) in the obese women. Heart rate and energy expenditure were increased in proportion to the exercise by the same amount in both groups. The results demonstrate for the first time that food intake is reduced immediately after strenuous exercise in nonobese women, as it is in animals, and validate the feasibility of this laboratory paradigm.

Adult↗
PubMed1989

Atrioventricular junctional parasystole with ventricular fusion beats due to complicating Wolff-Parkinson-White syndrome.

We present a case of atrioventricular (AV) junctional parasystole manifesting with ventricular fusion beats due to the presence of an accessory AV conduction pathway. Ventricular fusion beats are usually impossible in AV junctional parasystole. In the reported case the ventricular fusion occurs because the ectopic AV junctional impulse is conducted through the His bundle, whereas the sinus impulse is conducted to the ventricles through the Kent bundle.

Adult↗