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Biomedical subjects

K Segal

Publications and source records attributed to K Segal.

At least 55 records · Page 3Linked to original sources
PubMed1988

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↗
PubMed1987

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↗
PubMed1987

Complete cricotracheal separation following blunt trauma to the neck.

We report a case of complete cricotracheal transection with wide separation of the ends, a rare injury. Because of the good general and respiratory condition of the patient on admission, the pathognomonic signs of laryngeal injury were not noticed, causing an unnecessary delay in treatment. Deteriorating respiratory status with progressing cervical subcutaneous emphysema brought up the diagnosis of laryngotracheal injury. Treatment was immediate and included tracheotomy and primary end-to-end anastomosis.

Adult↗
PubMed1986

Hurthle cell carcinoma of the thyroid gland. A tumor of moderate malignancy.

Hurthle cell carcinoma is a rare thyroid cancer histologically related to the well-differentiated malignancies of the thyroid gland. This report presents the evaluation of 30 years experience in treating 17 patients (out of 549 thyroid cancer patients) with Hurthle cell carcinoma. All 17 patients were treated surgically. Six patients (35.3%) died of their thyroid disease. Survival rates for 10 and 15 years were 63.7% and 25%, respectively. These rates are above those of high-grade malignancies and below those of low-grade malignancies of the thyroid gland. Nonsurgical treatment, including radioactive iodine therapy, is disappointing; thus, initial radical surgery is recommended as the treatment of choice.

Adolescent↗
PubMed1986

Acute myelogenous leukemia presenting as facial nerve palsy. A case report.

A case is presented of a 5.5-year-old girl admitted with acute mastoiditis and facial nerve palsy. The final diagnosis of leukemic infiltration of the mastoid bone, middle ear and VIIth cranial nerve was made only after surgery and histological examination. Similar cases described in the English literature are reviewed and treatment is discussed. Chemotherapy or combined chemo- and radiotherapy are the treatment of choice in known leukemic patients without symptoms of superimposed infection of the ear or the mastoid process. Surgical management is restricted to cases in which tissue for histological diagnosis is required or drainage of acute infection is needed.

Child, Preschool↗
PubMed1986

Haemangioma of the zygoma presenting as a tumour in the maxillary sinus.

A case of haemangioma of the zygomatic bone is presented. The presenting symptoms and signs of this case, unlike those of the other five cases described in the English literature, were of an antral tumour. The treatment comprised surgical removal through a Caldwell-Luc approach. Clinical and histopathological considerations are discussed.

Diagnosis, Differential↗
PubMed1986

Inverting papilloma of the nose and paranasal sinuses.

A series of 30 patients with inverted papillomas of the nose and/or the paranasal sinuses is presented. The inverted papilloma is a rare tumor with an overall incidence varying from 0.5% to 4% of all primary nasal tumors. The incidence of inverted papilloma is much more common in the fifth to seventh decades. An association between inverted papilloma and carcinoma is well established. In the large series of patients, the incidence of malignancy associated with inverted papilloma ranges from 1% to 13%, and in our series 10%. Treatment of inverted papilloma is always surgical. The incidence of recurrence is directly related to the method of surgical treatment. Among our 20 patients who were treated by limited surgery, there was recurrence in 14 cases (70%). By contrast, medial maxillectomy and ethmoidectomy via lateral rhinotomy reduced the recurrence rate dramatically. In our opinion this approach is the surgery of choice in the treatment of inverted papilloma.

Adolescent↗
PubMed1985

Levels of serum sex hormones and risk factors for coronary heart disease in exercise-trained men.

On the basis of previous findings, it has been hypothesized that hyperestrogenemia may be the major predisposing factor for coronary heart disease and that an elevation in the estradiol-to-testosterone ratio, or a closely related hormonal alteration, may cause the expression of risk factors for coronary heart disease. The present study was carried out to investigate whether exercise training, which has been reported to reduce risk factors for coronary heart disease, affects the serum sex hormone levels. The serum sex hormone levels, established risk factors for coronary heart disease, and physical fitness were measured in 10 men who had undergone at least six months of intensive exercise training and in 10 sedentary men of similar age. Despite evidence for a strikingly higher level of physical fitness and a lower level of risk factors in the trained group, no significant difference in mean serum estradiol level was found. Nor did three subjects from the sedentary group show a decrease in estradiol level after three to four months of exercise training. The mean estradiol-to-testosterone ratio, however, was significantly lower in the trained group and might account for the lower level of risk factors in that group. If the hypothesis is correct, exercise training may decrease established risk factors for coronary heart disease without decreasing the risk of coronary heart disease.

Adult↗
PubMed1984

Carcinomas of the thyroid gland invading larynx and trachea.

Twenty-nine patients with a thyroid carcinoma invading the larynx and trachea were treated over a 25-yr period. Eight patients had invasion of the walls of the trachea or larynx and 21 had invasion into the lumen. Of the 15 patients who underwent limited surgery, i.e. total thyroidectomy, tracheostomy and neck dissection, 8 had intraluminal invasion and 7 suffered from bleeding into the trachea or airway obstruction. In contrast, none of the 13 who underwent extensive surgery, i.e. thyroidectomy, laryngectomy, partial resection of the trachea and one resection of the pharynx, (12 of whom had intraluminal invasion) showed either bleeding into the trachea or airway obstruction. Although the prognosis was no better in the group undergoing extensive operation there is the feeling that in cases with intraluminal invasion extensive surgery is indicated to prevent the severe airway difficulties which often develop in such patients.

Adult↗
PubMed1983

A new method for estimation of body composition in the live rat.

Measurement of total body electrical conductivity (TOBEC) has been used to estimate lean and fat content of meat based on the principle that electrical conductivity of lean tissue is far greater than that of fat. This approach was used to estimate body composition of live rats. An instrument designed for commercial analysis of ground meat (DjMe 100) was used to measure TOBEC in 30 male Sprague-Dawley rats (197-433 g). Individual TOBEC values were obtained in 20 seconds and repeated twice for each rat. The animals were then killed with ether, hair was shaved, lungs collapsed and body density measured hydrostatically. Carcasses were homogenized and analyzed for fat, nitrogen, and water. A high correlation was found between TOBEC and lean body mass by densitometry (r = .97) and between TOBEC and fat-free mass derived from direct carcass analysis (r = .97). Rats weighing up to 450 g could be accommodated in this particular instrument. Measurement of TOBEC should prove useful in estimating body composition and monitoring its changes in live rats and other small laboratory animals.

Animals↗
PubMedDate not supplied

Follicular carcinoma of the thyroid.

BACKGROUND: Follicular carcinomas of the thyroid are less common than papillary carcinomas of the thyroid, and the available data on prognostic factors are relatively scant. A retrospective study covering four decades was undertaken to evaluate clinical and pathologic findings with regard to their effect on prognosis. METHODS: In 195 cases of follicular carcinoma treated from 1954 to 1991 age, sex, histologic type (minimally invasive vs. widely invasive), tumor size, and local, regional, and distant spread as well as the contribution of treatment to survival were evaluated in relation to prognosis. RESULTS: Age was a significant prognostic factor: there was 100% survival of patients younger than 20 years of age at diagnosis and only one death in the 20-39 year age group. Sex was not a significant prognostic factor, although there was a tendency to a better prognosis in females. Tumor size was significant, more than 6 cm having a poor prognosis. Blood vessel invasion influenced prognosis for the first 10 years. The presence of distant metastases was significant regarding survival. Lymph node involvement had a negative effect on the outcome. CONCLUSIONS: The factors of age, tumor size, invasion of blood vessels, and distant metastases are significant predictors of survival for patients with follicular carcinoma, whereas sex is not; regional spread needs to be evaluated further.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Pure squamous cell carcinoma and mixed adenosquamous cell carcinoma of the thyroid gland.

Four cases of pure squamous cell carcinoma and two cases of mixed squamous cell and glandular carcinoma are reported. Obviously, there is a possibility that squamous cell carcinoma of the thyroid gland develops from the existing squamous cells or as a result of metaplasia of follicular cells. Metastases and direct extension of squamous cell carcinoma in the thyroid gland are much more frequent and must be excluded before the diagnosis can be established. Although the gross and microscopic pathology of these lesions presents no unusual features, follicles lined by metaplastic squamous cells offer strong presumptive evidence of a primary thyroid neoplasm. These tumors are comparatively radioresistant and biologically highly malignant. The treatment of choice is radical surgical resection, and these neoplasms must be treated more aggressively in the initial stage.

Adenocarcinoma↗
PubMedDate not supplied

Bilateral chylothorax complicating radical neck dissection: report of a case with no concurrent external chylous leakage.

Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Six cases are reported in the English literature. All of these patients' cases were associated with a concurrent external chylous fistula, as evidenced by the appearance of a milky fluid confirmed to be chyle by chemical determination. Chyle had also been noted to leak during the operation. This presentation illustrates an additional case of bilateral chylothorax occurring after radical neck dissection, and the first case, to our knowledge, with no concurrent external lymph leakage. Anatomic and physiologic considerations are presented and possible mechanisms of pathogenesis are discussed. Chylothorax has two major complications--respiratory and metabolic. A short summary of the modern concepts of treatment is presented.

Adult↗