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Biomedical subjects

R Feinmesser

Publications and source records attributed to R Feinmesser.

At least 55 records · Page 3Linked to original sources
PubMed1994

Epstein-Barr virus surveillance after renal transplantation.

At least 1% of organ transplant recipients develop Epstein-Barr virus-positive, often fatal lymphomas. EBV-positive cells accumulating in some organ transplant recipients were suggested to predict EBV+ lymphoma risk but no prospective study has been reported. We used the polymerase chain reaction (PCR) to detect EBV genomic sequences in successive blood samples of 60 kidney recipients before and up to 11 years after renal transplantation. Xenotransplantation of EBV-positive patient and -negative control samples into mice with severe combined immunodeficiency (SCID) was used to assess the tumor risk inherent in these samples. Despite single EBV+ cell detection sensitivity, none of the control samples was positive for EBV genomic sequences. In nearly 2/3 of patients EBV genomic DNA was detectable 3-6 months after transplantation for about 3 months. No patient developed lymphoma. Lymphocytes from 8 EBV-genome positive patients and 10 healthy donors were engrafted into 38 SCID mice. Human B cell lymphoma developed in 75% of the control grafts within about 3 months. In striking contrast, none of the patient grafts developed lymphoma despite the large numbers of EBV+ cells initially transplanted. Patient lymphocyte grafts were resistant to injection of live EBV, while in control lymphocyte grafts this caused lymphoma development within 3 weeks. We conclude that a 100-1000-fold expansion of circulating EBV+ B cell pools occurs frequently after organ transplantation and that it is balanced by effective EBV immunosurveillant functions resistant to immunosuppression. The mere detection of EBV genomic material was not predictive of lymphoma development.

Adolescent↗
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

Epstein-Barr virus and nasopharyngeal carcinoma: bringing molecular genetics strategies to head and neck oncology.

In this article, we consider the tools of molecular genetics and strategies that have, or likely will have, an impact in otolaryngology, either as diagnostic tools or as strategies, with more far-reaching applications in tumour therapy, relapse monitoring, and ultimately, approaches to tumour prevention. Nasopharyngeal carcinoma (NPC) is closely associated with Epstein-Barr virus (EBV). Detection of the virus following gene amplification by the polymerase chain reaction (PCR) can provide a diagnostic tumour marker, both in primary and metastatic sites. NPC can be considered as a model disease on which molecular genetics is and likely will be of considerable impact. NPC is characterized by the presence of a genetically stable, viral agent of proven oncogenicity. The presence of attractive experimental systems for the study of EBV-associated tumours and their accessibility may combined with new molecular approaches towards diagnostic and, eventually, therapeutic improvements in the treatment of this clinically ominous malignancy.

Biomarkers, Tumor↗
PubMed1994

Papillary endothelial hyperplasia in the tongue: a benign lesion that may be mistaken for angiosarcoma.

Papillary endothelial hyperplasia is an exuberant, intravascular, endothelial proliferation bearing some similarities to angiosarcoma. To the best of our knowledge, it has never been described in the tongue. A case of such a lesion is herein reported. The lesion, despite its benign nature, may be clinically and histopathologically mistaken for an angiosarcoma and, thus, lead to inappropriate treatment. Papillary endothelial hyperplasia differs from angiosarcoma in its being confined entirely within large vascular lumens and in its lacking of mitosis, necrosis, and true, solid, cellular areas devoid of vascular differentiation.

Arteries↗
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

Radial forearm free flap in head and neck reconstruction.

The use of the radial forearm free flap, otherwise known as the "Chinese" flap, to provide reconstruction of large ablative defects of the face or oral lining is reported in three patients. Microvascular anastomosis was used to ensure flap viability. This donor site was found to be especially versatile because it enables the transfer of skin areas of a variety of sizes and because the thin pliable nature of the forearm skin is well suited to replace oral mucosa. Part of the radius and muscles may also be included in the flap.

Aged↗
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↗
PubMed1993

A monomorphic adenoma of the minor salivary glands presenting at the base of the tongue: a case report and review of the literature.

A case of a monomorphic adenoma of the minor salivary glands situated at the base of the tongue in a 49-year-old female is reported. The patient had a prolonged clinical course of eight years' duration. The histopathologic, immunohistologic and ultra-structural findings are described. A review of the literature concerning minor salivary gland tumors and their location in the oral cavity is presented. This is the first case, to our knowledge, of a monomorphic adenoma presenting at the base of the tongue. The difficulties in its diagnosis are discussed specifically in regard to its location.

Adenoma↗
PubMed1992

Diagnosis of nasopharyngeal carcinoma by DNA amplification of tissue obtained by fine-needle aspiration.

BACKGROUND: In nasopharyngeal carcinoma the primary lesion is often difficult to find. Metastatic lesions occur frequently but are difficult to distinguish from other head and neck tumors. The viral genome of the Epstein-Barr virus (EBV) can be identified in the cells of this carcinoma. METHODS: We used the polymerase chain reaction (PCR) to test for the presence of EBV genomes in 15 samples of metastatic squamous-cell carcinoma of the neck obtained by fine-needle aspiration and in 26 samples obtained by biopsy of lymph nodes. For controls we used disease-free lymph nodes from 10 patients with various head and neck tumors, tonsillar tissue from 46 subjects, blood from 59 EBV-seropositive blood donors, and mononuclear cells from 8 patients with fatal lymphoproliferative lesions. RESULTS: Of the 41 malignant lesions examined, only the nine nasopharyngeal carcinomas (one primary lesion and eight metastases) contained EBV genomes. None of the 20 nodes with other types of cancer, the 10 disease-free nodes, or any of the 105 normal control samples contained detectable EBV. In two patients with suspected metastases from occult primary tumors, the presence of EBV was predictive of nasopharyngeal carcinoma; in both cases overt nasopharyngeal carcinoma developed within one year. CONCLUSIONS: In patients with suspected nasopharyngeal carcinoma, fine-needle aspiration can provide tissue for diagnosis by DNA amplification of EBV genomes. The presence of EBV in metastases from an occult primary tumor is predictive of the development of overt nasopharyngeal carcinoma.

Base Sequence↗
PubMed1992

Detection of occult nasopharyngeal primary tumours by means of in situ hybridization.

Detection of nasopharyngeal carcinoma primaries in patients presenting with neck node metastases may sometimes demand considerable efforts. By using the 'in situ hybridization' technique, we manage to identify the Epstein-Barr virus in neck metastases secondary to nasopharyngeal carcinomas. We propose that such identification in neck node metastases where the primary lesion is unknown indicates a nasopharyngeal primary.

DNA, Viral↗
PubMed1992

Fistulae in the inner canthus associated with ethmoiditis.

A case of fistulae in the inner canthus arising from the ethmoidal air cell sinuses is presented. This type of complication is very rare, and to the best of our knowledge no similar case has been reported in the literature. Clinical findings, imaging, pathology and treatment are presented and discussed.

Adult↗