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Biomedical subjects

R Gal

Publications and source records attributed to R Gal.

At least 91 records · Page 5Linked to original sources
PubMed1992

The riddle of the uvula.

Since ancient times, the uvula has been a subject of interesting and contradictory observations. On the one hand, it was regarded as having a functional role in speech and in immunology, but on the other hand it was regarded as a potentially hazardous organ, possibly responsible for sudden infant death syndrome. None of these hypotheses, however, has been proved. In a previous study on patients undergoing uvulopalatopharyngoplasty, we suggested that the most important function of the uvula is connected with the muscularis uvula. Its function could be related to drinking while bending over. This previous assumption was that the uvula is a phylogenetic remnant from mammals that drink while bending their neck downward. In the present study, the soft palate of eight different mammals was macroscopically and microscopically studied and compared. Of all animals in the study, a small underdeveloped uvula was found only in two baboons. We found that the human uvula consists of an intermix of serous and seromucous glandular masses, muscular tissue, and large excretory canals. The serous and seromucous glands are absent in the other mammals. Thus, the uvula is a highly sophisticated structure, capable of producing a large quantity of fluid saliva that can be excreted in a short time. Both uvula and speech serve to differentiate human beings from animals. Our conclusion is that the uvula is possibly an accessory organ of speech, and may be another marker of human evolution that differentiates man from other mammals.

Animals↗
PubMed1992

Systemic amyloidosis secondary to chronic leg ulcers.

Chronic leg ulcers due to any cause are almost invariably associated with an inflammatory process. As with any long-standing inflammation, leg ulcers may be complicated by systemic amyloidosis, which occurs in rheumatoid arthritis, cystic fibrosis, tuberculosis, and other disorders. There are, however, very few reports on the association between these two conditions. We report a patient with severe leg ulcers of twenty years' duration in whom reactive systemic amyloidosis presented as a nephrotic syndrome.

Aged↗
PubMed1991

[Sarcoidosis presenting with subcutaneous nodules].

Sarcoidosis is an uncommon disease with many types of presentation. A 32-year-old woman is described in whom subcutaneous nodules were the presenting symptom. This presentation is vary rare; the differential diagnosis includes rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus and fungal infections.

Adult↗
PubMed1991

Echocardiographic demonstration of decreased left ventricular dimensions and vigorous myocardial contraction during syncope induced by head-up tilt.

Two-dimensional echocardiography was performed during a head-up tilt test in 11 control subjects (group I) and 18 patients with recurrent unexplained syncope. In four patients (group II), the head-up tilt test was negative at baseline and after isoproterenol infusion. Syncope was induced during baseline head-up tilt in nine patients (group III) and after isoproterenol challenge in five (group IV). The echocardiographic variables assessed were left ventricular end-systolic and end-diastolic areas and percent fractional shortening. At the end of head-up tilt, end-systolic area decreased by 4.5 +/- 1.3 and 3.0 +/- 1.2 cm2 in groups III and IV, respectively, compared with 0.5 +/- 0.7 and 0.2 +/- 0.1 cm2 in groups I and II, respectively (p less than 0.04). Similarly, end-diastolic area decreased by 5.5 +/- 2.6 cm2 in group III compared with 2.7 +/- 1.9 and 1.75 +/- 0.4 cm2 in group I and II, respectively (p less than 0.04). Additionally, at the end of the baseline study, fractional shortening was significantly greater in group III and group IV (43 +/- 5%) than in groups I and II (p less than 0.01). In conclusion, syncope induced by head-up tilt is associated with vigorous myocardial contraction and a significant decrease in left ventricular end-systolic dimensions. This left ventricular hypercontractility may play an important role in the pathogenesis of syncope induced by head-up tilt.

Adult↗
PubMed1991

Squamous and basal cell cancers directly invading major salivary glands.

Epidermoid carcinoma of the skin of the head and neck may uncommonly involve the parotid gland by either direct extension or metastases to the parotid lymph nodes. The parotid gland contains a rich network of superficial and deep nodes, draining a large area of the facial region, with the preauricular, cheek, ear, and eyelid dominating. Few patients with direct parenchymal invasion of the parotid gland by a simultaneously existing squamous or basal cell carcinoma were reported. We could find no report discussing direct tumoral invasion into the submandibular salivary gland. Three patients with squamous cell carcinomas and 2 with basal cell carcinomas of the skin directly involving the underlying salivary glands are presented. The few authors discussing this subject concur that treatment should include resection of the primary tumor along with parotidectomy. Elective neck dissection and irradiation are proposed. The course of disease, treatment, and survival of our patients are discussed.

Adult↗
PubMed1991

Crush and smear technique for rapid detection and semiquantitation of amyloid deposition.

A method using Congo red to rapidly identify and semiquantitate amyloid deposits in tissues for experimental research and clinical medicine is described. Examination by polarization microscopy revealed amyloid deposits as bright green birefringent clumps on a dark red background. On semiquantitative evaluation, good correlation was found between this technique and the conventional histological one, the present technique being more sensitive. The method described saves time and expense.

Amyloid↗
PubMed1990

Metastatic thyroid carcinoma masquerading as lacrimal gland tumor.

A 56-year-old woman presented with orbital signs and symptoms suggestive of lacrimal gland tumor. An excised biopsy specimen was obtained and showed glandular tissue, which could be confused with lacrimal gland acini. Closer microscopic examination and immunohistochemical studies revealed a metastatic tumor of thyroid gland origin. Initially, there was no identifiable nodule in the thyroid, but 3 months later a thyroid nodule was found by ultrasound and radioisotope scan. The histopathologic appearance of the thyroid nodule was similar to that found in the orbit. This case demonstrates the usefulness of immunohistochemistry in establishing a diagnosis when the microscopic appearance is inconclusive.

Adenocarcinoma↗
PubMed1990

Technically suboptimal first-pass radionuclide angiographic studies.

First-pass radionuclide angiography (FPRNA) has proven to correctly assess left ventricular function, however, technical difficulties do occur. One hundred and thirty one patients had contrast angiography and resting radionuclide angiography within 24 h. Of the 131 patients, 86 (66%) had adequate studies and 45 (34%) were technically suboptimal studies. In the latter group, low counts affected the quality of the images but did not change the left ventricular ejection fraction (LVEF) or regional wall motion (RWM) scores. Patients with high background activity showed overestimation of LVEF, however, by using a formula that was derived from the linear regression the LVEF could be calculated accurately in most cases. Multiple technical problems were noted in 14 patients in whom the best correlation was between contrast LVEF and background uncorrected LVEF from FPRNA (r = 0.87). In the latter group, FPRNA showed overestimation of RWM in 8 patients (57%), mainly in the inferior wall. We conclude that for most technically compromised first-pass radionuclide angiographic data, accurate LVEF values can be achieved but errors in regional wall motion interpretation will occur, especially when multiple technical problems exist.

Female↗
PubMed1990

Basaloid-squamous carcinoma of larynx metastatic to the skin of the nasal tip.

Basaloid-squamous carcinoma is a rare, highly malignant epithelial tumour with problematic histological characteristics and a poor prognosis. This unusual tumour has been described in the tongue, hypopharynx, and larynx. A unique case of basaloid-squamous carcinoma of the larynx metastatic to the skin of the nasal tip is presented. The literature regarding the histopathological and clinical aspects of basaloid-squamous carcinoma is reviewed.

Aged↗
PubMed1990

True malignant mixed tumour of the parotid gland.

Carcinoma ex-pleomorphic adenoma is an uncommon tumour of the parotid gland. True malignant mixed tumours of the parotid are rare and we could find only 14 such cases reported. A case of a 76-year-old man diagnosed as suffering from this entity is presented. The diagnosis was based on a series of immunohistochemical studies demonstrating the existence of two separate sarcomatous and carcinomatous elements. The clinical and histological data are presented and the literature is reviewed.

Adenoma, Pleomorphic↗
PubMed1990

Unusual case of crescentic glomerulonephritis associated with malignant lymphoma. A case report and review of the literature.

Renal lesions in non-Hodgkin's lymphoma are rare. Furthermore, to the best of our knowledge, only 5 cases of crescentic glomerulonephritis associated with non-Hodgkin's lymphoma have been previously described. We report a case of crescentic glomerulonephritis and renal failure which preceded the diagnosis of non-Hodgkin's lymphoma. Following steroid therapy there was a resolution of these histological findings a year later.

Acute Kidney Injury↗
PubMed1990

Automatic implantable cardioverter/defibrillator discharges and acute myocardial injury.

Multiple defibrillations by the automatic implantable cardioverter/defibrillator (AICD) have been reported to result in localized epicardial damage. No data exist, however, regarding whether this damage can be detected in the clinical setting or whether it interferes with the detection of true myocardial infarction. Forty-nine patients who received defibrillations by patch electrodes were studied prospectively. We attempted to document the presence of myocardial injury with the following three commonly used modalities for the detection of myocardial infarction: serial electrocardiographic changes, serial creatine phosphokinase (CPK) and CPK-MB release, and technetium 99m pyrophosphate scanning. Fifteen patients received defibrillations by AICD patches at the time of AICD generator replacement. Nine patients received defibrillations at the time of new AICD lead placement. The average total energy delivered was 85 +/- 29 J. None of these patients had detectable myocardial injury. Ten patients had defibrillations by the AICD patches at the time of bypass operation. One patient in this group developed acute myocardial infarction in the inferior wall after posterior descending coronary bypass operation, as detected by electrocardiogram, 99mTc pyrophosphate scanning, and CPK-MB analysis. Fifteen patients were evaluated for spontaneous AICD discharges. Thirteen had a maximum of five consecutive shocks, and cumulative energy delivered was not greater than 330 J. None of these patients had detectable injury. Two patients had CPK-MB release of 15.3% and 7.5%, respectively. One of these patients had a positive 99mTc pyrophosphate scan. These two patients received 12 and 17 rapid and consecutive AICD discharges, respectively, with cumulative delivered energy of 360 and 510 J, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Tuberculosis of a periglandular lymphnode presenting as a parotid tumor.

The presentation of tuberculosis as isolated cervical adenopathy is not a common entity. The presentation of this disease as a parotid mass has rarely been reported. In most instances, direct parenchymal involvement exists, although involvement of intraglandular lymphnodes has also been reported. In most cases, an initial misdiagnosis of a parotid tumor, usually a pleomorphic adenoma, was made. We report a case of a 57-year-old patient with a left parotid mass of two years' duration. The patient was referred because of the development of firm, nontender, ipsilateral cervical adenopathy, suggesting possible malignancy. The course of the disease, diagnosis, and treatment are reported. The relevant literature is reviewed.

Diagnosis, Differential↗