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Biomedical subjects

S Halachmi

Publications and source records attributed to S Halachmi.

49 records · Page 3Linked to original sources
PubMed1996

A comparison between histological grade and nuclear morphometry for predicting the clinical outcome of localized renal cell carcinoma.

OBJECTIVES: To determine the interrelationship of histological grade and nuclear morphometry and to compare their prognostic significance in patients with localized renal cell carcinoma (RCC). PATIENTS AND METHODS: A retrospective prognostic study of 39 patients with localized (pT1, pT2) RCC was performed. Conventional histological grade and nuclear morphometry were assessed independently and the correlation between these grading systems and their impact on the patients' outcome were evaluated. RESULTS: Histological grade and the nuclear morphometric variables were significantly correlated: the strongest association was that between grade and the nuclear regularity factor. The best predictor of disease-free interval and survival (by univariate analysis) was the combination of nuclear area and nuclear elongation factor, followed by conventional tumour grade, nuclear elongation factor, nuclear regularity factor and nuclear area. However, a multivariate analysis showed that the only independent prognosticator for survival was the combination of nuclear area and nuclear elongation factor. CONCLUSIONS: This study indicates that nuclear morphometry is prognostically superior to histological grade in patients with localized RCC.

Carcinoma, Renal Cell↗
PubMed1996

Transthoracal approach for the removal of adrenal tumors. Early experience with 10 cases.

OBJECTIVES: To evaluate the early results of a transthoracal approach for the removal of various adrenal tumors. METHODS: Between May 1994 and March 1995, 10 patients with adrenal masses underwent transthoracal adrenalectomy. Operation time, blood loss, the use of parenteral analgesia, duration of thoracal drainage, time to oral intake, ambulation and hospitalization period were assessed. RESULTS: All tumors were excised successfully, with a short operation time (mean 91.5 min), minimal blood loss (mean 35 ml), limited use of parenteral analgesics (mean 1.4 days), early ambulation (mean 1.9 days to ambulation) and shorter period of parenteral nutrition (mean 2 days) leading to a reduced hospital stay (mean 6.7 days). CONCLUSIONS: The transthoracal approach provided excellent exposure and is a quick and safe procedure even for large, malignant and hormone-producing tumors. At present this is our preferred method for the removal of adrenal masses.

Adolescent↗
PubMed1995

Polarity-specific activities of retinoic acid receptors determined by a co-repressor.

Retinoic acid receptors (RARs) and retinoid-X receptors (RXRs) activate or repress transcription by binding as heterodimers to DNA-response elements that generally consist of two direct repeat half-sites of consensus sequence AGGTCA. On response elements consisting of direct repeats spaced by five base pairs (DR + 5 elements), RAR/RXR heterodimers activate transcription in response to RAR-specific ligands, such as all-trans-retinoic acid (RA). In contrast, on elements consisting of direct repeats spaced by one base pair (DR + 1 elements), RAR/RXR heterodimers exhibit little or no response to activating ligands and repress RXR-dependent transcription. Here we show that ligand-dependent transactivation by RAR on DR + 5 elements requires the dissociation of a new nuclear receptor co-repressor, N-CoR, and recruitment of the putative co-activators p140 and p160. Surprisingly, on DR + 1 elements, N-CoR remains associated with RAR/RXR heterodimers even in the presence of RAR ligands, resulting in constitutive repression. These observations indicate that DNA-response elements can allosterically regulate RAR-co-repressor interactions to determine positive or negative regulation of gene expression.

Allosteric Regulation↗
PubMed1995

Successful treatment of postretroperitoneal lymph node dissection in massive chylous ascites.

A rare complication of retroperitoneal surgery is damage to lymphatic vessels, leak of chyle and the development of chylous ascites. This complication can be life threatening and has a relatively high mortality rate. We describe a 38-year-old patient with a massive chylous ascites after extensive retroperitoneal lymph node dissection of metastatic nonseminomatous germ cell testicular tumor. The patient was treated surgically and with fat-free diet, medium chain triglycerides and diuretics resulting in complete resolution of the ascites.

Adult↗
PubMed1994

Estrogen receptor-associated proteins: possible mediators of hormone-induced transcription.

The estrogen receptor is a transcription factor which, when bound to estradiol, binds DNA and regulates expression of estrogen-responsive genes. A 160-kilodalton estrogen receptor-associated protein, ERAP160, was identified that exhibits estradiol-dependent binding to the receptor. Mutational analysis of the receptor shows that its ability to activate transcription parallels its ability to bind ERAP160. Antiestrogens are unable to promote ERAP160 binding and can block the estrogen-dependent interaction of the receptor and ERAP160 in a dose-dependent manner. This evidence suggests that ERAP160 may mediate estradiol-dependent transcriptional activation by the estrogen receptor. Furthermore, the ability of antiestrogens to block estrogen receptor-ERAP160 complex formation could account for their therapeutic effects in breast cancer.

Base Sequence↗
PubMed1994

Tumor spectrum analysis in p53-mutant mice.

BACKGROUND: The p53 tumor suppressor gene is mutated in a large percentage of human malignancies, including tumors of the colon, breast, lung and brain. Individuals who inherit one mutant allele of p53 are susceptible to a wide range of tumor types. The gene encodes a transcriptional regulator that may function in the cellular response to DNA damage. The construction of mouse strains carrying germline mutations of p53 facilitates analysis of the function of p53 in normal cells and tumorigenesis. RESULTS: In order to study the effects of p53 mutation in vivo, we have constructed a mouse strain carrying a germline disruption of the gene. This mutation removes approximately 40% of the coding capacity of p53 and completely eliminates synthesis of p53 protein. As observed previously for a different germline mutation of p53, animals homozygous for this p53 deletion mutation are viable but highly predisposed to malignancy. Heterozygous animals also have an increased cancer risk, although the distribution of tumor types in these animals differs from that in homozygous mutants. In most cases, tumorigenesis in heterozygous animals is accompanied by loss of the wild-type p53 allele. CONCLUSION: We reaffirm that p53 function is not required for normal mouse development and conclude that p53 status can strongly influence tumor latency and tissue distribution.

Alleles↗
PubMed1993

Premature ovarian failure--the prognostic application of autoimmunity on conception after ovulation induction.

OBJECTIVE: To assess whether the presence of autoimmune activity in patients with premature ovarian failure (POF) can predict the response to ovulation induction and conception. DESIGN: Assessment of autoimmune activity in patients with POF, correlating the response to ovulation induction with this autoreactivity. SETTING: Tertiary care academic center. PATIENTS: Forty women with POF, 15 of them treated by ovulation induction because of infertility. INTERVENTIONS: All patients were tested for the presence of autoimmune activity, antibodies against various tissues, and 15 of them were treated with combinations of hMG/hCG, glucocorticosteroids as immunosuppressant, and some of them also with a long-acting GnRH agonist. Those patients not interested in infertility were put on hormone replacement therapy (HRT). MAIN OUTCOME MEASURES: Serum E2 and P were measured during ovulation induction as well as follicular diameter monitoring by transvaginal sonography. Achievement of gestations and their outcome were monitored in the group in which ovulation induction was accomplished. RESULTS: Antibodies against thyroglobulin, nuclear antigens, heart, tissue gluten, or increased levels of immunoglobulin (Ig)M, or decreased levels of complement C3 and C4 were significantly different in the patients with POF than in the control population. Autoreactivity of at least one class of the tested antibodies was found in 31 of 40 patients (77%). In 15 patients with autoimmune activity who have undergone ovulation induction using hMG/hCG, 14 pregnancies were achieved in 8 patients. Two of the pregnancies were spontaneous, and 12 were generated by hMG/hCG and fluocortolone, with or without pretreatment with GnRH-a. Twelve healthy babies were generated by 10 gestations, 3 ended in spontaneous abortions (23%), and 1 is ongoing. All the nonspontaneous pregnancies were achieved in the first three cycles of ovulation induction. CONCLUSIONS: Patients with POF and autoimmune activity, suggesting an autoimmune etiology to the ovarian failure, may respond to ovulation induction and have a conception rate of approximately 40% in three cycles. Those who do not conceive in three treatment cycles have a very low probability to conceive; therefore, further attempts of ovulation induction should be discouraged. However, some patients may spontaneously conceive in association with HRT.

Adult↗
PubMedDate not supplied

Bladder cancer--genetic overview.

BACKGROUND: This article review the serial genetic changes which are responsible to the initiation and progression of bladder cancer. Knowledge of the exact genetic alteration has a direct implication on the development of knew more sensitive and specific tool for an early diagnosis and better prognosis calculations. CONCLUSION: Bladder cancer develop and progress through a series of genetic alterations. Understanding of the genetic mechanisms which lead to malignant transformation gave rise to the development of various genetic mechanisms which lead to malignant transformation gave rise to the development of various genetic tools providing better ability of early detection and more accurate prognosis prediction.

Chromosome Aberrations↗
PubMedDate not supplied

A new intraurethral sphincter prosthesis with a self contained urinary pump.

An intraurethral sphincter prosthesis with a self contained urinary pump for the management of atonic bladder in women was developed and tested. The prosthesis is comprised of a short, self retaining silicone catheter in which there is a valve and pump. Available in a range of lengths and diameters according to urethral size, its insertion is similar to that of a urethral catheter. The prosthesis is secured by a novel fixation method that has soft expandable silicone fins at the bladder neck and a flexible flange at the external meatus. It is activated by a small hand-held control device. To urinate, the activator is placed on the lower abdomen area and the "on" button is pressed, providing energy to the pump by a magnetic coupling method. Once activated, the valve opens and the pump rotates at a high speed, drawing urine from the bladder and pushing it forward, allowing the patient to "void" with a urine flow of 10 to 12 cc/sec. When the bladder is completely evacuated, the pumping ceases and the valve closes, restoring continence. The device was evaluated clinically in 17 women. Fifteen of the patients had a range of use of 2 weeks to 16 months during which they were dry and had complete bladder emptying. Two patients did not tolerate the device because of uninhibited detrusor contractions and, in both cases, it was removed without complication after 5 days.

Adolescent↗
PubMedDate not supplied

Bladder neck suspension using bone anchors for the treatment of female stress incontinence.

A new technique and related devices for the treatment of urinary incontinence in women was developed and tested. The technique involves soft tissue to bone fixation by means of miniature bone anchors and a bone anchor inserter. The novel bone anchors are made of a shape-memory nickel titanium alloy (Nitinol) attached to Polypropylene or Gortex suture. A spring-loaded bone anchor inserter drives the anchors through the vaginal wall to a predetermined depth into the pubic bone medulla regardless of the bone's hardness, with no incision or drilling required. The device allows for the performance of a minimally invasive transvaginal bladder neck suspension. The procedure has minimal morbidity and a short learning curve. This technique was evaluated clinically in 15 women with incontinence, with a mean follow-up of 6 months. Good urinary continence was achieved in all patients, with no mechanical failures.

Adult↗