Early cancer in gastric Crohn's disease.
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Crohn Disease↗
Biomedical subjects
Y Wolloch
Publications and source records attributed to Y Wolloch.
Effect of colon carcinoma cell supernatants on cytokine production and phagocytic capacity.
The ability of colon carcinoma cells to produce IL-1 beta, IL-6 and TNF alpha, and the effect of tumor cell supernatants (sups) on the capacity of peripheral blood mononuclear cells to produce these three cytokines was examined. In addition, the effect of colon carcinoma cell sups on the engulfing capacity of phagocytic cells was detected. The results showed that IL-1 beta, IL-6 and TNF alpha levels were significantly higher in tumor cell sups compared with those of autologous colon mucosal cells obtained from healthy tissue. Tumor cell sups caused a decrease in both phagocytic capacity, and the number of latex particles engulfed by each individual cell.
Culture Media, Conditioned↗
The value of early and double phase 99Tcm-sestamibi scintimammography in the diagnosis of breast cancer.
The aim of this study was to assess the additional value of early and double phase scintimammography (SMM) with 99Tcm-sestamibi in the detection of breast cancer following initial evaluation by palpation and mammography. Altogether, 322 women with breast lesions evaluated prospectively by palpation, fine-needle aspiration and mammography were assigned a malignancy risk according to the results. Scintimammography was performed in all patients in the prone breast dependent position. Immediate and delayed views were obtained. Acquisition of immediate tracer uptake was termed 'early phase' SMM, whereas a combination of both immediate and delayed phase images was termed 'double phase' SMM. All patients underwent breast biopsy. Both early phase and double phase SMM detected eight of nine tumours in the low-risk group (88.8% sensitivity). In the uncertain cases (moderate-risk group), early phase SMM detected all malignant tumours, but double phase SMM missed one (92.3% sensitivity). In the high-risk group, early phase SMM missed two breast cancers (94.6% sensitivity) and double phase SMM missed four (89.2% sensitivity). Overall, early phase SMM had a sensitivity of 94.9% and a specificity of 80.2% in detecting breast cancer, whereas double phase SMM had a sensitivity of 89.8% and a specificity of 94.3%. Both methods had 100% sensitivity for tumours larger than 1 cm. In conclusion, SMM detected additional breast cancers following an initial evaluation by palpation, fine-needle aspiration and mammography. Our results suggest that double phase SMM is more specific than early phase SMM, although early phase SMM is more sensitive. Whether the interpretation of SMM results should rely on both early and delayed images, or early images alone, should be based on the relative risk of malignancy of the breast lesion as estimated by the initial evaluation.
Adult↗
Diverticulitis: the effect of age and location on the course of disease.
To examine the effect of patient's age and the location of diverticular disease on the course of the acute disease we retrospectively collected demographic data, symptoms, laboratory findings, imaging techniques, type of treatment (conservative vs. surgical), early and late complications, and follow-up data on 119 patients with acute diverticulitis (74 women, 45 men; mean age 64+/-14 years; follow-up 7-102 months, median 40). Patients were divided by their age into two groups (42 aged 60 years or younger, 77 aged over 60) and on the location of their disease (108 to the left of the middle transverse, 11 to the right). Lower abdominal pain, abdominal tenderness, and fever were the most common complaints (70-97%). In the younger patients we found a significantly greater preponderance in the right colon (P = 0.02) than in older patients. Abdominal abscesses and fistulas were more common in right-sided diverticulitis (P = 0.01). Patients with right-sided colon diverticulitis were treated surgically (82%) and on an emergency basis more often than patients with left-side colon diverticulitis (25%; P = 0.001). Older patients treated conservatively suffered more than younger patients (61% and 33% respectively; P = 0.04) from recurrent abdominal pain but not from recurrent, confirmed diverticulitis. Patients with right-sided diverticulitis treated conservatively suffered more from recurrent diverticulitis episodes than patients with left-sided diverticulitis (P = 0.05). Younger patients thus do not have a more aggressive form of diverticulitis than older patients. Patients with acute diverticulitis in the right colon are likely to be operated earlier and for mistaken diagnoses than patients with left-sided diverticulitis.
Adult↗
Double-phase 99mTc-sestamibi scintimammography and trans-scan in diagnosing breast cancer.
UNLABELLED: The goal of our study was to assess the value of both scintimammography with 99mTc-sestamibi (SMM) and trans-scan (T-scan) in detecting breast cancer. METHODS: A total of 121 women were evaluated by palpation, mammography, SMM and T-scan. SMM was performed in the prone, breast dependent position. Immediate and delayed views (double-phase) were obtained. T-scan is a new breast imaging method that maps noninvasively the distribution of tissue electrical impedance and capacitance. RESULTS: SMM had 88.9% sensitivity, 88.4% specificity and 88.4% accuracy in detecting breast cancer. SMM had 100% sensitivity in detecting breast tumors >1 cm and only 66% sensitivity in detecting tumors <1 cm. T-scan had 72.2% sensitivity and 67% specificity in detecting breast cancer. It detected one more breast cancer than SMM, at the expense of 27 additional false-positive results. CONCLUSION: Double-phase SMM was sensitive and specific in detecting breast cancer. This method may reduce the rate of negative breast biopsies in tumors >1 cm. T-scan was only moderately accurate in detecting breast cancer. Its addition to SMM did not improve significantly the rate of breast cancer detection. However, because of its complete noninvasiveness, large-scale applicability and low cost, T-scan deserves further refining.
Adult↗
Adenocarcinoma of the appendix: an unusual disease.
OBJECTIVE: To describe our experience with primary appendiceal tumours. DESIGN: Retrospective study. SETTING: University hospital, Israel. SUBJECTS: 2520 patients who had appendectomies during the 14 years, January 1982-December 1996. RESULTS: 22 patients 5 male and 17 female, mean age 56.2 years, had primary neoplasms; 14 were carcinoid tumours and villous adenomas and were treated by appendicectomy only. Adenocarcinoma was diagnosed in 8 patients (0.3%), 5 after appendicectomy (0.2%) which is twice the reported incidence. They were all treated by right hemicolectomy. Seven of the patients were classified as Dukes' B and one as Dukes' C. All patients were alive and disease-free after a mean follow-up period of 57.4 months. CONCLUSION: Right hemicolectomy is the treatment of choice for adenocarcinoma of the appendix.
Adenocarcinoma↗
Effects of mild perioperative hypothermia on cellular immune responses.
BACKGROUND: Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. METHODS: Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. RESULTS: Patients in the normothermia group maintained normal body core temperature, whereas temperature decreased by approximately 1 degree C in the hypothermia group. Mitogenic responses were suppressed in cells from patients in the hypothermia but not in the normothermia group 24 and 48 h after surgery. Proinflammatory cytokine (IL-1beta, IL-6, TNF-alpha) production increased in both groups, although the production of IL-1beta was significantly higher in the normothermia group 24 h after surgery. Production of IL-2 was suppressed in the hypothermia but not in the normothermia group at 24 h. CONCLUSIONS: Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.
Antibody-Dependent Cell Cytotoxicity↗
[Gastric duplication cyst in an adult].
Gastric duplication cysts are rare in adults and usually asymptomatic. In most cases they are discovered incidentally by abdominal ultrasound, CT, or upper gastrointestinal x-rays. Most of the duplications (82%) are cystic and do not communicate with the stomach. Approximately half of the cases are associated with other congenital anomalies. We report a 59-year-old woman operated on for a pancreatic mass that proved to be a gastric duplication cyst. The cyst was resected and the postoperative course was uneventful.
Adult↗
Comparative study of the early postoperative course and complications in patients undergoing Billroth I and Billroth II gastrectomy.
Distal gastric resection can be followed by reconstruction according to the Billroth I (BI) or Billroth II (BII) techniques. The aim of this study was to compare the early postoperative results and complications of patients undergoing BI and those undergoing BII resection. Eighty-eight patients operated during the years 1991 to 1994 underwent distal gastric resection (41 had BI, and 43 had BII resections). The indications for BI resections were gastric tumors in 39 patients (95%) and duodenal ulcer in 2 (5%). The indications for BII resection were malignancy in 28 patients (65%) and duodenal ulcer disease in 15 (35%). The average duration of the procedure was 147 +/- 28 minutes for the BI resection and 175 +/- 38 minutes for the BII resection (p < 0.05). No patient in the BI group developed anastomic leakage. Two patients who underwent BII resection developed duodenal stump leakage (4.7%). Relaparotomy was indicated in five patients, two from the BI group (malignant cells in the resection margins) and three from the BII group (one due to duodenal stump leakage and two for bleeding). There was no postoperative mortality in the BI group. The postoperative mortality in the BII group was 7.1% (p < 0.05). The average proximal gastric resection margins were significantly smaller in the BI group than in the BII group (3.65 +/- 2.83 cm and 5.18 +/- 2.57 cm, respectively; p < 0. 05). The number of lymph nodes found in the resected specimen did not differ significantly between the two groups. Recurrent tumor at the gastric remnant developed in two patients in the BI group but not in the BII group. The results of our study revealed that the BI procedure is accompanied by significantly lower postoperative complication and mortality rates than the BII procedure in cases of gastric malignancy. BI resection performed for malignancy seems to achieve smaller proximal gastric resection margins, which may influence the recurrence rate.
Adenocarcinoma↗
[Colonic obstruction due to endometriosis and schistosomiasis].
A 40-year-old woman was hospitalized for mechanical colonic obstruction. The past history of ovarian endometriosis, and preoperative endoscopy and CT of the abdomen suggested the diagnosis of endometriosis. It was confirmed by pathological examination of the resected specimen, which also showed schistosomiasis. Repeated stool examination for the parasite ova were negative. Literature related to combined endometriosis and schistosomiasis as a possible etiology for mechanical colonic obstruction is reviewed.
Adult↗
Evidence for the involvement of the Wnt 2 gene in human colorectal cancer.
Colorectal cancer (CRC) is one of the most frequent cancers in humans. It develops via a multistage process involving alterations of both protooncogenes and tumor suppressor genes. In the present report we determined the level of expression of several Wnt genes in CRC by RT-PCR and direct sequencing. While Wnt-1 was not detectably expressed in any colonic tissues, Wnt-5a gene was efficiently expressed both in nontumorous as well as in colonic tumor tissues. In contrast, the Wnt-2 gene, which was expressed at low levels in normal colon, exhibited overexpression in all tumor tissue samples at the different Dukes' stages of CRC progression, including premalignant polyps and liver metastases. Overexpression of the Wnt-2 gene occurred also in other digestive neoplasms such as gastric and esophageal carcinomas, as well as in diverticulitis associated with stenosis or pseudo-tumor.
Base Sequence↗
[Late solitary metastases of breast origin presenting as primary colonic carcinoma].
The case of a 72-year-old woman with 2 solitary metastases to the colon of breast origin with mimicked primary colonic cancer is presented. The primary breast lesion was an infiltrating duct carcinoma and the metastases to the colon were discovered 6 years later. Some of the regional lymph nodes draining the colon were infiltrated by tumor, probably originating from the 2 colonic metastases. This is an unusual condition that has not as yet yet been reported.
Aged↗
Late solitary pancreatic metastasis from renal cell carcinoma.
A 76-year-old woman was admitted for a pancreatic mass. Twenty-one years previously she had undergone a left nephrectomy for renal cell carcinoma. A computerized tomography-guided needle biopsy of the pancreatic mass raised the suspicion of metastatic renal cell carcinoma. Final pathologic examination of the resected mass after distal subtotal pancreatectomy confirmed the preoperative diagnosis of metastatic renal cell carcinoma.
Aged↗
Patient satisfaction in two departments of surgery in a community hospital.
Patient satisfaction with medical and nursing care was evaluated in two surgical departments of a community teaching hospital in Petah Tikva (now called Rabin Medical Center, Golda Campus). The interview, conducted before the patients were discharged, related to their perception of the preoperative period, the attitude of the personnel in the operating room before anesthesia was administered, and their satisfaction during the postoperative period. The questionnaire completed by the interviewer included questions on the time that elapsed from admission to the first examination by a physician and a nurse, whether the patient received information about the operation and its possible complications, was examined by the anesthetists, received details regarding the results of the surgical procedure, and what his or her impression was of the attitude of the nursing staff. The patients were asked to rate their evaluation on a scale from 1 to 10. The results showed high satisfaction with the services provided and were similar for both departments. The small number of patients whose satisfaction rated from 5 to 8 complained about the sanitary conditions in the toilets, the overcrowded departments, and the lack of sufficient number of registered nurses during the night shifts.
Adolescent↗
Surgery in chronic dialysis patients.
During recent years there has been a continuous increase in the number of patients with end-stage renal failure who require long-term dialysis. The purpose of this retrospective work was to look at the number and type of operations performed and the postoperative outcome and complications that may be typical for these patients. This report details our experience with surgery in chronic dialysis patients, focusing mainly on major surgical procedures. During 21 years (1972-93) 22 patients on long-term hemodialysis or peritoneal dialysis underwent 44 operations. All access operations and parathyroidectomies were excluded. Each patient underwent between 1 and 6 operations; 27 (61.4%) operations were elective and 17 (38.6%) were emergencies. The most common type of operation performed was abdominal surgery and hernia repair; the others, in decreasing order, were urological operations, amputations, and vascular surgery. Postoperative complications occurred in 54% of the operations, the most common being hyperkalemia in 32%, infectious complications in 16%, and bleeding in 11%. One patient (2%) died postoperatively; the cause was most probably secondary to hyperkalemia and a fatal arrhythmia. From a review of the literature and from the results of our study it appears that surgery in uremic patients can be performed with acceptable results in terms of morbidity and mortality rates. Complications, such as hyperkalemia, a fall in blood pressure, and bleeding, are expected and preventive measures should therefore be taken. Perioperative measures are recommended to minimize complications.
Adult↗
Oncogenic osteomalacia induced by schwannoma in a patient with neurofibromatosis.
A 62-year-old woman known to be suffering from Von Recklinghausen disease and osteomalacia was operated on for a pelvic mass. Pathological examination of the excised tumor showed it to be a schwannoma and this tumor was considered to be responsible for the osteomalacia. The return of previously abnormal laboratory data to normal values and the impressive clinical and subjective improvement further support the assumption that the excised schwannoma was responsible for the pathology observed in this patient.
Female↗
[Recurrent spontaneous jejunal perforation].
A 70-year-old woman had recurrent spontaneous perforations of the jejunum. The first perforation, located 40 cm distal to the ligament of Treitz, was treated by debridement and suture closure. The second perforation, 2 months later, was located 20 cm distal to the first perforation and was treated by resection and primary anastomosis. On both occasions the postoperative course was uneventful and at follow-up 4 years later there were no gastrointestinal complaints. The resected specimen revealed a thinner-than-normal muscularis propria, most probably of congenital origin.
Aged↗