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Biomedical subjects

Y Ziv

Publications and source records attributed to Y Ziv.

At least 91 records · Page 5Linked to original sources

Conservative surgery of renal cell carcinoma.

Recently more conservative surgery of renal cell carcinoma is being performed. Patients with small, low-grade and low-stage tumors can be treated by enucleation or partial nephrectomy and will have about the same cure rate as those patients who were treated before by radical nephrectomy. Six patients, who would have been candidates for chronic dialysis, underwent enucleation or partial nephrectomy. Three of them had Stage I, and three had Stage II renal cell carcinomas. Patients were followed up 6 to 52 months (average 34) after surgery, and no local recurrence or distant metastases were found. It has recently been recognized that not every patient with renal cell carcinoma requires radical nephrectomy. Renal parenchyma can be saved without a decline in effective control of the tumor or a change in prognosis.

Aged↗

Use of 5-micron filter in administering 'all-in-one' mixtures for total parenteral nutrition.

An assessment was made of the stability of nine total nutrient admixtures (TNA) for total parenteral nutrition (TPN) and of Intralipid 20% filtered through a 5-micron filter. Mixture samples from 3-litre EVA plastic bags were obtained for tests 4 and 24 h after preparation, before and after filtration through a 5-micron filter during a period of 24 h. The filtered mixtures were collected in 3-litre EVA plastic bags and the contents of the filter were also examined. Stability parameters studied were pH, lipid globule size and visual signs of emulsion breakage. Used for assessment of lipid globule size were a light microscope and a Coulter Counter TA II, which measures particles from 1.4 microns to 43.8 microns in diameter. There were no physical signs of instability in any of the mixtures tested while they were being filtered and collected through the 5-micron filter. Examination of mixture samples prior to filtration and of filter contents revealed the presence of large fat globules, precipitates, solid particles and aggregates. Although these were trapped on the surface of the filter there was no slowing of the rate of flow of the mixture. These findings demonstrate the importance of using a 5-micron filter in delivering total nutrient mixtures in order to avoid the hazards posed by the presence of particles larger than 5 microns in size and show that its use does not affect stability.

Journal Article↗

Spontaneous rupture of the stomach.

A patient with spontaneous rupture of the stomach, treated successfully by a proximal gastrectomy, is described. The probable cause of the rupture was the ingestion of a large meal accompanied by functional blockage of the normal gastric outlets. Only immediate surgical intervention can reduce the high mortality rate associated with this rare condition.

Aerophagy↗

Catheter obstruction: analysis of filter content of total nutrient admixture.

Catheter blockage in patients receiving long-term parenteral nutrition with fat-containing total nutrient admixture (TNA) is a relatively common complication. A study was carried out to characterize the material which is filtered out of the TNA and is a potential cause of catheter blockage. A total of 45 bags containing the same TNA solution were stored for 7 days at 4 degrees C. The stability of the solution in all the bags was then confirmed by light microscope and Coulter Counter, to determine the particle-size distribution, following which the solution was filtered through a 5-microns filter. Chemical analysis was then made to determine the amount of solid particles, fat and precipitates of Mg, Zn, Ca, Na, and K in the filter contents. Each bag was found to contain 7326 +/- 2681 solid particles as plasticizers and the main component of the filter contents was fat (99.4%) whereas electrolytes as precipitates constituted less than 0.5%. The amount of fat and electrolytes lost on the filter from the solution was negligible. Our analysis of the material trapped on the filter, which may block the catheter during long-term therapy, suggests the importance of filtration and of finding a means for dissolving the fat, the main component of the filter material.

Catheterization, Peripheral↗

Ataxia telangiectasia and lymphoma: an indication for individualized chemotherapy dosing--report of treatment in a highly inbred Arab family.

Ten of 18 children in a highly inbred Arab kindred suffered from either ataxia telangiectasia (AT) or a variant syndrome consisting of ataxia, microcephaly, and congenital cataract (AMC). Four of the nine afflicted children were treated in our unit when they developed lymphomas (both Hodgkin's and non-Hodgkin's including Burkitt's). They were given chemotherapy (either standard COMP or low-dose ABV/CVPP). The children with non-Hodgkin's lymphomas died of sepsis after receiving full-dose COMP. Low-dose ABV/CVPP brought about a 20-month remission in one child with nodular sclerosing Hodgkin's lymphoma and both AT and AMC, but she developed a preleukemic syndrome and her parents refused further treatment; she too died. A fourth child, also with nodular sclerosing Hodgkin's lymphoma, is currently in complete remission after ABV/CVPP. Treatment of lymphomas in patients with AT is extraordinarily difficult and has potential side effects so grave as to necessitate careful monitoring and individualized protocols.

Antineoplastic Combined Chemotherapy Protocols↗

Lymphocyte subpopulation before and after operation in patients with benign vs malignant breast disease.

Multiple parameters of immune function were measured serially before and one and five weeks following operation in 14 patients with fibrocystic disease of the breast (Group A) and in 20 patients with stage 1-2 infiltrating duct carcinoma (Group B). These parameters included the following: WBC, total number and percentage of lymphocytes, numbers of B cells, T cells, T-active, T-helper and T-suppressor cells and the ratio between the latter as well as spontaneous suppressor or helper activity and the graft-versus-host reaction. Prior to operation no statistically significant difference was found between the two groups except for the number of T-helper cells, which was higher in Group B (p less than 0.05), and the spontaneous suppressor activity, which was higher in Group B (p less than 0.05). The finding of such a high percentage (80%) of negative graft-versus-host reactions five weeks after operation together with the high suppressor activity may indicate the presence of tumor micrometastases. The burden of surgery and general anesthesia was stronger in Group B, with a pronounced difference found between the groups (p = 0.0005), but the interaction between the influence of time (surgery and anesthesia) and the groups was not as great (p = 0.4864) and was found to be different for each group.

Breast Neoplasms↗

Familial varicocele.

Described are two families in each of which two young males had varicocele. HLA-A, B, C and D5R antigen studies were performed in one family but no genetic factors could be determined. In a review of several large series of patients with varicocele we found no mention of familial occurrence. Although the linkage between adolescent varicocele and spermatogenic dysfunction is still debatable, it is concluded from our experience that it is worthwhile examining other male members of families of affected adolescents or children but that expensive invasive studies are not warranted.

Adolescent↗

The influence of perioperative transfusions on the immunological profile of patients with colorectal adenocarcinoma.

Seventy patients with Duke's C adenocarcinoma scheduled to undergo operation were divided into two groups, those who received no perioperative transfusion (Group I, 26 patients) and those who received an average of 2.1 units per person of packed red blood cells perioperatively (Group II, 44 patients). Immunological parameters were tested before and one and five weeks after the operation in order to determine the influence of the transfusion on these parameters as well as that of the site of the tumor, whether right colon, left colon or rectum. Comparison of the mean values obtained before operation with those obtained one week post-operatively revealed a significant change in the number of B cells (p = 0.014), with a decrease in Group I and a rise in Group II, which was seen to persist for the mean values obtained five weeks after operation. The higher rates of recurrency and lower rates of survival reported in patients who received transfusion may be related to an as yet unidentified role of B cells or a subpopulation in the immune system, manifested in the suppression of activity of those components responsible for destroying micrometastases. In relation to the site of the tumor no definite conclusions can yet be drawn as to the prognostic importance of our findings concerning the immunological parameters.

Adenocarcinoma↗