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Biomedical subjects

Z Israel

Publications and source records attributed to Z Israel.

At least 19 recordsLinked to original sources
PubMed2001

Anaplastic and atypical meningiomas express high levels of Fas and undergo apoptosis in response to Fas ligation.

In this study we characterized the expression of Fas and Fas ligand in different types of meningiomas and examined the effect of Fas ligation on the death of meningioma cells in culture. Using Western blot analysis, we found that extracts derived from anaplastic and atypical meningiomas expressed high levels of Fas, whereas benign meningiomas did not express detectable levels of this protein. All of the meningiomas examined expressed low levels of Fas ligand. Cultures of anaplastic meningiomas also expressed Fas and treatment of these cells with anti-Fas antibody induced cell death. The results of this study indicate that Fas is preferentially expressed in atypical and anaplastic meningiomas and suggest that it is involved in the increased apoptosis observed in these tumors.

Antibodies↗
PubMed2001

Safety of perioperative minidose heparin in patients undergoing brain tumor surgery: a prospective, randomized, double-blind study.

OBJECT: Thromboembolic phenomena (TEPs) continue to be a significant source of morbidity and mortality in patients undergoing neurosurgery. Although the efficacy of low-dose heparin in preventing TEPs in neurosurgical patients is well established, neurosurgeons are reluctant to use it perioperatively because of concern for increased bleeding complications. To clarify this issue, the authors used a prospective, randomized, double-blind design to evaluate the safety of minidose heparin treatment in patients undergoing surgery for supratentorial brain tumors. METHODS: One hundred three patients, all 40 years of age or older, were treated with either 5000 U of heparin (55 patients) or placebo (48 patients) starting 2 hours before surgery and continuing until full mobilization or for 7 days. Both groups were well matched for sex, weight, duration of surgery, and tumor diagnosis. Subjective and objective parameters were used to estimate and calculate the perioperative bleeding tendency in all patients. Red blood cell mass loss was calculated by assessing the preoperative and postoperative hematocrit and the patient's weight. Intraoperative blood loss was determined by measuring the quantity of blood in the suction containers and subtracting the amount of irrigation fluids. Postoperative bleeding was measured by determining the amount of fluid in the subgaleal drain, and blood cell replacement was monitored during and after the procedure. Intracranial bleeding was graded according to findings on the postoperative computerized tomography scan obtained 48 to 72 hours after surgery. In addition, the senior surgeon in each case was asked to assess each patient's bleeding tendency during the operation. The results showed that perioperative administration of heparin did not significantly alter bleeding tendency by any measured parameter. The surgeon was blinded to which group individual patients had been allocated. CONCLUSIONS: Perioperative minidose heparin is safe for use in patients undergoing craniotomy for supratentorial tumors. This relatively simple and inexpensive measure is recommended as a routine regimen for the prevention of TEPs in patients undergoing neurosurgery.

Anticoagulants↗
PubMed2000

Failed back surgery syndrome.

Over the years, a number of treatments for persistent low back pain following spine surgery, the failed back surgery syndrome (FBSS), have been developed. The complexity of the clinical problem, the multidimensional nature of chronic pain, and general lack of rigorous study design, however, have obscured outcome assessment and hampered efforts to optimize patient selection criteria. Recent work has focused on refinement of existing therapies for FBSS and identification of factors that influence outcome and improve patient selection criteria. In combination with more rigorous study methodology, these efforts have led to improved understanding of the clinical response to a number of pharmacologic, surgical, and neuromodulation therapies for FBSS.

Acupuncture Therapy↗
PubMed2000

CNS granulomatosis in a child with chronic granulomatous disease.

Chronic granulomatous disease (CGD) is a disease in which a granulomatous process involves various organ systems and in which recurrent infections are seen. The basic defect is the absence of the granulocyte respiratory burst. CNS involvement is rare. We present a report of a child with CGD and CNS involvement, presenting with hydrocephalus. Candida was identified in the granulomata. The patient responded well to a CSF shunt and antifungal therapy.

Brain Diseases↗
PubMed2000

Radiation-induced meningioma: a distinct molecular genetic pattern?

Radiation-induced meningiomas arise after low-dose irradiation treatment of certain medical conditions and are recognized as clinically separate from sporadic meningioma. These tumors are often aggressive or malignant, they are likely to be multiple, and they have a high recurrence rate following treatment compared with sporadic meningiomas. To understand the molecular mechanism by which radiation-induced meningioma (RIM) arise, we compared genetic changes in 7 RIM and 8 sporadic meningioma (SM) samples. The presence of mutations in the 17 exons of the neurofibromatosis type 2 (NF2) gene, which has been shown to be inactivated in sporadic meningiomas, was analyzed in RIM and SM using single-strand conformation polymorphism (SSCP) and DNA sequencing. In contrast to SM, which showed NF2 mutations in 50% of specimens, no mutations were found in RIM. In addition, Western blot analysis of schwannomin/merlin protein, the NF2 gene product, demonstrated protein levels comparable to normal brain in 4/4 RIM tumor samples analyzed. Loss of heterozygosity (LOH) of genomic regions, which were reported for SM, was also analyzed in all cases of RIM using 22 polymorphic DNA markers. Allele losses were found on chromosomes 1p (4/7), 9p (2/7), 19q (2/7), 22q (2/7), and 18q (1/7). From these observations we conclude that unlike sporadic meningiomas, NF2 gene inactivation and chromosome 22q deletions are far less frequent in RIM, and their role in meningioma development following low dose irradiation is less significant. Other chromosomal lesions, especially loss of 1p, possibly induced by irradiation, may be more important in the development of these tumors.

Adult↗
PubMed1998

Rapid spontaneous resolution of acute subdural hematoma and HIV related cerebral atrophy: case report.

BACKGROUND: The natural history of a traumatic acute subdural hematoma is usually interrupted by its prompt surgical removal. Rapid spontaneous resolution within 48 hours, although infrequently reported, may be, underestimated and demonstrates a benign course of this condition. To our knowledge, this is the first case of rapid spontaneous resolution of an acute subdural hematoma in a patient with HIV encephalopathy and cerebral atrophy. METHODS AND RESULTS: This 27-year-old man, an intravenous drug user with AIDS-related complex and HIV encephalopathy, suffered an acute subdural hematoma due to head injury in a car accident. The hematoma spontaneously resolved within 12 hours, resulting in a favorable outcome with nonoperative treatment. CONCLUSIONS: AIDS related cerebral atrophy may not only have predisposed the patient to the development of an extracerebral collection, but may have also favorably influenced the spontaneous resolution of the hematoma. The mechanism of the hematoma resolution and the influence of HIV related cerebral atrophy is discussed.

AIDS Dementia Complex↗
PubMed1996

Resistance of previously infected chimpanzees to successive challenges with a heterologous intraclade B strain of human immunodeficiency virus type 1.

To test whether the protective effects of attenuated simian immunodeficiency virus vaccines in macaques were applicable to the human immunodeficiency virus type 1 (HIV-1)-chimpanzee system, two groups of animals, previously infected with HIV-1(IIIB) or HIV-1(SF2) were each challenged with a heterologous clade B virus, HIV-1(DH12). Following challenge, the parameters measured included virus isolation (from plasma, peripheral blood mononuclear cells, and lymph node tissue); quantitative DNA PCR using primers capable of distinguishing HIV-1(IIIB), HIV-1(SF2), and HIV-1(DH12) from one another; and serologic assays to monitor changes in binding and neutralizing antibodies. In contrast to an HIV-1-naive chimpanzee that rapidly became infected following the inoculation of HIV-1(DH12), the two chimpanzees previously infected with HIV-1(IIIB) resisted repeated and escalating inoculations of HIV-1(DH12), as monitored by virus isolation and PCR. The two animals previously infected with HIV-1(SF2) became infected with HIV-1(DH12) but in contrast to the case with the HIV-1-naive chimpanzee, no cell-free viral RNA was detected in the plasma by the branched DNA procedure and levels of peripheral blood mononuclear cell-associated viral DNA were reduced 35- to 50-fold.

AIDS Vaccines↗
PubMed1995

[Central neurocytoma].

4 cases of central neurocytoma are reported. Sex distribution was symmetrical, average age at presentation was 29.7 years, and duration of symptoms varied from 1 day to 5 years. Headache and nausea were the most frequent symptoms; 1 patient was asymptomatic, 3 tumors were located in the left lateral ventricle and 1 in the third ventricle. 3 were operated on via an interhemispheric transcallosal route and 1 transcortically. Morbidity included symptomatic subdural effusions (2 cases), short term memory deficit (1) and transient hemiparesis with aphasia (1). There was no mortality.

Adult↗
PubMed1995

[Stereotactic brain biopsy].

During a 3-year period starting in 1991, 49 patients with brain lesions underwent 50 stereotactic brain biopsy procedures. The average age was 46 years (range 4-74). Specimens were taken from various brain regions, particularly from the deep aspect of the cerebral hemispheres and midline structures. The pathologic entities included 27 gliomas (13 glioblastomas, 6 astrocytomas, 3 anaplastic astrocytomas, 1 pilocytic astrocytoma and 4 oligodendrogliomas), 5 lymphomas, 2 germinomas, 1 primitive neuroectodermal tumor, 2 metastatic tumors and 11 non-neoplastic lesions (4 demyelination, 2 infarcts, 1 hematoma, 1 brain abscess, 1 radiation necrosis, 1 Alzheimer's disease and in 1 case no diagnosis). The diagnostic success of the stereotactic brain biopsies in this series was 96% (in 98% of the patients). The mean hospital stay was 3 days. 1 patient with a multifocal bilateral glioblastoma died due to early postoperative hematoma of the basal ganglia (2%). Another 2 patients underwent craniotomy due to post-biopsy hematoma. They continued to suffer from hemiparesis after discharge. Transient Horner's syndrome was noted in 1 patient. Thus the permanent morbidity rate was 4%. We conclude that stereotactic brain biopsy can be performed relatively safely, has a high diagnostic yield, and facilitates planning of treatment.

Adolescent↗
PubMed1995

Intracranial haemorrhage from a meningioma in a patient receiving aspirin prophylaxis: a case report.

A case of acute subdural haematoma originating spontaneously from an angiomatous meningioma in a patient receiving prophylactic aspirin therapy is presented. To the best of our knowledge no comparable case and no discussion of possible complications of aspirin prophylaxis in patients with brain tumours have been published. Possible reasons and clinical significance of this complication are discussed. This observation questions the suitability of aspirin as prophylaxis for vascular disease in patients with meningiomas.

Aged↗
PubMed1995

Compressive epidural autologous free fat graft in a patient with failed back syndrome: case report.

A patient who had undergone surgery twice previously for lumbar spine disease presented with paraparesis and urinary sphincter problems. Imaging showed a large epidural compressive lesion with the consistency of fat at the L3/4 level. At operation a large mass of compressing epidural fat was removed. This was an epidural autologous free fat graft placed in a previous operation when stabilizing the lumbar spine. The merits of a free fat graft in relation to the prevention of epidural scar and the failed back syndrome are discussed, and the significance of this complication was considered.

Adult↗
PubMed1995

Isolation and characterization of a syncytium-inducing, macrophage/T-cell line-tropic human immunodeficiency virus type 1 isolate that readily infects chimpanzee cells in vitro and in vivo.

Fresh human immunodeficiency virus type 1 (HIV-1) isolates from patients with AIDS were screened for infectivity in chimpanzee peripheral blood mononuclear cells (PBMC) to identify strains potentially able to generate high virus loads in an inoculated animal. Only 3 of 23 isolates obtained were infectious in chimpanzee cells. Of these three, only one (HIV-1DH12) was able to initiate a productive infection in PBMC samples from all 25 chimpanzees tested. HIV-1DH12 tissue culture infections were characterized by extremely rapid replication kinetics, profound cytopathicity, and tropism for chimp and human PBMC, primary human macrophage, and several human T-cell lines. An infection was established within 1 week of inoculating a chimpanzee with 50 50% tissue culture infective doses of HIV-1DH12; cell-free virus was recovered from the plasma at weeks 1, 2, and 4 and was associated with the development of lymphadenopathy. Virus loads during the primary infection and at 6 months postinoculation were comparable to those reported in HIV-1-seropositive individuals.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Conservative treatment of a traumatic subdural hematoma of the posterior fossa in a child: case report.

Traumatic posterior fossa hematomas are uncommon. Subdural hematomas in this location are probably the rarest. The natural history in acute cases is one of rapid deterioration and death from brain-stem compression. Rapid surgical intervention is indicated in acute cases. We report a case of a traumatic posterior fossa subdural hematoma in a 3-year-old child treated conservatively with a good outcome.

Child, Preschool↗
PubMed1994

Hyperextension fracture-dislocation of the thoracic spine with paraplegia in a patient with diffuse idiopathic skeletal hyperostosis.

The case is described of a hyperextension thoracic spine fracture in a patient with diffuse idiopathic skeletal hyperostosis (DISH). A 70-year-old woman awoke paraplegic after retroperitoneal surgery after having been positioned in the hyperextended axially rotated position. Imaging demonstrated a T9-10 fracture-dislocation with severe pressure on the spinal cord, as well as findings typical of DISH. This case emphasizes the danger inherent in manipulating the ankylosed hyperostotic spine. It is proposed that patients undergoing surgery in this position should be evaluated for DISH as an additional risk factor.

Aged↗
PubMed1992

Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts.

Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 degrees C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.

Adolescent↗