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Biomedical subjects

Z Weshler

Publications and source records attributed to Z Weshler.

68 records · Page 4Linked to original sources

Experience with contrast mammography in the diagnosis of various breast diseases.

Contrast mammography, with oxygen or positive contrast material, was performed on 88 women with various diseases of the breast. The examination was done after simple mammography had failed to establish a clear diagnosis. In each case, the roentgenologic diagnosis was confirmed by histological examination. In some cases, bicontrast studies of the duct system or of cysts were performed. With contrast mammography, a correct diagnosis was established in 98.7% of malignant tumors and in 97.8% of benign tumors. Bicontrast studies demonstrated intraductal and intracystic malignancies.

Adenofibroma↗

The effect of ionizing irradiation on vasomotor reactivity in the rat thoracic aorta in vitro.

PURPOSE: Ionizing irradiation inhibits restenosis in animal models and human. Vasomotor tone preservation during and after radiation therapy is of clinical importance. We therefore investigated vascular reactivity following radiation therapy. METHODS AND MATERIALS: Wistar Sabra rats were treated with a single dose of 1000 cGy external X-ray irradiation. Vascular reactivity of 192 segments of rat thoracic aorta was studied in vitro in four groups (12 rats in each group, four segments from each aorta). Immediately after in vivo irradiation, immediately after ex vivo irradiation, 1 month after irradiation, and no irradiation (control). RESULTS: Vasoconstriction to phenylephrine (PE) 10(-9)-10(-5) M or KCl 118.0 mM in all the irradiated groups was similar to controls. Endothelium-dependent vasorelaxation to acetylcholine (ACh) 10(-9)-10(-5) M in segments studied immediately after in vivo irradiation was increased compared to controls at all concentrations (109.7+/-35. and 90.0+/-40.0%, respectively, at 10(-5) M, P=.006). Endothelium-independent relaxation to nitroglycerin 10(-9)-10(-5) M in all irradiated groups was similar to controls. CONCLUSIONS: External-ionizing irradiation with 1000 cGy in the rat aortic model induces acute and transient increase in endothelium-dependent relaxation to ACh, and does not alter vasoconstriction and endothelium-independent relaxation.

Analysis of Variance↗

Primary presentation of malignant lymphoma in middle ear cleft.

An unusual case of histiocytic type malignant lymphoma with primary presentation in the middle ear cleft in a 32-year-old female patient is reported. Despite combined surgical, radiological and chemotherapeutic treatment, the patient expired from a fulminant spread of the lymphoma 14 months after the first clinical manifestation of the disease in the right ear.

Adult↗

Diffuse large cell non-Hodgkin's lymphoma: results of M-BACOD combination chemotherapy.

Twenty-seven adult patients with diffuse large cell lymphoma were treated with the M-BACOD regimen during the period 1980-86. Of these, 24 (89%) had advanced Stage III-IV disease by clinical staging and only 3 (11%) had limited disease. CR was achieved in 14 patients (52%), all of whom had advanced disease prior to therapy. The remaining 13 patients (48%) achieved only PR. Of the entire group of 27 patients, 11 (41%) died, 12 (44%) are still in CR, and 4 (15%) have relapsed and are still alive with PR. Of the 14 patients who achieved CR, 1 relapsed, but is currently in PR, showing minimal disease. All of these 14 patients are alive (11 months to 6 years post therapy), and 13 (93%) still remain in CR with a median time of CR of 45 months. Of the 13 patients who only achieved PR, 11 (85%) relapsed and died within a median time of 3.6 months, and 2 patients remain in PR. The above results are similar to those obtained in larger series recorded from other centers. In the light of improved results obtained with new regimens and ABMT, we have now adopted the MACOP-B regimen for treating aggressive lymphoma and have entered an ABMT program for patients with predictable poor prognostic features.

Adolescent↗

Chemotherapy induction, consolidation radiotherapy and maintenance alternating chemotherapy in small cell carcinoma of the lung.

Forty-four evaluable, previously untreated patients with small cell lung cancer were treated with two courses of induction chemotherapy consisting of POCC. Subsequently, all limited-disease patients and extensive-disease patients in CR received 4,000 to 5,000 cGy irradiation over 4 to 5 weeks (or the equivalent) to the primary tumor, mediastinum and supraclavicular areas and 3,000 cGy prophylactic cranial irradiation during 2 weeks. All patients received maintenance chemotherapy for a full year after CR or until disease progression. Eleven continued POCC while 33 received vinblastine, cyclophosphamide, and either adriamycin or methotrexate on an alternating schedule (VCMA). For the 20 limited-disease patients, the CR rate was 70% and the PR rate was 20%. Median survival was 22 months, local control was 62%, 2-year DFS was 35% and 3-year DFS was 20%. Of the 24 extensive-disease patients only 21% achieved CR and 54% achieved PR. Median survival was only 8 months and there were no disease-free survivors at 2 years. Toxicity was moderate with nausea and vomiting in all patients, and there were two deaths from myelosuppression in the group that received POCC maintenance therapy; there were no drug-related deaths in the VCMA group. Since these results are similar to those obtained with simpler regimes, we cannot recommend our regimen for the treatment of small cell lung cancer. The optimal treatment for this disease has yet to be elucidated.

Adult↗

Functional and morphological alterations following isolated rat stomach irradiation. A model for estimation of radiation injury.

Exposure of the stomach to tumoricidal doses of radiation is associated with functional and morphological changes. The experimental data have been mainly obtained from studies of whole body irradiation of the stomach. We investigated the separate effect of irradiation on the surgically exposed stomach with doses of between 3 and 30 Gy. A dose-dependent decrease in free and total acidity was observed with relatively low doses (5-9 Gy). Serum pepsinogen and serum gastrin levels increased following irradiation with doses ranging from 5 to 15 Gy. Two phases of increased regenerative activity were documented (between the 1st and 3rd weeks and between the 4th and 8th weeks). No radioprotective effect was observed when sucralfate or misoprostol were utilized. Further investigations are mandatory in order to find an effective radioprotector for the irradiated stomach.

Animals↗

The effects of ionizing irradiation on production of thromboxane and prostacyclin by the isolated perfused rat kidney.

Exposure to whole body radiation is associated with prompt changes in urinary excretion of prostaglandins. We investigated the separate effects of radiation on rat kidney capillary and tubular system prostaglandin synthesis. Animals were irradiated to the left kidney area with a single dose of 15 Gy. One week later the rats were anesthesized, the renal artery, vein and ureter of the left kidney cannulated, and the kidney removed and perfused with Krebs-Henseleit physiological buffer at a rate of 10-12 ml/min. Effluent fluids were collected separately from the renal vein and from the ureter of irradiated and control (operated sham-irradiated animals) and were assayed by radioimmunoassays for thromboxane A2 (TXB2) and prostacyclin (6 keto PGF1 alpha). Histological examination of the irradiated kidneys showed no significant changes, and electron microscopy revealed minimal interstitial edema. In contrast to these minimal changes, TXB2 assays showed a significant increase both in the venous and ureter effluents. Following stimulation with angiotensin II in the perfusate, a further significant increase in TXB2 production was observed both by the capillary and the tubular systems. With 6 Keto PGF1 a slightly different response was seen. The basal production was increased only in the ureter effluent of the irradiated animals, while there were no changes in the release in the venous effluents. In parallel, radiation significantly increased the angiotensin II stimulated production capacity of prostacyclin by the tubular system. The response of the capillary system following irradiation may create imbalance between these two important substances and lead to the radiation effects in the renal tissue.

Animals↗

Continuous course of megavoltage radiotherapy for carcinoma of the prostate.

Between 1978 and 1983, 55 patients with advanced carcinoma of the prostate (38 with Stage C and 17 with Stage D) were treated with external beam MeV radiotherapy. In 29 patients radiotherapy was the first treatment modality, and 26 patients had previously received hormonal therapy. Both treatment modalities were continued simultaneously for Stage D and bulky Stage C of the disease. Severe urodynamic problems were the main treatment indications for patients with Stage D carcinoma. The treatment consisted of two courses each of 25 gray (Gy) whole pelvic irradiation, interrupted for 2 weeks to deliver a rotation field to the prostate at a dose of 20 Gy. Patients have been followed for a minimum of 36 months. For patients with Stage C disease the overall 3-year survival was 80%, with 55% disease-free survival. Palliative irradiation for Stage D prostatic carcinoma improves the quality of life and probably the survival rate. Acute minor complications were observed in 49% of the patients, and chronic complications occurred in 14% of the patients. The described MeV technique is well tolerated and effective for Stage C as well as for Stage D prostatic cancer patients.

Adenocarcinoma↗

Testicular seminoma: the Hadassah University Hospital experience.

A retrospective study of all cases of pure testicular seminoma treated at the Hadassah University Hospital in Jerusalem from 1978 through 1986 was conducted. Of the 22 patients, 15 (70%) presented in Stage I, 4 (18%) in Stage II, 2 (9%) in Stage III and 1 (4%) in Stage IV. The results of treatment were evaluable for 20 of these patients. After a median follow-up of 4 years, only the patient with Stage IV disease died of disseminated seminoma. The remaining 19 patients are all alive and disease free, including 3 after radiotherapy for recurrent disease. Elevated beta-human chorionic gonadotropin levels before treatment did not predict an unfavorable outcome. Our excellent results are similar to those obtained at larger treatment centers.

Adult↗

New approaches for the prevention of rejection and graft-vs.-host disease in clinical bone marrow transplantation.

The two major barriers to successful allogeneic bone marrow transplantation (BMT) in animals and man are graft-vs.-host disease (GVHD) and the risk of graft rejection. GVHD is the result of alloreactivity of mature donor T-lymphocytes present in the graft-vs.-host tissues and can be completely prevented by pregraft depletion of T-lymphocytes. Graft rejection results from residual host immunocompetent lymphocytes that survive heavy chemoradiotherapy prior to allogeneic BMT. Host resistance to allograft cannot be eradicated even by conventional conditioning with high-dose cyclophosphamide (120 mg/kg) and lethal whole body irradiation (1,200 rad). In the present report we have utilized two new techniques to overcome GVHD and graft rejection following allogeneic BMT. GVHD can be prevented by a new monoclonal rat antihuman lymphocyte antibody, CAMPATH-1, which binds human complement, enabling donor serum to serve as the source of complement. Prevention of rejection of T-lymphocyte-depleted marrow allografts can be achieved by the application of total lymphoid irradiation (TLI) in addition to conventional chemoradiotherapy, prior to allogeneic BMT. TLI causes potent immunosuppression with minimal side effects. A combination of TLI for overcoming host resistance to allograft, and CAMPATH-1 for overcoming GVHD, leads to a relatively smooth posttransplant outcome with no evidence of GVHD and with no need for posttransplant immunosuppression.

Antilymphocyte Serum↗

Treatment of locally advanced breast carcinoma with high-dose external beam supervoltage radiotherapy.

Between 1960 and 1978, 85 patients with locally advanced T3-4N0-3M0 carcinoma of the breast were treated with 5,000 to 8,000 rad of external beam supervoltage radiotherapy. Initial clinical eradication of the tumor was observed in 76 of 87 cases (87%), but the actuarial probability of local control at 6 yr was only 53%. Furthermore, the actuarial probability of disease-free survival was 25% at 5 year and 13% at 10 yr. Most of the patients eventually succumbed to metastatic breast carcinoma and the actuarial survival at 5 yr was 43% and at 10 yr, 16%. The addition of adjuvant low-dose chemotherapy, given to 13 patients, did not affect the rates of local control, survival or disease-free survival. The most common long-term complication was extensive and deforming radiation-induced fibrosis of the treated breast. The actuarial probability of 10-yr survival without a local recurrence and without severe fibrosis of the treated breast was only 17.5%. The role of adjuvant high-dose chemotherapy in the treatment of locally advanced breast carcinoma and the possible use of improved radiotherapy techniques to achieve a more effective long-term local control and a more desirable cosmetic end result are discussed.

Adult↗