[EVALUATION OF THE DIZZY PATIENT - FROM THE VESTIBULAR IMPAIRMENT TO THE PATIENT'S FUNCTIONAL ABILITY].

The vestibular system - the sixth sense - allows humans to preserve balance, stable vision, and body orientation in space. This system performs a continuous integration of the activity of the vestibular end-organ in the inner ear, the sense of sight, and the proprioceptive sense. Damage to the components of the vestibular system causes dizziness, imbalance, and poor orientation in space.

Autologous melanoma vaccine induces antitumor and self-reactive immune responses that affect patient survival and depend on MHC class II expression on vaccine cells.

Purpose: Autologous melanoma cells display a broad variety of tumor antigens and were used for treatment of American Joint Committee on Cancer stages III and IV melanoma as an adjuvant or active therapy. Survival data and immune response were evaluated in vaccinated patients.

Experimental Design: Forty-seven patients received 2,4-dinitrophenyl-conjugated autologous melanoma vaccine as an adjuvant (23 patients) or therapy (24 patients).

[Is there an indication for parenteral nutrition support in the terminally ill cancer patient?].

Cancer cachexia is mediated by cytokines affecting intermediate metabolism of energy, proteins, carbohydrate and lipid. It is aggravated by common therapeutic measures: surgery, chemotherapy and radiotherapy that reduce oral intake as well as increase catabolism. Enteral or parenteral nutrition support decreases the catabolic rate of the patient, helping the patient withstand the side effects of the therapeutic measures, but do not reverse to anabolism.

Bleeding, obstruction, and perforation in a series of patients with aggressive gastric lymphoma treated with primary chemotherapy.

Background: The management of patients with gastric lymphoma has evolved, with a shift toward nonsurgical treatment. The rates of surgical complications in patients receiving chemotherapy have been insufficiently studied. The objective of this study was to assess the frequency of bleeding, perforation, and gastric outlet obstruction in patients who received chemotherapy as primary treatment for gastric diffuse large B cell lymphoma (DLBCL).

Dental complications following gastric restrictive bariatric surgery.

Background: Morbid obesity is a scourge of the 21st century. The effective therapeutic measure is bariatric surgery. The medical literature has inadequately reported the potential deleterious effects of such surgery on dental health.

Unique features of laparoscopic cholecystectomy in Beta thalassemia patients.

Beta Thalassemia patients suffer from a high incidence of gallstones as well as systemic complications of iron overload. We performed laparoscopic cholecystectomy in 8 beta thalassemia patients and describe their specific features. Diagnosis was based on patients' clinical presentation and sonography.

Autologous cell vaccine as a post operative adjuvant treatment for high-risk melanoma patients (AJCC stages III and IV). The new American Joint Committee on Cancer.

This study evaluates the overall survival and disease free survival of melanoma patients that were treated with an autologous melanoma cell vaccine, administered as a post-operative adjuvant. Included are 43 patients with totally resected metastatic melanoma (28-AJCC stage III, 15-AJCC stage IV), with a median follow up of 34 months (6-62). The treatment consisted of eight doses of a vaccine made of 10-25x10(6) autologous melanoma cells either released from the surgical specimen or grown in cell cultures.

[Medical support during the Sinai War of Attrition (1968-1970) from a 30-year perspective].

The War of Attrition between Israel and Egypt along the Suez Canal line lasted 23 months (9/1968-8/1970), during which the Israel Defense Forces (IDF) were mostly in fixed fortifications. A few of the important principles of field medical support, which became cornerstones of IDF procedure, were established during that war. These included use of armored vehicles for evacuation under artillery fire, as well as emergency treatment, physiological stabilization, and maintenance of the wounded until evacuation.

Right atrial thrombi are related to indwelling central venous catheter position: insights into time course and possible mechanism of formation.

We studied the effect of central line catheters on thrombus formation in the right atrium (RA), including the incidence and echocardiographic characteristics of the catheter-associated thrombus as well as possible clinical implications in patients. We prospectively studied 55 patients by transesophageal echocardiography within 1 week after Hickman catheter implantation and on a follow-up study at 6 to 8 weeks. We succeeded in imaging the catheter tip in 48 of the 55 patients (87%).

Abdominal compartment syndrome due to delayed identification of a ureteral perforation following abdomino-perineal resection for rectal carcinoma.

Abdominal compartment syndrome develops whenever the mean intraperitoneal pressure rises above the physiological pressure, leading to renal and mesenteric ischemia and respiratory decompensation due to pressure on the diaphragm. Abdominal compartment syndrome may occur after conditions such as peritonitis, intestinal obstruction, laparoscopic procedures, or abdominal tumors. Leakage from the urinary tract may cause accumulation of urine in the peritoneal cavity which commonly manifests as single or multiple urinomas, or urinary ascites.

Irradiation induced blood flow changes in the breast during radiotherapy--a pilot study.

Skin blood flow and underskin temperature were measured in breasts during the complementary radiotherapy following lumpectomy, using the noninvasive transient thermal clearance method. On average, blood flow and tissue temperature increased at the start of the irradiation then slightly decreased. The response varied significantly among the patients.

Torture rhabdomyorhexis--a pseudo-crush syndrome.

Two patients who were systematically tortured and deprived of any oral intake presented with acute renal failure several days later. Unlike the classical crush syndrome, we describe a clinical entity wherein repeated direct muscle injury from blunt trauma, in addition to forced dehydration, led to myoglobinuria and renal failure. The literature is reviewed, and biochemical indices predicting severity of injury, pathophysiology, and management protocol are described.

Skin blood flow measurements on the breast areola.

Blood flow and thermally insulated skin temperature were measured in the aerolae of normal breasts by means of the non-invasive transient thermal clearance method. Both parameters showed high variability among different women, but also showed typical dependence on the subject's age: the two parameters were constant up to age 50, and then showed a decrease at higher ages. The decrease can be attributed to the normal decrease of tissue blood flow at higher age and to atrophy of the breast glandular tissue after menopause.