Treatment of rectal cancer by chemoradiation followed by surgery: analysis and early clinical outcome in 66 patients.

Background: Abdominoperineal resection entails the need for a permanent colostomy, which significantly reduces patient self-image and quality of life.

Objective: To investigate the effectiveness of preoperative chemoradiation in increasing the resectability rates of rectal cancer and increasing the anal sphincter preservation rate.

Methods: The study group included 66 patients aged 33-84 years with T2-T3 rectal carcinoma who were treated in our institute from 1997 to 2002 with preoperative chemoradiation followed by surgery 6 weeks later.

The effect of 17beta estradiol withdrawal on the level of brain and peripheral neurosteroids in ovarectomized rats.

Dehydroepiandrosterone (DHEA), pregnenolone (P) and their sulfate derivatives are neuroactive neurosteroids synthesized endogenously in the brain and in steroidogenic organs and influence or are influenced by a variety of physiological processes. Since parturition is followed by a rapid drop in estrogen levels in serum and brain it may be hypothesized that the drastic drop in the brain exposure to estrogens may cause a disturbance in the neurosteroid-to-neurosteroid-sulfate equilibrium with clinical relevance. In order to develop a rat animal model for human postpartum rapid estrogen decline conditions, the present study investigated effects of sudden withdrawal of hyperphysiological estrogens levels on levels of DHEA, DHEAS, P and PS in peripheral blood and brain tissue as well as cortical sulfatase activity.

Antibacterial susceptibility of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli.

Background: The prevalence of extended-spectrum beta-lactamase-producing organisms and their antimicrobial resistance patterns may vary between geographic areas.

Objectives: To evaluate the prevalence and susceptibility of ESBL-producing organisms among Klebsiella pneumoniae and Escherichia coli isolated from adult and pediatric patients in two Israeli hospitals.

Methods: ESBL production was tested according to recommendations of the Clinical and Laboratory Standards Institute, using ceftazidime (30 microg) and a combination of ceftazidime/clavulanate (30/ 10 microg) disks with a > or =5 mm difference indicating positivity.

The emerging role of the new aromatase inhibitors in the treatment of breast cancer.

The clinical development of aromatase inhibitors in recent years represents a significant addition to our armamentarium for the treatment of postmenopausal patients with hormone receptor-positive breast cancer--both for metastatic disease and in the adjuvant setting. In patients with metastatic disease, third-generation aromatase inhibitors have shown significantly superior efficacy over tamoxifen as first-line hormone therapy. In the adjuvant setting, preliminary results with the use of aromatase inhibitors in ongoing large clinical trials indicate significant gains in disease-free survival rates and in the occurrence of contralateral breast cancer, either alone for 5 years or sequentially after tamoxifen for 2-3 or 5 years.

Initial experience with a mechanical ventilation weaning unit.

Background: While increasing numbers of patients require prolonged mechanical ventilation, resources for weaning are either limited (ICU beds) or inadequate (general wards).

Objectives: To report on our initial experience over a 7 month period with an eight-bed mechanical ventilation weaning unit.

Methods: Sixty-nine patients requiring MV for > 10 days were admitted to the unit (nurse:patient ratio 1:4).

Cancer disease predictive diagnosis: BAT/CD3-positive lymphocytes in cancer patients.

BAT is an immune-activating monoclonal antibody produced against Daudi cell membranes and selected for stimulating lymphocyte proliferation. The anti-tumor activity of BAT is related to its immunostimulatory properties. Both T and NK cells mediate the anti-tumor activity of BAT.

Integral therapeutic potential of bone marrow mesenchymal stem cells.

Bone marrow derived mesenchymal stem cells (MSC) are adult stem cells that reside within the bone marrow compartment. In the traditional developmental model, adult stem cells are able to differentiate only to the tissue in which they reside. Recent data have challenged the committed fate of the adult stem cells, presenting evidence for their multi-lineage differentiation potential.

[Anesthesia for aesthetic surgery].

Anesthesia for aesthetic surgery has changed along with the development in plastic surgery during the last two decades. This is the first report of a large series of anesthesia conducted for aesthetic surgery in Israel. The article presents the experience of ten thousand procedures performed during the last four years.

Embryonic and adult stem cells as a source for cell therapy in Parkinson's disease.

The rationale behind the use of cells as therapeutic modalities for neurodegenerative diseases in general, and in Parkinson's disease (PD) in particular, is that they will improve patient's functioning by replacing the damaged cell population. It is reasoned that these cells will survive, grow neurites, establish functional synapses, integrate best and durably with the host tissue mainly in the striatum, renew the impaired wiring, and lead to meaningful clinical improvement. To increase the generation of dopamine, researchers have already transplanted non-neuronal cells, without any genetic manipulation or after introduction of genes such as tyrosine hydroxylase, in animal models of PD.

Is there a need to remove an old pacemaker when implanting a new device in the contralateral side?

Background: Device replacement or revision may constitute 25% of pacemaker procedures. In patients needing pacemaker system replacement the usual approach is from the ipsilateral side of the previous system. In cases where the contralateral side is used the previous pulse generator is removed.

Prehospital management of uncontrolled bleeding in trauma patients: nearing the light at the end of the tunnel.

The management of uncontrolled bleeding in trauma patients is difficult in the prehospital setting, especially when transfer time to a care facility is prolonged. The goal of treatment is to stabilize the patient until surgery can be performed. In modem practice, the major aspects of optimal patient stabilization are the timing and volume of resuscitation and the use of blood products.

Expression of adhesion molecules on leukemic B cells from chronic lymphocytic leukemia patients with predominantly splenic manifestations.

Background: The highly tissue-specific trafficking of normal and malignant lymphocytes to particular organs is mediated by adhesion molecules, or "homing receptors." Among our patients with B cell chronic lymphocytic leukemia 15% demonstrate predominantly splenic manifestations and are classified as stage II(S).

Objective: To investigate whether expression of cell surface adhesion molecules can distinguish stage II(S) patients from stage 0 or stage 0 and I CLL patients.

Trends in cardiac surgery in Israel, 1985-2002.

Background: Reports from Europe and North America indicate that significant changes have occurred in the practice of cardiac surgery in the last two decades.

Objectives: To examine the trends and case-mix in cardiac surgery in Israel and their relationship with changes in invasive cardiology.

Methods: We analysed data collected by the Ministry of Health from all cardiac centers in Israel from 1985 to 2002.

DCC protein expression in clear cell renal cell carcinoma.

Objectives: To investigate whether the expression of protein from the "deleted in colorectal cancer" (DCC) gene, which predicts a poor outcome for patients with colorectal carcinoma, can also serve as a prognostic factor in renal cell carcinoma (RCC).

Patients And Methods: The expression of DCC was evaluated immunohistochemically in 94 paraffin-embedded tumour samples from patients with stage T1, T2, and T3 clear cell RCC. The mean follow-up was 52.

Assessment of iodine intake in the Israel coastal area.

Background: Iodine intake is necessary to maintain normal thyroid function and prevent iodine deficiency disorders. In 1990, a resolution calling for universal salt iodination to eliminate iodine deficiency worldwide was taken by the World Health Organization and endorsed by some 130 countries. As of today, very little is known about iodine intake and the prevalence of iodine deficiency disorders in Israel, and the authorities do not require iodine enrichment of regular salt.

Quantitative three-dimensional sonographic assessment of pelvic blood after transvaginal ultrasound-guided oocyte aspiration: factors predicting risk.

Objectives: To evaluate the fluid volume in the pelvis immediately and 3-5 days after transvaginal ultrasound-guided oocyte aspiration (TOAS) and to identify predictive factors for intraperitoneal bleeding.

Methods: This was a prospective study of 83 infertile women undergoing controlled ovarian hyperstimulation followed by TOAS and embryo transfer (ET). Pelvic blood volume was measured by three-dimensional (3D) ultrasound examination 3-5 h after TOAS (post-TOAS), and prior to ET (2-3 days after TOAS; pre-ET).