Flexible bronchoscopy and bronchoalveolar lavage in pediatric patients with lung disease.

Objective: The use of flexible bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in investigating pediatric patient with airway abnormalities and pulmonary infiltrates are indispensable and are now a routine procedure in many centers. Immunocompromised and cancer patients, especially after bone marrow transplantation, and children who have undergone surgery for congenital heart disease (CHD) are at high risk for pulmonary disease. Our aim was to study the diagnostic rate, safety, and clinical yield of FOB in critically ill pediatric patients.

Diffuse lymphangiomatosis--a fatal case with atypical skeletal features.

Diffuse lymphangiomatosis is a rare idiopathic condition that occurs mostly in children, is characterized by a non-neoplastic proliferation of lymphatic vessels, leading to organ dysfunction, chylous effusions, and death. A closely related condition-the Gorham-Stout syndrome-is also characterized by lymphangiomatosis and chylous effusions, but also with massive osteolytic changes ("vanishing bone disease"). A 33-year-old woman presented with a 5-year history of worsening chylous effusions and organomegaly.

Attenuation of colon carcinoma tumor spread by intravenous immunoglobulin.

The impact of IVIg on metastatic capacity of CT26 murine colon carcinoma cells was studied using in vitro and in vivo methods. IVIg inhibited CT26 cell proliferation and invasion through an extracellular matrix in a dose- and time-dependent manner. Systemic treatment of mice with IVIg significantly inhibited metastatic potential of CT26 colon carcinoma cells observed as tumor nodules and lung weight reduction.

The role of flexible fibreoptic bronchoscopy in evaluation of pulmonary diseases in children with congenital cardiac disease.

Background: Diseases of the lungs and airways can be life-threatening in patients with congenital cardiac disease. External compression, and tracheobronchomalacia, as well as pathology of the large airways, can cause respiratory symptoms such as wheezing, stridor, fever, and dyspnoea, along with producing difficulty to wean the patient from mechanical ventilation. A definite diagnosis may be achieved by fibreoptic flexible bronchoscopy.

Psychological and cytokine changes in children and adolescents undergoing hematopoietic stem cell transplantation.

Background: Hematopoietic stem cell transplantation is a therapeutic option of a large variety of diseases. It involves several physiological and psychological changes. Investigations of mood changes in patients undergoing hematopoietic stem cell transplantation are common.

[Simple bone cyst in the mandible--a rare occurrence in an elderly patient].

Simple bone cyst (SBC) is an intra-osseous pseudocystic lesion lined by a thin fibrovascular membrane but lacks an epithelial lining. SBC is uncommon and comprises of approximately 1% of all jaw cysts. The lesion is usually discovered incidentally during the first two decades of life.

Fiberoptic bronchoscopy and bronchoalveolar lavage for the evaluation of pulmonary disease in children with primary immunodeficiency and cancer.

Background: Patients with childhood cancer or primary immunodeficiencies (PID) are at high risk for developing pulmonary infections and non-infectious complications. The broad differential diagnoses and the critical condition of these patients often drive physicians to start broad-spectrum antibiotic therapy before a definite diagnostic procedure is performed. A definite diagnosis may be achieved in these situations by fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL).

Prenatal prediction of survival in isolated left-sided diaphragmatic hernia.

Objective: To investigate the potential value of antenatally determined intrathoracic herniation of the liver and the ratio of fetal lung area to head circumference (LHR) in the prediction of postnatal survival in isolated, left-sided congenital diaphragmatic hernia (CDH).

Methods: In this multicenter study, we searched the antenatal-CDH-Registry for fetuses with isolated left-sided CDH that were liveborn after 30 weeks of gestation and were followed up postnatally for at least 3 months after discharge from hospital. The patients were subdivided into those with and those without intrathoracic herniation of the liver and into subgroups according to the LHR that had been measured between 22 + 0 and 28 + 0 weeks of gestation.

Enteric fever in Israeli travelers: a nationwide study.

Background: Enteric fever (EF) has become a travel-related disease in industrialized countries. The possible effects of vaccination on typhoid epidemiology in travelers are unknown. We compared the incidence and clinical and microbiologic findings in travelers returning with EF, according to pretravel vaccination status and vaccine type.

The feasibility of rigid stroboscopy in children.

Objective: Voice disorders in children are common but ways of their analysis are limited. We conducted a prospective feasibility study of rigid stroboscopy in children.

Methods: All children referred for voice analysis during the years 2002-2003 were evaluated including subjective perception of voice, voice recording, flexible or rigid laryngoscopy and stroboscopy.

Characterization of arterial stenosis and elasticity by analysis of high-frequency pressure wave components.

We describe a novel method for assessing stenosis severity based on pressure wave measurements. Pressure waves for several degrees of stenosis at different distances proximal to the stenosis were recorded from in vitro and in vivo models. Signal analysis was performed using power spectral density, and radial compliance was also measured.

B-cell lymphoma developing in the donor 9 years after donor-origin acute myeloid leukemia post bone marrow transplantation.

Donor-cell leukemia post bone marrow transplantation is a rare event. Most of the cases reported to date have developed in cells from an HLA-matched sibling, who had no evidence of malignant disease before or following the occurrence of donor-origin leukemia. We describe a 17-year-old female who developed B-cell lymphoma 9 years following the occurrence of donor-origin acute myeloid leukemia in her brother for whom she had donated marrow.

Clopidogrel-induced systemic inflammatory response syndrome.

Clopidogrel bisulfate, a widely used inhibitor of platelet aggregation, is considered at least as safe as aspirin. We describe a patient who developed a systemic inflammatory response syndrome consisting of high fever, tachycardia, cellulitis-like rash, impaired liver function, and mild leukopenia after receiving clopidogrel before coronary angiography and stent implantation. The reaction resolved promptly after withdrawal of the drug and recurred shortly after a rechallenge dose was administered, thus making the diagnosis of a clopidogrel-induced reaction highly probable.

Management of hemorrhoidal disease in patients with chronic spinal cord injury.

Hemorrhoidal disease is a common pathology in patients with chronic spinal cord injury (SCI). We describe our experience with the primary approach to this problem at the Proctology Division of the Sheba Medical Center. We treated 29 patients (26 men) with paraplegia due to SCI between 1995 and 1999.

Coronary benefits of calcium antagonist therapy for patients with hypertension.

Calcium antagonists effective in lowering blood pressure are a heterogeneous group including three main classes: phenylalkylamines, benzothiazepines and dihydropyridines. Dihydropyridines have a dual mode of action upon the endothelium contributing to their beneficial antihypertensive effects: (1) direct relaxation by inhibition of smooth muscle L-type calcium current, and (2) indirect relaxation through release of nitric oxide from the vascular endothelium. Calcium antagonists may affect many calcium-dependent events in the formation of atherosclerosis such as the localized accumulation of collagen, elastin, and calcium together with monocyte infiltration and smooth muscle proliferation and migration.

General subjective health status or age-related subjective health status: does it make a difference?

This study examines the agreement between two subjective health measures, a general question on subjective health and an age-related question on subjective health. The study identifies specific groups differing in their answer to the two questions. These measures are used frequently in health-related studies where a short measure is needed to estimate health.

CMV reactivation induced BK virus-associated late onset hemorrhagic cystitis after peripheral blood stem cell transplantation.

Hemorrhagic cystitis (HC) is a known complication of stem cell transplantation. In contrast to early-onset HC that is usually attributed to cyclophosphamide and occurs within a few days of infusion, late onset HC is associated with viral infection. In recent years BK virus has emerged as an important causative agent.

Breast augmentation with fresh-frozen homologous fat grafts.

The purpose of this report is to present a patient who underwent breast augmentation with fresh-frozen fat homografts in Russia 10 years ago, despite the publication of major complications following this procedure.

Reduced rate of retinal detachment following silicone oil removal.

Purpose: To investigate the rate of retinal redetachment and other complications after silicone oil removal over a 4-year period.

Methods: Retrospective analysis of charts of patients who underwent vitrectomy and silicone oil injection between January 1994 and June 1998 followed by oil removal.

Results: Sixty-eight eyes of 67 patients were included.

Lipoxygenase metabolism following laser induced retinal injury in rabbits.

Purpose: 1) to investigate whether leukotriene B(4) (LTB(4)) is a factor in the inflammatory reaction following chorioretinal laser injury in rabbits; 2) to study its relationship with the cyclooxygenase (COX) metabolic pathway; 3) to study the influence of Nordihydroguaiaretic acid (NDGA), an inhibitor; of the lipoxygenase (LOX) cascade, on both COX and LOX metabolism.

Methods: Prostaglandin E(2) (PGE(2)) and LTB(4) synthesis by incubated samples of chorioretina obtained from rabbits' eyes exposed to Neodymium:Yag laser along with these eicosanoids accumulation in the vitreous were measured over one week follow-up period. The effect of NDGA pre-treatment on the COX and the LOX pathways in the laser-injured chorioretina was also assessed.

Homocystinuria in the Arab population of Israel: identification of two novel mutations using DGGE analysis.

This study describes, for the first time, a thorough genetic investigation in Israeli Arab homocystinuric patients. By using a DGGE methodology and sequencing we were able to identify the disease causing mutation in all. Of the mutations that were detected, two are novel: a 785C>G transversion in exon 7 (T262R) and a 5-bp deletion in the 5' of IVS17 including the T in the +2 position that is crucial for correct splicing (g18327-18331del5).

ICGA-guided laser photocoagulation of feeder vessels of choroidal neovascular membranes in age-related macular degeneration. Indocyanine green angiography.

Purpose: To report the ability of indocyanine green angiography (ICGA) with a confocal scanning laser ophthalmoscope (SLO) to identify feeder vessels of choroidal neovascular membranes (CNVM) secondary to age-related macular degeneration (ARMD) and to show the feasibility of inducing complete closure of the CNVM by photocoagulation targeted exclusively to the feeder vessels.

Methods: Five consecutive patients with exudative ARMD in whom ICGA with the confocal SLO showed extrafoveal feeder vessels supplying choroidal neovascular nets had laser photocoagulation done only to the feeder vessels. In two patients, two separate membranes were seen.

Pneumatic retinopexy as supplemental therapy for persistent retinal detachment after scleral buckling operation.

Purpose: Persistent retinal detachment following scleral buckling may be caused by persistent open retinal tears with a large amount of subretinal fluid, despite proper positioning of the buckle. In this study we evaluated the effectiveness of supplemental pneumatic retinopexy in flattening of the detached retina.

Methods: During 1990-1994 twelve cases of persistent retinal detachment following scleral buckling operation with appropriate position of the buckle, underwent supplemental gas injection.