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Sacks M, Byrne DP, McConnell EJ. Bromide intoxication in a 3‐year‐old Thoroughbred filly. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Sacks
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
| | - D. P. Byrne
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
| | - E. J. McConnell
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
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Tam H, Zhang W, Infante D, Parchment N, Sacks M, Vyavahare N. Fixation of Bovine Pericardium-Based Tissue Biomaterial with Irreversible Chemistry Improves Biochemical and Biomechanical Properties. J Cardiovasc Transl Res 2017; 10:194-205. [PMID: 28213846 DOI: 10.1007/s12265-017-9733-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
Bioprosthetic heart valves (BHVs), derived from glutaraldehyde crosslinked (GLUT) porcine aortic valve leaflets or bovine pericardium (BP), are used to replace defective heart valves. However, valve failure can occur within 12-15 years due to calcification and/or progressive structural degeneration. We present a novel fabrication method that utilizes carbodiimide, neomycin trisulfate, and pentagalloyl glucose crosslinking chemistry (TRI) to better stabilize the extracellular matrix of BP. We demonstrate that TRI-treated BP is more compliant than GLUT-treated BP. GLUT-treated BP exhibited permanent geometric deformation and complete alteration of apparent mechanical properties when subjected to induced static strain. TRI BP, on the other hand, did not exhibit such permanent geometric deformations or significant alterations of apparent mechanical properties. TRI BP also exhibited better resistance to enzymatic degradation in vitro and calcification in vivo when implanted subcutaneously in juvenile rats for up to 30 days.
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Affiliation(s)
- H Tam
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - W Zhang
- Department of Biomedical Engineering, University of Texas, Austin, TX, USA
| | - D Infante
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - N Parchment
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA
| | - M Sacks
- Department of Biomedical Engineering, University of Texas, Austin, TX, USA
| | - N Vyavahare
- Department of Bioengineering, Clemson University, Clemson, SC, 29634, USA.
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Xia X, Zhu M, Sun L, Sacks M, Genin G, Hu C, Guo L, Feng Y. WE-FG-206-11: Measuring Mechanical Biomarkers of Liver Tumors Using Tagged MRI. Med Phys 2016. [DOI: 10.1118/1.4957941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kobler A, Hartnack S, Sacks M, Bettschart-Wolfensberger R. Evaluation of tidal volume measurements of the anaesthesia device Tafonius® in vitro and in vivo. PFERDEHEILKUNDE 2016. [DOI: 10.21836/pem20160505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
The aim of the study was to conduct a qualitative exploration of the sociotechnical processes underlying retained surgical swabs, and to explore the fundamental reasons why the swab count procedure and related protocols fail in practice. Data was collected through a set of 27 semistructured qualitative interviews with scrub nurses from a large, multi-site teaching hospital. Interview transcripts were analysed using established constant comparative methods, moving between inductive and deductive reasoning. Key findings were associated with interprofessional perspectives, team processes and climate and responsibility for the swab count. The analysis of risk factors revealed that perceived social and interprofessional issues played a significant role in the reliability of measures to prevent retained swabs. This work highlights the human, psychological and organisational factors that impact upon the reliability of the process and gives rise to recommendations to address contextual factors and improve perioperative practice and training.
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Affiliation(s)
- L. Klein
- Equine Department; University of Zurich; Switzerland
| | - M. Sacks
- Equine Department; University of Zurich; Switzerland
| | - A. E. Fürst
- Equine Department; University of Zurich; Switzerland
| | - F. Del Chicca
- Section of Diagnostic Imaging; University of Zurich; Switzerland
| | - P. Grest
- Institute of Veterinary Pathology; Vetsuisse Faculty; University of Zurich; Switzerland
| | - M. A. Jackson
- Equine Department; University of Zurich; Switzerland
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Benharroch D, Shemer-Avni Y, Myint YY, Levy A, Mejirovsky E, Suprun I, Shendler Y, Prinsloo I, Ariad S, Rager-Zisman B, Sacks M, Gopas J. Measles virus: evidence of an association with Hodgkin's disease. Br J Cancer 2004; 91:572-9. [PMID: 15226778 PMCID: PMC2409981 DOI: 10.1038/sj.bjc.6601900] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The quest for an infectious agent that may account for cases of Hodgkin's disease (HD) especially in young adults has proven vain until lately. We have recently reported findings that suggested the presence of measles virus (MV) antigens and MV RNA in the tissues of patients with HD. Support for an association between MV and HD has been provided by recent epidemiological findings relating the occurrence of HD to exposure to measles in pregnancy and the perinatal period. We now present further evidence of this putative association based on immunohistochemical, reverse transcriptase-polymerase chain reaction (RT-PCR) and in situ hybridisation studies (ISH) on HD tissues. Biopsies from 82 (54.3%) of our cohort of 154 patients showed a positive immunostain with at least two of the anti-measles antibodies used. Latent membrane protein-1 immunostaining for Epstein-Barr virus was positive in 46 (31.1%) of the patients examined. Reverse transcriptase-PCR and ISH for measles RNA were positive in seven and 10 of 28 patients, respectively. Preliminary clinicopathological associations between MV and HD are noted in this study, but no causal relationship can be claimed at this stage.
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Affiliation(s)
- D Benharroch
- Department of Pathology, The Soroka University Medical Center, PO Box 151, Beer-Sheva 84101, Israel.
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Abstract
Epidemiologic and molecular investigations of Hodgkin's disease (HD) suggest a strong infectious association. The Epstein-Barr virus (EBV), together with its viral proteins, is expressed in Hodgkin-Reed-Sternberg (HRS) cells in the lymph nodes involved by HD. EBV is more likely to be related to childhood and older adult cases of HD and is much less frequently expressed in young adult HD patients, the group most expected to be associated with an infectious agent. In addition, the "hit and run" theory of EBV infection remains speculative and no other lymphotropic viruses studied to date seem to satisfy the quest for a new candidate virus in young adults with HD. We have recently found preliminary evidence suggesting a possible association between the measles virus (MV) and HD. This evidence is the subject of the present review.
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Affiliation(s)
- D Benharroch
- Department of Pathology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva 84101, Israel.
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Benharroch D, Dima E, Levy A, Ohana-Malka O, Ariad S, Prinsloo I, Mejirovsky E, Sacks M, Gopas J. Differential expression of sialyl and non-sialyl-CD15 antigens on Hodgkin-Reed-Sternberg cells: significance in Hodgkin's disease. Leuk Lymphoma 2000; 39:185-94. [PMID: 10975398 DOI: 10.3109/10428190009053553] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CD15 expression has been used for years to confirm the diagnosis of Hodgkin's disease (HD). Little is, however, known on the relevance of the CD15 antigen to the pathobiology of the disease and there is conflicting evidence as to the prognostic value of its expression. To investigate the significance of the differential expression of CD15 in Hodgkin's disease, a retrospective study of 102 patients with "classical" Hodgkin's disease was performed. Immunohistochemical studies were carried out using antibodies against two types of CD15: non-sialylated CD15 (LeuM1 and 80H5) and sialylated CD15 (FH6 and CSLEX1). Cases that were negative for non-sialylated CD15 or positive for the sialylated variant were stained again following neuraminidase pretreatment. The cohort included 27 patients in whom sequential biopsies were available. Both CD15 expression in its non-sialylated form and absence of sialyl-CD15 expression correlate with a favorable outcome. Subsequent biopsies show a preferential expression of sialyl-CD15, notably in bone marrow metastases. Our findings suggest that, in the progression of HD towards a widely disseminated disease, the LewisX moiety of the CD15 antigen on the tumor cells acquires a sialyl-group. This change may confer on the tumor cells the capacity to metastasize.
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Affiliation(s)
- D Benharroch
- Department of Pathology, Soroka University Medical Center, Beer-Sheva, Israel.
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Levy A, Diomin V, Gopas J, Ariad S, Sacks M, Benharroch D. Hodgkin's lymphoma in the Bedouin of southern Israel: epidemiological and clinical features. Isr Med Assoc J 2000; 2:501-3. [PMID: 10979320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND A previous study on Hodgkin's lymphoma in southern Israel found that Bedouin patients had an increased rate of Epstein-Barr virus expression in their tumor cells. OBJECTIVES To determine the influence of the patients' communities on the pattern of disease in HL. METHODS We compared the clinical features, demographic data, stage at diagnosis, treatment modality and outcome, as well as laboratory findings, in four community-based subgroups. These groups comprised kibbutz residents (n = 11), Bedouin (n = 19), new immigrants from the former USSR (n = 22), and town-dwellers (n = 82). RESULTS The Bedouin patients differed significantly from the new immigrants and town-dwellers, particularly regarding the rate of EBV sequences in the tumor tissues, and a poorer response to treatment. The kibbutz patients did not differ significantly from the other populations regarding most of the parameters studied, but showed an intermediate expression of EBV antigens compared to Bedouin patients and the rest of the cohort. CONCLUSIONS This study indicates that HL may behave differently in different population groups in a given geographic area. Notably, the Bedouin patients showed markedly different clinical and biological patterns of this malignancy.
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Affiliation(s)
- A Levy
- Department of Epidemiology, Ben-Gurion University of the Negev, Israel
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Gibson KM, Burlingame TG, Hogema B, Jakobs C, Schutgens RB, Millington D, Roe CR, Roe DS, Sweetman L, Steiner RD, Linck L, Pohowalla P, Sacks M, Kiss D, Rinaldo P, Vockley J. 2-Methylbutyryl-coenzyme A dehydrogenase deficiency: a new inborn error of L-isoleucine metabolism. Pediatr Res 2000; 47:830-3. [PMID: 10832746 DOI: 10.1203/00006450-200006000-00025] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
An 4-mo-old male was found to have an isolated increase in 2-methylbutyrylglycine (2-MBG) and 2-methylbutyrylcamitine (2-MBC) in physiologic fluids. In vitro oxidation studies in cultured fibroblasts using 13C- and 14C-labeled branched chain amino acids indicated an isolated block in 2-methylbutyryl-CoA dehydrogenase (2-MBCDase). Western blotting revealed absence of 2-MBCDase protein in fibroblast extracts; DNA sequencing identified a single 778 C>T substitution in the 2-MBCDase coding region (778 C>T), substituting phenylalanine for leucine at amino acid 222 (L222F) and absence of enzyme activity for the 2-MBCDase protein expressed in Escherichia coli. Prenatal diagnosis in a subsequent pregnancy suggested an affected female fetus, supporting an autosomal recessive mode of inheritance. These data confirm the first documented case of isolated 2-MBCDase deficiency in humans.
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Affiliation(s)
- K M Gibson
- Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland 97201, USA
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Vyavahare N, Ogle M, Schoen FJ, Zand R, Gloeckner DC, Sacks M, Levy RJ. Mechanisms of bioprosthetic heart valve failure: fatigue causes collagen denaturation and glycosaminoglycan loss. J Biomed Mater Res 1999; 46:44-50. [PMID: 10357134 DOI: 10.1002/(sici)1097-4636(199907)46:1<44::aid-jbm5>3.0.co;2-d] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bioprosthetic heart valve (BPHV) degeneration, characterized by extracellular matrix deterioration, remodeling, and calcification, is an important clinical problem accounting for thousands of surgeries annually. Here we report for the first time, in a series of in vitro accelerated fatigue studies (5-500 million cycles) with glutaraldehyde fixed porcine aortic valve bioprostheses, that the mechanical function of cardiac valve cusps caused progressive damage to the molecular structure of type I collagen as assessed by Fourier transform IR spectroscopy (FTIR). The cyclic fatigue caused a progressive loss of helicity of the bioprosthetic cuspal collagen, which was evident from FTIR spectral changes in the amide I carbonyl stretching region. Furthermore, cardiac valve fatigue in these studies also led to loss of glycosaminoglycans (GAGs) from the cuspal extracellular matrix. The GAG levels in glutaraldehyde crosslinked porcine aortic valve cusps were 65.2 +/- 8.66 microg uronic acid/10 mg of dry weight for control and 7.91 +/- 1.1 microg uronic acid/10 mg of dry weight for 10-300 million cycled cusps. Together, these molecular changes contribute to a significant gradual decrease in cuspal bending strength as documented in a biomechanical bending assay measuring three point deformation. We conclude that fatigue-induced damage to type I collagen and loss of GAGs are major contributing factors to material degeneration in bioprosthetic cardiac valve deterioration.
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Affiliation(s)
- N Vyavahare
- Children's Hospital of Philadelphia and the Department of Pediatrics, University of Pennsylvania School of Medicine, 19104, USA
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Abstract
Hodgkin's disease (HD) is an unusual malignant neoplasm, mainly because of the rarity of tumor cells in the diseased tissues, but also due to a relatively favorable response to treatment. In a previous study, we have shown a variable degree of apoptosis in lymph nodes from HD patients. We now looked for clinicopathological correlations of apoptosis with special emphasis on the prognosis in this disease. A retrospective study of 92 patients was carried out, using in situ end labelling of DNA fragments and an apoptosis detection kit. An apoptotic index (Al) was calculated in each case, as the percentage of apoptotic Hodgkin-Reed-Sternberg cells out of the total number of tumor cells in 10 selected high power fields. An association between a high Al and advanced stages was noted. A Kaplan-Meier analysis showed a negative correlation between Al and survival (p=0.05). In a multivariable analysis adjusting for Ann Arbor stage, a high Al carried a 3.27 fold risk of dying of HD (OR=3.27; Cl=0.89-11.94). However, in our limited cohort of HD patients, Al was not an independent prognostic factor. The results of this study confirm the important role played by apoptosis in HD and suggest that the apoptotic index is probably a negative prognostic marker in this disease. Its assessment in patients with HD may provide a new, important clinical tool.
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Affiliation(s)
- D Benharroch
- Department of Pathology, Soroka Medical Center and the Faculty of Health Sciences and Cancer Research Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Sacks M, Gordon J, Bylander J, Porter D, Shi XL, Castranova V, Kaczmarczyk W, Van Dyke K, Reasor MJ. Silica-induced pulmonary inflammation in rats: activation of NF-kappa B and its suppression by dexamethasone. Biochem Biophys Res Commun 1998; 253:181-4. [PMID: 9875241 DOI: 10.1006/bbrc.1998.9763] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The goal of this study was to examine the relationship of the transcriptional regulatory factor nuclear factor-kappaB (NF-kappa B) to the early inflammatory events involved with silica exposure. Male F-344 rats received an intratracheal (i.t.) instillation of silica (100 mg/kg in a volume of 1 ml/kg) of saline. At 1, 3, 6, and 18 h postinstillation, and the rats were sacrificed and underwent bronchoalveolar lavage (BAL) for functional analysis of inflammation. Beginning at 1 h postinstillation, the silica-instilled (Si) rats displayed significant increases in neutrophils in BAL fluid compared to the saline controls. BAL cells from the Si group displayed a significant increase in luminol-dependent chemiluminescence (LDCL) compared to the controls. NF-kappa B activation was measurable at 3 h postinstillation, and this activation continued throughout the 18-h time course. Treatment with dexamethasone (5 mg/kg) at -3 h prior to silica instillation, at the time of instillation (0 h), and +1.5 h postinstillation resulted in both a reduction in NF-kappa B expression (by 70%) at 3 h postinstillation and corresponding reductions in LDCL, BAL cell count, and BAL neutrophils. These results show that activation of NF-kappa B is associated with silica-induced pulmonary inflammation, and the inhibition of its activation correlates temporally with suppression of inflammation.
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Affiliation(s)
- M Sacks
- Program in Genetics and Developmental Biology, West Virginia University, Morgantown 26506, USA.
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Van Dyke K, Sacks M, Qazi N. A new screening method to detect water-soluble antioxidants: acetaminophen (Tylenol) and other phenols react as antioxidants and destroy peroxynitrite-based luminol-dependent chemiluminescence. J Biolumin Chemilumin 1998; 13:339-48. [PMID: 9926361 DOI: 10.1002/(sici)1099-1271(199811/12)13:6<339::aid-bio501>3.0.co;2-e] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study is based on a simple chemical interaction of peroxynitrite (O = N-O-O-) and luminol, which produces blue light upon oxidation. Since peroxynitrite has a half-life of about 1 s, a drug known as linsidomine (SIN-1) is used as a peroxynitrite generator. Peroxynitrite can oxidize lipids, proteins and nucleic acids. Upon the stimulation of inflammation and/or infection, macrophages and neutrophils can be induced to produce large amounts of peroxynitrite, which can oxidize phenols and sulphhydryl-containing compounds. Therefore, phenols and sulphhydryls eliminate peroxynitrite. This is an example of the Yin-Yang hypothesis e.g. oxidation-reduction. Acetaminophen (Tylenol) can inhibit fever and some types of pain without being a particularly effective anti-inflammatory. Since it is a phenol, it could act as a nitration target for peroxynitrite. Then peroxynitrite, the possible cause of pain and elevated temperature, might be destroyed in the reaction. Acetaminophen is a phenolic compound which produces a clear inhibitory dose-response curve with peroxynitrite in its range of clinical effectiveness. Whether acetaminophen actually works as we suggest is to be proven. Three different types of reaction could decrease the amount of peroxynitrite: (a) interference with base-catalysed opening of the SIN-1 molecule; (b) destruction of one or both substances needed to form it--superoxide and/or nitric oxide; when the SIN-1 degrades to superoxide and nitric oxide, the former may be destroyed by superoxide dismutase (SOD); (c) peroxynitrite may react directly with phenols (mono-, di-, tri- and tetraphenols), possibly by nitration. Nordihydroguaiaretic acid and 2-hydroxyestradiol (catechol estrogen) are potent inhibitors of luminol light emission. Epineprine, isoproterenol, pyrogallol, catechol and ascorbic acid (a classic antioxidant) are all inhibitors of luminol chemiluminescence. Isoproterenol, norepinephrine/and epinephrine first inhibit light but overall stimulate the light production. Initially, SIN-1 degrades to produce peroxynitrite, which reacts with luminol to produce blue light. If any of three catecholamines are present with the reaction that produces light, there is an initial inhibition of light production, and then a marked stimulation. A possible reason for this is that these catechols are oxidized and the metabolized phenol stimulates the production of light from luminol. Also, during oxidation of catecholamines superoxide is sometimes formed, which could stimulate production of peroxynitrite. This simple screening system is introduced to find useful antioxidants against peroxynitrite.
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Affiliation(s)
- K Van Dyke
- Robert C. Byrd Health Sciences Center of West Virginia University, Department of Pharmacology and Toxicology, School of Medicine, Morgantown 26506, USA
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Abstract
OBJECTIVE Admissions to an acute care psychiatric hospital were studied to determine what proportion of admissions were for HIV-related psychiatric disturbances, what evidence exists that the HIV-related admissions constitute a new population of psychiatric inpatients, and whether any psychiatric variables distinguish patients with HIV-related disorders from patients without such disorders. METHODS Charts for 2,094 consecutive admissions to the hospital in a three-year period were reviewed. Chi square analyses and t tests were used to compare various groups of HIV-related admissions and non-HIV-related admissions on sociodemographic characteristics, length of stay, history of psychiatric hospitalization, and other clinical measures. RESULTS One-hundred and sixty-three admissions (7.8 percent of the total admissions) were judged to be HIV related. The largest category of HIV-related admissions, nearly half, were patients experiencing functional or psychological complications of HIV infection or risk. AIDS-phobic patients, who expressed irrational concerns about infection, accounted for 20.2 percent, and patients with organic manifestations for 18.4 percent. If the AIDS-phobic, HIV-bereaved, and factitious HIV-positive admissions were excluded, the rate of HIV-related admissions was 5.2 percent. CONCLUSIONS Psychiatric hospitals can expect a significant but not overwhelming number of HIV-related admissions.
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Affiliation(s)
- M Sacks
- Department of Psychiatry, Payne-Whitney Clinic, New York Hospital-Cornell Medical Center, New York, USA
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Abstract
A case of gamma/delta-positive T-cell lymphoma localized primarily in the subcutaneous adipose tissue and associated with an extensive hemophagocytic syndrome and a rapid, fatal outcome is presented. Previous reports of gamma/delta cutaneous and subcutaneous T-cell lymphomas are reviewed. To define the characteristics of a T-cell subset of neoplastic cells bearing the gamma/delta receptor in a subcutaneous lymphoma, we undertook clinical and laboratory examinations, morphological evaluation of biopsies, electron microscopy, and extensive immunohistochemical studies. Immunohistochemical studies showed that the neoplastic cells expressed the gamma/delta T-cell receptor (CD3+, C gamma M1+) and were CD2+, CD43+, CD45+, CD45RO+, PCNA+, but were beta F1-, CD1-, CD4-, CD8-, CD15-, CD20-, CD25-, CD30-, CD45R-, CD57-, CD68-, Mac 387-, and HLA Dr-. To the best of our knowledge, this is the first report of a subcutaneous T-cell lymphoma of gamma/delta type involving the subcutaneous tissue and associated with a hemophagocytic syndrome.
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Affiliation(s)
- I Avinoach
- Dermatopathology Unit, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract
Of 300 patients admitted to an alcohol rehabilitation unit, serological testing of discarded admission blood samples revealed that 31 (10.3%) had HIV infection. Chart records indicated that four patients were known to be HIV infected on admission, and HIV infection was detected in another three patients during hospitalization; however, 24 (77.4%) of the HIV-positive patients were discharged with their HIV infection still undetected.
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Affiliation(s)
- J Mahler
- Department of Psychiatry, Cornell University Medical College, New York
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Glick ID, Burti L, Okonogi K, Sacks M. Effectiveness in psychiatric care. III: Psychoeducation and outcome for patients with major affective disorder and their families. Br J Psychiatry 1994; 164:104-6. [PMID: 8137088 DOI: 10.1192/bjp.164.1.104] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This hypothesis-generating study had the objective of dissecting the process of psychiatric care in an attempt to understand outcomes for patients and their families. In all, 24 patients who carried a DSM-III diagnosis of major affective disorder were identified 12-18 months after hospital admission. The patients, their families, and their doctors were interviewed using instruments measuring delivery of treatment and achievement of treatment goals; findings were then correlated with resolution of the index episode and patient global outcome. Delivery of patient and family psychoeducation was associated with better resolution of the index episode and better global outcome.
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Affiliation(s)
- I D Glick
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, CA 94305
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Abstract
We report a patient with progressive systemic sclerosis in whom an autopsy, performed 13 years after diagnosis, revealed the presence of bronchioloalveolar carcinoma and of generalized amyloidosis. Characterization of the amyloid fibril protein suggested an immunoglobulin light chain (AL) origin.
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Affiliation(s)
- D Benharroch
- Institute of Pathology, Soroka Medical Center, Beer-Sheva, Israel
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Sacks M, Dermatis H, Looser-Ott S, Perry S. Seroprevalence of HIV and risk factors for AIDS in psychiatric inpatients. Hosp Community Psychiatry 1992; 43:736-7. [PMID: 1516910 DOI: 10.1176/ps.43.7.736] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Sacks
- Department of Psychiatry, Payne Whitney Clinic, New York Hospital-Cornell Medical Center, NY 10021
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Abstract
Serological testing of waste bloods revealed that 25 (7%) of 350 acutely ill psychiatric inpatients had HIV infection. Eight of the 10 HIV-positive patients whose serological status was not recorded on admission were discharged with their status still unrecorded and presumably undetected. Thirty-nine (51%) of the 77 inpatients with HIV-related risk behaviors identified on admission were discharged with no record of their having been serologically tested before or during hospitalization.
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Affiliation(s)
- M Sacks
- Department of Psychiatry, Payne Whitney Clinic, New York Hospital-Cornell University Medical College, NY
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Sacks M. The ethical man. J AHIMA 1992; 63:72-5. [PMID: 10160842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Sorting out the painful dilemmas of medicine is an everyday duty for Stanford Medical School's biomedical ethicist Ernle Young.
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Sacks M, Fels A, Munich R. VID (very important disease) syndrome. Lancet 1991; 337:1485. [PMID: 1675353 DOI: 10.1016/0140-6736(91)93179-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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27
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Tovi F, Hirsch M, Sacks M, Leiberman A. Ectopic pituitary adenoma of the sphenoid sinus: report of a case and review of the literature. Head Neck 1990; 12:264-8. [PMID: 2192994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Ectopic pituitary adenoma of the sphenoid sinus in a 68-year-old woman is presented. The confusing discrepancy between the imaging features and the mild clinical manifestations of extensive bone destruction of the skull base is emphasized. A definite diagnosis can be established only by histopathological examination supported by immunohistochemical studies.
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Affiliation(s)
- F Tovi
- Department of Otorhinolaryngology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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28
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Abstract
The authors report the results of a survey of senior medical students who matched to a PGY-1 position in psychiatry. With a 64% response rate, the authors found the following: 1) senior medical students were generally satisfied with the program that they plan to attend; 2) the students utilized nonprogrammatic features heavily in their decision making; and 3) there appeared to be subgroups of students defined by demographic (i.e., gender and age) and decision-making properties (i.e., time of decision) that choose programs with fundamentally different aims in mind.
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Affiliation(s)
- W H Sledge
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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29
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Mozes M, Mozes G, Greiff M, Sacks M. Metastatic osteogenic sarcoma of small intestine with intussusception. Isr J Med Sci 1988; 24:426-8. [PMID: 3165973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- M Mozes
- Department of Pathology, Soroka Medical Center, Beer Sheva, Israel
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30
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Liel Y, Biderman A, Biran C, Katz M, Sacks M. Carcinoma of the Prostate Clinically and Radiologically Simulating Malignant Lymphoma. J Urol 1987. [DOI: 10.1016/s0022-5347(17)43688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Y. Liel
- Departments of Internal Medicine, Diagnostic Radiology and Pathology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - A. Biderman
- Departments of Internal Medicine, Diagnostic Radiology and Pathology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - C. Biran
- Departments of Internal Medicine, Diagnostic Radiology and Pathology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - M. Katz
- Departments of Internal Medicine, Diagnostic Radiology and Pathology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - M. Sacks
- Departments of Internal Medicine, Diagnostic Radiology and Pathology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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31
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Gabriel AN, Linn L, Strain JJ, Sacks M. Electroconvulsive therapy in the medically ill: experience and guidelines. Bull N Y Acad Med 1987; 63:713-26. [PMID: 3479221 PMCID: PMC1629301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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32
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Sacks M. Academic promotions in the University Center for Health Sciences and Services. Isr J Med Sci 1987; 23:964-8. [PMID: 3692782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- M Sacks
- Department of Pathology, Ben-Gurion University of the Negev. Beer Sheva, Israel
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33
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Abstract
A 65-year-old man presented with supraclavicular, mediastinal, and retroperitoneal lymphadenopathy clinically thought to be due to malignant lymphoma. Biopsy of a supraclavicular lymph node revealed metastatic adenocarcinoma positive for prostatic-specific antigen. This site of the primary tumor was confirmed by needle biopsy of the prostate gland. The tumor regressed dramatically following treatment with estramustine phosphate.
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34
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35
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Abstract
Alterations in central dopamine function have been identified in depression and in alcohol withdrawal. Attempts to determine the magnitude and direction of the central dopamine alteration in alcohol withdrawal have produced conflicting results. In this study serum prolactin (PRL) was used as an indicator of central dopamine activity since dopamine is the most important factor in the control of prolactin secretion from the pituitary. Increased serum PRL levels were found during alcohol withdrawal and they correlated significantly with high scores on the Hamilton Depression Rating Scale (HDRS). No significant correlations were identified with The Brief Psychiatric Rating Scale (BPRS), the 'Mini-Mental State' of Folstein (MMS), The Beck Depression Inventory (BDI) or The Modified Gross Alcohol Withdrawal Selective Severity Assessment Scale (GAWSSA). The authors concluded that the transient depressive symptomatology typically found in detoxifying alcoholic patients may be, in part, the result of a central hypodopaminergic state.
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36
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Abstract
The clinical diagnosis of drug abuse is frequently omitted from the differential diagnosis of transient fevers, arrhythmias and changes in mental status in the elderly despite the high risk of iatrogenic dependence in this age group. In pursuit of symptomatic relief from unrecognized depressions and from the chronic ailments of advancing age, the elderly receive many medications from numerous physicians. Therapeutic interventions are often duplicated or contradictory and result in the co-administration of tranquilizers, sedatives and analgesics. The result may be dependence which the patient and physician fail to recognize or to diagnose in the presence of withdrawal symptoms. In this report we present two such cases.
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37
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Krugliak L, Zimlichman RR, Schlaeffer F, Sacks M. Immunoblastic lymphoma and thymic epithelial hyperplasia in angioimmunoblastic lymphadenopathy following gold therapy. Isr J Med Sci 1985; 21:381-5. [PMID: 3922920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A 62-year-old woman with well-established polyarthritis developed angioimmunoblastic lymphadenopathy (AILD) during gold therapy. She subsequently developed an immunoblastic lymphoma which showed monoclonality (IgA, lambda) by immunoperoxidase techniques. There was a tumor-like enlargement of the thymus gland due to involvement by AILD, with secondary proliferation of thymic epithelium. The finding of thymic involvement, which has not been described previously in AILD, might be one of the manifestations reflecting a disturbance of the immune system in this disease.
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38
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Sacks M, Miller F, Gunn J, Paul E, Sellew A. Unusual erectile activity as a side effect of trazodone. Hosp Community Psychiatry 1985; 36:298. [PMID: 3979983 DOI: 10.1176/ps.36.3.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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39
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Abstract
We report the seventh case of malignant fibrous histiocytoma arising from the spermatic cord. The followup of our patient supports the generally accepted approach of radical inguinal orchiectomy along with wide en bloc local resection of the adjacent soft tissue.
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40
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Abstract
A 59-year-old woman presented with bilateral tonsillar masses due to metastases from a primary pancreatic carcinoma. Tonsillar metastases from many different primary tumors are well documented in the literature, but this seems to be the first case in which the pancreas was the primary site. It is also one of the very few recorded cases in which the patient's presenting symptoms were due to tonsillar metastases.
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41
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Hauben DJ, Zirkin H, Mahler D, Sacks M. The biologic behavior of basal cell carcinoma: Part I. Plast Reconstr Surg 1982; 69:103-9. [PMID: 7053497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The influence of histopathologic and clinical factors on the biologic behavior of basal cell carcinoma of the face is discussed on the basis of a retrospective study of 188 cases. Fourteen different parameters were studied and correlated with the histologic type and the frequency of incomplete excision of the lesions. The highest frequency of incompletely excised tumors was seen with the adenocystic and morphea types and with Clark level III lesions. The adenocystic type appeared to be the most aggressive form, with the highest frequency of thick lesions and the most marked mitotic activity. The histologic parameters studied provide more information about the behavior of basal cell carcinoma than the conventional subdivision into solid, morphea, and adenocystic types.
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42
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Hauben DJ, Zirkin H, Mahler D, Sacks M. The biologic behavior of basal cell carcinoma: analysis of recurrence in excised basal cell carcinoma: Part II. Plast Reconstr Surg 1982; 69:110-6. [PMID: 7053498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
On the basis of a study of 188 cases of basal cell carcinoma of the face, the differences between the characteristics of recurrent and incompletely excised lesions are stressed. There was almost no difference in the recurrence rate of completely excised lesions and those in which there was histologic evidence of tumor at one of the margins. On the basis of these findings, a policy of conservative management of incompletely excised basal cell carcinoma is outlined.
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43
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Sacks M, Selzer G. Breast cancer in Israel. Histopathologic types in the different population groups. Isr J Med Sci 1981; 17:882-7. [PMID: 7309477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The histological sections of 1,605 cases of breast cancer in Israeli women were examined to determine the frequency of the various histological subtypes inthe different population groups. Infiltrating ductal carcinoma was the most common type in all groups. Circumscribed and medullary carcinoma were relatively less frequent among women born in North Africa than among immigrants from Europe or Asia. Invasive lobular carcinoma was very rare among women born in Asia. The findings are compared with those in other countries and discussed in relation to survival patterns in the different population groups in Israel.
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44
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Abstract
After the suicide of a patient, staff on an inpatient ward anxiously take increased suicide precautions, including special attention to patients known to be associated with the victim. However, in identifying other patients at risk, they may overlook those who have formed pathological identifications with the victim as the result of a history of similar past experience, especially that of a suicidal or abandoning parent, and of the often unrecognized intimacy that occurs between patients during a brief hospitalization. Pathological identifications involved in a suicide, a subsequent suicide attempt, and suicidal preoccupation are illustrated by the case histories of three patients treated on an inpatient ward at the same time.
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45
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Avni A, Haikin H, Feuchtwanger MM, Sacks M, Naggan L, Sarov B, Sarov I. Antibody pattern to human cytomegalovirus in patients with adenocarcinoma of the colon. Intervirology 1981; 16:244-9. [PMID: 6282775 DOI: 10.1159/000149273] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The role of human cytomegalovirus (CMV) was examined according to serological patterns in 37 patients with adenocarcinoma of the colon (ACC). The sera were examined for the presence of IgG antibodies by the immunoperoxidase antibody to membrane antigens (IPAMA) method and by the complement-fixation (CF) test. Antibody determinations were also performed by the IPAMA method for three other members of the herpesvirus group: Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV). Comparison groups included normal subjects, ACC patients treated with chemotherapy, and patients operated on for benign diseases. No significant difference was found in the geometric mean titers (GMTs) for CMV and the other herpesviruses in the sera of nontreated ACC patients when compared with the control groups. However, a significantly elevated antibody titer to CMV was found in chemotherapy-treated ACC patients by both the IPAMA and CF methods. In this group, elevated titers were found by the IPAMA method for EBV and HSV, but not for VZV. The significance of serological studies in elucidating the role of CMV in ACC patients is discussed.
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46
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Abstract
Aberrant adrenocortical tissue along the spermatic cord is a far more common finding than has previously been reported. During a period of 12 consecutive months, 360 children, aged 13 days to 13 yr, underwent 386 operations for common inguinoscrotal pathology at the Soroka Medical Center. In 12 cases ectopic adreno-cortical tissue was found along the spermatic cord, an overall incidence of 3.8%. None was found in females. Considering the group operated upon for undescended testis, in which by nature of the procedure the spermatic cord was dissected throughout its length, the frequency of ectopic adrenal tissue found rose to 9.3%, the highest figure cited for this location. The nature of aberrant adrenocortical tissue is briefly discussed, including its embryology, histology, and clinical implications. It usually appears as an incidental finding during surgery. Its removal is indicated whenever found although no special attempt should be made to search for it.
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47
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Selzer G, Sacks M, Sherman G, Naggan L. Primary malignant lymphoma of the small intestine in Israel. Changing incidence with time. Isr J Med Sci 1979; 15:390-6. [PMID: 447505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
One hundred and eighty-one cases of primary small intestinal lymphoma were diagnosed in residents of Israel--145 Jews and 36 Arabs--during a 16-year period, 1960--75. The male:female ratio was 1.8:1. Incidence rates were higher in children, the middle-aged and the elderly than in teenagers or young adults. Crude and age-adjusted incidence rates were higher in Arabs than in Jews. The pattern among the subgroups of the Jewish population varied with age. In young adults of both sexes the rates were much higher among Jews born in North Africa or Asia than among those born in Europe or Israel. In elderly males, however, the rates were almost twice as high in European-born Jews than among those born in North Africa or Asia. The mean annual incidence of primary small intestinal lymphoma fell from 4.8 per million during 1960--67 to 3.6 per million during 1968--75. This was due to a marked fall in the rates in children and young adults, whereas the rates in those aged 40 years or more rose with time. The pattern of the change with time suggests that environmental conditions are an important factor in the causation of primary intestinal lymphoma in young adults.
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48
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Abstract
Digitalis is a ubiquitous drug in modern clinical medicine and digitoxicity is one of the more common iatrogenic disorders. Psychiatric problems are often overlooked as manifestations of digitalis excess and may range from mild disorientation, lethargy, or restlessness to full blown delirium. In this paper we discuss two patients who presented to a psychiatric inpatient unit and were later found to be digitoxic. Psychiatrists are advised to consider digitalis as a possible cause of mental abnormalities and are reminded that psychiatric signs may be the first indication of a potentially lethal drug toxicity. Psychiatric patients may also be at special risk for the development of digitoxicity because of erratic drug taking, electrolyte imbalance or increased autonomic tone.
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49
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Abstract
A group pf 19 acute, medication-free schizophrenic patients was studied, using average-evoked responses (AERs) to four intensities of light. Comparison with age- and sex-matched normal controls and patients with bipolar affective disorders showed that schizophrenics had smaller AER amplitudes and either no increase or an actual decrease in amplitude with increasing stimulus intensity. Normal subjects and schizophrenic patients were discriminated with 71% accuracy using AER variables; normals, patients with bipolar disorders, and schizophrenic patients with 64% accuracy. Patients who evidenced this AER "reducing" pattern to a noticeable extent early in hospitalization showed greater improvement and tended to have relatively good premorbid histories.
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50
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Abstract
The authors describe their experience in carrying out clinical and psychobiological research in a therapeutic milieu setting. The clinical-research meeting, composed of clinical-care staff with secondary research responsibilities, researchers, and acutely psychotic patients, proved to be a useful mechanism for identifying and resolving inevitable problems at the clinical-research interface and enhanced the effectiveness of research implementation and patient care. The authors discuss three specific areas where covert issues threatened to undermine the work of the unit-the abrogation of research responsibility, the abrogation of clinical responsibility, and intergroup competition and envy.
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