Different stages of tumor development are unequally affected by pretreatment of tumor cells with a polysaccharide

Pretreatment with the polysaccharide levan of Lewis lung carcinoma and AKR lymphoma cells affected unequally different stages of tumor development. While levan pretreatment sharply reduced the evolution of tumors from subcutaneously inoculated cells, no such inhibition was observed with pretreated cells inoculated intravenously. Since levan is known to affect the cell membrane, it is concluded that different cell membrane properties may be involved in the various stages of tumor progression.

Choledochoduodenal fistula: a rare complication of duodenal ulcer

Spontaneous biliary enteric fistula caused by duodenal ulcer is a rare phenomenon. In most cases it is diagnosed incidentally, because it seldom gives clinical symptoms. The fistula per se is not an indication for surgery. When surgery is recommended, the operation of choice is vagotomy and antrectomy. A short review of the literature with three of our cases is presented.

Unusual presentation of carcinoma of the vermiform appendix: a report of two cases

Two unusual presentations of perforated mucoid adenocarcinoma of the appendix are described. One patient presented with a large periappendicular abscess that extended into the gluteal region, the other with a retroperitoneal abscess and abscesses in the right flank and groin. Recognition of the source of the abscess may be difficult but is essential for the prevention and elimination of the sepsis which may be life-threatening. The presence of mucin in the drained pus is highly suggestive for perforated bowel carcinoma. A high index of suspicion and the performance of prompt diagnostic procedures may bring early surgical treatment and better results.

Granulomatous peritonitis caused by glove starch

Corn starch particles are used as a surgical glove lubricant. At present there is no better alternative for this lubricant. Implantation of corn starch particles into the peritoneal cavity can induce foreign body reactions, starch peritonitis and starch granulomata, and may cause adhesions and intestinal obstruction. Starch peritonitis should be treated conservatively.

Amniotic fluid embolism and disseminated intravascular coagulation complicating hypertonic saline-induced abortion

Amniotic fluid embolism (AFE) associated with disseminated intravascular clotting (DIC) is usually fatal. Such a combination generally occurs at the term of pregnancy or in the immediate postpartum period. A case of AFE with DIC following a hypertonic-saline-induced abortion, is reported. The patient was in the midtrimester with a live fetus. Prompt recognition and treatment of her condition ensured her complete recovery. Such a case has not, to our knowledge, been previously reported.

Endometriosis of the umbilicus

Endometriosis is a common phenomenon. Most cases reported are pelvic endometriosis which cause typical symptoms. Cutaneous endometriosis is rare, usually appearing in surgical scars or following surgical procedures. Umbilical endometriosis can occur after surgery but is generally spontaneous. Six cases of spontaneous umbilical endometriosis are presented.

Perforation complicating carcinoma of colon

Eight hundred thirty-six patients with carcinoma of colon and rectum were treated surgically in the Ichilov Medical Center from 1968 to 1975. Forty-five patients (5.38%) suffering from perforative carcinoma were followed up. It was found that the treatment of choice for perforative carcinoma of the descending colon is primary resection without primary anastomosis. In ascending colon perforation the treatment of choice is primary resection with primary anastomosis. Thus aggressive surgical procedures afford the patient the best chance for smoother postoperative course and recovery. In patients surviving the operation, the survival time is not influenced by the type of perforation but by the stage of tumor invasion.

Endometriosis of the colon

A case of endometriosis of the colon is presented. The incidence, symptomatology and treatment are discussed.

Combined treatment of Lewis lung carcinoma by tumor excision and levan

A combined treatment modality including surgical excision and daily injections of high molecular levan seemed to be effective against Lewis lung carcinoma in C57BL mice. The inhibitory effect of levan on tumor growth in mice treated by resection of the primary tumor was demonstrated as follows: (1) recurrence of primary tumors was less in levan-treated mice compared to untreated animals; (2) metastases were less numerous in the levan-treated animals; (3) levan treatment partly prevented loss in body weight, and (4) it increased the survival rate. Recurrence of primary tumors appeared to be more efficiently inhibited by local levan treatment, while systemic (i.p.) administration was more effective than local treatment in preventing metastases. The mechanism of inhibition of tumor growth was related to accumulation of macrophages around the metastases.

Congenital hypertrophic pyloric stenosis: a long-term follow-up of 41 cases

From 1946 to 1977, 228 infants were operated on for congenital hypertrophic pyloric stenosis in the Tel-Aviv Municipal Medical Center, all by the method of Fredet-Ramstedt. An evaluation was made of the late morbidity in 41 patients, ranging in age from 15 to 30 years. The emphasis is on gastrointestinal diseases and their possible connection to the operation. Twenty-four of 41 patients had gastrointestinal symptoms, including dyspepsia, diarrhea, constipation, and abdominal pains. X-ray examination of the stomach was performed in 31 patients, in order to examine the structure and function of the stomach. Five patients showed clear signs of ulcer disease, four in the duodenum and one in the stomach. Another five patients showed mild deformation of the duodenal bulb, and two showed signs of gastritis. No correlation was found between the severity of the congenital pyloric stenosis and the presence of later illness or disturbances.

Testicular feminization syndrome

The testicular feminization syndrome is an uncommon condition with a familial background. The clinical features of a typical case are presented, as well as its management. It is emphasized that these patients and their parents must be treated with the greatest sensitivity when the condition is explained to them.

Aberrant adrenal tissue in the wall of a hernial sac

An aberrant adrenal, which is a supplementary to the normal adrenal, was found in the apex of hernial sacs in ten out of 350 operated children. This tissue contains adrenal cortex, which tends to atrophy and disappear during childhood, but uncommonly may persist into adult life. Rarely it may secrete abnormally or undergo neoplastic changes. The embryological development is discussed, and the literature briefly reviewed.

Acid esterase activity in the pathogenesis of atherosclerosis: effect of partial aortic ligation in rabbits

Partial ligation of the aortas of rabbits below the ostia of the renal arteries resulted in a proliferative intimal reaction. Myocytes in the media of the ligated area showed little or no acid esterase activity. This reduction in acid esterase activity is believed to play an important role in atherogenesis.

The role of acid esterase in the pathogenesis of xanthoma. A histochemical study in rabbits

Previous studies of our group indicated that two types of cells are involved in the pathogenesis of atheroma. The one type, myocytes, are poor in acid esterase activity, store lipid droplets which they cannot hydrolyze and are transformed into foam cells. The other type, macrophages, are rich in this enzyme activity, can and do hydrolyze the esters with possible healing by fibrosis. In the present study the importance of acid esterase activity in experimental xanthoma in hyperlipidemic rabbits was studied. Perithelial cells of small blood vessels were found to be poor in acid esterase activity and to contain bulky lipid masses. With time, increasing numbers of cells with high enzyme activity were found mainly at a distance from the vessels. These cells, which mostly contained finely emulsified lipids are believed to be macrophages. Thus, in both atheroma and xanthoma, vessel wall cells take a "passive" part in formation of the lesion, while blood borne cells play a role in disposing of the lipid with eventual possibility of healing.