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Migdal Ha‘Emeq, Israel

Amsterdam A.,Weizmann Institute of Science | Raanan C.,Weizmann Institute of Science | Schreiber L.,Wolfson Hospital | Freyhan O.,Weizmann Institute of Science | And 2 more authors.
Acta Histochemica | Year: 2013

LGR5 and Nanog were recently characterized as stem cell markers in various embryonic, adult and cancer stem cells. However, there are no data on their precise localization in the normal adult ovary, which may be important for the initial steps of development of ovarian cancer, the most lethal gynecological cancer. We analyzed by immunocytochemistry the precise localization of these markers in normal ovary (11 specimens, age range 43-76), in borderline specimens (12 specimens), and in serous ovarian cancer (12 specimens of stage II) which comprises the vast majority (80%) of all ovarian cancer. Surprisingly, we revealed that both Nanog and LGR5 are clearly localized in the epithelial cells of the normal ovary. However, in 5 of 12 ovaries there was no labeling at all, while in 3 ovaries staining of Nanog was more prominent with only weak labeling of LGR5. In addition, we found in 3 of 11 ovaries clear labeling in foci of both LGR5 and Nanog antibodies, with partial overlapping. Occasionally, we also found in the stroma foci labeled by either Nanog or LGR5 antibodies. In general, the stroma area of tissue sections labeled with LGR5 was much greater than that labeled with Nanog. In borderline tumors a significant portion of the specimens (7 of 12) was labeled exclusively with Nanog and not with LGR5. In ovarian carcinomas almost 100% of the cells were exclusively labeled only with Nanog (6 of 12 of the specimens) with no labeling of LGR5. These data may suggest the potential of ovaries from postmenopausal women, which express Nanog, to undergo transformation, since Nanog was shown to be oncogenic. We conclude that Nanog, which probably plays an important role in ovarian embryonic development, may be partially silenced in fertile and post-menopausal women, but is re-expressed in ovarian cancer, probably by epigenetic activation of Nanog gene expression. Expression of Nanog and LGR5 in normal ovaries and in borderline tumors may assist in the early detection and improved prognosis of ovarian cancer. Moreover, targeting of Nanog by inhibitory miRNA or other means may assist in treating this disease. © 2012 Elsevier GmbH. Source


Konstantino Y.,Soroka Medical Center | Konstantino Y.,Ben - Gurion University of the Negev | Haim M.,Soroka Medical Center | Haim M.,Ben - Gurion University of the Negev | And 6 more authors.
Journal of Cardiovascular Electrophysiology | Year: 2016

Clinical Outcome of Single- versus Dual-Chamber ICDs Objective To compare the clinical outcomes of a single- versus dual-chamber ICD for primary prevention of sudden cardiac death in a large, national ICD registry. Methods Data were collected from the prospective Israeli ICD Registry. Baseline characteristics and clinical outcomes including mortality, admissions for heart failure (HF), and ICD therapy were compared between the two groups. Results A total of 1,125 subjects, 37% with a single-chamber and 63% with a dual-chamber ICD, constructed the baseline cohort. Approximately 80% had ischemic heart disease (IHD). Mean follow-up was 22 months, mean ejection fraction was 30%, and mean QRS width was 103 milliseconds in both groups. During follow-up, there were no significant differences in the rate of mortality, admissions for HF, appropriate or inappropriate therapy, or in time to any of the clinical outcomes. Using multivariate analysis, single-chamber ICD was not associated with increased risk of death or admission for HF. In a subgroup of patients with IHD, single-chamber ICD was associated with a higher rate of inappropriate therapy. Conclusions In this large retrospective population-based cohort, dual-chamber ICD showed no benefit in reducing the incidence of death or HF admissions, whereas in a subgroup of patients with IHD, single-chamber ICD was associated with increased inappropriate therapy. Further prospective studies are necessary to assess the benefit of dual-chamber ICD in reducing the rate of inappropriate therapy. © 2016 Wiley Periodicals, Inc. Source


Bogdan S.,Leviev Heart Center | Nof E.,Leviev Heart Center | Eisen A.,Rabin Medical Center | Sela R.,Western Galilee Hospital | And 8 more authors.
American Journal of Nephrology | Year: 2015

Background: Renal dysfunction is associated with increased mortality in heart failure (HF) patients. However, there are limited data regarding clinical and arrhythmic outcomes associated with implantable cardioverter defibrillator (ICD) therapy in this population. Methods: We evaluated outcomes associated with the severity of renal dysfunction with or without dialysis among 2,289 patients who were enrolled and prospectively followed up in the Israeli ICD Registry. The primary endpoint of the study was all-cause mortality. Secondary endpoints included cardiac mortality, HF hospitalization, non-cardiac hospitalization, and appropriate and inappropriate ICD therapy. Results: Severe renal dysfunction patients (estimated glomerular filtration rate <30 ml/min/1.73 m2; n = 144 patients; 6%) were older, with higher comorbidities prevalence, and more likely to suffer from advanced HF. Among severe renal dysfunction patients, those on dialysis had a lower prevalence of wide QRS and complete left bundle branch morphology, resulting in lower cardiac resynchronization therapy defibrillator (CRTD) implantation rates. Dialysis was associated with an overall increased risk for all-cause mortality (hazard ratio (HR) 3.22; 95% CI 1.69-6.13; p < 0.01) and for noncardiac hospitalizations (HR 2.80; p < 0.001) compared to all other study patients. However, within the subgroup of patients with severe renal dysfunction, the presence of dialysis was not an independent risk factor for all-cause mortality (HR 0.99; p = 0.97) as compared to non-dialysis. The rate of appropriate ICD therapy for ventricular tachyarrhythmias increased with declining renal function, with the highest rate observed among those undergoing dialysis. Conclusions: The present findings suggest that dialysis does not significantly modify the adverse outcomes associated with severe renal dysfunction following ICD/CRTD implantation. © 2015 S. Karger AG, Basel.All rights reserved. Source


Bromiker R.,Hebrew University of Jerusalem | Bromiker R.,Shaare Zedek Medical Center | Kasinetz Y.,Hebrew University of Jerusalem | Kasinetz Y.,Ha Emek Medical Center | And 7 more authors.
Archives of Pediatrics and Adolescent Medicine | Year: 2012

Objective: To determine whether correction of anemia of prematurity by packed red blood cell transfusion improves sucking. Design: Nonexperimental intervention study. Setting: Neonatal intensive care unit of Shaare Zedek Medical Center, Jerusalem, Israel, between July 23, 2006, and December 16, 2007. Patients: Thirty-six neonates at a gestational age of 34 weeks or younger, feeding orally, who developed anemia of prematurity. Intervention: Packed red blood cell transfusion, 15 mL/kg. Main Outcome Measures: Change in sucking parameters recorded with the Kron Nutritive Sucking Apparatus for 5 minutes and ingested volume, prior to and 1 to 2 days after intervention. Results: The mean (SD) gestational age was 30.1 (2.1) weeks, and the mean (SD) birth weight was 1436 (45) g. At the time of the study, the mean (SD) postnatal age was 46 (26) days, the mean (SD) weight was 2311 (36) g, and the mean (SD) hematocrit was 26.7% (2.6%). Overall, there was no change in the number of sucks, number of bursts, or maximum negative pressure generated. Daily weight gain increased after transfusion (mean [SD] weight gain, 30.9 [10.0] g before transfusion vs 36.5 [13.0] g after transfusion; P = .02). The babies were then stratified into those below the median number of sucks (109 sucks) before transfusion (poor feeders) and those at or above the median (better feeders). In the former subgroup only, changes from before transfusion to after transfusion were found in the number of sucks (mean [SD] sucks, 73.4 [29.5] vs 108.9 [53.3], respectively; P = .006; mean [SD] sucks per burst, 3.4 [1.4] vs 4.9 [2.8], respectively; P = .01) and volume consumed (mean [SD] volume, 17.1 [9.8] mL vs 23.2 [12.8] mL, respectively; P = .004). Conclusions: Correction of anemia of prematurity with blood transfusion improved sucking and volume ingested in premature infants who were poor feeders prior to the transfusion. It also enhanced overall weight gain. ©2012 American Medical Association. All rights reserved. Source


Har-Shai Y.,Carmel Medical Center | Har-Shai Y.,Technion - Israel Institute of Technology | Sommer A.,Technion - Israel Institute of Technology | Gil T.,Carmel Medical Center | And 18 more authors.
International Journal of Dermatology | Year: 2016

Background: Incidences of basal cell carcinoma (BCC) on the lower extremities in elderly patients are rising. Surgical approaches to the treatment of BCC are subject to possible difficulties in healing, failure of skin grafts, and wound infection. This study assessed the efficacy of intralesional cryosurgery in the treatment of BCC of the lower limbs in elderly patients. Methods: This study included eight patients aged >60 years in whom a total of 10 nodular or superficial BCCs of the lower limbs were confirmed by biopsy. The patients' medical histories revealed comorbidities including hypertension, diabetes, hypercholesterolemia, venous insufficiency, and deep vein thrombosis of the legs, congestive heart failure, chronic renal failure, and ischemic heart disease. Using liquid nitrogen, an intralesional cryosurgery needle (CryoShape) was inserted into the tumor to facilitate its complete freezing. Treatment success was confirmed by biopsy taken approximately 3 months after complete healing of the cryo-wound. Results: The average size of the lesions treated was 2.49 cm2 (16.4 × 15.2 mm). Mean recovery time was 79.9 days. Biopsies were obtained at a mean of 85.3 days after the wound had healed. All 10 biopsies verified the complete destruction of the tumor. There was no evidence of wound infection or tumor recurrence over a follow-up period of 28 months. Conclusions: This study demonstrates that a single intralesional cryosurgery session can completely eradicate BCC on the lower extremities in elderly patients. This technique is associated with relatively minor complications, is well tolerated, and represents a safe and effective therapeutic modality for BCC of the lower limbs. © 2016 International Society of Dermatology. Source

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