I G Ron

Tel Aviv Sourasky Medical Center, Tell Afif, Tel Aviv, Israel

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Publications (51)117.57 Total impact

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    ABSTRACT: In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the "match" is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.
    Medical dosimetry: official journal of the American Association of Medical Dosimetrists 03/2011; 36(4):434-9. DOI:10.1016/j.meddos.2010.11.001 · 0.95 Impact Factor
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    ABSTRACT: Carboplatinum was injected into four groups of mice for 5 successive days at one out of four daily equidistant hours. Upon the cessation of these injections, granulocyte colony stimulating factor was injected into half of these mice for 2 days at the same times. The stimulating factor was also injected into groups of untreated mice for 2 days at the same times. In each experiment the rhythms of four variables were monitored after the cessation of all injections: peripheral WBC count, bone marrow and sperm stem cells DNA synthesis, and sperm ribosomal RNA content. The results indicated that in the course of repeated drug administrations, variables' rhythm parameters (phases and periods) were altered. These changes have to be considered in chronotherapeutic schedules when variables which serve for toxicity diagnosis or as drug target are rhythmic in nature.
    Biological Rhythm Research 08/2010; February 1998(1-Vol. 29):98-104. DOI:10.1076/brhm.29.1.98.3039 · 1.22 Impact Factor
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    ABSTRACT: To assess activity and toxicity of gemcitabine treatment in heavily pretreated epithelial ovarian cancer (EOC) patients and compare the outcome between platinum-sensitive and platinum-resistant patients. We conducted a retrospective analysis of 43 women with EOC treated with gemcitabine on Days 1, 8 and 15 every 28 days. Response was evaluated by physical examination and serial CA 125 measurements. The patients (median age 62 years, range 29-87) were previously exposed to a median of 3 (2-8) chemotherapy regimens. A median of 3.5 (1-14) gemcitabine cycles were administered. Eleven (25.6%) patients showed partial response, 19 (44.2%) had stable disease and 13 (30.2%) progressed. Among 22 platinum-sensitive and 21 platinum-resistant patients, the response rate was 45.5% and 4.7% respectively (p = 0.001), and the median time to progression was 5.0 and 2.8 months, respectively (p = 0.0006). The respective median survival was 16.5 and 6.3 months (p = 0.0001). Grade III-IV hematological toxicities included anemia in four (9.3%) patients, thrombocytopenia in four (9.3%) and leucopenia in two (4.7%). The main non-hematological toxicities were grade III fatigue in two patients (4.7%) and nausea and vomiting in two (4.7%). Single agent gemcitabine is an attractive option for heavily pretreated EOC patients. The significant difference between platinum-sensitive and resistant patients' warrants further investigation.
    Acta Oncologica 02/2006; 45(4):463-8. DOI:10.1080/02841860500509035 · 3.71 Impact Factor
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    N Asna · H Lewy · I E Ashkenazi · V Deutsch · H Peretz · M Inbar · I G Ron
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    ABSTRACT: Efficacy of chemotherapy may be maximized and its toxicity can be minimized if drugs would be administered at specified daily times. The present study was aimed to examine if the protection of amifostine against cisplatin toxicity is time dependent. Amifostine is an organic thiophosphate that protects selectively normal tissues, but not tumors, against the cytotoxicity of DNA binding chemotherapeutic agents such as cisplatin. ICR male mice which were entrained to Light:Dark (L:D) 14:10 were injected (intrapritoneal bolus) for 5 consecutive days with either: cisplatin, cisplatin plus amifostine (administered 30 minutes prior to cisplatin). Injections were given at either 08:00, 13:00, 20:00 or 01:00. Five days later, on day 10, each set of mice was sacrificed (at the same hour corresponds to the injection hour), blood count, blood creatinine and blood urea nitrogen (BUN) were assayed. Cisplatin treated mice exhibited nephrotoxicity, as indicated by increased blood urea nitrogen values and by high blood urea nitrogen to creatinine ratios, as well as myelotoxicity that was indicated by low levels of hemoglobin and platelets. Co-administration of amifostine-cisplatin reversed both, the nephrotoxicity of cisplatin, and its myelosuppressive effects. For BUN, hemoglobin and platelets, maximal protections were observed at 08:00, (p <0.05, p <0.01 and p <0.01 respectively). For BUN/Cr ratio (p <0.05), maximal protections was observed at 13:00. These findings show that amifostine exhibits time dependent protection against cisplatin toxicity and thus it is recommended to use the protector when treatments are given during morning hours. The results also further validate the notion that chronochemotherapy is advantageous at least in reducing drug toxicity and thus should be integrated in the design of clinical protocols.
    Life Sciences 03/2005; 76(16):1825-34. DOI:10.1016/j.lfs.2004.09.028 · 2.30 Impact Factor
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    ABSTRACT: The Israeli Society for Clinical Oncology and Radiotherapy appointed experts in breast cancer therapy to assess the Society's policy regarding hormone replacement therapy (HRT) in breast cancer survivors with menopausal symptoms. The first policy letter was published in November 2002, and referred to available literature at that time which included retrospective data alone. The professional literature suggested no increased risk in breast cancer recurrence or cancer specific mortality, and no effect on overall survival with the use of HRT for a limited period (up to 3 years). This data served as the rationale for international prospective studies. Former committee recommendations and precautions are detailed in the original publication. In February 2004, the interim analysis of a prospective trial, the HABIT (Hormonal replacement therapy after breast cancer--is it safe?) was published. In that trial, breast cancer survivors with menopausal symptoms were randomized to HRT (estrogens with or without progestins) or no therapy for 2 years. A total of 434 women were recruited from centers in Scandinavia who participated with the International Breast Cancer and the European Organization for Research and Treatment groups. Analysis was restricted to 345 women with at least one follow up report; median follow-up period was 2.1 years. The relative risk for breast cancer event was 3.5 (95% C.I. 1.5-8.1) in HRT users as compared with the non-HRT group and the HABIT trial was terminated. Study limitations are discussed. Thereby, at this time HRT can no longer be considered safe in breast cancer survivors. Physicians treating breast cancer survivors for severe menopausal symptoms should present study results and alternative non-hormonal treatment options to allow patients optimized consented treatment decisions.
    Harefuah 11/2004; 143(10):753-6, 764.
  • D L Sarid · I G Ron · I Avinoach · F Sperber · M J Inbar
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    ABSTRACT: Spontaneous regression of pure seminoma metastases is a rare phenomenon, with only a few cases reported to date. To the best of our knowledge, this is the first report of regression of anaplastic pure seminoma metastases located in the retroperitoneum. We present a 27-year-old man, a marihuana smoker, with metastatic pure anaplastic seminoma in the high retroperitoneal lymph nodes. After orchiectomy, his metastases regressed with no medication. Several mechanisms are suggested to explain this phenomenon, which still remains elusive.
    American Journal of Clinical Oncology 09/2002; 25(4):380-2. DOI:10.1097/00000421-200208000-00012 · 2.61 Impact Factor
  • I G Ron · V Soyfer · D Goldray · M J Inbar · Y Weisman
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    ABSTRACT: Megestrol acetate (MA) has glucocorticoid activity and can induce significant secondary adrenal suppression. We designed this study to determine the extent of adrenal insufficiency in cancer patients receiving MA by utilising a sensitive low-dose adrenocorticotropin (ACTH) stimulation test. Adrenal function was assessed by a low-dose (0.625 microg) ACTH (1-24) stimulation test in 30 patients receiving MA for metastatic cancer. 10 of the patients who failed this test underwent a standard (250 microg) test on another day. Adrenal function was also evaluated in 15 of the patients by measuring the excretion of free cortisol in 24-h urine samples. Peak serum cortisol levels following stimulation with low-dose (0.625 microg) ACTH (1-24) were <18 microg/dl in 16 of 30 (53%) patients, of whom 9 had a basal serum cortisol level of <5 microg/dl. Five of 16 poor responders to the low-dose test showed normal stimulation with the standard (250 microg) ACTH (1-24) test. Thus, adrenal insufficiency would fail to be detected by the standard high dose test in these patients. Patients who failed the low-dose ACTH (1-24) test had lower 24-h urinary free cortisol excretion (8.7+/-10.3 microg/24 h) than normal responders (35+/-12.7 microg/24 h). Impaired adrenal function is common in cancer patients receiving MA. The low-dose ACTH (1-24) test is apparently capable of revealing adrenal insufficiency undetected by the standard high-dose ACTH test. Patients receiving MA might have inadequate adrenal function during episodes of infection or after withdrawal of MA therapy and this may require prompt corticosteroid treatment.
    European Journal of Cancer 07/2002; 38(11):1490-4. DOI:10.1016/S0959-8049(02)00077-1 · 4.82 Impact Factor
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    I. Cohen · I. Golding · I. G. Ron · E. Ben-Jacob
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    ABSTRACT: Various bacterial strains exhibit colonial branching patterns during growth on thin poor substrates. The growth can be either diffusion-limited or kinetic-limited, according to the imposed growth conditions. We present experimental observations of patterns exhibited by the bacterial strains Paenibacillus dendritiformis and Paenibacillus vortex. All manners of branching patterns are observed, the three main being: (1) basic branching; (2) chiral branching; (3) vortex branching. We show that the following biological features can explain the spectrum of observed patterns: (1) Formation of a lubricating fluid. (2) Food chemotactic. (3) Attractive and repulsive chemotactic signaling. (4) Flagella handedness. (5) Transition into pre-spore state. In the theoretical studies we employ knowledge drawn from branching patterning in non-living systems and the mathematical properties of reaction–diffusion models and atomistic models. The above can be used not just to describe existing biological understanding, but also to derive new understanding. For example, reaction–diffusion models that include bacterial density and nutrient concentration, can exhibit branching dynamics if the growth term is a meta-stable fixed point or if the diffusion is state dependent. We show that biologically the growth term has to be an unstable fixed point, but that state-dependent diffusion can represent the lubrication fluid excreted by the bacteria. Copyright © 2001 John Wiley & Sons, Ltd.
    Mathematical Methods in the Applied Sciences 11/2001; 24(17‐18):1429 - 1468. DOI:10.1002/mma.190 · 0.88 Impact Factor
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    ABSTRACT: A multicenter phase III randomized study compared the efficacies of two adjuvant polychemotherapeutic regimens in 145 patients with stage II node-positive breast cancer. The standard chemotherapy combination, CMF (cyclophosphamide, methotrexate, 5-fluorouracil), was administered to 77 women. The experimental protocol, CNF (cyclophosphamide, mitoxantrone, 5-FU), in which mitoxantrone (Novantrone) replaced methotrexate, was given to 68 patients. Follow-up of the 145 patients by six participating hospitals showed no statistically significant difference (p = 0.6) between the two treatment regimens during a median follow-up of 4.5 years in terms of overall survival. There was, however, a significant advantage (p = 0.04) in the disease-free survival for those receiving mitoxantrone (mean survival 4.4 years for CNF versus 2.7 years for CMF). Toxic side effects associated with CNF (particularly alopecia and myelotoxicity) were relatively more frequent but acceptable and did not lead to dose reduction. In light of its association with improved disease-free survival in this study, larger studies should be undertaken on the role of mitoxantrone as adjuvant treatment in stage II breast cancer.
    American Journal of Clinical Oncology 09/2001; 24(4):323-7. DOI:10.1097/00000421-200210000-00020 · 2.61 Impact Factor
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    ABSTRACT: Disagreement persists on the necessity of axillary lymph node dissection for small T1 stage unilateral breast cancers. In this study of 120 women with T1 primary tumors who underwent extensive dissection, better definition of pathological factors that can predict axillary node metastases might have spared 88 (73.3%) who were node negative. We assessed age, tumor size, histology, grade and hormone receptor status as possible indicators of lymph node involvement. As expected, tumor size was a strong predictor of the likelihood of node involvement (p = 0.026 in univariate and p = 0.0024 in multivariate analyses). Progesterone receptor status also correlated significantly (p = 0.0008 in univariate and p = 0.017 in multivariate analyses) with axillary positivity. Tumor grade was found to be significant (p 0.018) only in univariate analysis. These findings contribute to the ongoing search for confident selection of subgroups of patients who will undergo lumpectomy but can safely be spared axillary node dissection.
    Acta Oncologica 02/2001; 40(5):629-32. · 3.71 Impact Factor
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    ABSTRACT: The purpose of this work was to evaluate the ability of testing for high-risk human papillomavirus (HPV) types using the hybrid capture technique to predict the presence of cervical intraepithelial neoplasia (CIN) II,III in patients with repeated atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LGSIL) on Pap smears. Hybrid capture testing and tissue biopsy were performed on 503 consecutive women with ASCUS or LGSIL on repeated Pap smears who were referred for colposcopy. A highly significant association (P < 0.0001) was found between a positive test for high-risk HPV types and CIN II,III, with an 87.0% positive predictive value and a 95.7% negative predictive value. In 226 women with ASCUS on repeated Pap smears, a positive test for high-risk HPV types had a 85.7% sensitivity and a 97% specificity for CIN II,III. In 277 patients with LGSIL on repeated Pap smears, a positive test for high-risk HPV types had an 88.2% sensitivity and a 94.7% specificity for CIN I,II. Reserving colposcopy examination for women who were positive for high-risk HPV types would have reduced the number of referrals for colposcopy to 24.6% and maintained a sensitivity of 87.0% for CIN II,III. A positive hybrid capture test for high-risk HPV types was highly sensitive and specific for the presence of CIN II,III in patients with ASCUS and LGSIL on repeated Pap smears. We believe that improved methodology will eventually enable more selective colposcopy referrals without affecting patient safety among these women.
    Gynecologic Oncology 11/2000; 79(2):177-80. DOI:10.1006/gyno.2000.5929 · 3.69 Impact Factor
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    ABSTRACT: Loop electrosurgical excision of the transformation zone (LEETZ) was recently associated with relatively high failure rates. We evaluated whether the combination of LEETZ with laser vaporization is superior to LEETZ alone in reducing the rates of recurrent abnormal cytology and residual disease. The study population included 426 women with histologic diagnosis of cervical intraepithelial neoplasia (CIN) 2-3, of whom 289 (study group) were treated by LEETZ followed by laser vaporization of the crater base and walls and 137 (control group) were treated by LEETZ alone. All women were followed scrupulously at regular intervals for recurrent abnormal cytology and residual disease. The mean follow-up periods were 43 and 59 months for the study and control groups, respectively. Both groups were derived from the same community and were similar in epidemiologic characteristics and disease severity. Although the incidence of positive surgical margins was similar in both groups (10.4 and 9.5% for the study and control groups, respectively), recurrent abnormal cytology (10.2% vs 5.5%, P = 0.07) and histologic residual disease (21.4% vs 0%, P = 0.05) were more frequent among women in the control group. This applied to women with both negative and positive surgical margins. Both study and control women with positive surgical margins, especially at the endocervix, were at higher risk for recurrence. The addition of laser vaporization to LEETZ may improve outcome of both women with positive margins and women with negative margins. Our results support conservative management for all treated women, regardless of cone margin status.
    Gynecologic Oncology 08/2000; 78(1):47-51. DOI:10.1006/gyno.2000.5825 · 3.69 Impact Factor
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    I. Golding · I. Cohen · IG Ron · E. Ben-Jacob
  • Ilan G. Ron · Hadar Ron · Yehuda Lerman
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    ABSTRACT: Three cases of fatal extrapulmonary neoplasms among asbestos-exposed power plant workers are described. These cases add to the growing evidence for a causal relationship between asbestos exposures and extrapulmonary neoplasms.
    International journal of occupational and environmental health 10/1999; 5(4):304-6. DOI:10.1179/oeh.1999.5.4.304 · 1.10 Impact Factor
  • I Cohen · I. Golding · Y. Kozlovsky · I. G. Ron
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    ABSTRACT: We study the effect of discreteness on various models for patterning in bacterial colonies (finite-size effect). We present two types of models to describe the growth of the bacterial colonies. The first model we present is the Communicating Walkers model (CWm), a hybrid model composed of both continuous fields and discrete entities -- walkers, which are coarse-graining of the bacteria. The coarse-graining might amplify the discreteness inherent to the biological system. Models of the second type are systems of reaction diffusion equations, where the branching of the pattern is due to non-constant diffusion coefficient of the bacterial field. The diffusion coefficient represents the effect of self-generated lubrication fluid on the bacterial movement. The representation of bacteria by a density field neglect their discreteness altogether. We implement the discreteness of the bacteria by introducing a cutoff in the growth term at low bacterial densities. We demonstrate that...
    Fractals 08/1999; 7(3). DOI:10.1142/S0218348X99000244 · 0.63 Impact Factor
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    ABSTRACT: To evaluate the effectiveness of a multidisciplinary approach to spinal cord compression (SCC) in accordance with prospective protocol, providing a uniform approach to diagnosis, decision making concerning optimal treatment modality in any particular case of SCC, treatment performance and evaluation of treatment results. The SCC patients treated by radiation therapy are described. Patients with SCC were examined and treated by a multidisciplinary team consisting of a neurologist, radiologist, oncologist, orthopedic surgeon, and neurosurgeon. Seventy-nine patients for whom radiation was recommended received a 30 Gy radiation dose to a compression-causing mass and course of high dose dexamethasone. Three fractions of 5 Gy and 5 fractions 3 Gy each were delivered by Co60 or 8 MV photon beam in 12 days. Treatment outcome was essentially evaluated by ambulation capabilities which were considered to be the main problem of SCC. Changes in other neurologic motor, sensory and autonomic disturbances were also evaluated. Seventy-two percent of the patients were already non-ambulatory at diagnosis. The first symptom was motor deficiency in only 33% of them while in all other cases it was pain. Ambulation capability was the main prognosticator of treatment outcome; 90% of patients who were ambulatory before treatment remained so while 33% of the non-ambulatory patients regained their ability to walk. The grade of motor disturbance was also an important variable: among the non-ambulatory patients, 50% of the paretic but only 14% of the plegic ones became ambulatory. Overall, 51% of the study patients were ambulatory after undergoing radiation. The ambulatory state after treatment was the main predictor for survival. Close cooperation of a multidisciplinary team in diagnosis and treatment according to the above protocol enabled the achievement of good results of radiation treatment in SCC. Early diagnosis and early treatment should further enhance therapeutic outcome.
    Journal of Neuro-Oncology 04/1999; 42(1):85-92. DOI:10.1023/A:1006124724858 · 2.79 Impact Factor
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    ABSTRACT: A phase II study of carboplatin and etoposide as salvage polychemotherapy in metastatic, infiltrating breast carcinoma was carried out with 25 multiply pretreated patients. Six of 25 patients (24%) had a partial response that lasted an average of 3.5 months; of the six responders, four had undergone either four or five previous chemotherapeutic treatments. Eight of 25 patients (32%) had stable disease, and 11 (44%) manifested disease progression. The median survival from time of entry to the salvage protocol was 8 months. There were treatment responses in lung, chest wall, liver, and skeleton. The most common side effects were leukopenia (68% of 25 patients), thrombocytopenia (56%), anemia (40%), fever (28%), and weakness (16%). Carboplatin combined with etoposide may be an effective and tolerable salvage regimen in advanced breast cancer.
    American Journal of Clinical Oncology 03/1999; 22(1):35-7. DOI:10.1097/00000421-199902000-00009 · 2.61 Impact Factor
  • T H Vishne · I G Ron
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    ABSTRACT: The authors report the cases of two patients in whom strontium-89 (89Sr) was used to relieve diffuse metastatic bone pain. The type of cancer involved, thymic carcinoid tumor, is itself rare and the risk of its metastasizing to the bone is very low. Both patients showed a measure of response to treatment, suggesting that this analgesic method has value for some patients. The marked benefit of one patient for a total of 9 months was attributable to two 89Sr injections, whereas the other patient improved for only 5 weeks after one injection.
    American Journal of Clinical Oncology 01/1999; 21(6):602-4. DOI:10.1097/00000421-199812000-00014 · 2.61 Impact Factor
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    ABSTRACT: A growing body of data suggests that cancer therapy may be improved and toxicity reduced by administration of antineoplastic agents and cytokines at carefully selected times of the day. The time-dependent effects of each of the drugs have been documented, but not their mutual time dependencies. In the present studies we sought to determine the best time for granulocyte colony-stimulating factor (G-CSF) administration after carboplatin treatment. Carboplatin was injected in different groups of ICR mice at four different circadian stages for 5 consecutive days. Mice were synchronized with an alternation of 12 h of light (from 6:00 a.m. to 6:00 p.m.) and 12 h of darkness. After the last injection, peripheral WBCs of three mice from each group were counted every 4 h over a 24-h period. Bone marrow toxicity was estimated with the mean 24-h WBC count. The most severe leukopenia occurred in the group injected at 3:00 p.m. – 9 h after light onset. The second set of experiments evaluated the time-dependent effect of G-CSF when singly injected or given after carboplatin injections for 5 days only at 3:00 p.m. G-CSF was injected into various groups on days 8 and 9 at the same four different circadian stages. On the 10th day after the first injection, peripheral WBCs of three mice from each group were counted every 4 h over a 24-h period. Time-dependent effects were observed when G-CSF was injected as a single agent. When G-CSF was given at various times to the group with the most severe carboplatin-induced leukopenia, peripheral WBC count recovery was monitored at all injection times; it reached its highest level (exceeding even that of the control) when G-CSF was injected at 3:00 a.m. Dosing times of both chemotherapy and growth factor are relevant for optimization of carboplatin's hematologic tolerability.
    Cancer Chemotherapy and Pharmacology 05/1998; 42(2):135-141. DOI:10.1007/s002800050796 · 2.57 Impact Factor
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    ABSTRACT: BACKGROUND AND METHODS: The cases of 245 patients diagnosed during 1980-1989 with stage I endometrial carcinoma were retrospectively reviewed in order to assess the contribution of lymph node sampling (LNS) to both course of treatment and outcome. The 183 women treated by gyneco-oncologic surgeons had undergone the standard surgical procedure of total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO) and pelvic lymph node sampling (LNS). Sixty-two other women, treated by gynecologists, received only TAH and BSO. Of women who had received TAH+BSO+LNS, 105 (57.4%) were referred for adjuvant radiotherapy on the basis of one or any combination of high grade histology (G2 or G3), myometrial invasion to a depth of 50% or more and LNS positivity. Of the group who had not had LNS, 37 (59.7%) likewise received adjuvant radiotherapy but on the bases of histology and/or depth of invasion. RESULTS AND CONCLUSIONS: Recurrence and survival over a mean follow-up period of 7.5 years (range 5-15 years) showed no significant differences between the patients who underwent LNS and those who did not. Of 43 recurrences, six were among 'low risk' women (those with both minimal invasion and low grade histology), suggesting a special need among this group for the additional staging information which LNS may provide.
    Acta Obstetricia Et Gynecologica Scandinavica 03/1998; 77(3):347-50. DOI:10.1080/j.1600-0412.1998.770318.x · 1.99 Impact Factor

Publication Stats

374 Citations
117.57 Total Impact Points

Institutions

  • 1985–2011
    • Tel Aviv Sourasky Medical Center
      • Division of Oncology
      Tell Afif, Tel Aviv, Israel
  • 1992–2005
    • Tel Aviv University
      • • Sackler Faculty of Medicine
      • • Department of Oncology
      • • Department of Human Molecular Genetics and Biochemistry
      Tell Afif, Tel Aviv, Israel
  • 1996–1997
    • Bar Ilan University
      • Department of Physics
      Gan, Tel Aviv, Israel