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Biomedical subjects

A Halevy

Publications and source records attributed to A Halevy.

120 records · Page 7Linked to original sources
PubMed1978

Stainless steel wire for closure of abdominal operative wounds.

In this prospective study, the abdominal wounds of 500 consecutive patients were closed with buried retention monofilament stainless steel wire. The strength of the suture material, the rapidity of the closure, the very low 0.4% dehiscence rate and the almost total lack of wound complications seems to override the relatively minor inconvenience of handling the wire. These results seem to justify the rountine use of this method of wound closure in abdominal surgery, especially in the elderly and high-risk patients.

Abdomen↗
PubMed1977

Ileostomates in Israel.

A survey of 47 Israeli ileostomates known to the Israel Ostomy Association was performed. The outstanding features are 1) a low (5 per cent) referral rate of patients with inflammatory bowel disease for procto colectomy and ileostomy; 2) a high (64-85 per cent) incidence of cutaneous problems; 3) a low rate of rehabilitation, as measured by return to previous occupation, sexual life and social adjustment. However, our 47 ostomates were operated on 14 institutions in five countries and live in a subtropical climate-factors that may negatively affect the outcome. Since the study, the situation has improved.

Adolescent↗
PubMed1976

The natural history of chronic otitis media.

A retrospective study was made of 200 chronic otitis media patients. Simple chronic otitis media was observed in 76 per cent of cases; the rest were associated with cholesteatoma. In about one third of the patients, the contralateral ear showed some inflammatory middle ear disease as well. The average time lapse between initial symptoms and hospitalization was about 10 years. The events leading to the tympanic perforation were difficult to ascertain, but included probably acute otitis media, possibly external otitis, trauma, and a rather large group (35-40 per cent) of insidious 'essential perforations'. The aetiology of the 'essential perforations' is so far not known, but might be non-inflammatory in nature but related to insufficient middle ear aeration and hypo-pneumatization as well as to what is termed atelectatic ears. The bacteria isolated from chronic otitis media ears (usually gram negative bacteria and staphylococcus aureus) are usually not the types of micro-organisms found in association with any primary or acute otitis media. It is proposed that the bacterial infection encountered in what is termed 'chronic otitis media' is often a secondary infection of a primary perforated tympanic membrane, the perforation originating or persisting in underventilated ears, and having arisen from various causes--some of them as yet unknown.

Adolescent↗
PubMedDate not supplied

Laparoscopic cholecystectomy: treatment of choice for cholelithiasis in children.

Laparoscopic cholecystectomy is rapidly replacing traditional cholecystectomy as the standard treatment for cholelithiasis and cholecystitis in adults. Over a period of 16 months, 14 children with a clinical diagnosis of cholelithiasis, ranging in age from 4 to 15 years (mean 12.2), were treated. All had symptoms of abdominal pain or vomiting; one had jaundice and recurrent cholecystitis. Five children (35%) had associated metabolic or hemolytic diseases. The 14 children were operated on using the laparoscopic cholecystectomy technique. No operation was converted to open cholecystectomy, but two patients required laparotomy: one because of suspected injury to the common duct, and the other because of nonvisualization of the gallbladder during laparoscopy. The mean post-operative hospital stay for the 11 children who underwent only laparoscopic cholecystectomy (one patient also had a simple mastectomy) was 50 hours (range 48-72 hours). All children resumed their normal activities almost immediately after discharge from hospital. No long-term biliary or other complications were seen in any patient throughout an average follow-up period of 6.2 months (range 3-16 months). The benefits of this operation in children are obvious: It is safe, effective, and well tolerated.

Adolescent↗
PubMedDate not supplied

Clearance of middle ear effusions and middle ear pressures.

Twenty-six children presenting bilateral secretory otitis media (SOM) had ventilating tubes inserted into both middle ears. Mucus was, however, aspirated only from one ear, the right side. The vast majority of ears right and left were seen to have cleared their effusion equally well regardless of whether they were aspirated on not. This experiment points toward the essential intactness of the mucociliary system and the patency of the lumen of the Eustachian tube in SOM. Promotion of middle ear clearance through ventilation, which reminds one of the second opening in a beer can, does obviously suggest the relief of some negative pressure. Direct manometric measurements of SOM middle pressure were performed in 41 ears showing negative pressure averaging --1.7 mm H2O, this range being two orders of magnitude less than tympanometric measurements. Normal ears did not have even such a small negative pressure. The validity of these direct manometric measurements was checked against a model of the middle ear. Tympanometry, which is a valid diagnostic tool, does indicate in all probability the presence of middle ear effusion due to its rheologic effects on the drum and ossicles rather than the measure of actual middle ear pressures. This is determined by the fact that direct needling of the middle ear, or even the insertion of a ventilating tube, did not change tympanometric values but aspiration of part of the effusion did: indeed the latter tended to bring manometry to normal values.

Child, Preschool↗
PubMedDate not supplied

Cholesterol granuloma.

The "idiopathic haemotympanum" is in reality a persistent secretory otitis media. Histologically it demonstrates a chronic granular mastoiditis associated with a cholesterol granuloma. This, however, is not a very specific finding and may be frequently found in other types of the 'underaerated middle ear syndrome', wuch as ears with central perforations or indeed with cholesteatoma. In these granulomas, iron deposits are found, as well as the iron-chelating agent--lactoferin, which is known to be part of the defence mechanism of all mucosas. Lactoferrin is specifically secreted by the exocrine glands and it is not surprising to find much of it in the middle ear in a situation where mucus is being abundantly synthesized--as the case may be in any otitis media. There is no real clinical or histological evidence, so far, that neither the iron deposits nor the cholesterol crystals of these granulomas emanate from a previous hemorrhage.

Bacterial Infections↗
PubMedDate not supplied

Does laparoscopic cholecystectomy influence peri-sinusoidal cell activity?

BACKGROUND/AIMS: To investigate the influence of laparoscopic procedures on perisinusoidal cell function. METHODOLOGY: In 31 patients who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis, the serum levels of beta-N-acetyl hexosaminidase (beta-NAH) and hyaluronic acid (HA) were measured. Six female patients, who underwent other laparoscopic procedures, not involving the hepatobiliary system, served as controls. RESULTS: HA serum levels increased significantly in both study and control groups, while beta-NAH serum levels remained within normal values. Post-operative AST and ALT serum levels increased significantly only in the study group. No elevation of serum ALP was noted in any of our patients, and post-operative bilirubin levels did not increase in patients with normal pre-operative levels. CONCLUSIONS: Laparoscopic procedures caused detectable damage to Kupffer and endothelial cells as reflected by elevation of post-operative HA serum levels. The damage to the liver hepatocytes and perisinusoidal cells has no clinical significance and the laparoscopic procedure itself is the probable cause of the Kupffer and endothelial cells damage, while other mechanisms caused damage to the hepatocytes.

Adult↗
PubMedDate not supplied

Short segments of frozen saphenous allografts for construction of A-V fistula.

A simple method for constructing an A-V fistula using a short segment of frozen saphenous allograft is reported. This method should be reserved for patients with veins of small calibre or in patients where the distance between vein and artery is such that a primary A-V anastomosis is not feasible.

Arteriovenous Shunt, Surgical↗