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Biomedical subjects

B Levin

Publications and source records attributed to B Levin.

At least 235 records · Page 13Linked to original sources
PubMed1988

Islet cell tumors metastatic to the liver: effective palliation by sequential hepatic artery embolization.

The value of sequential percutaneous hepatic artery embolization with polyvinyl alcohol particles was examined in 22 patients with islet cell carcinoma metastatic to the liver. Nine patients had gastrinoma, 2 had glucagonoma, and 11 had no discernible hormonal secretions or syndromes. Ninety-seven embolizations were done with a median number of 4 (range, 1 to 12) per patient. The interval between embolizations ranged from 1 to 8 months. Twelve of twenty evaluable patients had a partial remission, frequently associated with subjective improvement and decrease in hormone levels. The projected median survival of all 22 patients from the initiation of embolization is 33.7 months (range, 1 to 72). Nausea, vomiting, fever, and abdominal pain occurred with each embolization and subsided usually by day 10 (range, 3 to 35). Sequential hepatic artery occlusion is an effective method for prolonged palliation in this selected group of patients.

Adenoma, Islet Cell↗
PubMed1988

Ulcerative colitis and colon cancer.

Chronic ulcerative colitis is an idiopathic inflammatory disease of the colon associated with an increased incidence of colorectal cancer. Colonoscopy with biopsy for mucosal dysplasia (precancer) can identify individuals with ulcerative colitis who are at increased risk for colorectal cancer. Identification of high-risk individuals can be used to guide clinical decisions regarding the timing and appropriateness of prophylactic colectomy.

Animals↗
PubMed1988

ENT abnormalities associated with Fraser syndrome: case report and literature review.

Fraser syndrome is an uncommon genetic disorder characterized by multiple congenital abnormalities. Newborns afflicted with this syndrome have abnormalities of the eyes, ears, nose, larynx, palate, extremities and urogenital system. A review of the literature shows a deficiency in the description of the ENT abnormalities. Most articles have appeared in the ophthalmologic literature with emphasis on the obvious ocular abnormalities. In this paper we will describe in detail, the ear, nose and throat abnormalities in a two-year-old child with Fraser syndrome.

Child, Preschool↗
PubMed1987

Posttraumatic stress disorder in Israeli combat veterans. Effect of phenelzine treatment.

Twenty-five Israeli combat veterans fulfilling DSM-III criteria for posttraumatic stress disorder (PTSD) participated in an open, prospective trial of phenelzine sulfate administration (median daily dose, 60 mg; range, 30 to 90 mg); three patients withdrew early due to side effects. Treatment was continued for at least four weeks in 22 cases and thereafter for as long as it was felt to be of benefit. Therapeutic efficacy was rated using a new PTSD scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale administered at four weekly intervals. Six patients completed four to eight weeks of phenelzine treatment; seven patients, nine to 13 weeks; and nine patients, 14 to 18 weeks. Comparison of mean prediscontinuation scores with pretreatment ratings showed, at best, only small (23% to 38%) differences (on the PTSD and Hamilton Anxiety scales) in the group treated for nine to 13 weeks. Two patients with a concurrent diagnosis of panic disorder and two with a concurrent diagnosis of dysthymic disorder were the most improved symptomatically but fell short of clinically significant remission. Although statistically significant improvement was observed on seven of the 12 items of the PTSD scale, sleep disturbance was the only symptom showing a clinically impressive change. These results only partially support previous positive reports of phenelzine treatment of PTSD.

Adult↗
PubMed1987

Gastroduodenal mucosal injury during hepatic arterial infusion of chemotherapeutic agents. Lack of cytoprotection by prostaglandin E1 analogue.

Eighteen colorectal cancer patients with liver metastases receiving hepatic arterial infusion of chemotherapeutic agents (mitomycin-C + 5-FUDR) were randomized to receive misoprostol (a prostaglandin E1 analogue) or placebo as a mode of cytoprotection against inadvertent gastroduodenal mucosal injury. Four of 10 patients on misoprostol and 3 of 8 patients on placebo developed gastroduodenal mucosal injury (p greater than 0.1), which was confirmed by endoscopy. Significant tumor responses to chemotherapy were equally distributed between the two groups. Although our sample size was small and type II error (false-negative trial) cannot be excluded, these data strongly suggest that prophylaxis with misoprostol does not prevent the acute gastroduodenal mucosal injury associated with hepatic arterial infusion of chemotherapeutic agents.

Alprostadil↗
PubMed1987

Hepatitis in patients receiving intraarterial chemotherapy for metastatic colorectal carcinoma.

Fifty-one patients with metastatic colorectal carcinoma confined to the liver received intraarterial chemotherapy through the hepatic artery via a subcutaneous pump. The chemotherapy consisted of sequential 14-day infusions of floxuridine (FUDR) and dichloromethotrexate (DCMTX) or a 14-day infusion of FUDR and bolus mitomycin (MMC). Twenty-four patients (47%) developed hepatitis with an elevation of hepatic serum transaminase (serum glutamic oxaloacetic transaminase, SGOT, or serum glutamic-pyruvic transaminase, SGPT). The median time to develop hepatitis was 11 weeks after initiation of chemotherapy. The morphologic effects of chemotherapy were evaluated in eight patients with hepatitis. All the patients with hepatitis had normalization of the serum transaminases after temporary cessation of chemotherapy. There was a trend toward a greater chance of remission in patients who developed hepatitis. Sixty-seven percent of the patients with a therapeutic response had hepatitis, whereas only 33% of the patients without a response had hepatitis. However, this difference was not statistically significant. The occurrence of hepatitis was not related to FUDR dose, drug program (FUDR-DCMTX vs. FUDR-MMC), pump flow rate, hepatic arterial anatomy, sex, or age of the patients.

Bilirubin↗
PubMed1987

A randomized study of two schedules of copovithane in patients with advanced colorectal carcinoma.

Copovithane (BAY i 7433), a copolymer of 1,3-bis(methylaminocarboxyl)-2-methylenepropanecarbamate and N-vinyl pyrrolidone, has antitumor activity in vitro and in vivo. The mechanism of this polymer is unknown. Thirty patients with advanced colorectal carcinoma with measurable tumors were treated in an open randomized study with two schedules of copovithane (schedule A: 6 g/m2 i.v. over 30 min daily for 5 consecutive days and repeated every 3 weeks; schedule B: 10 g/m2 i.v. over 30 min once a week until progression, unacceptable toxicity, or up to 18 months). Fifteen patients received copovithane on a weekly schedule, and 15 patients received it on an intermittent schedule. None of the patients on either schedule achieved a complete or partial remission. Copovithane was ineffective against colorectal carcinoma by both schedules selected in this study.

Antineoplastic Agents↗
PubMed1987

The impact of passive smoking on emergency room visits of urban children with asthma.

Baseline data obtained from a study of 276 children with asthma from 259 low income families were analyzed to test the hypothesis that passive smoking is associated with frequency of emergency room (ER) visits, hospitalizations, and impaired pulmonary function. The data were analyzed using multiple regression techniques. We controlled for other variables that might affect the frequency of ER visits, including smoking by the children themselves and the presence of other irritants or allergens in the child's home. Passive smoking was positively associated with ER visits (p less than 0.01), but not with hospitalizations or abnormalities in pulmonary function. The frequency of days with symptoms of asthma per month was also directly associated with ER visits (p less than 0.02). The estimated mean annual increase in ER visits attributable to the presence of one or more smokers in the household was 1.34 +/- 0.50, an increase of 63% over nonsmoking households. The estimated annual health care cost for emergency care of children with asthma that can be attributed to passive smoking is 92 dollars (95% confidence interval from 24 to 160 dollars) for families with 1 or more smokers.

Adolescent↗
PubMed1987

A school health education program for children with asthma aged 8-11 years.

It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; reduce school absences and improve school performance. The study population consisted of 239 low-income, predominantly Hispanic and black children from 12 elementary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. The program emphasized the child's responsibility for recognizing symptoms and taking appropriate management steps. Follow-up data obtained one year after the program showed that compared to controls experimental group children had higher scores on an index of asthma management (p less than 0.05), greater self-efficacy with respect to asthma management skills (p less than 0.05), more influence on parents' asthma management decisions (p less than 0.05), better grades in school (p = 0.05), and fewer episodes of asthma (p less than 0.01) of shorter average duration (p less than 0.01). No differences were observed for changes in number of school absences. These findings show that asthma health education designed for delivery to children can significantly increase management skills, reduce symptoms of asthma, and improve school performance.

Asthma↗
PubMed1986

Liver pathology following hepatic arterial infusion chemotherapy. Hepatic toxicity with FUDR.

The authors reviewed the liver histopathology and the clinical features of eight patients with liver metastases from colorectal cancer who were treated by hepatic arterial infusion chemotherapy (HAIC) via an implantable pump (Infusaid). Before HAIC, these patients had no evidence of hepatitis, and results of liver biopsies performed on three patients showed only minor morphologic alterations. All the liver tumors responded to HAIC, but all patients developed hepatitis. Clinical findings included nausea, vomiting, abdominal pain and jaundice. Serum transaminases, alkaline phosphatase and bilirubin levels were increased. Clinical observations suggested that 5-fluoro-2'-deoxyuridine (FUDR), the predominant drug given, was the hepatotoxic agent. Toxic effects were hepatocyte necrosis, steatosis, cholestasis, central vein sclerosis, and alterations in the portal triad. In addition, central vein lesions like those in veno-occlusive disease, and micronodular cirrhosis resembling that induced by alcohol, were encountered. Although individual susceptibility to FUDR appeared to vary, portal triad fibrosis was present in all eight cases and, together with central vein sclerosis and cirrhosis, appeared to be related to the dose and duration of HAIC.

Adult↗
PubMed1986

Chromosomes and large bowel tumors.

As a variety of chromosome banding techniques are applied in the systematic study of large bowel neoplasms coupled with new approaches in cell and molecular biology, one can anticipate much new knowledge in this area. This report will present a synopsis of recent work from our laboratory. Chromosomal changes in large bowel neoplasms can be classified into those involving an abnormal number of chromosomes and those involving structural changes.

Adenoma↗
PubMed1986

Phase II study of spirogermanium in patients with advanced colorectal carcinoma.

Twenty one evaluable patients with advanced colorectal carcinoma were treated with continuous infusion of spirogermanium at a median daily dose of 150 mg/m2 (range 120-210) for five consecutive days every 14 days. Treatments were accomplished by using outpatient infusion devices. Fifteen patients had not received any prior radiation therapy, immunotherapy, or chemotherapy. Nineteen patients were previously untreated with chemotherapy. Five patients had received prior immunotherapy with copovithane and only two patients had received radiation therapy prior to spirogermanium therapy. None of the patients achieved a complete or partial remission. Minor tumor regressions were observed in two patients, both were less than 12 weeks in duration. The major toxicities included nausea and vomiting and neurologic side effects; however, the toxicity was completely reversible. Spirogermanium is not effective in the treatment of patients with advanced colorectal carcinoma.

Adult↗