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Biomedical subjects

D Levine

Publications and source records attributed to D Levine.

At least 19 recordsLinked to original sources

The olive on end: a useful variant of the "shoulder" sign in the barium X-ray diagnosis of idiopathic hypertrophic pyloric stenosis.

We describe a radiographic sign of infantile hypertrophic pyloric stenosis. This sign, elicited during firm compression of the barium-coated pyloric region, is a round or avoid filling defect caused by the hypertrophied pyloric muscle protruding en face into the gastric lumen. This filling defect typically reveals a barium-containing central depression or stellate indentation, representing the proximal end of the obstructed pyloric channel. This sign, like the closely related "shoulder sign", appears to establish the diagnosis of hypertrophic pyloric stenosis without need for filling of the pyloric channel or for additional radiographic maneuvers.

Barium Sulfate

Simple adnexal cysts: the natural history in postmenopausal women.

Transabdominal and transvaginal ultrasound (US) examinations were performed in 184 asymptomatic postmenopausal volunteers to determine prospectively (a) the frequency and natural history of simple adnexal cysts in healthy postmenopausal women and (b) the relationship between cyst activity and both hormone replacement and length of time since menopause. Eighty-three simple adnexal cysts were found in 52 women. Thirty-two of 184 women (17%) had 37 cysts identified at initial examination; 46 new cysts appeared in 31 women (11 of whom previously had cysts). Forty-nine women with 72 cysts were reevaluated with subsequent US scanning over a period of 3-23 months. Thirty-eight of the 72 cysts (53%) disappeared completely, 20 (28%) remained constant in size, eight (11%) enlarged by 3 mm or more, two (3%) decreased in size by 3 mm or more, and four (6%) both increased and decreased in size on repeated examinations. No statistical relationship was found between presence of cysts or cyst activity with respect to the type of hormone replacement or length of time since menopause.

Adnexal Diseases

Taurine attenuates renal disease in chronic puromycin aminonucleoside nephropathy.

Repeated administration of low doses of puromycin aminonucleoside (PAMN) to rats induces a proteinuric renal disease that resembles focal segmental glomerulosclerosis (FSGS). Reactive oxygen molecules may be involved in the progressive course of this nephropathy. Therefore we evaluated whether taurine, an endogenous antioxidant, could limit the extent of renal injury. Sprague-Dawley rats received low-dose injections of PAMN, 2 mg/100 g body wt, over a 12-wk period. Two groups were studied: 1) controls given tap water (n = 23), and 2) an experimental group that drank 1% taurine-supplemented water (n = 22). Taurine-treated nephrotic rats had a reduction in albuminuria, as assessed by the urinary albumin-to-creatinine ratio (26 +/- 4 vs. 44 +/- 4, P less than 0.0001). After 12 wk, creatinine clearance was 0.33 +/- 0.03 (experimental) vs. 0.17 +/- 0.03 ml.min-1.100 g body wt-1 (control) (P less than 0.001), and inulin clearance (n = 6 pairs) was 0.26 +/- 0.04 (experimental) vs. 0.13 +/- 0.02 ml.min-1.100 g body wt-1 (control) (P less than 0.025). Administration of taurine reduced the percentage of segmentally sclerosed glomeruli (9.8 +/- 1.7 vs. 16.2 +/- 1.8%, P less than 0.02) and the tubulointerstitial injury score (1.36 +/- 0.19 vs. 2.61 +/- 0.25, P less than 0.0025) in experimental vs. control rats. Taurine treatment normalized the elevated renal cortical malondialdehyde level in rats with PAMN nephropathy (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Synthetic vs human surfactants in the treatment of respiratory distress syndrome: radiographic findings.

Exosurf, a synthetic surfactant, was instilled endotracheally in 49 neonates as treatment for respiratory distress syndrome. The radiologic courses of these neonates were compared with the courses of 18 neonates previously treated with human surfactant and of 18 untreated neonates. The radiologic severity of respiratory distress syndrome decreased significantly in neonates treated with Exosurf compared with that in untreated neonates. Radiologic improvement in those treated with Exosurf was slightly delayed when compared with the improvement of age-matched neonates treated with human surfactant. Otherwise no significant difference was noted between Exosurf and human surfactant in radiologic severity of respiratory distress syndrome or in the prevalence of pulmonary interstitial emphysema, pneumothorax, and bronchopulmonary dysplasia. These findings support the thesis that artificial surfactant is an acceptable substitute for surfactants of biological origin, with possible benefits of safety and ease of use.

Bronchopulmonary Dysplasia

Subacute scrotal pain: evaluation of torsion versus epididymitis with MR imaging.

Torsion knot and whirlpool patterns result from the twisting of the spermatic cord, which produces distortion of cord structures. These two findings, along with spermatic cord vascularity, were used to prospectively differentiate testicular torsion from epididymitis in 11 patients with subacute scrotal pain who underwent magnetic resonance (MR) imaging. The final diagnosis was established clinically in four patients and surgically in five. MR imaging enabled the recognition of each entity without error. Retrospective review of findings highlighted other potential discriminating features, the most important of which were testicular size and vascularity. Because of its ability to highlight vessels and detail normal and abnormal intrascrotal anatomy, MR imaging in this small series enabled the differentiation of subacute torsion from epididymitis with 100% accuracy. This high degree of accuracy warrants further investigation.

Adolescent

Patterns of thought disorder associated with right cortical damage, schizophrenia, and mania.

The authors used the Thought Disorder Index to measure thought disorder in 23 patients with unilateral right hemisphere cortical damage, 20 patients with bipolar mania, and 25 patients with schizophrenia. There were no differences in the total amount of thought disorder in these groups, but each showed a unique pattern of thought disorder. Patients with right hemisphere damage displayed fragmented thinking, manic patients displayed playful thinking, and schizophrenic patients displayed idiosyncratic thinking. These findings support the view that thought disorder is manifested in different forms that are relatively specific to psychiatric or neurological condition.

Adolescent

Physician knowledge, attitudes, and behavior related to reporting adverse drug events.

Voluntary physician reporting of adverse drug events (ADEs) in their patients remains the single most important source of information on serious and rare ADEs. Yet, substantial underreporting exists and the factors producing it are unclear. We surveyed 3000 randomly chosen physicians by mailed questionnaire to determine their knowledge about the reporting system, attitudes toward reporting, and their past behavior in reporting the ADEs they had detected. Responses numbered 1121. Only 57% were aware of the Food and Drug Administration's reporting system. While 418 physicians had detected an ADE in their practices during the previous year, only 21 physicians reported these events directly to the Food and Drug Administration. The physicians appear to appreciate the safety issues involved in prescription drug use and view reporting as a professional obligation; however, the current reporting system is considered inconvenient.

Attitude