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Biomedical subjects

E Levy

Publications and source records attributed to E Levy.

At least 271 records · Page 15Linked to original sources
PubMed1984

[Fistulas of the small intestine with evisceration. New therapeutic approach. 120 cases].

One hundred and twenty cases of post-operative jejuno-ileal fistula with evisceration are reported: 90% of the patients came from other departments. Depending on their mechanism, these fistulae fell into two categories: out-flowing fistulae (93 cases) consecutive to spontaneously opened peritonitis draining through the surgical incision, and in-flowing fistulae (24 cases) resulting from trauma of a superficial small bowel loop; 48% of open small bowel fistulae were due to a questionable operation. Unfavourable prognostic factors were: age over 50, supramesocolic initial lesion, fluid production equal or superior to 1000 ml/24 h, history of at least 2 previous median laparotomies and presence of one or several of 7 severity factors. The overall mortality rate was 46%, falling to 38.5% (inoperable cases excluded) after active treatment. The authors propose to concentrate on prolonged medical intensive care, salvage operations being reduced to a minimum. Over the last 4 years, this approach has brought down to 36% the overall mortality rate.

Adolescent↗
PubMed1984

Removal defect of very-low-density lipoproteins from diabetic rats.

The disappearance rate of triacyl[3H]glycerol carried on very-low-density lipoproteins (VLDL), isolated from diabetic rats and reinjected into normal recipient rats, was about twice as low as that of VLDL-triacyl[3H]glycerol from non-diabetic rats. The VLDL derived from diabetic rats was deficient in the apolipoprotein E component. These results indicate that the triacylglycerol removal defect in diabetes may be related to the quality of the protein carrier.

Animals↗
PubMed1984

Postoperative peritonitis due to gastric and duodenal fistulas. Operative management by continuous intraluminal infusion and aspiration: report of 23 cases.

A new surgical procedure is presented for the management of postoperative peritonitis due to a leak from a suture line in the stomach or the duodenum. At re-operation, an intraluminal unit made of three silicone tubes is inserted through the fistula into the bowel lumen. Extraluminal drains are placed near the fistula. A Witzel jejunostomy is constructed in order to provide continuous high energy enteral support. Intraluminal infusion and aspiration starts immediately after operation. Twenty-three patients have been treated according to this technique. Five died (22 per cent): one from mediastinitis and four from complications unrelated to the fistula. Three (13 per cent) patients developed recurrent abdominal abscesses and underwent re-operation for drainage with no mortality. In the first 2 weeks after operation, most of the discharge was collected by the extraluminal drains. Thereafter the intraluminal unit collected the majority of the fluid, thus allowing the extraluminal drains to be removed. At an average time of 27 days after operation the intraluminal unit was withdrawn. The external fistula created by this technique healed spontaneously in 15 of the 18 survivors, and was surgically closed in three, with no complication. This procedure prevents the recurrence of intra-abdominal sepsis and local complications due to the enzymatic action of the gastroduodenal secretions.

Adult↗
PubMed1984

Surgical anatomy of liver segment IV.

Classical studies of the anatomy of the liver have led to the wide practice of hepatic resection. The difficulties encountered in the course of either right hepatectomy enlarged to include segment IV or left hepatectomy are mainly related to the vascular relations of this liver segment. This paper presents a summary of data from the literature concerning segment IV of the liver, as well as the results of experimental study via an original technique of resin injection of the portal vasculature and biliary drainage of this segment. The relations of the portal pedicles of segment IV with the bile duct originating from the confluence of the ducts draining segments II and III and with the left paramedian branch of the portal vein are described. Knowledge of these anatomical relations is essential to the proper execution of major hepatectomy.

Bile Ducts↗
PubMed1984

Anatomical and physiological basis of parietal treatment of severe peritonitis and evisceration.

The failures observed in attempts to obtain abdominal closure "at all costs" and the risks and difficulties of laparostomy led us to develop a technique of exclusive cutaneous cover to treat cases of severe peritonitis and evisceration with or without exposed fistula. This method is based on certain anatomical features of the anterolateral abdominal wall and its physiological properties when eventration or evisceration is present. The forces of parietal dehiscence were determined in 6 patients having undergone major surgery of the digestive tract. The magnitude of these forces, the neccessity of obtaining biological protection and the structure and physiology of the superficial layers of the abdominal wall require a cutaneous cover with traction-free sutures via cutaneoaponeurotic incisions of relaxation. The rich vascularization of the abdominal wall, the number and topography of the perforating arteries and the existence of hypodermal, subdermal and subpapillary anastomoses allow the surgeon to perform extensive cutaneoaponeurotic mobilization.

Abdominal Muscles↗
PubMed1984

Cell adhesiveness is related to tumorigenicity in malignant lymphoid cells.

Mouse lymphoma cells (S49) that grow in suspension culture were selected for increased tumorigenicity through continuous passages in syngeneic BALB/c mice. Developing tumors were classified as high grade malignant lymphoma, small noncleaved type. Variants were selected from these tumorigenic cells that were able to grow as a monolayer attached to their substrate, resembling, in this respect, fibroblastoid cells. Whereas the tumorigenic suspension-growing parental cells were able to induce progressive tumors with an inoculum as low as 100 cells per mouse, the adherent cells were unable to develop as tumors even at an inoculum of 1 X 10(8) cells per mouse. In addition, mice inoculated once with live adherent cells were immunized against 1 X 10(7) suspension-growing cells. Involvement of an immune response in the rejection of tumorigenic S49 cells was suggested by (a) adoptive transfer experiments in which spleen cells from immunized mice protected naive mice and (b) the appearance of antibodies in the sera of immunized syngeneic mice that specifically recognized both adherent and suspension-growing S49 cells and detected differences in [35S]methionine-labeled antigens from these cells. Antibodies raised in rabbits against adherent cells recognized three proteins of 34,000, 61,000, and 72,000 apparent molecular weight in radiolabeled adherent cell extracts that are either absent or present in small amounts in extracts of suspension-growing tumorigenic S49 cells. These findings, taken together with our previous report (Hochman, J., A. Katz, E. Levy, and S. Eshel, 1981, Nature (Lond.), 290:248-249), suggest the S49 system as a novel system for studying growth control in malignant lymphoid cells.

Animals↗
PubMed1984

Gastric handling of medium-chain triglycerides and subsequent metabolism in the suckling rat.

We have previously shown that preduodenal lipases account for 50% of the lipolytic capacity of 14-day-old rats. The present investigation was designed to study the kinetics of and optimal conditions for absorption of fat in the stomach of suckling rats and its subsequent distribution in the body. After the simultaneous instillation of medium-chain triglycerides (MCT) containing 1.25 microCi 2,3-[3H]trioctanoate and of long-chain triglycerides containing 1.25 microCi 1-[14C]glycerol trioleate into the stomach ligated at the pylorus, we were able to show that gastric absorption of fat is limited to MCT. Two and a half minutes after injection, 88.6% of the radioactivity in the wall of the stomach was associated with free fatty acids, proving that lipolysis had preceded the absorption of the majority of the MCT. The remainder of the radioactivity was found in mono-, di-, and triglycerides as well as with cholesterol ester and phospholipids. In the plasma, peak radioactivity was attained within 2.5 min and a steady state ensued which lasted at least 30 min. Over this time period, specific radioactivity continued to rise in the liver, suggesting that hepatic uptake proceeded at the same rate as gastric absorption. Uptake could also be demonstrated in the three other organs tested, the lungs, the heart, and the kidneys. Absorption of MCT at pH 3 was only 20% of absorption at pH 6, which is the physiological pH in the suckling rat stomach within the first 10 min after a feed. Both at pH 3 and at pH 6, the addition of sodium taurocholate increased absorption of MCT over threefold. It is likely that the absorption of MCT by the stomach is a physiological event in the suckling rat.

Absorption↗
PubMed1983

Defective gamma interferon production in leprosy. Reversal with antigen and interleukin 2.

Antigen and mitogen-induced gamma interferon (gamma-IFN) production was studied in peripheral blood mononuclear cells from 34 leprosy patients. 17 of 18 lepromatous leprosy and borderline lepromatous patients (LL and BL) failed to release gamma-IFN in response to specific antigen (Mycobacterium leprae) and displayed reduced responses to mitogen (concanavalin A) stimulation. In contrast, cells from six tuberculoid and borderline tuberculoid patients (TT and BT) produced considerable levels of gamma-IFN under the same experimental conditions. Normal controls failed to respond to M. leprae and most displayed good responses to concanavalin A. Mid-borderline patients (BB) showed intermediate levels of gamma-IFN release. gamma-IFN release by lepromatous patients could be partially restored with purified interleukin 2 and M. leprae antigen but not with interleukin 2 alone.

Antigens, Bacterial↗
PubMed1983

The fatty meal test: an alternative to stool fat analysis.

In view of the technical difficulties inherent in using stool fat estimations as a parameter of malabsorption, we used a fatty meal absorption test. Children under investigation for failure to thrive were divided into two groups, those having a normal stool fat output (less than 3.2 g/day) constituting the control group, and those having steatorrhea. After a fatty meal containing 25 g of margarine and 25 g of butter fat, we measured the rise of serum triglycerides and chylomicrons hourly for 5 h. Serum triglyceride rise of less than 100 mg/dl or less than 100% above basal values and the appearance of less than 7% of chylomicrons were considered pathological. Of our control group 95% had a normal rise of triglycerides; and 96% of our patients with steatorrhea had an abnormal rise. This test was more reliable than the two-point triglyceride test previously described for the diagnosis of fat malabsorption. The fatty meal test as described here is considered to be a useful test of absorptive function.

Celiac Disease↗
PubMed1983

Lipogenesis in the sand rat (Psammomys obesus).

Synthesis of fatty acids was measured in the liver and in epididymal adipose tissue of sand rats and albino rats. In chow-fed sand rats the rate of hepatic lipogenesis, as measured by the incorporation of 3H2O into fatty acids, was four- to sevenfold higher than in albino rats and in sand rats on a low-calorie saltbush diet. The contribution of [14C]glucose to lipogenesis in sand rat liver was lower than in albino rats. In fed sand rats lipogenesis incorporating 3H2O was stimulated by casein but not by glucose. In adipose tissue, lipogenesis measured 1 h after administration of 3H2O was much lower in sand rats than in albino rats. In vitro incorporation of [14C]glucose or acetate into adipose tissue fatty acids was negligible. In adipose tissue, uptake of very-low-density lipoproteins (VLDL) and lipoprotein lipase activity were sevenfold higher than in albino rats. Activities of NADP-malate dehydrogenase, acetyl CoA carboxylase, and fatty acid synthetase were considerably higher in the liver of chow-fed sand rats than in albino rats. It was concluded that obesity in sand rats originates from hepatic lipogenesis without a significant contribution of local fatty acid synthesis in adipose tissue.

Acetates↗
PubMed1983

Detection of varicella-zoster virus-specific IgA antibodies in varicella and zoster patients and in healthy adults of various ages by solid-phase radioimmunoassay.

The varicella-zoster virus(VZV)-specific serum immunoglobulin A(IgA) response was studied in varicella and zoster patients and in healthy adults of various ages by a sensitive solid-phase radioimmunoassay technique. Significant rises in VZV-specific IgA titer were found for both varicella and zoster patients, while VZV-specific IgA was also detected in greater than 90% of healthy adults but at lower titers. No significant decrease in VZV-specific IgA titer with increasing age was found. The role of humoral versus cell-mediated immunity in VZV reactivation is discussed.

Adult↗