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Biomedical subjects

K Levin

Publications and source records attributed to K Levin.

At least 55 records · Page 3Linked to original sources
PubMed1993

The diagnosis of acute pyelonephritis in the piglet using single photon emission computerized tomography dimercaptosuccinic acid scintigraphy: a pathological correlation.

Single photon emission computerized tomography (SPECT) scintigraphy has proved to be an extremely sensitive renal imaging modality in children with genitourinary pathology, including pyelonephritis, particularly when compared to 2-dimensional planar imaging. This study was undertaken to corroborate SPECT dimercaptosuccinic acid (DMSA) scintigraphic findings with specific histopathology in acute pyelonephritis. Unilateral vesicoureteral reflux was produced in 19 Yorkshire piglets 3 to 4 weeks old. The bladders of 12 animals were inoculated with Escherichia coli 2 weeks later, after baseline SPECT DMSA scans had been obtained. The animals were then re-imaged at 3 (4), 7 (4) or 14 (4) days after infection and sacrificed for histological evaluation. Seven purposefully uninfected piglets with unilateral reflux served as controls and were followed for up to 6 weeks before imaging and sacrifice. SPECT proved to be 97% sensitive and 93% specific in providing the diagnosis of acute pyelonephritis. The SPECT findings were manifest by a spectrum of abnormal findings (mottling, striations, inner cortical scalloping and focal cortical defects), which correlated precisely with the extent and severity of cortical involvement in the acute pyelonephritic process. We propose a new classification scheme for SPECT DMSA renal scintigraphic imaging, and believe that this modality is exquisitely sensitive in providing the diagnosis as well as in evaluating the extent of renal parenchymal involvement when acute pyelonephritis is induced in the animal model.

Acute Disease↗
PubMed1993

Using the radionuclide salivagram to detect pulmonary aspiration and esophageal dysmotility.

That the radionuclide "milk" scan is insensitive for aspiration has been demonstrated. Here the authors review their experience with the radionuclide salivagram in its ability to detect aspiration in children. Tc-99m sulfur colloid, 0.5 to 1.0 mCi in less than 1 mL, is instilled into the mouth and sequential supine posterior images of the thorax are obtained for an hour with delayed images until the oropharynx is cleared of radiotracer. Fourteen studies have been performed in 13 patients aged 1 month to 6.5 years. There are scintigraphic findings consistent with aspiration in 4 of 14 studies (28%); dysmotility (prolonged retention of activity in the esophagus) in 7 of 14 studies (50%); and normal studies in 3 of 13 patients (22%). Eight of 13 patients had milk scans; all were negative for aspiration. One patient studied twice had aspiration on the first examination, and dysmotility on the second study. It is concluded that the salivagram can detect aspiration of oral secretions, is superior to the milk scan in detecting aspiration, and can demonstrate esophageal dysmotility.

Child↗
PubMed1993

Psychological adjustment and distress among Soviet immigrant physicians: demographic and background variables.

The goal of the present study was to examine the psychological distress of Soviet immigrant physicians in Israel and to identify risk and resilience factors in the psychological adjustment to immigration. This is a first report on a study conducted among 385 (152 men and 233 women) Soviet immigrant physicians who participated in preparatory licensing courses. The design of the study is described in detail and initial results are presented. These include demographic characteristics of the sample, background variables connected with motivation for immigration and reported absorption difficulties encountered in Israel. Family problems were found to be significantly correlated with depression: the highest rate of reported depression was found among single parents. Subjects who were examined during the second year after immigration reported depression more often than subjects who were in Israel less than a year. The findings suggest that motivational and family factors may enhance or mitigate the psychological distress experienced by immigrants.

Acculturation↗
PubMed1990

High resolution single photon emission computerized tomography (SPECT) 99mtechnetium-dimercapto-succinic acid renal imaging: a state of the art technique.

The 99mtechnetium-dimercapto-succinic acid renal scan has become the gold standard for evaluating renal parenchymal pathology. The traditional pinhole technique provides 2-dimensional imaging. Recent application of high resolution single photon emission computerized tomography (SPECT) has provided the means to obtain even greater cortical detail. With 360-degree imaging and computer reconstruction, SPECT provides coronal, sagittal and transaxial imaging. We prospectively compared the SPECT and pinhole techniques in 33 patients (65 renal units) ranging in age from 2.5 months to 18 years. Both scans were obtained in all patients. All scans were reviewed by an independent interpreter. Using SPECT imaging, diagnostic information was enhanced in 46 of the 65 kidneys (71%). Of the 24 kidneys that appeared "normal" by pinhole imaging 15 (63%) had defects on SPECT imaging. High resolution SPECT imaging improves the ability to identify cortical defects and visualize asymmetry of cortical thickness compared to standard pinhole imaging.

Adolescent↗
PubMed1990

Lower serum magnesium level after exposure to cold in women with primary Raynaud's phenomenon.

Serum levels of magnesium (s-Mg), calcium (s-Ca), potassium (s-K) and sodium (s-Na) were measured in 80 women with primary Raynaud's phenomenon (RP) and in 24 age-matched female controls recruited from a population survey. The blood samples were taken after a 40-min standardized whole body cooling test. The mean s-Mg level in the group with RP was significantly lower than in the controls (0.81 +/- 0.05 vs. 0.86 +/- 0.07 mmol l-1, P less than 0.05). One year later, 66 members of the RP group and 22 members of the control group were investigated further, but without any exposure to cold. No differences in mean s-Mg values were found between the groups. The mean s-Mg level was significantly higher in the blood samples taken later without cold exposure than at the initial examinations after exposure to cold in the RP group, but not in the controls. The s-Mg level was lower after exposure to cold in 82% of the women with RP, compared to 45% of the controls (P less than 0.001). No differences in the other electrolytes were found. It is concluded that exposure to cold under standardized conditions may decrease the s-Mg level in women with primary RP. Further studies of the role of magnesium in patients with RP are required.

Adult↗
PubMed1988

Thyroid cancer: the case for total thyroidectomy.

Since there are no prospective studies concerning the treatment of thyroid cancer, there continues to be a considerable disagreement about the 'best' or most appropriate form of surgical treatment for patients with papillary or follicular thyroid cancer. Some surgeons recommend selective treatment depending upon the type of thyroid tumor and stage of the disease. Some advocate thyroid lobectomy and isthmusectomy, some near total thyroidectomy, and some total thyroidectomy for patients with papillary and follicular thyroid cancer. Total thyroidectomy for thyroid cancer would be the treatment of choice for virtually all patients with thyroid cancers if it could be done without complications. We therefore reviewed 160 consecutive patients who had total thyroidectomy for suspected or proven thyroid cancer to determine the complication rate of total thyroidectomy. One hundred and three patients had primary operations, 57 had reoperations with completion of total thyroidectomy and 124 had thyroid cancer. Serious complications (i.e. vocal cord paralysis or hypoparathyroidism) included two cases of transient bilateral recurrent nerve palsy, two patients with presumed transient unilateral vocal cord paralysis, three recurrent laryngeal nerves that were purposely sacrificed because of invasion of the nerve, and one case of permanent hypoparathyroidism. Two other patients developed postoperative wound infections. Only one of the permanent complications, the case of permanent hypoparathyroidism, could have been avoided by a lesser procedure. The experienced surgeon can perform a total thyroidectomy with minimal morbidity, and this procedure has certain theoretical and practical advantages. It should not be done, however, if it will result in a significant complication rate and, in selected patients, it may be preferable to leave a small amount of thyroid tissue to protect the blood supply to the parathyroid glands or recurrent laryngeal nerve.

Humans↗