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Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

At least 631 records · Page 35Linked to original sources
PubMed1978

Mobilization of ascites in cirrhotic dogs following furosemide or mannitol diuresis.

Mobilization of ascites was studied in 20 anesthetized dogs with experimental cirrhosis following a mannitol- or furosemide-induced diuresis. Observations were made at 2 h following the drug, at which time the diuresis was invariably completed, and repeated at 4 h following a 2-h recovery period, during which the ureters were clamped to prevent further urinary losses. In the furosemide group the mean urinary loss was 459 +/- 6 ml and was accompanied by a decline in central venous pressure and hemoconcentration. At 2 h plasma volume had declined by 14% from control values, but at 4 h plasma replenishment was 99% complete. At this time ascites volume had decreased by 467 ml, acting as the major source for vascular replenishment. In the mannitol group, the average urinary loss was 190 +/- 10 ml and was accompanied by maintenance of venous pressure, lack of hemoconcentration, and hyponatremia. At 2 h plasma volume had expanded from control values by 22%, but at 4 h vascular replenishment was only 78% complete. The average ascites volume had decreased by only 55% of the diuretic loss, and was mobilized by a complex sequence of events involving movement of intracellular water.

Animals↗
PubMed1978

Squamous cell carcinoma associated with sarcoidosis in the lung.

A male patient, operated for squamous cell carcinoma of the lung, in whom sarcoidosis was discovered in the resected lung specimen, is reported. The increased association of sarcoidosis along with malignant diseases is discussed, as well as the various mechanisms probably responsible for this association.

Aged↗
PubMed1978

Immune reactions associated with practolol therapy.

A review of adverse reactions following practolol therapy is presented. The appearance of antinuclear antibodies seems to herald the clinical manifestations. Antinuclear antibodies were found in 30% of patients treated with practolol for prolonged periods. It is suggested that patients who develop an immune reaction following practolol metabolize the drug differently than those who do not.

Antibodies, Antinuclear↗
PubMed1978

Membranous glomerulonephritis associated with anti-tubular and anti-alveolar basement membrane antibodies.

The renal biopsy of a 3-year old boy with complete Fanconi syndrome showed the association of a membranous glomerulonephritis with severe tubulointerstial changes. Immunofluorescence microscopy disclosed linear and granular deposits of Ig along tubular basement membranes. The presence of anti-tubular basement membrane antibodies in the patient's serum was demonstrated by indirect immunofluorescence and radioimmunoassay. The child also developed pulmonary involvement associated with episodes of acute anemia. Anti-alveolar basement membrane antibodies were detected by indirect immunofluorescence. The present case is the first reported example of auto-immune disease characterized by the presence of anti-tubular and alveolar basement membrane antibodies associated with an immune complex glomerulonephritis.

Autoantibodies↗
PubMed1978

The significance of pure diffuse mesangial proliferation in idiopathic nephrotic syndrome.

The prognostic significance of the finding of diffuse mesangial proliferation (DMP) in patients presenting with idiopathic nephrotic syndrome (INS) has not been well established. The clinical course, therapeutic response and final outcome of 38 patients in whom renal biopsy showed DMP are reported. They have been subdivided into 2 groups according to the absence (18 patients: group I) or presence (20 patients: group II) of superimposed lesions of focal and segmental sclerosis and/or hyalinosis (FSS/H). Clinical presentation was similar in both groups although patients in group I were less severely affected. Non of the patients of group II responded to corticosteroids, whereas in group I 2/16 responded and 2 infants remitted without treatment. At the latest assessment, 5/18 patients in group I and 10/20 in group II had progressed to terminal renal failure or had impaired renal function. Five patients in group I and 3 in group II were in clinical remission. Eight of 11 repeat biopsies performed in patients of group I showed the development of FSS/H. Thus patients with DMP seem prone to develop lesions of FSS/H. Their course if often worse than that of minimal change with FSS/H since 7 of the 10 patients who developed renal failure did so within 3 years of onset. The finding of DMP in a patient with idiopathic nephrotic syndrome is usually but not invariably an ominous feature.

Complement C3↗
PubMed1978

[Prolonged glomerulonephritis and cyanotic heart disease].

Three children with congenital heart disease presented with more or less severe renal dysfunction. Histologic studies showed signs of membranoproliferative pseudoglomerulonephritis without deposits on immunofluorescence. Surgical correction of the heart defect induced a spectacular functional and histologic improvement.

Adolescent↗
PubMed1978

Renal sodium retention and ascites formation in dogs with experimental cirrhosis but without portal hypertension or increased splanchnic vascular capacity.

Renal handling of sodium was studied in five dogs where an end-to-side portacaval fistula was constructed prior to the induction of cirrhosis with DMN. Such a model permits the effects of cirrhosis to be studied separately from the consequences of portal hypertension. Three control animals without cirrhosis maintained normal liver and kidney function and remained in sodium balance for as long as 8 weeks following surgery. In the five cirrhotic dogs, urinary sodium retention preceded ascites formation and was independent of hyperaldosteronism, hypoalbuminemia, hepatic ischemia, or decreased renal perfusion. Portal venous pressure remained normal in all cirrhotic dogs, and the splanchnic area remained free of venous collaterals. Plasma volume expansion also preceded ascites formation, and this variable increased by 8.4% (p less than 0.05) following 6 days of sodium retention. These temporal relationships between sodium retention, expanded plasma volume, and ascites formation are similar to those observed in ordinary cirrhotic dogs previously studied in this laboratory. Total plasma volume increased by 13.2% (p less than 0.05) when measured during the ascitic phase of cirrhosis. However, when the splanchnic and nonsplanchnic ("effective") components of plasma volume were measured by an exclusion technique, the ratio of these components to total plasma volume was not different from that observed in normal dogs. Thus no preferential consignment of retained salt and water had occurred. We conclude that urinary sodium retention in cirrhotic dogs occurs independently of portal hypertension or augmented splanchnic vascular capacity and is associated with expansion of the effective plasma volume, even though ascites is present.

Abdomen↗
PubMed1978

Treatment of ruptured interventricular septum with afterload reduction.

Two patients with a ruptured interventricular septum complicating acute myocardial infarction were treated with isosorbide dinitrate. The first patient recovered from cardiogenic shock after sublingual administration of 5 mg of isosorbide dinitrate every two hours and was successfully operated on. The second patient recovered from severe pulmonary edema during the acute stage of the infarction with sublingual isosorbide dinitrate. Moreover, she experienced a considerable symptomatic improvement when a 5 mg sublingual dose of isosorbide dinitrate every three hours was added to her long-term treatment. Analysis of hemodynamic data showed that the most striking change following administration of the drug was the substantial reduction of pulmonary wedge pressure. The striking symptomatic and hemodynamic improvement was achieved by the favorable effect of afterload reduction on left ventricular performance and not by reduction in left to right shunt.

Aged↗
PubMed1978

Gas-liquid chromatographic determination of bupivacaine and lidocaine in plasma.

A modified gas-liquid chromatographic method for determining plasma concentrations of bupivacaine and lidocaine is described, with cyclizine as an internal standard. The extraction procedure requires no solvent evaporation, thus overcoming the problem of drug volatility. Concentrations as low as 0.1 mg/liter can be determined. The plasma sample is made alkaline and extracted into n-hexane, re-extracted into a small volume of an aqueous acid phase, and finally extracted into 50 microliter of methylene chloride after alkalinization. The final extract is assayed by gas chromatography on a 5% OV-17 column. The extraction scheme of the present method eliminates interferences by endogenous plasma constituents.

Bupivacaine↗
PubMed1978

Temporal relationships between urinary salt retention and altered systemic hemodynamics in dogs with experimental cirrhosis.

In the present study, we undertook to examine the relationship between urinary sodium retention and systemic hemodynamics in dogs with experimental portal cirrhosis induced by the sporadic feeding of dimethylnitrosamine. Sodium handling was studied by blanace techniques; plasma volume was measured serially with Evan's blue; and CO, blood pressure, CVP, and PVR were monitored through indwelling catheters. Six dogs were studied while standing quietly in a Pavlov sling, in a serial fashion starting 4 weeks after drug administration and continuing for some 3 months thereafter, until all dogs developed cirrhosis and ascites. Urinary sodium retention commenced generally between the ninth to twelfth week following the initation of treatment, but renal perfusion remained normal. Plasma volume expansion was noted within 1 week following the onset of sodium retention. Ascites was generally detected about 2 weeks following the initiation of sodium retention. No alteration in CO or PVR could be detected until ascites was present in significant amount. At that time, CO rose and PVR fell by about 20%. ABP tended to fall during the period of observation, but this was not significant. The initiation of sodium retention in this canine model does not depend on antecedent changes in CO or PVR.

Alkaline Phosphatase↗
PubMed1978

The pathophysiology of sodium balance.

Whether deficit or surfeit, sodium imbalance responds best to management based on an understanding of the underlying mechanisms that have gone awry. A review of the kidney's role in normal sodium homeostasis lays the groundwork for rational therapeutic approaches to correcting the pathophysiology of the major depletion and retention states. Clinical implications and management principles of various disease entities are discussed.

Aldosterone↗