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Biomedical subjects

O Levy

Publications and source records attributed to O Levy.

71 records · Page 4Linked to original sources
PubMed1993

The operative results of tibial plateau fractures in older patients: a long-term follow-up and review.

A retrospective review of 19 elderly patients (65 years of age or older) with operatively managed tibial plateau fractures demonstrated that most patients had acceptable functional results, based on Rasmussen's criteria. The follow-up period was of 8-14 years (average 11 years). Seventy-nine percent of the patients (15/19) had excellent or good results. They regained their preinjury walking capacity and suffered only occasional pain. Four patients had fair results with limitation of walking capacity, pain on certain positions, and/or pain after activity. One of these 4 patients had significant medial instability. In this age group, internal fixation of tibial plateau fractures and early mobilization appeared to be beneficial in achieving good functional results.

Aged↗
PubMed1992

Developmental changes of EAA metabotropic receptor activity in rat cerebellum.

The potency but not the efficacy of t-ACPD stimulation of phosphatydil inositide hydrolysis changes in developing rat cerebellum. This suggests that the excitatory amino-acid-stimulated metabotropic receptors and/or their coupling are ontogenically regulated. In this, cerebellum differs from other CNS regions where only efficacy changes were described. Differently from hippocampus, the t-ACPD effect, at all ages, is independent of the activation of the NMDA receptor.

Aging↗
PubMed1992

[Inhibition of elastase activity in human gingival extracts by elastin peptides].

Effects of elastin peptides on elastase activity of gingival biopsy specimen extracts were studied in vitro and in vivo. All the extracts from biopsy specimens from 15 patients with a variety of periodontal diseases demonstrated fairly marked elastase activity. In vitro, addition of elastin peptides produced a mean inhibition of 54% +/- 14% with a concentration of 0.25 mg/ml and a mean inhibition of 90% +/- 6% with 2.5 mg/ml. In vivo treatment of gums with a paste containing 1% elastin peptides reduced elastase activity by 47% in 7 of 8 patients. These data suggest that elastin peptides are effective inhibitors of periodontal elastase activity and may be useful in preparations used for the preventive or curative treatment of periodontal diseases with tissue lysis.

Adolescent↗
PubMed1991

Inhibition of the Na+/I- symporter by harmaline and 3-amino-1-methyl-5H-pyrido(4,3-b)indole acetate in thyroid cells and membrane vesicles.

Novel inhibitors of the Na+/I- symporter were identified using rat-thyroid-derived FRTL-5 cells and sealed vesicles from calf thyroid as model systems. Na(+)-dependent 125I- uptake was inhibited by the hallucinogenic drug harmaline and by a chemically related convulsive agent, 3-amino-1-methyl- 5H-pyrido(4,3-b)indole acetate (TRP-P-2). TRP-P-2 (Ki = 0.25 mM) was tenfold more effective as an inhibitor than harmaline (Ki = 4.0 mM). Inhibition by TRP-P-2 was competitive with respect to Na+ and was fully reversible. Although TRP-P-2 is a relatively low-affinity inhibitor, its affinity for the Na+ site of the Na+/I- symporter is over 100 times higher than that of Na+ (Km = 50 mM). 45Ca(2+)-efflux rates in calf thyroid membrane vesicles were not affected by TRP-P-2, indicating that membrane integrity is not disrupted by the drug. These findings show that TRP-P-2 may be a potentially useful tool for the identification and characterization of the Na+/I- symporter.

Animals↗
PubMed1990

Isolation of two isoforms of a novel 15-kDa protein from rabbit polymorphonuclear leukocytes that modulate the antibacterial actions of other leukocyte proteins.

We have recently reported the use of the highly selective and reversible binding of the potent bactericidal/permeability-increasing protein (BPI) to target Gram-negative bacteria (Escherichia coli) for its isolation from crude extracts of human polymorphonuclear leukocytes (PMN). We now report the use of the same procedure for the purification from rabbit PMN of BPI and also of a novel 15-kDa species that consists of two nearly identical isoforms. These 15-kDa proteins have no demonstrable antibacterial activities by themselves. However, one isoform (p15A) potentiates strongly and the other (p15B) weakly the early antibacterial effects of both rabbit and human BPI. Both isoforms inhibit the late lethal action of BPI. Whereas the potentiating effect is specific for BPI the inhibitory effect is seen also with another antibacterial protein of PMN granules, azurocidin. Thus, we have identified in rabbit PMN a previously unrecognized 15-kDa protein species that may modulate during phagocytosis the antimicrobial effects of BPI (and other granule proteins).

Amino Acid Sequence↗
PubMedDate not supplied

Trends of childhood infective endocarditis in Israel with emphasis on children under 2 years of Age.

This study retrospectively analyzed the characteristics of infective endocarditis (IE) in children in light of recent advances in pediatric cardiology. We evaluated 25 consecutive patients with IE from 1980 to 1991 at a tertiary Children's Medical Center in Israel. The incidence of IE increased significantly over the second half of the study period, owing mainly to an increase in the number of patients less than 2 years old. Concomitantly, the causative microorganisms changed considerably, with a decrease in viridans streptococci, an increase in staphylococci and other uncommon causes of IE, and increased antibiotic resistance. Children under the age of 2 years, previously considered uncommon IE patients, accounted for 47% of the IE cases during the second half of the study period. The infection often (78%) appeared in children with complex congenital heart diseases, commonly after early palliative or definitive cardiac surgery. Infants who underwent systemic-to-pulmonary shunting, especially with implantation of foreign materials, were at highest risks. IE was more often hospital-acquired (56% versus 6%) and acute (56% versus 44%) in the younger children than in the older ones and often lacked the typical clinical presentation of the disease. In addition, uncommon causative organisms were noted more frequently (67% versus 13%; p = 0.009) in the younger group. The study shows a significant increase in IE in infants and young children with distinctive underlying conditions, clinical presentation, and microbiologic findings, all of which should be considered currently for the diagnosis and treatment of pediatric IE.

Adolescent↗
PubMedDate not supplied

Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity.

Frozen shoulder is still an enigma of shoulder surgery. It is reported that at 2 years from onset, most patients will have recovered whether treated or not. However, the duration of morbidity has major implications for patient function and satisfaction. In view of this fact, we have focused on the early effect of manipulation under anesthesia on shoulder function. We prospectively assessed 39 shoulders in 37 patients who were given the diagnosis of primary frozen shoulder between June 1997 and June 1998 and were treated with manipulation under anesthesia of the affected shoulder. The median preoperative Constant score rose from 24 of 100 to 63 of 100 at 3 to 6 weeks and to 69 of 100 at 3 months. Improvement was maintained at a mean follow-up of 11 months after surgery (range 6 to 18 months). Overall, 94% of patients were satisfied with the procedure. At 3 months 59% (23 shoulders) were rated as having no or mild disability only, 28.2% (11 shoulders) as having a moderate degree of disability, and 12.8% (5 shoulders) as having a severe degree of disability. Of the 5 cases scoring less than 50 of 100 (mean 40) at 3-month follow-up, 1 had unmasked symptoms of a subacromial impingement syndrome that has required further treatment. There was no relationship between the initial Constant score or the initial range of movement after manipulation and the eventual result. We recommend the use of manipulation under anesthetic in primary frozen shoulder to restore early range of movement and to improve early function in this often protracted and frustrating condition.

Adult↗
PubMedDate not supplied

An operative technique for recurrent shoulder dislocations in older patients.

Recurrent anterior shoulder dislocation in the elderly is not as exceptional as it was once thought to be. That anterior shoulder dislocation in older patients is caused by a rotator cuff tear through the posterior mechanism is well accepted. However, in the subset of patients who have multiple recurrent or intractable dislocations develop, there may be combined pathologic conditions at work: large or massive rotator cuff tears together with anterior capsulolabral injuries such as a Bankart lesion or fracture of the glenoid rim. These patients have multiple recurrences because of disruption of both the anterior and the posterior stability mechanisms. We suggest a procedure that provides anterior stabilization with the capsular shift technique and that is supplemented by Bankart repair as necessary. The capsule transfer is performed superiorly and posteriorly to close the defect in the cuff. In this way a capsulodesis effect can be achieved that displaces the humeral head downward and produces active centering of the head in the course of abduction. Use of only the anterior capsule for the shift, and not the subscapularis tendon, does not compromise subscapularis function. Between 1990 and 1996, we used this technique to treat 16 patients older than 55 years of age with multiple recurrent anterior shoulder dislocation and massive rotator cuff tear. We report the results for the first 10 patients with a minimum follow-up of 2 years (range 2 to 7 years) and an average follow-up of 52 months. There were 7 excellent results, 2 good results, and 1 fair result according to the Rowe criteria. None of the patients had a recurrence of the dislocation. All the patients regained full or functional range of motion with stable shoulders, and most of them could perform activities of daily living without limitation. The average Constant score was 83%. This procedure appears to be successful in treating older patients with recurrent shoulder dislocation.

Aged↗
PubMedDate not supplied

A wide and versatile combined surgical approach to the shoulder.

Complex injuries and conditions of the shoulder may necessitate wide exposure during the operative procedure. The commonly used approach today is a wide anterior deltopectoral approach with extensive detachment of the deltoid muscle, leading to muscle damage, which may result in difficult postoperative rehabilitation and deteriorated function. We describe a simple combined approach that consists of a deltopectoral approach in conjunction with a subcutaneously performed lateral deltoid split with a single skin incision. We believe this surgical technique provides another useful tool to achieve wide and versatile exposure of the shoulder without jeopardizing the function of either the deltoid muscle or axillary nerve.

Fractures, Comminuted↗
PubMedDate not supplied

Reossification and fusion across the acromioclavicular joint after arthroscopic acromioplasty and distal clavicle resection.

Arthroscopic acromioplasty and distal clavicle resection has now become an accepted method of treatment for acromioclavicular (AC) joint arthritis. Complications following arthroscopic acromioplasty are relatively uncommon and include instrument breakage, hematoma, traction neuropathy, infection, acromial fracture, reflex sympathetic dystrophy, and recurrence of symptoms. Although heterotopic ossification within the soft tissues has also been reported, complete reossification of the resected clavicle has not. We report a case of reossification of the clavicle and fusion across the AC joint following arthroscopic acromioplasty and distal clavicle resection.

Acromioclavicular Joint↗
PubMedDate not supplied

Regeneration of the coracoacromial ligament after acromioplasty and arthroscopic subacromial decompression.

The clinical observation of apparent and complete regeneration of the coracoacromial ligament after known partial excision of the ligament and acromioplasty has been investigated. Ten patients who had open revision surgery following failure of symptomatic relief after arthroscopic subacromial decompression were studied. All of them had acromioplasty with documented partial resection of the coracoacromial ligament at the first operation. There were 5 men and 5 women with an average age of 54.5 years (range, 44-65 years). In all patients surgery revealed a ligamentous structure resembling the coracoacromial ligament that was attached to the anterior acromion. Histology in all patients revealed appearances indistinguishable from normal ligament, which was in continuity with the reformed periosteum of the acromion.

Acromion↗
PubMedDate not supplied

Distal transfer of the greater trochanter revisited: long-term follow-up of nine hips.

Seven female patients (nine hip joints) with avascular necrosis and functional coxa vara secondary to developmental dysplasia of the hip joint (DDH) were treated by distal transfer of the greater trochanter (DTT). A 5-year follow-up showed good results in 89% of the hip joints. We reviewed the patients again 12 years later using the Mayo Clinic hip score. Improvement of gait was maintained in the majority of the patients (71%), but the hip score was low in 67% of the patients because of the development of osteoarthritis. Two patients underwent a total hip arthroplasty, and a third is awaiting this operation. Distal transfer of the trochanter is beneficial in improvement of gait but may enhance the development of osteoarthritis.

Adolescent↗
PubMedDate not supplied

Headache in systemic lupus erythematosus and its relation to other disease manifestations.

OBJECTIVE: To investigate headache in systemic lupus erythematosus (SLE) and its relation to other disease manifestations. METHODS: Clinical and laboratory variables of 148 SLE patients were prospectively recorded in a computed data base. RESULTS: The patients were divided into two groups. Group A consisted of patients who reported moderate to severe headache on at least two consecutive encounters, and Group B consisted of the remainder of the patients, with mild or no headache. The two groups did not significantly differ in age or in sex distribution. Patients in Group A suffered from more severe joint pain and inflammation, muscle pain, photosensitivity, mouth ulcers, fever and fatigue. They also had higher disease activity scores, and a higher number showed central nervous involvement. There were no significant differences between the two groups in any of the laboratory variables examined, nor in the proportion of patients with renal involvement. The prevalence of non-thromboembolic central nervous system (CNS) manifestations was 7.2%. The sensitivity of headache for the diagnosis of non-thromboembolic CNS manifestations was 90.9%, and the specificity was 29.2%. On logistic regression analysis, the total arthritis score, muscle pain, fatigue and photosensitivity were each found to be significantly independently related to headache. CONCLUSIONS: Headache is common in SLE, and in the majority of patients is related to musculoskeletal and constitutional disease manifestations.

Adolescent↗