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Biomedical subjects

R A Levy

Publications and source records attributed to R A Levy.

100 records · Page 6Linked to original sources

Contractile cells and fibrillin-1 distribution is disturbed in terminal villi of placentae from patients with preeclampsia and systemic lupus erythematosus.

Placentae from patients with preeclampsia (PE) and systemic lupus erythematosus (SLE) present many alterations that may impair materno-fetal exchange. We investigated the distribution of contractile cells and fibrillin-1 in terminal villi of term placentae from patients with PE or SLE and compared to control placentae. Stroma in terminal villi exhibited intense labelling for fibrillin-1. The fibrillin-1 villi surface fraction was greater in PE and SLE placentae than in controls (13+/-0.4%, 14+/-0.5%, 10+/-0.4%; p=0.0001). Immunohistochemistry for alpha-smooth muscle (SM) actin showed few contractile cells in control terminal villi stroma, localized around fetal capillaries and showed rare processes in vasculo-syncytial membrane. PE and SLE placentae exhibited an increase in the number of capillaries presenting alpha-SM actin adventitial positive cells. The presence of alpha-SM actin processes interposed in the vasculo-syncytial membrane was greater in SLE villi than in PE and controls. Ultrastructural observations confirmed in SLE and PE terminal villi the presence of these processes in vasculo-syncytial membrane and also showed a thickened trophoblastic basement membrane. The present study demonstrates that an important myofibroelastic system is present in term terminal villi, and that this system is actively remodelled in PE and SLE placentae.

Actins↗

Evaluation of the cholesterol influence in type II collagen-induced arthritis in DBA/1J mice: an autoradiographic study.

In order to verify the cholesterol influence in RA severity in DBA/1J mice, we quantified the cholesterol present in the knee joints of normal (N) and with collagen II induced arthritis (CIA). Forty male DBA/1J mice, were divided in normal (n=20) and CIA group (n=20). Mice in CIA group were injected with 100 microg of collagen II emulsified in Freund's complete adjuvant. Sixteen DBA/1J (8 N and 8 CIA) received an injection of 2.96 x 10(6) Bq of (3)H-cholesterol and were anesthetized and sacrificed. Semi-fine sections were covered with LM-1 emulsion, exposed for six weeks and developed. Collagen induced edema, erythema and dysfunction of knee joints in CIA group. Radioactive cholesterol was located more on the synovial membrane, where we found the greatest density of silver grains, significantly (P<0.0001) higher in group CIA vs. controls (61-/+2.3 X 18-/+0.7). We conclude that the cholesterol deposits on the synovial membrane is related to CIA severity.

Animals↗

Designing an integrated drug benefit for the elderly.

The elderly are hit hard by high out-of-pocket expenses for medicines, but a stand-alone pharmaceutical benefit could cost the country billions and still not improve older Americans' quality of care. Such a benefit should be coordinated with patients' overall medical benefits. A systems-based pharmaceutical benefit is financially feasible through a combination of premiums and cost sharing, market-driven price reductions, and cost savings achieved through integrated managed care programs and improved outcomes.

Aged↗

Facial trauma and 3-D reconstructive imaging: insufficiencies and correctives.

PURPOSE: To address the clinical relevance of and optimal technique for 3-D CT imaging of facial trauma. METHODS: Bioengineered cadaveric models were developed to enhance the concepts of LeFort. Diverse CT imaging techniques were applied to obtain optimal data sets for processing on various 3-D workstations. The fidelity of the 3-D reconstructions was determined by comparison with photographs of the cadaveric models. Optimized 3-D images were then used in conjunction with the initial 2-D data sets to assess whether additional accuracy was contributed by the 3-D images in the evaluation of modeled facial fractures. RESULTS: Image definition was heavily dependent upon the specific 3-D reconstruction algorithm and the processor utilized. Orbital fractures were best imaged when 1- to 1.5-mm coronal sections were processed on an advanced 3-D workstation. The 3-D CT images resulted in additional accuracy in the 2-D CT evaluation of facial fractures in 29% of trials. CONCLUSIONS: We believe that bioengineered models of facial trauma--matched with appropriate CT scanning parameters--facilitate graphically reliable 3-D reconstructive imaging. 3-D reconstructions can improve accuracy in the 2-D CT evaluation of facial trauma.

Algorithms↗

Assessing whether the plane of section on CT affects accuracy in demonstrating facial fractures in 3-D reconstruction when using a dried skull.

CT slice thickness and threshold value are well-known determinants of accuracy in three-dimensional (3-D) CT image reconstruction. The purpose of this study was to assess whether the plane selected for primary CT data acquisition, axial vs coronal, might also contribute to the accuracy and ease of identification of abnormalities in 3-D image reconstruction independent of the 3-D processing system used. Two sets of 10 observers evaluated fractures created in a dried skull and corresponding 3-D image data. A General Electric 9800 scanner was used to acquire the two-dimensional CT data. The 3D98 Quick software and ISG Camra Allegra workstation were used for two sets of 3-D reconstructions. The expected result was that fractures oriented perpendicularly to the initial plane of CT section would be better reconstructed on 3-D than when the initial plane of CT imaging paralleled the fracture. Our results indicate that Le Fort fractures (types I and III) are better displayed with coronal CT data and that zygomatic tripod fractures may be better displayed in 3-D with axial CT image data.

Cadaver↗

Alternative complement pathway in hypocomplementemic/normal C1s-C1 inhibitor complex patients with SLE.

To test whether alternative complement pathway activation explains normal C1s-C1 inhibitor complex in hypocomplementemic (low CH50cl) patients with systemic lupus erythematosus, we examined alternative pathway hemolytic complement (CH50alt) factor B, and Ba fragment in hypocomplementemic sera with normal and with elevated C1s-C1 inhibitor complex. Sera with and without high C1s-C1 inhibitor complex were similar in CH50cl, C3, and C4. There was little evidence for important alternative complement pathway activation in either group, but patients with classical pathway activation (elevated C1s-C1 inhibitor complex) had slightly lower CH50alt and slightly higher factor B and Ba compared to patients with normal C1s-C1 inhibitor complex. Pregnant patients did not differ from non-pregnant patients. Alternative complement pathway activation does not account for hypocomplementemia in this group of patients.

Complement Activation↗

Pregnancy in systemic lupus erythematosus.

Experience with more than 150 pregnancies of women with systemic lupus erythematosus demonstrates that: many conventional measures of lupus activity, including complement, platelet count and urinary protein, are invalid during pregnancy; pregnancy does not cause lupus exacerbation; anti-phospholipid antibody is common and is closely associated with fetal loss, but is not the sole determinant factor of fetal loss; specific characteristics of anti-phospholipid antibody do not identify which antibody-positive women will have poor fetal outcome; prednisone therapy does not improve fetal prognosis; and neonatal lupus, diagnosed by rash and thrombocytopenia, is common but congenital heart block is rare.

Autoantibodies↗