A modification of the modified barium swallow.
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Adult↗
Biomedical subjects
R Levine
Publications and source records attributed to R Levine.
Prenatal sonographic assessment of the fetal thorax: normal values.
Fetal thoracic circumference and thoracic length measurements were obtained by ultrasonographic examination on 576 women between 16 and 40 weeks gestation. Nomograms for thoracic circumference and thoracic length with respect to gestational age were developed. Growth of both thoracic parameters was observed to be linear throughout gestation. In normal pregnancy the ratios of thoracic circumference to abdominal circumference and thoracic length to humerus length remained virtually constant at 0.89 and 0.93, respectively.
Adolescent↗
Cardiopulmonary bypass after cardiac arrest and prolonged closed-chest CPR in dogs.
We studied a clinically realistic field-to-hospital scenario in dogs with four-minute ventricular fibrillation (VF) cardiac arrest followed by 30-minute standard external CPR basic life support (BLS). At the end of this 34-minute insult, cardiopulmonary bypass (CPB) was used for early defibrillation and assisted circulation for one hour (n = 10). Recovery was compared with that of control dogs (n = 10) in which standard CPR with advanced life support (ALS) for another 30 minutes was used for restoration of spontaneous circulation (ROSC). Both groups had hemodilution and heparinization; controlled blood pressure, blood gases, ventilation, and other parameters for 20 hours; and intensive care to 72 hours. During CPR-BLS of 30 minutes in both groups signs of cerebral viability returned. CPB achieved ROSC more successfully (ten of ten vs five of ten CPR-ALS controls) (P less than .02); and more rapidly, with less defibrillation energy (first countershock in eight of ten) and with less epinephrine (P less than .01). CPB improved 72-hour survival (seven of ten vs three of ten controls) (P less than .05). Between two and 24 hours, of those with ROSC, cardiac complications killed three of ten CPB dogs (after weaning), and two of five CPR-ALS dogs (NS). All seven CPB survivors to 72 hours were neurologically normal; of the three CPR-ALS survivors, one remained with severe neurologic deficit and two were neurologically normal (seven of ten CPB vs two of ten controls, P = .025). Starting CPR-BLS within four minutes of arrest can maintain cerebral viability.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Ophthalmia neonatorum: study of a decade of experience at the Mount Sinai Hospital.
We reviewed the charts of neonates who received a diagnosis of conjunctivitis or ophthalmia neonatorum during a 10-year period at the Mount Sinai Hospital, New York City. Ninety-five cases were discovered, four of these were born elsewhere and were not subject to our protocol, which at present consists of intramuscular penicillin and topical tetracycline ointment (1%). The 91 cases represent an incidence of 3.1 cases per 1000 live births (9.1/year), an incidence approximately equal to that reported in other published studies. The clinical characteristics examined were: age, sex, race, birth weight, gestational age, Apgar scores, presence or absence of fever or other systemic illnesses, complications, type of delivery, time of year, incubation period, presence and type of discharge, uni- or bilaterality, Gram stain, Giemsa stain, culture results, antibiotic disc sensitivities, cervical culture, antibiotic therapy, sequelae, and type of prophylaxis received. Seven aetiological diagnostic categories were established: gonococcal (3%), chlamydial (3%), staphylococcal (30%), other pathogens (25%), chemical conjunctivitis (7%), culture negative/normal flora (22%), and unobtainable (10%). This distribution differs from others published. In contrast with other studies, moreover, we found few gonococcal and no chlamydial cases in neonates subject to the Mount Sinai Hospital treatment protocol. Correlation of clinical characteristics and aetiological categories showed no statistically significant trend. So far there have been no cases of ophthalmia neonatorum, treated as on our protocol, caused by penicillin resistant gonococci or chlamydiae.
Bacterial Infections↗
Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle.
The surgical results in 69 patients with unilateral tumors of the cerebellopontine angle or internal auditory canal in whom total tumor removal was accomplished, and in whom an attempt was made to preserve hearing, are presented. The success rate of preservation of hearing and facial nerve function was correlated with the size of the tumor. Useful hearing, as defined by speech reception threshold no poorer than 70 dB and a discrimination score of at least 15%, was preserved in 73% of cases in which the tumor extension to the posterior fossa was no greater than 0.5 cm. In contrast, useful hearing was preserved in 22% of cases in which posterior fossa extension was greater than 2.5 cm. No significant correlation was found between preoperative evoked responses and success in preservation of hearing. The techniques and value of intraoperative monitoring of electrocochleogram (ECoG) and brain stem evoked responses are discussed. A theory of pathogenesis of intraoperative hearing loss, based on correlation of changes in evoked responses and simultaneous surgical events, is presented.
Adult↗
Case-control study of hepatocellular carcinoma, occupation, and chemical exposures.
The relation of hepatocellular carcinoma (HCC) to occupation and chemical exposures was evaluated in a case-control study. The study included 80 cases and 146 matched hospital controls on whom a work history was obtained. No persuasively positive association between HCC and any particular occupation, industry, or chemical exposure was found. However, the relative rate (RR) of HCC for persons employed in highway construction compared with those never so employed is 5.0 with 95% confidence limits (CL), 1.0 to 26. The RR for farming occupations, 1.4 (95% CL, 0.7 to 2.9), is also slightly elevated. The RR for persons exposed to pesticides compared with those not exposed is 2.4 (95% CL, 0.9 to 6.5). Asphalt exposures are associated with a RR of 3.2 (95% CL, 0.9, 11). These findings are compared to the results of other epidemiologic studies.
Adult↗
Cigarette smoking and invasive cervical cancer.
A case-control study of 480 patients with invasive cervical cancer and 797 population controls, conducted in five geographic areas in the United States, included an evaluation of the relationship of several cigarette smoking variables to cervical cancer risk. Although smoking was correlated with both age at first intercourse and number of sexual partners, a significant smoking-related risk persisted for squamous cell carcinoma after adjustment for these factors (relative risk, 1.5). The risk of squamous cell cancers increased significantly with intensity and duration of smoking. Twofold excess risks were seen for those smoking 40 or more cigarettes per day and those smoking for 40 or more years. In addition, users of nonfilter cigarettes were at particularly high risk. Increased risks, however, were observed only among recent and continuous smokers. In contrast to squamous cell cancer, no relationship was observed between smoking and risk of adenocarcinoma or adenosquamous carcinoma (n = 63). These results suggest a causal relationship between cigarette smoking and invasive squamous cell cervical cancer, perhaps through a late-stage or promotional event, although the mechanisms of action require further elucidation.
Adenocarcinoma↗
Measuring difficult temperament in infancy.
Thirty-four couples rated their 6-month-old first-born infants' temperaments with Bates' Infant Characteristics Questionnaire (ICQ) and Carey's Infant Temperament Questionnaire (ITQ). Mothers and infants were videotaped in their homes during feedings on two consecutive days to assess mother and infant behavior. Results indicated that parents had moderate agreement about their own infant's temperament on the ICQ. There was little convergence between the ICQ and the ITQ measures of infant difficulty. ICQ parent-rated unpredictable infants were rated by observers as less responsive during the feedings. These results are discussed in the context of the meaning and measurement of infant temperament.
Adult↗
Pulmonary function tests, serum angiotensin-converting enzyme levels, and clinical findings as prognostic indicators in sarcoidosis.
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Adult↗
Monosaccharides in health and disease.
In healthy persons, glucose homeostasis maintains blood glucose levels between 70 and 130 mg/dl despite perturbations by meals, fasting, and exercise. Long-term follow-up of diabetic patients has suggested that "good control" of blood sugar levels minimizes the long-term complications of diabetes, such as retinopathy, nephropathy, and atherosclerosis. It now seems likely the products of insulin-independent metabolic pathways in epithelial and endothelial cells leading to polyol formation and protein glycosylation may be factors in the genesis of retinopathy, neuropathy, nephropathy, and premature atherosclerosis of diabetic patients. Dietary complex carbohydrates of various type, including those rich in dietary fiber, which are the cell walls of fruits, vegetables, and cereals, may slow the rate of absorption of glucose from those diets and contribute to a lowering of the postprandial glucose peak. Glycemic responses to various foods compared to glucose have been studied and show a large variation, which is dependent upon gastric emptying, overall effects on rate of hydrolysis and absorption of glucose from food mixtures. Dietary sucrose seems to cause a degree of insulin resistance. The active part of the disaccharide is fructose, which does not elicit an acute insulin response, but appears indirectly to increase insulin levels in both animals and man. Sucrose in animals appears to promote obesity more than glucose because of its lack of stimulation of thermogenesis. Xylitol has been used as a sweetener and as a sugar substitute in total parenteral nutrition. It is a paradox that the most physiological of sugars (glucose) can be a menace at high concentrations. The use of nonphysiological sugars or their derivatives in diabetics and patients with special needs, such as TPN, requires much more investigation to develop a sound rationale in nutrition management.
Animals↗
A blinded clinical comparison of MR imaging and CT in neuroradiology.
The sensitivity and specificity of magnetic resonance (MR) imaging and computed tomography (CT) were compared in blinded readings of images of a consecutive series of patients with subsequently proved diagnoses. Overall, MR imaging was less sensitive than CT because of its lower sensitivity in detecting benign tumors. With a similar experimental protocol, the effects of technical refinements or contrast media on the sensitivity of MR imaging can be determined.
Aged↗
Comparative effects of aminoglycosides on renal cortical and urinary phospholipids in the rat.
We examined the relationship between the nephrotoxicity potential of four aminoglycosides and the capacity of the drugs to induce a renal cortical phospholipidosis. Sprague-Dawley rats were injected subcutaneously with neomycin, gentamicin, tobramycin, or netilmicin, 100 mg/kg per day, for 1 to 4 days, and phospholipid accumulation in the renal cortex and phospholipid excretion in the urine were measured. The rank order of the drug-induced renal cortical phospholipidosis was netilmicin greater than tobramycin greater than gentamicin greater than neomycin. This order is the reverse of the previously established nephrotoxicity potentials of these drugs. Conversely, the rank order according to peak urinary excretion of phospholipids was gentamicin greater than neomycin greater than tobramycin greater than netilmicin. The rank order of the total urinary phospholipid excretion during the 4 days of the study was neomycin greater than or equal to gentamicin greater than tobramycin greater than or equal to netilmicin. Urinary phospholipid excretion may prove to be a sensitive indicator of aminoglycoside nephrotoxicity.
Aminoglycosides↗
A case-control study of hepatocellular carcinoma and the hepatitis B virus, cigarette smoking, and alcohol consumption.
A case-control study was undertaken to evaluate the roles of the hepatitis B virus (HBV), cigarette smoking, and alcohol use in the etiology of hepatocellular carcinoma (HCC). A major purpose of the study was to evaluate the effect of cigarette smoking on HCC among hepatitis B surface antigen (HBsAg)-negative persons, since it had been suggested that the relative effect of cigarette smoking on HCC was higher among HBsAg-negative persons than among HBsAg-positive persons. Eighty-six cases and 161 hospital controls were included in the study. This study confirmed the strong relationship between the HBV and HCC. Twelve of 67 cases and none of 63 controls were chronically infected with HBV as evidenced by serum HBsAg. The study also found a moderately strong relationship between alcohol use and HCC. The results of the present study do not support the hypothesis that cigarette smoking is a risk factor for HCC. Among all subjects, the relative rate of HCC for cigarette smokers compared with nonsmokers after adjustment for alcohol consumption was 1.0 with 95% confidence limits, 0.5 to 1.8. Among HBsAg-negative subjects, the relative rate was 1.1 with 95% confidence limits, 0.5 to 2.4. There was also no consistent dose-response relationship between quantity smoked and HCC in this study.
Adult↗
Historical view of the classifications of diabetes.
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Diabetes Mellitus↗
Regulation of dihydrofolate reductase in human breast cancer cells and in mutant hamster cells transfected with a human dihydrofolate reductase minigene.
The regulation of dihydrofolate reductase (DHFR) gene expression was studied in gene-amplified, estrogen-responsive human breast cancer cells (MTX MCF-7). Previous studies have shown that estrogen increases, whereas tamoxifen decreases the rate of DHFR enzyme synthesis resulting in corresponding changes in the level of this enzyme. DHFR levels also increase following incubation with methotrexate (MTX), an effect which is dependent on both the concentration of extracellular drug and the duration of exposure and which occurs at concentrations that are insufficient to inhibit cell growth. MTX, like estrogen and tamoxifen, has no apparent effect on the rate of DHFR enzyme degradation. The increase in DHFR in response to MTX is additive with that of estrogen and is not prevented by tamoxifen. Whereas hormone-mediated changes in DHFR are associated with changes in the level of DHFR mRNA, there is no apparent change in DHFR mRNA concentrations in cells exposed to MTX. The regulation of DHFR enzyme levels was also studied in gene-deleted Chinese hamster ovary cells which were transfected with a functional human DHFR minigene constructed from human DHFR genomic and cDNA sequences. Incubation with MTX increases DHFR levels in Chinese hamster ovary cells transfected with the human DHFR minigene but has no effect in cells transfected with a DHFR minigene which uses a viral promotor and polyadenylation signal. Thus, the human DHFR minigene contains sequences other than the protein coding region which effect the regulation of this gene by MTX.
Animals↗
The correlation of performance variables in preadolescent tennis players.
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Child↗
Obstetric brachial plexus palsy.
This article supplies data related to 11 operated children with obstetric brachial plexus palsy. Discussion of the obstetric background, pathology, pre- and postsurgical testing and of primary and secondary surgical reconstruction also is given. The need for rehabilitation regimen is stressed.
Brachial Plexus↗