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Biomedical subjects

S Porat

Publications and source records attributed to S Porat.

At least 37 records · Page 2Linked to original sources
PubMed1997

External fixation or flexible intramedullary nailing for femoral shaft fractures in children. A prospective, randomised study.

We report the outcome of 19 children aged 5.2 to 13.2 years with 20 fractures of the femoral shaft requiring surgery, who were randomly assigned to have external fixation (EF) or flexible intramedullary nailing (FIN) (10 fractures each). The duration of the operation averaged 56 minutes for the EF group with 1.4 minutes of fluoroscopy, compared with 74 minutes and 2.6 minutes, respectively, for the FIN group. The early postoperative course was similar, but the FIN [corrected] group showed much more callus formation. The time to full weight-bearing, full range of movement and return to school were all shorter in the FIN group. The FIN complications included one transitory foot drop and two cases of bursitis at an insertion site. In the EF group there was one refracture, one rotatory malunion requiring remanipulation and two pin-track infections. At an average follow-up of 14 months two patients in the EF group had mild pain, four had quadriceps wasting, one had leg-length discrepancy of over 1 cm, four had malalignment of over 5 degrees, and one had limited hip rotation. In the FIN group, one patient had mild pain and one had quadriceps wasting; there were no length discrepancies, malalignment or limitation of movement. Parents of the FIN group were more satisfied. We recommend the use of flexible intramedullary nailing for fractures of the femoral shaft which require surgery, and reserve external fixation for open or severely comminuted fractures.

Absenteeism↗
PubMed1996

Solitary eosinophilic granuloma of the pelvis in children. A report of three cases.

We present three cases of eosinophilic granuloma of the ilium in children. Imaging investigations (computed tomography and magnetic resonance imaging) did not elucidate the disease but rather revealed patterns more like malignant tumours than a benign condition. However, these investigations were of value in directing the surgeon to the correct site for biopsy.

Adolescent↗
PubMed1996

Selective role of glutathione in protecting human neuronal cells from dopamine-induced apoptosis.

The role of glutathione and other antioxidants in dopamine-induced apoptosis has been analyzed in cultures of the human neuronal cell line NMB. Apoptosis, induced by 0.1-0.3 mM dopamine, was blocked by glutathione in a dose- and time-dependent manner. This was observed by monitoring cell morphology, cell viability, and the release of the cytosolic enzyme lactate dehydrogenase into the culture medium. L-Cysteine and N-acetylcysteine had a similar effect in protecting against dopamine neurotoxicity, but at lower concentrations than glutathione. The dopamine-induced alteration in the cell cycle profile, detected by flow cytometry (FACS), and intranucleosomal DNA fragmentation, were both blocked by glutathione. Treatment of NMB cells with buthionine sulfoximine, an irreversible inhibitor of gamma-glutamylcysteine synthetase, increased the neurotoxic effect of, dopamine, suggesting that endogenous glutathione participates in reducing dopamine neurotoxicity. The relationship between glutathione and dopamine was further investigated by testing the effect of dopamine on the endogenous glutathione level. Dopamine decreased glutathione levels within 16-24 hr; however, this effect was preceded by a transient increase in the level of the tripeptide within the first 0.5-7 hr. Two other types of endogenous antioxidants, (+)-alpha-tocopherol (vitamin E) and ascorbic acid (vitamin C), were tested; vitamin E (at 1-100 microgram/ml) was inactive against dopamine toxicity, whereas vitamin C had no effect at 0.05-0.2 mM, but increased dopamine toxicity at 0.5-2 mM. The results indicate that glutathione has a selective role in protecting human neural cells from the toxic effect of dopamine. This study may contribute, therefore, to a better understanding of the mechanisms underling the excessive loss of dopaminergic neurons in neurodegenerative diseases, such as Parkinsonism, and in the aging process.

Antioxidants↗
PubMed1996

Dopamine-induced apoptosis in human neuronal cells: inhibition by nucleic acids antisense to the dopamine transporter.

Human neuroblastoma NMB cells take up [3H]dopamine in a selective manner indicating that dopamine transporters are responsible for this uptake. These cells were therefore used as a model to study dopamine neurotoxicity, and to elucidate the role of dopamine transporters in controlling cell death. Treatment with 0.05 0.4 mM dopamine changed cells' morphology within 4 h, accompanied by retraction of processes, shrinkage, apoptosis-like atrophy, accumulation of apoptotic particles, DNA fragmentation and cell death. Cycloheximide inhibited dopamine's effect suggesting that induction of apoptosis by dopamine was dependent upon protein synthesis. Dopamine cytotoxicity, monitored morphologically by flow cytometric analysis, and by lactate dehydrogenase released, was blocked by cocaine but not by the noradrenaline and serotonin uptake blockers desimipramine and imipramine, respectively. Attempting to inhibit dopamine transport and toxicity in a drug-free and highly selective way, three 18-mer dopamine transporter antisense phosphorothioate oligonucleotides (numbers 1, 2 and 3) and a new plasmid vector expressing the entire rat dopamine transporter complementary DNA in the antisense orientation were prepared and tested. Antisense phosphorothioate oligonucleotide 3 inhibited [3H]dopamine uptake in a time- and dose-dependent manner. Likewise, transient transfection of NMB cells with the plasmid expressing dopamine transporter complementary DNA in the antisense orientation partially blocked [3H]dopamine uptake. Antisense phosphorothioate oligonucleotide 3 also decreased, dose-dependently, the toxic effect of dopamine and 6-hydroxydopamine. Western blot analysis with newly prepared anti-human dopamine transporter antibodies showed that antisense phosphorothioate oligonucleotide 3 decreased the transporter protein level. These studies contribute to better understand the mechanism of dopamine-induced apoptosis and neurotoxicity.

Apoptosis↗
PubMed1996

Topically applied halofuginone, an inhibitor of collagen type I transcription, reduces peritendinous fibrous adhesions following surgery.

To test in vivo the effect of previously observed inhibition of collagen type I transcription by the plant alkaloid Halofuginone, deep flexor tendons of 12 chickens were severed and sutured, and Halofuginone was applied topically at the site of surgery. Intact tendons, and severed but untreated tendons served as controls. The effect of the treatment was assessed by histological, biochemical, and biomechanical examinations of the operated and intact tendons three weeks after surgery. The results indicated an almost complete absence of fibrous peritendinous adhesions in the histologic sections of the Halofuginone treated tendons. There was a statistically significant decrease in collagen contents of and in both force and energy required to pull out the Halofuginone treated tendons from their sheath, relative to the untreated controls. Halofuginone had no effect on the cellularity of the healing tissue. We conclude that Halofuginone is a potent inhibitor of fibrous peritendinous adhesions with potentially important clinical applications.

Animals↗
PubMed1994

The efficacy of naltrexone in preventing reabuse of heroin after detoxification.

The efficacy of Naltrexone in preventing reabuse of heroin among heroin addicts in Israel was studied in a double-blind, controlled design. Naltrexone (or placebo) treatment was given as part of a general treatment plan that continued for 12 weeks. Thirty-two addicts who successfully completed a detoxification program and met research criteria, were included in the study. Fifty milligrams of Naltrexone were taken orally three times a week (25 mg twice a week for the first 2 weeks). The follow-up procedure included an interview, urine tests, and screening for possible adverse effects. In addition, social and psychological parameters were evaluated. Fewer heroin-positive urine tests were found the Naltrexone group than in the placebo group. Throughout the entire study, the number of drug-free patients in the Naltrexone group was higher than in the placebo group. The Naltrexone group showed a significant improvement in most psychological parameters as compared with the placebo group. No differences were found in compliance or ratio of adverse effects between the Naltrexone and placebo groups. The concept "heroin abuse load" based on daily heroin consumption and duration of addiction enabled us to predict which addicts would complete the treatment program. The results suggest that heroin addicts in Israel may benefit from treatment with Naltrexone.

Adult↗
PubMed1994

[Percutaneous, CT-guided excision of femoral osteoid osteoma].

An osteoid osteoma in the distal femur of a 10-year-old girl was excised, percutaneously, under CT guidance. Location of the nidus was by insertion of a Kirshner wire under CT control. Hollow Mill was used to excise the nidus by drilling over the Kirshner wire, with CT guidance during each stage. There were no complications and pain ceased overnight. Follow-up after 4 months showed complete recovery and no pain.

Child↗
PubMed1994

Fine-needle bone biopsy to diagnose osteomyelitis.

In 30 patients in whom osteomyelitis was suspected fine-needle bone biopsies (FNBB) were taken at the same time as bone was aspirated for bacteriological examination. The diagnosis of osteomyelitis was eventually confirmed in 15 patients; the other 15 had myositis (3), arthritis (3), trauma (2), microgeodic phalangeal syndrome (2), haematoma in a non-ossifying fibroma (1), and Ewing's sarcoma (1). In three patients no pathology was found. The temperature, WBC and ESR at presentation did not help to distinguish osteomyelitis from other conditions. FNBB, however, proved to be a useful additional investigation with a sensitivity for osteomyelitis of 87% and a specificity of 93%.

Adolescent↗
PubMed1994

Cure of the limp in children with congenital dislocation of the hip and ischaemic necrosis. Fifteen cases treated by trochanteric transfer and contralateral epiphysiodesis.

Fifteen patients who limped and had early fatigue on walking caused by ischaemic necrosis after treatment for congenital dislocation of the hip had distal and lateral transfer of the greater trochanter. Nine of them in whom the predicted leg-length discrepancy was more than 3 cm also had epiphysiodesis of the contralateral leg. At skeletal maturity the limp was eliminated and walking distance was significantly improved in them all. In those who had epiphysiodesis the average leg-length discrepancy was 0.7 cm at maturity. Two of those not treated by epiphysiodesis used a heel raise of 1.5 cm. In seven cases the two operations were performed simultaneously without serious complications. This procedure is recommended at about the age of 12 years.

Adolescent↗
PubMed1993

Osteomyelitis of the pelvis.

Four cases of osteomyelitis of the pelvis are reported to demonstrate the several clinical syndromes to which this disease can give rise. Extensive surgical drainage and antibiotic treatment led to recovery in all cases.

Adolescent↗
PubMed1992

Physical and psychosocial benefits of modified judo practice for blind, mentally retarded children: a pilot study.

A modified form of judo training was practiced by a class of 7 blind, mentally retarded children with associated neuropsychiatric disturbances. The biweekly training program lasted for 6 months. Analysis indicated improvements in physical fitness, motor skills, and psychosocial attitude. The authors concluded that a modified form of judo can be used as a therapeutic, educational, and recreational tool for multiply handicapped children.

Blindness↗
PubMed1991

Complications of suppurative arthritis and osteomyelitis in children.

Three children with suppurative arthritis and osteomyelitis are described to emphasise that delayed or incorrect diagnosis may lead to serious cardiopulmonary complications. In two patients, bilateral bronchopneumonia developed with pneumatocoeles, pneumothorax and empyema. The other had cardiac failure from septic pericarditis. In one case, disarticulation of the knee was needed as a life-saving measure, and the other leg developed an infected pseudarthrosis of the tibia. The causative organism in each case was staphylococcus aureus and no evidence of immunodeficiency was demonstrated.

Acute Disease↗
PubMed1991

Congenital dysplasia of the heel fat pad: a case report of a previously undescribed entity.

We describe a 13-year-old girl who was born with a congenital anomaly of her left heel fat pad. We call this anomaly congenital dysplasia of the heel pad, due to under development of all elements of the heel fat pad. In the case presented the vertical fibrous septa were missing and the amount of fat and its distribution were abnormal. As a result, the abnormal biomechanical shock absorber mechanism caused a painful callosity formation. A surgical procedure aiming to produce adhesions between the fat pad and the calcaneous in order to decrease the shear of the heel pad was only partially successful. Different types of orthotic devices did not resolve the clinical problem of the painful heel. Such a congenital anomaly has never been described in the English literature, and we coined the term congenital dysplasia for the previously undescribed entity.

Adipose Tissue↗
PubMed1989

[Limb length discrepancy determined by computerized tomography and radiography].

A reliable radiographic limb length measurement is necessary for evaluating and treating discrepancies in limb length, a most difficult problem in pediatric orthopedics. The accuracy and efficiency of conventional orthoroentgenography was compared to that of computerized tomographic (CT) scanography in 17 patients. There was no significant difference in measurements between the techniques. CT scanography with a 66% reduction in radiation dose is now our routine examination for leg length discrepancy.

Evaluation Studies as Topic↗
PubMed1989

Dural penetration by interspinous process segmental spine instrumentation: case report.

A case of pseudo-meningocele complicating posterior spine fusion with interspinous process segmental spinal instrumentation is presented. The L rod rotated postoperatively 90 degrees and penetrated the dura. The presenting symptoms were pain accompanied by fixed lumbar and hip flexion contractures that improved dramatically after removal of the penetrating part. The unusual course as well as the treatment and recommendation for prevention are discussed.

Adolescent↗