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Biomedical subjects

J I Kessler

Publications and source records attributed to J I Kessler.

18 recordsLinked to original sources
PubMed2000

Augmented amputations of the lower extremity.

Ten patients who had amputations of a lower extremity for high-grade sarcomas underwent bone augmentation with either allograft or autograft between 1988 and 1996. There were eight transfemoral amputations and two transtibial amputations. The transferred segments consisted of one proximal tibia and six distal tibia autografts, two allografts, one autograft talar dome and first metatarsal, and one with a patellar cap of a supracondylar amputation. The average length of followup was 54 months. There were no nonunions of any of the grafts. There were three wound problems requiring additional operations. One autograft resorbed, and one autograft had a late infection. There was one local recurrence. Augmentation to provide length resulted in a 42% increase in bone length in those performed purely for length. All patients were able to use standard prostheses. Functional outcome was appropriate to the amputation level. Half of the patients avoided more proximal levels of amputation because of the ability to augment the osteotomy. The use of nonvascularized structural autografts or allografts is a simple procedure that can produce a superior residual limb in patients undergoing amputation. Its use should be considered in patients for whom traditional amputation techniques will result in poor function, difficulty in fitting a prosthesis, or greater than necessary anatomic loss.

Adolescent↗
PubMed1979

Alterations of hepatic triglyceride in patients before and after jejunoileal bypass for morbid obesity.

The effect of obesity and jejunoileal bypass on the amount and composition of hepatic lipid and the relationship of adipose tissue fatty acids, body weight, and rate of weight reduction to hepatic triglyceride (TG) were investigated in 16 patients before and at various times after jejunoileal bypass. Liver and adipose tissue biopsy sections were taken at surgery and at various times thereafter. Hepatic lipid was measured and the composition of triglyceride fatty acids (TGFA) compared with that of adipose tissue. Liver TG increased by an average of 2.5-fold during the period of rapid weight loss and decreased during the period of stable weight, but remained above control values. There was no relationship between concentration of liver TG and body weight or rate of weight reduction. The hepatic TGFA composition at surgery and during the period of stable weight resembled that of adipose tissue. During the period of rapid weight loss the composition of hepatic TGFA was markedly different, showing an increase in palmitic (16:0, P less than 0.01), palmitoleic (16:1, P less than 0.05), and oleic acids (18:1, P less than 0.05) and a decrease in linoleic acid (18:2, P less than 0.001). These changes could not be accounted for by a preferential absorption or mobilization of 16:0, 16:1, and 18:1, or by an increased utilization of 18:2 by the liver. It is proposed that an increased conversion of carbohydrate to fat occurs during the period of rapid weight loss when a relative excess of carbohydrate to amino acids results from an imbalance in the intestinal absorption of carbohydrate and protein.

Adipose Tissue↗
PubMed1975

Uptake and compartmental distribution of fatty acid by rat small intestine in vivo.

The uptake and esterification of micellar [3-H]oleate and [14-C] palmitate were uniform along the entire length of the small intestine in vivo. Fatty acids (FA) radioactivity taken up by the small intestine could be described in terms of four functionally distinct compartments analogous to those described in vitro. The KRP-extractable compartment (KEC) and albumin-extractable compartment (AEC) contained reversibly adherent unesterified FA radioactivity, while the tissue free and esterified FA compartments contained irreversibly bound radioactivity. Wheras 27% and 63% of FA uptake were reversibly bound in the KEC and AEC by the most proximal and most distal regions of the small intestine in vitro (15), less than 10% was contained in these compartments in vivo, independent of location. Linear inverse relationships were found betweeen tissue FA esterification and proportion of FA radioactivity present in the KEC,AEC, and the tissue free FA compartment in vivo. These observations allow for the possibility that FA molecules pass through these compartments prior to esterification.

Animals↗
PubMed1972

Stages of uptake and incorporation of micellar palmitic acid by hamster proximal intestinal mucosa.

The stages of uptake and incorporation of micellar palmitic acid by hamster proximal intestinal mucosa were investigated by incubation of everted sacs at 4 degrees C and 37 degrees C for 2, 5, 10, and 15 min in a micellar solution (10 micro moles of [1-(14)C]palmitic acid, 10 micro moles of monoolein, and 100 micro moles of sodium taurodeoxycholate) and subsequent serial rinsing of the sacs in ice-cold solutions as follows: one 20-sec rinse in unlabeled micellar solution, five 1-min rinses in Krebs-Ringer buffer (0.15 m, pH 6.3), and ten 2-min rinses in 2.5% albumin solution. The fatty acid-solubilizing capacity of all the rinsing solutions was always in excess of the amounts of radioactive palmitic acid released during each rinse. Radioactivity was determined in the tissue homogenates, rinsing solutions, and serosal fluids. The results indicate that a significant proportion of radioactive palmitic acid taken up by the sacs during the short incubation was released into the rinsing solutions. Rinsing in Krebs-Ringer buffer resulted in release of 15.5 +/- 2.4% of the labeled fatty acid, and this fraction was independent of the temperature of incubation. In contrast, the amounts of palmitic acid released in albumin were significantly greater and were markedly dependent on the temperature of incubation; a total of 48.6 +/- 7.0% and 26.3 +/- 5.1% was released from sacs incubated at 4 degrees C and 37 degrees C, respectively. While the proportion of radioactive palmitic acid in the free fatty acid fraction of the tissue after the rinsing sequence remained reasonably constant regardless of the temperature and duration of incubation, the radioactivity of the esterified palmitic acid in the tissue was much greater in the sacs incubated at 37 degrees C and tended to increase linearly up to 10 min of incubation. A highly significant inverse relationship was found between the fraction of radioactive palmitic acid released by rinsing in albumin and the fraction of the label in the tissue esterified fatty acids. The results suggest that the initial uptake of micellar fatty acid by intestinal mucosa may involve reversible binding to superficial sites with at least two strengths of binding: a weak, temperature-independent binding which could be easily dissociated by rinsing in Krebs-Ringer buffer, and a stronger, temperature-dependent binding which could be dissociated by rinsing in albumin, but not in Krebs-Ringer buffer. Analogous binding of micellar palmitic acid occurred in a brush border preparation of proximal intestine which was devoid of any fatty acid esterifying activity. This suggested that the reversible binding of fatty acid by the intestinal mucosa may be a property of its superficial components, namely the glycocalyx or microvillous membranes, and that it may be independent of the esterifying capacity of the tissue.

Animals↗
PubMed1969

Effect of DL-ethionine on the intestinal absorption and transport of palmitic acid-1-14C and tripalmitin-14C. Role of intramucosal factors in the uptake of luminal lipids.

The effect of DL-ethionine on the uptake and transport of lipid by the rat small intestine was investigated. A cottonseed oil emulsion containing (14)C-labeled tripalmitin or palmitic acid was administered intragastrically to rats pretreated with DL-ethionine, DL-ethionine plus methionine, or saline, and the rats were sacrificed 2, 4, and 6 hr later. Lipids from the plasma, the stomach, the colon, the luminal contents of the small intestine, and the wall of the small intestine were extracted, fractionated, and their radioactivity assayed. Ethionine markedly inhibited the uptake of lipids by the small intestine. This inhibition was not related to impairment of intraluminal lipolysis since analagous inhibitions were observed when palmitic acid or predigested triglyceride (TG), obtained through a jejunal fistula from normal animals, was administered instead of tripalmitin. Ethionine also inhibited the transport of lipid from the wall of the small intestine. A significant fraction of the administered lipid remained in the wall of the small intestine, and only a small fraction was transported to the blood stream. Although most of the wall radioactivity was in the form of TG, significant proportions were also found in the free fatty acid (FFA) and partial glyceride fractions, indicating a marked inhibition of mucosal reesterification to TG. The degree of inhibition of mucosal reesterification and the degree of inhibition of transport of wall lipids were directly related to the degree of inhibition of uptake of luminal radioactivity. This relationship suggests that the rate of reesterification, the level of mucosal FFA, and the rate of transport of intramucosal TG may be of importance in determining the extent of uptake of intraluminal lipid by the mucosal cells. Since a significant fraction of the wall radioactivity was in the form of TG, the decreased transport of wall lipids was attributed to an impairment of chylomicron completion due to inhibition of either the synthesis of chylomicron apoprotein or the association of preformed TG with the protein moiety of chylomicrons. Experiments with labeled amino acids support the first possibility.

Animals↗
PubMed1967

Rates of tissue uptake of palmitic acid-1-14C complexed with albumin by two different procedures.

The effect was investigated of two different methods of preparing an albumin-palmitic acid complex on the tissue uptake of the palmitic acid, both in vivo and in vitro. Complex A was prepared by exposing monomolecular layers of palmitic acid-1-(14)C deposited on a solid surface to albumin dissolved in buffer. Complex B was prepared by the interaction of albumin with a micellar solution of palmitate-1-(14)C. The radioactivities and chemical compositions of the two complexes were almost identical. Rat epididymal fat pads took up, during a 1 hr incubation, about 2.5 times as much palmitic acid from complex A as from complex B; the extent of esterification of the incorporated label was equal for the two complexes. The fractional turnover rate of palmitic acid of complex A, administered intravenously to dogs, was about twice that of palmitic acid from complex B. The label of the two complexes recirculated in the esterified fatty acid fraction of plasma to an equal extent. It is proposed that differences in the orientation of the fatty acid molecules may affect their interaction with the binding sites of albumin and that the metabolic differences of the resulting complexes are related to differences in the ease of transfer of the fatty acid from the complex to receptor sites of tissues.

Adipose Tissue↗
PubMed1966

Effect of ingestion of saline, glucose, and ethanol on mobilization and hepatic incorporation of epididymal pad palmitate-1-14C in rats.

The effect of ingestion of saline, glucose, and ethanol (isocaloric with the glucose) on the mobilization of radiopalmitate from epididymal fat prelabeled in vivo and the incorporation of the mobilized label into liver lipids was investigated in rats. The mobilization of radiopalmitate from epididymal fat and the incorporation of the mobilized label into liver triglyceride were most markedly elevated by ingestion of ethanol. Increased mobilization and diversion of epididymal adipose tissue fatty acids to liver lipids of ethanol-treated rats were shown also by the close resemblance of the fatty acids of liver triglyceride to the fatty acids of epididymal fat. The amount of radiopalmitate mobilized by the saline-treated rats, comprising approximately a third of that mobilized by the ethanol-treated animals, was larger than the amount mobilized by the rats treated with glucose; most of it was oxidized rather than incorporated into the liver fats. In glucose-treated rats a larger fraction of radiopalmitate mobilized from one prelabeled epididymal pad was diverted to and incorporated into the lipids of the contralateral pad of the same animal. The specific activity of hepatic triglyceride of ethanol- and saline-treated rats was similar and significantly higher than that of animals treated with glucose. These data indicate that the ethanol-induced fatty liver can be attributed to an increased mobilization and incorporation of adipose tissue fatty acids into liver lipid and to an altered hepatic metabolism of fatty acids and triglyceride.

Animals↗
PubMedDate not supplied

Use of allografts in Pemberton osteotomies.

SUMMARY: Twenty patients treated with 26 Pemberton osteotomies with allograft bone wedges were retrospectively evaluated radiographically. Two patients undergoing four osteotomies were excluded because of incomplete records or <1 year of follow-up. Eleven of the remaining 18 patients had other procedures performed. Osteotomies all united radiographically within 3 months. The acetabular index improved from 33 degrees before surgery to 18 degrees after surgery, and the lateral migration index improved from 60% to 26%. This new technique of Pemberton osteotomy with patellar allograft wedges allows good correction of acetabular dysplasia with immediate graft stability. This stability often obviates the need for postoperative spica casting, even for patients undergoing bilateral procedures, thereby allowing more rapid rehabilitation.

Acetabulum↗