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Biomedical subjects

S E Levin

Publications and source records attributed to S E Levin.

At least 55 records · Page 3Linked to original sources
PubMed1980

Arteriohepatic dysplasia: association of liver disease with pulmonary arterial stenosis as well as facial and skeletal abnormalities.

The clinical features and course of five children with the recently described syndrome of arteriohepatic dysplasia are presented. All had bilateral pulmonary arterial stenosis, proven at cardiac catheterization, as well as associated liver disease of varying severity. In one of the fatal cases, a hitherto undescribed anomaly was found--stenosis of the right coronary artery ostium. A viral etiology, eg, the congenital rubella syndrome, was considered most likely, but detailed investigations proved to be negative.

Abnormalities, Multiple↗
PubMed1979

Transposition of the great arteries associated with a double left ventricular outflow tract.

A case is described in which, at semilunar valve level, the aorta and pulmonary artery arose from inappropriate ventricles. Despite this, the outflow tracts to both vessels originated from the left ventricle. Embryologically, it is speculated that this anomaly is the result of normal rotation of the proximal conus, without concomitant truncal inversion, and excessive leftward shift of the proximal conus and conal septum or anterior and rightward deviation of the anterior segment of the ventricular septum. Surgical repair using a double conduit between the right ventricle and pulmonary artery and left ventricle and aorta, respectively, was unsuccessful.

Child, Preschool↗
PubMed1978

Significance of intracranial bruits in neonates, infants, and young children.

In a control group an intracranial bruit (ICB) was heard in 4 of 13 children aged between 4 months and 3 years, but in none of 43 younger infants between the ages of one day and 4 months. In a group of 70 infants with cardiac murmurs of intensity grade III/VI or more, 19 of 30 aged between 4 months and 3 years had an ICB, compared with 4 of 40 younger infants aged between one day and 4 months (P less than 0.0005). It is concluded that in infants under the age of 4 months, even in the presence of a loud cardiac murmur, an ICB is rarely heard. The presence of an ICB, with or without signs of cardiac failure, strongly suggests an intracranial arteriovenous fistula.

Age Factors↗
PubMed1977

Infantile cortical hyperostosis (Caffey's disease): a case report.

An infant in hospital unexpectedly developed infantile cortical hyperostosis (Caffey's disease) while under-going treatment for an unrelated illness. The presentation of the disease was classic and there was marked thrombocytosis. The aetiological possibilities are discussed.

Female↗
PubMed1977

The use of a curved uterine vulsellum for removal of rectal foreign bodies: report of a case.

Removal of retained foreign bodies can be a tedious process, requireing considerable skill and ingenuity on the part of the surgeon. Employment of a curved, double-pronged, uterine vulsellum can be useful in simplifying removal of certain of these objects. A method which can be employed on an outpatient basis is described. When this method fails, suitable cooperation by the patient is lacking, or there is evidence of serious rectal injury or perforation, hospitalization for appropriate treatment under general or regional anesthesia is indicated.

Adult↗
PubMed1976

Occurrence of primary hepatocellular cancer and peliosis hepatis after treatment with androgenic steroids.

Three patients are reported in whom treatment of Fanconi's anaemia with androgenic steroids was complicated by the development of either primary hepatocellular cancer (PHC) or peliosis hepatis. The first, a White woman aged 34 years, was found to have PHC after receiving first methyltestosterone and then oxymetholone for a total period of 7 years. She died 4 months after the diagnosis was made. The other 2 patients were White children who presented with peliosis hepatis after receiving methyltestosterone and oxymetholone for 8 years and oxymetholone for 5 years, respectively. Both died from their primary diseases shortly after oxymetholone treatment was discontinued. Possible pathogenic mechanisms involved in the development of these serious complications are discussed and the therapeutic dilemma raised by their occurrence is emphasised.

Adolescent↗
PubMed1975

Phaeochromocytoma in childhood. A case report.

The clinical features of a 9-year-old boy with an extra-adrenal phaeochromocytoma, complicated by malignant hypertension, are described. The value of urinary and blood catecholamine assays and specialised radiological investigations in the accurate localisation of the tumour, is emphasised. Successful removal of the tumour was facilitated by pre-operative control of the hypertension with a combination of alpha and beta-adrenergic blockade (phenoxybenzamine and practolol). Intra-operative control of fluctuations in blood pressure was simplified by the use of Ethrane (enflurane compound 347) as one of the anaesthetic agents. As a result, sodium nitroprusside was infrequently used.

Anesthesia, General↗
PubMed1975

Aberrant left pulmonary artery: a rare cause of congenital stridor.

Aberrant left pulmonary artery is a rare cause of stridor and respiratory difficulty in infancy and childhood. Diagnosis can be made on oesophagram, and is confirmed conclusively on angiography. Surgery can be curative, especially in cases without severe associated cardiovascular anomalies. A case report is presented of the condition occurring in a South African Black infant.

Esophageal Stenosis↗
PubMed1975

Bile duct adenomatosis of the liver: a misleading finding on surgical exploration of the abdomen.

A patient found to have the unusual condition of bile duct adenomatosis of the liver is discussed. The liver was "peppered" with small subcapsular nodules, which microscopically appeared as multilocular cysts, lined with cuboidal cells similar to those of normal bile ducts. This benign condition most likely is developmental in etiology, and may present early in life as polycystic liver disease, or later when discovered as an incidental finding at laparotomy or autopsy. Its differentiation from metastatic disease by the surgeon on gross examination of liver alone may not be possible.

Adenoma↗
PubMed1975

Portacaval shunt as emergency procedure in unselected patients with alcoholic cirrhosis.

A prospective evaluation of emergency portacaval shunt has been conducted during a 12 year period in 138 unselected, consecutive patients with alcoholic cirrhosis and bleeding esophageal varies. An extensive diagnostic evaluation was completed within seven hours of hospital admission, and the shunt operation was undertaken within a mean of 8.5 hours. Follow-up study was conducted in a special clinic, and the current status of 97.1 per cent of the patients had jaundice, ascites or encephalopathy alone or in combination on admission. Systemic intravenous administration of posterior pituitary extract temporarily controlled the hemorrhage in 94 per cent of the patients, and the emergency portacaval shunt promptly and permanently controlled the varix bleeding in 96 per cent of the patients. Contrary to recent proposals, patients with the highest portal perfusion pressure and, presumably, the largest hepatopetal portal flow had the highest survival rate and those who were presumed from pressure measurements to sustain the smallest portal flow diversion from the shunt had the lowest survival rate. The operative survival rate was 51 per cent, the predicted seven year survival rate for those operated upon seven or more years ago was 42.5 per cent. Encephalopathy requiring dietary protein restriction developed at some time in 17 per cent of the survivors. Sixty per cent of the survivors abstained from alcohol, and 53 per cent resumed gainful employment or full time housekeeping. Preoperative factors that adversely influenced survial rate were ingestion of alcohol within one month of bleeding, ascites, severe muscle-wasting and a small liver. Postoperatively, the single most important factor that compromised long term survival was resumption of alcoholism. In comparisons with our previous prospective studies, emergency portacaval shunt resulted in a significantly greater long term survival rate than did either emergency medical therapy or emergency varix ligation, followed by elective shunt. It is concluded that emergency portacaval shunt is the most effective treatment of bleeding esophageal varices in patients with alcoholic cirrhosis. Criteria for exclusion of those patients who are unlikely to derive long term benefits from portacaval shunt remain to be defined by further studies.

Adult↗