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Biomedical subjects

S Levitt

Publications and source records attributed to S Levitt.

At least 37 records · Page 2Linked to original sources
PubMed1987

Routine intraoperative post-ligation venography in the treatment of the pediatric varicocele.

Varicocelectomy in the adult is followed by a relatively low recurrence rate but children treated by conventional techniques seem prone to have more frequent recurrences. We believe that the higher recurrence rate observed in children after routine varicocelectomy actually represents residual varicose communications that had been missed at the primary operation. Routine post-ligation intraoperative venography has been used to detect these occult communications in 26 children undergoing varicocelectomy. Our results indicate a low recurrence rate (3.6 per cent), suggesting that routine use of this procedure with childhood varicocelectomy is beneficial.

Adolescent↗
PubMed1986

Cystic fibrosis, Crohn's colitis, and adult meconium ileus equivalent.

A 23-year-old man with cystic fibrosis developed massive rectal bleeding that continued intermittently, necessitating an emergency laparotomy and total colectomy. The resected colon was shortened by fibrosis and displayed widespread excessive production of mucus, forming a carpetlike layer over the mucosa as well as segmental discrete areas of mucosal ulceration with fissures, transmural inflammation, and multiple epithelioid granulomas, which are in keeping with Crohn's disease. One case, in a seven-year-old girl, had been reported previously.

Adult↗
PubMed1986

Mechanisms of injury in unilateral testis torsion.

We investigated the mechanisms of injury involved in unilateral testis torsion as well as the interventional effects of orchiectomy at 48 h and immunosuppression with corticosteroids in rats. Torsion was associated with abnormal contralateral testis histology and raised antilymphocytes and antisperm antibody titers. Both orchiectomy and steroid administration lessened these findings, suggesting that an immunological process underlies the abnormality seen in this experiment model.

Animals↗
PubMed1985

Intrarenal hemangiomas in the Klippel-Trenaunay syndrome.

The Klippel-Trenaunay syndrome is composed of the triad of unilateral limb hypertrophy, abnormalities of the deep venous system, and port-wine hemangiomas. An interesting case is presented in which there were multiple abnormalities of the renal veins and intrarenal hemangiomas resulting in renal failure in addition to the usual peripheral abnormalities.

Angiomatosis↗
PubMed1985

Extrapelvic colon--areas of failure in a reoperation series: implications for adjuvant therapy.

A total of 230 patients had planned single or multiple reoperative procedures following "curative" resection of colorectal cancer at the University of Minnesota. The site of the primary lesion was extrapelvic in 91, and later evidence of cancer was found in 58 patients (64%) at re-operation and/or other follow-up. Eight of the 58 (14%) were converted to disease-free status. Incidence and patterns of failure were correlated with initial operative-pathologic extent of disease (87 of the 91 at risk had initial tumor extension beyond the bowel wall, involved nodes or both) and comparisons were made with the previously analyzed rectal reoperation patients. While a component of local-regional failure was more common with rectal lesions (48/74 at risk, 65%), it was not uncommon with extrapelvic primaries (44/91-48%). The incidence of hematogenous metastasis (DM) was equal, but the pattern of initial DM differed (extrapelvic colon--primarily liver; rectum--liver and lung). Peritoneal seeding was a more common component of failure with the extrapelvic primaries (19/91--21% vs 3/74-4%). Since surgery alone is inadequate treatment for many patients with colon as well as rectal cancer, the rationale of adjuvant radiation and systemic therapy, alone or in combination, is discussed.

Carcinoma↗
PubMed1984

Soft tissue sarcomas of the extremity. Is prognosis related to local environment?

Thirty-two patients with soft tissue sarcomas of the extremities were treated and retrospectively evaluated for the period from 1974 to 1978. Patients were treated by surgery with wide or radical margins or surgery with postoperative radiation therapy. Thirty-one patients were available with a minimum follow-up of 48 months. No significant difference could be detected between treatment modalities for continuous disease-free survival. The presence of tumor in muscular tissue gave a negative prognosis using multivariant discriminant analysis (P less than 0.05) with 39% of patients continuously disease-free at 48 months versus 77% of patients with tumors in nonmuscular tissue continuously disease-free. This observation suggests that the biologic milieu in which a soft tissue sarcoma grows may affect the course of the disease. These observations need to be confirmed by other investigators before using this criteria for treatment stratification.

Adolescent↗
PubMed1984

Aphasia after left thalamic infarction.

We examined a 70-year-old woman who became aphasic after a left thalamic infarction. Computed tomographic scan showed injury that was largely limited to the ventral anterior and rostral ventral lateral thalamic nuclei. Speech was characterized by reduced voice volume, impaired auditory and reading comprehension, perseverations, intermittent use of jargon, fluctuations in the ability to perform confrontation naming, extraneous intrusions, verbal paraphasia, intact repetition skills, and fluent speech that was laconic but grammatically correct. We propose that the deficits after left thalamic injury can be grouped into the following four large clusters: extrapyramidal deficits (decreased or fading voice volume), deficits in lexical access (anomia, verbal paraphasia), deficits in vigilance (neologisms, intrusions, fluctuating performance, jargon, perseverations), and comprehension defects.

Aged↗
PubMed1984

Subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion): a case report and review of the literature.

A 45-year-old woman presented with gross hematuria and pain in the right flank. Blood was found in the right renal pelvis with bleeding from the lower pole of the kidney. Partial nephrectomy revealed hematomas in and about the pelvis and calices, confirming the diagnosis of Antopol-Goldman lesion. The cause of the lesion remains uncertain, although renal trauma superimposed on a hyperplastic pelvic capillary network, secondary to analgesic abuse, is suspected.

Analgesics↗
PubMed1984

Serum angiotensin converting enzyme in Crohn's disease, ulcerative colitis and peptic ulceration.

Serum angiotensin converting enzyme (ACE) activities were determined in patients with different types of inflammatory disease of the gastrointestinal tract, in patients with peptic ulcer, and in healthy volunteer subjects. ACE activity in serum was measured by its in vitro ability to cleave hippuric acid from the synthetic tripeptide hippuryl-L-histidyl-L-leucine. The hippuric acid so formed was quantified by high performance liquid chromatography and results are expressed as nmol hippuric acid produced/ml plasma/min. ACE activity was 27.4 +/- 7.7 (mean +/- SD, n = 37) in control subjects and was not related to age or sex. Compared to controls, patients with ulcerative colitis had similar ACE values (26.5 +/- 7.7, n = 16) while, surprisingly, there was a significant (p less than 0.01) increase in the enzyme in those with active peptic ulcers (33.8 +/- 8.8, n = 21) irrespective of whether the site of ulceration was gastric or duodenal. In a mixed group of patients with active and inactive Crohn's disease, ACE activity (24.8 +/- 7.2, n = 19) was not different from controls. However, ACE activity was significantly (p less than 0.02) depressed in active Crohn's disease (19.8 +/- 7.3, n = 8) compared to either control subjects or patients with inactive disease (28.4 +/- 6.3, n = 9). There was wide inter-patient variability in ACE levels and hence the diagnostic value of random measurements of this enzyme in Crohn's disease is limited.

Adolescent↗
PubMed1983

The morbidity and utility of periaortic radiotherapy in cervical carcinoma.

From 1971 through 1981, 81 women received 4350 to 5075 rad to the periaortic lymph nodes as part of their primary management for carcinoma of the uterine cervix. While two patients developed chronic small bowel damage, only one required surgical intervention. Five-year disease-free survival was 40%. Approximately one-third of the first recurrences were within the pelvic and periaortic radiation portals, with the remainder in the lungs, liver, bones, abdomen, and supraclavicular lymph nodes. Radiation dose and volume guidelines are presented in order to minimize enteric morbidity.

Adenocarcinoma↗
PubMed1983

Stage II nonseminomatous testicular cancer: a 10-year experience.

Between 1970 and 1980, 82 patients with pathologic stage II nonseminomatous germ cell testicular carcinoma were treated at the University of Minnesota. Of the 30 patients treated with a retroperitoneal lymph node dissection, 22 (77%) relapsed. Of the 18 patients treated with retroperitoneal lymph node dissection and adjuvant radiotherapy, 12 (63%) relapsed. Sixteen patients received adjuvant chemotherapy before 1976, and 14 (87.5%) relapsed. After 1976, 18 patients received adjuvant chemotherapy (11 with cisplatin) and 2 (11%) have relapsed. No patient treated with cisplatin-based adjuvant chemotherapy has relapsed. The toxicity has been modest. Cisplatin-based chemotherapy is an effective and a safe adjuvant therapy for stage II nonseminomatous germ cell testicular carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Allogeneic bone marrow transplantation in acute nonlymphocytic leukemia: a pilot study.

The objective of the current study, initiated in 1976, was to improve upon the high relapse rate and subsequent mortality in children and young adults with acute nonlymphocytic leukemia (ANLL). Seventeen patients, ages 6--28, with ANLL in first bone marrow remission, received cyclophosphamide and total body irradiation using a radiation scheme of 750 rad (7.5 Gy) total dose, delivered at a dose rate of 26 rad (26 cGy) per minute. Allogeneic marrow from HLA-matched sibling donors was followed by prophylactic therapy or graft-versus-host disease (GVHD). Median follow-up of the entire group is 20+ mo; survivors have been followed for a minimum of 14+ mo. Interstitial pneumonitis was observed in 6% of patients, and GVHD was observed in 29%. Seventy percent of patients are alive and in complete continuous remission. Two patients have relapsed (at 7 and 24 mo). Actuarial relapse-free survival is 76% at 1 yr and 64% at 5 yr. Quality of life in this disease-free survivors is excellent; all patients are free of active GVHD, receive no maintenance chemotherapy, and have high Karnofsky performances scores. High dose rate total body irradiation plus cyclophosphamide followed by allogeneic BMT may provide an opportunity for long-term complication-free survival in a substantial proportion of children and young adults with ANLL.

Acute Disease↗
PubMed1978

Sister chromatid exchange in lymphocytes from patients with malignant lymphoma.

Sister chromatid exchange (SCE) frequencies were studied in differentially stained lymphocytes from 47 patients with malignant lymphoma. Thirteen patients were untreated when studied. The mean SCE frequency [+/- standard error (SE)] for these patients was 12.7 +/- 0.9 per mitosis. The mean score for 40 controls was 6.1 +/- 0.3. SCE mean scores were significantly higher in the untreated patients than in the controls (P less than 0.001). Seven patients were treated with radiotherapy alone. They demonstrated a mean SCE frequency (8.8 +/- 0.8) significantly lower (P less than 0.01) than that found in untreated patients. Eleven patients received cyclophosphamide within 4 weeks prior to study. They demonstrated a mean SCE frequency (14.3 +/- 1.3) significantly higher (P less than 0.05) than that found in patients who had received regimens that did not contain cyclophosphamide in the prior 4 weeks (11.1 +/- 1.3) or who had been off drugs for at least 8 weeks (10.1 +/- 0.8). Our data suggest that untreated patients with malignant lymphoma have elevated SCE frequencies, which may be further increased by certain chemotherapeutic agents.

Adolescent↗
PubMed1978

Gardner's syndrome: a report of two Western Australian families.

Patients from two families are reported who exhibited features of Gardner's syndrome: familial polyposis coli; epidermoid cysts; and osteomata. The difficulty in defining this syndrome, its clinical features and suggested management are discussed. Follow up has been difficult in one family because of the late age at which lesions developed, and because family members have moved interstate. The premalignant potential of Gardner's syndrome is emphasized.

Adolescent↗
PubMed1978

Isolated torsion of penis. Report of 6 cases.

Torsion of the penis as an isolated anomaly has rarely been reported. Six such cases seen in a pediatric urologic practice within a two and one-half-year span suggest that it is not as rare as has been hitherto suggested. The embryologic abnormality appears to be an isolated skin and dartos defect, since the torsion is completely remedied by simply freeing the penile shaft of its investing tissue. The ease of achieving a normal appearance would appear to justify its surgical correction.

Adolescent↗