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Biomedical subjects

A Blum

Publications and source records attributed to A Blum.

At least 199 records · Page 11Linked to original sources
PubMed1993

Lymphokine expression in granulomas of Schistosoma mansoni-infected mice.

Lymphokine mRNA for IL-2, IL-4, IL-5, IL-10, and IFN-gamma was identified in total RNA, extracted from granuloma and spleen cells of Schistosoma mansoni-infected mice. The specific mRNA in these preparations was identified after reverse transcription and polymerase chain reaction amplification. In some experiments, spleen cells were incubated in the presence of soluble egg antigens or mitogen before RNA extraction. Also, the secretion of these lymphokines from cells maintained in vitro was measured by ELISA or bioassay. The spleen cells from either uninfected or infected mice constitutively released no detectable cytokines and expressed only IL-10 mRNA prominently. Mitogen induced spleen cells from either source to express IL-2 and IFN-gamma mRNAs and their corresponding proteins. Also, spleen cells from noninfected mice stimulated with mitogen expressed IL-4 mRNA, but not IL-5 mRNA, and no detectable protein products. Yet, IL-5 was inducible in spleen cells from infected animals. Soluble egg antigens induced spleen cells from infected mice to prominently express a variety of cytokine genes and produced large amounts of cytokine proteins, but spleen cells from uninfected mice did not respond. Unlike the spleen, the granulomas constitutively expressed mRNAs for all the cytokines examined. Yet, there was limited expression of IL-2 mRNA as compared to that of other cytokines. Except for IL-5, unfractionated granuloma cells constitutively released cytokines at low or undetectable levels. Soluble egg antigens or mitogen enhanced the production of all cytokines to different extents. These observations indicate that schistosome granulomas and spleens express both Th1 and Th2 cytokines. The various lymphokines display complex differences in both lymphokine mRNA and product expression. These results suggest that the production of granuloma lymphokines is governed selectively, possibly by a variety of undetermined regulatory pathways.

Animals↗
PubMed1993

Direct coronal view of the shoulder with arthrographic CT.

Direct coronal oblique views of the shoulder were obtained with arthrographic computed tomography (CT) in 35 shoulders with surgical correlation. There were 18 complete cuff tears, four partial ones, two type 3 superior labral, anterior, and posterior (SLAP) lesions, and one type 4 SLAP lesion. The coronal sections were obtained after double-contrast shoulder arthrography and axial CT sections had already been obtained. The patient was seated directly on the slope of the gantry, and the shoulder to be studied was positioned in the center of the gantry. The maximal time needed for this procedure was 5 minutes. Rotator cuff tears were detected with a sensitivity of 95% and a specificity of 100%. The size of the tears as determined on the coronal sections was strongly correlated with surgical measurement (r = .939). All SLAP lesions were detected. The authors' experience shows that obtaining coronal oblique sections is an effective way to improve arthrographic CT.

Adolescent↗
PubMed1993

"Infective" myocardial infarction.

Four patients who developed acute myocardial infarction (AMI) in the setting of systemic febrile illness are described. They were all treated with anticoagulants or lytic agents (or both), demonstrating patient coronary arteries following infarction. We discuss the pathogenesis and therapeutic implications of AMI occurring in this setting.

Adult↗
PubMed1993

Prognostic significance of the initial electrocardiographic pattern in a first acute anterior wall myocardial infarction.

The availability of potent, but potentially dangerous, types of reperfusion therapy for acute myocardial infarction (AMI) has forced us to refine our tools for early and accurate diagnosis and for early risk stratification of patients with evolving AMI. The estimation of risk has to be made shortly after admission, when only the history, physical examination, and the ECG are available. This study was undertaken to compare in-hospital mortality with different patterns of the ECG obtained at admission in 147 consecutive patients with an evolving first AMI of the anterior wall. By using a new classification of the admission ECG, it was possible to divide the patients into 3 groups: (1) group A contained 12 patients with tall peaked T waves in the involved leads, without ST segment elevation; (2) group B comprised 77 patients with abnormal T waves and ST elevation, but without major changes in the terminal portion of the QRS complex; and (3) group C comprised 58 patients with abnormal T waves, ST elevation, and distortion of the terminal portion of the QRS. The mortality was 0, 3 percent, and 29 percent in groups A, B, and C, respectively (chi 2 = 22.91; p = 0). By using a logistic regression model, it was found that the initial ECG pattern alone is a strong predictor of in-hospital mortality in patients with an evolving anterior wall AMI. The predicted probabilities of death in groups A, B, and C are 0.0016, 0.025, and 0.29, respectively. This simple classification of the initial ECG pattern in patients with a first AMI of the anterior wall may enable the differentiation of patients with low in-hospital mortality (groups A and B) and of those with an in-hospital mortality of almost 30 percent (group C).

Aged↗
PubMed1993

[Arthrodesis of the ankle joint: effect of the position of the arthrodesis on the foot. Apropos of a series of 50 cases reviewed with an average follow-up of 9 years].

UNLABELLED: A functional assessment of fifty patients after ankle arthrodesis for post traumatic arthritis was carried out by means of an extensive clinical evaluation after an average follow-up of nine years. The data on position of ankle arthrodesis and gait analysis were examined to determine the effect of arthrodesis of the ankle on the subtalar and small joints of the foot. The Duquennoy point system was used to grade the ankle clinically and a new radiological method to determine the sagittal position of the ankle arthrodesis was developed. Equinus position was related with clinical damage on sub talar joint, and anterior cavus foot (92.8 per cent). This position was related with metatarsalgia in 26.9 per cent. Calcaneus position was related with posterior cavus foot (verticalization of the calcaneus). This position was related with the best functional results on walking, jumping and running. CLINICAL RELEVANCE: this study has showed that the ideal position of fusion of the ankle was neutral or slight flexion, slight valgus angulation of the hind part of the foot and 10 degrees of external rotation.

Adult↗
PubMed1993

[Selective arteriography of the supra-aortic trunks by right humeral approach with a 4F catheter].

Three hundred and sixty seven patients were studied for cerebrovascular disease with intra-arterial digital subtraction. Examination were performed using a right transbrachial approach with a 4F catheter. Selective catheterization of the carotid arteries was possible in 98% for the left and 99% for the right. Image quality was consistently good or excellent. There was 2 neurologic complications and 1 local complication (hematoma) requiring surgery few weeks later. Selective carotid and vertebral catheterizations by the brachial route is safe, simple, accurate and rapid (15 mn) and can be employed in outpatients.

Adult↗
PubMed1993

Physician awareness of prescription drug costs: a missing element of drug advertising and promotion.

BACKGROUND: Although the cost of prescription drugs is recognized as an important facet of health care expenditures, many physicians are purportedly unaware of actual drug costs. To test this hypothesis, we surveyed physician awareness of the cost of 20 actively marketed prescription drugs. METHODS: A questionnaire listing four possible cost categories for each drug was administered to 305 registrants of a 5-day family medicine continuing education course. RESULTS: Ninety-two physicians completed the questionnaire. Only one, a 40-year-old, board-certified physician who had been in practice for 3 years, answered 70% of questions correctly. The average score for the other participants was 37% (range 0% to 75%). CONCLUSIONS: The majority of physicians questioned could not accurately identify the price range of commonly prescribed drugs. We recommend drug cost disclosure in drug advertising to help address this problem.

Adult↗
PubMed1992

Black scorpion envenomation: two cases and review of the literature.

Scorpion envenomation is quite common in India, southeast Asia, the U.S. southwest, and Israel (in the Negev and around Jerusalem). Yellow scorpion is considered the most dangerous scorpion that causes cardiac toxicity. Two patients are described, who lived in a nonendemic area of yellow scorpions and were envenomated by the black scorpion. Both suffered temporary cardiac involvement (manifested by electrocardiographic changes) which reverted to a normal pattern within 24 h. These are the first two cases that have been reported (from black scorpion envenomation) and indicate that the toxin of the black scorpion is also cardiotoxic, but much less than the "yellow scorpion" toxin.

Animals↗
PubMed1992

The macrophage-activating properties of growth hormone.

1. We compared the ability of growth hormone (GH) and a well-characterized macrophage-activating factor, interferon-gamma (IFN-gamma) to activate highly purified populations of alveolar macrophages. Both GH and IFN-gamma primed macrophages triggered with opsonized zymosan to secrete superoxide anion (O2-) in vitro, but IFN-gamma was effective at a 40-fold lower concentration. Antibody blocking studies demonstrated that the priming activity of GH was independent of IFN-gamma, and the activity of IFN-gamma was distinct from that of GH. 2. Both IFN-gamma and GH increased the capability of macrophages to kill Pasteurella multocida in vitro. 3. Hypophysectomized rats challenged with Salmonella typhimurium were significantly protected by injections of either GH or recombinant rat IFN-gamma in vivo compared to vehicle-treated controls, and the protective effect of GH was increased by incorporation into liposomes. 4. Insulin-like growth factor-I (IGF-I) also primed alveolar macrophages in vitro, which is consistent with the idea that the protective effects of GH in vivo might be mediated by augmenting the synthesis of IGF-I. These data support the concept of reciprocal systems of communication between the neuroendocrine and immune systems.

Animals↗
PubMed1992

Electrocardiographic Q-waves inconstancy during thrombolysis in acute anterior wall myocardial infarction.

It is the purpose of this paper to describe the electrocardiographic inconstancy of Q-waves during administration of thrombolytic therapy. This was documented in four patients given streptokinase early in the course of anterior wall myocardial infarction. Understanding the pathogenesis of sequential dynamic variations of Q-waves in this setting may offer important insights into coronary physiology and management of acute coronary events. We discuss the possible explanations for such changes with respect to tissue viability, dynamic vascular changes and electrophysiological properties of the reperfused infarcted myocardium.

Angioplasty, Balloon, Coronary↗
PubMed1992

Treatment of tardive dyskinesia with vitamin E.

OBJECTIVE: Vitamin E (alpha-tocopherol), a free-radical scavenger, has been reported to improve symptoms of tardive dyskinesia. The authors attempted to replicate this finding under more controlled conditions in a larger study group. METHOD: Fifteen inpatients and six outpatients with tardive dyskinesia received up to 1600 IU/day of vitamin E for 6 weeks in a double-blind, placebo-controlled crossover study. Abnormal Involuntary Movement Scale (AIMS) examinations of these patients were videotaped and rated independently by two trained raters. Levels of neuroleptic medication and vitamin E were measured during both treatment periods. Eighteen patients who demonstrated high blood levels of vitamin E were included in the data analysis. RESULTS: Vitamin E levels were significantly higher while the patients were receiving vitamin E than while they were receiving placebo. For all 18 patients, there were no significant differences between AIMS scores after receiving vitamin E and AIMS scores after receiving placebo. In agreement with previous studies, however, the nine patients who had had tardive dyskinesia for 5 years or less had significantly lower AIMS scores after receiving vitamin E than after receiving placebo. There were no changes in neuroleptic levels during vitamin E treatment. CONCLUSIONS: Vitamin E had a minor beneficial effect on tardive dyskinesia ratings in a selected group of patients who had had tardive dyskinesia for 5 years or less. This effect was not due to an increase in blood levels of neuroleptic medications.

Adolescent↗
PubMed1992

Snuffing tobacco out of sport.

Use of oral snuff has risen sharply among baseball players following a tobacco industry marketing campaign that linked smokeless tobacco with athletic performance and virility. Millions of adolescents have copied these professional role models and, today, are at risk of developing oral cancer and other mouth disorders. New policies and programs are needed to break the powerful grip that the tobacco industry has on professional sport. Health agencies, including the National Cancer Institute and the National Institute for Dental Research, have teamed up with major league baseball to help players quit and reduce public use of oral tobacco. If these efforts are successful, our national pastime will once again become America's classroom for teaching health and fitness, not nicotine addiction.

Adolescent↗