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Biomedical subjects

A J Epstein

Publications and source records attributed to A J Epstein.

17 recordsLinked to original sources
PubMed2002

Viscous behavior in a quasi-1D fractal cluster glass.

The spin glass transition of a quasi-1D organic-based magnet ([MnTPP][TCNE]) is explored using both ac and dc measurements. A scaling analysis of the ac susceptibility shows a spin glass transition near 4 K, with a viscous decay of the thermoremanent magnetization recorded above 4 K. We propose an extension to a fractal cluster model of spin glasses that determines the dimension of the spin clusters (D) ranging from approximately 0.8 to over 1.5 as the glass transition is approached. Long-range dipolar interactions are suggested as the origin of this low value for the apparent lower critical dimension.

Journal Article↗
PubMed2001

Solvent dependence of the structure and magnetic ordering of ferrimagnetic manganese(III) meso-tetraphenylporphyrin tetracyanoethenide, [MnTPP]+[TCNE]*-.

Tetraphenylporphinatomanganate(III) tetracyanoethenide, [MnTPP][TCNE], is the prototype of a growing family of linear chain (1-D) coordination polymers that magnetically order as ferrimagnets. [MnTPP][TCNE].xS [S = PhMe (x = 2), 1,2-C(6)H(4)Me(2) (x = 1), 1,2-C(6)H(4)Cl(2) (x = 3), 1,2,4-C(6)H(3)Cl(3) (x = 2), and 1,3-C(6)H(4)Cl(2) (x = 2)] have been prepared and structurally and magnetically characterized. All form 1-D chain structures with intrachain Mn.Mn separations ranging from 9.202 to 10.218 A. The 173 K crystal structure of [MnTPP][TCNE].2PhMe has been rerefined, revealing that the [TCNE](*)(-) is 2-fold-disordered and coordinated to Mn(III) by a pair of trans cyano nitrogen atoms to form parallel one-dimensional chains. The two orientations of [TCNE](*)(-) are related by a 180 degrees rotation about the diagonal axis joining the trans nitrogen atoms bound to Mn(III). The major form has an occupancy of 83.3(4)% with a Mn-N(TCNE) distance of 2.328(3) A and a MnNC angle of 146.8(8) degrees. The minor form, with 16.7(4)% occupancy, has a Mn-N(TCNE) distance of 2.176(15) A and a MnNC angle of 152.3(39) degrees. Lattice packing and molecular bonding imply static as opposed to dynamic disorder. The magnetic properties depend on the type and quantity of the solvent present in the structure. Desolvation via heating in n-octane (127 degrees C), n-dodecane (216 degrees C), and/or vacuum thermolysis (175 degrees C) leads to numerous different desolvated materials with differing magnetic properties. At higher temperatures the magnetic susceptibility can be fit by the Curie-Weiss expression, chi varies with (T - theta)(-1), with theta = 44, 52, 72, 55, and 77 K for the toluene, 1,2-xylene, 1,2-dichlorobenzene, 1,3-dichlorobenzene, and 1,2,4-trichlorobenzene solvates, respectively. The T(c)'s were taken as the maximum in 10 Hz chi'(T) and are 7.8, 9.2, 11.3, 10.8, and 8.2 K for the PhMe, 1,2-xylene, 1,2-dichlorobenzene, 1,3-dichlorobenzene, and 1,2,4-trichlorobenzene solvates, respectively. Upon desolvation the T(c)'s increase for the PhMe, 1,2-xylene, 1,2,4-trichlorobenzene solvates and decrease for the 1,2- and 1,3-dichlorobenezene solvates. The compounds show one-dimensional ferrimagnetic exchange behavior at high temperatures with intrachain exchange of J/k(b) = -63, -99, -234, -100, and -200 K for toluene, 1,2-xylene, 1,2-dichlorobenzene, 1,3-dichlorobenzene, and 1,2,4-trichlorobenzene solvates, respectively, as determined from fits to the Seiden expression, which models isolated 1-D interactions among alternating S = 2 classical and S = (1)/(2) quantum spins. For variation in the temperature at which the peak occurs per decade of frequency, phi, (DeltaT(f)/T(f))/Delta(log omega) is 0.167, 0.168, 0.066, 0.171, and 0.024 for toluene, 1,2-xylene, 1,2-dichlorobenzene, 1,3-dichlorobenzene, and 1,2,4-trichlorobenzene, respectively, typical of spin glass behavior. Since [TCNE](*)(-) is only disordered for the PhMe solvate and all five solvates exhibit spin glass behavior, the spin glass behavior cannot be attributed to this disorder.

Journal Article↗
PubMed2001

Cataract surgery in a patient with Brown-McLean syndrome.

The Brown-McLean syndrome is defined by corneal edema that involves the peripheral 2.0 to 3.0 mm of cornea, sparing the central cornea. This syndrome is usually associated with previous cataract surgery but has been reported rarely in patients with other predisposing factors such as angle-closure glaucoma or spontaneous lens absorption with iridodonesis. We describe the clinical course of a 50-year-old man with myotonic dystrophy who had Brown-McLean syndrome with no identifiable predisposition for peripheral corneal edema. Although this syndrome appears to be the result of peripheral endothelial dysfunction, this patient was able to tolerate cataract extraction without developing central corneal edema.

Cataract↗
PubMed2001

The role of public clinics in preventable hospitalizations among vulnerable populations.

OBJECTIVE: To determine if the availability of public ambulatory clinics affects preventable hospitalization (PH) rates of low-income and elderly populations. DATA SOURCES: PH rates were calculated using elderly and low-income discharges from 1995-97 Virginia hospital discharge data. Other data sources include the 1990 Census, the 1998 Area Resource File, the 1996 American Hospital Association Survey, the Virginia Department of Health, the Virginia Primary Care Association, and the Bureau of Primary Health Care. STUDY DESIGN: Multiple linear regression was used to evaluate the relationship between ambulatory clinic availability and PH rates, controlling for population and other provider characteristics in a cross-section of zip code clusters. DATA EXTRACTION METHODS: Clusters with populations of at least 2,000 were assembled from zip codes in each county in the state of Virginia. Overlapping medical market service areas were constructed around the population centroid of each cluster. PRINCIPAL FINDINGS: Populations in medically underserved areas (MUAs) served by a Federally Qualified Health Center had significantly lower PH rates than did other MUA populations. The presence of a free clinic had a marginally significant association with lower PH rates. CONCLUSIONS: The availability of public ambulatory clinics is associated with better access to primary care among low-income and elderly populations.

Adolescent↗
PubMed1999

A claims data approach to defining an episode of care.

OBJECTIVE: To utilize health services research techniques in developing an episode of care using an administrative data set. This method is demonstrated for an episodic clinical condition, migraine. DATA SOURCES: Medicaid administrative data set of 3,372 patients with a diagnosis of migraine (ICD-9-CM 346.0, 346.1) in the state of Pennsylvania between May 1990 and March 1992. STUDY DESIGN: The duration of a migraine episode was measured by assessing the magnitude of resource utilization and the proportion of patients with charges in the period after the index migraine as compared to the period before the index migraine. A confidence interval (CI) was developed around each measure using bootstrap techniques. DATA COLLECTION METHODS: All charge data were extracted daily for a 113-day observation period surrounding each index migraine in order to observe the duration of impact of a migraine diagnosis on resource utilization. PRINCIPAL FINDINGS: The lower limits of both the 95% and 99% CIs for the difference in charges are greater than 0 for three weeks. The lower limits of both CIs for the difference in the proportion of patients with charges are above 0 for six weeks. CONCLUSIONS: Our analysis demonstrates that a health services research framework can be used to define an episode of care for a chronic disease category such as migraine. This method can be used to evaluate episodes of care for clinical studies of limited or episodic conditions and to complement clinical expertise in developing time horizons for clinical trials.

Adult↗
PubMed1993

Sulfonylurea-binding sites and ATP-sensitive K+ channels in alpha-TC glucagonoma and beta-TC insulinoma cells.

alpha-Cells secrete glucagon in a fuel-dependent fashion. We tested the hypothesis that alpha-cells contain sulfonylurea- and ATP-sensitive K+ channels. We studied two clonal lines of alpha-TC cells (simian virus 40 T-antigen induced glucagonoma cells) and for reference purposes, similarly transformed beta-TC insulinoma cells. alpha-TC cells each contained approximately 3000 high-affinity binding sites for the sulfonylurea [3H]glyburide. Whole-cell ATP- and tolbutamide-sensitive K+ currents of alpha-TC and beta-TC cells, relative to cell surface area, were comparable. In cell-attached membrane patches of alpha-TC cells, two types of K+ channels were observed. They had slope conductances of approximately 63 and 33 pS when the electrode contained 151 mM K+. Tolbutamide and diazoxide decreased and enhanced, respectively, the open probability of these channels. The membrane of alpha-TC cells depolarized periodically. This electrical activity was inhibited by diazoxide. A physiological mixture of amino acids enhanced glucagon release, and high glucose partially inhibited this release. Tolbutamide also enhanced glucagon release, whereas diazoxide inhibited it. Thus, alpha-TC glucagonoma cells contain ATP-sensitive K+ channels that regulate glucagon release, yet allow inhibition of hormone release by glucose.

Adenosine Triphosphate↗
PubMed1988

Magnetic resonance imaging in an unusual presentation of herpes encephalitis.

We report a patient with herpes simplex virus encephalitis who presented with left hemiparesis and progressed to aphasia and generalized spasticity. Computerized axial brain tomography with and without infusion of contrast medium was normal, as were the cerebrospinal fluid findings. However, magnetic resonance imaging scan and brain biopsy, were diagnostic of herpes simplex encephalitis.

Child↗
PubMed1983

Left ventricular thrombus. Detection by ECG synchronized cineangiography.

The detection of a left ventricular mural thrombus, a potentially fatal complication of various heart diseases, is often missed by current radiographic techniques. The findings on ECG synchronized radionuclide cineangiography in a patient with a large thrombus in the left ventricular cavity, confirmed by echocardiography and angiography are reported. This suggests a role for radionuclide cineangiography in the detection of left ventricular mural thrombus.

Coronary Disease↗
PubMed1983

CT diagnosis of renal cyst wall tumor.

Renal cysts are common lesions especially in the older population. Although the occurrence of a tumor within the wall of an otherwise benign cyst is rare, its accurate diagnosis is difficult. We present such a case, diagnosed preoperatively by computed tomography.

Female↗
PubMedDate not supplied

A claims data approach to defining an episode of care.

OBJECTIVE: To utilize health services research techniques in developing an episode of care using an administrative data set. This method is demonstrated for an episodic clinical condition, migraine. DATA SOURCES: Medicaid administrative data set of 3,372 patients with a diagnosis of migraine (ICD-9-CM 346.0, 346.1) in the state of Pennsylvania between May 1990 and March 1992. STUDY DESIGN: The duration of a migraine episode was measured by assessing the magnitude of resource utilization and the proportion of patients with charges in the period after the index migraine as compared to the period before the index migraine. A confidence interval (CI) was developed around each measure using bootstrap techniques. DATA COLLECTION METHODS: All charge data were extracted daily for a 113-day observation period surrounding each index migraine in order to observe the duration of impact of a migraine diagnosis on resource utilization. PRINCIPAL FINDINGS: The lower limits of both the 95% and 99% CIs for the difference in charges are greater than 0 for three weeks. The lower limits of both CIs for the difference in the proportion of patients with charges are above 0 for six weeks. CONCLUSIONS: Our analysis demonstrates that a health services research framework can be used to define an episode of care for a chronic disease category such as migraine. This method can be used to evaluate episodes of care for clinical studies of limited or episodic conditions and to complement clinical expertise in developing time horizons for clinical trials.

Adult↗