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A Kaplan

Publications and source records attributed to A Kaplan.

211 records · Page 12Linked to original sources
PubMedDate not supplied

Reconstruction of the subglottic larynx with a myoperiosteal flap: clinical and experimental study.

The literature describes numerous techniques for reconstruction of the subglottic larynx. The use of rigid bone grafts or flaps has been associated with problems because the rigid bone cannot conform to the defect and form an airtight seal. We have performed subglottic reconstruction using the sternocleidomastoid myoperiosteal flap with very optimistic results on long-term follow up. The sternocleidomastoid myoperiosteal flap is a relatively simple procedure that can be used for a large variety of defects. The pliable periosteal flap used for closing the defect can be molded over a stent to form an airtight seal. We have demonstrated bone formation in the periosteum which is crucial to the stability of the airway and long-term success of the procedure. The sternocleidomastoid myoperiosteal flap yields a pliable, durable tissue capable of airtight closure and a tension-free suture line. This technique will make the closure of subglottic defects a much more practical task.

Aged↗
PubMedDate not supplied

Apolipoprotein E type 4 allele and cerebral glucose metabolism in relatives at risk for familial Alzheimer disease.

OBJECTIVE: Cerebral parietal hypometabolism and left-right asymmetry occur early in the course of Alzheimer disease (AD), and the apolipoprotein E type 4 allele (APOE epsilon 4) is a risk factor for familial AD. To determine if APOE epsilon 4 is associated with lowered brain function in nondemented relatives at risk for familial AD, we studied 12 relatives with APOE epsilon 4 and 19 relatives without APOE epsilon 4. We also compared them with seven patients with probable AD. DESIGN: After grouping subjects according to diagnosis and genotype, brain function measures were compared among groups. SETTING: University medical center. PATIENTS: At risk subjects had mild memory complaints, normal cognitive performance, and at least two relatives with AD. Subjects with APOE epsilon 4 did not differ from those without APOE epsilon 4 in mean age at examination (56.4 vs 55.5 years) or in neuropsychological performance (mean Mini-Mental State Examination score, 28.8 vs 29.3). MAIN OUTCOME MEASURES: Cerebral glucose metabolism was measured using positron emission tomography and fludeoxyglucose F 18. RESULTS: Parietal metabolism was significantly lower and left-right parietal asymmetry was significantly higher in at-risk subjects with APOE epsilon 4 compared with those without APOE epsilon 4. Patients with dementia had significantly lower parietal metabolism than did at-risk subjects with APOE epsilon 4. CONCLUSIONS: These results suggest that the inheritance of APOE epsilon 4 is associated with reduced cerebral parietal metabolism and increased asymmetry in non-demented relatives at risk for probable AD. Longitudinal study will determine if glucose metabolic measures provide a means to monitor experimental treatment responses during the early phases of the disorder.

Adult↗
PubMedDate not supplied

Are selective macromolecule removal plasmapheresis systems useful for autoimmune diseases or hyperlipidemia?

Although technical limitations exist with existing selective removal systems, very few products are available and no major clinical trials have demonstrated the superiority or equivalence of selective removal systems over plasma exchange. It is generally recognized that selective removal systems are preferable, and that selective macromolecule removal plasmapheresis systems are useful for autoimmune diseases or hyperlipidemia. In the treatment of a disease with a selective removal device, the disease pathogen should be identified and the efficacy of removal demonstrated. In general, for plasmapheresis applications, there is a need to better understand the pathophysiology of the disease states and to identify the pathogenic molecules. With such information, development of the optimal selective removal method will be possible. There is the need for clinical studies to compare selective removal and plasma exchange for specific disease states. Incentives for the development of improved selective removal technologies where cost effectiveness could be demonstrated should be encouraged.

Autoimmune Diseases↗