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Biomedical subjects

A Shapiro

Publications and source records attributed to A Shapiro.

At least 163 records · Page 9Linked to original sources
PubMed1987

Shock-wave treatment for stones in the kidney and ureter. The Jerusalem experience.

We report on our first 6 months' experience with the extracorporeal shock-wave lithotripter (ESWL). During this period, 410 treatments were given to 350 kidneys and ureters. Our series was characterized by a particularly high proportion (40%) of multiple and large calculi and included 25 complete staghorns. The latter required multiple treatments (up to five), but no adjunct percutaneous nephrolithotomies were used in this series. A percutaneous nephrostomy was inserted in 20 cases. Thirty-six ureteric calculi above the pelvic level were treated in situ, with 95% success. The presence of a ureteric catheter is useful in these cases. Posttreatment pain was graded, and 61% of the patients did not require any analgesia. High-frequency jet ventilation was used in 91% of the 172 patients receiving general anesthesia and was of great value in minimizing respiratory-stone movement. The principal complication encountered was ureteric obstruction due to impacted particles. Temperature greater than 38 C occurred in 8.5% of the cases. It is suggested that the availability of the ESWL should encourage the early treatment of both renal and ureteric calculi, as well as enable the treatment of certain patients rejected for conventional surgery.

Adolescent↗
PubMed1986

A clinicopathologic study of hematic cysts of the orbit.

Hematic cyst of the orbit has been described in association with various diseases, but its pathogenetic mechanism remains unclear. We treated two patients (two men, 38 and 35 years old) who had growing cysts suspected of being malignant tumors. Surgical exploration of the orbits disclosed birefringent crystals (hematodin) either in the cyst wall or in the cyst's contents. The crystals imitated foreign bodies in their appearance and in the reactions they induced.

Adult↗
PubMed1986

Inhibition of murine bladder tumor growth by bacille Calmette-Guerin: lack of a role of natural killer cells.

Intravesical instillation of bacille Calmette Guerin (BCG) currently is considered the most effective treatment for recurrent superficial bladder cancer, but little is known about the mechanism of action. We have adapted a model in which the mouse bladder tumor, MBT-2, is implanted directly into the bladder to examine the mechanism by which BCG inhibits tumor growth. The intravesical administration of BCG inhibited MBT-2 implantation in a dose-dependent manner. Concomitantly, natural killer (NK) activity was augmented in a dose-dependent manner. Conversely, BCG doses which did not augment NK activity lacked antitumor activity. Linear regression analysis showed a significant correlation between the antitumor activity of BCG and modulation of NK activity (correlation coefficient, 0.991). Additional studies were performed in which NK activity was abrogated by administration of anti-asialo-GM1 serum. NK activity was depressed in spleens and lymph nodes of both normal and BCG-treated mice. Abrogation of NK activity did not alter the efficacy of BCG therapy suggesting that NK cells are not a major contributor to the antitumor activity of BCG.

Animals↗
PubMed1986

Optimisation of indices of external pneumatic compression for prophylaxis against deep vein thrombosis: radionuclide gated imaging studies.

The amount and rate of blood expelled with different modes of intermittent external pneumatic compression applied to the lower leg were studied on a regional basis in a series of experiments on healthy human volunteers. Radionuclide imaging of the labelled blood pool, with acquisition of counts synchronised to the pressurisation cycle, provided data on regional blood volumes in the leg in relation to time. To determine the changes in blood volume of the lower leg resulting from external pneumatic compression labelled red blood cell counts were determined during 10 different types of compression cycle. Since venous stasis is considered to be a major cause of venous thrombosis the red blood cell counts were used to calculate regional values of the fraction of blood ejected as well as comparative indices proportional to regional flow rate, regional velocity, and regional wall shear stress. All these indices should be maximised for optimal prophylaxis against deep vein thrombosis. The four compartment cuff in each compression mode applied a mean pressure of 45 mm Hg, but different combinations of values were used for intercompartmental pressure gradation (delta p) and for intercompartmental time sequencing to the onset of compression (delta t). Uniform compression (delta p = 0; delta t = 0) was substantially inferior to cycles with gradation and sequencing. The optimal values of delta p were in the range 5-10 mm Hg and of delta t in the range 0-0.5 seconds.

Adolescent↗
PubMed1986

A double-blind, placebo-controlled trial of TRH in amyotrophic lateral sclerosis.

A double-blind, placebo-controlled trial of single doses of thyrotropin releasing hormone (TRH) was performed on 12 patients with amyotrophic lateral sclerosis. Each patient was given subcutaneous injections of TRH 150 mg or placebo, and IV infusions of TRH 500 mg or placebo at 72- to 96-hour intervals. Eight motor and functional ratings were scored at regular intervals after each injection. Side effects were seen in all patients and were obvious to patients and examiners, making true blinding impossible. Nevertheless, statistically significant improvement was seen only in dynametric strength 1 hour after subcutaneous injection (p less than 0.05). Significant improvement occurred, in one patient only, on subjective speech testing during IV infusion of TRH. In none of six other ratings was there a significant difference between TRH and placebo. Subjective improvement was noted by 11 of 12 patients.

Adult↗
PubMed1986

The effect of menstrual cycle on blood alcohol levels and behavior.

To determine whether the behavioral effects of alcohol were altered by menstrual cycle phase, 10 women between the ages of 21 and 24 who reported regular menstrual cycles of 28-31 days participated in three experimental sessions, the dates of which coincided with the flow, midcycle and premenstrual phases of their cycles. In each session, the effects of alcohol (.65 g/kg) were measured on memory for words, standing steadiness, coding vigilance and blood alcohol level (BAL). The following measures were obtained in each of three testing rounds: baseline, the ascending limb of the BAL curve and the descending limb of the BAL curve. Peak BALs of 83 +/- 2 mg/d1 were obtained. On coding vigilance, the subjects were observed to perform better during the flow phase of their cycle than they did in either the midcycle or premenstrual phase. No significant phase by alcohol effects were obtained, however. These results suggest that neither the pharmacokinetics of alcohol nor certain behaviors affected by alcohol were affected by menstrual cycle phase. These results are generally consistent with previous research, and they question the logic of excluding women subjects from studies on the effects of alcohol on behavior, at least for the variables used in this study.

Adult↗
PubMed1985

Histopathologic condition of fascia lata implant 42 years after ptosis repair.

Fascia lata implants have been employed since the early part of this century in the repair of blepharoptosis. Although much has been written concerning surgical techniques and results of implanting different preparations of fascia lata, there are relatively few reports of long-term histopathologic follow-up of recovered tissue. In the case described herein, autogenous fascia lata was recovered at the time of repeated surgery and examined 42 years later. On microscopic examination the tissue was viable but demonstrated significantly more vascularization, fibroblastic infiltration, and incorporation with surrounding structures than previously reported implants.

Aged↗
PubMed1985

Diagnosis and management of renal angiomyolipoma.

Renal angiomyolipoma (hamartoma) is an uncommon benign tumor of the kidney. Although about 400 cases of renal angiomyolipoma have been reported, it still causes difficulties in diagnosis and treatment. Until a few years ago it was almost impossible to arrive at a correct diagnosis preoperatively, and most of the cases underwent nephrectomy with the wrong diagnosis of renal carcinoma. More recently, abdominal computerized tomography and renal sonography have made it possible to reach the correct preoperative diagnosis in many cases, and thus to avoid unnecessary nephrectomies. We report on our experience with 13 cases of renal angiomyolipoma, and our conservative approach in a number of cases, which has enabled us to preserve renal tissue and function.

Adolescent↗
PubMed1985

Intravesical bacillus Calmette-Guerin therapy for superficial bladder cancer: effect of bacillus Calmette-Guerin viability on treatment results.

We treated 40 patients with superficial bladder cancer via intravesical bacillus Calmette-Guerin for 1) prophylaxis against tumor recurrence, 2) residual carcinoma or 3) flat carcinoma in situ. A single course of intravesical bacillus Calmette-Guerin therapy was successful in 6 of 11 patients (55 per cent) treated for residual carcinoma and 6 of 12 (50 per cent) treated for carcinoma in situ. Of 17 patients receiving a single course of bacillus Calmette-Guerin for prophylaxis 11 remained free of tumor during short-term followup. A second course of therapy was administered to failures in each treatment category, which resulted in favorable responses in 5 of 6 patients treated for prophylaxis, 2 of 5 treated for residual tumor and 3 of 6 treated for carcinoma in situ. Over-all complete responses were achieved in 16 of 17 patients (94 per cent) treated for prophylaxis, 8 of 11 (73 per cent) for residual carcinoma and 8 of 12 (66 per cent) for carcinoma in situ, with a mean followup from the final treatment of 9.3, 12.3 and 7.9 months, respectively. Favorable results occurred more frequently among patients who exhibited a granulomatous inflammatory response in the bladder and delayed hypersensitivity skin test response to purified protein derivative. Marked variability in viability of bacillus Calmette-Guerin organisms was observed among different lots of bacillus Calmette-Guerin, and a direct relationship was observed between bacillus Calmette-Guerin vaccine viability and therapeutic efficacy. Most patients who failed initial therapy with a low viability lot of bacillus Calmette-Guerin responded favorably to re-treatment with a higher viability lot. The results suggest that the level of viability of each lot of bacillus Calmette-Guerin vaccine should be verified before clinical use.

Adult↗
PubMed1985

Double composite lid reconstruction: a new method of upper and lower lid reconstruction.

The double composite grafting technique utilizes two composite lid grafts from an opposing upper and lower lid for reconstruction of extensive lid defects. These two composite grafts are covered by a rotational pedicle advancement skin flap. The skin defect created by such an advancement graft is covered by a free skin graft. The donor areas are closed directly by a layer-by-layer approximation. This new single-stage technique allows reconstruction of large lid defects without covering an affected eye for a prolonged period and without jeopardizing the irreplaceable entity of a "normal" lid margin.

Eyelids↗