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Biomedical subjects

A Yellin

Publications and source records attributed to A Yellin.

At least 73 records · Page 4Linked to original sources
PubMed1991

Portal vein thrombosis complicating endoscopic variceal sclerotherapy. Convincing further evidence.

Portal vein thrombosis occurred in a patient who bled from gastric varices that developed after obliteration of esophageal varices by endoscopic sclerotherapy. This complication was recognized only at surgery when thrombectomy and endovenectomy preceded the successful placement of an end-to-side portocaval shunt. At histopathology, the presence of an amorphous, eosinophilic material staining negatively for fibrin and similar to sclerosant injected at sclerotherapy was observed within the clot. This latter finding, previously unreported, provides convincing evidence for the causal relationship of portal vein thrombosis to endoscopic sclerotherapy.

Esophageal and Gastric Varices↗
PubMed1991

Postoperative unilateral diaphragmatic paralysis in children, a plea for early plication.

Unilateral diaphragmatic paralysis (UDP) is not an uncommon occurrence after cardiovascular operations. Its incidence in the pediatric age group is at least 1.5%, and severely symptomatic (for example: requiring mechanical ventilation) patients account for about one third of the cases. We have encountered four such cases among 850 children (0.5%) undergoing cardiovascular procedures, and have treated two additional patients. All required prolonged intubation and mechanical ventilation. Diaphragmatic plication in five was performed rather late in the course of their illness, after 21-120 days mechanical ventilation, and was successful in three who survived, allowing weaning from ventilation within 3-6 days. The procedure itself is simple and safe. We recommend that diaphragmatic plication be performed early in children with UDP and weaning difficulties.

Adolescent↗
PubMed1991

Penetration of ofloxacin into human lung tissue following a single oral dose of 200 milligrams.

The penetration of ofloxacin into lung tissue was studied in 10 patients subjected to pulmonary surgery. Samples of blood and lung tissue were obtained 3 to 8 h (mean, 5 h) after oral administration of 200 mg. The mean level in tissue was 2.17 +/- 0.5 micrograms/g, while the mean level in serum was 0.85 +/- 0.23 micrograms/ml. The mean lung tissue/serum concentration ratio was 2.55 +/- 0.30. The achievable levels of ofloxacin in lung tissue are above the MICs for most pulmonary pathogens.

Administration, Oral↗
PubMed1991

Radiation associated malignant pleural mesothelioma.

Malignant pleural mesothelioma of epithelial type developed in a 24 year old woman, 20 years after radiotherapy for Hodgkin's disease. This case and a review of published cases indicate that radiation may induce malignant mesothelioma.

Adult↗
PubMed1991

Familial multiple bilateral pneumothorax associated with Marfan syndrome.

Three members of one family, a father and two sons, inflicted with Marfan syndrome, suffered multiple bilateral episodes of spontaneous pneumothorax that required repeated drainage procedures. The youngest patient also had an episode of unilateral expansion pulmonary edema; he underwent sequential pleural abrasions. Familial pneumothorax is very uncommon, and its association with Marfan syndrome is an exception.

Adult↗
PubMed1990

Effects of 5-azacytidine in Syrian golden hamsters: toxicity, tumorigenicity, and differential modulation of bronchial carcinogenesis.

5-Azacytidine (AZC) was studied in a lung cancer model in outbred and syngeneic (F1D) hamsters wherein benzol[a]pyrene (BP) from sustained release implants (SRI) induces preneoplastic mucosal changes which progress to bronchogenic cancer. In pilot studies to evaluate AZC toxicity, a dose schedule of 5 mg/kg biweekly was found suitable and was then used for long-term administration in all subsequent studies. Three groups of outbred hamsters were studied: BP SRi alone (n = 60), BP SRI + AZC (n = 60), and AZC alone (n = 54). AZC treatment was begun 3-5 days after SRI placement. Sixty-one days after the start of the experiment, seven or eight hamsters were sacrificed from each group. Later sacrifices were at 3-week intervals in groups receiving BP SRI and at 6-week intervals in the AZC only group. Four groups of F1D syngeneic hamsters were studied: BP SRI alone (n = 50); BP + AZC starting 3-5 days after SRI placement and continuing until death (n = 52); BP + AZC from 3 to 5 days until 75 days after SRI placement (n = 49); BP + AZC starting 80 days after SRI placement and continuing until death (n = 52). Hamsters (n = 9-14) from each group were sacrificed at 120, 150, 180, and 220 days after SRI implantation. AZC alone was not carcinogenic under these conditions. Both outbred and F1D hamsters treated with early or continuous AZC had slower rates of neoplastic change from BP SRI than did animals receiving BP SRIs alone or BP + late AZC. The incidence of epidermoid cancer were the same for all regimens, but the tumors in those receiving AZC early in carcinogenesis were smaller than in those receiving late or no AZC. The incidences of nonepidermoid cancer were lower in those receiving AZC during early carcinogenesis, and larger tumors were noted in the absence of AZC. Thus, within the study period in this unique hamster lung cancer model, AZC given early in carcinogenesis inhibited only the later (promotional) phase of BP epidermoid carcinogenesis, but inhibited all phases of nonsquamous cancer development induced by BP. This differential modulation of bronchial carcinogenesis, which occurs from AZC given during preneoplastic stages, may prove useful for delineating molecular mechanisms underlying specific phenotypic types of bronchogenic cancers.

Animals↗
PubMed1990

Septic arthritis of the sternoclavicular joint in healthy adults.

Septic arthritis of the sternoclavicular joint (SCJ) is a rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis and diabetes mellitus. Three cases in previously healthy adults are reported here. The aetiology, clinical manifestations and treatment are briefly reviewed. The considerable difficulty in diagnosing this disorder in adults is emphasized. In summary, diagnosis of septic arthritis of the SCJ in adults requires a high index of suspicion, and must be considered not only in patients with predisposing factors, but also in previously healthy adults.

Adult↗
PubMed1990

Superior vena cava syndrome. The myth--the facts.

This retrospective review was performed with an intent to clarify several misconceptions associated with superior vena cava syndrome (SVCS). During a 16-yr period, we diagnosed and treated 63 patients with SVCS, including seven (11%) children younger than 10 yr of age. Thirty patients (47.6%) had bronchogenic carcinoma, and 13 (20.6%) had lymphoma. In 43 cases SVCS was the presenting symptom of a mediastinal condition. Forty-one patients underwent diagnostic procedures with no major complications, and diagnosis was obtained in 36. Only six patients had surgical treatment, and 45 had radiation therapy, chemotherapy, or both. There was no mortality associated directly with venous congestion. Symptomatic relief occurred in 80% of treated patients. We conclude that: (1) SVCS per se should not be feared (symptomatic relief is the rule), (2) accurate diagnosis can be achieved with minimal morbidity, and (3) the versatile underlying etiology dictates the outcome that can be improved with appropriate therapy.

Adolescent↗
PubMed1990

Quantitative DNA alterations during 5-azacytidine-induced differential modulation of benzo(a)pyrene carcinogenesis in hamster bronchi.

Sustained release implants (SRI) containing 10% benzo(a)pyrene (BP) were placed endobronchially into outbred and syngeneic (F1D) hamsters. Randomly selected OB and F1D hamsters also received 5-azacytidine (AZC), 5 mg/kg i.p., twice weekly until death (AZC-CONT); two more groups of F1D hamsters were given the same AZC dose either for the first 75 days of SRI implantation (AZC-EARLY) or from 80 days after SRI placement until death (AZC-LATE). OB Hamsters were sacrificed at regular intervals from 62 to 189 days of SRI exposure. F1D Hamsters were sacrificed in groups after 120, 150, 180, and 220 days of SRI exposure. The bronchial mucosa at the SRI site was examined cytologically and histologically, as were the tumors that developed. Mean quantitative total cellular DNA values (QDNA) were measured by image analysis. For both varieties of hamster given AZC, QDNA values were higher in early carcinogenesis (CG) and lower in the late stage of CG than in hamsters that did not get AZC (P less than 0.001). QDNA values were lower in epidermoid than in non-epidermoid cancers (P less than 0.001); for both types of cancer, QDNA was lower in AZC-treated hamsters (P less than 0.01). Cancers induced under the influence of AZC included more epidermoid cancers (P less than 0.01) and were of a higher degree of differentiation (P less than 0.01) than those induced by BP alone, especially when AZC was given early in CG. There was no consistent relationship between QDNA and degree of differentiation in tumors. These differential effects of AZC given early during CG suggest that 1) for epidermoid bronchial CG, some of the molecular alterations involved in hyperploidy and in differentiation occur early in the sequential progression of carcinogenesis; and 2) for both epidermoid and non-epidermoid bronchial CG, the necessary changes must occur in a fixed sequence instead of as random events, until all needed changes have occurred.

Animals↗
PubMed1989

Effect of tobacco withdrawal on sustained attention.

Sixteen smokers completed a sustained attention task, were randomly assigned to either continue smoking or abstain for 24 h, and were retested. Eight nonsmokers served as a control group. Abstinence increased the variability in responding. Abstinence also appeared to impair the ability to inhibit responding. Abstinence did not potentiate fatigue during the task. These results are consistent with reports that tobacco withdrawal increases difficulty concentrating and impatience but does not increase fatigue.

Adult↗
PubMed1989

Program on the Surgical Control of the Hyperlipidemias (POSCH): design and methodology. POSCH Group.

The Program on the Surgical Control of the Hyperlipidemias (POSCH) is a prospective, randomized, controlled, multi-center, secondary, atherosclerosis intervention trial. POSCH addresses the therapeutic arm of the lipid-atherosclerosis theory, i.e. whether lowering of plasma cholesterol is directly related to a reduction in atherosclerosis risk. In this trial, lipid modification is accomplished by the partial ileal bypass operation. Between 1975 and 1983, 838 patients were randomized into this study. All patients were between 30 and 64 years of age, had survived one and only one electrocardiogram and enzyme-documented myocardial infarction, and had a total plasma cholesterol of at least 220 mg/dl or a low density lipoprotein (LDL)-cholesterol of at least 140 mg/dl if the total plasma cholesterol was between 200 and 219 mg/dl after a minimum of 6 weeks of dietary fat and cholesterol restriction. The primary response variable in POSCH is overall mortality. Secondary endpoints include fatal and non-fatal myocardial infarctions, serial electrocardiographic changes, and, most importantly, sequential coronary arteriography changes. The minimum follow-up is currently planned to be 7 years. Study analyses will be made primarily on the "intention to treat" basis. This paper is the first detailed presentation of POSCH design and methodology. Included are descriptions of study design, implementation, and data collection, including data processing, quality assurance/quality surveillance, and patient safety monitoring. POSCH seeks to demonstrate a significant reduction in overall mortality by lipid modification and to validate the use of coronary arteriographic change as a surrogate endpoint for change in coronary heart disease risk.

Adult↗