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Biomedical subjects

C Solomon

Publications and source records attributed to C Solomon.

At least 37 records · Page 2Linked to original sources
PubMed1996

Endothelin-1 is increased overlying atherosclerotic plaques in human arteries.

The distribution of Endothelin-1 (ET-1), a potent vasoactive peptide, within endothelium of human atherosclerotic arteries was examined using a novel en face immunohistochemical technique. The vast majority of endothelial cells were immunoreactive for ET-1. Staining intensity was increased in areas overlying atherosclerotic plaques, calcified media, fatty streaks and about flow dividers, compared with adjacent regions. Multinucleated 'giant' endothelial cells were more common in regions containing strong ET-1 staining than elsewhere. Clusters of leucocytes (probably monocytes) were frequently observed adhering to the endothelial monolayer but not neighbouring regions of denudation. Occasionally underlying macrophage/foam cells and smooth muscle cells were exposed to the surface and included in the en face (Häutchen) preparation. Smooth muscle cells did not stain for ET-1 while macrophages and the larger foam cells were positive for ET-1. These results support the hypothesis that expression of ET-1, at sites containing atheromatous disease, may be involved in the development of atherosclerosis.

Aged↗
PubMed1996

Video image analysis of hands: development of an 'anatomic index' as a potential outcome measure in rheumatoid arthritis.

In this study, we used video image analysis for the measurement of hand dimensions to reflect destructive changes in rheumatoid arthritis. Thirteen dimensions were measured from anteroposterior and lateral views of the hands, open and closed. Comparison of measurements in 19 patients and 19 control subjects showed significant differences for nine of the 13 measurements. Five were reproducible on retesting in a subset of patients and normals. Two were eliminated because they were similar to other measurements. The three remaining measurements selected for differentiation of patients and normals, and reproducibility, were combined in an arbitrary 'anatomic index'. This enhanced separation of normals and patients with rheumatoid arthritis. The results demonstrate that measurement of certain hand dimensions and their combination in an 'anatomic index' could provide a measure reflecting the progressive anatomical abnormality caused by rheumatoid arthritis. Validation of this concept could provide a further outcome measure in patients with rheumatoid arthritis.

Aged↗
PubMed1995

The use of video image analysis for the measurement of venous ulcers.

The accurate measurement of the size of skin wounds and ulceration is important for comparing the efficiency of treatment modalities and for monitoring progress in the individual patient. Although various methods of differing sophistication are in use, many of the common simpler techniques lack accuracy and reliability. We describe a new technique of ulcer measurement which uses video image recording, capture and computer analysis. A method of correcting for limb convexity in a two-dimensional image is presented. The method has an overall accuracy of 1.82% and a clinical precision of 3.41%, both of which are significantly better than acetate tracings or photographic methods. The technique is simple and rapid, and once established it incurs minimal ongoing costs.

Humans↗
PubMed1995

The endodontic-periodontal lesion: a rational approach to treatment.

When a periapical lesion communicates with a deep periodontal pocket, the etiology can be either endodontic or periodontal. This article clarifies the relationship between pulpal and periodontal disease and presents a systematic approach to the diagnosis and management of endodontic-periodontal lesions. It also presents a case that demonstrates the successful treatment of teeth that appear to be hopelessly diseased.

Dental Pulp Necrosis↗
PubMed1995

Plasma catecholamine and ventilatory responses to cycling after propranolol treatment.

The purpose of the present study was to examine the relationship between minute ventilation (VE) and plasma concentrations of epinephrine (EPI) and norepinephrine (NE) during incremental cycling (20 W.2 min-1) performed under conditions of beta-adrenergic blockade (80 mg of propranolol) and placebo in six untrained male subjects. No significant differences existed between treatments in O2 uptake, CO2 output, blood lactate, pH, or VE during the submaximal work stages of incremental exercise common to both treatments (20 - 220 W). During exercise with beta-blockade, EPI, and NE concentrations were both significantly elevated compared with control levels at every submaximal work stage. Significant positive correlations between VE and plasma levels of EPI and NE were found during both beta-blockade (r = 0.98 and 1.00) and control conditions (r = 0.98 and 0.96). Although the high correlations were unchanged during exercise with beta-blockade, the slopes of the regression lines for the VE-EPI and the VE-NE relationships were both significantly reduced compared with control conditions. Beta-blockade resulted in elevated plasma levels of both EPI and NE compared with control conditions without causing a change in exercise VE. These findings suggest that catecholamines may not be important substances in regulating breathing during exercise.

Adrenergic Agonists↗
PubMed1994

Amputations in the surgical budget.

AIM: To describe the extent and distribution of in patient costs of nontraumatic lower limb amputations and to identify areas of high cost as a basis for cost saving strategic planning. METHODS: Retrospective review of 134 consecutive admissions resulting in lower limb amputations for reasons other than trauma over a 33 month period. General surgical and orthopaedic costs were compared. More detailed cost distribution analysis was then conducted for a group of general surgical amputees corroborating data from the resource utilisation system, Otago surgical audit and patient records. RESULTS: The mean cost of admission for nontraumatic lower limb amputations performed by general surgeons was $11,342 (median $21,439 range $144-$43,022) and was significantly more expensive than orthopaedic amputations, mean $2318 (median $6277 range $307-$13,907) p < 0.001. Of general surgical patients, 38.7% had diabetes and these accounted for 36.1% of total costs. Most amputations (73.9%) in diabetics were of the minor type compared with 29.0% in the nondiabetic group (p < 0.001). Ward costs accounted for the largest proportion of total cost 55.6% (95% CI 45.1, 66.0). For major amputees 40% (95% CI 31.4, 48.1) of in-hospital time was used for rehabilitation. CONCLUSION: Nontraumatic amputations are costly. Diabetics, having mainly minor amputations, account for a disproportionate amount of the cost. Length of hospital stay is the most important determinant of cost, much of which is spent on rehabilitation. A case is made for early definitive surgery and a greater use of community based services and low cost centres in rehabilitation.

Amputation, Surgical↗
PubMed1994

The effects of exercise duration on dynamics of respiratory gas exchange, ventilation, and heart rate.

This study investigated the effect of exercise duration on the response dynamics of oxygen consumption (VO2), carbon dioxide output (VCO2), ventilation VE), and cardiac frequency (fc) following stepped changes in exercise intensity, by manipulating the duration of the pretransition exercise period. A group of 11 healthy men performed a stepped exercise intensity cycling protocol on three separate occasions, each consisting of a stepped increase from 55% to 65% peak oxygen consumption (VO2,peak) of 6-min duration, followed by a stepped decrease to 55% VO2,peak of 10-min duration. This stepped protocol was preceded by either 5, 15, or 60 min of cycling at 55% VO2,peak. The response times for each variable were calculated at 10% increments between the prestep baselines and poststep plateaux. Following the stepped increase, the response times for VO2 at the 50%, 60%, 70%, 80%, and 90% relative increments were significantly reduced in the 60-min condition compared to the 15-min condition (P < 0.05); however, the response times for VCO2, VE, and fc were not significantly altered across the three conditions. No significant differences were found in the response times for VO2, VCO2, VE, and fc, across the three conditions following the stepped decrease in exercise intensity. It was concluded that the faster response time of aerobic metabolism to a stepped increase in exercise intensity was mediated by increases in active muscle temperature, leading to improved oxygen utilisation.

Adult↗
PubMed1994

Anatomic and physiologic characteristics of venous ulceration.

PURPOSE: The purpose of this study was to describe the combination of physiologic and anatomic changes present in limbs with venous ulceration. METHODS: Limbs with venous ulceration (chronic venous insufficiency [CVI] class 3) were assessed prospectively by air plethysmography and color-flow duplex scanning. Findings were compared with clinically normal contralateral limbs and normal control limbs (CVI class 0), as well as with limbs without skin changes (CVI class 1). RESULTS: Of the 120 ulcerated limbs studied, only 28% had deep system incompetence. Reflux at the saphenofemoral or saphenopopliteal junctions without perforator incompetence was present in 40%. Raised venous filling indexes (> 2 ml/s) and high residual volume fractions (> 20%) were present in 90% and 95%, respectively. Although levels of these parameters were significantly different from the other groups (p < 0.05), absolute ejection volumes and outflow parameters were the same (p > 0.05). One third of contralateral "normal" limbs (class 0) had abnormal duplex scanning findings. The ratio of venous filling time to residual volume fraction produced a useful discriminating index for the ulcerated limb. CONCLUSION: The ulcerated limb was characterized by high rates of reflux and high residual volumes that were independent of the site of reflux. This study highlights the important association of venous ulceration and isolated superficial venous system incompetence.

Adult↗
PubMed1994

Ventilatory and hyperkalemic responses to incremental exercise after propranolol treatment.

The purpose of the present study was to examine the relationship of plasma potassium (K+) and minute ventilation (VE) during incremental cycling (20 W/2 min) under conditions of beta-adrenergic blockade (80 mg of propranolol) and placebo in six untrained male subjects. No significant differences existed between treatments in O2 uptake, CO2 production, blood lactate, pH, or VE during the submaximal work stages of incremental exercise common to both treatments (20-220 W). During exercise with beta-blockade, plasma K+ concentrations were found to be significantly elevated compared with control levels at every work stage except 20 W. Significant positive correlations between VE and plasma K+ were found during both beta-blockade (r = 0.99) and control conditions (r = 1.00). Although the high correlation between VE and K+ was not altered with beta-blockade, propranolol treatment resulted in a significant reduction in the slope of this relationship during incremental exercise (P < 0.01). These findings suggest that 1) beta-blockade decreases the VE-K+ relationship observed during exercise and 2) K+ stimulation of muscle afferents is not an important signal in the control of exercise ventilation.

Adult↗
PubMed1994

Chelation therapy for intermittent claudication. A double-blind, randomized, controlled trial.

BACKGROUND: The use of repeated intravenous infusions of EDTA, which has become known as "chelation therapy," has been promoted for treating intermittent claudication as well as a wide range of other disorders. Multiple reports of excellent results in large numbers of patients have encouraged the use of this regimen. The lack of well-controlled studies substantiating the benefits of this treatment has limited its use mainly to private clinics. The aim of the study was to assess the benefits of chelation therapy in patients with intermittent claudication. METHODS AND RESULTS: A double-blind, randomized, controlled trial included 32 patients with intermittent claudication who were randomized to a treatment group (15) and a control group (17). Main outcome measures were subjective and measured walking distances and ankle/brachial pulse indices. Other outcome measures included lifestyle and subjective parameters of improvement, cardiac function, ECG, renal function, hematology, blood glucose, and lipid biochemistry. No clinically significant differences in main outcome measures between chelation therapy and placebo groups were detected up to 3 months after treatment. Measures of mood state, activities of daily living, and quality of life factors were not consistently affected by chelation therapy. An equal proportion (13%) of each group thought that they had received the active agent. The proportion of patients showing an improvement in walking distance was not significantly different between the chelation group (60%) and the control group (59%). CONCLUSIONS: Chelation therapy has no significant beneficial effects over placebo in patients with intermittent claudication.

Activities of Daily Living↗
PubMed1994

Guided tissue regeneration: an adjunct to endodontic surgery.

Membrane barriers used in conjunction with periodontal surgery have promoted regeneration of lost marginal attachment. Membrane barriers also may be indicated during surgical endodontics, in selected cases, where primary apical lesions are complicated by the loss of marginal attachment. The indications for using guided tissue regeneration in endodontic surgery are discussed and two cases are presented.

Adult↗
PubMed1990

Biliary cystadenoma: ultrasound, CT, and MRI.

Two cases of intrahepatic biliary cystadenoma, a rare tumor with malignant potential, are discussed. The sonographic, computed tomographic (CT), and magnetic resonance imaging (MRI) findings are presented together with clinical features of this entity and a brief review of the pertinent literature.

Bile Duct Neoplasms↗
PubMed1990

Removal of restorative posts for the purpose of nonsurgical endodontic retreatment: report of cases.

Nonsurgical endodontic retreatment can be a successful treatment option, especially if the existing root canal therapy is technically deficient. It is the preferred treatment for most endodontic failures unless iatrogenic, restorative, or morphological factors dictate otherwise. A restorative post in the involved canal is usually considered an indication for apical surgery; however, in cases where nonsurgical retreatment is preferable to surgical management, many posts can be removed.

Crowns↗
PubMed1989

Computed tomography in traumatic defects of the diaphragm.

Two patients with traumatic diaphragmatic defects visible on computed tomography are presented. The diagnosis was delayed for several years in both patients. The diagnosis of these acquired diaphragmatic defects is often difficult. Computed tomography can lead to earlier diagnosis by demonstrating the defect in some patients when radiographic studies are not diagnostic.

Adult↗