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Biomedical subjects

D Bernstein

Publications and source records attributed to D Bernstein.

At least 145 records · Page 8Linked to original sources
PubMed1988

Prevention of chymopapain anaphylaxis by screening chemonucleolysis candidates with cutaneous chymopapain testing.

With chymopapain at a concentration of 10 mg/ml, the authors skin tested 540 chemonucleolysis candidates; six were positive, and 534 were negative. None of the positive patients received therapeutic injections of chymopapain. There were no instances of unequivocal anaphylaxis to chymopapain in the patients with negative skin tests treated with chymopapain. When this 0% incidence of systemic reactions in skin test negative patients is compared with the historical rate of 1%, this difference is statistically significant (p less than 0.05). Restriction of chymopapain treatment to patients with negative prick tests can reduce the incidence of systemic reactions.

Anaphylaxis↗
PubMed1987

Monoclonal antibody staining and impact of surgical technique on the identification and quantitation of steroid receptors in human breast cancer.

In this prospective study of 31 patients, paired receptor levels from biopsy and mastectomy specimens were found to be significantly correlated on biochemical assay. Despite this fact, 6 of 20 tumors that were estrogen receptor-positive on biopsy, had a negative assay from the mastectomy specimen, indicating the need for a fresh tumor specimen. Immunocytochemical staining with monoclonal antibody H222 Spy, an antibody specific for the estrogen receptor, was evaluated in 34 biopsy and mastectomy specimens. With a sensitivity of 85 percent and specificity of 93 percent, this technique compares favorably with the standard biochemical assay.

Adult↗
PubMed1987

Redistribution of regional blood flow and oxygen delivery in experimental cyanotic heart disease in newborn lambs.

Redistribution of regional blood flow is an important compensatory response to acute hypoxemia which preserves oxygen delivery to the most vital organs. It is not known if this change in blood flow persists when hypoxemia is prolonged, as occurs in cyanotic congenital heart disease. Chronic hypoxemia was produced in newborn lambs by creating pulmonary stenosis and an atrial septal defect. Oxygen saturation was maintained at 60-70% of control for 2 wk. Distribution of cardiac output was then measured with radionuclide-labeled microspheres. As compared with control, chronic hypoxemia did not alter total cardiac output. Regional blood flow was redistributed, however, the pattern of this redistribution was different from that seen during acute hypoxemia. Myocardial and cerebral blood flows, which increase during acute hypoxemia, return to control levels during chronic hypoxemia. Renal, splenic, gastrointestinal, carcass, and skin blood flows remain decreased. Hemoglobin gradually increases so that after 2 wk of hypoxemia total systemic oxygen delivery returns toward control. However, oxygen delivery to all organs except the heart and brain is reduced. Thus, although cardiac output and total systemic oxygen delivery return toward normal during chronic hypoxemia, these measurements may not reflect important regional variations in blood flow and oxygen delivery. Decreased oxygen and substrate delivery to the gastrointestinal tract, liver, and carcass may account for the alterations of metabolism and growth seen in the newborn with cyanotic congenital heart disease.

Animals↗
PubMed1987

Efficacy and safety of tissue plasminogen activator.

Simple aspiration to remove acute intracerebral hematomas has been thwarted by the solidity of the clot. Urokinase, a first generation fibrinolytic agent, has been used to liquefy such clots with some success. Therefore, tissue plasminogen activator (t-PA), a second generation fibrinolytic drug that may be safer and more effective, was studied to evaluate its ability to lyse clot in vitro and its reactivity in the brain and subarachnoid space. t-PA seems to cause partial clot lysis in small dosages (3750 units/70-cc clot) and in a short time (15 minutes). It seems to perfuse through the clot when injected in one place. It does not cause inflammation or bleeding when injected into the rat brain, but indeed seems to promote resorption of blood when the two are injected together. It does not cause aseptic meningitis when injected into the cisterna magna of rabbits. t-PA may prove to be an important adjuvant to the stereotactic aspiration of intracerebral hematomas. It may be particularly helpful in lysing these clots to make possible more gentle aspiration, removing the risk to surrounding brain of strong vacuum.

Animals↗
PubMed1987

A new biological carrier for follicle stimulating hormone: an aid for the diagnosis of menopause.

The excretion of follicle stimulating hormone (FSH) was measured in urine samples collected every 2 weeks and on biological carriers (sticks) collected for 15-30 weeks from 10 perimenopausal women aged 38-53 (median 48 years), with a recent history of irregular menstrual cycles following regular cyclicity. In the 3 months preceding the menopause, long cycles were common and 8 of the 10 women experienced intermenstrual intervals lasting 50 days. FSH excretion was usually elevated to within the postmenopausal range (less than 8 mIU/ml), and only 1 woman excreted the low levels which are characteristic of fertile young women. Overall, FSH levels were higher in the period between 15 and 20 weeks after the menopause (18.3 +/- 6.2 mIU/ml) than in the first 4 weeks (9.6 +/- 5.2 mIU/ml). 95% correlation was found in parallel measurements of FSH attached to the biological carrier, the stick. It is proposed that the biological carrier, the stick, for FSH measurements in urine samples can help physicians to distinguish intervals of amenorrhea from the menopause: 2-3 measurements of FSH attached to the stick in an interval of 1 week can give a reliable answer.

Adult↗
PubMed1987

Prevention of chymopapain anaphylaxis by screening chemonucleolysis candidates with cutaneous chymopapain testing. A preliminary report.

The risk of anaphylaxis in candidates for chemonucleolysis for herniated lumbar discs is approximately 1%. An investigation was designed to eliminate or reduce the incidence of chymopapain anaphylaxis. The procedure was to restrict chemonucleolysis to patients who are prick test-negative to chymopapain at a concentration of 10 mg/ml. The authors skin-tested 292 chemonucleolysis candidates; five were positive and 287 were negative. None of the positive patients were injected with chymopapain. There were no instances of unequivocal chymopapain anaphylaxis in the skin test-negative group. This 0% incidence of anaphylaxis in skin test-negative patients was compared with a population estimate of 1%, based on historical data. The resulting value of p = 0.08 value fell short of the conventional level of significance of 0.05. The p value will reach 0.05 when the series of skin test-negative patients without anaphylaxis reaches 360. It is important that this information is readily available to physicians concerned about anaphylactic reactions to chymopapain.

Adult↗
PubMed1986

Pulmonary embolism in adolescents.

To clarify the epidemiology of pulmonary embolism in adolescents, a retrospective analysis of adolescent admissions to a general hospital over a 15-year period was performed. Eighteen patients had 19 episodes of pulmonary embolism, an incidence of 78 per 100,000 hospitalized adolescents. There were twice as many female as male patients. Common complaints were chest pain, dyspnea, cough, and hemoptysis. Common findings were hypoxemia and deepvein thrombosis. Major risk factors were oral contraceptive use and elective abortion in 75% of female patients and trauma in 67% of male patients. Unlike its effect in adults, pulmonary embolism is rarely fatal in adolescents. Although clinical features in adolescents are similar to those in adults, there is a high incidence of both overdiagnosis and underdiagnosis. The early use of pulmonary arteriography in difficult diagnostic situations is suggested.

Adolescent↗
PubMed1986

Perinatal myocardial infarction: a case report and review of the literature.

Myocardial infarction in the perinatal period is a rare occurrence, usually associated with congenital heart lesions or isolated coronary artery abnormalities. In the absence of structural heart disease the most common etiologies are intrauterine asphyxia and thromboembolic coronary occlusion. A paradoxical embolus usually arises from a thrombus in the ductus venosus or umbilical vein and reaches the coronary circulation via normal fetal circulatory pathways. We describe a case of perinatal myocardial infarction due to thromboembolism of the coronary artery secondary to an intrauterine renal vein thrombosis. The difficulties encountered in making an accurate premortem diagnosis are emphasized as well as the poor prognosis of myocardial infarction in the perinatal period.

Coronary Disease↗
PubMed1985

Radial maze performance in young and aged mice: neurochemical correlates.

Young (8 month) and aged (27-28 month) male C57BL/6J mice were trained in a spatial discrimination task requiring working memory. The mice were tested during three trials daily in an eight-arm radial maze for 36 test days. Correct choices were reinforced with isotonic saline. In contrast to past reports, young mice learned the task. Old mice also learned the task, and no significant age-related differences in performance were observed. Following maze training, the mice were killed, the brains removed, and the specific activities of choline acetyltransferase (E.C.2.3.1.6., ChAT) and L-glutamic acid decarboxylase (E.C.4.1.1.15., GAD) were assayed in the hippocampus, and in frontal, sensorimotor, and cingulate areas of the cerebral cortex. The activities of these neurotransmitter synthetic enzymes did not differ significantly between young and old mice. Correct responding in the radial maze was positively correlated to ChAT activity in the cingulate cortex and negatively correlated to ChAT activity in the sensorimotor cortex. There was a similar pattern of correlation between performance and regional GAD activity, although none of the correlations involving GAD reached statistical significance.

Aging↗
PubMed1985

Recognition of left coronary artery fistula to the left and right ventricles by contrast echocardiography.

A coronary-cameral fistula was inspected clinically by two-dimensional and pulsed Doppler ultrasound. At cardiac catheterization a fistulous connection between the left coronary artery and the right ventricle was observed. Contrast echocardiography using agitated saline solution injected into the aortic catheter clearly showed the passage of microcavitations into the left and the right ventricles confirming the connection of the fistula to both chambers. Contrast echocardiography is a valuable technique that can help define the site of drainage of coronary artery fistulas.

Child, Preschool↗
PubMed1985

Measurement of amikacin in serum by a latex agglutination inhibition test.

Levels of amikacin in serum were determined in 106 serum specimens by a latex agglutination inhibition card test and by radioimmunoassay (RIA). Linear regression analysis demonstrated a high degree of correlation between the two assays (latex = 0.95 (RIA) + 0.69; r = 0.97). Assay of three control sera containing 7.5, 15, and 30 micrograms of amikacin per ml on 7 separate days showed good reproducibility with a coefficient of variation of 0 to 11.7% for the latex assay compared with 7.01 to 22.2% for RIA. Recovery of amikacin in spiked sera varied between 93 and 108% for the latex assay compared with 90 and 100% for RIA. Because the procedure involves a titer, the latex agglutination inhibition card test produces results which are categorized rather than results which are continuous. However, it is a rapid and specific method for determining amikacin levels in clinical specimens and is particularly useful when processing small numbers of specimens.

Amikacin↗
PubMed1985

Chronic hypoxemia in the newborn lamb: cardiovascular, hematopoietic, and growth adaptations.

We have created a model of chronic hypoxemia in the newborn lamb by decreasing pulmonary blood flow in the presence of an atrial septal defect. Via a left lateral thoracotomy, we place an inflatable balloon around the pulmonary artery and perform an atrial septostomy under direct vision. We also insert several vascular catheters and place an electromagnetic flow transducer around the ascending aorta. Three days after surgery, we inflated the balloon in 11 lambs such that arterial oxygen saturation decreased to 60 to 75%. Studies were performed on these lambs twice weekly and weekly on 12 normoxemic lambs. Growth decreased sharply (47 +/- 123 versus 221 +/- 82 g/day) at the onset of hypoxemia and remained low, although oxygen consumption followed the normal gradual decline. Heart rate remained elevated throughout the study. Arterial PCO2 levels decreased from 40 +/- 5 to 35 +/- 7 torr and remained low. Systemic blood flow decreased at balloon inflation but quickly returned to normal. Mixed venous saturation was low, but could decrease further with shivering. Systemic oxygen delivery decreased initially but returned to normal as Hb concentration rose (from 9.4 +/- 1.5 to 12.5 +/- 2.2 g/dl). P50 increased normally over the study period. Four of the 11 hypoxemic lambs died during the study. These data show that, in the chronically hypoxemic newborn, systemic oxygen delivery is maintained primarily by a rising Hb. Total body oxygen consumption is maintained at rest but is redistributed away from anabolic requirements and toward cardiorespiratory work. This signal to decrease growth occurs despite less than maximal oxygen extraction at rest.

Animals↗
PubMed1985

Treatment of first episode genital HSV with oral acyclovir: long term follow-up of recurrences. A preliminary report.

Systemic acyclovir (ACV) treatment has been shown to have significant effects on shortening the clinical course of first episode genital HSV infections, decreasing the quantity of HSV antibody in convalescent phase serum, without affecting the incidence of recurrences in 6 months of follow-up. In order to assess long term recurrence patterns, we prospectively studied subjects enrolled in a randomized double blind trial of oral ACV for first episode genital HSV. Sixty-three of sixty-eight subjects were followed monthly for recurrences for a mean of 36 months with 90% of subjects completing two years. There was no difference in the incidence of recurrence (90%) in (29) placebo vs (37) ACV treated HSV-2 infected subjects. Recurrences rates were similar between ACV and placebo treated subjects with nonprimary HSV-2 infection followed 2 years. The majority of these subjects were found to have HSV-2 antibody in their acute sera suggesting prior asymptomatic acquisition of HSV-2 infection and therefore established ganglionic latency at the time of first clinical disease. In subjects with true primary HSV-2 infection, however, mean recurrence rates were significantly lower in ACV treated subjects after 6 months, 0.87 ACV vs 3 placebo per 6 month period (p less than 0.01). The percentage of subjects experiencing recurrences after 1 year was also reduced by ACV treatment (70% placebo subjects vs 12.5% ACV subjects).(ABSTRACT TRUNCATED AT 250 WORDS)

Acyclovir↗
PubMed1984

The cervical factor of infertility and intrauterine insemination.

Results with intrauterine insemination in 25 couples are presented. The indication for this procedure was a cervical factor of infertility. After an extensive fertility survey in both partners, intrauterine insemination was performed four to seven times per cycle with up to 0.8 ml fresh semen per insemination. Only the first ejaculatory spurt was used. Prophylactic antibiotics were given to all female partners during the insemination period. Within a mean of 6 months 13 couples reported pregnancies (52%). Except for one midtrimester abortion that was probably due to obstetrical reasons, the abortion rate was 33.3%. There were no side effects related to the insemination procedure. Our data indicate that, with appropriate safeguards, intrauterine insemination should be regarded as a safe and effective method for the treatment of the cervical factor of infertility.

Adult↗