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Biomedical subjects

E Shapiro

Publications and source records attributed to E Shapiro.

At least 145 records · Page 8Linked to original sources
PubMed1991

Obstacles to Adolescent Care in General Practice.

The physician who provides care for the adolescent must integrate a number of issues outside the usual framework of medical practice. The adolescent alternates between the child and young adult, and so creates a series of challenges for his or her physician relative to the young person's autonomy and the continued legal role of the family. This article outlines several problems inherent in work with adolescents. ADOLESC MED 2:389-396, 1991

Journal Article↗
PubMed1991

Peritonitis after cecal perforation. An experimental model to study the therapeutic role of antibiotics associated with allopurinol and catalase.

This work uses cecal perforation on the rat as a model of intra-abdominal sepsis. Under these conditions, various antibiotics were tested alone or in association with free radical scavengers, such as allopurinol and catalase. It can be concluded that the scavengers were not effective alone, but when combined with antibiotics they rendered good results in the majority of the groups when given postsepsis. Further studies are needed to determine the real role of agents like the free radical scavengers in infectious situations such as the one discussed here.

Allopurinol↗
PubMed1990

A novel technique for the production of hybrid antibodies.

Chemically linked bifunctional antibodies (heteroconjugates) composed of one antibody specific for the TcR/CD3 complex on cytotoxic T cells and another specific for viral antigens expressed on the surface of infected cells have been shown to redirect CTL to lyse virus-infected cells. Hybrid antibodies are bifunctional antibodies produced by the fusion of two hybridomas. As a result of their native dimeric immunoglobulin structure, hybrid antibodies may be more effective than heteroconjugates in vivo. We have developed a unique method for production of hybrid antibodies by infecting each hybridoma with a different retrovirus vector which confers resistance to either G418 or methotrexate. The hybridomas are fused and selected in medium containing both inhibitors. Using this technique, we have produced hybrid antibodies made up of one antibody combining site which binds to the TcR and a second specific for the hemagglutinin of X-31 influenza virus. We show that this hybrid antibody effectively mediates the lysis of virus-infected cells in the presence of appropriate CTL. Thus hybrid antibodies as well as heteroconjugates can redirect CTL to lyse virus-infected targets.

Animals↗
PubMed1990

Binding and functional properties of doxazosin in the human prostate adenoma and canine brain.

The binding and functional properties of doxazosin were characterized in the canine brain and human prostate. 3H-Doxazosin binding sites were characterized in canine brain and human prostate homogenates using saturation experiments. The binding of 3H-doxazosin in the canine brain was consistently saturable and of high affinity. The mean equilibrium dissociation constant (Kd) and density (Bmax) of 3H-doxazosin binding sites in the canine brain were 0.19 nM and 2.17 fmol/mg wet wt, respectively. The binding of 3H-doxazosin in human prostate homogenates was not consistently linear owing to a relatively high proportion of nonspecific doxazosin binding sites. The mean Kd and Bmax of 3H-doxazosin binding sites in the prostate determined from the saturation experiments yielding linear Scatchard plots were 0.2 nM and 0.51 fmol/mg wet wt. The pharmacology of doxazosin binding sites was further characterized in the canine brain using competitive binding experiments. The rank order of IC50corr values for norepinephrine, clonidine, yohimbine, terazosin, and prazosin indicated that doxazosin binds selectively to alpha 1 and alpha 2 adrenergic binding sites. The relative affinity of unlabeled doxazosin for alpha 1 and alpha 2 binding sites in the human prostate was determined by displacing 125I-Heat or 3H-rauwolscine with varying concentrations of unlabeled doxazosin. The affinity of doxazosin for alpha 1 binding sites in the prostate adenoma was approximately 100-fold greater than its affinity for alpha 2 binding sites. The potency of doxazosin for inhibiting phenylephrine-induced contractions in the prostate indicated that prostate smooth muscle contraction is mediated by alpha 1 adrenoceptors.

Adenoma↗
PubMed1990

Determination of norepinephrine levels in the adult human prostate.

Tissue levels of norepinephrine were measured in prostate tissue from 24 men ranging in age between 41 and 83 years. Prostatic tissue was obtained from men with subtle palpable prostate nodules undergoing transperineal needle biopsy. None of the patients were shown to have histologic evidence of adenocarcinoma. The severity of the symptoms of prostatism was evaluated prospectively using a standardized micturition symptom score questionnaire. Norepinephrine levels were quantified using a sensitive radioenzymatic assay (REA). Overall, the prostates contained relatively high levels of norepinephrine (1666 +/- 124 ng./gm.). Inverse correlations were observed between tissue norepinephrine levels and severity of symptoms of prostatism (r = -0.58; p = 0.003); age (r = -0.53; p = .008); and prostate size (r = -0.48; p = .02). Norepinephrine levels were also measured in tissue specimens obtained from men undergoing enucleation prostatectomy and transurethral resection of the prostate (TURP). The level of norepinephrine in these prostatectomy specimens (115 ng./gm.) was only 14% the level of the prostate biopsy specimens. The relatively low level of norepinephrine in the specimens obtained from patients with symptoms necessitating prostatectomy provides further evidence that norepinephrine levels are inversely related to the degree of symptomatic bladder outlet obstruction.

Adult↗
PubMed1990

Characterization of 1,4, dihydropyridine calcium channel binding sites in the human prostate.

The binding and functional properties of calcium channel receptors have not been previously characterized in the normal or hyperplastic prostate. Dihydropyridine (DHP) binding sites have been characterized in other tissues using the ligands 3H-nitrendipene and (+)3H-PN200-110. Saturation experiments were performed on homogenates obtained from five human prostate adenomas using these ligands. The binding of 3H-nitrendipine and (+)3H-PN200-110 in the prostate was saturable and of high affinity. The mean Kd of 3H-nitrendipine and (+)3H-PN200-110 was 0.92 +/- 0.11 nM and 0.14 +/- 0.02 nM, respectively. The mean Bmax of 3H-nitrendipine and (+)3H-PN200-110 was 0.57 +/- 0.06 and 0.19 +/- 0.02 fmol/mg. wet wt., respectively. The percent specific binding of 3H-nitrendipene and (+)3H-PN200-110 was 18 +/- 1% and 38 +/- 4%, respectively. The pharmacology of (+)3H-PN200-110 binding sites was further characterized using competition displacement experiments. The IC50 corrected values for Bay K 8644, nifedipine, verapamil, and diltiazem in the human prostate and other tissues are of the same order of magnitude. The prostate contains an abundance of high affinity DHP binding sites. The physiologic significance of the DHP binding sites in the prostate requires further investigation.

Binding Sites↗
PubMed1990

Autonomic receptors in human prostate adenomas.

Radioligand receptor binding techniques were used to characterize alpha 1 adrenergic, alpha 2 adrenergic and muscarinic cholinergic (MCh) binding sites in human prostate adenomas obtained from men with symptomatic and asymptomatic benign prostatic hyperplasia (BPH). Prostate adenoma specimens were obtained from nine men with asymptomatic BPH undergoing cystoprostatectomy, 11 men with symptomatic BPH undergoing open prostatectomy, and 11 men with symptomatic BPH undergoing transurethral resection of the prostate (TURP). A quantitative symptoms score analysis and urinary flow rate determinations documented the absence of bladder outlet obstruction in men undergoing cystoprostatectomy and confirmed the presence of bladder outlet obstruction in men undergoing prostatectomy. The mean equilibrium dissociation constants (Kd) and the mean densities of 125I-Heat (alpha 1 adrenergic) and 3H-NMS (MCh) binding sites were similar in tissue homogenates obtained from men with asymptomatic and symptomatic BPH. The mean Kd of 3H-Rauwolscine (3H-Ra) was significantly greater in the prostatectomy specimens obtained from men with symptomatic BPH compared to the specimens obtained from men with asymptomatic BPH (p less than 0.05). The density of 3H-Ra (alpha 2 adrenergic) binding sites was significantly greater in the prostate adenomas obtained from men with symptomatic BPH compared to the prostate adenomas obtained from men with asymptomatic BPH (p less than 0.05). The difference in alpha 2 adrenoceptor density was accounted for by an increased receptor density in the open prostatectomy specimens. There was no significant correlation between alpha 2 adrenergic, alpha 1 adrenergic, and MCh receptor densities and prostate weight or patient age. This study indicates that the development of infravesical obstruction in men with BPH is not related to upregulation or altered binding affinity of alpha 1 adrenergic or MCh receptor binding sites. The significance of the observed upregulation of alpha 2 adrenoreceptors in the prostate adenomas obtained from men undergoing open prostatectomy is unknown, and requires further investigation.

Humans↗
PubMed1990

Identification of histaminergic neurons in Aplysia.

1. We have identified putative histaminergic neurons in the central nervous system of Aplysia californica by light-microscopic autoradiography after uptake of [3H]histamine and by immunohistochemistry with the use of an antibody specific for histamine. 2. In the cerebral ganglion cells previously shown to contain histamine (C2 and 2 large neighboring cells in the E cluster and a group of smaller cells in the L cluster) were identified both by uptake of [3H]histamine and by histamine immunoreactivity. The identification of C2 was confirmed by experiments in which individual C2s were characterized electrophysiologically and injected with Lucifer yellow before processing for immunohistochemistry. The giant serotonergic neuron did not take up [3H]histamine and was not immunoreactive. 3. In the abdominal ganglion two clusters of cells--one in the left hemiganglion and the other in the right--took up [3H]histamine and were histamine immunoreactive. These clusters are located in the regions occupied by the 30 identified respiratory interneurons, R25 and L25. Individual cells in the R25 and L25 clusters were identified electrophysiologically, marked by injection of Lucifer yellow, and processed for immunocytochemistry. Eleven of the 30 L25 cells examined (from 7 ganglia) and 2 of the 25 R25 cells (from 6 ganglia) that had been marked with Lucifer yellow were also histamine immunoreactive. 4. Also in the abdominal ganglion, identified cells in the L32 cluster were not histamine immunoreactive and did not take up [3H]histamine. These interneurons, which mediate presynaptic inhibition, had previously been considered histaminergic. Neurons in the ganglion known to use transmitters other than histamine (L10, R2, RB cells, and bag cells) were not histamine immunoreactive.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1990

Embryologic development of the prostate. Insights into the etiology and treatment of benign prostatic hyperplasia.

Pharmacologic strategies for the treatment of BPH are at present directed toward relaxing prostate smooth muscle and reducing prostate volume. Historically, the primary limitation of pharmacotherapy for BPH has been that the symptomatic improvement achieved was overshadowed by the morbidity of treatment. However, the morbidity has been markedly diminished based on a more precise understanding of the embryology, physiology, and pharmacology of the prostate. The origins and pharmacologic properties of the smooth musculature of the prostate and bladder are unique. Therefore, drugs such as alpha blockers may relax the prostate selectively without altering bladder function. Although phenoxybenzamine, a nonselective alpha blocker, relieves infravesical obstruction secondary to BPH, the severity of the adverse reactions limits the use of this drug. The contractile properties of the prostate smooth muscle are mediated by alpha-1 adrenoceptors. The effectiveness of phenoxybenzamine and selective alpha-1 blockers such as prazosin and terazosin are similar. The side effects of the selective alpha-1 blockers are negligible. Androgen suppression, which lowers testosterone, produces intolerable side effects such as gynecomastia, erectile dysfunction, and impaired libido. The androgen dependency of the prostate provides the rationale for using 5 alpha-reductase inhibitors for the treatment of BPH. Reduction of prostate volume can be achieved by blocking the action or synthesis of dihydrotestosterone without impotence, gynecomastia, and hot flashes. These recent advances in pharmacotherapy for BPH are based on understanding of the fundamental developmental properties of the prostate.

Adrenergic alpha-Antagonists↗
PubMed1990

Muscarinic cholinergic and alpha 2-adrenergic receptors in the epithelium and muscularis of the human ileum.

The aim of this study was to characterize the binding and functional properties of muscarinic cholinergic (MCh) and alpha 2-adrenergic receptors in the human ileum to provide insight into pharmacologic strategies for managing urinary and fecal incontinence after bladder and rectal replacement with intestinal segments. MCh and alpha 2-adrenergic binding sites were characterized in the epithelium and muscularis of eight human ileal segments with 3H-N-methylscopolamine and 3H-rauwolscine, respectively. The dissociation constant for 3H-N-methylscopolamine in the epithelium and muscularis was 0.32 +/- 0.07 nmol/L and 0.45 +/- 0.10 nmol/L, respectively (p = 0.32). The MCh receptor content was approximately eightfold greater in the muscularis compared with the epithelium (p = 0.008). The dissociation constant for 3H-rauwolscine in the muscularis and epithelium was 2.55 +/- 0.42 nmol/L and 2.03 +/- 0.19 nmol/L, respectively (p = 0.29). The alpha 2-adrenoceptor density was twofold greater in the epithelium compared with the muscularis (p = 0.05). Noncumulative concentration-response experiments were performed with carbachol, an MCh agonist, and UK-14304, a selective alpha 2-adrenergic agonist. The epithelium did not contract in the presence of high concentrations of carbachol and UK-14304. The muscularis preparations were responsive only to carbachol. The muscularis contains primarily MCh receptors mediating smooth muscle contraction. The alpha 2-adrenoceptors are localized primarily to the epithelium and may regulate water secretion in the intestine. The distribution and functional properties of ileal MCh and alpha 2-adrenergic receptors provide a theoretic basis for the treatment of incontinence after bladder and rectal replacement with intestinal segments.

Epithelium↗
PubMed1990

Brainstem auditory evoked potential studies in patients with tinnitus and/or vertigo.

The significance of brainstem auditory evoked potential (BAEP) studies in patients with vertigo and/or tinnitus is not universally recognized. In this study, 29 patients with these complaints as the presenting symptoms were evaluated with BAEPs, some of them as part of a work-up for a hearing and vertigo center. Case reports are presented. Absolute and interpeak latencies were related to patients' demographics and to stimulation parameters. Factors that correlated with increased numbers of abnormalities included male gender and higher stimulation rates (30 or 40/sec). Patient age and polarity of the stimulus had no major significance; neither did findings on either the right or left side. Overall, the percentage of cases with abnormalities was high (86.2%). This study confirms the importance of BAEPs in patients with vertigo and/or tinnitus. Furthermore, it is recommended that repeated trials be performed using a variety of parameters in order to facilitate the emergence of subtle abnormalities that would otherwise be missed.

Adult↗
PubMed1989

Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette's syndrome.

The results of this controlled study of the treatment of 57 patients with Gilles de la Tourette's syndrome suggested that both haloperidol and pimozide were more effective than placebo, but that haloperidol was slightly more effective than pimozide. Adverse effects occurred more frequently with haloperidol vs placebo than with pimozide vs placebo, but the frequency was not significantly different for haloperidol compared with pimozide. Clinically significant cardiac effects did not occur at a maximum dosage of 0.3 mg/kg or 20 mg/d for pimozide and 10 mg/d for haloperidol. However, the QTc interval was prolonged during pimozide treatment compared with that during haloperidol treatment, although the values for both medications were not in an abnormal range.

Adolescent↗
PubMed1989

Contractile properties of human prostate adenomas and the development of infravesical obstruction.

The contractile response of human prostate adenomas to KCl, phenylephrine (alpha 1 adrenergic agonist), UK 14304 (alpha 2 adrenergic agonist), and carbachol (muscarinic cholinergic agonist) was evaluated in tissue specimens obtained from men with symptomatic and asymptomatic BPH. Prostate specimens were obtained from 5 men with asymptomatic BPH undergoing cystoprostatectomy, 11 men with symptomatic BPH undergoing open prostatectomy, and 11 men with symptomatic BPH undergoing transurethral resection of the prostate (TURP). Quantitative symptom score analysis and urinary flow rate determination documented the absence of bladder outlet obstruction in men undergoing cystoprostatectomy and confirmed the presence of bladder outlet obstruction in men undergoing prostatectomy. The magnitude of the contractile response (Emax) and the potency of phenylephrine-induced contractions (EC50) in prostatic preparations obtained from men with symptomatic and asymptomatic BPH were similar. The IC50 for the inhibition of phenylephrine-induced contractions by prazosin was 3.2 nM, confirming that phenylephrine-induced contraction in the human prostate is mediated by the alpha 1 adrenoceptor. The contractile responses of prostate adenomas to muscarinic cholinergic and alpha 2 agonists were negligible. This study demonstrates that the development of bladder outlet obstruction in men with BPH is not related to alterations in the functional response of the smooth muscle component of the prostate adenoma.

Aged↗