Biomechanical stability and design. Wear.
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Animals↗
Biomedical subjects
G Schwartz
Publications and source records attributed to G Schwartz.
A double blind comparison of alprazolam and amitriptyline hydrochloride in the treatment of nonpsychotic depression.
In a six week, double-blind, parallel study of alprazolam and amitriptyline hydrochloride in 130 outpatients suffering from moderate to severe nonpsychotic depression, alprazolam was as effective as amitriptyline hydrochloride in relieving depressive symptoms and significantly more effective in relieving symptoms of anxiety and somatization. Alprazolam showed an earlier onset of activity in most measurements of efficacy and produced fewer side effects than amitriptyline hydrochloride. Anticholinergic side effects were reported more frequently by patients taking amitriptyline hydrochloride, while drowsiness was reported more frequently by patients taking alprazolam. At the end of the study, the average daily doses were 2.4 mg alprazolam and 135 mg amitriptyline hydrochloride. The Hamilton Psychiatric Rating Scale for Depression, Hamilton Anxiety Rating Scale, Physician's Global Impressions, Patients' Global Impressions, Hopkins Self-Rating Symptom Scale, and Symptom and Side Effects Checklist were evaluated at the end of weeks 1, 2, 3 and 6 to determine and compare the efficacy and safety of the two study drugs.
Adult↗
Wear, creep, and frictional heating of femoral implant articulating surfaces and the effect on long-term performance--Part II, Friction, heating, and torque.
In Part I, (J.A. Davidson and G. Schwartz, "Wear, creep, and frictional heating of femoral implant articulating surfaces and the effect on long-term performance--Part I, A review," J. Biomed. Mater. Res., 21, 000-000 (1987) it was shown that lubrication of the artificial hip joint was complex and that long-term performance is governed by the combined wear, creep, and to a lesser extent, oxidation degradation of the articulating materials. Importantly, it was shown that a tendency for heating exists during articulation in the hip joint and that elevated temperatures can increase the wear, creep, and oxidation degradation rate of UHMWPE. The present study was performed to examine closely the propensity to generate heat during articulation in a hip joint simulator. The systems investigated were polished Co-Cr-Mo alloy articulating against UHMWPE, polished alumina ceramic against UHMWPE, and polished alumina against itself. Frictional torque was also evaluated for each system at various levels of applied loads. A walking load history was used in both the frictional heating and torque tests. The majority of tests were performed with 5 mL of water lubricant. However, the effect of various concentrations of hyaluronic acid was also evaluated. Results showed frictional heating to occur in all three systems, reaching an equilibrium after roughly 30 min articulation time. Ceramic systems showed reduced levels of heating compared to the cobalt alloy-UHMWPE system. The level of frictional torque for each system ranked similar to their respective tendencies to generate heat. Hyaluronic acid had little effect, while dry conditions and the presence of small quantities of bone cement powder in water lubricant significantly increased frictional torque.
Hip Prosthesis↗
The effects of cortical ablation on mastication in the rabbit.
To verify the hypothesis that the control of movement by the cortical masticatory area (CMA) is particularly important at the beginning of the mastication, we compared movements before and after bilateral CMA ablation. After ablation, the animal could not manipulate food placed in the front of the mouth for several days. With further recovery, the animals could masticate in a more normal way, but the times taken to manipulate the food and to chew to the point of swallowing were increased. However, the form and amplitude of the masticatory cycles were only slightly changed by loss of cortical control. The results indicate that CMA is of great importance at the beginning of mastication and probably also in terminating chewing and initiating swallowing.
Animals↗
Metastatic neuroblastoma after 52 years of dormancy.
A metastatic neuroblastoma arose in a posterior mediastinal tumor that had been present for at least 52 years. The diagnosis of neuroblastoma was first made when the patient was 81 years of age from biopsy of a metastatic lesion to the femur and later from biopsy of the mediastinal mass.
Aged↗
Wear, creep, and frictional heat of femoral implant articulating surfaces and the effect on long-term performance--Part I, A review.
Creep and wear of articulating reconstructed joints is a complex process, resulting in adverse tissue response, decreased range of motion, and eventual revision. As improvements are made in the design and surgical techniques of reconstructed joints, the long-term performance of the articulating system and materials becomes more important, particularly for younger, heavier, and more active patients. One aspect previously ignored in the long-term performance of articulating systems is the tendency for these systems to generate heat during articulation, particularly for extended periods of relatively strenuous activity. The present study reviews the various aspects of joint lubrication, friction, wear, and overall system performance. Local heating can increase the creep, wear, and oxidation degradation of UHMWPE, thus, specific attention is given to the effect that heat generation can have on long-term performance of these systems. Because of the complexity of this issue, the treatment of these various performance aspects is divided into two parts. The present part, Part I, reviews the various aspects of articulation performance. Part II presents results of friction, heating, and torque testing of various metal and ceramic hip systems. Criteria for frictional heating is also presented, along with discussion related to the various heat transfer mechanisms involved with heat dissipation.
Biomechanical Phenomena↗
A DR3-related DX alpha gene polymorphism strongly associates with insulin-dependent diabetes mellitus.
HLA-DQ alpha and HLA-DX alpha gene polymorphisms were analyzed by Southern blot techniques in 78 Caucasoid insulin-dependent diabetes mellitus (IDDM) subjects and 55 control subjects. Five restriction fragment length polymorphisms of the HLA-DQ alpha gene correlated with HLA-DR typing. Two allelic DX alpha-related gene fragments, of 2.1 kb (U) and 1.9 kb (L) in size were identified. Genotype frequencies in the IDDM group for UU, UL, and LL were 54%, 38.5%, and 7.5%, respectively, whereas the corresponding frequencies in the control group were 24%, 40%, and 36% (P less than 0.00005 for differences in genotype frequencies). The U allele was associated particularly with IDDM patients who were DR3, with healthy controls who were DR3, as well as with IDDM patients who were not DR3. Thus, if this DX alpha U allele is not the DR3-associated IDDM susceptibility gene, it is the closest marker hitherto studied.
Chromosome Mapping↗
Insulin autoantibodies in the pre-diabetic period: correlation with islet cell antibodies and development of diabetes.
IgG and IgM class insulin autoantibodies were measured by an enzyme-linked immunosorbent assay in sera from members of the Barts-Windsor-Middlesex prospective family study for Type 1 (insulin-dependent) diabetes. One hundred and twelve individuals from 28 families were selected for study on the basis of a clearly defined islet cell antibody status. IgG insulin autoantibodies were found to be significantly associated with islet cell antibody positive (n = 30) versus islet cell antibody negative (n = 57) first degree family relatives (p = 0.002), with increased significance (p = 0.0003) if complement-fixing (CF)-islet cell antibody individuals (n = 20) only were considered. In addition, a significant association of IgG insulin autoantibodies with subsequent development of diabetes was observed within the CF-islet cell antibody positive group (p less than 0.0003). No such associations were found for IgM insulin autoantibodies, but a higher prevalence of these autoantibodies was observed in islet cell antibody negative first degree relatives (n = 57) compared with a control group of 73 Blood Bank donors (p = 0.00007), and they were significantly associated with siblings (n = 48) rather than parents (n = 39), (p = 0.001). We conclude that the presence of IgG insulin autoantibodies and CF-islet cell antibodies confer more risk for future development of diabetes than the presence of either marker alone.
Autoantibodies↗
Early versus late onset psychosis and tardive dyskinesia.
Patients with late-onset psychosis (defined as psychosis requiring hospitalization at age 45 or more, n = 20) were compared with early-onset psychosis patients (defined as psychosis requiring hospitalization at age 25 or less, n = 56) for the prevalence of tardive dyskinesia (TD). Late-onset psychosis patients were found to have significantly more TD (p less than 0.01), which was more severe (p less than 0.05) and developed in a relatively shorter period of neuroleptic treatment (p less than 0.001), than patients with early-onset psychosis. In addition, TD patients (irrespective of early or late onset of neuroleptic treatment) were found to show a preponderance of drug-free periods (p less than 0.01) in their past neuroleptic history, more so than non-TD patients. Our findings indicate that late-onset psychosis should be considered to be a risk factor for the development of TD.
Adult↗
Effects of emotion on perceptual asymmetry: interactions with personality.
Perceptual asymmetry on a series of four specially constructed dichotic word tests was found to change as a function of the emotional quality of the words in the tests (P = 0.05). This was most pronounced in the case of positively valued words which produced an increase in asymmetry consistent with facilitated left-hemisphere function (P less than 0.004). Changes in asymmetry with emotion differed as a function of personality characteristics of the subjects, with repressors and high anxious subjects showing an increase with emotion while true low anxious subjects showed a decrease (P less than 0.02). Personality groups also differed in asymmetry on an emotionally neutral test (P less than 0.04) and in changes in asymmetry over time independent of emotion (P less than 0.001). These data suggest that emotion mediated activation of the left hemisphere may facilitate information processing within that hemisphere. Moreover, they indicate that dichotic listening tests may provide a non-invasive and inexpensive method for assessing emotion mediated changes in brain state that are clinically relevant.
Adolescent↗
Neurofibromatosis, factor IX deficiency, and rhabdomyosarcoma.
A paratesticular rhabdomyosarcoma occurred in a child with factor IX deficiency and neurofibromatosis, illustrating the need to consider carefully the various etiologic possibilities of a soft-tissue mass in a child with neurofibromatosis and/or a bleeding disorder.
Diseases in Twins↗
A clinical trial comparing intramuscular haloperidol decanoate and oral haloperidol in chronic schizophrenic patients: efficacy, safety, and dosage equivalence.
Thirty patients with chronic schizophrenia received oral haloperidol and haloperidol decanoate in a two-phase open study. In the first phase, patients were stabilized on haloperidol tablets for 2 weeks, then maintained on a constant daily dose for 2 more weeks. They were then switched to haloperidol decanoate for the second phase. Patients were first stabilized on a monthly dose of haloperidol decanoate and then received this dose for 5 consecutive months. Haloperidol decanoate, administered in monthly injections at 9.4 to 15 times the daily oral dose, was at least as efficacious as oral haloperidol in controlling the symptoms of schizophrenia. There were no serious adverse reactions to either drug. Blood samples were taken from 22 patients during both the oral and the decanoate phases and analyzed for steady state haloperidol concentrations. These determinations demonstrate that the release of haloperidol with the decanoate form is sustained throughout the 4-week dosing interval. Lower plasma drug concentrations were observed during decanoate treatment than during oral treatment. Despite these lower plasma concentrations, patients remained stable on both drug regimens. This finding suggests that haloperidol decanoate injected every 4 weeks can provide control of psychotic symptoms at least as effectively as daily oral haloperidol.
Administration, Oral↗
Attenuation correction in echocardiography.
A commercial two-dimensional echo unit, modified to permit digital acquisition (2.2 MHz) of echo signals prior to time-gain-compensation (TGC), was ratiometrically calibrated. Simulating the TGC in software, we demonstrated improvements in image quality as compared to conventional video methods. A path-dependent attenuation correction (PDAC) algorithm, utilizing the gray level image statistics to assign one of three attenuation coefficients (for chest, myocardium or blood) to each image pixel, was then developed. Using it on left ventricular (LV) short axis images obtained in nine healthy closed chest dogs, we demonstrated that the backscatter intensity at end diastole (ED) was 2.0 +/- 0.5 dB (mean +/- SEM) higher (p less than 0.01) than at end systole (ES), in circumferential segments of the myocardium oriented anteriorly and posteriorly, relative to the transducer. In seven of the dogs, subsequently occluded for one hour in the anterior descending branch of the left coronary artery (LAD), this normal phasic myocardial backscatter (PMB) variation decreased or was reversed in ischemic segments, relative to preocclusion values, suggesting utility of the method for sequential study of myocardial ischemia and its treatment.
Animals↗
Multiple sclerosis and childhood infections.
Migration from an area where MS is common to an area where it is rare (and vice versa) affects the risk of MS, provided migration occurs in childhood. A childhood infection might explain this effect. Therefore, the age pattern of infectious diseases in different regions was examined. A higher proportion of children showed positive titers to many viral diseases early in life in areas where MS is rare compared with those where MS is common. Also, mortality rates from a variety of infectious diseases correlated negatively with the MS mortality. Thus, infection early in life may "protect" against MS, and conversely, later infection, when the immune system has partially matured, may increase risk. MS may be an age-dependent, host-immune response to childhood infection.
Asia↗
Imipramine treatment differentially affects platelet 3H-imipramine binding and serotonin uptake in depressed patients.
Uptake of serotonin and 3H-imipramine binding in platelets of depressed patients were investigated simultaneously with changes in clinical state. Both Vmax for serotonin uptake and Bmax for 3H-imipramine binding were significantly lower in unmedicated depressed patients with respect to normal subjects. Successful treatment with imipramine led to a significant increase in Bmax for 3H-imipramine binding, without significant change in Vmax for serotonin uptake. Bmax values increased to the normal range following complete, rather than partial clinical improvement. These data indicate that successful antidepressant treatment may increase the density of 3H-imipramine binding sites on platelets by a process which is independent of the uptake of serotonin.
Adolescent↗
Digital signal and image processing in echocardiography. The American Society of Echocardiography.
Digital signal and image processing techniques are acquiring an increasingly important role in the generation and analysis of cardiac images. This is particularly true of 2D echocardiography, in which image acquisition, manipulation, and storage within the echocardiograph, as well as quantitative analysis of echocardiographic data by means of "off-line" systems, depend upon digital techniques. The increasing role of computers in echocardiography makes it essential that echocardiographers and technologists understand the basic principles of digital techniques applied to echocardiographic instrumentation and data analysis. In this article, we have discussed digital techniques as applied to image generation (digital scan conversion, preprocessing, and postprocessing) as well as to the analysis of image data (computer-assisted border detection, 3D reconstruction, tissue characterization, and contrast echocardiography); a general introduction to off-line analysis systems was also given. Experience with other cardiac imaging methods indicates that digital techniques will likely play a dominant role in the future of echocardiographic imaging.
Echocardiography↗
Unchanged platelet 3H-imipramine binding in normal subjects after imipramine administration.
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Adult↗
Effect of normal aging on the prolactin response to graded doses of sulpiride and to arginine.
The prolactin (PRL) response to placebo, sulpiride (2.5, 5, 10 and 20 mg im) and arginine HC1 infusion (0.33G/kg) was examined in young (18-25 yrs) and old (65-75 yrs) normal men. Analysis of variance for the sulpiride data showed no significant dose x age group interaction or dose X age group X period interaction. There was, however, a significant age group X period interaction (p less than 0.05). PRL concentrations were significantly lower in the old subjects (N = 9) compared with the young (N = 9) 15 min after 2.5, 5, or 10 mg but not significantly after 20 mg sulpiride or at any other time interval. The areas under the concentration-time curves and the mean individual peak PRL concentrations were not significantly different between the two groups. The pattern of findings suggests a delayed absorption of sulpiride in the elderly rather than a change in pituitary dopamine (DA) receptor sensitivity to account for the lower PRL concentrations at 15 min. Differences in magnitude of the PRL response between the four doses of sulpiride were small and results suggest that the 2.5 mg dose is close to that required to saturate DA receptors on the lactotrophe and that the 10 and 20 mg doses are sufficient to completely block pituitary DA receptors. There was no significant age effect on arginine-induced PRL secretion (N = 11 in each group).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗