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Biomedical subjects

J Bernheim

Publications and source records attributed to J Bernheim.

At least 163 records · Page 9Linked to original sources
PubMed1991

Cutaneous responses to histamine, compound 48/80, and codeine in patients with chronic renal failure.

Pruritus is a common symptom associated with chronic renal failure (CRF). But increased plasma histamine levels and skin mast cell proliferation previously reported in these patients did not correlate with the intensity of the pruritus. Since increased mast cell releasability was described in chronic idiopathic urticaria, we attempted to examine whether this mechanism could explain pruritus in patients with CRF. Twenty-five patients with end stage renal failure were skin tested with histamine, codeine, and compound 48/80. There were nine patients on continuous ambulatory peritoneal dialysis, eight patients on hemodialysis, (tested both before and after dialysis) and eight patients with advanced CRF. Wheal area after intradermal injection of three concentrations of the above substances was measured. In general, the wheal areas in all patients with CRF were either similar to or smaller than those of the control group who were without renal impairment. In conclusion, patients with CRF with or without dialysis therapy demonstrated unchanged or decreased skin test responses to histamine, codeine, and compound 48/80. Increased mast cell releasability cannot explain the pruritus in patients with CRF.

Adult↗
PubMed1990

Experimental ultrasonic angioplasty: disruption of atherosclerotic plaques and thrombi in vitro and arterial recanalization in vivo.

To investigate the use of high energy ultrasound as an alternative energy for angioplasty, an experimental ultrasonic angioplasty device was developed. The device was studied in two bioassay systems: an in vitro system for the disruption of atherosclerotic plaques and thrombi and an in vivo system for the recanalization of occluded canine femoral arteries. In vitro, sonication efficiently reduced the size of the plaques. Atheromatous plaques (n = 11) disrupted at a rate of 21 +/- 8 s/cm2; complicated plaques (n = 14) disrupted at a rate of 132 +/- 45 s/cm2 (p less than 0.001). Histologic examination revealed that the disruption of the plaques took place without concurrent damage to the media or adventitia. Ninety percent of the disrupted plaque debris had a diameter of less than 20 microns and was composed primarily of cholesterol monohydrate crystals. Solid thrombus (n = 5) weight was reduced from 1.6 +/- 0.2 to 0.4 +/- 0.1 g (p less than 0.0001) after 20 s of sonication. In vivo, sonication resulted in recanalization in all seven arteries tested in seven dogs. The obstruction was reduced from 93 +/- 11% to 18 +/- 7% (p less than 0.001). On histologic examination, the arterial wall injury index was found to be 1.56 +/- 0.42 in the test arteries compared with 1.37 +/- 0.47 in the control arteries (p = NS). The disruption of atherosclerotic plaques and thrombi, together with the efficient recanalization of the occluded arteries, demonstrates the potential of ultrasound angioplasty as a catheter-based technique for angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1990

Role of prolonged excessive estrogen stimulation in the pathogenesis of endometrial sarcomas: two cases and a review of the literature.

Two cases of endometrial sarcoma that developed many years after exposure to unopposed exogenous and endogenous estrogens, with no previous pelvic irradiation, are described. The literature is reviewed and the possible effect of prolonged unopposed estrogen stimulation is suggested as an etiologic factor in such extremely rare conditions. These cases add additional support to the assumption that prolonged and excessive endogenous or exogenous unopposed estrogen stimulation of the uterus may increase the risk of endometrial sarcoma.

Aged↗
PubMed1990

Hypercalcemic nephropathy: chronic disease with predominant medullary inner stripe injury.

Because of the recently observed augmentation of medullary hypoxic injury by calcium in isolated perfused rat kidneys (Kidney Int 34:186-194, 1988), renal morphology of chronic, prolonged hypercalcemia was investigated in vivo. Rats were treated with repeated injections of vitamin D2 (400,000 units/week) for two to eight weeks. Chronic elevation of plasma calcium from 2.1 to 2.8 mmol/liter (P less than 0.001) was associated by a fall in maximal urine osmolality with no change in glomerular filtration rate. The most significant morphological alterations occurred in the inner stripe of the outer medulla; these changes were characterized by a sequence of active injury with subsequent destruction and atrophy of the medullary thick ascending limbs, fibroblastic and lymphocytic infiltration, and secondary dilatation of collecting ducts. Similar changes occurred in the medullary rays. These alterations were accompanied by increased renal prostanoid production and a predisposition to acute kidney failure from indomethacin. Because of its selective occurrence in zones of poorest oxygen supply, this inner stripe injury may derive from vulnerability to hypoxia and may play a role in some chronic nephropathies.

Animals↗
PubMed1990

Prophylactic treatment of grass pollen-induced asthma with cetirizine.

In a double-blind randomized parallel-group study, six investigators enrolled 43 subjects to study the prophylactic effect of 10 mg cetirizine b.i.d. on grass pollen-induced asthma. The control group received 60 mg b.i.d. terfenadine, given to avoid withdrawals from the trial because of hay fever symptoms. Subjects were included in the study between the appearance of the first symptoms of hay fever and those of pollen-induced asthma. The hay fever and asthma symptoms, visual analogue scores (VAS), FEV1 and self-assessment data on complaints, salvage treatment and peak-flow values were statistically analysed. Both treatments were well tolerated, with a low and similar incidence of side-effects. During the last 3 weeks of treatment, six (32%) of the 19 subjects on cetirizine who were evaluable for efficacy remained free of asthma complaints, and another two (10%) had only a single minor attack. None had a grade 3 (incapacitating) attack. Conversely, only one (5%) of the 20 evaluable subjects on terfenadine remained complaint free, and all others (95%) had multiple attacks, which incapacitated three (15%) of them. Nasal obstruction, dyspnoea, morning peak flow, consumption of beta 2-mimetics and an efficacy index on asthma, combining complaints and rescue drug consumption, were significantly better on cetirizine (P less than 0.05). It is concluded that cetirizine is able to prevent the exacerbation of asthma induced by grass pollen.

Adolescent↗
PubMed1990

NaCl modulates captopril effects on glomerular prostaglandin synthesis and glomerular filtration.

Captopril stimulates glomerular prostaglandin (PG) synthesis and increases glomerular filtration rate (GFR) in Na-repleted rats, whereas, in Na-depleted rats, it fails to stimulate PG synthesis and decreases GFR. In the present work the influence of chronic and acute NaCl loading on PG synthesis and renal function was studied in Na-depleted rats receiving captopril (LNC rats). Glomerular PGE2 and 6-keto-PGF1 alpha were not increased in LNC rats and were significantly lower than in Na-depleted rats (LN). Na repletion, while continuing captopril, increased PG synthesis above control levels. Addition of captopril in vitro to the incubation medium stimulated PGE2 synthesis in glomeruli of control rats, whereas it depressed it in LN rats. Acute loading with NaCl in LNC rats increased inulin and PAH clearances to values significantly greater than in control rats and similar to those of normal rats receiving captopril. Comparable volume loading with isotonic mannitol or 3% albumin increased inulin and PAH clearances only to control values. The specific effect of NaCl in acute loading was prevented by cyclooxygenase inhibition and was not mediated by increased systemic blood pressure. The results provide evidence that the effects of captopril on glomerular PG synthesis and renal function depend on the state of Na balance.

Animals↗
PubMed1990

Potassium load prevents the decrease of GFR induced by captopril in sodium-depleted rats.

Captopril decreases the glomerular filtration rate (GFR) in Na-depleted rats and inhibits the stimulation of glomerular prostanoid synthesis induced by Na depletion. Because K loading stimulates glomerular prostanoid production in normal rats, we studied the effects of K loading in Na-depleted captopril-treated (LNC) rats. Potassium, but not Cl, loading stimulated the glomerular synthesis of 6-ketoprostaglandin F1 alpha (PGF1 alpha) and thromboxane B2 (TxB2). Urinary kallikrein-like activity (UKALLV) and plasma aldosterone increased in K-loaded animals. LNC rats had lower clearances of inulin (CIN) and p-aminohippurate (CPAH) than controls (0.22 +/- 0.02 vs. 0.94 +/- 0.07 and 0.56 +/- 0.12 vs. 2.23 +/- 0.23 ml.min-1.100 g body wt-1, both P less than 0.01). KCl-loaded LNC rats had CIN and CPAH greater than LNC (0.64 +/- 0.16 and 1.90 +/- 0.28 ml.min-1.100 g body wt-1, P less than 0.01). Similar results were observed in LNC rats loaded with a K solution not containing Cl, but not in LNC rats loaded with a mixture of CaCl2, MgCl2, and HCl. In KCl-loaded LNC rats, cyclooxygenase inhibition decreased CIN from 0.49 +/- 0.09 to 0.30 +/- 0.08 ml.min-1.100 g body wt-1 (P less than 0.01). Aprotinin did not affect renal function despite significant decrease of UKALLV. We conclude that K loading prevents the decrease of GFR induced by captopril in Na-depleted rats and that this might be mediated by stimulation of glomerular prostanoid synthesis.

Aldosterone↗
PubMed1990

Captopril, but not diltiazem, favorably affects the course of early chronic renal disease in rats.

The concepts that increased intracellular Ca2+ content and increased glomerular capillary pressure play an important role in the progression of chronic renal diseases has led to the suggestion that treatment with calcium-blocking agents (diltiazem; CBB) or converting enzyme inhibitors (captopril; CEI) may be indicated to prevent renal failure. We studied the effects of CCB and CEI on the early course of adriamycin (ADR) nephropathy, where glomerular pressure has been shown to be unchanged, blood pressure was only mildly elevated and renal failure incipient. Animals were studied 2, 7, 12, 16 and 20 weeks after the second injection of ADR, 2 mg/kg. In treated rats, blood pressure remained normal. At the end of the study, proteinuria and serum creatine were lower in ADR-CEI than in ADR rats (149 +/- 42 vs. 616 +/- 90 mg/day, p less than 0.01 and 0.36 +/- 0.04 vs. 0.58 +/- 0.02 mg%, p less than 0.01, respectively). ADR-CCB had values similar to those of untreated ADR rats. Mesangial expansion and focal glomerulosclerosis were present only in ADR and ADR-CCB rats, whereas in ADR-CEI rats the glomeruli were virtually normal. Glomerular 45Ca uptake was increased in ADR, decreased in ADR-CCB rats, and normal in ADR-CEI. Glomerular 6-keto PGF1 alpha and TxB2 were significantly increased in ADR rats, and both treatments decreased TxB2. The results suggest that endogenous angiotensin II is important for the early progression of glomerular injury toward renal insufficiency, while tissue Ca2+ accumulation may play an important role in more advanced phases.

Animals↗
PubMed1990

Cavernous hemangioma of the frontal bone.

A 61-year-old female presented with a tumor of her left superior orbital rim, which caused blepharoptosis and slight displacement of the globe. X-ray films showed a lytic defect in the frontal bone, while a computed tomography revealed the tumor to extend along the orbital roof, as well as to involve the posterior lamina of the frontal bone. A biopsy taken from the tumor showed it to be an intraosseus cavernous hemangioma.

Female↗
PubMed1990

Effects of changes in sodium balance on prostaglandin synthesis and prostaglandin E2 9-ketoreductase activity in the rat kidney.

The in vitro synthesis of prostaglandins E2 and F2 alpha by renal cortex, medulla and papilla was measured in normal rats and in rats receiving either a low or a high sodium intake for 14 days. The production of both prostaglandins was unchanged in the cortex. In the medulla, both low and high sodium intakes led to a similar decrease in prostaglandin E2 synthesis in vitro, but prostaglandin F2 alpha synthesis was unchanged. In the papilla, a low sodium intake increased prostaglandin E2 synthesis. The activity of prostaglandin E2 9-ketoreductase, a cytosolic enzyme catalysing the conversion of prostaglandin E2 to prostaglandin F2 alpha, was unchanged in cortical preparations. In medullary slices, prostaglandin E2 9-ketoreductase activity was decreased by both sodium depletion and loading. In the papilla, prostaglandin E2 9-ketoreductase activity was slightly decreased by sodium loading and increased with sodium depletion. These results obtained in the rat are at variance with findings in the rabbit. The role played by prostaglandin E2 9-ketoreductase in the regulation of prostaglandin biosynthesis during changes of sodium balance remains controversial.

Animals↗
PubMed1990

Atrial natriuretic peptide-induced increase of glomerular filtration rate, but not of natriuresis, is mediated by prostaglandins in the rat.

This study addressed the question of whether some renal effects of atrial natriuretic peptide (ANP) are mediated by prostaglandins (PGs). Inhibition of PG synthesis (aspirin, 10 mg/kg) abolished the increase in inulin clearance (CIN) induced by ANP in rats. In contrast, diuresis and natriuresis remained significantly elevated after aspirin administration. ANP, either infused in vivo immediately before sacrifice or added to the incubation tubes, stimulated the synthesis of PGE2 and 6-keto-PGE1 alpha by isolated rat glomeruli but not by medullary or papillary slices. We conclude that the effect of ANP on the glomerular filtration rate is PG dependent, whereas that on diuresis and natriuresis is direct.

Animals↗
PubMed1990

Treatment of hypertension by enalapril and hydrochlorothiazide separately and together: a multicenter study.

The efficacy and safety of enalapril and hydrochlorothiazide was investigated in a multicenter study of 81 patients with mild to moderate essential hypertension. The subjects were randomly assigned to one of three groups and, following a placebo period, given enalapril maleate (20 mg), hydrochlorothiazide (12.5 mg), or a combination of the two drugs (32.5 mg). A significant decrease in blood pressure was observed after only 2 weeks in the enalapril and enalapril-hydrochlorothiazide groups. A double dose was required to achieve a satisfactory response in one-third of the patients in both the enalapril (9 of 27) and the enalapril-hydrochlorothiazide groups (8 of 27). Adverse reactions included cough in one patient and mild hyperkalemia in another, both of whom received enalapril. Two patients on the drug combination developed side effects--symptomatic orthostatic hypotension in one and impotence in the second. Enalapril alone and in combination with hydrochlorothiazide appears to be effective and well tolerated.

Adult↗