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Biomedical subjects

J Kaufman

Publications and source records attributed to J Kaufman.

At least 181 records · Page 10Linked to original sources
PubMed1989

Analysis and HPLC fractionation of urine from patients with cystic fibrosis, chronic lung diseases and normal controls.

The amounts of creatinine, protein, carbohydrate and sialic acid in the urine of 19 patients with cystic fibrosis (CF), 12 normal controls and 11 pathological controls with chronic lung disease have been determined. The mean creatinine excretion levels of the total CF group as well as the CF subgroups are significantly decreased when compared to normal controls but comparable to pathological controls. Mean urinary protein levels appear to be increased in patients with CF compared to normal controls and pathological controls but the increased levels resulted from factors (e.g., presence of diabetes mellitus) other than CF. No significant differences were found in amounts of total carbohydrate and sialic acid in urine and fractionated urinary preparations for the total group of nondiabetic patients with CF when compared to both normal and pathological controls. HPLC fractionation of low Mr (less than 10,000 Daltons) urinary preparations indicated the presence of an unknown peak in all of the antibiotic-treated CF patients, 43% of CF patients on low or no medication, 17% of the normal controls and 9% of the pathological controls. The present results illustrate the importance of including appropriate pathological controls and dividing patients with CF into subgroups according to clinical factors and types of therapy employed.

Adolescent↗
PubMed1989

Peripheral vascular complications from percutaneous transluminal coronary angioplasty: a comparison with transfemoral cardiac catheterization.

The peripheral vascular complications associated with percutaneous transfemoral coronary angioplasty were compared with those that occurred during conventional transfemoral cardiac catheterization. Among 644 patients undergoing percutaneous transluminal coronary angioplasty (PTCA), 6 patients (0.9%) suffered peripheral vascular complications, whereas 35 of 2904 patients having cardiac catheterizations (1.2%) had a peripheral vascular complication. The types of complications associated with both procedures were similar and included groin hematomas, false aneurysms, arterial dissection, arterial perforation, and neurological deficits. The frequency of surgical repair of these complications also was similar in the two groups (50% required repair for a PTCA complication, 34% were repaired after a catheterization complication). The PTCA-associated complications included one myocardial infarction and one death, whereas neither of these occurred in association with a catheterization-induced vascular complication. The surgical management of five of the six PTCA complications was difficult, largely because of the size of the sheath-related puncture site and the presence of active bleeding from the associated systemic anticoagulation. PTCA carries the same risk of development of a peripheral vascular complication as found in transfemoral cardiac catheterization. Care must be taken to prevent sheath-related injury to the aorta-iliac-femoral system and hemorrhagic complications at the puncture site are of particular concern and require urgent surgical attention.

Aged↗
PubMed1989

Alfentanil infusion in neurosurgical patients.

Alfentanil administered by constant rate infusion was evaluated as a main anesthetic in craniotomy patients. Eleven patients (ASA II) received either an induction dose of 200 microg/kg alfentanil followed by a 1 microg/kg/min infusion, or a 150 microg/kg bolus followed by a 1.5 microg/kg/min infusion. The infusion was stopped at least 1 h before the end of surgery. In addition to routine clinical neuroanesthesia monitoring, cardiovascular parameters, extubation conditions, and recovery scores were systematically recorded. Plasma alfentanil levels were determined in all patients during and for 6 h after the infusion. Finally, pharmacokinetic studies were carried out in five patients from both groups. This technique provided a remarkable cardiovascular stability, excellent extubation conditions, a comfortable recovery period, and no signs of prolonged or recurrent narcotization. No difference in clinical signs or alfentanil blood concentrations between the two drug regimens could be found. Pharmacokinetic parameters found were comparable to those obtained after single bolus drug elimination. Despite large individual variations and sometimes very prolonged infusion, there was no evidence of delayed drug administration. All of the above findings warrant the use of alfentanil infusion in neuroanesthesia and confirm the unique pharmacological properties of this drug among existing narcotics.

Journal Article↗
PubMed1989

Isolation of a corncob (coaggregation) receptor polypeptide from Fusobacterium nucleatum.

Corncobs, which are distinct morphological units formed by the ordered coaggregation of a filamentous microorganism and streptococci, can be made in vitro by using oral strains of Fusobacterium nucleatum and Streptococcus sanguis. Previous studies have shown that strains of F. nucleatum contain one of at least two different types of corncob receptor. The objective of this study was to isolate the receptor from F. nucleatum ATCC 10953 as the first step in the elucidation of the molecular basis of corncob formation. The cell envelope fraction from this bacterium was treated with trypsin, delipidated with chloroform-methanol, and subjected to ion-exchange chromatography. A single polypeptide (apparent Mr, 39,500), which was eluted from the column with 0.5 M sodium chloride and extracted with dodecyltrimethylammonium bromide to remove contaminating lipopolysaccharide, inhibited corncob formation between strain ATCC 10953 and S. sanguis CC5A. Similarly derived cell fractions from either F. nucleatum FDC 364 or Fusobacterium necrophorum failed to effect coaggregation in the inhibition assay. Amino acid analysis of the polypeptide showed a moderately hydrophobic character (polarity index, 41) and 11% basic residues. Antiserum made against the purified polypeptide agglutinated F. nucleatum ATCC 10953, neutralized the ability of this bacterium to form corncobs, and agglutinated whole cells of S. sanguis CC5A that were precoated with the receptor polypeptide. The identification and isolation of this receptor should greatly enhance our ability to define some of the complex intergeneric coaggregation mechanisms that are thought to occur in the human oral cavity.

Animals↗
PubMed1989

Bronchial hyperreactivity and cough due to angiotensin-converting enzyme inhibitors.

Seventeen patients using angiotensin-converting enzyme (ACE) inhibitors for hypertension were evaluated with baseline spirometry followed by determination of bronchial reactivity by challenge with methacholine. There were nine coughers and eight noncoughers in the study. Among the nine coughers, eight demonstrated bronchial hyperreactivity. Conversely, none of the noncoughers disclosed bronchial hyperreactivity. Eight of the nine coughers were rechallenged two to six months following cessation of ACE inhibitor therapy. Six of these eight showed persistent bronchial hyperreactivity. We conclude that cough is associated with the use of ACE inhibitors in patients with underlying bronchial hyperreactivity. The findings indicate caution in administration of ACE inhibitors in asthmatic patients and those with known bronchial hyperreactivity.

Asthma↗
PubMed1988

Clinical and experimental evaluation of aortic polytetrafluoroethylene grafts for aneurysm replacement.

The aortic expanded polytetrafluoroethylene bifurcation graft has a unique taper design. This was studied in an in vitro model using hydrogen bubbles and colored dyes to assess its hemodynamic significance compared with a conventional nontapered graft model. Under conditions of nonpulsatile flow the only significant differences were seen with a high percentage of occlusions of one outflow limb. Clinical experience with this new graft for infrarenal aneurysm replacement was accumulated in 163 elective cases and 53 emergency cases. The results with this new graft were compared with those obtained in the same time frame with alternative Dacron grafts. No detrimental problems with the graft have appeared in its use up to 78 months following aneurysm bypass or replacement.

Aged↗
PubMed1988

Effects of orpanoxin on arachidonic acid metabolism of human polymorphonuclear leucocytes and platelets in vitro.

1. The effect of orpanoxin, a nonsteroidal anti-inflammatory drug, on cyclo-oxygenase and lipoxygenase activity in human polymorphonuclear leucocytes (PMNL) and platelets was studied ex vivo to see if lipoxygenase inhibition contributed to orpanoxin's mechanism of action. 2. In PMNL, orpanoxin (50, 100, and 200 mumols/l), like indomethacin (100 mumols/l), had little effect on synthesis of leukotriene B4 or 5S-hydroxy-6-trans,8,11,14-cis-eicosatetraenoic acid. BW755c at 100 mumols/l inhibited synthesis of both. 3. In PLT, orpanoxin (100 mumols/l) inhibited formation of cyclo-oxygenase products (thromboxanes, prostaglandins, and 12-L-hydroxy-5,8,10-heptadecatrienoic acid) and increased synthesis of the lipoxygenase product, 12S-hydroxy-5,8-cis,10-trans,14-cis-eicosatetraenoic acid. Effects of indomethacin (100 mumols/l) and benoxaprofen (100 mumols/l) in platelets were qualitatively similar to those of orpanoxin. 4. These results indicate that the discrepancy between the low potency of orpanoxin in inhibiting bovine seminal vesicle cyclo-oxygenase in vitro and its high potency as an anti-inflammatory agent in vivo is not explained by its having an additional lipoxygenase inhibitory mechanism.

4,5-Dihydro-1-(3-(trifluoromethyl)phenyl)-1H-pyraz↗
PubMed1988

Tracheal blastomycosis.

A patient with pulmonary blastomycosis is presented. In addition, the patient had extensive involvement of the trachea. This is the first known reported case of tracheal blastomycosis.

Adolescent↗
PubMed1988

Are patients with multiple sclerosis protected from thrombophlebitis and pulmonary embolism?

To study the incidence of deep venous thrombophlebitis (DVT) and pulmonary embolism (PE) in patients with multiple sclerosis (MS), charts of 228 subjects with multiple sclerosis who constituted 1986 hospital admissions to the Milwaukee Regional Medical Center were reviewed, covering a 3 1/2-year period. The records were investigated for any other hospitalization for deep venous thrombophlebitis and pulmonary embolism. No case of pulmonary embolism or deep venous thrombophlebitis was found. There were over 57,416 non-MS-related admissions during the same interval. Among these patients there were 175 with PE and 258 with DVT. The presence of lower extremity spastic disease may have prevented clotting. This statistically low incidence of thromboembolic events in MS is less than expected, and further studies are warranted.

Adult↗
PubMed1987

Characterization of cognitive functioning in a subgroup of children with congenital HIV infection.

The cognitive status of 12 clinically stable children with congenital HIV infection, nine of whom were neurologically impaired, age three to nine years, was assessed using the Kaufman ABC test. Seven of the children had ARC; five were diagnosed as having AIDS. The same children were evaluated by standard neurologic examinations with Characterization of tone and fine motor functioning. Two were diagnosed as being mildly retarded; six were borderline; and four tested as being of average intelligence. Visual-spatial perceptual based functioning was found to be more impaired than were abstract reasoning and verbally mediated skills in six (50%) of the patients. This pattern of impaired information processing was found irrespective of overall cognitive status. On neurological and physiatric examination abnormal developmental histories were obtained, or poor fine motor coordination, abnormal tone and gait, and impaired rapidly alternating movements were found in 9 of the 12 subjects. These findings suggest selective impairment in distinct areas of neurologic and neuropsychological functioning during stable phases of HIV infection in a select group of children. These patterns appear to persist over time. They differ from the clustering of impaired skills seen in children of comparable socio-cultural backgrounds without HIV infection. Similarities in functioning are noted between this subgroup of children with AIDS and ARC and comparable groups with cerebral palsy.

Journal Article↗
PubMed1987

Anatomic location of acute diabetic foot infection. Its influence on the outcome of treatment.

One hundred ten diabetic foot infections were studied in 76 patients with reference to the effect of the anatomic location of the infection on the treatment outcome. Distal infections were located in the toes or metatarsal-phalangeal joints; proximal infections were located along metatarsals, at the heel, or above the ankle. Overall limb salvage was significantly lower in the proximal group (47.8%) than in the distal group (96.6%). A revascularization for healing was required in 12 per cent of hospitalizations. Mortality was significantly higher in the proximal group, but the healing times for open wounds and overall morbidity were not different between the groups. Diabetic foot infections must receive careful and timely treatment by concerned surgeons. The outcome of proximal infections is poor, with major risk of limb loss and mortality, but not hopeless. The treatment of distal infections derives greater limb salvage with nevertheless similar morbidity and healing time.

Acute Disease↗