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Biomedical subjects

J N Weinstein

Publications and source records attributed to J N Weinstein.

At least 91 records · Page 5Linked to original sources
PubMed1994

Use of the Kohonen self-organizing map to study the mechanisms of action of chemotherapeutic agents.

BACKGROUND: Many natural and synthetic compounds might prove to be effective in cancer chemotherapy. To identify potentially useful agents, the National Cancer Institute screens over 10,000 compounds annually against a panel of 60 distinct human tumor cell lines in vitro. This screening program generates large amounts of data that are organized into relational databases. Important questions concern the information content of the data and ways to extract that information. Previously, statistical techniques have revealed that compounds with similar patterns of activity against the 60 cell lines are often similar in structure and mechanism of action. Feed-forward, back-propagation neural networks have been trained on this type of data to predict broadly defined mechanisms of action of chemotherapeutic agents. PURPOSE AND METHOD: In this report, we examine the information that can be extracted from the screening data by means of another type of neural network paradigm, the Kohonen self-organizing map. This is a topology-preserving function, obtained by unsupervised learning, that nonlinearly projects the high-dimensional activity patterns into two dimensions. Our dataset is almost identical to that used in the earlier neural network study. RESULTS: The self-organizing maps we constructed have several important characteristics. 1) They partition the two-dimensional array into distinct regions, each of which is principally occupied by agents having the same broadly defined mechanism of action. 2) These regions can be resolved into distinct subregions that conform to plausible submechanisms and chemically defined subgroups of submechanism. 3) These results (and exceptions to them) are consistent with those obtained with the use of such deterministic measures of similarity among activity patterns as the Euclidean distance or Pearson correlation coefficient. CONCLUSIONS: Our results indicate that the activity patterns obtained from the screen contain detailed information about mechanism of action and its basis in chemical structure. The self-organizing map can be used to suggest the mechanism of action of compounds identified by the screen as potentially useful chemotherapeutic agents and to probe the biology of the cell lines in the cancer screen. Kohonen self-organizing maps, unlike the previously applied neural networks, preserve and reveal the relationships among compounds acting by similar mechanisms and therefore have the potential to identify compounds that act by novel cytotoxic mechanisms.

Algorithms↗
PubMed1994

Hydroxyurea as an inhibitor of human immunodeficiency virus-type 1 replication.

Hydroxyurea, a drug widely used in therapy of several human diseases, inhibits deoxynucleotide synthesis--and, consequently, DNA synthesis--by blocking the cellular enzyme ribonucleotide reductase. Hydroxyurea inhibits human immunodeficiency virus-type 1 (HIV-1) DNA synthesis in activated peripheral blood lymphocytes by decreasing the amount of intracellular deoxynucleotides, thus suggesting that this drug has an antiviral effect. Hydroxyurea has now been shown to block HIV-1 replication in acutely infected primary human lymphocytes (quiescent and activated) and macrophages, as well as in blood cells infected in vivo obtained from individuals with acquired immunodeficiency syndrome (AIDS). The antiviral effect was achieved at nontoxic doses of hydroxyurea, lower than those currently used in human therapy. Combination of hydroxyurea with the nucleoside analog didanosine (2',3'-dideoxyinosine, or ddl) generated a synergistic inhibitory effect without increasing toxicity. In some instances, inhibition of HIV-1 by hydroxyurea was irreversible, even several weeks after suspension of drug treatment. The indirect inhibition of HIV-1 by hydroxyurea is not expected to generate high rates of escape mutants. Hydroxyurea therefore appears to be a possible candidate for AIDS therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Factors that affect surgical rates in Iowa.

STUDY DESIGN: This study analyzed insurance claims to estimate the probability of medical and surgical treatments in different Iowa communities. The likelihood of surgical treatment was associated with patient characteristics of age and gender as well as hospital characteristics of size (number of beds), occupancy rate, and number of staff. OBJECTIVES: Our findings are being used by a study group of 25 physicians to understand the causes of variation in surgical rates for low back pain. Medical education and other interventions are being implemented. SUMMARY OF BACKGROUND DATA: Hospitalization rates for lower back operations in the United States increased by more than 20% from 1978 to 1985. Consequently, several studies in Iowa and the US have been initiated to examine the medical effectiveness of these treatments. METHODS: A logistic regression model was used to determine the factors associated with the likelihood of having a low back surgery in a population of Blue Cross/Blue Shield (BCBS) subscribers in Iowa. The outcome, or dependent variable, of interest was a hospitalization that resulted in a surgical procedure on a low back pain patient. RESULTS: Surgical rates for the treatment of low back pain are likely to be increased if a BCBS Iowa subscriber is female, older than 44 years of age, or if the surgery is performed in a hospital with either an occupancy rate less than 62%, with fewer than 774 staff members, fewer than 267 beds, or no residency programs.

Adult↗
PubMed1994

Experimental lumbar radiculopathy. Immunohistochemical and quantitative demonstrations of pain induced by lumbar nerve root irritation of the rat.

OBJECTIVE: A series of experiments were designed to develop and validate an animal model of lumbar radiculopathy. More specifically, these investigations introduced a model of chronic neuropathic pain in the rat associated with clinically relevant lumbar nerve root trauma and evaluated the ability of the model to effect symptoms and begin to understand the underlying neurochemical and neurophysiologic factors associated with these neurologic abnormalities. SUMMARY OF BACKGROUND DATA: A search of the literature suggested that these studies were a first attempt to distinguish and elucidate an experimental lumbar radiculopathy. METHODS: Two basic approaches to nerve trauma were considered, direct damage to the nerve via compression, and introduction of foreign materials in proximity to the nerve root that might cause irritation and inflammation leading to chronic symptoms. Ligature around the nerve (i.e., surrounding the nerve with a suture) was considered a plausible irritant that might behave in an animal model in a similar way that nerve root entrapment, often observed in HNP and stenosis cases, might function in humans. Further, varying levels of irritation was modeled by using 4-0 silk as a mild and 4-0 chromic gut as a more harsh irritant. STUDY DESIGN: Five distinct treatments of the nerve roots were investigated initially: 1) a sham intervention, where the surgery simply exposed the nerve roots and dorsal root ganglion followed by standard closing procedures; 2) nerve root clipping, where the nerve roots were clipped with a microhemoclip; 3) 4-0 silk ligature, where two loose ligatures of 4-0 silk were placed around the nerve roots; 4) 4-0 chromic gut 1, where one loose ligature of 4-0 chromic gut was placed around the nerve roots; and 5) 4-0 chromic gut 2, where four 0.3 cm pieces of 4-0 chromic gut were laid adjacent to the nerve roots and secured by two loose ligatures of 4-0 chromic gut. ANOVA techniques were used to test for differential effects across time for the five treatment groups in terms of animal function and biochemistry in the DRG. RESULTS: Rats treated with chromic gut ligature in large quantity demonstrated differential patterns of results on the injured and noninjured sides consistent with a lumbar radiculopathy. The injured side demonstrated significantly worse thermal hyperalgesia related to neuropathic pain (P < 0.0001); initial mechanical hypoalgesia (P < .001), and motor dysfunction (P < .001) resolving within 2 weeks; significantly increased c-fos counts (P < .0001) 2 weeks postoperatively, which showed a consistent trend toward baseline and return to baseline by 12 weeks; significantly greater and highly increased VIP concentrations in the dorsal root ganglia 2 weeks postoperatively (P < .0001) that did not resolve or tend towards baseline after 12 weeks of follow-up in conjunction with a trend toward VIP depletion in the spinal cord 2 weeks postoperatively that did resolve to baseline until a 12-week concentration indicated a significant increase in concentration (P < .002). Quantitative and qualitative changes in c-fos and VIP, correlated with the patterns of behavior and function. Thus, for the first time, evidence to link outcome behaviors and function with underlying neurochemical processes is suggested. CONCLUSIONS: When the same apparent conditions can be demonstrated in some situations to be causing pain and in other situations to be independent of pain, some additional factor or factors not considered in the original investigations may be mediating the outcome. Neurochemical consequences of nerve root irritation provide a theoretical framework for hypothesizing about various types of mediating events that might explain how similar apparent pathology might reasonably lead to different predictions about behavior consequences of the pathology.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

Experimental lumbar radiculopathy. Behavioral and histologic changes in a model of radicular pain after spinal nerve root irritation with chromic gut ligatures in the rat.

OBJECTIVE: The recently proposed animal model of lumbar radiculopathy was used to investigate behavioral consequences and histologic changes in spinal nerve roots, dorsal root ganglia, and spinal nerves after the L4, L5, and L6 nerve roots were loosely ligated with either silk or chromic gut sutures in an attempt to better understand the pathophysiologic mechanisms that give rise to pain associated with lumbar radiculopathy. SUMMARY OF BACKGROUND DATA: Little is known about the pathophysiologic mechanisms that give rise to pain associated with lumbar radiculopathy. The recently proposed animal model of unilateral lumbar radiculopathy, which demonstrated an association with motor paresis and thermal hyperalgesia of the affected hind limb and showed evidence of spontaneous pain has been demonstrated, may serve as a vehicle to allow direct investigation of the nature of the pathophysiological mechanisms associated with lumbar radiculopathy. METHODS: Three distinct treatments of the nerve roots were initially investigated: 1) a sham intervention, where the surgery simply exposed the nerve roots and dorsal root ganglion followed by standard closing procedures; 2) 4-0 silk ligature, where two loose ligatures of 4-0 silk were placed around the nerve roots; and 3) 4-0 chromic gut 2, where four 0.3 cm pieces of 4-0 chromic gut were laid adjacent to the nerve roots and secured by two loose ligatures of 4-0 chromic gut. STUDY DESIGN: ANOVA techniques were used to test for differential effects across time for the three treatment groups in terms of animal function. A qualitative analysis of the histology of the ipsilateral and contralateral nerve roots, dorsal root ganglia, and spinal nerves was done to correlate histologic changes with behavioral changes. RESULTS: Behavioral results were consistent with the previous study. Rats treated with chromic gut, but not silk, reliably demonstrated a prolonged thermal hyperalgesia that was maximal 2 weeks after surgery and lasted for up to 12 weeks. These behavioral changes, however, were not correlated with histologic changes in myelinated fiber content in the L4, L5, and L6 nerve roots, dorsal root ganglia and spinal nerves, the ipsilateral spinal nerved, dorsal root ganglia, and nerve roots of rates ligated with silk or chromic gut showed similar, significant, decreased in the number of large diameter myelinated fibers. CONCLUSIONS: These results suggest that mechanical constriction of the L4, L5, and L6 spinal nerve roots, as evidenced by a loss of myelinated fibers, is not sufficient to produce the behavioral effects associated with this model of lumbar radiculopathy. It is hypothesized that chemical factors from the chromic gut play a role in the pathophysiology and development of the behavioral, but not histological, changes in this model of lumbar radiculopathy.

Animals↗
PubMed1994

Effects of whole body vibration on dorsal root ganglion neurons. Changes in neuronal nuclei.

STUDY DESIGN: This blinded, histomorphometric analysis compared neuronal nuclei from lumbar dorsal root ganglia from three groups of rabbits: normal controls, immobilized controls, and an experimental group exposed to daily, whole body vibration. OBJECTIVES: To identify ultrastructural changes in dorsal root ganglion neurons consistent with, and capable of producing, neuropeptide changes previously documented in vibration-exposed animals. METHODS: Normal adult rabbits were exposed to modulated whole body vibration at a frequency and amplitude previously shown to produce changes in dorsal root ganglion neuropeptides. Lumbar ganglia from control and vibrated rabbits were fixed, stained, and studied under transmission electron microscopy. One-thousand-two-hundred cells were sampled, and 190 appropriately sectioned cells were analyzed. SUMMARY OF BACKGROUND DATA: Epidemiologic studies have suggested a strong correlation between vibration and back pain. Previous studies have shown that short-term exposure to whole body vibration alters the normal neuropeptide profile seen in dorsal root ganglion neurons. RESULTS: Nuclear clefting was increased 39% in vibrated nuclei relative to controls, and nuclear pores were increased 46% in areas of clefting compared with adjacent nonclefted segments and controls (P < .001). Mitochondria, rough endoplasmic reticulum, and free ribosomes crowded the cleft spaces of vibrated cells, and the normal perinuclear clear space was lost. Mitochondrial and lysosomal volumes were significantly increased in vibrated cells. CONCLUSIONS: These ultrastructural changes, generated by a physiologically valid vibration stimulus, provide an anatomic link between the clinical observation of increased back pain and the biochemical alterations involving pain-related neuropeptides.

Animals↗
PubMed1994

Two-step targeting of experimental lung metastases with biotinylated antibody and radiolabeled streptavidin.

Two-step monoclonal antibody tumor targeting using an avidin-biotin system has unique characteristics because of the high-affinity binding (10(15) M-1) and the lower molecular weight ligands (avidin, streptavidin, or biotin) used as carriers of radioisotopes, toxins, or drugs. The distribution of radiolabeled streptavidin in a two-step targeting strategy was investigated in lung metastases of line 10 carcinoma in guinea pigs. The microdistribution of administered D3 monoclonal antibody and 125I-labeled streptavidin in metastatic nodules was examined by immunohistochemistry and autoradiography, and the uptake was quantitated. With monoclonal antibody pretargeting, streptavidin was found mainly at the periphery of metastatic nodules 1.5 h after injection; it had penetrated deeper at 4 h and was approaching homogeneity in many of the tumor nodules at 24 h. These results indicate that streptavidin can penetrate into metastatic nodules more rapidly than can the antibody. The concentration of streptavidin in metastatic nodules 4 h after injection was 5.6 times higher for the pretargeted group than for the nonpretargeted group, and the pretargeting index was 4.7. Although the absolute uptake of streptavidin had decreased between 4 and 24 h, the metastasis:blood ratio had increased from 1.2 to 2.4. When compared with the animals injected with 125I-labeled D3 antibody alone, the pretargeted group achieved higher tumor:blood and tumor:lung ratios and a higher localization index at early times after injection of the radiolabeled species.

Animals↗
PubMed1994

Streptavidin distribution in metastatic tumors pretargeted with a biotinylated monoclonal antibody: theoretical and experimental pharmacokinetics.

We have developed a pharmacokinetic model for the analysis of a protocol that involves injection of a biotinylated monoclonal antibody followed at a later time by radiolabeled streptavidin. Three distinct physiological spaces are described: an avascular tumor nodule, the normal tissue surrounding the tumor, and the plasma. The model incorporates processes such as plasma kinetics, transcapillary transport, interstitial diffusion, binding reactions, and lymphatic clearances. We have modeled cases in which antigen turnover does not occur, in which antigen turnover does occur (24-h time constant), and in which circulating antibody is cleared from the plasma immediately prior to injection of streptavidin. We have calculated the spatial and temporal distributions of a tumor-specific antibody and of streptavidin in the tumor nodule using parameter values that simulate conditions of recent experiments on metastatic nodules in the guinea pig lung. The theoretical distribution of streptavidin in the tumor nodule shows an initial localization at the periphery that progresses to a fairly uniform distribution throughout the nodule, a temporal sequence that is very similar to experimental observation. This finding indicates that, in a tumor pretargeted with biotinylated antibody, streptavidin can encounter significant retardation in its penetration as a consequence of the high affinity interaction between these two species. Tumor:blood and tumor:lung ratios were calculated and compared to experimental results. In addition, the calculated tumor:blood ratios, tumor:lung ratios, and relative exposures were compared to values obtained from a model of one-step antibody delivery. The two-step protocol yielded an approximately 2- to 3-fold enhancement in these pharmacokinetic indices compared with the one-step method.

Animals↗
PubMed1994

Predictive statistics and artificial intelligence in the U.S. National Cancer Institute's Drug Discovery Program for Cancer and AIDS.

The National Cancer Institute's drug discovery program screens more than 20,000 chemical compounds and natural products a year for activity against a panel of 60 tumor cell lines in vitro. The result is an information-rich database of patterns that form the basis for what we term an "information-intensive" approach to the process of drug discovery. The first step was a demonstration, both by statistical methods (including the program COMPARE) and by neural networks, that patterns of activity in the screen can be used to predict a compound's mechanism of action. Given this finding, the overall plan has been to develop three large matrices of information: the first (designated A) gives the pattern of activity for each compound tested against each cell line in the screen; the second (S) encodes any of a number of types of 2-D or 3-D structural motifs for each compound; the third (T) indicates each cell's expression of molecular targets (e.g., from 2-dimensional protein gel electrophoresis). Construction and updating of these matrices is an ongoing process. The matrices can be concatenated in various ways to test a variety of specific hypotheses about compounds screened, as well as to "prioritize" candidate compounds for testing. To aid in these efforts, we have developed the DISCOVERY program package, which integrates the matrix data for visual pattern recognition. The "information-intensive" approach summarized here in some senses serves to bridge the perceived gap between screening and structure-based drug design.

Antineoplastic Agents↗
PubMed1994

Site-directed mutagenesis of tryptophan residues to conserved hydrophobic residues inhibits the processing of human KB cell folate receptor.

We are interested in identifying the ligand binding site of the human folate receptor (hFR). Previous reports have suggested a role of tryptophan(W) residues in ligand binding. We used site-directed mutagenesis to change the conserved W residues in positions 86, 116, 142, 143, 156, 160, and 193 of the hFR to either leucine(L) or phenylalanine(F) to examine the role of these W residues in hFR function. Although all W to L changes except W86L produced unstable proteins, W to F changes were tolerated. Based on total folate binding and transport studies, Chinese hamster ovary (CHO) cells transfected with W86L, W116F, and W143F expressed high levels of functional hFR, equivalent to cells transfected with wt hFR. CHO cells transfected with W142F, W156F, W160F, and W193F expressed low or undetectable levels of functional hFR although mRNA was present. Of these four mutants, only W142F expressed easily detectable immunoprecipitable protein but it was not fully glycosylated. Since glycosylation may affect the ability of hFR to bind folate, we expressed W142F in Xenopus oocytes which glycosylate the mutant and wild type proteins to the same apparent extent. In oocytes, the stoichiometry of folate binding was identical between the fully processed mutant protein and the wild type hFR. These results indicate that in CHO cells three of the seven W mutations (W86L, W116F, and W143F) function normally, whereas four of the seven W mutations (W142F, W156F, W160F, and W193F) produce unstable or abnormally processed protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMed1994

The effect of vibration on back discomfort and serum levels of von Willebrand factor antigen: a preliminary communication.

The von Willebrand factor (vWf) is a complex protein whose release is a marker for endothelial damage; serum levels of its antigen (vWFAg) can be used as a marker for such changes. We measured the levels of back discomfort and vWFAg in 11 subjects following 25-min periods of (1) lying down, (2) sitting upright, (3) vibrating whilst sitting and (4) sitting upright. Back discomfort appeared and vWf levels were significantly increased following sitting upright, compared with lying flat, and increased further following vibration. They fell thereafter with a period of sitting still upright. These results demonstrate that vibration has a significant effect in increasing back discomfort and the serum levels of vWFAg, and it is possible that vibration may induce vascular damage within the spine.

Adult↗
PubMed1994

A method for the fatigue testing of pedicle screw fixation devices.

Spinal devices/instrumentation are used to augment the stability of a decompressed spinal segment during surgery. Like any other mechanical component, the device can fail. A standard in vitro test protocol, was developed to determine load vs number of cycles to failure curve for a pedicle screw-plate/rod type spinal device. The protocol based on the use of an 'artificial spine' model, is clinically relevant. The protocol was used to characterize the load-carrying capacities and failure modes of a specific pedicle screw-rod type fixation device to demonstrate its appropriateness. The devices (Kaneda) were tested in the quasi-static as well as fatigue bending modes. In the bending fatigue mode, the devices failed at loads significantly smaller than the corresponding quasi-static failure load magnitude (806 N). The device exhibited an endurance limit in the fatigue bending mode. The device is not likely to exhibit failure if subjected to cyclic loads which cause less than 380 N axial compression (and an accompanying bending moment relative to the device of less than 13.57 Nm). The failures observed in specimens subjected to the fatigue tests ranged from complete to partial breakage of the paraspinal rods as opposed to failure due to permanent deformation (yielding) of the rods in the quasi-static bending test specimens. The protocol developed can be used for any other screw-plate/rod type spinal instrumentation. The use of a standard protocol by researchers would enable a comparison of various devices currently available in the market. Such comparative data would be useful for the scientific community, and agencies such as the FDA and ASTM.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Plates↗
PubMed1994

Stress analysis of a canine spinal motion segment using the finite element technique.

Canine models have been frequently employed to investigate the in vivo effects of a surgical procedure. Various studies indicate that canine models can provide a successful in vivo biological model for these studies. Use of canine models for the biomechanical studies of the spine, however, have been questioned because of different loading conditions on the canine and human spines originated from posture differences between canine and human. Similarities between the stress distributions within the canine and human motion segments under physiological loads will strengthen the use of canine models for the studies of spine biomechanics. In the present study, finite element models of the canine intact and stabilized motion segments were developed to investigate these aspects. Comparison of model predicted flexion angle, axial stiffness, and facet contact force for the canine intact L6-L7 motion segment revealed good agreement with the corresponding parameters experimentally measured under the similar loading conditions. Similar stress distributions within the intact canine and human models were found from the predicted results in response to the physiological load. Stabilizing and stress-shielding effects of a pedicle screw-plate-type fixation device [variable spinal plating (VSP)] on the stabilized motion segment were also similar for the canine and human stabilized models. Furthermore, maximum stresses in the pedicle screws were found at the junction between the bone screw and the integrated nut of the inferior screw in both the canine and human stabilized models. This corresponds to the location of pedicle screw breakage reported in the literature. These findings suggest that a canine is a suitable model for the biomechanical studies of the lumbar spine.

Animals↗
PubMed1994

A comparison of stress-induced porosity due to conventional and a modified spinal fixation device.

A hypothesis that device-related osteopenia can be reduced by decreasing the rigidity of a fixation device was tested through a canine study. Polymer washers were interposed between the integral nut and plate of the variable spinal plating (VSP) system to reduce its rigidity. A solid fusion was observed 6 months postoperatively in all of the animals using VSP or modified systems. The stabilized segment using both systems showed similar load-displacement behaviors immediately after surgery and 6 months postoperatively. Although not significant, 5.6 and 1.8% decreases in volumetric density of mineralized bone were found in the stabilized segments due to VSP and modified systems, respectively. The modified system also increased bone growth around screws. The new concept of using polymer washers, to decrease rigidity of the fixation device over time, may reduce device-related osteopenia.

Animals↗
PubMed1994

Effect of dipyridamole on zidovudine pharmacokinetics and short-term tolerance in asymptomatic human immunodeficiency virus-infected subjects.

Zidovudine delays the progression of infection and prolongs the survival of human immunodeficiency virus (HIV)-infected patients, but these benefits are limited by dose-related toxicity and the cost of the drug. Dipyridamole, in micromolar concentrations, acts synergistically with zidovudine, reducing the anti-HIV 95% inhibitory concentration of zidovudine 5- to 10-fold in vitro. We sought to establish a well-tolerated dose of dipyridamole for use in combination with zidovudine and to detect clinically significant pharmacokinetic interactions. Both objectives are essential for planning studies of the efficacy of the zidovudine-dipyridamole combination. Eleven asymptomatic HIV-infected subjects (median CD4+ cell count, 311 cells per mm3), 10 of whom had been on zidovudine at 500 mg/day for at least 6 months, were admitted to the study. Zidovudine pharmacokinetics were measured on day 1. Dipyridamole was then begun at 600 mg/day (subjects 1 to 3) or 450 mg/day (subjects 4 to 11), and zidovudine and dipyridamole pharmacokinetics were measured on day 5. All subjects given 600 mg of dipyridamole per day developed headache or nausea, or both. Six of eight subjects given dipyridamole at 450 mg/day developed headache or mild nausea that resolved after a median of 2 days. The area under the zidovudine concentration-time curve was not significantly different on day 1 in comparison with that on day 5 (P = 0.11). Symptoms were significantly correlated with the maximum zidovudine concentrations, which were achieved when dipyridamole was dosed concomitantly (p = 0.03). Total (free and protein-bound) dipyridamole trough concentrations were near those demonstrating synergy with zidovudine against HIV in vitro. Dipyridamole was highly protein bound, with a median free/total dipyridamole ratio of 0.7%; the percent free/total dipyridamole ratio was inversely correlated with alpha 1 acid glycoprotein concentrations (r2 =0.66). Results of the study indicate that adjustment of the zidovudine dose was not required to achieve equivalent zidovudine concentrations when zidovudine was administered in combination with dipyridamole at the doses studied. In the short study described here, the zidovudine-dipyridamole combinations was well tolerated in asymptomatic HIV-infected subjects after the occurrence of mild transient symptoms.

Adult↗
PubMed1994

Effect of shock wave treatment on femoral prosthesis and cement removal.

The present study has examined the efficacy of shock wave treatment to aid in the removal of bone cement in human cadaver femora after femoral prosthesis implantation. The shock waves were applied to the specimens at four points, in the circumference 90 degrees apart, at three levels. Four hundred shocks were applied at each point with intensity level of 25 kV. Extraction time of the bone cement was significantly (p < 0.002) faster in the treated versus untreated control groups. The average extraction time was decreased by 32%. Shock wave treatment also reduced the amount of residual cement inside the bone surface by an average of 55% (p < 0.006). The number of shocks needed to remove the prosthesis from bone cement also decreased significantly (p < 0.001) after shock wave treatment.

Aged↗