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Biomedical subjects

J Schulman

Publications and source records attributed to J Schulman.

At least 55 records · Page 3Linked to original sources

Heterogeneous proliferative characteristics of human adult lung fibroblast lines and clonally derived fibroblasts from control and fibrotic tissue.

Pulmonary fibrosis results from an altered deposition of collagen within the lung parenchyma. This alteration is likely the result of both increased fibroblast proliferation and abnormalities in fibroblast collagen metabolism. Although the development of pulmonary fibrosis is preceded by inflammatory events in the lung, it is unclear whether altered fibroblast behavior requires continuous exposure to inflammatory mediators or alternatively results from the emergence in the lung of fibroblast populations possessing characteristics such as to explain the abnormalities seen in pulmonary fibrosis. To examine the latter hypothesis, we have established a number of fibroblast cell lines from control (C) lung tissue as well as from tissue from patients with active pulmonary fibrosis (PF), and have examined their in vitro proliferative characteristics. Our data show that PF fibroblasts proliferate significantly faster compared to C fibroblasts under standard culture conditions. We have also examined the in vitro proliferative characteristics of a substantial number of clonally derived fibroblasts. We report that a marked heterogeneity exists in terms of proliferation and also that a small but significant number of fast-growing clones are present in panels of clones derived from fibrotic tissue. These data suggest that there exists in fibrotic tissue, clones of fibroblasts with intrinsic growth characteristics which could in itself explain the increased fibroblast proliferation seen in pulmonary fibrosis. The fibrotic clones may emerge as dominant in the fibrotic lung under conditions of injury and repair likely to favor the expansion of this phenotype.

Adult↗

A note on the assessment of exposure using one-sided tolerance limits.

Conceptual problems with OSHA's use of an absolute standard have led to alternative methods of assessing exposures to toxic materials in the workplace. One of these methods employs a one-sided tolerance limit. This statistical approach is explored from three points of view--identifiability, sampling strategies and statistical power. In general, assessing risk in the work environment with tolerance limits is found to give inadequate answers in several important respects.

Humans↗

Cerebellar stimulation for spastic cerebral palsy--double-blind quantitative study.

Thirty spastic cerebral palsy (CP) patients were involved in a double-blind quantitative study to determine the effectiveness of chronic cerebellar stimulation, (CCS) and 19 patients completed the testing. Of the 12 patients undergoing the five motor performance tests, 8 (66%) showed improvements with the stimulation. Of the 16 patients tested for active motion in seven bilateral joints, 10 (63%) showed increases with CCS. Profiles of six mood states were tested in 15 patients, and CCS produced an overall 15% improvement.

Cerebellum↗

Cerebellar stimulation for cerebral palsy--double blind study.

Twenty spastic cerebral palsy (CP) patients undergoing chronic cerebellar stimulation (CCS) for reduction of spasticity and improvement in function have participated in a double-blind study. Seven US centers involving 9 neurosurgeons (1984-6) have replaced the depleted Neurolith 601 fully implantable pulse generator (Pacesetter Systems Incorp.-Neurodyne Corp., Sylmar, CA) with new units in 19 CP patients, 1 patient entered the study following his initial implant. A magnetically controllable switch was placed in line between the Neurolith stimulator and the cerebellar lead, so allowing switching sequences for the study. Physical therapists, living in the vicinity of the patient's home, carried out two quantitative evaluations: 1. Joint angle motion measurements (passive and active). 2. Motor performance testing was done when possible and included: reaction time, hand dynamonetry, grooved peg board placement, hand/foot tapping, and rotary pursuit testing. Testing was done presurgery, at 2 weeks postimplant, then the switch was activated either "on" or "off" to a schedule, with testing and reswitching at 1, 2 and 4 months, then the switch was left turned "on". Of the 20 patients, 16 finished the tests, 2 patients failed to finish and 2 had switch problems and were deleted from the study. Two of the 16 patients were "off" through the entire testing. Of the 14 that had periods of the stimulator being "on", 10 patients (72%) had quantitative improvements of over 20%, (1 pt: 50+% improvements; 4 pts: 30-50%, 5 pts: 20-30%); while 1 patient (7%) had improvements in the 10-20% level, whereas 3 patients (21%) showed no improvement.

Adolescent↗

Spatial distribution of disease: three case studies.

Maps transformed so as to have constant density of residential population were used to analyze the spatial distribution of disease in three specific areas. Each area had received recent attention because of suspected environmental pollution. The area adjacent to the Rocky Flats Facility (CO) was examined to identify any association between possible plutonium releases and increases in lung cancer or leukemia incidence. The industrial area of northern Contra Costa County (CA) was studied to explore a relationship between petrochemical industrial emissions and histologic-specific lung cancers. Finally, a suspected increase in the risk of congenital cardiac defects possibly related to pollution of the Santa Clara County (CA) water supply was investigated. No evidence of elevated risk of disease was found to be associated with either the Rocky Flats Facility or the polluted water of Santa Clara County. An increase in lung cancer, found by other investigators in earlier years, was shown to persist in association with industrial emissions in Contra Costa County.

Adult↗

The intraocular penetration of acyclovir after subconjunctival administration.

Five patients received a subconjunctival injection (25 mg) of acyclovir before undergoing scheduled enucleation. Seven hours after injection, the observed aqueous and vitreous levels of acyclovir were above the minimum inhibitory concentrations for many herpes simplex viruses types 1 and 2. Systemic absorption measured at two and seven hours after injection was negligible.

Acyclovir↗

Diagnosis and therapeutic surgery of the uvea--Part II: Results.

Fifty-five patients underwent eye wall biopsy (11) or eye wall resection (44). Eye wall resection was performed for suspected melanoma in 42 cases and large von Hippel angiomas in an additional two patients. Two of the 35 individuals with choroidal melanoma died, representing a 5.7% mortality rate over a mean follow-up period of more than five years. Visual acuity, ocular morbidity, and tumor-associated deaths in this series are compared with results using other treatment modalities for choroidal melanoma.

Angiomatosis↗

Retinoblastoma and simulating lesions: role of CT and MR imaging.

Diagnosis of retinoblastoma is one of the most challenging problems of pediatric ophthalmology and radiology. It must be differentiated from numerous simulating lesions. Accurate diagnosis by means of ultrasonography, CT, and MR is essential for prompt treatment and prevention of metastasis. The CT and MR findings in 45 patients are presented in this article in order to evaluate and compare the usefulness of these two imaging techniques in the diagnosis of retinoblastoma.

Calcinosis↗

Intraocular penetration of new antiviral agent, hydroxyacyclovir (BW-B759U).

9-[(2-hydroxyl-1-(hydroxymethyl)ethoxy]methyl)guanine (hydroxyacyclovir) is a nucleoside analogue with a high degree of efficacy against herpes simplex virus types 1 and 2 and cytomegalovirus (CMV). This antiviral agent demonstrates a low toxicity towards uninfected cells. Intraocular levels in rabbits were evaluated following subconjunctival, intravenous, intravitreal and topical administration. Retinal toxicity studies were performed. Hydroxyacyclovir may have applications in the treatment of deep herpetic infections, CMV retinitis, and acute retinal necrosis.

Acyclovir↗

Intraocular 9-([2-hydroxy-1-(hydroxymethyl) ethoxy] methyl) guanine levels after intravitreal and subconjunctival administration.

Clearance studies in rabbits following intravitreal injection of 400 micrograms of 9-([2-Hydroxy-1-(hydroxymethyl)ethoxy]methyl) guanine demonstrated levels of the antiviral at 60 hours above the in vitro ID50 for several strains of human cytomegalovirus. Intravitreal administration of this new antiviral may have therapeutic application in the treatment of acute retinal necrosis and cytomegalovirus retinitis complicating acquired immune deficiency syndrome (AIDS).

Acyclovir↗

Diagnosis and therapeutic surgery of the uvea--Part I: Surgical technique.

Surgical techniques of iridocyclectomy, iridochoroidectomy, eye wall resection, eye wall biopsy, and ab interno retinochoridectomy are described. Surgical approaches to uveal neoplasms offer a new alternative for management of these disorders. Uveal and retinal biopsy expand our knowledge of pathological processes involved in tapetoretinal degeneration and uveitides. Additionally, both eye wall biopsy and resection provide tissue to confirm tumor diagnosis and malignancy.

Biopsy↗

Monocyte procoagulant activity and plasminogen activator. Role in human renal allograft rejection.

Currently the mechanism of renal allograft rejection is not well understood. This study was designed to determine whether induction of monocyte procoagulant activity (MCPA) is important in the pathogenesis of renal allograft rejection. The MPCA assay was performed utilizing a one stage clotting assay both in normal and in factor-VII-deficient plasma. There was no increase in spontaneous MPCA in 20 patients with endstage renal failure and in 10 patients following abdominal or orthopedic operation, as compared with 20 normal controls. MPCA was assessed daily in 18 patients who had received renal allografts. Rejection episodes (RE) were predicted on the basis of persistent elevation in MPCA as compared with pretransplant levels. Rejection was diagnosed clinically and treated on the basis of standard criteria. Treated RE were compared with those predicted by elevated MPCA, and 3 patients were assessed as having no RE by MPCA and by standard criteria. In 8 RE, MPCA correlated temporally with RE (same day) when compared with standard criteria. In 12 RE, MPCA was predictive of rejection preceding standard criteria by at least 24 hr. There were 7 false-positive predictions on the basis of MPCA; however, there was only 1 false negative. MPCA was shown to be a prothrombinase by its dependence only on prothrombin and fibrinogen for full activity. MPCA may be important in the pathogenesis of allograft rejection, and additionally it may be a useful adjunct in the clinical management of this disease.

Adult↗

Indications for vitrectomy in congenital retinoschisis.

Two patients with congenital retinoschisis developed rhegmatogenous retinal detachments with either a tractional component or associated vitreous haemorrhage. The second patient also had a large, raised schisis cavity under vitreous traction, which obscured visualisation of the macula. Vitrectomy is indicated for some patients with congenital retinoschisis.

Child↗

Bioengineering changes in spastic cerebral palsy groups following cerebellar stimulation.

Quantitative bioengineering tests were performed on 30 spastic cerebral palsy (CP) patients who underwent chronic cerebellar stimulation (CCS) using the fully implantable pulse generator (Neurolith 601, 1.1-1.8 microC/cm2/phase). Using respiratory inductive plethysmography to measure 8 patients with paroxysmal and/or ataxic breathing patterns, 5 were shown to revert to normal with 3 others markedly improved within 5 months of CCS. Compliance testing of the ankle was performed on 4 patients who showed improvement in 9 of the 16 tests performed. Motor performance ability was evaluated with 9 comprehensive tests in 17 patients. Following 1-2 weeks of CCS, 52% showed performance increases greater than 10%, increasing to 62% during the first year.

Cerebellum↗

Monocyte procoagulant activity in glomerulonephritis associated with systemic lupus erythematosus.

Monocyte infiltration and activation of the coagulation system have been implicated in the pathophysiology of glomerulonephritis. In this study, spontaneous procoagulant activity (PCA) was measured in circulating mononuclear cells to determine whether elevated PCA correlated with the presence of proliferative glomerulonephritis in patients with systemic lupus erythematosus (SLE). No increase in PCA was found in 20 patients with end-stage renal failure, 8 patients with glomerulonephritis without SLE, and 10 patients undergoing abdominal surgical or orthopedic procedures as compared with 20 normal controls. In eight patients with SLE but with no apparent active renal disease, PCA was not elevated above normal basal levels. Seven additional patients with SLE who had only mesangial proliferation on biopsy also had no increase in PCA. In contrast, eight patients with focal or diffuse proliferative lupus nephritis, and one patient with membranous nephritis who ultimately developed a proliferative lesion, had a marked increase in PCA with greater than 100 times the base-line levels. The activity was shown to originate in the monocyte fraction of the mononuclear cells and was shown to be capable of cleaving prothrombin directly. The prothrombinase activity was not Factor Xa, because it was not neutralized by anti-Factor X serum and was not inhibited by an established panel of Factor Xa inhibitors. Monocyte plasminogen activator determinations did not correlate with renal disease activity. We conclude that monocyte procoagulant activity, a direct prothrombinase, seems to correlate with endocapillary proliferation in lupus nephritis and could be a mediator of tissue injury.

Blood Coagulation Factors↗

Computed tomography in choroidal detachment.

Computed tomography proved valuable in localizing and differentiating serous or hemorrhagic choroidal detachment and scleral infolding. The mean attenuation values (CT numbers) in the region of fresh hemorrhagic choroidal detachment were 74 Hounsfield units (HU). The 90% confirmation limit of the mean was 55 to 84 HU. For serosanguineous choroidal detachment, the mean was 50 HU, with a 90% confirmation limit of 46 to 54 HU. For serous choroidal detachment the mean was 46 HU, with a 90% confirmation limit of 39 to 53 HU. Inflammatory choroidal detachment showed uveoscleral enhancement, which in cross section appeared as a ring (ring sign), and subchoroidal or intrauveal accumulation of fluid. Ocular hypotony produced the characteristic CT "umbrella sign."

Adolescent↗