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Biomedical subjects

J Weinberger

Publications and source records attributed to J Weinberger.

At least 91 records · Page 5Linked to original sources

Transient ischemic attacks with external carotid artery stenosis and a normal internal carotid artery.

Transient ischemic attacks have been attributed to emboli from the external carotid artery in patients with complete occlusion of the internal carotid artery. We report a patient with an external carotid stenosis and normal internal carotid who developed ipsilateral transient ischemic attacks. Real time B-mode ultrasonography demonstrated that the plaque obstructing the external carotid artery extended into the carotid sinus. This may have served as a source of emboli into the internal carotid circulation.

Aged↗

The differential effect of ischemia on the active uptake of dopamine, gamma-aminobutyric acid, and glutamate by brain synaptosomes.

Ischemic stroke was induced in the Mongolian gerbil by left common carotid ligation. No change in uptake of [3H]dopamine, [3H]gamma-aminobutyric acid ([3H]GABA), or [14C]glutamate in synaptosomes obtained from the ischemic hemisphere was observed for up to 8 h. At 16 h after ligation, marked decrements in uptake were observed in animals showing hemiparesis: Uptake values expressed as a percent of the corresponding control hemisphere were 15.2% for dopamine, 28.9% for GABA, and 47.5% for glutamate. The differential sensitivity of dopamine terminals compared with glutamate terminals was highly significant. Separate experiments performed with synaptosomes isolated from the corpus striatum showed that the greater sensitivity to damage was intrinsic to the dopamine nerve terminal and not the result of regional variations in ischemic damage in brain. No bilateral effect of ischemia on dopamine uptake was evident. In animals exhibiting milder behavioral deficits (circling), a smaller and comparable decrement in uptake of dopamine, GABA, and glutamate was evident at 16 h, whereas animals not affected behaviorally showed no decrement at 16 h. Following uptake, the subsequent fractional release of neurotransmitter stimulated by 60 mM-potassium ions was not affected at any time point studied. Therefore, the loss in uptake at 16 h probably represents overt destruction of nerve terminals. Experiments with urethane used in place of pentobarbital for anesthesia during carotid occlusion showed that "protection" by pentobarbital was not a factor in the delayed response to ischemia. These results show that damage or destruction of nerve terminals is a delayed event following ischemia and that dopamine terminals are intrinsically more sensitive than glutamate terminals.

Animals↗

Hemodynamics of the carotid-artery circulation in the elderly "dizzy" patient.

One hundred and one consecutive patients complaining of dizziness were assessed by noninvasive carotid-artery testing, including oculoplethysmography, supraorbital directional Doppler and direct carotid flow Doppler. Hemodynamically significant carotid disease was found in 8 of 34 patients with the nonspecific complaint of "lightheadedness," in 4 of 21 patients with syncope, in 3 of 12 patients with vertebrobasilar insufficiency, and in 7 of 27 patients with associated focal cerebral signs or symptoms. None of 7 patients with vertigo alone were affected. In summary, 21 of the 101 patients with dizziness had hemodynamically significant obstruction to flow in the carotid-artery circulation. These findings suggest that in a fairly large proportion of patients complaining of dizziness, the symptoms may be the result of decreased cerebral perfusion due to carotid-artery occlusive disease. In these patients, noninvasive carotid-artery testing appears to be useful in identifying those with significant obstruction to blood flow in the carotid-artery circulation.

Aged↗

Effect of intracerebral vasculitis on regional cerebral blood flow.

Regional cerebral blood flow was measured by the xenon 133-inhalation method in a 40-year-old man during an acute exacerbation of intracranial vasculitis. Neurologic function was quantitated by the Halstead-Reitan Neuropsychological test battery. The patient was also studied during remission that was induced by steroid therapy. Vasculitis produced a diffuse encephalopathy with generalized reduction in cerebral blood flow. During remission, only local symptoms secondary to a small cerebral infarction remained and regional cerebral blood flow returned to the normal range. There seems to be a close correlation between the severity of symptoms in cerebral vasculitis and reduction of flow through diseased vessels.

Adult↗

Mechanism of action of anticonvulsants. Role of the differential effects on the active uptake of putative neurotransmitters.

The effect of pentobarbital and phenytoin on the high-affinity uptake of the putative neurotransmitters gamma-aminobutyric acid (GABA), glutamate, and norepinephrine was examined in synaptosomes prepared from rat brain. Both pentobarbital and phenytoin inhibited the uptake of norepinephrine. Pentobarbital increased the uptake of GABA twofold and only slightly increased the uptake of glutamate. Phenytoin facilitated GABA uptake to a lesser extent than did pentobarbital, but also increased the uptake of glutamate. This suggests that these drugs may limit the propagation of seizures through the balance of excitatory glutamate pathways and inhibitory GABA and norepinephrine pathways. The contrasting effects of these drugs on GABA and glutamate uptake may be related to the hypnotic properties of pentobarbital not present in phenytoin.

Animals↗

Downbeat nystagmus as a sign of brainstem involvement in acute meningoencephalitis.

Two cases of acute meningoencephalitis, presumably viral in origin, with brainstem involvement are reported. Common to both patients during the course of their illness was coma, downbeat nystagmus, and ataxia. Although both reached what appeared to be a terminal state, recovery began following treatment with corticosteroids. The significance of the neurologic signs, particularly the unusual occurrence of downbeat nystagmus, is discussed, as is the appropriate management of the disorder.

Acute Disease↗