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Biomedical subjects

M Cohen

Publications and source records attributed to M Cohen.

At least 775 records · Page 43Linked to original sources
PubMed1985

Ultrasonography in the diagnosis and follow-up of hepatic sinusoidal dilatation.

Hepatic sinusoidal dilatation is a rare complication of oral contraceptive use. A 29-year-old woman who had been taking oral contraceptive pills for eight years was found to have persistently elevated erythrocyte sedimentation rates and alkaline phosphatase levels, hepatomegaly, diffuse hepatic sinusoidal dilatation, and a large nonhomogeneous hyperechogenic lesion in the right hepatic lobe. The abdominal ultrasonogram, liver size, erythrocyte sedimentation rates, and alkaline phosphatase levels reverted to normal within 24 months after discontinuing oral contraceptives. This case should encourage the use of abdominal ultrasonography in detection and follow-up of hepatic sinusoidal dilatation.

Adult↗
PubMed1985

Mandibular reconstruction.

Although there is no general agreement, we think immediate reconstruction with free bone graft from the iliac crest or rib is the method of choice for a small mandibular body or arch defect without concomitant significant loss of soft tissue. Soft tissue reconstruction with well-vascularized tissue should always be performed when extensive loss of soft tissue occurs after hemimandibulectomy to avoid tension on the stump and mandibular drift. When postoperative radiation is not anticipated, immediate bone grafting is appropriate. A free bone covered by well-vascularized tissue or a composite graft is our primary choice, but alloplastic trays with cancellous bone can also be considered. If postoperative radiation is anticipated, only soft tissue repair should be performed and osseous reconstruction should be deferred until radiotherapy is completed. Defects of the arch require special attention because of the severe deviation of the mandibular stumps. Immediate reconstruction is recommended in uncomplicated cases, but secondary bone grafting will be needed when the patient is in poor condition, or postoperative radiation places the bone graft in jeopardy. In such cases, immediate stabilization of the bone segments by internal or external fixation is absolutely necessary. Finally, secondary reconstruction should be considered only if there is no evidence of residual tumor. The defect should be recreated, scarred or irradiated tissue resected, and immediate reconstruction obtained with well-vascularized pedicled or free flaps.

Bone Transplantation↗
PubMed1985

[Significance of precordial ST segment depressions in acute inferior infarct--correlation with coronary angiography and ventriculography findings in the acute infarct phase].

Thirty-two patients presenting with acute transmural inferior wall myocardial infarction underwent cardiac catheterization and angiography within 12 hours of onset of symptoms. Twelve lead electrocardiograms performed within 11/2 hours of catheterization revealed the following: Seventeen patients exhibited ST-segment depression in the anterior precordial leads in addition to inferior wall changes (group A). Fifteen patients did not manifest any ST-segment changes in the anterior precordial leads (group B). Clinical, arteriographic, and ventriculographic variables were compared between the two groups. No significant differences were observed with regard to age, sex, risk factors for coronary disease, duration of symptoms prior to angiography, Killip class, number of inferior leads with ST-segment elevation, or initial creatine kinase. The extent of coronary artery disease as well as the prevalence of severe disease in the left anterior descending artery were similar for both groups. Biplane left ventriculography revealed no significant differences between the two groups with regard to global or local left ventricular function.

Arrhythmias, Cardiac↗
PubMed1985

[Relation between electrocardiography and coronary angiography findings in the infarct stage].

One hundred and fifty-two patients underwent cardiac catheterization and coronary arteriography within 6.3 +/- 6.0 hours from onset of acute myocardial infarction. All had a standard 12-lead electrocardiogram recorded within 1.5 hours of cardiac catheterization. The electrocardiographic abnormalities present were correlated with the infarct related artery as determined by coronary arteriography. ST segment elevation was the most common finding in patients with the left anterior descending (LAD), or right coronary artery (RCA) as the infarct related artery. ST segment depression was the most common abnormality in patients with left circumflex artery (CX) as the infarct related artery. A typical pattern of anterior acute myocardial infarction was seen in 93% of all patients with the LAD as the infarct related artery. A typical pattern of acute inferior myocardial infarction was seen in 53% of all patients with RCA or CX narrowing taken as one group. The pattern of true posterior or posterolateral wall acute myocardial infarction in the absence of typical changes in the inferior leads was highly specific and predictive of CX narrowing. In contrast, the pattern of an inferior wall myocardial infarction, in the absence of true posterior or lateral wall changes, was highly specific and predictive of right coronary artery narrowing. Fifty-six percent of patients with CX artery as the infarct related artery presented with non-classical electrocardiographic abnormalities. The electrocardiographic pattern in patients with subtotal occlusions were similar to those of patients with total occlusions. Thus the electrocardiogram obtained in the first few hours of acute myocardial infarction is reliable in localizing the LAD as the infarct related artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1985

Respiratory morbidity benefit of awaiting onset of labor after elective cesarean section.

Respiratory morbidity in term neonates is an important complication of elective cesarean delivery. The effect of preceding labor on the incidence and severity of respiratory morbidity in two comparable groups of neonates, 107 with and 80 without labor and with no predisposing factors to respiratory morbidity, was evaluated. Transient tachypnea of the newborn accounted for the majority of cases in term neonates. Respiratory morbidity occurred less frequently in neonates delivered after the onset of labor compared with those delivered before labor (11.2 versus 30%, P less than .002). The risk of respiratory morbidity decreased 1.5 times for each week of advancing gestational age. The presence of labor significantly reduced the risk of respiratory morbidity, independently of gestational age (P less than .03), and disease was less severe in neonates born during labor. Awaiting the onset of labor appears to be beneficial in preventing respiratory morbidity in term neonates delivered by elective cesarean section.

Adult↗
PubMed1985

Rehabilitation outcome of combat head injuries: comparison of October 1973 War and Lebanon War, 1982.

A comparative study between two series of penetrating head injuries that occurred during the October 1973 (Yom Kippur) War and the Lebanon War, 1982, was conducted following the clinical impression that patients wounded in 1982 experienced shorter periods of unconsciousness. Patients in both series were of similar age and educational levels. Duration of coma was shorter, transfer to rehabilitation hospitals quicker and the overall hospital stay shorter, all significantly so, in the 1982 series. Other significant differences were the abundance of associated chest and abdominal injuries in the 1982 series and the fact that not a single patient underwent tracheostomy in the later series, in contrast to 64% of the 1973 patients. No differences were noted with regard to neurological sequelae, independence in activities of daily living, and high mental functions. Rehabilitation outcome, as evaluated by actual work placement, differed significantly in favor of the 1982 series. This was probably due to faster patient transfer to rear hospitals for definitive interventions, thus reducing secondary brain damage and resulting in shorter periods of unconsciousness.

Adolescent↗
PubMed1984

Thrombolytic therapy in acute myocardial infarction: review of clinical trials.

Intracoronary infusion of streptokinase is associated with recanalization rates of 60 to 90% immediately after the procedure. Mortality data in published trials are conflicting. In 125 registry patients who had paired contrast ventriculograms before streptokinase infusion and hospital discharge, improvement in ejection fraction correlated with incomplete coronary obstruction before angiography, the presence of collateral vessels to the infarct area and recanalization of complete obstruction. In assessing the risk/benefit ratio of intracoronary streptokinase infusion, the risks of angiography in the setting of acute myocardial infarction, reocclusion, bleeding and such secondary interventions as angioplasty or bypass surgery must be considered. Intravenous infusion of conventional doses of streptokinase was associated with improved survival in some trials in which therapy began within 12 hours after the onset of infarction. Immediate recanalization rates in patients who received large doses of intravenous streptokinase were lower than those associated with intracoronary streptokinase infusion. The risks and benefits of high-dose intravenous streptokinase administration must still be assessed.

Clinical Trials as Topic↗
PubMed1984

The long terminal repeat sequences of a novel human endogenous retrovirus.

The complete nucleotide sequence of both the 5' and 3' long terminal repeats (LTR's) has been determined for a human endogenous retroviral genome. These sequences are 593 and 590 nucleotides long and have diverged from one another by 8.8 percent. The LTR's resemble those of functional mammalian type C retroviruses in length and in the presence and location of eukaryotic promoter sequences. The 5' LTR is followed by a presumptive primer binding site unlike that of any known mammalian type C retrovirus, exhibiting 17 out of 18 nucleotides complementary to arginine transfer RNA rather than proline transfer RNA.

Base Sequence↗
PubMed1984

ERV3, a full-length human endogenous provirus: chromosomal localization and evolutionary relationships.

A full-length human endogenous provirus termed ERV3 was isolated from a human fetal recombinant DNA library by low stringency hybridization with two probes: baboon endogenous virus LTR; and a pol-env subclone from the endogenous chimpanzee provirus, CH2. DNA sequencing within the clone and comparisons with other retroviruses revealed that ERV3 contains gag and pol gene sequences that are significantly related to those of mammalian type C retroviruses and previously described human endogenous proviruses. The ERV3 genome was determined to reside at a single locus on human chromosome 7 using a panel of rodent X human somatic cell hybrids.

Amino Acid Sequence↗
PubMed1984

An immunoenzyme quantitative assay for the antiviral effect of interferons.

A technique is described for measurement of the antiviral activity of interferon by an immunoenzymatic assay for viral proteins. Cells treated by tested samples of interferon (IFN) are infected with vesicular stomatitis virus (VSV) and following the development of viral cytopathy are lysed by the addition of deoxycholate and then transferred into ELISA microplates. The viral proteins bind effectively to the microplates proportionally to their level in the culture and may be measured by incubating the plates sequentially with (1) rabbit antiserum against VSV, (2) a conjugate of alkaline phosphatase either to protein A or to an antibody against rabbit IgG and (3) p-nitrophenylphosphate. This procedure may be further simplified by using antibodies against VSV to which alkaline phosphatase has been directly conjugated. We found this immunoenzyme assay to be superior to the 'cytopathic effect inhibition' assay in precision and sensitivity and in being independent of the effectiveness of viral cytopathy.

Adsorption↗
PubMed1984

Electrocardiographic and coronary arteriographic correlations during acute myocardial infarction.

One hundred fifty-two patients underwent cardiac catheterization and coronary arteriography within 6.3 +/- 6.0 hours from the onset of acute myocardial infarction (AMI). All had standard 12-lead electrocardiograms recorded within 1 hour of cardiac catheterization. The electrocardiographic abnormalities present were correlated with the infarct-related artery as determined by coronary arteriography. ST-segment elevation was the most common finding in patients with the left anterior descending (LAD) or right coronary artery as the infarct-related artery. ST-segment depression was the most common abnormality in patients with the left circumflex (LC), artery as the infarct-related artery. A classic pattern of anteroseptal AMI was seen in 93% of all patients with the LAD as the infarct-related artery. A classic pattern of inferior AMI was seen in 53% of patients with right of LC narrowing taken as 1 group. The pattern of true posterior and isolated lateral wall AMI in the absence of classic changes in the inferior leads was highly specific and predictive of LC narrowing. In contrast, the pattern of an inferior wall AMI, in the absence of true posterior or lateral wall changes, was highly specific and predictive of right coronary artery narrowing. Fifty-six percent of patients with LC artery as the infarct-related artery presented with non-classic electrocardiographic abnormalities. The electrocardiographic patterns in patients with subtotal occlusions were similar to those of patients with total occlusions. Thus, the electrocardiogram obtained in the first few hours of AMI is reliable in localizing the LAD as the infarct-related artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Neurosurgical management of single brain metastasis.

A series of 74 consecutive cases undergoing craniotomy for single brain metastasis in the Beilinson Medical Center between October 1975 and October 1981 were reviewed. All patients underwent radiation therapy after craniotomy. The most common metastasis was that of unknown origin (35%), followed by lung (24%) and breast (16%). Overall median survival after craniotomy was 6.6 months. Overall 1- and 2-year survival rates were 30 and 15%, respectively. Operative mortality (30 days) was 15%. For the patients with metastases to the lung, median survival was 7.5 months and 1-year survival rate was 33%. It appears from this report that two dominant factors affect the prognosis of these patients. The first is the long latent interval (time between diagnosis of primary tumor and detection of metastasis). The second is the location of the metastasis; those with lesions in the cerebral hemispheres had a far better outcome than those with cerebellar lesions (p less than 0.0001).

Adult↗
PubMed1984

Update: varicocelectomy--a safe outpatient procedure.

One hundred ninety-two males with palpable varicoceles and subfertility who underwent varicocelectomy were studied. Fifty-five patients underwent inpatient varicocelectomy and 137 ambulatory varicocelectomy. We have shown that ambulatory varicocelectomy is safe and effective. Surgical success is not compromised. Most importantly, outpatient varicocelectomy is extremely cost-effective. The average cost of ambulatory varicocelectomy was less than 25 per cent that of an equivalent inpatient procedure, with a mean cost of $372 and $1,536 per person, respectively.

Adult↗