Biomedical subjects
M D Silver
Publications and source records attributed to M D Silver.
Varicella pneumonitis.
Four adults had varicella pneumonitis. All developed respiratory symptoms within a week of the exanthem. Cough and/or dyspnea, cyanosis and chest pain were common. Radiological signs of disease were more marked than physical signs. A slight polymorphonuclear leukocytosis and normal sputum culture were usual. One man with mild symptoms recovered. Two women, one pregnant, had severe symptoms and died. A second man succumbed to secondary bacterial pneumonia. The lungs in fatal cases showed interstitial pneumonitis with mononuclear cell infiltrate, focal areas of necrosis, and acidophilic inclusion bodies in two cases. Patients received oxygen, antibiotics and, in one instance, corticosteroid therapy. The value of antibiotics and corticosteroid treatment is questionable. Use of gamma globulin in preventing varicella pneumonitis is mentioned and residual pulmonary changes are discussed.
Morphology of microtubules in rabbit platelets.
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Microtubules in the cytoplasm of mammalian platelets.
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Arterial lesions induced by methyl cellulose.
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Cytoplasmic microtubules in rabbit platelets.
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Unusual development of basement membrane about small blood vessels.
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The behaviour of platelets in vivo.
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Symptomatic interarticular migration of glenoid suture anchors.
SUMMARY: There have been numerous modifications of Bankart's initial description of glenoid labral repair to help simplify and facilitate this procedure. One of the more common devices used for this purpose has been the suture anchor. The authors report a case of interarticular migration of the suture anchor used for anterior capsular stabilization in the shoulder. Surgeons need to be aware of this potential complication, especially in patients who have had suture anchors placed and develop mechanical symptoms postoperatively.
Acute myocardial and plasma catecholamine changes in experimental stroke.
Focal cerebral ischemia in humans increases the incidence of cardiac arrhythmias, and serum cardiac enzyme and plasma norepinephrine levels. In addition, systemic administration of catecholamines causes myocardial damage. This suggests that cerebral ischemia may cause myocardial damage as a consequence of elevated plasma norepinephrine levels. Therefore, experiments were done in 23 chloralosed, paralyzed and artificially ventilated cats to investigate the effects of occluding (n = 17) or sham-occluding (n = 6) the left middle cerebral artery on the myocardium and on circulating levels of plasma catecholamines. After occlusion of the middle cerebral artery for 12-22 hr, 41% (7/17) of the hearts had either acute myocardial necrosis (3/7), focal hemorrhage (3/7), or both (1/7). In animals with acute myocardial damage the levels of plasma norepinephrine and epinephrine were significantly increased compared to pre- middle cerebral artery occlusion values (+46 +/- 18% and +142 +/- 45%, respectively). As well, in cats with acute myocardial damage, changes from initial levels of plasma norepinephrine and epinephrine were significantly increased over those of experimental cats without acute myocardial damage. In animals which did not have acute myocardial damage (10/17) the circulating plasma levels of catecholamines were not significantly different from pre-occlusion values. Similarly, sham occlusion did not alter plasma catecholamine levels. These data demonstrate that a percentage of animals subjected to middle cerebral artery occlusion have myocardial damage and an increase in plasma concentration of norepinephrine and epinephrine. This suggests that a rise in plasma catecholamine levels, due to increased sympathetic activity after middle cerebral artery occlusion, may cause myocardial damage.
Use of ergogenic aids by athletes.
"Ergogenic aid" is defined as any means of enhancing energy utilization, including energy production, control, and efficiency. Athletes frequently use ergogenic aids to improve their performance and increase their chances of winning in competition. It is estimated that between 1 and 3 million male and female athletes in the United States alone have used anabolic steroids. In response to the problem of drug use, many athletic organizations have established policies prohibiting the use of certain pharmacologic, physiologic, and nutritional aids by athletes and have implemented drug testing programs to monitor compliance. Therefore, it is important for physicians to be knowledgeable about the available ergogenic aids so they can appropriately treat and counsel the athletic patient.
Detailed examination of complete bioprosthetic heart valves.
Six (3 control and 3 explanted) bioprostheses were examined histologically after embedding the complete valve in "plastic" and sectioning across the valve at 90 degree to the horizontal plane, and then horizontally across a stent post, with a low speed saw. The prostheses, porcine or pericardial, had been in place 52 to 121 months. In addition to cusp changes of degeneration and calcification that have been previously reported, the authors found extensive pannus deposition on the cloth covering the inflow surface of the prostheses, with some extension onto the biologic components; evidence of insudation of tissue fluid and ingrowth of fibroblasts; deposition of collagen; and infiltration of mononuclear cells in the interstices and interfaces. Non-biologic components showed changes which may have affected prosthesis function. The synthetic material covering the metal/plastic frame showed interstitial mononuclear cells. Two of the three explanted valves showed changes in the polymeric plastic, and one in the metal components, including accentuated notching along the surfaces when compared to unimplanted prostheses. A larger number of prostheses must be examined before definite conclusions can be drawn.
Morpho-functional anatomy of the human coronary arteries with reference to myocardial ischemia.
The vascular beds of 42 human hearts were examined to determine the underlying morpho-functional arrangement of the coronary arteries. The hearts were obtained at autopsy from cases where the immediate cause of death was not related to cardiovascular disease. It was found that while the course and size of individual vessels vary considerably from heart to heart, there is an underlying pattern in the functional arrangement of the vessels. On the basis of this pattern, a new functional classification of coronary arteries is proposed, together with a related concept of intrinsic "zones" of the myocardium. It is concluded that a deficiency in coronary blood supply in ischemic heart disease would be more accurately described in terms of the affected zones of the myocardium rather than the affected vessels. It is the effect of stenosis, not the stenosis per se, which must be assessed and documented ultimately. A chart is proposed to facilitate that documentation.
Vasa vasorum in autogenous dog vein by-pass grafts.
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The side effects of cyclosporin A: clinical and histologic findings following 31 canine heterotopic cardiac allotransplants.
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Coexistence of Fabry's disease and systemic lupus erythematosus.
This report describes a case of a female with systemic lupus erythematosus, who was subsequently diagnosed with Fabry's disease. Due to similarities in the organs involved by these two multisystem disorders, difficulties were encountered in establishing a prompt diagnosis of Fabry's disease. That and subsequent management of this patient are discussed. A literature review of the coexistence of the two disorders along with the potential pathogenic mechanisms explaining this association are explored.