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Biomedical subjects

M Goldman

Publications and source records attributed to M Goldman.

At least 559 records · Page 31Linked to original sources

Saralasin acetate test in renal transplant hypertension. Report of 17 cases and a review of the literature.

The saralasin acetate test was performed in 17 hypertensive patients with renal transplants. These results were compared with 39 previously published reports of transplant patients who had been tested in the same manner. Eighty-two percent of our patients had a positive saralasin acetate test, suggesting renin-dependent hypertension. Baseline plasma renin activity (PRA) was significantly higher in patients with positive tests (6.96 +/- 1.75 v 2.88 +/- 0.53 ng/mL/hr). However, positive tests were obtained in several patients who had normoreninemia, and PRA levels did not correlate with the magnitude of vasodepressor BP response to saralasin. Transplant artery stenosis, acute rejection, and chronic rejection were the most common posttransplant complications associated with a positive test, but several patients had hypertension alone. While highly sensitive for renin-dependent hypertension posttransplantation, the test had poor specificity for identification of any one cause of posttransplant hypertension.

Blood Pressure↗

Effect of clonidine therapy on renal hemodynamics in renal transplant hypertension.

Antihypertensive medications have a variable effect on renal hemodynamics and may contribute to renal insufficiency in some patients. Since clonidine has actually been found to improve renal hemodynamics in patients with essential hypertension, we studied the effects of clonidine therapy in patients with renal transplant hypertension. Baseline measurements of BP and renal hemodynamics were made in six patients after two weeks of therapy with furosemide. Clonidine was then added and titrated until BP was controlled. Repeated measurements of renal hemodynamics were made four and 16 weeks after clonidine therapy was begun. Glomerular filtration and effective renal plasma flow as assessed by inulin and aminohippurate sodium clearances were preserved during prolonged clonidine therapy.

Adult↗

A double-blind study comparing sodium aurothiomalate and auranofin in patients with rheumatoid arthritis previously stabilized on sodium aurothiomalate.

Auranofin, an orally active gold preparation, was compared with sodium aurothiomalate in a double-blind trial in patients with rheumatoid arthritis fulfilling the ARA criteria, who had been stabilized on sodium aurothiomalate for at least six months. Twenty-four patients have so far been entered in the trial, of whom fourteen have been randomly allocated to receive auranofin and ten to receive sodium aurothiomalate. After initial stabilization, patients receive either auranofin 6 mg daily and placebo injection, or sodium aurothiomalate 50 mg monthly and placebo tablets. Five patients have completed one year on auranofin. The remaining nine patients were withdrawn because of loss of efficacy (two), side-effects, (five), loss of efficacy and side-effects (one) and default (one). Four patients have completed one year's treatment with sodium aurothiomalate. Of the remaining six patients, two were withdrawn because of side-effects, three because of poor disease control and one because of side-effects and poor disease control. Diarrhoea occurred in eight patients receiving auranofin. Rashes occurred in both groups but otherwise there were no serious side-effects. The efficacy of both drugs appeared similar, there being no significant differences in morning stiffness, fatiguability, visual analogue pain score, grip strength and articular index. There were also no significant differences in laboratory parameters of efficacy. Auranofin appears to control disease activity in rheumatoid arthritis but diarrhoea is a frequent side-effect.

Adolescent↗

[Comparative effects of oral water load of different mineral compositions on the excretion of ions and oxalic acid].

The effects on urinary excretion of a 1500 ml daily load of three drinking waters with different ionic contents were studied in six normal subjects. Diuresis was similarly increased by the three waters of an amount equal to the load. Urine output of urea, creatinin, uric acid, phosphate, potassium, magnesium was not significantly modified by the three waters as compared to a control period. Natriuresis was significantly increased following the intake of the water which contained sodium as well as calciuria with the water containing calcium. Urine output of oxalate was increased by the three waters in correlation with the free water content of the load. This effect is probably due to a reduction in passive tubular reabsorption of oxalate since a similar effect was observed with an equivalent water load given by intravenous route. Nevertheless, due to the dilution of urine, the index of urine saturation for calcium oxalate was diminished by the three waters.

Absorption↗

Does 111indium-platelet deposition predict patency in prosthetic arterial grafts?

The relationship between the rate of 111In-platelet deposition on vascular grafts and subsequent thrombosis has been examined in patients undergoing femoropopliteal by-pass. Sixty-seven patients undergoing femoropopliteal by-pass using vein, Dacron or PTFE were randomized to aspirin plus dipyridamole (ASA/DPM) or placebo. Autologous 111In-platelets were injected in the second postoperative week and Thrombogenicity Index (TI) calculated as the mean daily rise in the ratio of radioactivity graft/contralateral thigh. Graft patency was assessed to 1 year. Mean (+s.e.m.) TI at 1 week in 21 grafts that occluded within 12 months was 0.19 +/- 0.018 compared with 0.07 +/- 0.009 in the 38 that remained patient (P less than 0.001). Grafts with a TI less or greater than the median had a 90 per cent or 39 per cent cumulative 1-year patency, respectively (P less than 0.001). In the prosthetic grafts ASA/DPM reduced mean TI from 0.17 +/- 0.02 to 0.11 +/- 0.01 (P less than 0.02) and enhanced 1-year patency from 36 to 67 per cent (P less than 0.05). Following femoropopliteal by-pass TI related to subsequent graft patency. Radiolabelled platelet deposition therefore provides a guide as to how new materials or antithrombotic drugs may influence clinical graft thrombosis. Platelet inhibition reduced both graft thrombogenicity and subsequent occlusion.

Aspirin↗

Serological studies on bovine besnoitiosis in Israel.

Sera from 1,700 beef and dairy cattle in Israel were tested for besnoitiosis by indirect immunofluorescence. Over 90% of dairy animals were negative whereas about 50% of beef cattle were positive. Among beef bulls the percentage of positive reactors increased with age but in beef cows the pattern was less clear; 36% of young imported bulls negative upon arrival developed antibody titres after one season on the range. Cross-tests with Toxoplasma gondii antiserum and antigen indicated that the results of the survey for besnoitiosis were unlikely to have been influenced by Toxoplasma antibodies.

Animals↗

Long-term myocardial preservation: thromboxane production and coronary resistance.

In a series of 18 experiments on long-term myocardial preservation we evaluated whether vasoactive substances like thromboxane and prostacyclin are associated with the secondary increase in coronary resistance during preservation perfusion of the canine heart. In a control group (n = 12) and in a group treated with a specific thromboxane synthetase inhibitor (OKY 1581) coronary resistance was measured at 10 and 30 min, and at 1, 4, and 24 hr. At the same time intervals thromboxane A2 and prostacyclin (PGI2) production were determined as TXB2 and 6-keto PGF1 alpha, respectively. After OKY 1581 treatment no increase in TXB2 occurred and no secondary increase in coronary resistance was observed, while in the control group both TXB2 levels and resistance increased (P less than 0.01); 6-keto PGF1 alpha levels showed the same increase in control and in treated hearts. From this study it is concluded that during 24-hr myocardial preservation the characteristic secondary increase in coronary resistance is related to thromboxane production in the heart and is prevented by inhibition of thromboxane synthetase.

6-Ketoprostaglandin F1 alpha↗

Altered glomerular permeability in the early phase of immune complex nephritis.

We investigated the pathogenesis of increased glomerular permeability in Balb/c mice after 5 weeks of administration of a polyclonal B cell activator (bacterial lipopolysaccharide). The glomerular transfer of anionic ferritin across the capillary walls and the urinary excretion of serum albumin served as probes of glomerular permeability; anionic groups of the glomerular basement membrane were assessed by the binding of cationized ferritin, and glomeruli were studied by light, immunofluorescence, and electron microscopy. The mice developed circulating immune complexes, proteinuria, and a proliferative glomerulonephritis, with mesangial and capillary loop deposits of immunoreactants. Increased transfer of anionic ferritin molecules occurred across capillary walls with and without demonstrable electron-dense deposits; detachments of visceral epithelium were not seen, and epithelial transport of anionic ferritin was negligible. Loss of anionic groups was extensive in glomerular capillary loops with and without associated electron-dense deposits. The findings indicate that an increase in glomerular permeability may precede the deposition of immunoreactants in the capillary wall; that filtration of macromolecules can occur across capillary walls with or without demonstrable immune deposits; and that loss of anionic groups of the glomerular basement membrane and enhanced filtration of macromolecules can occur in the absence of focal detachments of the visceral epithelium.

Animals↗

Modification of glycogen synthase activity in isolated rat hepatocytes by tumor-promoting phorbol esters: evidence for differential regulation of glycogen synthase and phosphorylase.

Glycogen synthase (UDPglucose:glycogen 4-alpha-D-glucosyltransferase, EC 2.4.1.11), in isolated rat hepatocytes, has been identified as a novel intracellular target for tumor-promoting phorbol esters such as phorbol 12-tetradecanoate 13-acetate (TPA). Exposure of hepatocytes to TPA resulted in a 50% decrease in the activity ratio of glycogen synthase without/with glucose 6-phosphate. The inactivation was dose dependent and was half-maximal at a TPA concentration of approximately 16 nM (10 ng/ml). Phorbol and phorbol 13-monoacetate, ineffective tumor promoters, had little influence on glycogen synthase activity. Other biologically active diesters, phorbol 12,13-didecanoate, phorbol 12,13-dibutyrate, and phorbol 12,13-dibenzoate, caused significant inactivation of glycogen synthase. Glycogen phosphorylase (1,4-alpha-D-glucan:orthophosphate alpha-D-glucosyltransferase, EC 2.4.1.1) activity, however, was unaffected by TPA or any of the tumor-promoting phorbol esters mentioned above. It is concluded that phorbol diesters can interact in the regulatory pathway for glycogen synthase, but the lack of effect on phosphorylase argues that distinct mechanisms can operate for the control of glycogen synthase and phosphorylase.

Animals↗