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Biomedical subjects

M Jellinek

Publications and source records attributed to M Jellinek.

At least 55 records · Page 3Linked to original sources
PubMed1979

Relations between academic departments of psychiatry and pharmaceutical companies.

The financial pressures placed on academic departments of psychiatry make the offers of assistance from pharmaceutical companies very attractive. The authors provide a sequential three-step decision-making approach to help the academic physician and the psychiatry department address the ethical issues involved in any given interaction with a pharmaceutical company. They also provide examples of the application of these guidelines.

Drug Industry↗
PubMed1979

Cold-blood potassium cardioplegia: evaluation of glutathione and postischemic cardioplegia.

Potassium (34 mEq/L) cardioplegia was induced with cold blood (CBK) in three groups of six dogs undergoing 60 minutes of myocardial ischemia at a systemic temperature of 27 degrees +/- 2 degrees and a myocardial temperature of 7 degrees +/- 2 degrees C (crushed ice). Group 1 (CBK) animals were reperfused initially with 400 ml cold blood over 8 to 10 minutes at increasing pressures of up to 75 mm Hg. Group II (CBK-K) dogs were reperfused in the same manner as Group I with the addition of potassium chloride, 30 mEq/L. In Group III (CBKG-KG) glutathione, 30 mg/100 ml, was added to both the pre- and postischemic perfusions with CBK. After 30 minutes of reperfusion control studies were repeated. Heart rate, peak systolic pressure, rate of rise of left ventricular pressure, maximum velocity of contractile element, pressure-volume curves, coronary flow distribution, muscle stiffness, and heart water were not significantly different from control values. Total coronary flow and myocardial uptake of oxygen, lactate, and pyruvate did not serve to separate the three groups; the same was true for right ventricular creatine phosphate, adenosine triphosphate, and adenosine diphosphate during ischemia and recovery. Ultrastructural myofibrillar lesions were noted in all groups. thus, postischemic cardioplegia and use of a physiological reducing agent do not enhance CBK cardioplegia with topical and systemic hypothermia.

Adenosine Diphosphate↗
PubMed1978

Topical cardiac hypothermia: the effect of methylprednisolone sodium succinate.

We evaluated the effects of methylprednisolone sodium succinate (MPSS) on 60 minutes of myocardial ischemia during profound (5 degrees C) topical cardiac hypothermia (ice chips) in a canine right heart bypass preparation. The ventricular function curve shifted to the right and downward, but not significantly, after ischemia, and stroke work declined significantly for both control and treated dogs. Contractility (rate of rise of left ventricular pressure and maximum velocity of the contractile element) declined for both groups but not significantly. Total coronary flow, oxygen consumption, and metabolism of lactate and pyruvate were not different for control and treated dogs. Ultrastructure of the outer and inner myocardium did not demonstrate benefit from MPSS. Intracellular and extracellular edema of moderate severity was slightly worse in the subendocardium, and reversible mitochondrial injury of a mild to moderate degreee was symmetrically present. Ice-related injury was not noted. We were unable to deomonstrate that pretreatment with MPSS favorably alters cardiodynamics or ultrastructure after 60 minutes of profound topical cardiac hypothermia.

Animals↗
PubMed1978

Referrals from a psychiatric emergency room: relationship of compliance to demographic and interview variables.

In a sample of 89 patients referred from a psychiatric service emergency room, the author investigated variables related to completion and noncompletion of the physician's recommendation. The completers (58%) tended to be older and more educated, to be diagnosed as depressed, and to demonstrate congruence in terms of their request and their perception of the physician's goal. Implications for referral include ensuring that the interview with the patient includes a communication, empathy, and mutual influence. Using the negotiated approach and criteria derived during the clinical interview, certain patients can be identified as being "at risk" for noncompletion and as requiring special efforts.

Adult↗
PubMed1978

Myocardial protection by intermittent perfusion with cardioplegic solution versus intermittent coronary perfusion with cold blood.

The myocardial protection provided by cardioplegic solution using buffered, isosmotic potassium (30 mEq. per liter) was compared with intermittent cold coronary perfusion for 2 hours of aortic cross-clamping in dogs. The cardioplegic solution (Group CS) or cold blood (Group CB) was infused every 15 minutes through a cooling coil to reduce the perfusate temperature to 5 degrees C. Myocardial function after 30 minutes of reperfusion and rewarming was reduced in Group CB with a significant reduction in peak systolic pressure at a left ventricular (LV) balloon volume of 20 ml. and a significant reduction of dp/dt. In contrast, in Group CS, LV function was unchanged from the base-line period. LV compliance also was significantly reduced in Group CB while being unchanged in Group CS. Myocardial extravascular water content, obtained by dessication, was significantly higher in Group CB than in Group CS, which may explain the reduction in compliance. Electron microscopy showed normal ultrastructure in Group CS but extracellular edema in Group CB. Total coronary blood flow showed a sustained increase during reperfusion in both groups. Oxygen consumption rose with rewarming to base-line levels in both groups, whereas lactate and pyruvate consumption was reduced in both groups, particularly Group CB. Cardioplegic solution thus appears to be superior to the intermittent perfusion of cold blood for myocardial protection. The addition of potassium arrest, by markedly reducing myocardial metabolism, improves the protection afforded by cold blood perfusion alone.

Animals↗
PubMed1977

Effects of progesterone on some enzymes of fat and carbohydrate metabolism in rat liver.

The known effect of progesterone on carbohydrate metabolism prompted a study of some of the hepatic "lipogenic" and "gluconeogenic" enzymes in rats treated with progesterone. Several enzymes providing lipid precursors (phosphofructokinase, malic enzyme, glucose-6-phosphate dehydrogenase, and citrate cleavage enzyme) showed increased specific activity. These changes may represent insulin effects. Specific activity of phosphoenolpyruvate carboxykinase, usually associated with control of gluconeogenesis, was also increased. The latter is compatible with increased capability for glycogenesis, which is recognized as a progesterone effect.

ATP Citrate (pro-S)-Lyase↗
PubMed1977

Evidence for additional mediator in prostaglandin-induced choleresis.

PGA1 and PGF2alpha were administered to isolated perfused porcine and canine livers to determine whether these hormones could induce hepatic choleresis. PGA1 (25 microgram/kg/10 min) decreased portal venous resistance, but had no effect on bile flow, oxygen, pyruvate, or lactate consumption in canine livers. PGF2alpha increased portal venous resistance and weight gain while decreasing bile flow and oxygen consumption in canine livers. At high doses (50 microgram/kg/10 min) these effects resulted in irreversible outflow block. At low doses (5 microgram/kg/10 min) these trends were reversible. Porcine livers did not exhibit the outflow block syndrome after PGF2alpha administration (100 microgram/kg/10 min); however, choleresis was not observed. Thus, the in-vivo choleretic effects of prostaglandins previously reported are probably mediated partially or wholly by extrahepatic release of other hormones, neurological stimulation or alterations in mesenteric blood flow.

Animals↗
PubMed1977

Coronary venous arterialization: acute hemodynamic, metabolic, and chronic anatomical observations.

Nine dogs that had anastomosis of the internal mammary artery (IMA) to the left anterior descending coronary vein (LADV) were studied acutely on right-heart bypass. Occlusion of the left anterior descending coronary artery (LADA) and LADV without venous arterialization resulted in a significant decline in stroke work, total coronary flow, and myocardial oxygen uptake; with reactive hyperemia an increase in lactate and pyruvate consumption resulted. Occlusion of the LADA and LADV with VA did not change these variables greatly, except for a marked increase in total coronary flow with reactive hyperemia. Chronic venous arterialization in 14 dogs was associated with a 14% mortality, while 10 controls had a 40% mortality. Dogs were killed at six weeks, and prior angiography in 9 showed patency of the IMA to the heart without filling of cardiac veins. All dogs had infarcts in the distribution of the LADA; these infarcts were smaller in dogs with venous arterialization. The anastomoses were obliterated by mature or maturing fibrous tissue, with alteration of the vein so that it was frequently not discernible, while the IMA was well preserved. Distal veins had foci of intimal proliferation, subintimal fibrosis, and medial hypertrophy. Although venous arterialzaiton provides protection for the acutely ischemic myocardium, this effect does not persist, perhaps because of anastomotic occlusion due to fibrous proliferation.

Animals↗
PubMed1977

Structure-function relationships of peptide fragments of gastrin and cholecystokinin.

This study evaluates the structure-function relationships of the C-terminal peptide fragments of gastrin and cholecystokinin (CCK) in the biliary system and the stomach. Dogs with chronic biliary and gastric fistulas were used. Administration of the common fragments of CCK and gastrin with four and five amino acids and the active fragments of CCK with six through eight amino acids without sulfation of tyrosine in position 7 failed to alter hepatic bile flow from control values while significantly stimulating gastric hydrogen ion output. Administration of the seven and eight amino acid peptide fragments of CCK with sulfation of tyrosine in position 7 significantly increased hepatic bile flow. Administration of the sulfated octapeptide with 4 microgram/kg per h of nonsulfated octapeptide did not result in the inhibition of the choleresis produced by the sulfated peptide. The gastric hydrogen ion response produced by the administration of the nonsulfated and sulfated peptide was equal to that of the nonsulfated peptide alone. These results suggest that in the biliary system the receptor is highly specific as sulfation of the peptide fragment of CCK is essential for combining with the receptor, whereas in the stomach the receptor has little specificity and combines with all of the peptide fragments evaluated.

Animals↗
PubMed1977

The effects of cardiopulmonary bypass with crystalloid and colloid hemodilution on myocardial extravascular water.

The effect of cardiopulmonary bypass (CPB) on myocardial extravascular water (MEW) was evaluated with crystalloid and colloid hemodilution. Heart water was measured gravimetrically and by the double-indicator and thermal methods. CPB without hemodilution resulted in a 5.7 per cent increase in the wet : dry weight ratio of the left ventricle obtained by desiccation to stable weight. CPB with colloid hemodilution to a hematocrit of 10.7 +/- 0.4 per cent resulted in a 5.4 per cent increase in the wet:dry weight ratio. Crystalloid hemodilution to a hematocrit of 9.5 +/- 0.8 per cent resulted in a marked increase in myocardial water with a wet:dry weight ratio 30.3 per cent greater than the controls. Hypothermic (22 degrees C.) crystalloid hemodilution resulted in a 37.4 per cent increase in the wet:dry weight ratio. MEW was also measured by the double-indicator method with Evans blue dye and tritiated water. This method measured 85 per cent of the gravimetrically measured water. Although it indicated the increase in heart water in the crystalloid group, it proved less reliable in the measurement of MEW in this dynamic situation. The thermal heart water was also measured with an impedance and thermistor-bearing catheter similar to that used to measure thermal lung water. This proved ineffective in measuring heart water. Colloid hemodilution was thus found to prevent the development of myocardial edema which occurred with crystalloid hemodilution (p less than 0.01) with and without hypothermia. These findings support the addition of colloid to the hemodilution prime used for cardiopulmonary bypass.

Animals↗