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Biomedical subjects

M Wolff

Publications and source records attributed to M Wolff.

At least 271 records · Page 15Linked to original sources
PubMed1988

Herpetic tracheobronchitis.

Nine adult patients from three community teaching hospitals had bronchospasm unresponsive to standard therapy. Bronchoscopic, cytologic, histopathologic, and virologic studies confirmed that necrotizing and exudative tracheobronchitis was due to herpes simplex virus. No patient had a history of previous chronic lung disease; most were not immunocompromised. Three patients never had intubation during hospitalization. All patients were successfully treated with intravenous acyclovir. Herpetic tracheobronchitis may be a commoner clinical syndrome than generally assumed. In an elderly patient with unresolving acute bronchospasm, herpesvirus infection of the lower respiratory tract should be considered in the differential diagnosis. In the immunocompetent host, antiviral therapy can successfully treat herpesvirus respiratory infection, with reversal of clinical, virologic, and pathologic findings. A prompt and accurate diagnosis is crucial.

Acyclovir↗
PubMed1988

Brain acetylcholinesterase after acute parathion poisoning: a comparative quantitative histochemical analysis post mortem.

The postmortem distribution of acetylcholinesterase (AChE) inhibition was studied in the brains of 2 victims of lethal parathion intoxication and 2 control brains matched for age and sex. AChE activity in discrete brain regions was studied by quantitative histochemistry of 40-micron-thick sagittal or coronal cryostat sections from the 4 brains. Inhibition of human brain AChE by parathion is regionally selective. The biggest decreases (60-85%) were observed in the cerebellum, some thalamic nuclei, and the cortex. Only a moderate decrease (10-30%) was observed in the substantia nigra and basal ganglia, and no effect was seen in white matter. Detailed knowledge of the brain regions affected by parathion poisoning may explain some of the clinical manifestations of organophosphate poisoning.

Acetylcholinesterase↗
PubMed1988

Brain acetylcholinesterase after parathion poisoning: a comparative quantitative histochemical analysis post-mortem.

The regional distribution of AChE inhibition by parathion in the human brain was examined in a comparative study of the brains of 2 victims of lethal parathion intoxication and 2 control brains matched for age and sex. AChE activity in discrete brain regions was studied by quantitative histochemistry of 40 microns-thick sagittal or coronal cryostat sections from the 4 brains. The inhibition of human brain AChE by parathion is regionally selective. The biggest decreases were observed in the cerebellum, some thalamic nuclei and cortex. Only a moderate decrease (10-30%) was observed in the substantia nigra and basal ganglia, while no effect at all was seen in white matter regions. Detailed knowledge of the brain regions affected by parathion poisoning may explain some of the clinical manifestations of organophosphate poisoning.

Acetylcholinesterase↗
PubMed1988

Comparative electrophysiologic evaluation of nerve grafts and autogenous vein grafts as nerve conduits: an experimental study.

This study was carried out to compare electrophysiologically the efficacy of autogenous vein grafts, with autogenous nerve grafts as conduits for nerve regeneration. A 0.75-cm segment of sciatic nerve was resected in two groups of Sprague-Dawley rats of equivalent maturity. The nerve gaps were bridged with an autogenous vein graft in the first group (31 rats), and an autogenous nerve graft in the second group (24 rats). Serial in vivo nerve conduction velocity studies and terminal in vitro nerve conduction velocity and nerve action potential measurements were performed. An additional group of 21 animals who had undergone no surgical procedures, were similarly studied to establish an age-adjusted baseline for comparison. Twelve animals in the first group, 14 in the second group, and 13 in the baseline group survived the full year of study. In vivo conduction velocities between the two experimental groups compared favorably. Nerve conduction velocity determined by in vitro technique confirmed this finding and measured similarly at about 78 percent of the baseline. Nerve action potential amplitude in the vein-grafted group was 12.0 percent of the baseline, while the nerve-grafted group was 23.9 percent of the baseline. This study demonstrated that the vein graft compares well with the nerve graft in nerve conduction velocity, but only one-half as well in nerve action potential.

Action Potentials↗
PubMed1988

"Maximal" thymectomy for myasthenia gravis. Surgical anatomy and operative technique.

Removal of all thymic tissue is the goal of surgical treatment of myasthenia gravis. In this report we describe an operation that predictably achieves that goal in most patients. The results of surgical-anatomic studies in 50 consecutive specimens obtained by this technique indicate that an en bloc transcervical-transsternal "maximal" thymectomy is required to ensure removal of all available thymus in all patients. This procedure is recommended for all patients undergoing thymectomy in the treatment of myasthenia gravis with or without thymoma and in the treatment of thymoma with or without myasthenia gravis.

Humans↗
PubMed1988

"Maximal" thymectomy for myasthenia gravis. Results.

Thymectomy has been shown to be effective in the treatment of myasthenia gravis. The logical goal of operation has been complete removal of the thymus, but there has been controversy about the surgical technique and its relation to results. Surgical-anatomic studies have shown gross and microscopic thymus widely distributed in the neck and mediastinum. We believe that an en bloc transcervical-transsternal "maximal" thymectomy is required to remove all thymic tissue predictably. Ninety-five patients with generalized myasthenia gravis underwent "maximal" thymectomy consecutively between 1977 and 1985 and were evaluated 6 months to 89 months after operation. In Group A (N = 72), myasthenia gravis without thymoma, the uncorrected data revealed that 96% (69) had benefited from operation: 79% (57) had no symptoms; 46% (33) were in remission; 33% (24) were symptom free when receiving minimal doses of pyridostigmine; and none were worse. Life table analysis yielded a remission rate of 81% at 89 months. In group B (N = 8), myasthenia gravis without thymoma for which patients underwent reexploration for incapacitating weakness after earlier transcervical or transsternal operations, residual thymus was found in all. One patient was in remission, two were symptom free when receiving medication, one was unchanged, and none were worse. In group C (N 15), myasthenia gravis and thymoma, two patients were in remission and nine were symptom free when receiving medication. Two patients in this group died 2 and 4 years postoperatively in crisis. Response to thymectomy in group A was greater in patients with mild myasthenia gravis and may have been better in patients who had symptoms for less than 60 months preoperatively, but the response did not depend on age, sex, presence or absence of thymic hyperplasia or involution, or titers of acetylcholine receptor antibodies. The response to thymectomy in group B was striking but slower than in group A, perhaps because symptoms were more severe and of longer duration. The response in group C was also less good than in group A and proportionately fewer benefited. These results support the recommendation for thymectomy in the treatment of patients with generalized myasthenia gravis and indicate the desirability of a maximal procedure. For persistent or recurrent severe symptoms after previous transcervical or submaximal transsternal resections, reoperation by this technique is also recommended.

Actuarial Analysis↗
PubMed1987

Serotonin 5-HT2 receptor binding on blood platelets--a peripheral marker for depression?

Several methods of platelet membrane preparation and binding conditions were screened in order to optimize the labeling of serotonergic 5-HT2 receptors on previously frozen human platelet membranes with tritiated ketanserin. Under optimal conditions, 5-HT2 receptors in normal subjects (5 males, 7 females, age range 21 to 71) have a Kd of 1.5 +/- 0.2 nM and a Bmax of 33.9 +/- 5.3 fmole/mg protein. In a group of patients with major depressive disorder exactly matched for age and sex with the normal control group, we find a significant increase in receptor density, to 66.8 +/- 11.4 fmole/mg, with no significant change in the affinity (2.3 +/- 0.5 nM). Four weeks of treatment with antidepressant drugs result in a significant decrease of Bmax, down to control levels (29.4 +/- 3.9). Thus, ketanserin can be used to monitor changes in platelet serotonin 5-HT2 receptors which may be a relevant marker for the state of depression.

Adult↗
PubMed1987

Bactericidal activity against Haemophilus influenzae of cerebrospinal fluid of patients given amoxicillin-clavulanic acid.

Patients with purulent meningitis received amoxicillin-clavulanic acid (200/20 mg/kg [body weight] per day). Clavulanic acid levels in cerebrospinal fluid were less than or equal to 0.05 micrograms/ml in 5 of 18 samples and ranged from 0.1 to 0.8 micrograms/ml in the others. Of 12 cerebrospinal fluid samples tested, 10 lacked bactericidal activity in vitro against a beta-lactamase-producing strain of Haemophilus influenzae.

Adolescent↗
PubMed1987

Penetration of ciprofloxacin into cerebrospinal fluid of patients with bacterial meningitis.

We evaluated the diffusion of ciprofloxacin into the cerebrospinal fluid (CSF) in 23 patients with bacterial meningitis or ventriculitis undergoing treatment with other antibiotics. Three successive ciprofloxacin doses of 200 mg were administered intravenously at 12-h intervals, first between days 2 and 4 and again between days 10 and 20 after the admission. Concentrations of ciprofloxacin in plasma and CSF obtained at 60, 120, 240, and 480 min after the third infusion were determined by high-performance liquid chromatography. In addition, serial samples were obtained from ventricular fluid in four patients. The concentrations of ciprofloxacin in CSF ranged from 0.35 to 0.56 micrograms/ml. These concentrations were equal to or higher than the MICs for most of the enterobacteria.

Adult↗
PubMed1987

[Staphylococcus aureus endocarditis].

Among 409 cases of bacterial endocarditis (BE) observed from 1972 to 1985, 142 were caused by Staphylococcus aureus. Of these 142 cases, 59 affected native valves of the left heart (left BE), 47 affected native valves of the right heart (right BE) (including 36 drug-addicts), and 36 involved prosthetic valves (BEP) and were associated with mediastinitis in 11 cases. Symptoms were acute in 122 cases and subacute in 2 cases. 91 of the BE on native valves were primary (86%). Cutaneous manifestations were present in 38 cases (27%). Of the 67 patients who died (47%), 28/59 had left BE (47%), 7/47 had right BE (15%) (including 2 drug addicts) and 32/36 had BEP (86%); all differences were statistically significant. Complications consisted of: heart failure in 78 cases (55%), including 40 cases of left BE, 8 cases of right BE and 30 cases of BEP; systemic peripheral embolism in 29 cases (left BE 17, BEP 12) and neurological accidents in 58 cases (left BE 34, right BE 24). Thirty of these accidents occurred before the 4th day (left BE 13, BEP 17). Documented neurological accidents included cerebral haemorrhage (13 cases), cerebral infarction (14 cases) and cerebral abscess (4 cases); 4 of the 12 patients who underwent arteriography were found to have one or several aneurysms. Thirty-nine of these 58 patients died, death being directly due to a neurological cause in 20 cases (left BE 10, right BE 10).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗