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Biomedical subjects

R Zimlichman

Publications and source records attributed to R Zimlichman.

At least 19 recordsLinked to original sources
PubMed1995

[Psoas abscess mimicking septic arthritis of the hip].

Primary psoas abscess is a relatively rare and imposes diagnostic and therapeutic challenges. We describe a 16-year-old boy who presented with fever, limp and the clinical picture of septic arthritis of the hip joint. He did not respond to conventional medical treatment. When the diagnosis of psoas abscess was made and the abscess was drained, he gradually recovered. The diagnosis of psoas abscess is frequently missed. Correct diagnosis is very important because usually, cure only follows surgical drainage.

Adolescent↗
PubMed1995

Acute hemodynamic effects of nisoldipine in young hypertensive patients.

The hemodynamic effects of oral nisoldiopine in 12 hypertensive patients aged 35-55 years were determined using the impedance cardiography method. Hemodynamic measurements were performed at hourly intervals before and following ingestion of the medication. Nisoldipine significantly decreased systolic and diastolic blood pressure, with a slight increase in heart rate. Stroke volume did not change significantly following the medication. Total peripheral resistance decreased gradually reaching its lowest values 2 h after ingestion of nisoldipine. We conclude that nisoldipine is a potent oral antihypertensive agent that induces peripheral vasodilatation without decrease in cardiac output.

Adult↗
PubMed1992

Analysis of the diminished skin perfusion in elderly people by laser Doppler flowmetry.

Clinical observations suggest an age-associated decline in skin perfusion but there are few quantitative in vivo data on skin perfusion at various ages. We studied skin perfusion of the dorsum of the foot by determining the capillary blood flow velocity (CBFV) expressed in millivolts (mV), using laser Doppler flowmetry, in ten young and 12 elderly men. Our data revealed that, at 32 degrees C skin temperature, the CBFV oscillations (vasomotions) are of higher median amplitude in young people than in elderly subjects: 9.4 mV (95% CI, 8.8-10.0 mV) and 4.6 mV (95% CI, 4.1-7.4 mV), respectively (p less than 0.05). The vasomotion frequency was similar in both age groups. At 44 degrees C skin temperature, the median CBFV peak in the young was 163 mV (95% CI, 128-192 mV), as opposed to 102 mV (95% CI, 92-124 mV) in the aged subjects (p less than 0.0005). The median increment in CBFV, driven by every heart beat, was also higher in the young age group: 86 mV (95% CI, 76.4-96.0 mV) compared with the elderly group: 63 mV (95% CI, 50-72 mV, p less than 0.005). Considering the fact that the magnitude but not the pattern of skin perfusion varied between the two groups, we conclude that ageing is associated with loss of capillary plexus functional units, and therefore the skin perfusion is lower in aged people.

Adult↗
PubMed1992

Murine typhus endocarditis.

We have described a 28-year-old male sheepfarmer who had fever, headache, chills, malaise, and aortic insufficiency. Echocardiography revealed a tricuspid aortic valve with a large vegetation on the right cusp, an enlarged left ventricle, and diastolic flutter of the mitral valve. Repeated blood cultures were negative. Seroconversion of IgG and IgM to Rickettsia typhi was found on the 13th day of hospitalization. The patient was treated with tetracycline for 1 year and remained afebrile and free of symptoms for 9 months, when he was lost to follow-up. IgM and IgG fluorescent antibodies to R typhi remained positive during 8 months of the follow-up period. We believe this to be the second reported case of endocarditis due to R typhi and the first not treated surgically.

Adult↗
PubMed1992

Carotid body tumor: diagnostic and therapeutic approach.

Carotid body tumor may be clinically suspected when the only clues are physiologic manifestations of carotid body dysfunction or when a palpable cervical mass is evident upon presentation. In the latter case, the physiologic signs of carotid body dysfunction are usually recognizable. We have presented the case of a patient who was completely disabled by a slowly enlarging carotid body tumor. An attempt at surgical excision of the tumor was unsuccessful because of its proximity and adhesion to vital neck structures. An endocardial pacemaker inserted to ameliorate the episodes of bradycardia and hypotension accompanied by transient complete atrioventricular block resulted in only partial and temporary relief. Finally, irradiation of the tumor induced fast shrinkage and rapid regression of symptoms.

Carotid Body Tumor↗
PubMed1991

Expression of a gene coding for breast tumor-associated antigen in thyroid papillary carcinoma.

The expression of the H23 gene, previously shown to be overexpressed in breast cancer tissue, was examined in various thyroid pathologies. Thyroid papillary carcinomas demonstrate significant H23 mRNA levels, whereas benign thyroid pathologies have very low levels of expression. H23 gene expression in thyroid cancer inversely correlated with that of thyroperoxidase and thyroglobulin genes. Immunoblot assays of thyroid cancer tissues revealed overexpression of H23 gene at the protein level as well The data presented indicate that dedifferentiation of thyroid tissue to the malignant state is associated with increased H23 gene expression and suppression of some thyroidal differentiation marker genes.

Antigens, Neoplasm↗
PubMed1991

The effect of cilazapril, a new angiotensin converting enzyme inhibitor, on peak and trough blood pressure measurements in hypertensive patients.

Cilazapril (CLZ) is a new, long-acting nonsulfhydril converting enzyme inhibitor (ACE-I). Its effect on peak and trough sitting diastolic blood pressure (SDBP) was studied in a total of 85 patients with uncomplicated, essential hypertension at three centers. After 4 weeks of a single-blind placebo (PLA) run-in period, patients whose SDBP was between 100 and 115 mm Hg, were randomized into active treatment with either PLA (n = 27), CLZ 2.5 mg (n = 29), or CLZ 5 mg (n = 29) once daily in a double-blind fashion for another 8 weeks. At the end of the PLA run-in and after 4 and 8 weeks active therapy, an hourly blood pressure (BP) profile during 1-10 and 21-24 h postdose was performed. The drop in SDBP at the end of the active treatment period at peak and trough was statistically and clinically significant for both CLZ doses in comparison with the PLA group. The peak/trough ratio after subtraction of the PLA effect was 62% for CLZ 2.5 mg and 59% for CLZ 5 mg. These results indicate that the dose regimen of CLZ 2.5-5 mg once daily is adequate and effective for 24 h.

Adult↗
PubMed1991

Antihypertensive duration of action of cilazapril in patients with mild to moderate essential hypertension.

The efficacy of cilazapril monotherapy was evaluated in 2 multicentre double-blind dose-response trials. After 4 weeks of a single-blind placebo run-in period, patients with uncomplicated mild to moderate essential hypertension and a sitting diastolic blood pressure of 100 to 115 mm Hg, 24 hours after the last placebo dose (trough), were randomised to take either placebo or cilazapril 2.5 mg or 5 mg for 4 weeks (study 1, 86 patients) or 8 weeks (study 2, 78 patients). Sitting diastolic blood pressure was checked every 2 weeks at trough in both studies and at peak in study 2. The reductions in sitting diastolic blood pressure from baseline at trough, and the difference from placebo, were clinically and statistically significant for both cilazapril groups in the 2 studies. The reduction in blood pressure in both active treatment groups was similar, but the response rate with cilazapril 5 mg was greater than that with 2.5 mg. More than 50% of the peak effect was still present at trough for both cilazapril groups. It is concluded that both dosages of cilazapril are effective and reduce blood pressure compared with placebo over a 24-hour period.

Adult↗
PubMed1991

Hypocalciuria of preeclampsia is independent of parathyroid hormone level.

Hypocalciuria is a feature of preeclampsia. The roles of parathyroid hormone (PTH) and vitamin D 1,25(OH)2D3 (calcitriol) in its pathogenesis have not yet been determined. Fourteen preeclamptic women were compared with 12 women with chronic hypertension and 11 normotensives, all in the third trimester. Preeclamptics had the lowest urinary calcium excretion rate (62.1 +/- 32.8 mg/24 hours) compared with chronic hypertensive women (162.6 +/- 97.8 mg/24 hours) and normotensive controls (225.6 = 146.9 mg/24 hours) (P less than .05). Serum PTH was lowest in preeclamptics (9.8 +/- 5.5 pg/mL), in contrast to the chronic hypertensives (18.5 +/- 2.7 pg/mL) and normotensives (16.4 +/- 3.2 pg/mL) (P less than .005). Similarly, urinary cyclic adenosine monophosphate (cAMP) excretion was 2.9 +/- 1.4 mumol/24 hours in the preeclamptics, 5.1 +/- 1.7 mumol/24 hours in the chronic hypertensives, and 4.6 +/- 1.3 mumol/24 hours in the normotensive group (P less than .05). These data suggest that the mechanism of hypocalciuria in preeclampsia is independent of the PTH-calcitriol axis. Therefore, it is suggested that the hypocalciuria of preeclampsia is due to intrinsic renal tubular dysfunction.

Adult↗
PubMed1990

1,25-Dihydroxyvitamin D3 enhances cytosolic free calcium in HL-60 cells.

1,25-Dihydroxyvitamin D3 (1,25[OH]2D3) caused a rise in the concentration of intracellular free calcium ions ([Ca2+]i) in HL-60 cells. This effect of 1,25(OH)2D3 parallels its suppression of cell proliferation and its induction of cell differentiation into monocyte-like cells. The changes in [Ca2+]i are dose and time dependent. The concentration of 1,25(OH)2D3 (10(-7) M) that induced maximal differentiation also caused the maximal increase in intracellular Ca2+. The rise in cytoplasmic free Ca2+ concentration was not immediate and reached statistical significance only after 24 h. The [Ca2+]i reached its peak at 48 h (134 +/- 4 nM vs 101 +/- 3 nM in controls) and remained stable at this level. The increase in intracellular Ca2+ was found to be related to new protein synthesis, because it was inhibited in the presence of specific RNA and protein synthesis inhibitors. The rise in [Ca2+]i was not observed during incubation of HL-60 cells with 24,25-dihydroxyvitamin D3 (24,25[OH]2D3), a vitamin D metabolite that does not induce the differentiation of HL-60 cells. In contrast, 25-hydroxyvitamin D3 (25-OH-D3) and phorbol 12-myristate 13-acetate (TPA), both of which induce differentiation in this cell line, also increase [Ca2+]i. In conclusion, the present study emphasizes that a significant increase in intracellular free Ca2+ occurs in the effect of 1,25(OH)2D3 on HL-60 cells.

Calcitriol↗