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Biomedical subjects

S Gottlieb

Publications and source records attributed to S Gottlieb.

At least 307 records · Page 17Linked to original sources

Zomepirac kinetics in healthy males.

Kinetics of zomepirac, an oral, nonnarcotic analgesic, were studied in healthy males in 3 clinical experiments. In study A, zomepirac 100 mg was taken as tablet, capsule, and solution. Bioavailability of zomepirac from the 3 dosage forms was much the same. Zomepirac absorption was rapid, peak plasma concentrations being reached within 1 to 1 hr. Plasma concentration profile could be described by the 2-compartmentoral absorption model with an absorption rate constant (Ka) of 7.66 hr-1 t 1/2 = 0.09 hr), a rapid disposition rate constant (alpha) of 0.75 hr-1 (t 1/2 = 0.94 hr), and a slow disposition rate constant (beta) of 0.16 hr-1 (t 1/2 = 4.3 hr). In study B, safety and acceptability were established with 100 mg 4 times a day for 14 days followed by 150 mg 4 times a day for 14 days. Zomepirac plasma levels indicated attainment of steady state within less than 3 days of treatment. There was little drug accumulation on the regimens studied. There was no change in plasma kinetics after 14 days on either regimen. In study C, dose/bioavailability response was followed at 50-, 100-, and 200-mg dose levels. There were linear correlations between dose and peak plasma concentration, area under the plasma concentration-time curve, and urinary excretion of intact and total (intact + glucuronide conjugate) zomepirac during the 12 hr following drug administration.

Adult↗

Effect of a physical conditioning program upon left ventricular ejection fractions determined serially by a noninvasive technique.

6 clinically normal subjects underwent a 3-month physical conditioning program with the ejection fractions determined before and after physical conditioning using a scintillation probe. All subjects achieved a conditioning effect as evidenced by increased treadmill test duration after conditioning (mean duration before conditioning: 658 vs. 715 sec after conditioning; p less than 0.02). All 6 subjects increased resting ejection fractions after conditioning (mean ejection fraction before conditioning: 54.5 +/- 5.4%; mean ejection fraction after conditioning: 67.0 +/- 9.0%; p less than 0.01). Thus, an aerobic physical conditioning program appears to increase resting ejection fractions in normal subjects.

Adult↗

Presymptomatic diagnosis of adult onset polycystic kidney disease by ultrasonography.

Results of an ongoing prospective study of progeny of patients with adult-onset polycystic kidney disease using grey-scale ultrasound and high-dose nephrotomography are reported. Six asymptomatic subjects out of 17 at risk for polycystic kidney disease were found by ultrasonography to have multiple renal cysts; this included two unrelated children aged 18 months and 6 y who had normal high-dose nephrotomography. We suggest that ultrasonography may be the method of choice for presymptomatic detection of polycystic kidney disease. Serial studies of at-risk individuals by sonography will be useful in determining the earliest age of detection, the latest age of ultrasonography presentation, and in following the natural history of polycystic kidney disease.

Adolescent↗

Computerized tomography, diagnostic ultrasound, and radionuclide scanning. Comparison of efficacy in diagnosis of pancreatic carcinoma.

Forty-six patients, including 33 with proved pancreatic carcinoma, were studied with computerized tomography (CT), ultrasound (US), and radionuclide (RN) scanning. The results of each scanning procedure were compared with the surgical and clinical findings. The detection rate was 82% for CT, and 92% with US. A mass is the most important finding in the diagnosis of pancreatic carcinoma. Measurements of the pancreas with CT and US were similar, with visualization of all parts of the pancreas routinely better with CT scans. Radionuclide scans were abnormal in 96% of the patients with pancreatic carcinoma as well as in 75% of patients without pancreatic disease. A rational approach to examination of a patient with suspected pancreatic carcinoma should begin with US scan with available, because the detection rate with this method is equal to that with CT and its cost per procedure and for equipment is substantially less.

Humans↗

Aortic aneurysm detected by 99mTc-pyrophosphate imaging: case report.

An example of aneurysmal concentration of 99mTc-pyrophosphate (Tc-PPi) is described. An abdominal aortic aneurysm was suspected when a rectilinear bone scan showed an abnormal paraspinal area of activity. The aneurysm was confirmed by ultrasonic examination. Conventional radiographic examination failed to reveal calcification within the aneurysm. Aneurysmal concentration of Tc-PPi should be considered in patients showing abnormal radioactivity in the region of vascular structures on radionuclide bone images.

Aged↗

Echocardiographic diagnosis of left atrial myxoma. Usefulness of suprasternal approach.

Three cases of left atrial myxoma were studied by echocardiography. In one case the atrial tumour was prolapsing through the mitral orifice into the left ventricular cavity; in the other two cases it was not. The angiocardiographic and operative findings correlated well with those from echocardiography. A systematic echocardiographic study is important; the suprasternal approach is useful in the echocardiographic exploration of the left atriu, especially for nonprolapsing tumours.

Adult↗

A new dual-probe system for the rapid bedside assessment of left ventricular function.

A mobile dual-probe system has been developed for the rapid bedside measurement of left ventricular ejection fraction (LVEF) from the beat-to-beat count rate variations that occur during the transit of a single radionuclide bolus through the left ventricle (LV). Cardiac output, pulmonary blood volume, and left ventricular end-diastolic volume can also be calculated. The dual-probe system incorporates a central collimated probe for monitoring activity in the LV surrounded by an annular detector collimated in such a manner as to provide simultaneous real-time monitoring of the LV background activity. The LVEFs obtained from this system correlated well with LVEFs derived from conventional single-plane contrast angiography (r=0.90) in a series of 33 patients with coronary artery disease. Positioning the dual probe over the midpoint of the LV is accomplished with standard M-mode ultrasound. Since the method is noninvasive and sensitive to volume changes in the LV, the dual probe is particularly useful for monitoring seriously ill patients as well as those with segmental wall-motion abnormalities.

Coronary Disease↗

Applications of diagnostic ultrasound and radionuclides to cardiovascular diagnosis. Part I. Acquired cardiovascular disease in the adult.

Noninvasive methods have become an important part of the diagnostic process for evaluation of cardiovascular anatomy and function in adults and in the young. Because there is a multiplicity of noninvasive methods presently available, in some cases with overlapping capabilities, there has been some confusion as to which constitutes the method of choice in a given clinical circumstance. The reviews that follow outline some of the practical strengths and limitations of two methods (echocardiography and radionuclide cardiography), hopefully thereby providing some rationale for choosing the more appropriate technique in the approach to specific clinical problems. We have found that the information available from radionuclide and from ultrasound studies frequently is complementary and that the most optimal diagnostic results often are obtained when they are combined. Since advances in technique and improvements in instrumentation are occurring continually in both of these areas, we have tried to provide only an overview. Further investigations and clinical experience will help to define the specificity, sensitivity, and capabilities of these methods in terms of present and future applications.

Aortic Valve Insufficiency↗

Applications of diagnostic ultrasound and radionuclides to cardiovascular diagnosis. Part II. Cardiovascular disease in the young.

Echocardiography (ECHO) and radionuclide cardiography have had a significant impact on pediatric cardiology because they have proved to be sensitive enough to permit early diagnosis of many forms of heart disease and in some cases to estimate its severity and to provide information concerning ventricular performance. An overview of the anatomic and functional information that can be obtained from these two methods will be presented first, followed by details concerning the indications for their use and their relative clinical value in various acquired and congenital heart diseases. We have stressed particularly those facets of pediatric cardiac disease that differ most from those in the adult.

Aortic Coarctation↗

Hemodynamic features of prolapsing and nonprolapsing left atrial myxoma.

In the course of the evaluation of five patients with left atrial myxoma, it was noted that the movement of the myxoma was related to specific changes in left atrial hemodynamics. Prolapsing tumors, Type I, move from the left ventricle to the left atrium in early systole and from the left atrium to the left ventricle in early diastole, thereby causing prominent c and v waves accompanied by a rapid y descent. Nonprolapsing tumors, Type II, remain in the left atrium during the entire cardiac cycle, impeding flow across the mitral valve. In these latter cases, the y descent is slow and indistinguishable from that caused by mitral valvular stenosis. The cineangiocardiograms and echocardiograms corroborate these two types of hemodynamic observations. The particular value of direct echocardiographic examination of the left atrium prior to cardiac catheterization was evident in two of the three patients with nonprolapsing tumors. Since the hemodynamic pattern of nonprolapsing left atrial myxoma resembles that of mitral valvular stenosis, it is stressed that echocardiography should have an important place in precatheterization assessment of patients with mitral valve disease. If left atrial myxoma is suspected clinically or on the basis of echocardiographic findings, regardless of the pressure curve contours, transseptal cardiac catheterization should be avoided and the left atrium visualized by pulmonary angiography levophase.

Adult↗

Rapidly progressive obstructive cardiomyopathy in infants with Noonan's syndrome. Report of two cases.

Two patients with hypertrophic obstructive cardiomyopathy and Noonan's syndrome are presented. Both patients were found at postmortem examination to have gross malformation of the mitral valve and obliteration of the left ventricle due to muscle hypertrophy. Each case demonstrated similar clinical, echocardiographic, and angiographic findings. The poor response to medical and surgical therapy are noted.

Cardiomegaly↗