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Biomedical subjects

T Rosenthal

Publications and source records attributed to T Rosenthal.

At least 127 records · Page 7Linked to original sources
PubMed1989

Short-term psychological outcome of anterior temporal lobectomy.

The purpose of this investigation was to determine the short-term behavioral and emotional effects of anterior temporal lobectomy (ATL). Forty-one patients who underwent ATL were administered a standardized measure of emotional adjustment (Mental Health Inventory) on four occasions: preoperatively, and 1, 3, and 6 months postoperatively. Patients who were rendered totally seizure-free by ATL showed significant improvements on multiple indices of psychological distress and psychological well-being, improvement that continued up to 3 months after surgery and remained constant at 6 months postoperatively. Patients who were significantly improved (greater than 75% reduction in seizure frequency) but continued to experience some seizure activity showed no significant improvements in behavioral or emotional adjustment. The clinical and theoretical significance of these findings is discussed, and it is suggested that functional outcome (for instance, mental health) following ATL may be best predicted by a binary seizure outcome classification (seizure-free or not seizure-free).

Epilepsy↗
PubMed1988

Nisoldipine: a replacement therapy for nifedipine in the treatment of severe hypertension.

The use of nisoldipine (10-20 mg b.i.d.) was evaluated as a replacement therapy for long-acting nifedipine (40-120 mg/day) in 21 patients with severe hypertension, who were resistant to or intolerant of nifedipine. Except for one patient with specific contraindications, all participants received an individually determined constant dose of beta blocker throughout the 8-month study. Results indicated a significant decrease in blood pressure after four weeks of treatment with nisoldipine (173 +/- 5/98 +/- 4 to 156 +/- 3/91 +/- 2 mmHg, p less than 0.05) without an associated change in pulse rate in 19 patients; only 5 of the 21 patients showed no further benefit from nisoldipine. No significant biochemical changes were noted in any of the patients during the study. In three patients, leg edema that had developed as a consequence of previous nifedipine therapy resolved completely following nisoldipine administration. Two patients withdrew from the study before term because of headaches and palpitations. An additional two patients suffered headaches, but tolerated the drug and continued the study. One patient suffered from polyuria. Nisoldipine appears to be an effective substitute treatment for nifedipine in severely hypertensive patients sensitive or resistant to nifedipine.

Adult↗
PubMed1988

The hypertensinogenic activity of 18-hydroxy-19-norcorticosterone in the adrenalectomized rat.

Hypertensinogenic properties of recently synthesized 18-OH-19-nor-B and the related 18-OH-B were examined in adrenalectomized, spontaneously hypertensive rats (SHR). Each steroid was given via Alzet miniosmotic pump (2002), with and without aldosterone. Neither 18-OH-19-nor-B (5 micrograms) nor 18-OH-B (5 micrograms) increased blood pressure in SHR when given alone, but when administered together with aldosterone (5 micrograms), which was ineffective by itself, resulted in a significant rise in blood pressure. There is a high probability that certain mineralocorticoids, which are inactive by themselves, are of importance in the etiology of hypertension under physiological conditions.

18-Hydroxycorticosterone↗
PubMed1988

The absence of long-term therapeutic effect of calcium channel blockade in the primary aldosteronism of adrenal adenomas.

The absence of long-term effect of calcium channel blockers in primary aldosteronism due to adrenal adenoma is described in two patients. Calcium entry channel blockers, which were claimed to be a new medical therapy for primary aldosteronism, neither prevented the increase of plasma aldosterone nor decreased potassium levels over time in these patients. The drugs did not even lower blood pressure in one patient. Whereas calcium channel blockers may be effective in adrenal hyperplasia, they are apparently not effective enough in the long term treatment of patients with primary aldosteronism due to adrenal adenoma.

Adenoma↗
PubMed1988

Calcium antagonists in the treatment of severe refractory hypertension.

Calcium antagonists such as nifedipine and verapamil, similarly to hydralazine (H) and minoxidil (M), act selectively on resistant arteriolar vessels; thus, they can be suitable for treating severe refractory hypertension. Nifedipine has been found safe and convenient even in elderly patients, both in emergency (sublingual capsules) and as long-term treatment. Unlike other vasodilators, it was easily tolerated, and was introduced as a replacement of H, M, and captopril (C) in combination therapy. Nitrendipine and felodipine have been found to be very effective on their own or in combination therapy, replacing H, M, C, and prazosin, whereas verapamil has been described by various authors as useful and rapidly effective when given intravenously to patients in hypertensive crises and in renovascular hypertension. The efficacy and relatively minor side effects of Ca antagonists would justify their inclusion in the treatment of severe hypertension.

Calcium Channel Blockers↗
PubMed1988

Perinatal development of angiotensin-converting enzyme in the rat's blood.

Angiotensin-I-converting enzyme (ACE) activity was measured by a fluorimetric technique in serum samples taken from rat fetuses and their mothers. The samples were collected from anesthetized rats on consecutive days from day 18 of gestation to day 22 (day of delivery) and one day after birth. Fetal ACE activities were significantly higher than the corresponding maternal values which remained nearly unchanged during pregnancy. No dramatic changes in serum ACE activity of the developing fetuses could be observed.

Animals↗
PubMed1988

Angiotensin converting enzyme in bleomycin-treated patients.

Angiotensin converting enzyme activity (ACE) was measured in two patient groups treated with a bleomycin combination. One group, with squamous cell carcinoma was treated according to the Price et al. [1975] protocol, with low doses of bleomycin. The second group, with testicular tumors, was treated according to the Einhorn and Donohue [1977] protocol, with high doses of bleomycin. No change in serum angiotensin converting enzyme activity was observed in the low dosage group. A late and prolonged elevation, not connected to the acute injection, was observed in the high dosage group. There is an indication that the monitoring of ACE may be helpful in establishing the prognosis of the treated patients.

Bleomycin↗
PubMed1988

Clinical features of sarcoidosis in elderly patients.

We reviewed 17 cases of biopsy-proven sarcoidosis occurring in patients who were 65 years of age or older at the time of diagnosis in order to determine the clinical features of sarcoidosis in this group of elderly patients. A female preponderance (76%) was noted, as well as significant respiratory and cutaneous symptoms. There were no characteristic diagnostic features of sarcoidosis in this group; therefore, we suggest that tissue biopsy is needed to exclude pulmonary diseases such as neoplasm or tuberculosis. Most elderly patients having sarcoidosis remained clinically stable during the period of follow-up and did not require therapy for sarcoidosis. We propose that sarcoidosis should be considered in the differential diagnosis of elderly patients presenting with pulmonary or multisystem disease.

Aged↗
PubMed1987

Aminopeptidase P activity in rat organs and human serum.

The substrate Lys(epsilon-Dnp)-Pro-Pro-NH-CH2-CH2-NH-ABz in which the fluorescent 2-aminobenzoyl (ABz) group (lambda ex = 320, lambda em = 410 nm) is intramolecularly quenched by the 2,4-dinitrophenyl (Dnp) chromophore was synthesized and used for the development of a sensitive assay for aminopeptidase P (EC 3.4.11.9). The emission of the intact compound was 160 times less than that of an equimolar concentration of Pro-Pro-NH-CH2-CH2-NH-ABz under the same conditions. The efficient resonance energy transfer permits an increased assay sensitivity as compared to the previously reported Phe(p-NO2)-Pro-Pro-NH-CH2-CH2-NH-ABz in which the p-nitrophenylalanyl [Phe(p-NO2)] residue caused only a 3.4-fold collisonal quenching. The kinetic constants Km were determined as 100 +/- 3.0 and 38 +/- 1.0 microM (mean of four experiments) for the human serum and the rat-lung enzymes, respectively. Both enzymes were inhibited by metal chelating agents and were not affected by 2.8 microM diisopropyl fluorophosphate. The mean activity in the sera of 53 healthy adults was 37.4 +/- 2.7 (standard error) with a standard deviation of 19.2 units/ml of serum. Only 10 microliters of serum was required for a reliable assay of the enzyme. The specific activity in rat-organ extracts was determined. High aminopeptidase P activity was observed in the testis, lung, kidney, and ovary and lower activity was observed in the serum.

Aminopeptidases↗
PubMed1987

Changes in plasma norepinephrine in normal labor following isometric contraction.

Changes in norepinephrine following a bimanual handgrip contraction test were used to evaluate the contribution of static physical effort exerted by the parturient on the rise in adrenergic stimulation observed during ongoing labor. Noradrenaline baseline values were 306.71 +/- (SE) 21.5 pg/ml); and after a maximal effort handgrip contraction test rose to 345.07 +/- 29.11 pg/ml (p = 0.11). This increase was less pronounced than found generally in nonpregnant subjects under similar test conditions and suggests a protection of the maternal organism from excessive adrenergic output during labor.

Female↗
PubMed1987

Nifedipine in the treatment of hypertension in systemic lupus erythematosus.

Treatment of hypertension in systemic lupus erythematosus (SLE) may be complicated by unwanted immunologic vascular and renal side effects of drugs. The safety of long-acting nifedipine tablets was studied in 8 SLE hypertensive subjects for six months. Nifedipine reduced blood pressure from a mean 151.9 +/- 10/103.7 +/- 8.6 mmHg to a mean of 130 +/- 14.1/87.5 +/- 5 mmHg. There was no deterioration of renal function or of hematologic or immunologic indices during that period. We believe nifedipine is a safe and effective hypotensive drug in SLE, either alone or combined with beta blockers and diuretics.

Antibodies↗
PubMed1987

Ketanserin versus nifedipine in the treatment of essential hypertension in patients over 50 years old: an international multicenter study.

The serotonergic antagonist ketanserin (K) was compared to nifedipine (N) in a five-center international study on hypertensive patients over the age of 50 years. After a 4-week placebo run-in period, patients were randomly assigned to receive for 3 months either ketanserin (40 mg b.i.d. after 2 weeks of 20 mg b.i.d.) or nifedipine (20 mg N retard b.i.d.). After 1 month, monotherapy patients whose blood pressure was not sufficiently reduced received a diuretic in combination therapy. At the end of the active treatment period, patients who had remained on monotherapy received placebo until hypertension returned or for a maximum of 2 months. One hundred and seventeen patients were entered in the study, 58 on K and 59 on N. More patients switched to combination with a diuretic in the K group (14 patients) than in the N group (6 patients). The overall reduction in blood pressure was similar for K and N. Total response rate was high (96%) for the two drugs. Blood pressure was reduced both at peak and trough drug levels. No orthostatic reactions were observed, and no rebound hypertension occurred at discontinuation of therapy. Ketanserin monotherapy slightly decreased heart rate (-1 beats/min). whereas N produced a significant increase (+6 beats/min). Body weight significantly increased with K (+1.1 kg) and was unchanged with N. More patients complained of adverse reactions during N monotherapy (47%) than during K monotherapy (34%). Flushing and leg edema were more frequent with N.

Blood Pressure↗
PubMed1987

Do beta-blockers alter lipids and what are the consequences?

The unpredictable effect of antihypertensive therapy on coronary risk resulting from changes in lipid levels is an increasingly recognized problem. Different drugs have been shown to exert varying effects on lipids. This problem is particularly evident in young hypertensive patients who may be candidates for lifelong therapy. The effects of chlorthalidone and metoprolol on fasting plasma lipids and lipoprotein levels were compared in two similar nonrandomized groups of patients with mild hypertension. Chlorthalidone therapy was associated with an increase in serum cholesterol of 8.1% (17 mg/dl), mainly reflecting an increase in low-density lipoprotein (LDL) cholesterol. Serum triglycerides increased by 16% (20 mg/dl) and high-density lipoprotein (HDL) cholesterol levels decreased by 10% (3 mg/dl, not significant). Metoprolol therapy induced no changes in total, low, very low, or high-density lipoprotein. Serum triglyceride concentration increased by 22% (28 mg/dl). Application of the Israel Ischemic Heart Disease Study data to these findings indicates a slight decrease at most in the 5-year estimated probability of myocardial infarction in the chlorthalidone-treated group, whereas a clearly favorable influence on the calculated risk of coronary heart disease was observed for those treated with metoprolol. These data suggest that the different forms of therapy for mild hypertension carry varying degrees of significance in terms of risk of coronary heart disease, which should be considered when choosing medication.

Adrenergic beta-Antagonists↗