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Biomedical subjects

B Krumholz

Publications and source records attributed to B Krumholz.

6 recordsLinked to original sources

Distribution of lidocaine and digoxin in heart tissues and aorta following intrapericardial administration.

The distribution of lidocaine and digoxin in myocardial and aorta tissues of open chest anesthetized dogs was studied, following the administration of 30 ml phosphate buffer solution of the drugs in the pericardial cavity where it was kept for increasing time intervals. Transfer of lidocaine (15 or 30 mg) from the solution to myocardium was almost complete within 60 min, while only 50% of digoxin (2 or 50 micrograms) was removed, and this occurred during the first 30 min. Accordingly, the absorption rate of lidocaine by heart tissues increased with time up to 60 min while that of digoxin decreased with time. Absorption of digoxin by the atria and absorption of both drugs by intrapericardial aorta were higher than that of other heart tissues, between 20 and 60 min. At 30 and 60 min, lidocaine was evenly distributed across the LV wall while digoxin 50 micrograms was mainly concentrated subepicardially. On the contrary, i.v. administration of digoxin resulted in even distribution in the LV wall without preferential concentration in the atria. The uptake of both drugs by aorta was several times lower compared to heart tissues after i.v. administration. Drug concentrations in LV wall almost at therapeutic level, were derived from solution of low concentration of the drug in the pericardial cavity. It is concluded that intrapericardial administration of the drugs may be used when increased concentration of them is desired in specific areas of the heart and the aorta.

Animals↗

Desquamative inflammatory vaginitis. A case report.

The differential diagnosis of noninfectious desquamative inflammatory vaginitis includes pemphigus vulgaris, erosive lichen planus and benign mucous membrane pemphigoid. A 32-year-old woman had persistent, noninfectious, erosive vaginitis and linear deposits of IgA in the vaginal epithelial basement membrane zone. The differential diagnosis should be expanded to include mucosal involvement by linear IgA disease, a cutaneous vesiculobullous disorder.

Adult↗

Diethylstilbestrol-related clear-cell adenocarcinoma in women with initial examinations demonstrating no malignant disease.

The DES Screening Center of Queens, Nassau, and Suffolk counties has screened approximately 2000 diethylstilbestrol (DES)-exposed women since its inception in 1979. Four women, who at their initial visit were noted to have only nonmalignant DES-related changes, subsequently developed clear-cell adenocarcinoma while under observation, between 18-81 months after their first colposcopy. The age at diagnosis ranged from 16-31. Three patients had been receiving close follow-up; one had not. These cases emphasize the need for frequent follow-up for these patients using careful inspection and palpation, vaginal and cervical cytology, colposcopy, and colposcopically directed biopsy of suspicious areas.

Adenocarcinoma↗

Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract.

Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.

Adult↗

Levels of human chorionic gonadotropin in unruptured and ruptured ectopic pregnancy.

Eighty-eight presenting with signs and symptoms that suggested ectopic pregnancy, all of whom had a positive radioreceptorassay (Biocept-G), were studied. Sixty-one patients (69%) were found to have intrauterine pregnancy. Twelve (14%) had unruptured tubal ectopic pregnancy with a mean (+/- SEM) human chorionic gonadotropin (hCG) level of 1190 +/- 320 mIU/ml, whereas 15 (17%) with ruptured ectopic pregnancies had a mean hCG level of 4160 +/- 400 mIU/ml. Among these 2 types of ectopic pregnancy, the mean hCG levels were statistically different (t = 5.0, P less than .001). Possible reasons for these differences are suggested, and the clinical implications of this finding are discussed.

Chorionic Gonadotropin↗

The utility and selection of laboratory tests in the diagnosis of the polycystic ovary syndrome.

Fourteen patients with clinically diagnosed and surgically documented polycystic ovarian (Stein-Leventhal) disease (PCOD) and 16 normal control women were studied to identify the laboratory test or tests that, from the clinician's point of view, are most likely to aid in the nonsurgical diagnosis of the disease. A single random morning blood specimen was assayed in all cases for testosterone, epitestosterone, androstenedione, FSH and LH. The mean testosterone level for the PCOD patients was significantly greater (p less than 0.001) than that for the controls, with 50% of the patients showing elevated levels. Androstenedione showed a similar pattern, but mean epitestosterone levels were not significantly different from controls. FSH was not significantly different, but LH levels were significantly higher than controls (p less than 0.005), with 10 of 13 (77%) demonstrating elevated levels. A strong positive correlation was also found between the degree of virilization and the levels of LH, testosterone and androstenedione. This study suggests that the most useful diagnostic laboratory assay from a single drawing of blood is the serum LH; the only other useful test is testosterone and/or androstenedione. These data do not support other reports of elevated levels of epitestosterone or decreased values of FSH in PCOD.

17-Ketosteroids↗