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Biomedical subjects

D Edelman

Publications and source records attributed to D Edelman.

7 recordsLinked to original sources

Factors influencing mouse heart creatine kinase efflux and ultrastructure.

An isolated mouse heart model has been developed to study the extracellular factors which influence the loss of myocardial enzymes. When added to a tris-HCl buffer/salt mixture at 25 degrees C, glucose, phosphate ion, increased osmolarity, oxygen exclusion and calcium reduced enzyme leakage. Of these, calcium effects on enzyme leakage and ultrastructure were assessed in detail. Concentrations less than or equal to 10(-4) M had no significant effect on enzyme efflux over a 5 hour period. At higher concentrations (10(-3) and 10(-2) M Ca2+), creatine kinase (CK) efflux was significantly altered in a time dependent fashion. In the first hour, 10(-3) and 10(-2) M Ca2+ reduced CK leakage to 33% and 25% of the control values, respectively; and to about 50% of the control values in the second and third hours. This protective effect was lost between the third and fifth hours, when an enzyme efflux 80% greater than control was observed. These studies indicated that CK leakage from mouse heart can be retarded for up to 3 hours by appropriate Ca2+ concentrations. The initial ultrastructural change, in the absence of Ca2+, was a dilatation of the transverse tubules, which gradually enlarged by coalescence. This was followed by a gradual disintegration and ultimate condensation of the myofibrils leaving altered mitochondria floating freely in an apparently intact sarcolemmal bag. These changes appeared to be delayed by Ca2+ for 3 hours, after which no protective effect was evident. Thus, CK leakage is a measure of myocardial autolysis, and numerous simple measures can retard this autolysis for several hours. This raises the possibility of prolonging the preservation of the normal heart in vitro.

Animals

Central retinal artery occlusion after facial trauma.

A case of traumatic retrobulbar hemorrhage resulting in occlusion of the central retinal artery which was relieved by surgical drainage of the hematoma pocket is presented. Osmotic agents are of little value in such situations, and we suggest that, after trauma causing the clinical picture of a tense retrobulbar hemorrhage and central artery occlusion, the more vigorous approach to the patient is justified.

Aged

Monitoring care in abortion clinics.

Medical directors of clinics must monitor three aspects of service to ensure high-quality care in abortion clinics: (1) physician training and selection, (2) patient selection, and (3) abortion outcome monitoring as a means of providing an ongoing audit of clinic performance standards. Methods and criteria for monitoring and evaluating these parameters are discussed, and the importance of such monitoring is emphasized.

Abortion, Induced

The clinical efficacy of the repeated transcervical instillation of quinacrine for female sterilization.

The safety and efficacy of the repeated transcervical instillation of quinacrine hydrochloride in a suspension of 5 ml of 2% Xylocaine was evaluated in 200 patients. All instillation procedures were performed during the proliferative phase of the menstrual cycle: the second instillation was made in the first menstrual cycle following the initial instillation and the third and last instillation at 6 months after the first. None of the patients used any adjunctive contraceptives. Follow-up visits were scheduled at 6-month intervals after the last instillation. The potentially serious complications following the instillation were four cases of cortical exitation, and one case of acute adnexitis. The second instillation was not performed for 16.0% and the third instillation was not performed for 16.7% of the patients, for medical and/or personal reasons. Fifty-one pregnancies were reported, 41 (80.4%) before completion of the three instillations. The results of this study show that the instillation schedule used is unsatisfactory for widespread use. Additional studies are currently being conducted to evaluate the use of an adjunctive contraceptive up to the time of the third instillation in order to reduce the high pregnancy rate.

Adult

First trimester abortion by vacuum aspiration.

To compare the efficacy and complications of using the 8 mm diameter metal and flexible plastic cannulae for performing abortions of pregnancies of 7--10 menstrual weeks' gestation by vacuum aspiration, a comparative study was conducted. Both types of cannulae were randomly assigned to 300 subjects in a study design where the physician who performed the abortion was not the same person who evaluated the subject after the abortion or at the time of the follow-up visit. All abortions were performed under paracervical block anesthetic after mechanical dilatation of the cervix to 8.6 mm. The rates of specific complications, blood loss and the need for secondary procedures to complete the abortion were not significantly different for the two types of cannulae. The amount of tissue obtained with a routine curette check following the vacuum aspiration, and the incidence of cannula obstruction were similar for the two types of cannulae.

Abortion, Induced