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Biomedical subjects

D Weinberg

Publications and source records attributed to D Weinberg.

52 records · Page 3Linked to original sources

Effects of selected repeated intravitreal chemotherapeutic agents.

The toxic effects of repeated intravitreal injections of selected chemotherapeutic agents were studied in female albino rabbits. Three groups of eyes participated in each therapeutic regimen. Agents studied were doxorubicin (dox), 3 and 5 micrograms; 5-fluorouracil (5-FU), 0.375 and 1.0 mg; bleomycin (bleo), 15 micrograms; thiotepa (thio), 12 micrograms; etoposide (VP-16), 150 micrograms; and methotrexate (MTX), 600 mic. Toxicity was evaluated using electroretinography (ERG) in 66% and histopathology in 100% of eyes 5 weeks following the initial injection and at least 2 weeks after the final injection of each series. Eyes receiving 2 doses of dox 3 micrograms showed no toxicity. Eyes receiving 3 or more doses of dox 3 micrograms and those treated with 2 or more doses of dox 5 demonstrated toxicity proportional to the number of doses received. Eyes treated with 5-FU 0.375 or 1.0 mg showed no toxic reaction. Successive intravitreal injections of 5-FU, 0.375 mg and dox 5 micrograms, and 5-FU, dox, and bleo produced no toxicity. Eyes treated with successive intravitreal injections of 5-FU, dox, bleo, and thio displayed decreased ERG response. The addition of VP-16 and MTX resulted in further loss of ERG response and more severe histologic retinal changes.

Animals↗

Effect of urokinase on posterior penetrating eye injuries.

We studied the effect of urokinase on the natural course of posterior penetrating eye injury in an animal model that consistently results in late tractional retinal detachment. A standard penetrating injury was performed on both eyes of 20 rabbits. Each eye received 0.4 mL of heterologous rabbit plasma. Then 10 000 U of urokinase was injected in one randomly chosen eye of each animal; an equal volume of balanced salt solution (BSS) was injected in the other. By 5 to 6 weeks after the surgery 13 (65%) of the 20 urokinase-injected eyes and 15 (75%) of the 20 BSS-injected eyes showed retinal detachment; the proportions are not significantly different. Gross and microscopic study of the enucleated, sectioned eyes failed to reveal any features distinguishing the control and urokinase-treated eyes. Thus, urokinase did not appreciably alter the natural course of development of late tractional retinal detachment after posterior penetrating eye injury.

Animals↗

Seminoma metastasis to the terminal ileum after a 17-year disease-free interval.

This is a report of a metastasis of a pure seminoma to the ileum after a 17-year latent period. The patient had a previous history of stage I testicular seminoma treated with primary orchiectomy and radiotherapy. He presented clinically with ileocolic intussuseption caused by a solitary metastasis in the terminal ileum. The rarity of this event is discussed.

Aged↗

Effects of epinephrine on resting potential in normal and hypertrophied cardiac muscles.

The role of the Na-K pump in the control of cellular ion balance has long been appreciated. Recent studies suggest that the manner in which this ion transport system functions in hypertrophied failing (HF) cardiac muscle is markedly different from that seen in normal muscles. The ability of the sympathetic neurohormone, epinephrine, to modulate membrane potential changes thought to reflect the activity of the Na-K pump in normal and HF cardiac muscle was examined in this study. Specifically rate-related changes in membrane potential (Emax) thought to be associated with the Na-K pump were measured in intact functioning cat papillary muscles. The results of these studies demonstrate that the rate-related changes in Emax thought to be associated with Na-K activity were markedly altered in HF cardiac muscles. Emax in these muscles responded to periods of transient stimulation by first depolarizing and then slowly returning to a new steady state which was depolarized with respect to the initial predrive Emax. Emax in normal muscles also depolarized on drive, but returned to a new steady state more rapidly and eventually hyperpolarized. Epinephrine significantly affected these rate-related changes in Emax in normal muscles by causing all the rates of change in Emax to be increased. In HF muscles, on the other hand, epinephrine had no significant effect on these parameters at the concentration tested. These results suggest that under certain conditions HF cardiac muscle may be incapable of maintaining normal resting membrane potentials. In addition the modulating influence of epinephrine is markedly blunted.

Action Potentials↗

Secondary metabolism: regulation by phosphate and trace elements.

Secondary metabolism and cellular differentiation occur within a range of concentrations of phosphate and, in specific taxonomic groups, of zinc, manganese, and/or iron that is much narrower than that permittee for primary metabolism. Possible molecular sites of action of the four elements are reviewed.

Anti-Bacterial Agents↗

Late persistence of serum gamma-glutamyl transpeptidase activity after mononucleosis. Report of 3 cases.

gamma-Glutamyl transpeptidase (GGTP) is a sensitive but nonspecific index hepatobiliary disease. In infectious mononucleosis (IM) or the mononucleosis-like disease attributable to cytomegalovirus (cytomegalovirus-induced IM), GGTP reverted to normal later than aspartate aminotransferase and alkaline phosphatase. In three cases elevated serum GGTP activity persisted for up to 24 months -- raising the question of persistent 'post-IM' hepatitis. Such prolonged GGTP activity was unusual in other late IM specimens. Possible, but unlikely, causes for such persistent GGTP activity are an unusual degree of hepatic damage during acute IM, excessive induction of microsomal enzyme system activity by drugs, or unusual Epstein-Barr virus carrier state activation that might contribute to ongoing hepatic structural damage. Other markers of chronic hepatocellular disease including aspartate aminotrasferase, alkaline phosphatase, and bilirubin were normal in late specimens from these 3 patients. The cause of their persistent elevated GGTP activities remains unknown.

Adult↗

Persistent iliac endarteritis with pseudoaneurysm formation following balloon-expandable stent placement.

We present a patient who developed endarteritis and pseudoaneurysm formation complicating iliac artery stent placement. Blood cultures grew Staphylococcus aureus. Three weeks after antibiotic treatment, the aortic bifurcation and the stents were removed, together with the left common iliac artery pseudoaneurysm. As with any other implantable device, septic complications are dreaded and should be recognized and treated early. Consideration may be given to the use of appropriate prophylactic antibiotics.

Aortic Diseases↗

Reduced postoperative atrial fibrillation using multidrug prophylaxis.

BACKGROUND: Atrial fibrillation (AFIB) is the most common complication following coronary artery bypass grafting (CABG). Despite three decades of recognition, efforts to reduce the high incidence reported (15%-30%) have been largely unsuccessful. Reasons for postoperative AFIB are likely multifactorial. As a result, we defined a multidrug prophylaxis based on agents known to be individually effective. This method was applied prospectively to a series of consecutive CABG patients with the goal of reducing the incidence of new-onset postoperative AFIB. METHODS: Isolated CABG with cardiopulmonary bypass was performed on 517 consecutive patients. A rapid recovery protocol emphasizing AFIB multidrug prophylaxis was applied to all patients. All patients received 10 microg of triiodothyronine intraoperatively when the clamp on the aorta was released. Immediately following CABG, parenteral magnesium was administered to assure a serum magnesium > 2.2 mEq/dL. Thyroxine 200 microg was administered parenterally to all patients on postoperative days 1 and 2. Metoprolol (25 mg to 100 mg/day) was begun on all patients after extubation provided: heart rate > 85 beats/min and systolic blood pressure > 130 mmHg. Parenteral procainamide (12 mg/kg) loading dose, followed by a maintenance dose (2 mg/min), was used for patients who developed premature atrial contractions (> 1/min), nonsustained supraventricular tachycardia, or any episodes of atrial fibrillation. All patients also received postoperative digitalization, steroids, and aggressive diuresis. RESULTS: The 30-day operative mortality was 3.7%. The overall incidence of new-onset postoperative AFIB was 10.3% (53 patients). There was no major difference in operative mortality (7.5% vs 3.2%, p = 0.23), Parsonnet risk score, or intraoperative variables between AFIB patients and the non-AFIB patients. Patients presenting with a preoperative acute myocardial infarction (p < 0.05), left main stenosis > or = 70% (p < 0.01), and advanced age > or = 70 years (p < 0.05) were at increased risk of developing AFIB. The length of stay for patients with AFIB was 9.9 +/- 9.6 days versus 5.9 +/- 5.2 days (p < 0.001). CONCLUSION: Application of a multidrug prophylaxis can reduce postoperative AFIB to a low incidence. Identification of associated clinical features can help predict patients at risk for postoperative AFIB. Additional strategies to target postoperative AFIB may include treatment at the earliest recognition of atrial rhythm instability.

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