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Biomedical subjects

E B Silberstein

Publications and source records attributed to E B Silberstein.

At least 91 records · Page 5Linked to original sources
PubMed1983

Predictive value of intracutaneous xenon clearance for healing of amputation and cutaneous ulcer sites.

A previously reported technique for the assessment of skin blood flow in the lower extremities of patients with ischemic lesions was evaluated using intracutaneous xenon clearance. The radioisotope was injected above and below both the ankle and the knee and flow was measured using a gamma camera with a low-energy collimator, 88-keV photopeak, and a 20% window. Healing was more frequent when skin blood flow was equal to or greater than 2.4 ml/min/100 g (38/39 patients) than when flow was less than 2.4 ml/min/100 g (4/7 patients). The authors conclude that this technique can be used to help determine the appropriate site for amputation in lower limb ischemic lesions.

Amputation, Surgical↗
PubMed1982

Semiautomated system for simultaneous assays of serum vitamin B12 and folic acid in serum evaluated.

We evaluated performance characteristics of a semiautomated radioassay system (ARIA II, Becton Dickinson Immunodiagnostics) for simultaneous measurements of vitamin B12 and folic acid in serum. The system requires off-line boiling of samples, which are then processed on-line. The automated process includes dispensing of boiled samples, tracers, and binders (purified intrinsic factor and milk binder); incubation, separation of bound and free ligands; elution; counting radioactivity of 57Co and 125I; and data reduction. Results were compared with those obtained by a manual method (Diagnostic Products Corp.). Although the nonspecific binding of the ARIA II is more than double that of the manual system, the precision values are comparable (within- and between-assay CVs are less than 8.5%). Values obtained with these two systems correlated well except that folic acid concentrations obtained with ARIA II tended to be lower at high folic acid concentrations. We observed no significant total carryover or drift in the semiautomated system.

Autoanalysis↗
PubMed1982

A quantitative method to measure human platelet chemotaxis using indium-111-oxine-labeled gel-filtered platelets.

Human blood platelets have been shown to migrate directionally and specifically toward collagen in plasma in vitro. We have developed a new system to monitor this behavior using a linear 7-compartment chamber with 111In-oxine-labeled gel-filtered platelets. The compartments are separated by various Nuclepore and Millipore filter membranes. Radiolabeled platelets suspended in plasma are placed in the central compartment and the other compartments are filled with platelet-free plasma. When collagen is added to an end compartment, platelets migrate toward that end. The degree of this directed movement or chemotaxis can be measured by counting the radioactivity of the contents of each compartment and then comparing the counts from radiolabeled platelets that have moved to the end that holds the chemotactic inducer with those that have randomly migrated to the opposite end, containing only plasma. This assay system allows quantitative comparisons between the chemotaxis-inducing abilities of different substances and permits the study of soluble materials. Experiments to determine the optimal conditions for the procedure are reported, and the advantages of this new method for the investigation of platelet chemotaxis and the identification of chemotaxins are discussed.

Adult↗
PubMed1981

A pathophysiologic study of the hypertension associated with burn injury in children.

Measurements of cardiac output, blood volume, plasma renin activity (PRA), serum aldosterone, plasma and urinary catecholamine levels, serum and urinary electrolyte levels, and of transfusion and fluid therapy have been made in eight hypertensive and seven normotensive burned children. Studies were conducted during the acute phase of burn injury when hypertension was first diagnosed and were repeated just before discharge from the hospital. Hypertensive patients perfused at an inappropriately high total peripheral resistance and hypervolemia was demonstrated in the hypertensive patients. No differences could be demonstrated between hypertensive or normotensive patients in PRA, aldosterone, catecholamine, or electrolyte levels. These data indicate that both the hypervolemia and the vasoconstrictor activity of PRA and/or catecholamines are present when hypertension develops in these patients. These data suggest that the renin-angiotension-aldosterone system is directly stimulated as part of the neuroendocrine response to trauma.

Acute Disease↗
PubMed1981

Are oral cathartics of value in optimizing the gallium scan? Concise communication.

The normal intestinal secretion of 9-15% of an administered dose of gallium-67 may prevent early detection of intra-abdominal disease. We randomized 50 patients to receive either no bowel preparation or 30 cc of milk of magnesia plus 5 cc of cascara. No significant difference was found between the two groups in frequency with which gallium interfered with readings or time to complete the study.

Abdomen↗
PubMed1981

Clinical significance of serum vitamin B12 measured by radioassay using pure intrinsic factor.

Serum vitamin B12 (B12) levels of 53 patients (15 with pernicious anemia) and 42 healthy volunteers were determined using crude intrinsic factor (IF), pure IF, and a mixture of crude IF + R-protein blocking agent (block IF). The radioassay using pure IF showed less sample-to-sample variation in nonspecific binding than the radioassay using block IF. The mean B12 levels in 42 healthy subjects were significantly higher with crude IF (499 +/- 23 pg/ml, 1 s.e.m.) than with pure IF (408 +/- 29 pg/ml) or with block IF (407 +/- 22 pg/ml). B12 levels were abnormally low in all 15 patients with pernicious anemia by pure IF (less than 100 pg/ml), in 14 patients by block IF (less than 150 pg/ml), and in only seven patients by crude IF (less than 200 pg/ml). Our data confirm previous reports that B12 deficiency can be diagnosed more reliably by measuring serum B12 levels with etiher pure IF or block IF.

Anemia, Pernicious↗
PubMed1980

A radiopharmaceutical and clinical comparison of 99mTc-Sn-hydroxymethylene diphosphonate with 99mTc-Sn-hydroxyethylidene diphosphonate.

A comparison of 99mTc labeled hydroxyethylidene diphosphonate (99mTc-HEDP) and hydroxymethylene diphosphonate (99mTc-HMDP), two bone scanning agents differing by a single methyl group, was performed in 20 patients. In nine patients, no difference in scan quality was found. Of the other 11, HMDP had significantly better bone delineation (p = 0.012), lower soft tissue background (p = 0.001), and improved overall scan quality (p = 0.012) in 10, while HEDP was preferred for bone delineation and overall quality in only a single patient. No significant difference in lesion detection was noted.

Adult↗
PubMed1980

Gentisic acid: a new stabilizer for low tin skeletal imaging agents: concise communication.

In vitro stabilization of low-tin bone-imaging agents has previously been achieved with ascorbic acid. In this study gentisic acid is shown to be an equally effective antioxidant for the (1-hydroxyethylidene) diphosphonate (HEDP) and hydroxymethylenediphosphonate (HMDP) skeletal agents. In vitro studies show less than 2% free sodium [99mTc] pertechnetate at 24 hr with the gentisic acid stabilizer. Studies in guinea pigs at 3 and 24 hr--whether with C-14 or H-3-labeled gentisic acid as stabilizer--show no alteration in the biodistribution of either skeletal imaging agent by the addition of the gentisic acid. Gentisic acid is a safe and effective stabilizer, and clinical studies have shown bioequivalency with ascorbic acid.

Animals↗
PubMed1979

Radionuclide therapy of hematologic disorders.

32P is effective therapy for polycythemia and primary thrombocytosis. The Polycythemia Vera Study Group is comparing radioactive phosphorus with alkylating agents to determine relative efficacy. Less well investigated is the effectiveness of 32P vs. busulfan in chronic granulocytic leukemia. Endolymphatic administration of radiopharmaceuticals may play a role in the therapy of infradiaphragmatic lymphoma. Among the radionuclides that have at times been used in hematology are 32P, 198Au 24Na, 76As, 89Sr, 52Mb, 54Mn, 91Y, 95Zr, 95Cb, 111Ag, 109Pd, 131I, 185W, and 192Ir. As stated, 32P has proven single most efficacious agent. The hematologic diseases that have been treated include both malignant and benign conditions. Among the malignant conditions are polycythemia vera, agnogenic myeloid metaplasia, thrombocythemia, leukemia, Hodgkin's disease, and multiple myeloma. Hemophilia, and Osler--Weber--Rendu disease are among the benign entities in which the agents have been tried. Polycythemia and thrombocythemia remain those in which the greatest success has been achieved.

Gold Radioisotopes↗
PubMed1979

The relationship of information density to pre-set counts obtained in brain, lung and liver scintigraphy.

The total number of counts required per view for brain and lung scintigraphy to achieve information or count density (CD) of 1 000 counts/cm2 and 2 000 counts/cm2 for liver scans was examined. To achieve these CDs, 600 000 counts per view are required for brain scans. For the lung, 500 000 counts in anterior and posterior views are required; 400 000 counts in the lateral view are sufficient. For 2 000 CD in the liver scan, 600 000 counts should be obtained in the anterior view and 500 000 in the right lateral. This number of counts assures the desired CD in 97% of cases.

Brain↗
PubMed1978

An evaluation of undergraduate family care programs.

Evaluation of the many new family care programs (FCP), and others of similar intent, however defined, is as essential as determining the value of any other curriculum change. Replies to a questionnaire from 101 U.S. and 15 Canadian medical schools indicated that 80% of the former and 93% of the latter had FCPs; 35% and 29%, respectively, were not evaluating their program by any method. No single evaluative technique was used by more than 42% of the American medical schools. A review of the literature on FCPs frequently indicated that the conclusions that could be drawn about the programs were ambiguous. Students in the University of Cincinnati Medical Center FCPs elected family practice or pediatric internships significantly more often than did the FCP nonparticipants, but they indicated that the program had little effect on this choice, despite almost uniformly favorable testimonials. We discuss the possibility that FCPs may be educating the wrong students, that FCPs, if not reinforced in other clinical areas, may have few lasting effects on student attitudes or career choice, and that we may be asking the wrong questions, and with inadequate methods.

Adult↗