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Biomedical subjects

J A Penner

Publications and source records attributed to J A Penner.

At least 55 records · Page 3Linked to original sources
PubMed1977

Prothrombin complex concentrates.

The use of the prothrombin complex products for the treatment of inhibitor patients is discussed in relation to our difficulty in identifying the effective therapeutic principle, as well as the factors responsible for thrombogenicity. It would appear that combination of factors is responsible for either or both therapeutic and thrombogenic phenomena. Possible intermediate or aggregate forms of the procoagulants are present in the products, protected from the neutralizing effects of antithrombin III.

Antithrombin III↗
PubMed1976

Antihemophilic factor inhibitors. Management with prothrombin complex concentrates.

Prothrombin complex concentrates have been evaluated in the treatment of acute bleeding episodes occurring in 11 hemophilic and two nonhemophilic patients with factor VIII inhibitors. In several of the hemophilic patients, a continued fall in inhibitor levels has been observed coincident with continued use of the concentrate Proplex, and one of these patients is now responsive to factor VIII therapy. The therapeutic effectiveness of prothrombin complex products appears to be related to the presence of small amounts of activated factors or to the continued formation of factor Xa in vivo as a result of the increased levels of prothrombin and factors VII and X. Until high-potency activated products are available, prothrombin concentrates offer an effective means of treating patients with factor VIII inhibitor.

Acute Disease↗
PubMed1976

Lymphomas of the masticator space.

Lymphomas that involved the masticatory space occurred in three patients. In one patient, the masticator space remained the sole manifestation for many years; in the other two patients, the masticator-space involvement was a local manifestation of constitutional disease. In all three patients, excisional biopsies and microscopical tissue examinations were carried out because of a mass deep to the parotid gland. The symptoms and signs are quite similar to those manifested in patients with infection. Surgical procedures other than incisional biopsy are not indicated. Irradiation and chemotherapy appear to be the treatments of choice.

Adult↗
PubMed1976

Treatment of refractory thrombocytopenic purpura with cyclophosphamine.

Cyclophosphamide, an immunosuppressive agent, was administered as an additional mode of therapy to 30 patients with idiopathic thrombocytopenic purpura (ITP) refractory to conventional management. Of 22 previously tested by splenectomy an excellent response was achieved in 12, who remained in complete hematologic remission for 14-96 months after therapy was discontinued; a fair response in 3, with definite increase in platelets, but not to normal levels; and a poor response in 7 who failed to improve. Of 8 nonsplenectomized patients who failed to respond to steroids or maintain a response after steroids were discontinued, 4 were considered excellent, 1 required continued therapy to remain in remission (good response), 2 were fair, and 1 was poor. Remission was observed in 2-10 weeks in both groups and appeared to be related to duration of disease; presence of disease for less than 1 year was associated with a much better response to treatment (11 of 15) when compared with disorders lasting over 2 years (6 of 15). Cyclophosphamide therapy offers additional means of treating patients with ITP who fail to respond to conventional therapy and may serve as an alternative to splenectomy when surgery is contraindicated.

Adolescent↗
PubMed1976

Hypercupremia associated with a monoclonal immunoglobulin.

Although copper is an essential constituent of many physiologic systems, most human diseases effect minimal changes in copper homeostasis. Therefore, the association of marked hypercupremia with copper deposition in the ocular media and with a circulating immunoglobulin G in an apparently healthy woman prompted our interest. Balance and radioisotopic studies suggest a normal gastrointestinal and renal threshold for copper but a specific and tight binding between the serum copper and the anomalous protein, the probable result of a preclinical myeloma. Because the response of the hypercupremia to chelation therapy was limited, the multiple myeloma was treated with cytoxic drugs.

Adult↗
PubMed1976

Pathophysiology of disseminated intravascular coagulation in saline-induced abortion.

Our previous studies suggested that disseminated intravascular coagulation (DIC) may be a sequel to saline-induced abortion. A hypothetical mechanism for the DIC is that hypertonic saline produces cellular disruption in the products of conception with the release of thromboplastic substances into the amniotic fluid. These substances, in turn, diffuse through the damaged membranes into the maternal circulation. To examine this hypothesis we obtained samples of amniotic fluid (AF) from 5 patients just prior to and at 1 hour, 6 hours, and 24 hours after intraamniotic instillation of hypertonic saline. The procoagulant and thromboplastic properties of the various AF specimens were quantitated using the prothrombin time (PT), partial thromboplastin time (PTT), and activated clotting time (ACT) as in vitro test systems. The results indicate that a change in the procoagulant and/or thromboplastic activity of AF following saline instillation is not afactor in the pathophysiology of DIC associated with saline abortion.

Abortion, Induced↗