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Biomedical subjects

J Meer

Publications and source records attributed to J Meer.

14 recordsLinked to original sources
PubMed2000

Long-term remission of idiopathic cervical dystonia after treatment with botulinum toxin.

Botulinum toxin type A (BTX-A) treatment for cervical dystonia is traditionally considered a purely symptomatic treatment. BTX-A blocks acetyl choline exocytosis for 3-6 months and most patients require reinjection after this period. We report on 6 patients (mean age 41.6 years, range 18-69) with idiopathic cervical dystonia who were treated with BTX-A injections and became asymptomatic for 2-4 years. Four patients showed remission after the first BTX-A treatment, 1 patient after the second set of injections and 1 after the third session. Amelioration of neck dystonia was observed within 1-4 weeks after the last BTX-A treatment and all 6 patients are symptom-free, off antidystonic medications for over 2 years. The possibility that BTX-A treatment may increase the chances of development of clinical remission in patients with idiopathic cervical dystonia is discussed.

Adolescent↗
PubMed1997

The impact of residual disease on local recurrence in patients treated by initial unplanned resection for soft tissue sarcoma of the extremity.

BACKGROUND AND OBJECTIVES: "Unplanned excision" in soft tissue sarcoma (STS) is defined as the gross removal of tumor without preoperative staging or consideration of the need for removal of normal tissue around the tumor. This study evaluated whether unplanned excision in patients with extremity STS would have an impact on local relapse (LR), even if reexcision of the tumor bed was undertaken. METHOD: Two hundred thirty-nine (239) patients with primary, extremity STS treated with limb salvage surgery were included in this study. Of the 239, 78% were treated with surgery and irradiation. Forty-seven tumors were low-grade and 192 high grade. Mean tumor diameter was 7.5 cm. Twenty had local recurrences and 64 relapsed systemically. RESULTS: Only margin and prior surgery were significant in univariate analysis (P < 0.05, log-rank test). The Cox multivariate analysis revealed that both margin of resection (P < 0.001) and the status of the local tumor site (P < 0.05) at definitive surgery were significant predictors of local relapse. CONCLUSIONS: These results suggest that the presence of microscopic disease in the reexcised specimen following unplanned resection is a risk factor for local disease recurrence.

Adolescent↗
PubMed1995

Glomerular mesangial cell altered contractility in high glucose is Ca2+ independent.

In diabetes, loss of renal arteriolar smooth-muscle cell contractility leads to intraglomerular hypertension. In glomeruli isolated from streptozotocin (STZ)-induced diabetic rats, the mesangial cells (smooth muscle-like) display loss of contractile responsiveness to angiotensin II. This study examines the mechanistic relationship between altered mesangial cell contractility and vasopressor hormone-stimulated Ca2+ signaling in high glucose. Glomeruli were isolated from normal or STZ-induced diabetic rats to observe ex vivo mesangial cell contractile function. Also, rat mesangial cells were cultured (10-20 passages) in normal (5.6 mmol/l) or high (10-25.6 mmol/l) glucose for 1-5 days. Reduction of glomerular volume and decreased planar surface area of cultured mesangial cells in response to vasoconstrictor stimulation over 60 min were measured by videomicroscopy and personal computer-based morphometry. Contraction of glomeruli isolated from STZ-administered rat in response to endothelin (ET)-1 (0.1 mumol/l) or the Ca2+ ionophore A23187 (5 mumol/l) was impaired significantly compared with that in normal glucose. In the presence of arginine vasopressin (AVP) (1.0 mumol/l) or ET-1 (0.1 mumol/l), mesangial cells demonstrated a dose-dependent loss of contractile response to increasing glucose concentrations (5.6-25.6 mmol/l) within 24 h of high-glucose exposure, which was sustained for 5 days. Mesangial cells in high glucose were consistently smaller in size compared with those in normal glucose. Mesangial cells were preloaded with myo-[2-3H]inositol and intracellular [3H] inositol phosphate release in response to AVP (1.0 mumol/l) was analyzed by Dowex chromatography. Comparing cells in normal (5.6 mmol/l) verus high (25.6 mmol/l) glucose, we observed no significant difference in stimulated inositol phosphate levels from 10 to 60 s.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Interventional neurology: botulinum toxin as a potent symptomatic treatment in neurology.

Local injections of botulinum toxin is a well-accepted treatment for focal dystonias, hemifacial spasms and strabismus. Its use by skilled neurologists has been reported to be safe and effective. We report our experience with botulinum toxin injections in 108 patients with various central nervous system disorders. Botox was effective in upper face dystonia (86% improvement), spastic dysphonia (92% improvement), platysma muscle spasms and spasmodic torticollis (range of movement 61%, pain and tension 90%). It was also very effective in a few patients with apraxia of eyelid opening, parkinsonian jaw tremor, teeth clenching, palatal myoclonus and adductor leg spasticity. No serious side effects were recorded. Botulinum toxin is a useful symptomatic treatment for many neurological disorders, and one of the leading mode of treatments in the new subspecialty in neurology called "Interventional neurology."

Adolescent↗
PubMed1993

[Botulinum toxin for palatal myoclonus and spastic dysphonia].

Botulinum toxin (B; Botox), produced by the anaerobic bacterium Clostridium botulinum, causes temporary paralysis by blocking the presynaptic release of acetylcholine at the neuromuscular junction. This action is clinically used to alleviate muscle spasm by injecting the toxin directly into the overactive muscle. We report our experience with B injections in 2 women, aged 20 and 21, respectively, 1 of whom had bilateral palatal myoclonus and the other adductor spastic dysphonia. Both showed remarkable improvement of conditions for which, until now, we had no effective treatment. These are the first cases in Israel treated with B for otorhinolaryngological conditions.

Adult↗
PubMed1991

Cloning and partial sequence of a cDNA for rabbit prothrombin.

A 1466 base pair cDNA for rabbit prothrombin has been isolated and partially sequenced. The deduced amino acid sequence shows considerable homology with the sequences of human and bovine prothrombin. The cDNA extends from the equivalent of nucleotide 516 in the bovine sequence through the coding region and 99 nucleotides in the 3' non-coding region.

Amino Acid Sequence↗
PubMed1991

Congenital mirror movements. Abnormal organization of motor pathways in two patients.

We studied 2 patients with congenital mirror movements by means of various neurophysiological and metabolic techniques, including mapping of motor evoked potentials to transcranial electrical and magnetic stimulation, premovement and somatosensory evoked potentials, kinematics of voluntary movements, muscle reflexes, and positron emission tomography (PET). Abnormalities in maps of motor and premovement potentials and in PET scans were consistent with a bilateral representation of hand muscles in the motor cortex, the existence of physiologically active connections capable of conducting fast efferent volleys from the motor cortex to ipsilateral muscles, the presence of mirror EMG activity in either hand with intended voluntary movement of the other hand, the absence of mirrored EMG responses from wrist flexors and extensors to mechanical perturbation of the contralateral wrist, and normal scalp distribution of somatosensory evoked potentials to right and left median nerve stimulation. Our findings are consistent with aberrant organization of motor representation areas and corticospinal pathways with ipsilateral as well as contralateral control of voluntary movement.

Adult↗
PubMed1991

Sudomotor function in autonomic failure.

We measured sweat production to direct gland stimulation with intradermal methacholine in patients with autonomic failure and in normal subjects. The sympathetic skin response (SSR) to electrical stimulation was assessed in some of the same subjects. Patients with pure autonomic failure (PAF) and multiple system atrophy (MSA) produced significantly less sweat than controls. None of the patients manifested greater than normal sweat production. Impaired sweat gland function does not differentiate MSA and PAF. The SSR did not correlate with sweat response to methacholine. An SSR can occur in the absence of normal sweat gland function. The diminished production of sweat in response to intradermal methacholine in PAF suggests that human sweat glands do not develop chronic denervation supersensitivity. Intradermal methacholine is a simple method to assess sweat gland function.

Adult↗
PubMed1990

The refractory period of transmission in patients with carpal tunnel syndrome.

In patients with the carpal tunnel syndrome (CTS) and in control subjects, pairs of shocks at intervals of 0.8 msec and 1.0 msec were used to stimulate the median nerve just above the wrist. Nerve action potentials were recorded at the elbow and from the index or middle finger. In patients but not in controls, recordings from the finger frequently showed loss of the second action potential of the pair, although a second action potential was present at the elbow. In these cases it seemed likely that impulse transmission through the carpal tunnel had failed because the damaged nerve at the level of the lesion had an increased refractory period of transmission (RPT) compared with its refractory period under the stimulating cathode. The possible diagnostic use of RPT measurement in CTS patients is discussed.

Adult↗
PubMed1990

Suramin-induced polyneuropathy.

We report the development of a severe polyneuropathy in 4 of 38 patients who were receiving parenteral suramin therapy for the treatment of various underlying malignancies. In 2 of these patients, the neuropathy progressed to generalized flaccid paralysis with bulbar and respiratory involvement, requiring endotracheal intubation and ICU monitoring. EMG and nerve conduction studies showed evidence of conduction block, suggestive of a demyelinating polyneuropathy. After several weeks, both patients improved clinically. The other 2 patients developed a reversible neuropathy with flaccid paresis of the limbs but without bulbar or respiratory compromise. No immediate response to plasmapheresis was noted. All 4 patients demonstrated an elevated CSF protein in the acute phase of their neuropathy, which declined or returned to normal during recovery. The development of polyneuropathy correlated with the maximum plasma suramin level, with an estimated 40% risk of developing neurotoxicity in those patients whose maximum level was 350 micrograms/ml or greater. No correlation could be made with the total dose of suramin administered or with the duration of therapy. Two of these 4 patients manifested tumor shrinkage while receiving suramin therapy. We conclude that suramin, a promising antineoplastic agent, is capable of inducing a severe sensorimotor polyneuropathy which appears to be related to the plasma concentration of suramin. Serial measurement of the plasma concentration during suramin therapy is recommended.

Adult↗
PubMed1989

Ring finger testing in carpal tunnel syndrome: a comparative study of diagnostic utility.

Because digit 4 (D4) has dual innervation, median and ulnar sensory latencies can be determined over identical distances. To determine if D4 testing is more sensitive than other commonly used techniques to diagnose carpal tunnel syndrome (CTS), we examined 42 hands with clinical evidence of carpal tunnel syndrome and 43 control hands. D4 latency was significantly longer than controls more often than digit 2 (D2) in patients with CTS. Comparing median to ulnar latencies from D4 was the most sensitive method to make the diagnosis of CTS. In mild CTS, a characteristic double peak potential was seen in recordings from the median nerve after stimulating D4. This potential provided immediate visual confirmation of the diagnosis of CTS. Comparing D4 latency along median and ulnar nerves is useful for detecting mild CTS and should be used whenever there are clinical signs and symptoms of CTS but electrodiagnostic studies are normal or borderline.

Adolescent↗
PubMed1988

Physiologic and anatomic basis for contralateral R1 in blink reflex.

We studied the rate of appearance and mechanism of contralateral R1 responses in normal subjects. Contralateral R1 could be produced by facilitating maneuvers such as a gentle contraction of the orbicularis oculi and conditioning stimulus of the median nerve. In addition, changing the position of the stimulating anode to the midline evoked these responses that were abolished by blocking the contralateral supraorbital nerve, confirming its peripheral origin. We conclude that crossed trigeminofacial pathways probably exist in normal subjects, but in some instances contralateral peripheral trigeminal ophthalmic sensory fibers may be stimulated, giving rise to a contralateral R1 response.

Blinking↗