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Biomedical subjects

L Silver

Publications and source records attributed to L Silver.

At least 19 recordsLinked to original sources
PubMed1992

Proteus syndrome.

Proteus syndrome is a rare congenital disorder that is characterized by a wide variety of deformities including macrodactyly. Skin and soft tissue lesions are common; they may increase in size as the child develops and may assume tremendous proportions. The syndrome is often mistaken for other more commonly recognized conditions such as neurofibromatosis. Unlike neurofibromatosis, the soft tissue masses in Proteus syndrome are not nerve tumors but, rather, are hamartomas composed primarily of lipomatous tissue. The hand surgeon should be aware of this condition when evaluating a child with macrodactyly.

Diagnosis, Differential↗
PubMed1992

Posttraumatic tibial osteomyelitis: a comparison of three treatment approaches.

The treatment of 25 tibias in 25 patients with posttraumatic chronic osteomyelitis was reviewed. The approaches to soft tissue management fell into three groups: 1) muscle flap coverage; 2) primary closure with suction irrigation; and 3) open cancellous bone grafting. Treatment success was judged by the presence or absence of drainage and the local signs or symptoms of infection, and by the status of the tibial nonunion. Overall, 19 of 25 tibias (76%) had successful treatment. We found flap coverage to have a higher success rate (80%) than either primary closure with suction irrigation (45.5%) or open cancellous bone grafting (40%). These results further attest to the refractory nature of chronic osteomyelitis.

Adult↗
PubMed1991

Lymphoma models for B-cell activation and tolerance. IX. Efficient reversal of anti-Ig-mediated growth inhibition by an activated TH2 clone.

We have utilized several B-cell lymphomas that are growth inhibited by anti-Ig reagents as models for tolerance induction. In a previous communication, we demonstrated that the growth inhibition by anti-Ig can be partially prevented by the recombinant lymphokine, IL-4. In this paper, we report that complete protection of B lymphomas from anti-Ig was provided by a type 2 helper cell clone, D10.G4, when these T cells were activated by monoclonal anti-CD3. Conditioned medium from anti-CD3-stimulated D10.G4 cells also provided protection from anti-Ig. In contrast, little protection was observed with activated cells from a type 1 T-cell clone, A.E7. Furthermore, we show that combinations of IL-4 and tumor necrosis factors (both TNF alpha and TNF beta), as well as IL-4, effected partial protection by themselves and enhanced the activity of the other lymphokine if used in a pretreatment protocol. However, anti-cytokine antibodies were ineffective at reversing the T-cell-mediated protection. The possibility that direct T:B-cell contact mediates part of the protective signal is discussed.

Animals↗
PubMed1991

[The development of diagnosis-related groups--DRG's. Methodology for classifying hospital patients].

The history of Diagnosis Related Groups (DRG's), a system for classifying patients in acute care hospitals, developed by researchers at Yale University, USA, is reviewed. DRGs are an instrument for measuring the hospital product, primarily from a management viewpoint. Starting with a review of the definitions of hospital product, the article follows the course from the first DRGs through the most recent revision, providing a summary of potential and current applications of the system in several countries, which range from payment mechanism to uses in quality control.

Diagnosis-Related Groups↗
PubMed1991

Rhegmatogenous retinal detachments in patients with AIDS and necrotizing retinal infections.

Rhegmatogenous retinal detachments can occur in patients with acquired immune deficiency syndrome (AIDS) and necrotizing retinal infections. Of 68 patients with AIDS and necrotizing retinal infections seen between 1983 and 1987, rhegmatogenous retinal detachments developed in 16 patients (27 eyes). In this group, cytomegalovirus retinopathy was present in 75% (12 of 16) of patients, 18.8% (3 of 16) had probable herpes simplex virus retinopathy, and 6.2% (1 of 16) had toxoplasmic retinochoroiditis. Retinal detachment was bilateral in 68.8% (11 of 16) of patients. The retina was reattached successfully in 91% (10 of 11) of operated eyes. Proliferative vitreoretinopathy was present preoperatively in 95% of these eyes. Seven of 11 operated eyes had initial improvement in visual acuity. However, 5 of 11 continued to lose vision despite successful reattachment. Techniques included pneumatic reattachment, scleral buckle, vitrectomy, and silicone oil injection. Complicated retinal detachments in AIDS patients with rhegmatogenous retinal detachments and necrotizing retinal infections are common and can be repaired, but the prognosis is guarded in many patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Screening of natural products for antimicrobial agents.

Antimicrobial research is geared toward the discovery and development of novel chemical structures such as therapeutic antimicrobial agents. The continuing problem of development of resistance to existing antibacterial agents and the dearth of good antifungal agents motivates this effort toward innovation. Selection of possible new enzyme targets for antibiotic inhibition may be made on theoretical grounds, but it appears premature to select any single, previously unvalidated target for the intensive study required for rational drug design. Instead, a broad screen of chemical entities can be undertaken, dedicated to the discovery of novel antimicrobial inhibitors. A number of target areas are under investigation, including fungal mRNA splicing and bacterial DNA synthesis. A major part of the endeavor is in the historically productive area of natural product screening. To make the best use of natural product resources for the discovery of novel antibiotics, a balance is struct between screening for inhibitors of rationally chosen targets for which clinically useful inhibitors are not yet available, and screening more broadly to ensure that rare activities of unanticipated mode-of-action are not missed.

Anti-Bacterial Agents↗
PubMed1990

Does paramedic-base hospital contact result in beneficial deviations from standard prehospital protocols?

We reviewed written and audio records of paramedic-base hospital radio contact to determine whether care differed from that suggested in standard prehospital care protocols. Records of all 659 contacts for seizure, syncope, abdominal pain, or altered mental state during 1987 (28.4% of all contacts) were scored for the use of standard therapies (such as intravenous access, oxygen, naloxone hydrochloride) and unanticipated therapies (intubation, nitroglycerin). Cases that involved unanticipated treatments were reviewed to determine whether they could have been prospectively identified by simple clinical findings. Standard therapies were used in the majority of patients. Unanticipated therapies were administered to 13 patients, all of whom had abnormal vital signs, diaphoresis, respiratory distress, or a second prominent symptom. Data suggest that protocols could replace radio contact for most patients and that the few who might benefit from radio contact can be easily identified. A 90% reduction in radio contacts in Los Angeles county could save $3 million each year.

Abdominal Pain↗
PubMed1990

Tropical pyomyositis. Demonstration of extent and distribution of disease by gallium scintigraphy.

Pyomyositis is a Staphylococcus aureus infection of muscles reported primarily in tropical countries but seen with increasing frequency in temperate climates. Because of its rarity in the United States, the diagnosis may not be considered immediately, and involved muscles may break down and become abscessed. Diagnosis is most reliably made by the recovery of pus from a muscle aspirate. Ga-67 scan findings of an interesting case of pyomyositis involving many muscle groups in both upper and lower extremities is reported. Despite arthralgias and complicating adult respiratory distress syndrome, Ga-67 correctly localized the infection to muscles in the shoulders, upper thorax, buttocks, and thighs. A bone scan was negative, excluding the possibility of extension of the infection to bone.

Adult↗
PubMed1989

Efficacy and safety of Minipress XL, a new once-a-day formulation of prazosin.

The efficacy and safety of prazosin GITS (gastro-intestinal therapeutic system), a new extended-release once-a-day formulation, were assessed both as monotherapy in mild essential hypertension and in combination with a diuretic in moderate essential hypertension in two multicenter, double-blind, placebo-controlled trials. Prazosin GITS (Minipress XL) given once daily in doses of either 10 or 20 mg significantly reduced sitting and standing systolic and diastolic blood pressure compared with placebo in both mild and moderate essential hypertension. There were minimal, clinically insignificant changes in heart rate following prazosin-GITS treatment (2.5, 10, and 20 mg) compared with placebo treatment. Prazosin GITS was well tolerated; the most common adverse experiences reported were headache, dizziness, and fatigue. All adverse experiences in the moderate hypertension group and the majority (91 percent) in the mild hypertension group were mild-to-moderate in severity. The results from these multicenter trials demonstrate the efficacy and safety of this new extended-release once-a-day formulation of prazosin in the treatment of patients with mild and moderate essential hypertension.

Adult↗
PubMed1989

Avoiding knee skin sloughs.

To avoid skin sloughs about the knee following knee arthroplasty, the principles that need to be emphasized are the blood supply in the area so that appropriate incisions can be designed; careful operative technique to avoid hematomas; appropriate use of drains and dressings; and postoperative care that monitors increased range-of-motion as it affects the wound. Should secondary coverage be needed, the options include secondary closure, skin graft, muscle or myocutaneous flaps, and on rare occasions, a free tissue transfer. In this way, the plastic surgeon can assist the orthopaedist by providing the appropriate soft tissue coverage in difficult knee surgical situations.

Humans↗
PubMed1988

Interaction of human adenovirus serotype 2 with human lymphoid cells.

Human adenoviruses (e.g., Ad2, Ad5) establish chronic infections in human lymphoid-derived cell lines, including Raji and Jijoye (R.E. Wallace, 1969, Proc. Soc. Exp. Biol. Med. 130, 702-710; N. Faucon, G. Ogier, and Y. Chardonnet, 1982, J. Natl. Cancer Inst. 69, 1215-1220); however, the mechanisms by which chronic infections are established and maintained are not understood. When Raji or MOLT-3 cell cultures were infected with Ad2 at high multiplicity, these cell lines continued to grow exponentially and produced only small amounts of infectious virus. Virus-specific antigens, including the DNA-binding protein and hexon, were expressed in only 5% of the Ad2-inoculated cultures. All Raji and MOLT-3 cells were found to have adenovirus receptors, but the Ad2 virions that adsorbed to most Raji cells were sequestered in caps, suggesting that most cells fail to internalize adsorbed Ad2. Cell synchronization experiments showed a correlation between the proportion of cells that became productively infected and the proportion of cells in mitosis at the time of infection. In contrast, primary blood lymphocytes had few, if any, Ad2 receptors and were not productively infected by Ad2.

Adenoviruses, Human↗
PubMed1988

Squamous cell carcinoma of the thyroid.

A patient with squamous cell carcinoma of the thyroid is presented. The I-123 images failed to show any cold areas but demonstrated the posterior extension of the gland.

Carcinoma, Squamous Cell↗
PubMed1988

Comparable energy expenditure after arthrodesis of the hip and ankle.

The energy expenditure and gait characteristics of eleven subjects who had a unilateral arthrodesis of the hip and ten subjects who had a unilateral arthrodesis of the ankle were measured during a twenty-minute walking trial. Oxygen consumption was determined and heart rate, respiratory rate, and step frequency were monitored. The average walking speed for both groups was sixty-seven meters per minute, which is 84 per cent of normal gait velocity. After an arthrodesis of the ankle, the average rate of oxygen consumption was 12.0 milliliters per kilogram of body weight per meter, which is 3 per cent more than normal. The oxygen cost averaged 0.166 milliliter per kilogram per meter, resulting in a gait efficiency of 90 per cent. After arthrodesis of the hip, the mean rate of oxygen consumption was 14.9 milliliters per kilogram of body weight per meter, which is 32 per cent greater than normal. The oxygen cost, 0.223 milliliter per kilogram per meter, represented a gait efficiency of 53 per cent. The physiological energy expenditure by the subject after an arthrodesis of the hip was found to be significantly greater than after an arthrodesis of the ankle and was more than that reported previously after a total hip arthroplasty for unilateral degenerative disease.

Adult↗
PubMed1987

A monoclonal antibody recognizing an icosapeptide sequence in the heavy chain of human factor XII inhibits surface-catalyzed activation.

A monoclonal antibody (mAb B7C9) to human factor XII was raised in murine somatic cell using purified factor XII antigen. The purified antibody was subtyped IgG1 kappa and had a KD of 9.8 nM for antigen factor XII. Functional studies indicated that mAb B7C9 blocks surface-mediated coagulant activity of factor XII but not the amidolytic activity of factor XIIa against the small substrate H-D-Pro-Phe-Arg-p-nitroanilide (S-2302), suggesting that the mAb B7C9 epitope is located at or near the surface binding domain of the heavy chain region of factor XII. Western blot analysis indicated that the antibody reacts with factor XII and the heavy chain of factor XIIa. Affinity isolation of factor XII peptides, produced after cleavage by kallikrein, resulted in three factor XII heavy chain domain segments that were identified in the known factor XII sequence by limited N-terminal analysis. The epitope was located to a 20-amino acid sequence of 2.5 kDa in the heavy chain of factor XII which is the putative surface binding region of factor XII. The 2.5-kDa peptide was synthesized and demonstrated to react with mAb B7C9. mAb B7C9 was immobilized on an affinity resin and was successfully utilized to purify functionally active factor XII from plasma.

Animals↗
PubMed1987

Technetium 99m scan in acute scrotal lesions.

Scrotal scintigraphy is nearly 100 per cent accurate in identifying testicular torsion and can distinguish that condition, which requires an operation, from torsion of testicular appendages, which often can be treated nonoperatively. The technique is 90 per cent accurate in distinguishing epididymo-orchitis, epididymitis, and testicular abscess and is valuable in the follow-up of testicular torsion or inflammation. It can screen patients for varicocele, identifying possible candidates for spermatic venography and embolization. However, it has nothing to offer in the differential diagnosis of painless testicular masses.

Acute Disease↗