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Biomedical subjects

M Fisher

Publications and source records attributed to M Fisher.

At least 19 recordsLinked to original sources
PubMed1992

[Echinococcosis in pregnancy].

Hydatid disease affects sheep and cattle and is caused by the larval form of Echinococcus granulosus. Affected human beings are only chance intermediate hosts. We present a woman admitted in her 22nd week of pregnancy because of upper abdominal pain and persistent vomiting. The presumptive diagnosis of hydatid cyst of the liver was established by ultrasound, X-ray and CT examinations. At laparotomy a 10 x 7 cm hydatid cyst was removed from the liver. She recovered completely and delivered spontaneously at term. There was no evidence of hydatid disease in the newborn or in the placenta.

Echinococcosis, Hepatic↗
PubMed1992

School-based adolescent health care. Review of a clinical service.

OBJECTIVE: To provide recommendations regarding the establishment and maintenance of school-based clinics, based on analysis of data from a clinic located in a New York City high school. DESIGN: Review of demographic, medical, and psychosocial data collected during student visits. SUBJECTS: During 2 1/2 years, 1283 students were seen. The students were 53% girls and 47% boys; 65% black and 25% Hispanic; and 65% grades 9-10 and 35% grades 11-12. RESULTS: There were 7920 visits. Visits were for acute or chronic medical problems (44%), physical examinations and immunizations (25%), gynecologic or sexuality-related issues (17%), and mental health concerns (14%). Psychosocial characteristics of the 378 students who enrolled during the 1989-1990 academic year indicated that only 27% lived with both natural parents, 55% were foreign-born, 37% had repeated a grade at least once, 44% were sexually active, 13% drank alcohol, and 14% had past or present suicidal ideation. CONCLUSIONS: These data demonstrate that a school-based clinic can be involved in the management of a wide range of health care needs for large numbers of at-risk youth. In addition, school-based clinics can serve as a major site for the teaching of medical students and residents, and as a valuable resource for clinical research.

Adolescent↗
PubMed1992

New magnetic resonance techniques for evaluating cerebrovascular disease.

Magnetic resonance (MR) imaging of acute stroke has made important contributions to diagnosis. Several novel MR technologies, now in preclinical and clinical development, will contribute to stroke diagnosis and perhaps help to guide therapy. MR angiography is the most clinically advanced new MR technology and offers the clinician a method to image noninvasively the extra- and intracranial vasculature. Diffusion-weighted MR imaging can demonstrate ischemic lesions quantitatively within minutes of onset in experimental stroke models, and human application is proceeding. Perfusion MR studies can reveal the presence or absence of cerebral perfusion in specific arterial territories. MR spectroscopy can assess tissue metabolites in vivo and reveal changes in these metabolites associated with ischemic injury. The combination of these new MR techniques should provide a plethora of information about the extent of ischemic lesions, associated vascular and perfusion deficits, and metabolic consequences. This information will afford the clinician the opportunity to assess and subtype ischemic stroke patients more rapidly and could be used to monitor therapeutic responses.

Animals↗
PubMed1992

Inhibition of lipid deposition in the hypercholesterolemic rat by clentiazem, a calcium channel blocker.

We studied the effects of clentiazem, a calcium channel blocker (1) on the accumulation of lipid in the aorta, (2) on the level of plasma lipids, and (3) on the number of adherent intimal monocytes and foam cells. Seventy Wistar rats were assigned to one of the following groups: (1) regular diet, (2) an atherogenic diet consisting of regular chow with 2% cholesterol, 1% cholic acid, and 0.5% thiouracil (CCT), (3) CCT supplemented with 5 mg/kg/day clentiazem, and (4) CCT with 25 mg/kg/day clentiazem. Animals were sacrificed after 6 or 12 weeks of diet. Aortas were studied by light microscopy after staining with oil red O (ORO) and/or hematoxylin. ORO staining was quantified in both abdominal and thoracic regions of the aorta. The aortas of the clentiazem groups demonstrated significantly less ORO staining than CCT diet controls in thoracic aorta after 6 weeks and abdominal aorta after 12 weeks. There was no significant difference in the plasma lipid concentrations. The clentiazem-treated groups had fewer numbers of adherent monocytes and foam cells. We conclude that clentiazem inhibits lipid deposition in cholesterol-fed rats without lowering plasma lipid concentrations and that the number of intimal monocytes and foam cells is decreased in the presence of this calcium antagonist.

Animals↗
PubMed1992

Inhibition of stimulated human leukocyte hydrogen peroxide generation by a novel antioxidant, OPC-14117.

Oxygen free radicals generated by leukocytes may contribute to tissue injury after central nervous system (CNS) focal ischemia or trauma. Inhibiting oxygen free radicals has improved outcome in experimental models of these conditions and antioxidant therapy appears promising. We evaluated the ability of a novel antioxidant, OPC-14117, to reduce hydrogen peroxide (H2O2) production by stimulated human polymorphonuclear (PMN) leukocytes and monocytes. Stimulated PMN and monocytes were incubated with several concentrations of OPC-14117 for 20 min and H2O2 production, nmol/1 x 10(6) cells/30 min, was measured. OPC-14117 significantly reduced PMN H2O2 production (P less than 0.001) and monocyte H2O2 production (P less than 0.05). A dose response relationship was observed for both leukocytes, as the 100 microM drug concentration was significantly (P less than 0.05) more effective than the 10 microM concentration. These results demonstrate that OPC-14117 inhibits H2O2 generation by stimulated human leukocytes and support further studies of its effects in disorders such as CNS focal ischemia and trauma, conditions where antioxidant therapy may be beneficial.

Adult↗
PubMed1992

Outcome of gestational diabetes in Bengali Asians living in an east London health district.

The characteristics and outcome of pregnancy complicated by gestational glucose intolerance are described in a consecutive series of 69 Bengali Asian patients and a parallel group of 22 Caucasian patients. The Bengali patients were older and of higher parity than the Caucasians and more frequently required insulin therapy. However, the outcome of pregnancy was similar in terms of antenatal clinic attendance, the number of antenatal hospital admissions, glycaemic control, birthweight and mode of delivery. Of those patients who attended for postnatal glucose tolerance test, 20% of the Bengali population demonstrated persisting abnormality of glucose tolerance, whereas no abnormalities were evident in the Caucasian group. These findings are consistent with the high prevalence and early age of onset of non-insulin-dependent diabetes in Asian populations. The World Health Organisation (WHO) criteria for the diagnosis of impaired glucose tolerance proved insufficiently sensitive for the diagnosis of gestational diabetes. This was particularly demonstrated by four patients with apparently normal glucose tolerance by WHO criteria who subsequently required insulin therapy.

Adult↗
PubMed1992

Substance use in a school-based clinic population: use of the randomized response technique to estimate prevalence.

Students attending school-based clinics acknowledge only minimal involvement with drug or alcohol use. In order to explain this unanticipated finding, we used a statistical method called randomized response to study adolescents in one school-based clinic. The sample consisted of 133 students (57% female; 75% black, 20% Hispanic, 5% other; and 58% grades 9-10, 42% grades 11-12). Using both lifetime and 30-day prevalence rates, these students revealed more cigarette smoking and alcohol use on randomized response than they had on questionnaires completed earlier the same academic year, minimal involvement with either marijuana or cocaine use by either method, and a similar amount of sexual activity by both methods. This study demonstrates that randomized response can be a useful method to generate more truthful group responses from adolescents.

Adolescent↗
PubMed1992

Amplified assay of alkaline phosphatase using flavin-adenine dinucleotide phosphate as substrate.

A simple to use, robust, quantitative, and extremely sensitive colorimetric assay for alkaline phosphatase (EC 3.1.3.1), designed to be used as a detection system in diagnostic assays employing antibodies or gene probes, is described. This technology is based on the novel principle of prosthetogenesis, according to which a purpose-designed substrate (a prosthetogen) for a primary analyte-linked enzyme label is hydrolyzed to produce a prosthetic group for a detector enzyme system. The prosthetogen employed here is a derivative of FAD which is phosphorylated at the 3'-position of the ribose ring (FADP), the label enzyme is alkaline phosphatase, and the detector is a D-amino-acid oxidase/horseradish peroxidase-coupled system. Essentially each turnover of every molecule of alkaline phosphatase produces a molecule of D-amino-acid oxidase for detection. Thus enormous amplification of the initial signal is achieved in short time periods because of the relatively high turnover number of alkaline phosphatase for FADP. The system can be formatted as a stable, preformed, freeze-dried preparation containing all analytical components, which is reconstituted simply by addition of buffer solution. This methodology can quantitate less than 0.1 amol of alkaline phosphatase in 30 min at 25 degrees C using microtiter plates.

Alkaline Phosphatase↗
PubMed1992

Anaphylactoid reaction to iopamiro (after pretreatment).

A patient is described with a past history of an anaphylactoid reaction to contrast media who reacted to nonionic contrast media after pretreatment with antihistamines and steroids. The available options to reduce the incidence of reactions include use of non-ionic contrast which has a reported lower frequency than ionic contrast or some form of pretreatment. Various forms of pretreatment have been described and in the majority steroids and antihistamines are used. We describe a patient who reacted to nonionic contrast after a pretreatment regime.

Anaphylaxis↗
PubMed1992

Hematogenous factors and prediction of delayed ischemic deficit after subarachnoid hemorrhage.

BACKGROUND AND PURPOSE: Delayed ischemic deficits contribute to the high morbidity and mortality rates associated with subarachnoid hemorrhage. We evaluated the potential usefulness of measuring coagulation and hemorheological variables and cardiolipin antibodies for prediction of delayed ischemic deficit after subarachnoid hemorrhage. METHODS: Consecutive patients with subarachnoid hemorrhage were studied. Coagulation and hemorheological variables and cardiolipin antibodies were measured on admission, within 7 days of subarachnoid hemorrhage. A subset of patients was studied on admission and at two subsequent occasions. RESULTS: Sixty-nine patients were studied. Sixty-one of these were without clinical manifestations of vasospasm at admission, and 16 developed delayed ischemic deficit during their hospitalization. None of the laboratory variables measured were significantly different between patients with or without later development of delayed ischemic deficit. Elevation of the fibrin fragment D-dimer was found in the group of eight patients admitted with ischemic symptoms and in 49% (34 of 69) of all patients, but this was not associated with delayed ischemic deficit. Sixteen patients were studied on three occasions; this group showed a significant decrease in hematocrit, an increased white blood cell count, and no change in fibrinogen concentration. Fibrin D-dimer levels rose significantly after surgery (from 5.01 +/- 0.69 to 5.53 +/- 0.58 ln-ng/ml, p less than 0.025) and after onset of delayed ischemic deficit (from 4.71 +/- 0.64 to 5.84 +/- 0.34 ln-ng/ml, p less than 0.01). CONCLUSIONS: Hemostatic measurements, hemorheological variables, and cardiolipin immunoreactivity did not predict delayed ischemic deficit in this population.

Adult↗
PubMed1992

Reversible focal ischemic injury demonstrated by diffusion-weighted magnetic resonance imaging in rats.

BACKGROUND AND PURPOSE: Diffusion-weighted magnetic resonance imaging (DWI) can quantitatively display focal brain abnormalities within minutes after the onset of ischemia. We performed the present study to determine the effects of 1 and 2 hours of temporary ischemia on DWI. METHODS: We examined DWI and T2-weighted magnetic resonance images (T2WI) during and after 1 and 2 hours of temporary middle cerebral artery occlusion in rats (n = 10 for each group). In a subgroup of four animals from each group, we employed perfusion magnetic resonance imaging to monitor cerebral perfusion. Neurological outcome and infarct size after survival for 24 hours were compared between the groups and correlated with DWI and T2WI studies. RESULTS: Perfusion studies qualitatively documented hypoperfusion and reperfusion during and after temporary occlusion. Lesion size on DWI during reperfusion was significantly less than that during ischemia for 1 (55% decline, p less than 0.02) but not 2 hours of occlusion. The DWI signal intensity ratio (intensity compared with that in the contralateral homologous area) just before withdrawal of the occluder was significantly less in regions where the hyperintensity disappeared after withdrawal than in regions with persistent hyperintensity (p less than 0.002). The T2WI studies revealed few or no abnormalities, except after 2 hours of occlusion. The neurological outcome was significantly better in the 1-hour than in the 2-hour group (p less than 0.05). Postmortem infarct volume was significantly smaller in the 1-hour group than in the 2-hour group (p less than 0.05). The postwithdrawal DWI accurately predicted infarct size (R = 0.96, p less than 0.0001). CONCLUSIONS: The present study indicates that DWI can rapidly display not only irreversible but also reversible ischemic brain damage and enhances the importance of DWI as a diagnostic modality for stroke.

Animals↗
PubMed1992

Diffusion-weighted magnetic resonance imaging: rapid and quantitative detection of focal brain ischemia.

We examined serial changes of diffusion- (DWI) and T2-weighted (T2WI) magnetic resonance images 30 minutes to 3 hours after intraluminal suture occlusion of the middle cerebral artery (MCA) in eight rats and after sham occlusion in four. We correlated the abnormal areas on DWI and T2WI with postmortem areas of infarction determined by 2,3,5-triphenyltetrazolium chloride (TTC), 24 hours after the operation. The 30-minute DWI in each MCA-occluded rat demonstrated increased signal intensity in the ipsilateral MCA territory, while T2WI showed no changes. At 3 hours, the ipsilateral DWI signal intensity increased further and the area of abnormality slightly increased. In some animals, the 3-hour T2WI disclosed an area of hyperintensity significantly smaller than that seen on the 30-minute DWI. TTC staining demonstrated an extensive MCA infarction in all rats with permanent MCA occlusion, confirmed by hematoxylin and eosin staining. The percent infarcted area of coronal brain sections, as determined by TTC staining, correlated significantly with areas on similar DWI sections at both 30 minutes and 3 hours. Sham-occluded control animals did not display any changes on DWI, T2WI, or TTC staining. The present study suggests that DWI is a very sensitive modality for detecting early ischemic brain injury, being highly correlated with post-mortem area of infarction, and may be useful to assess pharmacologic intervention.

Animals↗
PubMed1992

Giant T-wave inversion in patients with acute coronary insufficiency.

We have observed an electrocardiographic (ECG) pattern of deep T-wave or "giant T wave" inversion in patients with acute coronary insufficiency. We reviewed the ECGs of 936 patients admitted to our coronary care unit during a one-year period. We found the pattern of giant T-wave inversion was present in nine patients (1 percent). We examined the echocardiograms of all of these patients and we analyzed the coronary angiograms on the seven patients in whom it was performed. We found that giant T-wave inversion was usually found in patients with stenosis in the left coronary system. In addition, the majority of these patients also had echocardiographic evidence of left ventricular hypertrophy. We conclude that the high frequency of a partially patent vessel in the left coronary system suggests that this ECG pattern may be useful in identifying patients who might benefit from coronary revascularization.

Acute Disease↗
PubMed1992

Parents' views of adolescent health issues.

To determine how important the parents of teenagers consider adolescent health issues to be and the kind of involvement they would like from their schools and physicians, a questionnaire was sent to 1090 families with children attending two public high schools in a suburban community. The 438 parents who completed the questionnaire (40% response rate) indicated that their adolescents had a mean age of 16.2 years, 52% were male, 54% were in grades 11 and 12, and 70% received regular care from a pediatrician. Most parents considered substance use, sexuality, mental health issues, nutritional concerns, and general medical issues to be issues requiring attention nationally; many considered these issues to require attention locally; fewer considered these issues to require attention for their teenager's friends; and only some indicated these issues require attention for their own teenagers. More than 95% of respondents said parents should discuss these topics with their teenagers, more than 80% said they themselves did, and more than 85% said they wanted these issues discussed with their adolescents in school. Approximately three quarters of parents said that they would bring their adolescent to their regular doctor for management of these issues, expected that their physician would be comfortable with such care, and wanted their doctor to discuss these issues with their teenagers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗