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Biomedical subjects

M J Shapiro

Publications and source records attributed to M J Shapiro.

At least 127 records · Page 7Linked to original sources
PubMed1987

Structures and biological activities of three synaptic antagonists from orb weaver spider venom.

The venom of Argiope aurantia, an orb weaver spider, contains a mixture of low molecular weight "argiotoxins", which block neuromuscular transmission in insects. Complete structure elucidation of three argiotoxins reveals common features; a hydrophilic, basic domain of arginine, a polyamine and asparagine is connected to an aromatic moiety contributed either by 4-hydroxyindole-3-acetic acid or 2,4-dihydroxyphenylacetic acid. Structural assignments of two argiotoxins are verified by chemical synthesis. The argiotoxins cause reversible paralysis when injected into insects and this is correlated with a stimulus-dependent inhibition of skeletal neuromuscular transmission at submicromolar concentrations.

Animals↗
PubMed1986

Cervical focal myositis in a child.

Focal myositis is a self limited, benign, inflammatory pseudotumor of skeletal muscle, which spontaneously regresses. A 10-year-old girl presenting with localized swelling of the left sternocleidomastoid muscle was seen with subsequent biopsy proven focal myositis. This is the second report of this distinct disease presenting in the neck and the first in the pediatric age group. Biopsy is the only diagnostic and therapeutic modality necessary.

Biopsy↗
PubMed1985

Catheter aspiration for simple pneumothorax (CASP) in the outpatient management of simple traumatic pneumothorax.

Catheter aspiration for simple pneumothorax (CASP) was evaluated prospectively in the outpatient management of simple traumatic pneumothorax in 17 patients and compared to conventional tube thoracostomy (CTT) in 17 matched control patients. In 16 of the 17 consecutive study patients CASP maintained lung reexpansion without complications. Pneumothorax was due to needle puncture for drug abuse in 11 patients, stab wounds in five patients, and blunt trauma in one patient. The CASP patients were not hospitalized, whereas the control CTT patients averaged 4.9 days' hospitalization. CTT was associated with complications in two patients versus none for CASP. Parenteral analgesics were utilized for greater than 48 hours in CTT patients but were not needed for CASP patients. Costs averaged +310 for CASP compared to +3,030 for CTT. This ongoing pilot study data indicates that CASP is a reasonable alternative to CTT in selected patients with simple traumatic pneumothorax.

Adolescent↗
PubMed1985

Leiomyomatosis peritonealis disseminata.

Leiomyomatosis peritonealis disseminata is a rare benign disorder in females characterized by multiple smooth muscle tumor nodules throughout the peritoneal cavity. All of the reported cases have been in menstrual-age women; some of whom have been pregnant or taking oral contraceptives. We report a postmenopausal woman who had symptoms related to bowel-wall involvement in two episodes 12 years apart.

Female↗
PubMed1984

Reimbursement for autopsies. A personal view.

Postmortem examinations have been reimbursed under Part A of Medicare and as a reimbursable expense of the pathology department by Blue Cross. As diagnostic-related group reimbursement is implemented, hospitals are likely to cut costs by reducing the number of autopsies. Third-party payers representing the private sector will protect the interests of their subscribers or clients by excluding autopsies from coverage. To preserve the clearly demonstrable benefits that the autopsy has for the community, it will be necessary to include the autopsy as a cost of research and education. There are other costs that traditionally have been subsidized by insurance that must also be shifted to research and education. The challenge for the College of American Pathologists is to work with those with similar interests to develop funding separate and distinct from health insurance.

Autopsy↗
PubMed1982

Internal thoracic vein cannulation as a complication of central venous catheterization.

Central venous catheterization is utilized in resuscitation and evaluation of the severely ill patient. It is also employed for total parenteral nutrition. The list of potential complications is extensive and includes catheter malposition, with its attendant morbidity, as the most frequent complication. Inaccurate venous pressure measurements and mediastinal phlebitis have been cited as natural sequelae of inadvertent catheterization of the internal thoracic (mammary) vein (ITV). The histories of four patients who had ITV cannulation are analyzed as to indications for central venous catheterizations, site of insertion, time of delayed recognition, and attendant complications. In addition, the records of 150 consecutive patients who underwent central venous line placement were reviewed to determine the number of lines placed (242), the number and percentage of postcatheterization chest films obtained with standard posterior-anterior (P-A) and lateral technique (70, 29%), the number and incidence of catheterization-associated complications (78, 32%), and the number and incidence of ITV cannulation (5, 2%). No untoward results were seen as a result of this complication in the nine patients discovered, although the potential for morbidity was present. Subtle changes on portable chest films and standard technique P-A and lateral films remain the best protection against complications associated with ITV cannulation.

Adult↗
PubMed1982

Trachea stoma vent voice prosthesis.

Having been in use for the past couple of years, the "duckbill" valved Silastic tube developed by Blom and Singer is well established as a device for vocal rehabilitation of the laryngectomee. The newer "voice button" prosthesis developed by Panje incorporates a similar vale in Silastic. Neither of these devices can be used with tracheal stomal stenosis or with a deep tracheal stoma behind prominent sternomastoid muscles. The ritual of taping the Blom-Singer prosthesis and the frequent failure of the tape to hold are other distinct disadvantages. Limitations are imposed on patient selection with the Panje prosthesis because of the rigid dimensions and the possibility of aspiration of the device, as well as the necessity for manual dexterity on the part of the patient. A new device has been fashioned utilizing the "duckbill" Silastic tube as a valve attached to a new type of trachea stoma button. This appears to have universal application, is not difficulty to change, requires no taping, and is self-maintaining. There is no possibility of aspiration. The device is simple and appears to overcome many of the disadvantages of the other two. The tracheal esophageal puncture must be made in a cephalad direction so that the tracheal air diverted through the prosthesis will be directed toward the pharynx and not toward the esophagus. Prostheses directed caudad will not function and those patients should be repunctured.

Humans↗
PubMed1981

Use of trapezius myocutaneous flaps in the reconstruction of head and neck defects.

The trapezius myocutaneous flap of skin and muscle has, as its major blood supply, the superficial branch of the transverse cervical vessels, which is used as a pedicle. The flap may include the scapular spine as a viable bone graft for mandibular defects. Anatomic and surgical experiences have verified the feasibility of using this flap. The intended vascular pedicle arises separately from the subclavian artery in 25% of these cases. Surgical results using the flap have been excellent. Above the level of the mandible, the flap may lack adequate length. It has been used with success to repair the tongue, floor of the mouth, pharyngeal wall, and skin surface. It is particularly impressive as a method of repairing mandibular defects.

Craniocerebral Trauma↗
PubMed1981

A study of the effects of cardiopulmonary bypass surgery on auditory function.

Cardiopulmonary bypass surgery is commonplace in many medical centers and rare instances of unilateral hearing loss in these patients have been reported and have been attributed to embolism. Two more patients are reported and their discovery prompted a study of pre and postoperative hearing in 68 patients at Newark Beth Israel Medical Center, where a single team performs the cardiopulmonary bypass surgery. Previous similar studies showed no changes following CPB surgery. Almost all patients have been male and prolonged pump times (over 150 min.) were noted in 7 of 11 reports. Based on changes in hearing found on pre and postoperative testing in the 6 patients, 3 groups were developed: those with no change and those with slight changes were compared with those having average deficits of more than 10 db. Prolonged pump times occurred only twice in the series and were not associated with loss. A second milder form of hearing loss, which was bilateral and affected the high tones, was noted in significant numbers. Two of these patients had persistent tinnitus after surgery. Although the series is small, there appears to be an increased susceptibility in males to the development of high tone loss as well. Based on the preponderance of males, with their high incidence of basilar artery atherosclerosis, and the frequent prolonged pump times, perfusion failure seems to be the most likely etiology for the rare cases of hearing loss accompanying cardiopulmonary bypass surgery.

Audiometry, Pure-Tone↗