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Biomedical subjects

M Kramer

Publications and source records attributed to M Kramer.

At least 181 records · Page 10Linked to original sources
PubMed1984

The NIMH Epidemiologic Catchment Area program. Historical context, major objectives, and study population characteristics.

The National Institute of Mental Health multisite Epidemiologic Catchment Area (ECA) program is described in the context of four previous psychiatric epidemiologic surveys that included a combined total of 4,000 subjects from Stirling County, the Baltimore Morbidity Study, Midtown Manhattan, and the New Haven third-wave survey. The ECA program is distinguished by its sample size of at least 3,500 subjects per site (about 20,000 total); the focus on Diagnostic Interview Schedule--defined DSM-III mental disorders; the one-year reinterview-based longitudinal design to obtain incidence and service use data; the linkage of epidemiologic and health service use data; and the replication of design and method in multiple sites. Demographic characteristics of community and sample populations are provided for New Haven, Conn, Baltimore, and St Louis.

Adolescent↗
PubMed1984

Six-month prevalence of psychiatric disorders in three communities 1980 to 1982.

Six-month prevalence rates for selected DSM-III psychiatric disorders are reported based on community surveys in New Haven, Conn, Baltimore, and St Louis. As part of the Epidemiologic Catchment Area program, data were gathered on more than 9,000 adults, employing the Diagnostic Interview Schedule to collect information to make a diagnosis. The most common disorders found were phobias, alcohol abuse and/or dependence, dysthymia, and major depression. The most common diagnoses for women were phobias and major depression, whereas for men, the most predominant disorder was alcohol abuse and/or dependence. Rates of psychiatric disorders dropped sharply after age 45 years.

Adolescent↗
PubMed1984

[Hemodynamics and changes in compliance of the extra-thoracic capacity system following administration of prostacyclin (PGI2)].

Hemodynamic effects of prostacyclin (PGI2) given as an intravenous infusion at a rate of 8 ng/kg/min were assessed in 50 patients with coronary artery disease at the time of aortocoronary bypass surgery. 1. During steady-state neuroleptic anesthesia, after sternotomy and pericardiotomy, before cannulation of the aorta and vena cava PGI2 led to the following changes: decreases in mean arterial pressure (-24%), total peripheral resistance (-46%), left ventricular pressure (-12%) and left ventricular end-diastolic pressure (-48%), increases in heart rate (+9%), cardiac output (+41%), stroke volume (+30%) and dp/dtmax (+26%) as well as nonsignificant decreases in right ventricular filling pressure (-13%) and mean pulmonary arterial pressure (-9%) together with an unaltered rate-pressure product. 2. In a randomized double-blind study PGI2 was infused throughout the period from two minutes prior to, until termination of extracorporeal circulation. The effects on compliance of the extrathoracic venous system were analyzed on the basis of changes in venous pressure and oxygenator volume. As compared with controls, patients receiving PGI2 were found to have a significant increase in compliance (.157 ml/mm Hg X kg). Thus, in this setting, PGI2 can affect marked vasodilatation with reductions in peripheral resistance and mean arterial pressure together with increases in cardiac output and heart rate.

Clinical Trials as Topic↗
PubMed1984

Problems in the use of long-acting hypnotics in older patients.

Insomnia and the use of long-acting hypnotic drugs are prevalent in geriatric populations. These drugs have been shown in the laboratory to adversely affect motor performance in the elderly. To examine the clinical significance of these findings, comparisons were made between patients who experienced a fall during their hospital stay and those who did not fall. It was found that patients over 70 years of age who experienced a fall in the hospital were more likely to be receiving flurazepam than the patients who did not fall.

Age Factors↗
PubMed1983

Nocturnal oxygen desaturation in patients with sickle cell anemia.

The sleep of two patients with sickle cell disease was punctuated by periods with notably reduced arterial O2 saturation despite simultaneous normal respiratory rates. The O2 levels returned to baseline during intermittent wakefulness. Gas exchange patterns during sleep may contribute to the morbidity of sickle cell disease.

Adult↗
PubMed1983

Regulation of plasminogen-activator in mastocytoma cells by lymphokines.

Culture supernatants from mitogen-stimulated splenocytes were found to stimulate protease production in P815Y mastocytoma cells. Such supernatants increased cell-associated plasminogen activator levels in a dose-dependent fashion, and under serum-free conditions. In contrast to peritoneal exudate cells, tumor-cell plasminogen activator was not enhanced by the mitogen ConA alone. The tumor cell line P815Y may, thus, be used as a homogeneous cell source for the quantitation of lymphocyte factors which activate or inhibit plasminogen activator activity.

Animals↗
PubMed1983

[Alfentanil, a new, short-acting opioid. Hemodynamic and respiratory aspects].

The haemodynamic and respiratory-depressive effects of 20 micrograms/kg and 40 micrograms/kg of alfentanil in 54 patients with coronary bypass operation were compared with a control group (n = 36). The measurements were carried out at 3 different times, each lasting over a 10 min period: 1. Before induction of anaesthesia but after premedication with flunitrazepam. 2. During anaesthesia and 3. during extracorporeal circulation (standardized conditions).--The preoperative as well as the intraoperative investigations showed a reduction in pulse rate, mean arterial pressure, left ventricular pressure and arterial perfusion pressure during extracorporeal circulation. As cardiac output remained constant in the awake patient, peripheral vasodilatation was predominant. Aside from this during anaesthesia reduction in cardiac output may have been responsible for the decrease in pressure although the cause of this could be the nitrous oxide as well. During the preoperative period a clear increase in wedge pressure, mean pulmonary artery pressure, right atrial pressure and pulmonary vascular resistance occurred from the 3rd minute after the injection. The cause is a vasoconstriction during apnoea. In the intraoperative period this did not occur. The respiratory depression(paO2: -34%, paCO2: +29%) resembles that after fentanyl, except that it starts earlier and lasts for a shorter time. In summary, it can be stated that all effects after alfentanil are similar to those of fentanyl.

Adult↗
PubMed1983

Phenotypic and genotypic differences between high- and low-metastatic related tumor lines and the problem of tumor progression and variant generation.

We have described a number of phenotypic and genotypic differences between defined tumor sublines from the Eb/ESb model system that differ greatly in metastatic capacity. Some of these differences are summarized in Figure 5. It can be seen that the differences are both structural and functional. They include differences in the glycosylation of membrane glycoproteins as well as differences in total membrane protein composition. The functional differences refer particularly to enzymatic activities, cell motility, and invasive capacity. In addition, a change in membrane fluidity and membrane dynamics was seen when we investigated membrane vesicles shed spontaneously from these tumor lines. ESb type cells were found to shed about three times as much membrane material as the low-metastatic, Eb cells. Since such vesicles carried degradative enzyme activity, they could play a role in the invasion process. The vesicles also carried TATA and thus could also play a role in preventing immunological attack against these tumor cells. Another immunological escape mechanism was found to be based on the ability of the high-metastatic cells to generate immunoresistant variants that no longer expressed the respective TATA. A cytogenetic comparison of such immunoresistant variants with the TATA+ line revealed several chromosomal changes. The contribution of chromosomal rearrangements to the ability of malignant cells to generate variants was discussed.

Animals↗
PubMed1983

Pulmonary cryptococcosis and Cushing's syndrome.

Pulmonary cryptococcosis occurred in two patients with Cushing's syndrome, both of whom were successfully treated with amphotericin B and flucytosine. Excessive endogenous production of corticosteroids may have predisposed these patients to the development of opportunistic infection. Persons with Cushing's syndrome and a pulmonary infiltrate should be examined for infection with Cryptococcus neoformans in addition to an examination for ectopic adrenocorticotropic hormone production.

Adult↗
PubMed1983

[Hemodynamic changes following the injection of lormetazepam under premedication and anesthesia conditions in coronary surgery patients].

Lormetazepam, a new short-acting benzodiazepine, was studied in 30 patients undergoing coronary artery bypass grafting (10 patients before induction of anaesthesia, 8 patients before extracorporeal circulation, 12 patients during extracorporeal circulation). Before induction of anaesthesia lormetazepam caused only a small reduction in CI, heart rate and a moderate hypoventilation. During anaesthesia (fentanyl, pancuronium bromide, ventilation with N2O/O2 1: 1) there was a decrease in CI (26%), SI (18%), HR (5,7%), dp/dt (15%) and an increase in TSR (25%) and TPR (32%); Part, PAP, PCWP and PRA remained unchanged. There was a small decrease in myocardial oxygen consumption. During ECC lormetazepam increased the arterial perfusion pressure (20%); the priming volume of the oxygenator decreased by 48% at the same time, indicating venous pooling.

Anesthesia, General↗