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Biomedical subjects

M Kushner

Publications and source records attributed to M Kushner.

65 records · Page 4Linked to original sources
PubMed1984

Contralateral cerebellar hypometabolism following cerebral insult: a positron emission tomographic study.

Positron emission tomographic studies of 16 patients with cerebral ischemia and brain tumor showed asymmetries in cerebellar metabolism not encountered in 14 normal control subjects. An asymmetry was present in 62.5% of cases. The lower metabolic rate occurred in the cerebellar hemisphere contralateral to the cerebral lesion (p less than 0.001; sign test). In all cases computed tomography showed the supratentorial lesion to be unilateral and the posterior fossa contents to be unaffected. The presence of depressed cerebellar metabolism was highly associated with involvement of the contralateral parietal lobe (p less than 0.02; phi coefficient). The presence of a cerebellar abnormality was not related to the presence of any particular sign. Serial studies showed normalization of cerebellar metabolism over time. It is likely that this effect is a result of interruption of the functional interconnections between the cerebrum and the cerebellum.

Adult↗
PubMed1984

Methadone dose decreases and anxiety reduction.

This research evaluated the efficacy of an Anxiety Reduction program designed to reduce anxiety early in methadone detoxification and thereby facilitate dose reduction. Major outcome variables were methadone dose, alcohol and illicit drug use, and withdrawal symptomatology. Fifty-three subjects were recruited and randomly assigned to Anxiety Reduction or Control conditions, and were followed for 48 weeks after study start. Statistically significant differences in dose between Anxiety Reduction subjects and Controls occurred early in treatment, and could only be interpreted when initial dose and initial mood disturbance were taken into account. The differences were not of sufficient magnitude to be of clinical importance, and reflected differences in the small number of subjects who changed dose, rather than overall group trends. Anxiety Reduction subjects reported less alcohol use at treatment termination and at follow-ups, and fewer withdrawal symptoms at termination. They were also less likely to be dropped from treatment for disciplinary reasons. High initial anxiety about detoxification was related to minimal dose reduction in both conditions. Also, in both conditions, anxiety increased with decreasing dose.

Adult↗
PubMed1984

The electrophysiologic effects of oral cibenzoline.

Five male patients with chronic stable ventricular arrhythmias underwent a placebo controlled ascending dose study with oral cibenzoline, a new type 1 antiarrhythmic drug. Ambulatory ECG (Holter) recordings and electrophysiologic studies were done while on placebo and on the maximum dose of cibenzoline. Drug toxicity, manifested by vomiting and QRS widening, accompanied by very high serum cibenzoline concentrations, was seen in two patients. A major reduction (greater than 85% in ventricular premature beats occurred in three patients including two in whom only relatively low serum concentrations had been achieved. Cibenzoline caused significant increases in AH (97 +/- 26 vs. 110 +/- 23 msec, p less than 0.01) and HV (59 +/- 7 vs. 78 +/- 7 msec, p less than 0.02), a major but statistically not significant increase in QRS (99 +/- 12 vs. 128 +/- 27 msec, NS) but QT (38 +/- 2 vs. 38 +/- msec) and QTc (42 +/- 1 vs. 44 +/- 3 msec) were essentially unchanged, even in toxic patients. Cibenzoline had no consistant effect on sinus cycle length, sinus node recovery time, or the relative, functional or effective refractory periods of the atrium and AV node. We conclude that cibenzoline has potent type 1 effects in prolonging HV but may be unique in not affecting QT or QTc, even at toxic levels. Its effects upon AH were unexpected and warrant further study.

Aged↗
PubMed1984

Cerebral hemodynamics in the diagnosis of normal pressure hydrocephalus.

We studied the effect of CSF drainage on cerebral blood flow (CBF) in normal pressure hydrocephalus (NPH) and non-NPH dementia using the 133Xenon inhalation technique. Dementia patients had lower CBF than matched elderly normals. Flow values for NPH and non-NPH patients did not differ before or after CSF drainage. CBF did not increase after lumbar puncture, and these measurements were not useful in predicting the outcome of ventricular shunt surgery. Postoperative CBF did not increase after successful shunting.

Cerebrospinal Fluid Shunts↗
PubMed1983

Zomepirac-induced serum sickness. A report of two cases.

Two patients, after several weeks of zomepirac sodium use, experienced acute toxic eruption, fever, lymphadenopathy, arthralgias, angioedema of the hands, and eosinophilia. We believe that these cases represent type 3 allergic reactions to zomepirac.

Adult↗
PubMed1981

Period of risk hypothesis after prophylactic radiotherapy.

A critical review is given of the period of risk hypothesis (Collins's law) in regard to treated medulloblastoma. Exceptions to the law are seen to be of two types. The first type involves recurrence of the primary tumor, either local or disseminated, and is normally observed close to the limit of the risk period. The second type usually presents a malignant astrocytoma at a considerable multiple of the risk period. The relevant pathological and cellular kinetic data are reviewed to answer the question whether glial tumor recurrence is due to dedifferentiation of the primary cell line or is secondary to the therapeutic irradiation.

Brain↗
PubMedDate not supplied

Changes in cerebral blood flow and recovery from acute stroke.

We prospectively studied 14 patients with acute cerebral infarctions using serial 133Xenon inhalation cerebral determination (133Xe-rCBF), scored neurological examinations, and neuropsychological testing. All patients underwent the same battery of tests at 3 days, 1 week, 2 weeks, and 4 weeks after cerebral infarction to determine the prognostic value of early rCBF studies and the chronological relationship of changes in rCBF to clinical status. Baseline rCBF within 3 days of symptoms of acute stroke did not correlate with clinical neurological outcome (r = -0.17, p less than 0.30; r = -0.18, p less than 0.28, for the two indices of rCBF used). Among the 11 patients demonstrating neurological recovery, 7 improved at 1 week, significantly before increases in rCBF (p less than 0.05). We conclude that early baseline rCBF does not predict clinical outcome in patients with acute cerebral infarctions and that return of neurological function precedes rather than follows increases in rCBF.

Aged↗
PubMedDate not supplied

Regional cerebral blood flow in stroke: hemispheric effects of cognitive activity.

Regional cerebral blood flow (rCBF) was measured with the xenon-133 inhalation technique in 15 patients with unilateral cerebral infarction and 12 matched controls. Measurements were performed during a standard resting baseline condition and during the performance of standardized verbal analogies and spatial line orientation tasks. Resting and activated CBF were lower in patients than in controls, and there were differences in the hemispheric pattern of activated CBF. Control subjects replicated earlier findings of asymmetric increase in CBF for the cognitive tasks, whereas patients showed abnormalities in lateralized CBF changes consistent with side of infarction. These findings underscore the utility of cognitive challenges in the study of rCBF in stroke. This can lead to an experimental paradigm in clinical studies of the relation between behavioral deficits and regional brain dysfunction and may also improve the utility of CBF measurements in clinical settings.

Cerebrovascular Circulation↗
PubMedDate not supplied

White noise as a pretest sensitizer for neonatal hearing screening.

To determine the effects of white noise as a pretest sensitizer in neonatal hearing screening, 450 neonates were tested under 18 test conditions which also permitted examination of infant state and criterion stimuli (warble tone versus narrow band noise) as variables. There were three pretest conditions: No pretest sensitizer; 90 dB pretest sensitizer, and 100 dB pretest sensitizer. Each pretest condition was followed by either a 90 or a 100 dB criterion stimulus. Analysis concerned an increase in the number and in the strength of the responses. Generally, there was no benefit associated with the use of white noise as a pretest sensitizer.

Acoustic Stimulation↗
PubMedDate not supplied

A multicenter comparison of adhesion, preference, tolerability, and safety characteristics of two transdermal nitroglycerin delivery systems: Transderm-Nitro and Deponit.

One hundred forty-two patients with stable angina were enrolled in a four-week, multicenter, office-based study to compare the adhesion properties, patient preference, and tolerability of two commercially available transdermal nitroglycerin patches. Data from 139 patients were analyzed. Each patient simultaneously wore one 5-mg Transderm-Nitro (TDN) patch and one 5-mg Deponit (DPT) patch. Patients daily recorded the following information in a diary format: number of angina attacks, frequency of sublingual nitroglycerin use, patch adhesion, and problems at the adhesion site or other medical problems. At the end of the study, patients rated their patch preferences based on ease of application and removal, ease of removing backing, overall adhesion, and adhesion under specific conditions, such as showering, swimming, exercise, hot weather, high humidity, and perspiration. They also specified which patch they would choose for their next prescription. Differences in adhesion properties (P less than 0.0001) and tolerability at the site of application favored TDN over DPT. In addition, significantly more patients (P less than 0.0001) specified TDN as their next prescription choice (83% vs 11%).

Adhesiveness↗