PubMed Health⌕ Search

Biomedical subjects

R D Levin

Publications and source records attributed to R D Levin.

7 recordsLinked to original sources
PubMed1991

Phase I clinical trial with floxuridine and high-dose continuous infusion of leucovorin calcium.

Sixty-two patients with metastatic disease were treated with continuous infusion folinic acid (leucovorin calcium; Lv) and 2-deoxy-5-fluorouridine (floxuridine; FUDR). Lv was given by constant intravenous (IV) infusion at 500 mg/m2/d, days 1 to 6, while FUDR was given by IV push, days 2 to 6, at 3:00 PM daily with doses ranging from 294 to 1,214 mg/m2/d. This program was well tolerated with dose-limiting toxicities of diarrhea and stomatitis, while hematologic toxicity was minimal. Eighty-two percent of the assessable patients (46 of 56) had failed at least one chemotherapy regimen. One complete remission lasting 9 months and 10 partial remissions ranging from 5 to 10 months were observed in this heavily pretreated patient population for an overall response rate of 20%. These data suggest that the combination therapy with Lv and FUDR may have clinical use. Because of differing patient sensitivity to this drug combination, the recommended dose of FUDR for the initial therapy cycle is 500 mg/m2/d, days 2 to 6, with subsequent escalation to 900 mg/m2/d in those patients without extreme sensitivity. Phase II studies are now in progress with these doses.

Adult↗
PubMed1991

[Intracavernous pharmacotherapy for treatment and evaluation of impotence].

Impotence affects about 10% of all men. During the past decade it has been treated with self-injection of vasoactive drugs into the erectile tissue. In 1982 Virag reported experience with intracavernous injection of papaverine. Since then other vasoactive drugs, such as prostaglandin E1 (PGE1), have been used successfully, and self-injection has been advised. Between 1987-1989 we evaluated 550 patients with erectile dysfunction and 95 aged 21-79, mean 53.7, were found suitable for this treatment, of whom 80 were entered into an autoinjection protocol, of 74 were treated with a mixture of papaverine and regitine and 6 with PGE1. The volume of the injections ranged from 0.1 to 1.0 ml, and erections lasted from 15 minutes to 8 hours. 72% of the patients continued autoinjection during a mean follow-up of 9.9 months and were satisfied with the results. There were 5 cases of corporal fibrosis, and 3 cases had prolonged erections, usually after the papaverine test. The method is simple and inexpensive, and allows many impotent men to resume sexual life. It is a good alternative to the insertion of a penile prosthesis.

Adult↗
PubMed1979

Fibrinolysis in familial pulmonary hypertension.

Although an autosomal dominant mode of inheritance has been documented for many cases of primary pulmonary hypertension, the pathogenesis of the disease remains unclear. A report of abnormal fibrinolysis in familial pulmonary hypertension has raised the possibility that the pathogenesis may be related to an impaired ability to lyse recurrent pulmonary microemboli. Primary pulmonary hypertension was diagnosed in three of ten members of a kindred. The pattern of inheritance was compatible with an autosomal dominant gene. Eight members of the kindred were available for study, one of whom has primary pulmonary hypertension. The results of coagulation studies, caseinolytic determinations of plasminogen and antiplasmin, and fibrinolytic titers of antiurokinase did not differ significantly from those of the control group. These findings suggest that a deficient fibrinolytic system is not the cause of primary pulmonary hypertension, although differences in methodology may explain our inability to demonstrate abnormal circulating fibrinolysis in this kindred.

Blood Coagulation↗
PubMed1978

Changes in platelet function during hemodialysis.

Platelet function was studied in 34 patients during 74 hemodialyses by means of a Cordis-Dow hollow fiber hemodialyzer (CDAK-4) with anticoagulation by porcine mucosal heparin. The mean arterial platelet levels fell 11% from predialysis values and remained stable throughout a 5 hr hemodialysis session. After 30 min of dialysis, the platelet concentration in afferent and efferent limbs of the dialyzer were similar, although retention of leukocytes was apparent. As measured by platelet aggregometry, heparin was clearly shown to potentiate the extent of aggregation induced by low concentrations of ADP. Platelets of the dialyzer afferent limb were less aggregable than normal and resistant to aggregation induced by submaximal concentrations of ADP or epinephrine. Platelets of the dialyzer efferent limb were aggregable only after excessive stimuli of 50 micrometer ADP or 10 micrometer epinephrine. These findings suggest that direct contact between dialyzer fibers and platelets or rheological effects led to impaired platelet function but that most platelets are not irreversibly injured.

Blood Cell Count↗
PubMed1977

Return of function in the thrombosed kidney after transplantation.

The incidence of intraglomerular thrombi in renal allografts and factors regulating their resolution were studied. A case report is presented in which resolution of intraglomerular thrombi is documented. In addition, 17 transplanted patients with renal biopsies were serially studied. Intraglomerular thrombi were found in 4 of 8 specimens taken 1 h after reanastamosis, all from donors with a terminal course involving prolonged hypotension. Glomerular fibrinolytic activity was markedly diminished in 4 of 11 patients' subsequent biopsy specimens; all taken during acute rejection. Resolution of thrombi was documented when signs of rejection were absent.

Adult↗