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R Stark

Publications and source records attributed to R Stark.

At least 37 records · Page 2Linked to original sources

[The value and consequences of nocturnal pulse oximetry in severe heart failure, suspected myocardial infarct and acute cerebral ischemia].

On extensive clinical monitoring of nocturnal oxygen saturation (Minolta Pulsox 7) we observed three groups with an increased risk of nocturnal hypoxemia. The hypoxemia was classified in terms of severity, frequency and duration into six groups of findings. The degree of oxygen desaturation was positively correlated to the severity of disease. In the group of patients with heart failure (NYHA III-IV) (n = 13) four had severe hypoxemia, and a history of previous cardiac infarction; three of them wore a pacemaker. Decrease in saturation after acute cerebral ischemia was seen in particular in patients with oropharyngeal disorders (dysphasia and dysphagia). In the group with suspected myocardial infarction (n = 16) we measured frequent short drops in saturation in ten patients, eight of whom were heavy snorers. Because of its simplicity, non-invasiveness and high information yield, especially in acute patients, pulse oximetry is important for clinical diagnosis, with immediate consequences for many patients.

Brain Ischemia

Contrasting effects of 5 alpha- and 5 beta-pregnane-3,20-dione on the motor activity of ovariectomized rats.

While progesterone metabolites have long been known to be potent anesthetics in pharmacological doses, there is no available information as to their effects on behaviour at physiological levels. In this study, 5 alpha- and 5 beta-pregnanediones in silastic capsules were implanted in ovariectomized rats. Approximately 4 mg/kg/day was absorbed over a 24-day period. Rats receiving 5 beta-pregnanedione had decreased motor activity (58% control, P less than or equal to 0.001) while those receiving the 5 alpha-isomer had increased activity (143% control, P = 0.01). These studies suggest that these progesterone metabolites may be responsible for some behavioural changes.

5-alpha-Dihydroprogesterone

Atypical manifestations of pulmonary adenoid cystic carcinoma.

Pulmonary adenoid cystic carcinoma (PACC) typically arises in large airways. A patient who presented with a peripheral lung mass due to PACC is reported. She was found to have multiple pulmonary nodules due to PACC 11 years after resection of the original tumour. We emphasize that 10-15% of patients with PACC present with peripheral tumours.

Carcinoma, Adenoid Cystic

Lay workers in primary health care: victims in the process of social transformation.

The training and utilization of non-professional Primary Health Care Workers (PHCW's) is currently a major strategy for meeting the minimal health needs of the four-fifths of the world's population without permanent access to care. Increasingly, however, in countries where the wealth is in the hands of the few, PHCW's are become victims of political violence. Because the implementation of the Primary Health Care Model in these Third World countries requires a major transformation of the existing socioeconomic structures, the PHCW may be knowingly or unknowingly placed in a vulnerable situation. This relates to the various functions--both latent and manifest--of the PHCW's role as well as to the way they have been trained and utilized. That PHCW's may be utilized as vehicles of a nation's overall political strategy is demonstrated by the role of the 'barefoot' doctors during the cultural revolution in China. In contradistinction, they may be trained and utilized as part of a government's strategy to 'take over' struggling liberation groups and to 'cool out' potentially explosive situations. In addition, they may be used as spies as may their foreign counterparts and trainers. PHCW's trained in programs which encourage health workers to participate with the community in a critical analysis of the root causes of their ill health may be subject to reprisals if, in fact, they actually participate with the community in the development and implementation of strategies designed to combat the underlying social causes of their problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Health Services

Comparison of enteric-coated levodopa with levodopa-carbidopa combination. A double-blind crossover trial.

Twenty-seven patients with idiopathic Parkinson's disease completed a double-blind crossover trial which compared enteric-coated levodopa (Prodopa) with levodopa-carbidopa combination (Sinemet). It was easy to stabilize the patients' condition with either drug, and the dose-sparing effect both of the enteric-coated preparation, and of the levodopa-carbidopa combination was again noted. At the dosages used, the levodopa-carbidopa combination was objectively shown to be more effective in 71% of the patients investigated, although there was no clear personal preference for either preparation when patients compared the two parts of the trial. Both drugs play a valuable role in the treatment of Parkinson's disease.

Adult

Detection and partial characterization of a new murine T-lineage antigen: evidence for its enzymatic modulation.

A molecule with an apparent molecular weight of 21,000 daltons was found to be a predominating differentiation antigen of peripheral rat T lymphocytes. This antigen is also expressed on the cell surface of thymus lymphocytes though partially in masked form. The observation that these determinants could be unmasked by neuraminidase treatment in vitro suggests that enzymatic processes may play an important role in antigenic transformation along the differentiation pathway of T axis lymphocytes. Since this structure was found to be displayed also by peritoneal exudate macrophages, it is referred to as T lymphocyte-macrophage antigen. The finding that an identical antigen could be identified in the mouse suggests its more common biological significance.

Animals

Bromocriptine in lieu of levodopa for Parkinson's disease.

Thirteen patients with Parkinson's disease, whose disability was increasing and on long-term levodopa therapy (both with and without carbidopa), had the levodopa fully replaced by bromocriptine. At three months, eight of the 13 patients (62%) were less disabled on bromocriptine and none became worse. The present indications for the use of bromocriptine are discussed.

Adult

Sixth graders can take blood pressures.

A curriculum guide entitled "Heart Health Curriculum Guide" was developed with and by teachers in Peabody Public Schools under a Massachusetts Public Health grant to the American Heart Association. The 67-page manual describes the format of the 12-hour teacher workshop, background physiology of heart/circulatory system, hypertension risk factors, a set of 20 lessons, and evaluating procedures. (Copies may be obtained for $3.00 by writing the corresponding author.) As a result of teaching this unit, sixth grade students in each school ran a Blood Pressure Screening Clinic for their parents and school staff.

Blood Pressure Determination

Serological and chromatographic analyses of antigenic structures detected in human brain, thymus and lymph nodes.

In the present paper it is shown that the non-species specific determinant of the antigenic thymus-brain system previously detected in murine and human brain also exists in human thymus. However, in contrast to the situation in mice and rats this antigenic structure is not expressed on suspended thymic lymphocytes, but is associated with thymic tissue largely depleted of thymic lymphocytes. Moreover, this determinant is also detectable in human lymph nodes. Besides the non-species-specific antigenic determinant human thymus and brain also share a species-specific determinant. In contrast to the non species specific determinant this structure is also displayed by suspended thymic lymphocytes, certain peripheral blood lymphocytes and bone marrow cells. The non-species-specific determinant detected in human thymus is borne by a structure, which physico-chemically resembles the thymus-brain antigen isolated from murine brain and thymus as well as from human brain. Although the structure bearing the species specific antigenic determinant has a similar apparent molecular weight both antigens could be separated by ion exchange chromotography indicating their molecular diversity.

Animals

Analysis of the antigenic structure of the thymocyte surface membrane by heterologous anti-thymocyte serum.

The surface membrane of rat thymocytes and lymph node cells was analyzed by comparing the capability of different rat cell types and of solubilized and chromatographically separated rat thymocyte membrane fractions to absorb cytotoxic antibodies on rat thymocytes and lymph node cells from a heterologous anti-rat thymocyte serum. The experiments described cause distinct antigenic specificities of the thymocyte membrane to be brought into relationship to structures of defined physio-chemical properties, and thus are an approach of a thymocyte cell surface mapping in antigenic as well as in molecular terms. Futhermore, the data presented allow conclusions on the distribution pattern of single antigenic determinants on different cells or tissues used as absorbents and target cells.

Animals

Evidence for the presence of choleragen receptor on the thymocyte-brain antigen molecule of mice.

CBA thymocytes were subjected to cocapping experiments using AThy-1.2 and choleragen. The finding that both structures showed a common ligant-induced redistribution implies that choleragen receptors of the cell membrane are associated with the thymocyte-brain molecule. Furthermore, it was found that the thymocyte-brain antigenic determinants on the thymocyte were not blocked by prior choleragen treatment. This suggests a spatial distance between these structures on the molecule.

Animals

Detection and molecular characterization of the thymus-brain antigen in human brain.

Anti-human brain sera were found to contain antibodies reacting with determinants present on murine thymocyte plasma membranes. This determinant is borne by the thymocyte-brain antigen of mouse thymocytes. The non species-specific determinant of the thymocyte-brain system is detectable on the thymocyte-brain antigen of human and mouse brain in comparable amounts. In contrast to these findings, the allogenic Thy-1 and the species-specific determinant of this system were only found on the thymocyte-brain antigen of mouse brain but not on the corresponding antigen of human brain. The molecular weight, Stokes radius and diffusion coefficient of the thymocyte-brain antigen of human and mouse brain are in good accordance with the data estimated for the corresponding antigen of murine thymocytes.

Animals

[Enuresis].

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Child