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Biomedical subjects

S Cohen

Publications and source records attributed to S Cohen.

At least 649 records · Page 36Linked to original sources
PubMed1987

Whole bowel irrigation as a decontamination procedure after acute drug overdose.

Whole bowel irrigation, routinely used before colonoscopy, is evaluated as a potential gastrointestinal decontamination procedure for acute drug overdose. Nine adult volunteers, who served as their own controls, each ingested 5.0 g of ampicillin trihydrate on two occasions, one week apart. Whole bowel irrigation with polyethylene glycol electrolyte lavage solution was performed one hour after one ingestion. Serial serum ampicillin levels, electrolytes, osmolalities, body weights, and hematocrits were obtained. The areas under the concentration vs time curves for ampicillin were computed for both groups, and their means were compared. Mean duration of the procedure was 234 minutes and mean volume of infused polyethylene glycol electrolyte lavage solution was 7.7 L. Whole bowel irrigation produced a 67% decrease in ampicillin absorption and there were no significant changes in body weight, hematocrit, serum electrolytes, or osmolality. We conclude that whole bowel irrigation is an effective and safe gastrointestinal decontamination procedure for acute drug ingestion.

Adult↗
PubMed1987

Computerized visual field and choroidal malignant melanoma.

We present a case report of suspected retinal malignant melanoma that was followed up with a threshold sensitivity visual field test. The correlation between computerized visual fields as used in proving retinal function disabilities and other tumor-growth diagnostic tools is discussed.

Aged↗
PubMed1987

An evaluation of the efficacy of arthroscopic synovectomy of the knee in rheumatoid arthritis: 12-24 month results.

Nine patients with rheumatoid arthritis (10 knees) with chronic knee synovitis unresponsive to medical therapy were entered into a prospective study of arthroscopic total synovectomy of the knee. Histopathological examination of the synovium revealed a proliferative synovitis in all knees. Patients were ambulatory and exhibited 90 degrees of knee flexion on the day after surgery and were discharged at 24 to 48 h postoperation. Mean joint tenderness and swelling improved from the preoperative level and was maintained for the initial 12 months of the study. Knee range of movement was improved in all patients (mean 21 degrees). Improvement of joint function in daily activities was also demonstrated, but patients with Grade IV articular cartilage damage failed to show significant improvement. Nine knees were followed for at least 24 months and 4 required repeat surgery. Arthroscopic synovectomy is comparable to synovectomy by arthrotomy in short term reduction of pain and swelling. The chief benefit of arthroscopic synovectomy is a reduction in morbidity, hospital stay and postoperative rehabilitation.

Adult↗
PubMed1987

Implantation growth of an iris melanocytic lesion simulating a ciliary body melanoma.

A 59-year-old woman had a sectorial pigmented iris tumor in her right eye and was found to have secondary glaucoma unresponsive to medical therapy. Gonioscopy revealed a satellite tumor in the inferior chamber angle, which we suspected to be a ciliary body melanoma. Subsequently, both lesions were removed completely by superior total and inferior partial iridocyclectomy. Histologic examination disclosed a spindle cell nevus with surface plaque associated with a borderline epithelioid cell nevus. This case is an example of unexpected clinical findings that may be encountered in any iris melanocytic lesion, benign or malignant, and the consequent problems of diagnosis and management.

Ciliary Body↗
PubMed1987

An improved comprehensive medical kit for passenger aircraft.

For the past 20 years, El Al has been carrying drugs and equipment for use by physicians on board the aircraft for medical emergencies. In addition, first aid equipment including a resuscitator (respirator)--to be used by the trained cabin attendants--and over-the-counter medications in a Hostess Purse are also carried. We have recently adopted a standard medical kit (MK) which contains primarily drugs considered essential to emergency cardiac care. However, its contents were extended, based on our experience in the airline and the recommendations of the Air Transport Medicine Committee of the Aerospace Medical Association. This would enable a competent physician on board to reasonably manage most medical emergencies until landing at the scheduled destination or at the nearest safe airport where better diagnostic means and treatment may be available. Equipment and drugs are designed to handle most acute allergic, cardiac, respiratory, gastrointestinal, renal, nervous, and psychiatric emergencies. Also included in the MK is a table of the drugs, their trade name, generic name, action, indications, contraindications, administration, and dosage. A check-off list of the drugs and equipment used by the physician, as well as space for provisional diagnosis and disposition, is provided.

Aircraft↗
PubMed1987

Chronic severe constipation. Prospective motility studies in 25 consecutive patients.

The purpose of this study was to determine the patterns of gastrointestinal and anal sphincter motility in 25 consecutive patients with severe constipation. Three patterns of abnormal motility were observed in 68% of the patients: (a) isolated anal sphincter dysfunction (20%), (b) a generalized disorder of gastrointestinal motility (24%), and (c) rectosigmoid dysfunction (24%). The remaining patients had either a previously unrecognized primary disorder leading to constipation or the irritable bowel syndrome. Duration of symptoms, laxative usage, or other historical features failed to distinguish each of the groups. Anal sphincter dysfunction was diagnosed by demonstrating impaired sphincter relaxation during rectal distention. Generalized motor disorders were diagnosed by demonstrating impaired colonic and esophageal function together with an abnormality in gastric emptying. Rectosigmoid dysfunction was manifest by an impaired rectosigmoid motor response to feeding without evidence of other organ dysfunction. These studies indicate that a high percentage of patients with more severe degrees of constipation have a serious but sometimes treatable disorder of bowel function, rather than the irritable bowel syndrome.

Adult↗
PubMed1987

Efficacy of Doppler echocardiography in the evaluation of aortic stenosis during pregnancy.

The recently developed technology of Doppler echocardiography was used to evaluate a pregnancy complicated by aortic stenosis. Given the lack of established norms for this test during pregnancy and the known cardiovascular changes during pregnancy, it is difficult to interpret this test. However, in the case presented, this test suggested the need for more conservative management, a plan that was justified postpartum.

Adult↗
PubMed1986

The IgG subclass distribution of thyroid autoantibodies.

There have been several conflicting reports concerning the subclass distribution of thyroid autoantibodies. We have therefore reinvestigated this with both a radioimmunoassay and an ELISA based on the use of a variety of monoclonal antibodies. Our results demonstrate the presence of subclasses IgG1, IgG2, IgG3 and IgG4 in both thyroglobulin and microsomal autoantibodies from patients with either Graves' disease or Hashimoto's thyroiditis. However, in many patients there is over-representation of the IgG4 subclass. We also found marked differences in the binding characteristics of monoclonal antibodies directed against the same subclasses, underlining the need for appropriate selection of such monoclonal reagents in any assay.

Antibodies, Monoclonal↗
PubMed1986

A calcium-dependent 35-kilodalton substrate for epidermal growth factor receptor/kinase isolated from normal tissue.

We have previously reported the isolation of a 35-kDa protein from A-431 cells that, in the presence of Ca2+, can serve as a substrate for the epidermal growth factor (EGF) receptor/tyrosine kinase (Fava, R.A., and Cohen, S. (1984) J. Biol. Chem. 259, 2636-2645). We now report the detection of an antigenically related 35-kDa protein in a number, but not all, of rat, pig, and human tissues. These antigenically related proteins also can serve as substrates for the EGF receptor/kinase in the presence of Ca2+. All of these proteins share the property of reversible, Ca2+-dependent binding to the particulate fraction (presumably membranes) of cell homogenates. We have isolated the 35-kDa substrate from porcine lung and have demonstrated that it is a Ca2+-binding protein. The amino-terminal sequence and the site of tyrosine phosphorylation therein have been determined. The positions of the acidic amino acid residues amino-terminal to the tyrosine phosphorylation site bear a distinct resemblance to the sequence in the homologous region of a number of other substrates for tyrosine kinases. Based on available data, the 35-kDa protein clearly differs from the protein I complex derived from intestinal mucosa and thought to be related to the proteins isolated herein (Gerke, V., and Weber, K. (1985) J. Biol. Chem. 260, 1688-1695). Finally, we report a striking sequence homology between the porcine 35-kDa described herein and human lipocortin, a phospholipase A2 inhibitor.

Amino Acid Sequence↗
PubMed1986

[Infectious endocarditis, complication of mitral valve prolapse].

Among 77 patients with bacterial endocarditis on native valves explored by echocardiography, 12 (7 male, 5 female, mean age: 50 years) presented with mitral valve prolapse. This condition is relatively common, being found in 15.5% of patients with bacterial endocarditis and in 32% of those with mitral valve endocarditis. Two-dimensional TM echocardiography showed the mitral valve prolapse in every case and, in 11/12 cases, a vegetation associated with a varying degree of thickening of the valve due to myxoid degeneration. Although cardiac signs were sometimes minimal. Ten hemocultures were positive: 7 for streptococci, 2 for staphylococci and 1 for Hemophilus para-aphrophilus. Two patients died of cerebral haemorrhage, and there were 2 cases of hemiplegia, 4 cases of transient left ventricular failure and 2 cases of spleen embolism. These findings suggest that prophylactic treatment of bacterial endocarditis should be undertaken in patients with mitral valve prolapse and signs of myxoid degeneration at echocardiography.

Adult↗
PubMed1986

Physicochemical studies of processes involving potential photodynamic drugs on route to their targets: self-aggregation and membrane-binding of Zn-hematoporphyrin.

The thermodynamics of zinc hematoporphyrin (ZnHP) dimerization and ZnHP-membrane binding were studied. The dimerization equilibrium was determined over the temperature range 19-40 degrees C, using fluorometric techniques. The dimerization constant obtained at 37 degrees C (neutral pH in phosphate-buffered saline) is 4.6 (+/- 0.6) X 10(4) M-1. The dimerization was found to decrease with temperature over the range 19-36 degrees C, the data allowing the extraction of the following thermodynamic parameters for the temperature range 19-31 degrees C: delta G0 = -9.3 kcal/mol, delta H0 = -7.4 kcal/mol, delta S0 = -6.4 eu. For temperatures above 36 degrees C the dimerization was found to be temperature independent, giving the following parameters: delta G0 = -6.6 kcal/mol, delta H0 = 0 kcal/mol, delta S0 = 21.2 eu. On the basis of the data the case is made for the existence of two types of ZnHP dimers, differing in the location of the fifth Zn2+ ligand and in the nature of the contribution of the solvent to the dimerization. For the membrane binding, large unilamellar liposomes served to model biological membranes. The binding of ZnHP to the liposomes was found to be similar, quantitatively, to the corresponding metal-free molecule, namely, fitting a case of one type of site and giving a binding constant of 1600 +/- 160 M (neutral pH and 37 degrees C) which is independent of the length of the porphyrin-liposome.

Binding Sites↗
PubMed1986

A study of the contractile response to acetylcholine in human ileal and detrusor muscle: origin of the low efficacy of acetylcholine.

In Krebs solution (3.36 mM Ca2+), the maximal contractile response of human ileal and urinary bladder detrusor muscle to acetylcholine (ACh) was 40-60% that to carbachol (CCh). The maximum response to ACh was reached at a bath concentration of about 1 microM and was maintained throughout a range extending to 100 microM. In the presence of neostigmine (0.1 microM), the maximum response to ACh reached the level of that of CCh. However, bioassay of bath concentrations of ACh at various points of the maximal response in the absence of neostigmine revealed only slight to insignificant diminution of the applied concentration of ACh. Joint application of ACh and CCh generated a dose-response profile consistent with a model of competitive antagonism between a full agonist (CCh) and a partial one (ACh). Also, choline (100 microM) reduced the maximum response to ACh in the presence of neostigmine and that to CCh to 60-80% of control. These observations are consistent with a mechanism whereby intact cholinesterase together with its substrate ACh and possibly a breakdown product of ACh constitute a filter or diffusional barrier regulating the flow of agonist from the enzyme compartment to the receptor compartment.

Acetylcholine↗
PubMed1986

[Hypertrophic myocardiopathy. Course and prognosis. 60 cases].

The evolution of 60 cases of hypertrophic cardiomyopathy over a mean period of 6.3 years is described. The cases were separated according to echo-cardiographic findings into 4 categories: obstructive cardiomyopathy (29 cases), asymmetrical septal hypertrophy (22 cases), diffuse cardiomyopathy (6 cases) and apical cardiomyopathy (3 cases). A number of complications occurred during the follow-up, consisting of cardiac failure (20 cases), embolic accident (9 cases), aortic endocarditis (1 case) and arrhythmia (32 cases including 12 cases of supraventricular arrhythmia and 20 cases of ventricular arrhythmia). Five patients died suddenly. These data are compared with those obtained from the literature in an attempt to determine the main prognostic factors in hypertrophic cardiomyopathy.

Adolescent↗
PubMed1986

Body contouring by liposuction. A 3-year experience with 1 509 procedures.

A series of 1 509 procedures of liposuction (in 333 patients) over a 3-year period is described. Liposuction is a surgical procedure used to remove localized collections of fat, which are resistant to diet and exercise. The fat is removed by suction through a blunt-ended cannula inserted into the area through a small wound. Advantages are the production of unobtrusive scars, rapidity of surgery, permanence of the result and short-lived postoperative morbidity. Complication rates are uniformly low. Disadvantages are a tendency towards immediate postoperative hypotension unless guarded against, the need for careful patient selection, and the need for a considerable degree of experience in the procedure on the part of the surgeon.

Adipose Tissue↗