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S Polsky

Publications and source records attributed to S Polsky.

11 recordsLinked to original sources

Acetaminophen hepatotoxicity in tumor necrosis factor/lymphotoxin-alpha gene knockout mice.

Recent evidence suggests that macrophages and/or other nonparenchymal cells may release important mediators contributing to the hepatic necrosis induced by high doses of acetaminophen (APAP). The nature and causative role of these mediators has remained elusive, however. To investigate the role of the proinflammatory cytokine, tumor necrosis factor (TNF) in the initiation and early propagation of APAP-induced liver injury, we have used mice deficient in both TNF and the closely related lymphotoxin-alpha (LT-alpha). Male TNF/LT-alpha knockout mice and C57BL/6 wild-type mice were treated with a hepatotoxic dose of APAP (400 mg/kg, intraperitoneally), and the development of liver injury was monitored over 8 hours. Both genotypes exhibited similar basal activities of hepatic cytochrome P450 2E1 and 1A2. After APAP administration, both the rate of glutathione consumption and the extent of subsequent selective protein binding did not differ significantly in the knockout and wild-type mice. The TNF/LT-alpha-deficient mice developed severe centrilobular necrosis and exhibited highly increased levels of serum alanine aminotransferase and aspartate aminotransferase, the extent of which was not significantly different from that in wild-type mice. In C57BL/6 mice exposed to APAP, no increases in hepatic transcripts of TNF or LT-alpha were found by reverse transcription-polymerase chain reaction, nor was immunoreactive serum TNF detected by enzyme-linked immunosorbent assay over 8 hours posttreatment. These data indicate that, in the absence of the genes encoding for TNF and LT-alpha, APAP bioactivation was not altered and mice still developed severe hepatic necrosis. Thus, TNF is unlikely to be a key mediator in the early pathogenesis of APAP-induced hepatotoxicity.

Acetaminophen↗

Pharyngo-esophageal perforation due to blunt trauma.

Pharyngoesophageal perforation due to blunt external trauma is a relatively rare and unreported injury. A patient is presented with such an injury secondary to assault, and the modes of diagnosis and management are discussed.

Esophageal Perforation↗

Treating wounds associated with decreased sensibility.

Neuropathic wounds are a problem most often associated with diabetes, particularly in those patients with decreased sensibility. More often than not, the patient is unaware of the insidious progression of dysfunction and its direct impact on tissue necrosis. Even when the underlying cause is discovered, often no mechanism is present to compensate for the loss of sensory protection. Current pharmacologic treatment for peripheral neuropathy is palliative with capsaicin and amitriptyline, used most frequently to treat symptoms of painful peripheral neuropathy. Orthotists and prosthetists are helpful in developing shoes or support devices to provide relief or lifts from weight-bearing areas in the insensate patient. Proper patient education and primary-care monitoring can greatly decrease the number of non-heating foot lesions and amputations.

Amitriptyline↗