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Biomedical subjects

T Zimmerman

Publications and source records attributed to T Zimmerman.

34 records · Page 2Linked to original sources
PubMed1992

[Locoregional chemotherapy in the treatment of liver metastasis of breast carcinoma].

Locoregional chemotherapy enables specific treatment of organ metastases by using a dosage of medication that is maximally effective but only has minimal side effects on other organs. Since 1983, we have applied this procedure in patients whose liver represented the only target-organ of metastases. Between 1983 and 1990, locoregional chemotherapy was performed in 59 women suffering from liver metastases of breast cancer. The average age of our patients was 52 years. 4 patients were treated for solitary metastases that could not be resected, in 5 patients the infiltration of hepatic parenchyma with metastases accounted to 25%, in 32 patients hepatic infiltration ranged between 25% and 75% and in 18 patients it surpassed 75%. In 39% of our patients, a partial remission occurred. The mean period of survival after beginning of treatment was 149 days, whereas the longest survival time lasted 1009 days. We conclude that the locoregional chemotherapy, destined for treatment of liver-metastases of breast cancer, with a mean survival time of only five months could insufficiently satisfy our expectations. Therefore, a decision to administer such palliative therapy should be made on an individual basis. In our opinion, one indication represents solitary metastases that are not resectable, a further indication is pain due to expansion of the liver capsule because of diffuse metastases.

Adult↗
PubMed1991

Evaluation of once-daily levobunolol 0.25% and timolol 0.25% therapy for increased intraocular pressure.

In a three-month, double-masked, randomized clinical trial, we evaluated the once-daily ocular hypotensive efficacy of 0.25% levobunolol and 0.25% timolol in 80 patients with open-angle glaucoma or ocular hypertension. Thirty-seven of the 39 patients (95%) in the 0.25% levobunolol group and 35 of the 41 patients (85%) in the 0.25% timolol group successfully completed the three-month study period. The overall mean decrease in intraocular pressure was 5.3 mm Hg (22%) in the 0.25% levobunolol group and 5.4 mm Hg (22%) in the 0.25% timolol group. This difference was not statistically significant. In both treatment groups, effects on mean heart rate and blood pressure were minimal. The data suggest that levobunolol 0.25% and timolol 0.25%, administered once daily, are equally effective in the treatment of open-angle glaucoma and ocular hypertension.

Adult↗
PubMed1991

Percutaneous iliac bone grafting of secondary alveolar clefts.

Secondary bone grafting of residual alveolar clefts has become an integral part of the comprehensive care of children born with facial clefting. Although indications and timing may remain somewhat controversial, bone grafting during the period of mixed dentition has gained widespread acceptance. A number of bone graft sites have been proposed; each has its enthusiastic proponents. We believe that cancellous bone harvested from the ilium provides optimal material to achieve successful alveolar bone grafting. Unfortunately, this site has been associated with significant morbidity, primarily pain, which can prolong a patient's hospitalization. We relate our experience from two centers encompassing 24 patients who underwent percutaneous harvesting of corticocancellous bone grafts from the ilium. With this method we were successful in obtaining adequate quantities of corticocancellous bone with the Craig bone biopsy needle regardless of the cleft size. Each patient was able to ambulate without difficulty within hours of surgery. We are currently performing alveolar bone grafting as an outpatient procedure employing this technique. In addition, we believe this method has particular usefulness in Third World countries.

Adolescent↗
PubMed1991

Comparison of combination pergolide and levodopa to levodopa alone after 63 months of treatment.

We retrospectively compared the clinical state of 14 patients with Parkinson's disease who took pergolide continuously for 63 +/- 17 months (Group I) to that of 12 similar patients who started pergolide and then stopped it after 60 +/- 5 days (Group II). Disability measured during the "on" state did not worsen during the observations period in Group I patients, whereas disability in Group II showed significant deterioration. There were no significant differences in the progression of motor fluctuations between the two groups. Combination treatment with pergolide and levodopa is effective long-term symptomatic therapy for advanced Parkinson's disease and deserves more rigorous study to determine whether or not it also retards progression of Parkinson's disease.

Aged↗
PubMed1989

Contribution of insulin resistance to catabolic effect of prednisone on leucine metabolism in humans.

To determine the role insulin resistance may play in the catabolic effect of high-dose prednisone therapy, healthy volunteers were studied on four occasions with the hormone-clamp technique at two insulin infusion rates. Subjects were studied after 5 days of prednisone (60 mg/day) or no steroid treatment and were infused with somatostatin, glucagon, growth hormone, [3H]glucose, [14C]leucine, and insulin (0.1 or 0.2 mU.kg-1.min-1). At each rate of insulin infusion, the rate of leucine oxidation was increased (P less than .001) after steroid treatment. Leucine flux, an indicator of whole-body proteolysis, was similar in the presence or absence of steroid treatment (2.26 +/- 0.08 vs. 2.13 +/- 0.04 mumol.kg-1.min-1, respectively) at the lower rate of insulin infusion but was higher during steroid treatment (2.18 +/- 0.06 vs. 1.84 +/- 0.13 mumol.kg-1.min-1) at the 0.2-mU.kg-1.min-1 insulin infusion. Steroid pretreatment had no significant effect on the nonoxidative rates of leucine disappearance. These data provide strong evidence that the protein wasting associated with glucocorticosteroid therapy is in part the result of steroid-induced resistance to the antiproteolytic effect of insulin and an increase in the oxidation (and thus wasting) of one essential amino acid, leucine.

Adult↗
PubMed1985

Minimum concentration of levobunolol required to control intraocular pressure in patients with primary open-angle glaucoma or ocular hypertension.

In a double-masked, randomized, comparison titration study to determine the effective dose of topically applied levobunolol, three concentrations of levobunolol (0.25%, 0.5%, and 1%) and of timolol (0.125%, 0.25%, and 0.5%) were evaluated in patients with mild open-angle glaucoma or ocular hypertension. Following a washout of ocular hypotensive medication, twice-daily treatment in both eyes was initiated with the lowest of the three doses of either drug. The concentration was increased if intraocular pressure remained uncontrolled. Intraocular pressure was controlled in 63% (15 of 24) of the patients tested with the lowest concentration of levobunolol and 69% (18 of 26) with the lowest concentration of timolol. Overall, 75% (18 of 24) of the patients in the levobunolol group and 73% (19 of 26) of the patients in the timolol group had adequately controlled intraocular pressure. At the lowest concentrations tested, mean decreases from baseline in intraocular pressure ranged from 6 to 8 mm Hg in both treatment groups.

Clinical Trials as Topic↗
PubMed1984

Biochemical abnormalities in spinal cord myelin and CNS homogenates in heterozygotes affected by the shiverer mutation.

Myelin was purified from the spinal cords of normal mice and mice heterozygous for the shiverer mutation, and measurements were made of the major myelin proteins and lipids and the specific activities of three myelin-associated enzymes. The myelin purified from the spinal cords of the heterozygotes (shi/+) was deficient by 30-40% in yield and had an apparently unique composition. In particular, when compared with normal mouse spinal cord myelin, there were more high-molecular-weight protein, less myelin basic protein, a higher protein-to-lipid ratio, and higher specific activities of 2',3'-cyclic nucleotide-3'-phosphohydrolase (EC 3.1.4.37) and carbonic anhydrase (EC 4.2.1.1) in the myelin purified from the shi/+ animals. These abnormalities were reflected in the composition of shi/+ whole spinal cord, where the protein-to-lipid ratio was intermediate between the respective values for +/+ and shi/shi spinal cords. Whole brains from shi/+ mice showed deficiencies in galactocerebroside and galactocerebroside sulfate and an increase in total phospholipid, and the lipid composition in the brains of the shi/shi mice was similar to that reported for another dysmyelinating mutant, quaking. The findings provide the first values for the lipids in normal mouse spinal cord myelin and show that heterozygotes are affected by the shiverer mutation. The observations imply that there can be considerable deviation from the normal CNS myelin content and composition without apparent qualitative morphological abnormalities or loss of function and that the amount of myelin basic protein available during myelination may influence the incorporation of other constituents into the myelin membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Acquired von Willebrand's disease in the myeloproliferative syndrome.

An acquired hemorrhagic disorder developed in two patients in association with postsplenectomy thrombocytosis and leukocytosis during the course of the myeloproliferative syndrome. The presence of acquired von Willebrand's disease in these individuals was demonstrated by a decrease or absence of the larger von Willebrand factor (vWF) multimers, alteration of the repeating vWF multimeric "triplet," decreased ristocetin cofactor activity (vWF:RCo), and prolonged bleeding time. The bleeding stopped in both patients after treatment with either 1-deamino-[8-D-arginine]-vasopressin (DDAVP) or Cohn fraction I. Treatment with thrombocytapheresis and azathioprine or busulfan resulted in reduction of the elevated platelet and white cell counts and was associated with partial correction of the vWF abnormalities and remission of the hemostatic abnormalities. In five additional patients with the myeloproliferative syndrome, but without bleeding symptoms, large multimers of plasma vWF were diminished also. These findings suggest that acquired von Willebrand's disease should be considered when a bleeding diathesis develops during the course of the myeloproliferative syndrome.

Adult↗
PubMed1983

Inheritance and the pigmentary dispersion syndrome.

We studied 23 patients in four families and have found that ten of these patients fulfill criteria for the pigmentary dispersion syndrome. Affected patients had characteristics associated with the pigmentary dispersion syndrome, which are: peripheral slit-like iris transillumination defects, increased trabecular meshwork pigmentation, Krukenberg spindle, myopia, and elevated intraocular pressure. We observed this syndrome to be transmitted in a direct linear manner from parent to sibling in three of the four families. The transmission of this syndrome was found to be independent of refractive error, iris color, and sexual predilection; all of which will be presented.

Adult↗
PubMed1978

Transplant size and elevated intraocular pressure. Postkeratoplasty.

Elevated intraocular pressure after keratoplasty is a well-recognized phenomenon both in aphakia and in combined lens extraction and penetrating keratoplasty. Ninety-two consecutive cases of penetrating keratoplasty procedures were studied. These were randomly assigned to group A or B. Group A received a donor transplant 0.5 mm larger than the recipient bed. Group B received donor buttons equal in size to the recipient bed. Intraocular pressure was measured preoperatively and daily until the patients were discharged. Group A, which had aphakic penetrating keratoplasty or the combined procedure (0.5-mm larger button), also had significantly lower intraocular pressures (P less than .001) than group B (same size button). There was no difference in postoperative intraocular pressure between groups A and B for those who had phakic penetrating keratoplasties. A larger donor size can alleviate induced "aphakic keratoplasty glaucoma."

Aged↗
PubMed1978

Studies on the paraplacental free fatty acid transport in rats.

Using the tracer method and a mathematical model the paraplacental transport of free fatty acids (FFA) (via uterine fluid--yolk sac--fetus) has been investigated in 21 days pregnant rats. The results show that only 0.3 nmoles FFA per min pass into the fetus via this paraplacental route. This accounts for less than 1% of FFA transported from the maternal plasma across the placenta into the fetus (0.14 mumoles FFA per min). From these results we would like to draw the conclusion that the paraplacental transport of FFA to the rat fetus is of minor importance from the quantitative point of view.

Animals↗
PubMed1978

The penetration of antistaphylococcal antibiotics into the aqueous humor of rabbits.

A multiple dose schedule of antibiotic administration parallels the clinical therapeutic situation. However, most reported studies on the aqueous humor concentration of antibiotics have been carried out following single doses of drug. We administered 2 penicillinase-resistant penicillins, 2 cephalosporins, and gentamicin to rabbits over a 24 hour period. Samples of serum and aqueous humor were obtained after the first and after the fifth dose of antibiotic. Of the agents studied, only methicillin in multiple doses gave therapeutic concentrations in the aqueous humor of normal rabbits. It is proposed that any future studies of intraocular penetration of antimicrobials be designed to include single and multiple doses in normal and infected eyes.

Animals↗