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Abstract
Seventy-two patients with retinoblastoma (RTB) (unilateral [47 patients] and bilateral [25 patients]) were studied for a period of 6 years. Treatment consisted of enucleation of those eyes that had severe involvement and was followed by radiation therapy and/or chemotherapy (systemic or intrathecal) according to clinical pathologic staging. All patients who underwent nonsurgical treatment received systemic chemotherapy. Intrathecal chemotherapy was administered when there was involvement of the central nervous system. Nonsurgical treatment consisted of radiation therapy and/or light coagulation, followed by enucleation if there was no response. The overall survival rates were 79% for unilateral disease (median follow-up time, 63 months) and 72% for bilateral disease (median follow-up time, 81 months). Vision was regained in 14 of 21 conserved eyes.
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202
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Schwartz L, Slater MA. The impact of chronic pain on the spouse: research and clinical implications. Holist Nurs Pract 1991; 6:9-16. [PMID: 1918189 DOI: 10.1097/00004650-199110000-00005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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203
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Bourassa MG, Lespérance J, Eastwood C, Schwartz L, Côté G, Kazim F, Hudon G. Clinical, physiologic, anatomic and procedural factors predictive of restenosis after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1991; 18:368-76. [PMID: 1856404 DOI: 10.1016/0735-1097(91)90588-z] [Citation(s) in RCA: 110] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In a recent prospective double-blind placebo-controlled trial, a combination of aspirin and dipyridamole was not associated with a reduction in the rate of restenosis within the 1st 6 months after coronary angioplasty. The purpose of this study was to determine whether clinical, anatomic or procedural factors were predictive of the observed restenosis rates in that prospective trial. A total of 247 patients and 280 segments underwent follow-up angiography and quantitative coronary angiographic analysis between 4 and 7 months after coronary angioplasty. Two baseline clinical characteristics--angina class and duration of angina in months--were related to the rate of restenosis by univariate analysis. Patient-related stepwise logistic regression analysis identified severity of angina as the only clinical predictor of restenosis. Three univariate baseline anatomic characteristics--percent diameter stenosis before angioplasty, stenosis greater than 10 mm in length and calcific stenosis--and two early postangioplasty characteristics--residual percent diameter stenosis and residual mean pressure gradient--were predictive of restenosis. Of these, only two--length of stenosis and residual percent diameter stenosis--were independently related to restenosis by multivariate analysis and only the former is identifiable before the procedure. It is concluded that in prospective studies in contrast to retrospective studies, few clinical and anatomic factors appear to be predictive of restenosis after coronary angioplasty.
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204
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Schwartz L. A note on the Jewish population of the USSR from the 1989 census data. SOVIET GEOGRAPHY 1991; 32:433-5. [PMID: 12316951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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205
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Matsson P, Enander I, Andersson AS, Nystrand J, Schwartz L, Watkins J. Evaluation of mast cell activation (tryptase) in two patients suffering from drug-induced hypotensoid reactions. AGENTS AND ACTIONS 1991; 33:218-20. [PMID: 1897443 DOI: 10.1007/bf01993172] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Tryptase is predominantly found in mast cells, where it resides in secretory granules, and is released with other mediators during mast cell degranulation. By using a newly developed commercial assay for measurements of tryptase levels we have investigated two cases of suspected drug-induced anaphylaxis. Each patient had a similar clinical presentation, consisting of hypotension and cyanosis after administration of thiopentone and suxamethonium. One of the patients showed a highly elevated serum level of tryptase reaching 26 micrograms/l 30 min after the initial reaction. In addition, slightly elevated levels of specific IgE antibodies to thiopentone were detected. The other patient with similar symptoms showed no increase in the level of tryptase, nor any specific IgE to thiopentone or suxamethonium. These data indicate the patient I suffered from true anaphylaxis, whereas the reaction of patient II occurred by a different mechanism.
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206
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Schwartz L. USSR nationality redistribution by republic, 1979-1989: from published results of the 1989 all-Union census. SOVIET GEOGRAPHY 1991; 32:209-48. [PMID: 12284133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
"An additional report on the results of the 1989 population census...describes changes in the ethnic composition of Soviet republics and other major regions (e.g., Siberia), as well as changes in the spatial distribution of the country's major ethnic groups. Data from the major 1989 Goskomstat source publication are refined and supplemented by information from more recent sources. Coverage is in a format similar to the reported ethnic results of the 1979 population census...to facilitate comparability."
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Abstract
Research demonstrates a positive and graded relationship between handweighted exercise energy costs, the distance through which handweights are swung and the weight used. The energy costs of handweighted exercise when swinging 0.45 to 1.36kg handweights have been shown to be 3 to 155% greater than costs of unweighted exercise at any pace. The upper limit of such increases is unknown. Moreover, the use of handweighted arm swings can convert walking, benchstepping or running from leg dominated endurance training modalities to exercises that simultaneously challenge muscles of both the upper and lower body. The use of handweights may induce a pressor response characterised by elevated heart rate and blood pressure responses at a given exercise intensity. However, such elevations have not been consistently reproduced and when they occurred, were on average small and of little physiological concern. Individual blood pressure responses may vary more widely between handweighted and unweighted walking, with some exhibiting higher and others lower blood pressures when using handweights. Taken together, research suggests that the prescription of handweighted exercise is safe for most individuals. However, it should be prescribed using precautions similar to those used when implementing new exercise regimens, particularly among those with cardiovascular complications. Potential strength and endurance training adaptations to handweighted exercise that incorporates large arm and leg range of motion movement patterns have yet to be determined.
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Thor A, Benz C, Moore D, Goldman E, Edgerton S, Landry J, Schwartz L, Mayall B, Hickey E, Weber LA. Stress response protein (srp-27) determination in primary human breast carcinomas: clinical, histologic, and prognostic correlations. J Natl Cancer Inst 1991; 83:170-8. [PMID: 1988702 DOI: 10.1093/jnci/83.3.170] [Citation(s) in RCA: 116] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Expression of an estrogen-regulated protein known as the 27,000-d heat-shock or stress-response protein (srp-27) was evaluated in human breast carcinomas and established breast cancer cell lines. Results obtained by Northern and Western blot analyses and immunohistochemical methods were concordant. Immunohistochemical assessment of srp-27 expression in 300 breast carcinomas (with median patient follow-up of 8 years) was performed. Twenty-six percent of lymph node-negative and 45% of lymph node-positive tumors were overexpressors. Univariate analysis demonstrated significant correlations between srp-27 overexpression and estrogen receptor (ER) content, pS2 protein expression, nodal metastases, advanced T stage, lymphatic/vascular invasion, and a shorter disease-free survival period (but not a shorter overall survival) for the study population as a whole. Regression tree analysis showed that srp-27 expression was an independent prognostic indicator for disease-free survival only in patients with one to three positive lymph nodes. The Cox proportional hazards model confirmed the independent prognostic significance of nodal involvement, T stage, and ER content but failed to recognize srp-27 overexpression as a significant independent parameter predictive of patient outcome in the patient population as a whole. The observed associations between srp-27 overexpression and more aggressive tumors suggest a biologic role for srp-27 in human breast carcinomas.
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Abstract
Recent advances concerning the genetic and biochemical basis of Duchenne and Becker muscular dystrophies have resulted in a good understanding of the etiology of these common dystrophies. An important secondary consequence of the genetic and biochemical research has been the generation of gene-based and protein-based diagnostic tools which enable a 'molecular diagnosis' for patients and their families. This review summarizes our current understanding of the genetics, biochemistry, and pathophysiology of Duchenne dystrophy, and gives an overview of the molecular diagnostic tools and their applications. Recent correlations of clinical, genetic and biochemical data have indicated that dystrophinopathies can present with a wide range of neuromuscular symptoms, and that neither male sex nor proximal weakness are diagnostic prerequisites for consideration of an underlying dystrophin abnormality.
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Zlotnik J, Schwartz L, Pearlstein S. OBRA's effect on nursing homes' social workers. CONTEMPORARY LONGTERM CARE 1990; 13:30, 92. [PMID: 10107034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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211
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Butany J, D'Amati G, Charlesworth D, Schwartz L, Daniel LA, Adelmen A, Silver M. Fatal left ventricular perforation following balloon mitral valvuloplasty. Can J Cardiol 1990; 6:343-7. [PMID: 2268798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Left ventricular perforation following a balloon mitral valvuloplasty is a rare complication. This paper reports morphological findings in such a case that was fatal. Cardiac tamponade was suspected clinically, but could not be confirmed or treated because of extensive anterior pericardial adhesions related to a previous closed mitral commissurotomy.
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Spears JR, Reyes VP, Wynne J, Fromm BS, Sinofsky EL, Andrus S, Sinclair IN, Hopkins BE, Schwartz L, Aldridge HE. Percutaneous coronary laser balloon angioplasty: initial results of a multicenter experience. J Am Coll Cardiol 1990; 16:293-303. [PMID: 2197310 DOI: 10.1016/0735-1097(90)90576-b] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A multicenter clinical trial was initiated to test the potential safety and short-term efficacy of a percutaneous coronary application of laser balloon angioplasty, which has been shown experimentally to alleviate the common causes (dissection, recoil, thrombus) of suboptimal luminal results of conventional balloon angioplasty. Fifty-five patients, the majority (62%) of whom had relatively high risk lesions, were treated in 10 centers with a laser balloon that was identical in size (3 x 20 mm) to a balloon used for conventional balloon angioplasty performed on the same lesion immediately before laser balloon angioplasty. One or more neodymium:yttrium aluminum garnet (Nd:YAG) (1,060 nm) laser doses of 250 to 450 J were each delivered over a 20 s duration per exposure. Immediately and 1 day after laser balloon angioplasty no significant adverse effects on the arterial lumen were noted in any patient. By computerized image analysis of cineangiograms initial conventional balloon angioplasty failed to achieve a minimal luminal diameter greater than 1.5 mm in 14 patients (25%), including 3 patients with acute closure. However, after subsequent laser balloon angioplasty, minimal luminal diameter exceeded this value in all patients including this subgroup. Overall, minimal luminal diameter increased from 1.74 +/- 0.46 mm after conventional balloon angioplasty to 2.32 +/- 0.31 mm after laser balloon angioplasty (p less than 0.001) with no change found on 1 day and 1 month follow-up angiograms. Thus, laser balloon angioplasty is a safe, effective procedure for improving luminal dimensions after conventional balloon angioplasty.
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Kracoff OH, Adelman AG, Marquis JF, Caspi A, Aldridge HE, Schwartz L. Twelve-lead electrocardiogram recording during percutaneous transluminal coronary angioplasty. Analysis of reciprocal changes. J Electrocardiol 1990; 23:191-8. [PMID: 2384724 DOI: 10.1016/0022-0736(90)90156-v] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Coronary angioplasty was used as a human model of transient myocardial ischemia to evaluate the electrocardiographic characteristics and significance of "reciprocal" ST-segment depression and T wave changes. Continuous 12-lead ECGs were recorded before and during coronary angioplasty in 20 patients, 19 of whom had single vessel disease. In 12 of 14 patients, LAD occlusion produced ischemic changes (peaked T and/or ST elevation) in L1, AVL and at least two precordial leads. "Reciprocal" changes (ST depression and/or T inversion) were observed in at least two inferior wall leads. One patient had ST depression in V4-V6 with no change in the inferior leads and in the other the only ECG change was inferior ST depression with partial inversion of the T wave. In four of six patients, RCA occlusion produced ischemic changes in at least two inferior wall leads and "reciprocal" changes in L1, AVL and at least two anterior wall leads. In LAD as well as RCA occlusions "reciprocal" changes were characterized by inversion of the T wave or inversion of its ascending limb with or without ST depression. The magnitude of the ischemic changes tended to be proportional to the magnitude of the "reciprocal" changes. Our data suggest that: (1) "Reciprocal" changes are not a specific indicator of distant myocardial ischemia due to multivessel disease; (2) the magnitude of ischemic changes correlates with the magnitude of "reciprocal" changes; (3) "Reciprocal" changes may be the only manifestation of acute myocardial ischemia; and (4) "Reciprocal" changes may be represented by inversion of the T wave without displacement of the ST-segment.
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214
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Matanoski GM, Santos-Burgoa C, Schwartz L. Mortality of a cohort of workers in the styrene-butadiene polymer manufacturing industry (1943-1982). ENVIRONMENTAL HEALTH PERSPECTIVES 1990; 86:107-17. [PMID: 2401250 PMCID: PMC1567763 DOI: 10.1289/ehp.9086107] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A cohort of 12,110 male workers employed 1 or more years in eight styrene-butadiene polymer (SBR) manufacturing plants in the United States and Canada has been followed for mortality over a 40-year period, 1943 to 1982. The all-cause mortality of these workers was low [standardized mortality ratio (SMR) = 0.81] compared to that of the general population. However, some specific sites of cancers had SMRs that exceeded 1.00. These sites were then examined by major work divisions. The sites of interest included leukemia and non-Hodgkin's lymphoma in whites. The SMRs for cancers of the digestive tract were higher than expected, especially esophageal cancer in whites and stomach cancer in blacks. The SMR for arteriosclerotic heart disease in black workers was significantly higher than would be expected based on general population rates. Employees were assigned to a work area based on job longest held. The SMRs for specific diseases differed by work area. Production workers showed increased SMRs for hematologic neoplasms and maintenance workers, for digestive cancers. A significant excess SMR for arteriosclerotic heart disease occurred only in black maintenance workers, although excess mortality from this disease occurred in blacks regardless of where they worked the longest. A significant excess SMR for rheumatic heart disease was associated with work in the combined, all-other work areas. For many causes of death, there were significant deficits in the SMRs.
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215
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Diamant S, Schwartz L, Atlas D. Potentiation of neurotransmitter release coincides with potentiation of phosphatidyl inositol turnover. A possible in vitro model for long term potentiation. Neurosci Lett 1990; 109:140-5. [PMID: 1969129 DOI: 10.1016/0304-3940(90)90552-k] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Carbachol (CCh) a cholinergic agonist which hydrolyses phosphatidyl-inositol bisphosphate (PIP2) to produce the breakdown products inositol trisphosphate (IP3) and diacylglycerol (DAG) was tested for its ability to induce [3H]norepinephrine ([3H]NE) release and to accumulate [3H]inositol phosphate ([3H]IP) under normal and membrane depolarizing conditions. Our results suggest two major points: first, muscarinic acetylcholine receptor (mAChR) agonists and depolarizing agents (of which KCl is the most effective) act in concert to induce potentiation of PI turnover and potentiation of neurotransmitter release. The simultaneous presence of both a depolarizing agent and a receptor agonist is obligatory for eliciting potentiatory effect. Facilitation of release by muscarinic agonist and K+, added together, was 2 to 5-fold above additivity and the levels of [3H]IP accumulated were 3-5-fold above additivity by K+ and CCh. Enhancement of release and of [3H]IP formation is reversed by pirenzepine, a muscarinic (MI) specific antagonist, Kdiss = 0.4 and 0.8 microM, respectively. Second, synergy of IP accumulation in correlation with synergy of neurotransmitter release elicited by mAChR activation and membrane depolarization, suggests a possible role for phospholipase C (PLC) in the bifurcating control of neurotransmitter release and for the involvement of PLC and voltage sensitive channels in mediation of long-term potentiation (LTP).
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Schwartz L, Lesperance J, Bourassa MG, Eastwood C, Kazim F, Arafah M, Ganassin L. The role of antiplatelet agents in modifying the extent of restenosis following percutaneous transluminal coronary angioplasty. Am Heart J 1990; 119:232-6. [PMID: 2405609 DOI: 10.1016/s0002-8703(05)80009-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We previously reported that a combination of aspirin and dipyridamole given before, during, and for 6 months following percutaneous transluminal coronary angioplasty (PTCA) did not reduce the incidence of restenosis. In that trial, a total of 272 successfully dilated segments in 243 patients reached final quantitative angiography and of these, 86 segments (31.6%) had restenosed (46 of 130 segments in the group of patients given placebo and 40 of 142 segments in the aspirin-dipyridamole group). A secondary analysis of these 86 segments revealed that at follow-up angiography the severity of restenosis was greater in the 46 segments in the placebo group than in the 40 segments in the active treatment group (mean minimal luminal diameter at the stenosis = 0.76 +/- 0.52 and 1.03 +/- 0.45 mm, respectively, p = 0.01). The frequency of total or subtotal occlusions was higher in the placebo group (17.4%) than in the active treatment group (5.0%), but this observation did not reach statistical significance (p = 0.07). Although long-term treatment with aspirin and dipyridamole after successful PTCA does not reduce the incidence of recurrence, this secondary analysis suggests that it is associated with a decreased likelihood of severe restenosis.
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Bourassa MG, Schwartz L, Lespérance J, Eastwood C, Kazim F. Prevention of acute complications after percutaneous transluminal coronary angioplasty. THROMBOSIS RESEARCH. SUPPLEMENT 1990; 12:51-8. [PMID: 2082488 DOI: 10.1016/0049-3848(90)90439-j] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The prevention of major complications occurring during or early after percutaneous transluminal coronary angioplasty was evaluated in 376 patients in a randomized, double-blind, placebo-controlled multicenter trial. Starting 24 hours before angioplasty, 187 patients received an aspirin-dipyridamole combination and 189 were given placebo. There were no periprocedural deaths. Periprocedural non-fatal myocardial infarction was diagnosed in 34 patients (9.0%). Q wave myocardial infarction occurred in 16 patients: 3 (1.6%) in the aspirin-dipyridamole group and 13 (6.9%) in the placebo group (p = 0.0113). Non-Q wave myocardial infarction occurred in 18 patients: 6 (3.2%) in the active drug group and 12 (6.3%) in the placebo group (p = 0.1538). Emergency myocardial revascularization was performed in 9 patients in each treatment arm. Q wave myocardial infarction occurred following revascularization in 5 patients (55.5%) in the placebo group and in only 2 (22.2%, p = 0.1670) in the aspirin-dipyridamole group. Thus the incidence of periprocedural Q and non-Q wave myocardial infarction is high in patients not on antiplatelet therapy (13.2%) and is markedly lower in those on the aspirin-dipyridamole combination (4.8%, p = 0.0044). Short-term antiplatelet therapy before and after angioplasty can be recommended for patients who do not have contraindications to this medication.
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Schwartz L, Atlas D. Synergy between membrane depolarization and muscarinic receptor activation leads to potentiation of neurotransmitter release (II). Brain Res 1989; 503:62-7. [PMID: 2611659 DOI: 10.1016/0006-8993(89)91704-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Amplification of muscarinic agonist-induced [3H]noradrenaline ([3H]NE)-release by depolarizing agents, was studied in rat brain cortical slices. [3H]NE basal outflow was enhanced by either K+ (25 mM) or veratridine (2 microM) in a Ca2+-dependent manner and was potentiated beyond additivity in the presence of muscarinic agonists. Facilitation of the [3H]NE-induced release by the simultaneous presence of muscarinic agonists and depolarizing agents is calcium-dependent with a maximal effective concentration of 0.6-0.8 mM. The efficacy of muscarinic agonist to induce basal outflow of [3H]NE is as follows: CCh greater than arecoline greater than oxotremorine M greater than bethanechol greater than pilocarpine, which is similar to their potentiatory effects observed in the presence of depolarizing agents. Potentiation of muscarinic agonist-induced release of [3H]NE by elevated K+ is more pronounced (up to 7-fold) in comparison to potentiation by veratridine (up to 4-fold), irrespective of the various muscarinic agonists. The sequential presence of muscarinic agonists followed by depolarizing agents is not sufficient for eliciting a synergy of [3H]NE outflow, whether receptor activation was initiated prior to depolarization or depolarization was initiated prior to receptor activation. Receptors which do not mediate phosphatidyl inositol (PI) turnover such as nicotine induced [3H]NE-release which is not affected by the presence of depolarizing agents and yielded in their presence additive fractional release only. In this report we establish synergy of [3H]NE release by muscarinic agonists under depolarizing conditions, similar to synergism of inositol phosphate (IP) production which was observed by muscarinic agonists and depolarization agents.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arafah M, Aldridge HE, Schwartz L. Percutaneous transluminal angioplasty of stenotic saphenous vein right coronary bypass grafts utilizing a peripheral balloon dilatation catheter without a guiding catheter. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1989; 17:92-6. [PMID: 2524270 DOI: 10.1002/ccd.1810170207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Effective angioplasty of stenosed saphenous vein coronary bypass grafts may be impossible with the standard-size coronary dilatation catheters because the large diameter of these grafts results in unacceptable balloon-to-vessel ratios. We avoided this problem by using a peripheral arterial dilatation catheter with an inflation diameter of 6 mm and obtained a satisfactory short- and long-term result in two patients in whom previous attempts with the largest coronary dilatation catheter (4 mm) had failed. This technique, which precludes the use of a guiding catheter, is suitable only for right bypass grafts.
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221
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Von Hofen D, Auble TE, Schwartz L. AEROBIC REQUIREMENTS FOR PUMPING VERSUS CARRYING .91 KG HANDWEIGHTS WHILE RUNNING. Med Sci Sports Exerc 1989. [DOI: 10.1249/00005768-198904001-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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222
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Heier LA, Bauer CJ, Schwartz L, Zimmerman RD, Morgello S, Deck MD. Large Virchow-Robin spaces: MR-clinical correlation. AJNR Am J Neuroradiol 1989; 10:929-36. [PMID: 2505536 PMCID: PMC8335297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
High-field MR scans frequently show Virchow-Robin spaces, which conform to the path of the penetrating arteries as they enter either the basal ganglia or the cortical gray matter over the high convexities. A retrospective review of 816 MR scans was undertaken to determine the clinical significance and associations (if any) of this finding. The Virchow-Robin spaces were graded, as were the nonspecific white-matter lesions. The presence of atrophy, infarction, hydrocephalus, and miscellaneous disease was noted. Large Virchow-Robin spaces were identified in 314 cases. A study sample was created consisting of a positive group containing all the larger grade 2 and 3 Virchow-Robin spaces (67 patients) and a negative or control group of 109 randomly selected patients from the original 502 who did not have large Virchow-Robin spaces. The charts of this study sample were reviewed and the following patient variables were noted: age, gender, incidental white-matter lesions, infarction, dementia, hypertension, and atrophy. For each variable, the proportion of patients who were positive for that variable was calculated for each of the two groups and compared across groups by using a Fisher exact test. Multiple logistic regression analysis was used to determine whether any of these variables were jointly associated with being "positive" or "negative" for large Virchow-Robin spaces. Some variables were strongly associated with being positive for large Virchow-Robin spaces: age, hypertension, dementia, and incidental white-matter lesions. Logistic regression analysis revealed that when all of these variables are considered jointly, only age remains significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Schwartz L, Guiochet N, Keiling R. Two partial remissions induced by an LHRH analogue in two postmenopausal women with metastatic breast cancer. Cancer 1988; 62:2498-500. [PMID: 2973369 DOI: 10.1002/1097-0142(19881215)62:12<2498::aid-cncr2820621208>3.0.co;2-i] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We report two cases of metastatic breast cancer occurring in two postmenopausal women. Treatment with a luteinizing hormone-releasing hormone (LHRH) analogue, D-TRP6-LHRH, induced partial remission. The blood levels of the follicle stimulating hormone (FSH) and luteinizing hormone (LH) fell sharply under treatment, but the levels of estradiol, estriol, and estrone did not change significantly. We also described the putative mechanisms of action of the LHRH analog.
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Pavlovsky S, Maschio M, Santarelli MT, Muriel FS, Corrado C, Garcia I, Schwartz L, Montero C, Sanahuja FL, Magnasco O. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I-II Hodgkin's disease. J Natl Cancer Inst 1988; 80:1466-73. [PMID: 3184196 DOI: 10.1093/jnci/80.18.1466] [Citation(s) in RCA: 120] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A total of 277 patients with untreated Hodgkin's disease, clinical stages I-II, were randomized to cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP) alone for 6 monthly cycles or to CVPP plus radiation therapy (RT), 3,000 rad, to involved areas (CVPP plus RT). One or more of the following factors were considered as unfavorable prognosis: age greater than 45 years, more than two lymph node areas involved, or bulky disease. In the favorable group, disease-free survival (77% vs. 70%) or overall survival (92% vs. 91%) at 84 months for CVPP versus RT plus CVPP was similar. Patients with unfavorable prognosis treated with RT plus CVPP had longer disease-free survival (75% vs. 34%) (P = .001) and overall survival (84% vs. 66%) than patients treated with CVPP alone.
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225
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Scully HE, Damle A, Goldman BS, Tong C, Azuma J, Mickleborough LL, Schwartz L, Baird RJ. Clinical performance of Bjork-Shiley mechanical heart valves: a perspective on outlet strut fractures in the 60 degrees and 70 degrees convexo-concave disc models. Can J Cardiol 1988; 4:386-92. [PMID: 3228767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The convexo-concave disc model of Bjork-Shiley mechanical heart valve is a significant improvement over the spherical disc model and compares favourably to other valves, including bioprostheses, with respect to hemodynamics, thromboembolism, anticoagulant related hemorrhage and prosthetic endocarditis. A small number of the 60 degrees and 70 degrees welded outlet strut Bjork-Shiley convexo-concave valves are at risk of sudden structural failure. The risk is constant or decreasing with time. Elective explanation is not recommended. The integral outlet monostrut 70 degrees Bjork-Shiley convexo-concave valve demonstrates further improvements in design and durability, and is recommended for use in patients who are appropriate candidates for mechanical cardiac prostheses.
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Goldman B, Scully H, Tong C, Mandell R, Butany J, Azuma J, Schwartz L. Clinical results of pericardial xenograft valves: the Ionescu-Shiley and Hancock valves. Can J Cardiol 1988; 4:328-32. [PMID: 3179796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Between 1979 and 1985, 552 Ionescu-Shiley valves were implanted in 511 patients. The Hancock valve was implanted in 122 patients (129 valves) between 1982 and 1983. Sixty percent of procedures were isolated aortic valve replacements. In the Ionescu series, 59% of these were 19 or 21 mm valves while only 15% of the Hancock valves were of this size. For isolated mitral valve replacement, 76% of Ionescu-Shiley valves were 25 to 27 mm, compared to 36% of the Hancock valves. Patient age, sex, prior operations, concomitant surgery (usually coronary bypass), operative mortality and late deaths were similar for both valves. A mean follow-up of 38 months was obtained for each valve population (99% complete) representing a cumulative 1497 patient-years for the Ionescu-Shiley valve and 375.4 patient-years for the Hancock valve. Actuarial survival for the former was 73 +/- 4% at 72 months, and 65 +/- 14% for Hancock valves at 60 months. The frequency of major events during follow-up (thromboembolism, anticoagulant related hemorrhage, bland perivalvular leak and prosthetic valve endocarditis) were similar, but the frequency of primary tissue valve failure was markedly different for the two valves (1.1% per patient-year for Ionescu-Shiley valves and 5.9% for the Hancock valve). The mean interval to replacement of an Ionescu mitral prosthesis was significantly shorter (23.4 months) than for replacement of an aortic prosthesis (42 months) while the mean interval to replacement of an Ionescu aortic and/or a Hancock aortic or mitral were all similar.(ABSTRACT TRUNCATED AT 250 WORDS)
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Scully H, Goldman B, Fulop J, Butany J, Tong C, Azuma J, Schwartz L. Five-year follow-up of Hancock pericardial valves: management of premature failure. J Card Surg 1988; 3:397-403. [PMID: 2980043 DOI: 10.1111/jocs.1988.3.3s.397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The durability and function of bovine pericardial valves are dependent upon design, preservation, patient factors (age, sex), and site of valve implantation. In 1983, a shelf recall of all Hancock bovine pericardial valves (HPV) was instituted by the manufacturer. This report represents the results of an organized 5-year follow-up in a hospital Prosthetic Valve Registry of 129 HPV implanted in 122 patients (79 males, 43 females) between May 1982 and April 1985 using echo Doppler and careful clinical evaluation. Mean age was 56 +/- 15 years. There were 81 AVR, 33 MVR, 7 DVR, and 1 TVR. Concomitant coronary bypass was performed in 38 patients (31%). Surgery was on a redo basis in 25 patients (20%), urgent in 14 (11%), and for SBE in 8 patients (7%). There were seven hospital deaths (5.7%). Mean follow-up was 44 months (maximum 66 months) for 114 patients (99% complete), representing 417 patient years. There have been 20 late deaths (18%), of which 7 were directly valve related. Linearized frequency of major events (per pt-yr) was: thromboembolism, 1.6%; anticoagulant related hemorrhage, 0.8% (1 late death); prosthetic valve endocarditis 1.3%; primary tissue failure, 5.8%. Patient symptomatology was a more accurate predictor of bioprosthetic failure requiring reoperation than echo Doppler studies, which were completed in 74 of 97 patients examined during scheduled follow-up visits. Twenty-four of the 96 patients (25%) have required re-replacement at a mean interval of 44 months (27-59 months) from initial implantation. This was due to vertical shear starting at the top of the strut anchoring commissural attachments in every case.(ABSTRACT TRUNCATED AT 250 WORDS)
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Schwartz L, Bourassa MG, Lespérance J, Aldridge HE, Kazim F, Salvatori VA, Henderson M, Bonan R, David PR. Aspirin and dipyridamole in the prevention of restenosis after percutaneous transluminal coronary angioplasty. N Engl J Med 1988; 318:1714-9. [PMID: 2967433 DOI: 10.1056/nejm198806303182603] [Citation(s) in RCA: 485] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To examine the role of antiplatelet therapy in the prevention of arterial restenosis after percutaneous transluminal coronary angioplasty (PTCA), we conducted a randomized, double-blind, placebo-controlled study in 376 patients. The active treatment consisted of an oral aspirin-dipyridamole combination (330 mg-75 mg) given three times daily, beginning 24 hours before PTCA. Eight hours before PTCA, the oral dipyridamole was replaced with intravenous dipyridamole at a dosage of 10 mg per hour for 24 hours, and oral aspirin was continued. Sixteen hours after PTCA, the initial combination was reinstituted. Treatment was continued in patients with a successfully dilated vessel until follow-up angiography four to seven months after PTCA--or earlier, if symptoms dictated. Of 249 patients who underwent follow-up angiography, 37.7 percent of patients receiving the active drug had restenosis in at least one segment, as compared with 38.6 percent of patients taking placebo (P not significant). The number of stenotic segments was virtually the same in the two groups. Among the 376 randomized patients, there were 16 periprocedural Q-wave myocardial infarctions--13 in the placebo group and 3 in the active-drug group (6.9 percent vs. 1.6 percent, P = 0.0113). Although the use of this antiplatelet regimen before and after PTCA did not reduce the six-month rate of restenosis after successful coronary angioplasty, it markedly reduced the incidence of transmural myocardial infarction during or soon after PTCA. Thus, the short-term use of antiplatelet agents in relation to PTCA can be recommended.
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Schwartz L, Richet G. [Evaluation by U.E.R. of health sciences: medicine, pharmacy and odontology]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 1988; 172:705-10. [PMID: 3056583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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230
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Johnston KW, Rae M, Steiner G, Kalman PG, Schwartz L, Hill ME, Walker PM. An atherosclerosis risk factor assessment program for patients with peripheral arterial occlusive disease. Ann Vasc Surg 1988; 2:101-7. [PMID: 3196645 DOI: 10.1016/s0890-5096(06)60789-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
From a group of 251 high-risk patients less than 65 years of age, 84 with angiographic or vascular laboratory proven peripheral arterial occlusive disease were evaluated in detail. The following risk factors were identified: smoking in 91% with an average of 35 +/- 18 pack/years; treated or untreated hypertension in 40%; hyperlipidemia in 49%; obesity with a body weight greater than 120% of ideal in 18%; diabetes in 9%; family history of premature vascular disease in 70%; and hyperuricemia in 13%. Based on these results, we have introduced a practical approach for investigating and managing risk factors that can be administered by paramedical personnel, utilizing a questionnaire given to patients and standard blood tests to identify important risk factors. The results of the completed questionnaires and blood test are entered on a microcomputer. A program written using d-Base III stores the data, identifies the risk factors and grades their severity. We have designed an information booklet that highlights the individual patient's risk factors and suggests alternatives for management based on the sources of medical and community help available in our area.
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Dubost T, Schwartz L, Benmoussa S, Manel J, Lambert H, Larcan A. [An information file for drug identification]. JOURNAL DE TOXICOLOGIE CLINIQUE ET EXPERIMENTALE 1988; 8:47-57. [PMID: 3373445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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232
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Zelter M, Gonzalez G, Schwartz L, Gallo G, Schvartzman E, Damel A, Muriel FS. Treatment of retinoblastoma. Results obtained from a prospective study of 51 patients. Cancer 1988; 61:153-60. [PMID: 3334942 DOI: 10.1002/1097-0142(19880101)61:1<153::aid-cncr2820610126>3.0.co;2-#] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
During 4 years, 51 patients with retinoblastoma were studied (unilateral 32, and bilateral 19). Treatment consisted of enucleation of those eyes which showed massive involvement followed by radiotherapy when there was optic nerve and/or orbit involvement. Systemic chemotherapy was administered to all patients who underwent nonsurgical treatment and when the histologic examination showed choroidal optic nerve head and/or optic nerve involvement or residual tumor after enucleation. When there was compromise of the central nervous system intrathecal chemotherapy was administered. Nonsurgical treatment consisted of radiotherapy and/or light coagulation. Survival was 90.6% for unilateral cases and 84.2% for the bilateral. The median follow-up was 31 months and 29 months, respectively. Of 19 conservated eyeballs, 16 preserve useful vision (63%).
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233
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Robertson RG, Bankier RG, Schwartz L. The female offender: a Canadian study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 1987; 32:749-55. [PMID: 3435880 DOI: 10.1177/070674378703200902] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Consecutive female admissions to the Winnipeg Remand Centre were studied and data concerning personal history, family background, psychological factors and mental health were recorded. An effort was made to determine a typical profile of female offenders and relate this to the alleged offences. Our data failed to identify what has been described by others as the "new female criminal".
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234
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Matanoski GM, Schwartz L. Mortality of workers in styrene-butadiene polymer production. JOURNAL OF OCCUPATIONAL MEDICINE. : OFFICIAL PUBLICATION OF THE INDUSTRIAL MEDICAL ASSOCIATION 1987; 29:675-80. [PMID: 3655951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A total of 13,920 males who had worked in eight styrene-butadiene rubber polymer manufacturing plants in the US and Canada for at least 1 year were followed for deaths from 1943 when the industry began to 1979. Mortality ratios standardized for age, race, and calendar time using US male rates as a comparison revealed no excess mortality in this population for any cause of death. The overall standardized mortality ratio (SMR) for all causes was 0.81. Only the SMR for arteriosclerotic heart disease among black males showed a significant excess (SMR = 1.28). Examination of risks by major work areas such as production, utilities, maintenance, and other jobs, as well as by salaried and hourly pay grade, revealed no significant differences in cancer mortality by specific sites. Because the ratios for selected digestive cancers were above the all-cause SMR, this group of neoplasms is under further investigation as is the exposure profile of specific jobs within the industry.
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235
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Arce-Gonzalez JM, Schwartz L, Ganassin L, Henderson M, Aldridge H. Complications associated with the guide wire in percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1987; 10:218-21. [PMID: 2955017 DOI: 10.1016/s0735-1097(87)80183-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This report describes three cases of unraveling of the platinum coil of the guide wire during percutaneous transluminal coronary angioplasty. In one case the wire ruptured and required surgical removal. The exact cause of this phenomenon is not known, but wire entrapment may be a factor. This is more likely to occur with tortuous vessels. Precautions to avoid uncoiling and rupture of guide wires during coronary angioplasty are discussed.
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236
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Griswold DE, Webb E, Schwartz L, Hanna N. Arachidonic acid-induced inflammation: inhibition by dual inhibitor of arachidonic acid metabolism, SK&F 86002. Inflammation 1987; 11:189-99. [PMID: 3108157 DOI: 10.1007/bf00916020] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The antiinflammatory activity of the structurally novel dual inhibitor of arachidonic acid metabolism, SK&F 86002 was evaluated using arachidonic acid-induced edema and inflammatory cell infiltration. Histological examination demonstrated extensive subcutaneous edema and neutrophil (PMN) accumulation in perivascular and interstitial locations one hour after application of arachidonic acid to the ear. SK&F 86002 and, to a lesser extent, phenidone demonstrated potent inhibition of this inflammatory response following oral and topical administration. Nordihydroguaiaretic acid (NDGA) displayed only topical activity. The selective cyclooxygenase inhibitors ibuprofen and naproxen were either inactive or stimulated ear swelling. Histological evaluation of the lesion in drug-treated animals revealed that SK&F 86002 impaired edema formation and caused a significant reduction in numbers of infiltrating neutrophils. Using arachidonic acid-induced peritoneal exudation, a reduction in the cellular infiltrate was observed after oral treatment with SK&F 86002 or phenidone, but not with naproxen. Taken together, these data illustrate the potent antiinflammatory effects of SK&F 86002 and support the suggestion that 5-lipoxygenase products play a significant role in both the edematous and cellular phases of arachidonic acid-induced inflammation.
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237
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Auble TE, Schwartz L, Robertson RJ. Aerobic Requirements for Moving Handweights Through Various Ranges of Motion While Walking. PHYSICIAN SPORTSMED 1987; 15:133-40. [PMID: 27404531 DOI: 10.1080/00913847.1987.11709378] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In brief: This study compared the aerobic metabolic requirements of normal walking (without handweights and with normal arm motions) with requirements of walking while pumping 1-,2-, or 3-lb handweights through Various ranges of motion. Nine male subjects Walked with and without handweights at speeds of 1.12 to 1.79 m· sec(-1). Adding hand-Weighted arm movements significantly increased the oxygen consumption (V O2) of normal walking by 2.1 to 25.5 ml· kg(-1)· min(-1). The V O2 for handweighted walking ranged from 17 to 43 ml· kg(-1)· min(-1), or 113% to 255% of normal walking requirements at any given speed. These results indicate that walking while moving handweights through large ranges of motion provides a combined upper and lower body aerobic stimulus that is sufficient for endurance training for persons with poor to excellent levels of aerobic fitness.
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238
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Schwartz L, Brooks E, Henderson M, Brown R, Aldridge H, Kendall S, Cseplo RM, Szarga C. The symptomatic status of patients one year following revascularization by either coronary surgery or angioplasty. Can J Cardiol 1987; 3:6-9. [PMID: 2950987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study consisted of a one year clinical follow-up of 81 patients who had coronary revascularization. In 32 patients, this was accomplished by bypass surgery and in 49, by percutaneous angioplasty. Prior to the procedure the two groups of patients were similar with regard to age, sex, antianginal medication and angina severity with 75% of the surgical patients and 65% of the angioplasty patients in CCS Angina Class III or IV. Although most of the surgical patients had multivessel disease and most of the angioplasty patients had single vessel disease, all had complete revascularization. At one year, 78% of the surgical patients and 84% of the angioplasty patients did not have angina and few patients in either group were taking medication. However, in the intervening year 39% of the angioplasty patients had had a second revascularization procedure, whereas, only 3% of the surgical patients required a second procedure. Extracardiac sequelae were more frequent in the surgical cohort. Therefore, at one year following complete revascularization, bypass surgery and angioplasty result in comparable symptomatic and functional improvement.
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239
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Ron M, Menczel J, Schwartz L, Palti Z, Kidroni G. Vitamin D3 metabolites in amniotic fluid in relation with maternal and fetal sera in term pregnancies. J Perinat Med 1987; 15:282-90. [PMID: 3501463 DOI: 10.1515/jpme.1987.15.3.282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The concentration of 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) were determined in amniotic fluid, fetal cord serum and maternal serum in 26 cases of elective cesarean sections at term. All the women had a normal pregnancy and did not get any vitamin D fortified preparations. The samples were collected during December 1982-April 1983, at 37-40 weeks of pregnancy. The respective levels (+/- S.D.) of 25(OH)D3, 24,25(OH)2D3 and 1,25(OH)2D3 in maternal serum were: 18.03 +/- 10.8 ng/ml, 1.473 +/- 1.562 ng/ml and 36 +/- 21.5 pg/ml; in fetal cord serum: 13.15 +/- 8.3 ng/ml, 0.9 +/- 0.76 ng/ml and 29.2 +/- 18.55 pg/ml and in amniotic fluid: 0.732 +/- 0.508 ng/ml, 0.212 +/- 0.104 ng/ml and 14.3 +/- 10.0 pg/ml. The levels of the three metabolites in maternal and fetal cord serum were not statistically different. There was a statistically significant correlation between maternal and fetal serum levels of 25(OH)D3 and 24,25(OH)2D3 (r = 0.79, p less than 0.01 and r = 0.743, p less than 0.01 respectively). No significant correlation was found in 1,25(OH)2D3 levels between maternal and fetal cord sera. This lack of correlation may well be in agreement with the recent findings of Kouppala, et al. who demonstrated that the fetus contributes to its own pool of 1,25(OH)2D3. A significant difference was found between maternal serum and amniotic fluid levels of the three metabolites. A statistically significant difference was also found between fetal serum levels of 25(OH)D3 and 24,25(OH)2D3 and amniotic fluid levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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240
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Steiner G, Schwartz L, Shumak S, Poapst M. The association of increased levels of intermediate-density lipoproteins with smoking and with coronary artery disease. Circulation 1987; 75:124-30. [PMID: 3791598 DOI: 10.1161/01.cir.75.1.124] [Citation(s) in RCA: 93] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Studies were undertaken to determine whether there is an association between elevated levels of intermediate-density lipoproteins (IDL) (Sf 12-60 lipoproteins) and coronary artery disease. Forty-five to sixty-five-year-old men with objectively documented coronary artery disease (n = 58) who were free of known risk factors (diabetes, hypertension, obesity, hyperuricemia, and hypercholesterolemia) were compared with similar men who were free of coronary artery disease (n = 52). Smokers could not be excluded. The coronary artery disease group had a higher rate of cigarette smoking (NS, due to large variations); higher concentrations of triglycerides in their plasma (p = .003) and higher levels of very low-density lipoproteins (VLDL) (p = .007), IDL (p = .016), and low-density lipoproteins (LDL) (p = .04); as well as somewhat lower levels of high-density lipoprotein (HDL) cholesterol (p = .04). Chi-squared analysis demonstrated a strong association between coronary artery disease and IDL apolipoprotein (apo) B (p = .006), coronary artery disease and IDL triglyceride (p = .032), and coronary artery disease and IDL apo B times IDL triglyceride (p = .006) when the top quintile of the population was compared with the bottom quintile for each of these variables. Stepwise logistic regression analysis resulted in rejection of an association between coronary artery disease and HDL cholesterol, plasma triglyceride, VLDL triglyceride, or LDL triglyceride. However, it did show that coronary artery disease was most strongly associated with smoking and that the second strongest association was with IDL.(ABSTRACT TRUNCATED AT 250 WORDS)
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241
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Christakis GT, Weisel RD, Fremes SE, Teoh KH, Skalenda JP, Tong CP, Azuma JY, Schwartz L, Mickleborough LL, Scully HE. Can the results of contemporary aortic valve replacement be improved? J Thorac Cardiovasc Surg 1986; 92:37-46. [PMID: 3724226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although the results of contemporary aortic valve replacement are excellent, cardiac surgeons must identify the factors that predict postoperative morbidity and mortality to develop alternative strategies for high-risk patients. Two hundred seventy-seven consecutive patients undergoing isolated aortic valve replacement between 1982 and 1984 were evaluated. Thirty-seven clinical and 13 preoperative hemodynamic variables were analyzed by univariate and multivariate statistics to determine the risk factors for postoperative morbidity and mortality. The operative mortality was 3%, the incidence of a postoperative low output syndrome was 12%, and the incidence of a perioperative myocardial infarction was 5%. A multivariate, logistic regression analysis found that age was the only the only independent predictor of mortality. Three factors independently predicted postoperative low output syndrome: age, the presence of coronary artery disease, and the peak systolic gradient in patients with aortic stenosis. Patients with aortic stenosis had a higher incidence of postoperative ventricular dysfunction (17%) than those with mixed valvular disease (9%) or aortic regurgitation (5%). Perioperative myocardial infarction was predicted by the extent of coronary artery disease. The incidence of perioperative myocardial infarction was higher in patients with triple-vessel coronary artery disease (13%) and those with left main stenosis (18%) than in patients with single- or double-vessel disease (4%) or those without coronary artery disease (4%). Because of the higher risk of aortic valve replacement in older patients, the risk-benefit ratio of the operation must be carefully assessed in the elderly. Improved methods of myocardial protection may reduce the risks for patients with aortic stenosis and symptomatic triple-vessel coronary artery disease.
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242
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Schwartz L, Arlin ML. Periodontal diseases. A differential diagnosis. ORAL HEALTH 1986; 76:29-33. [PMID: 3462603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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243
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Davis VA, Schwartz L. Dielectric properties of silver-gelatin granular suspensions. PHYSICAL REVIEW. B, CONDENSED MATTER 1986; 33:6627-6630. [PMID: 9937983 DOI: 10.1103/physrevb.33.6627] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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244
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Ullman S, Wilson RP, Schwartz L. Bilateral angle-closure glaucoma in association with the acquired immune deficiency syndrome. Am J Ophthalmol 1986; 101:419-24. [PMID: 3963100 DOI: 10.1016/0002-9394(86)90639-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Two homosexual men, 35 and 42 years old, had bilateral acute angle-closure glaucoma in association with the acquired immune deficiency syndrome. In one patient, the angle-closure attack was the initial manifestation of AIDS. Choroidal effusion with secondary anterior rotation of the ciliary body at the scleral spur appeared to be the pathophysiologic mechanism. Pupillary block, angle crowding, and inflammatory synechial angle closure must be differentiated from anterior rotation of the ciliary body as the mechanism of the angle closure to provide optimal treatment. Whereas primary angle closures are treated with miotics and iridectomy, secondary angle closure may be worsened with this treatment. Cycloplegics and, if necessary, drainage of suprachoroidal fluid may be curative in AIDS-related angle closure associated with a choroidal detachment. Both patients died before the long-term efficacy of this treatment could be assessed.
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245
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Auble TE, Schwartz L, Robertson RJ. CARDIORESPIRATORY RESPONSES TO HEAVYHANDS EXERCISE. Med Sci Sports Exerc 1986. [DOI: 10.1249/00005768-198604001-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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246
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Gorski JM, Schwartz L. A device to measure X-ray magnification in preoperative planning for cementless arthroplasty. Clin Orthop Relat Res 1986:302-6. [PMID: 3955963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Non-cemented press fit prostheses require a high degree of surgical precision for success. Since components vary in size by millimeters, the optimum preoperatively-determined size becomes a vital factor in selecting the correct size at the time of surgery. The preoperatively-determined component size is useful only if the information is obtained in a reliable and reproducible manner. The proper sequence combines X-rays of known magnification and templates of corresponding magnification. X-ray magnification is not a constant value even if the X-ray tube is maintained at a standardized height. Variables such as patient size and positioning make magnification measurements a necessity for every X-ray taken. A dense lead plate was designed for this purpose because commercially-available devices are over-penetrated by the X-ray exposures routinely used for hip roentgenograms. Manufacturers can provide templates in varying magnifications. This makes it possible to obtain a high correlation between the preoperative choice and the actual size chosen at surgery.
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247
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Schwartz L. President's address to the 1985 Connecticut Nurses' Association House of Delegates. CONNECTICUT NURSING NEWS (MERIDEN, CONN. : 1980) 1985; 58:1, 3. [PMID: 3853498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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248
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Christakis GT, Kormos RL, Weisel RD, Fremes SE, Tong CP, Herst JA, Schwartz L, Mickleborough LL, Scully HE, Goldman BS. Morbidity and mortality in mitral valve surgery. Circulation 1985; 72:II120-8. [PMID: 4028354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To develop strategies for the management of high-risk patients, contemporary risk factors for operative mortality and postoperative ventricular dysfunction were identified in 214 patients undergoing mitral valve surgery in 1982 and 1983. Thirty-eight preoperative and perioperative variables were prospectively collected and analyzed by univariate and multivariate statistics. The overall mortality was 4.6% and the incidence of postoperative low-output syndrome (LOS) was 18.7%. Forty-seven patients with coronary artery disease (CAD) had a higher mortality and incidence of LOS (as evidenced by the need for inotropic drugs or counterpulsation to maintain blood pressure) (those with CAD 15% mortality, 40% LOS; those without CAD 2% mortality, 13% LOS; p less than .05). The presence of unstable angina and ischemic mitral regurgitation further increased the risk. Age was also a predictor of outcome. Patients who died or had LOS were older (those who died, 65 +/- 7 years, those with LOS, 58 +/- 11 years) than patients who survived and did not have postoperative dysfunction (those who survived, 53 +/- 11; those with no LOS, 53 +/- 11; p less than .01). Mitral regurgitation was associated with a higher (p less than .05) mortality and incidence of LOS (mortality 10.5%, LOS 36%; n = 76) than was mitral stenosis (mortality 0%, LOS 4%; n = 74) or mixed lesions (mortality 3%, LOS 15%; n = 64). In patients without CAD, mitral regurgitation remained a significant predictor of mortality and ventricular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
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Habasha FG, Smith BP, Schwartz L, Ardans A, Reina-Guerra M. Correlation of macrophage migration-inhibition factor and protection from challenge exposure in calves vaccinated with Salmonella typhimurium. Am J Vet Res 1985; 46:1415-21. [PMID: 3896069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Migration of bovine macrophages under agarose was used to assess cellular immunity in 7 nonvaccinated calves and 9 calves vaccinated with Salmonella typhimurium. The 9 vaccinated calves were allotted to 4 groups. Group I calves were vaccinated twice orally with small doses of virulent S typhimurium; group II calves were vaccinated twice orally with genetically altered aromatic-dependent (aro-) S typhimurium SL3261; group III calves were vaccinated twice IM with small doses of virulent S typhimurium; and group IV calves were vaccinated twice IM with aro- S typhimurium SL1479. Samples of blood were obtained from these calves at 2 weeks after the 2nd vaccinal dose was given, and lymphocytes were harvested, using lymphocyte separation medium. Lymphocytes in serum-free medium were then incubated with S typhimurim antigen for 48 hours. Lymphocytes were then transferred to antigen-free medium and incubated for 48 hours, and the supernatant was assayed for the migration-inhibition factor (MIF). Lymphocyte supernatant was assayed for MIF by incubating it for 48 hours with 2.0 X 10(4) alveolar macrophages in agar wells. The macrophage migration distance was measured and compared with control values. Macrophage migration was inhibited in the presence of supernatant of lymphocytes from vaccinated calves that had been incubated with antigen, indicating the presence of the MIF in the supernatant. Migration distances, as a percentage of control, were 33% for group I calves (oral vaccination, virulent vaccinal organism), 60% for group II calves (oral vaccination, aro- vaccinal organism), 41% for group III (IM vaccination, virulent organism), and 25% for group IV (IM vaccination, aro- vaccinal organism).(ABSTRACT TRUNCATED AT 250 WORDS)
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Marquis JF, Schwartz L, Brown R, Matushinsky E, Mickleborough L, Aldridge H, Henderson M. Percutaneous transluminal angioplasty of coronary saphenous vein bypass grafts. Can J Surg 1985; 28:335-7. [PMID: 3160452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Between December 1981 and August 1983, percutaneous transluminal angioplasty of saphenous vein grafts was performed in 14 men and 4 women, selected because of recurrent anginal symptoms and graft stenosis. The interval from bypass to angioplasty was 41 +/- 36 months. Of 24 lesions, 9 were at the proximal anastomosis, 13 in the distal segment and 2 in the middle segment of the vein graft. The primary success rate was 79%. Failure to cross the stenosis occurred in three patients and failure to dilate in one. The stenosis was reduced from a mean of 82% +/- 13% to 26% +/- 15%. No patient required emergency coronary artery bypass grafting but two underwent elective grafting after the angioplasty had failed. No patient sustained a Q-wave myocardial infarction and all who had a successful angioplasty were asymptomatic or much improved after the procedure. Angiographic follow-up was available in 12 of 14 patients (86%). Six patients had significant symptoms (Canadian Cardiovascular Society class II to III) and five of these had evidence of restenosis. Among the six patients who were asymptomatic, two had angiographic evidence of restenosis. The overall rate of restenosis was 58% (7 of 12). Repeat angioplasty was successful in three of the five patients in whom it was attempted. The authors conclude that percutaneous transluminal angioplasty of a saphenous vein graft for a localized area of stenosis is effective and safe, but there is a high rate of restenosis that possibly is due to intimal fibrous proliferation in saphenous vein grafts.
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