Internists
37 years of experience

Accepting new patients
West Bloomfield
6450 Farmington Rd
Ste 103
West Bloomfield, MI 48322
248-661-0800
Locations and availability (7)

Education ?

Medical School Score
Wayne State University (1973)
  • Currently 1 of 4 apples

Awards & Distinctions ?

Appointments
University Of Michigan Medical School
ASSISTANT PROF
Northwestern University Medical School
ASSISTANT PROF
University Of Florida College Of Medicin
ASSISTANT PROF
University Of Texas Medical School At Ho
ASSISTANT PROF

Affiliations ?

Dr. Kaplan is affiliated with 8 hospitals.

Hospital Affilations

Score

Rankings

  • Providence Hospital and Medical Center
    16001 W 9 Mile Rd, Southfield, MI 48075
    • Currently 4 of 4 crosses
    Top 25%
  • St John Detroit Riverview Hospital
    7733 E Jefferson Ave, Detroit, MI 48214
    • Currently 3 of 4 crosses
    Top 50%
  • University Physicians Hospital at Kino
    2800 E Ajo Way, Tucson, AZ 85713
    • Currently 2 of 4 crosses
  • Eisenhower Med Center
  • Shands Hospital At The University Of Flo
  • University Medical Center
  • Providence Park Hospital
    47601 Grand River Ave, Novi, MI 48374
  • Mercy Hospital Turner Memorial
  • Publications & Research

    Dr. Kaplan has contributed to 38 publications.
    Title Comparison of Planned Dose Distributions Calculated by Monte Carlo and Ray-trace Algorithms for the Treatment of Lung Tumors with Cyberknife: a Preliminary Study in 33 Patients.
    Date April 2010
    Journal International Journal of Radiation Oncology, Biology, Physics
    Excerpt

    To compare dose distributions calculated using the Monte Carlo algorithm (MC) and Ray-Trace algorithm (effective path length method, EPL) for CyberKnife treatments of lung tumors.

    Title [prophylactic Requirements for Sanitary and Epidemiological Surveillance in Dentistry].
    Date March 2010
    Journal Gigiena I Sanitariia
    Excerpt

    The paper outlines the requirements for sanitary-and-epidemiological surveillance to prevent dental diseases. The investigations pose tasks to medical prevention centers to solve the problems in tooth prophylaxis, such as organizational-and-methodological, sanitary-and-educational, health-improving, and others. The sanitary-and-hygienic requirements for therapeutic-and-prophylactic dental facilities are defined. A procedure for keeping a management protocol for the prevention of tooth diseases is described.

    Title Christ/messiah Delusions Revisited: Toward an Anthropological Definition of Religious Delusions.
    Date September 2008
    Journal Psychoanalytic Review
    Title Exposures to Air Pollutants During Pregnancy and Preterm Delivery.
    Date July 2006
    Journal Environmental Health Perspectives
    Excerpt

    The association between preterm delivery (PTD) and exposure to air pollutants has recently become a major concern. We investigated this relationship in Incheon, Republic of Korea, using spatial and temporal modeling to better infer individual exposures. The birth cohort consisted of 52,113 singleton births in 2001-2002, and data included residential address, gestational age, sex, birth date and order, and parental age and education. We used a geographic information system and kriging methods to construct spatial and temporal exposure models. Associations between exposure and PTD were evaluated using univariate and multivariate log-binomial regressions. Given the gestational age, birth date, and the mother's residential address, we estimated each mother's potential exposure to air pollutants during critical periods of the pregnancy. The adjusted risk ratios for PTD in the highest quartiles of the first trimester exposure were 1.26 [95% confidence interval (CI), 1.11-1.44] for carbon monoxide, 1.27 (95% CI, 1.04-1.56) for particulate matter with aerodynamic diameter < or = 10 microm, 1.24 (95% CI, 1.09-1.41) for nitrogen dioxide, and 1.21 (95% CI, 1.04-1.42) for sulfur dioxide. The relationships between PTD and exposures to CO, NO2, and SO2 were dose dependent (p < 0.001, p < 0.02, p < 0.02, respectively) . In addition, the results of our study indicated a significant association between air pollution and PTD during the third trimester of pregnancy. In conclusion, our study showed that relatively low concentrations of air pollution under current air quality standards during pregnancy may contribute to an increased risk of PTD. A biologic mechanism through increased prostaglandin levels that are triggered by inflammatory mediators during exposure periods is discussed.

    Title Coronary Artery Diameter As a Risk Factor for Acute Coronary Syndromes in Asian-indians.
    Date October 2005
    Journal The American Journal of Cardiology
    Excerpt

    Asian-Indians have high rates of coronary artery disease (CAD), which also occurs at an earlier age, with 50% of all heart attacks occurring in patients <55 years old and 25% in those <40 years old. Previous studies have cited structural factors in Asian-Indians, specifically smaller coronary arteries, as the cause of increased CAD in this population. We found that Asian-Indian patients have smaller coronary arteries, with a statistically significant difference in the mean diameter even after correction for body surface area.

    Title Primary Angioplasty in a Patient with Dextrocardia.
    Date August 2005
    Journal Journal of Interventional Cardiology
    Excerpt

    Dextrocardia is a rare anomaly affecting 0.01% of newborns. We report on a case of a 60-year-old female with mirror-image dextrocardia who presented with an acute myocardial infarction and underwent primary angioplasty of the left circumflex artery. A review of the literature and technical challenges of the case will be addressed.

    Title Reversible Atrioventricular Block and the Amplatzer Device.
    Date May 2005
    Journal Journal of the American College of Cardiology
    Title Using Gis to Study the Health Impact of Air Emissions.
    Date March 2000
    Journal Drug and Chemical Toxicology
    Excerpt

    Geographical Information Systems (GIS) is a fast-developing technology with an ever-increasing number of applications. Air dispersion modeling is a well-established discipline that can produce results in a spatial context. The marriage of these two applications is optimal because it leverages the predictive capacity of modeling with the data management, analysis, and display capabilities of GIS. In the public health arena, exposure estimation techniques are invaluable. The utilization of air emission data, such as U.S. EPA Toxic Release Inventory (TRI) data, and air dispersion modeling with GIS enable public health professionals to identify and define the potentially exposed population, estimate the health risk burden of that population, and determine correlations between point-based health outcome results with estimated health risk.

    Title Nonrandomized Comparison Between Stent Deployment and Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial Infarction.
    Date January 2000
    Journal American Heart Journal
    Excerpt

    BACKGROUND: Compared with angioplasty, elective stent implantation has improved short-term and long-term outcome with a decrease in abrupt closure and a reduced 6-month restenosis rate. Although primary angioplasty during acute myocardial infarction has improved outcome, recurrent ischemic events and restenosis are still a problem. METHODS: Outcomes for 166 consecutively treated patients who underwent stent insertion procedures within 24 hours after the onset of acute myocardial infarction were compared with those for a similar group of patients (n = 212) who underwent consecutive balloon angioplasty procedures at one tertiary care institution. The objective of this study was to examine in-hospital and late clinical outcomes for the 2 groups. RESULTS: The procedural success rate for stenting in acute myocardial infarction was 100%; that for angioplasty was 98%. Mortality rates during hospitalization were similar for the stent group and the angioplasty group (4.0% vs 2.0%). The rate of in-hospital acute reocclusion necessitating urgent percutaneous reintervention was significantly lower for the stent group (0% vs 3%, P =.02). Six months after the procedure, the stent group had a significantly lower need for revascularization of the infarct-related artery (8% vs 20%, P =.001) and a significantly lower incidence of combined serious clinical events (death, acute occlusion, emergency bypass, target vessel revascularization, and nonfatal myocardial infarction; 12% vs 30%, P =.00003). CONCLUSION: Compared with balloon angioplasty, stent deployment in the setting of acute myocardial infarction was associated with significantly lower frequency of in-hospital acute occlusion and significantly less need for target-vessel revascularization 6 months after myocardial infarction.

    Title Murmurs Associated with Mitral Annular Calcification and Aortic Sclerosis.
    Date April 1999
    Journal Gerontology
    Excerpt

    Auscultation of patients with mitral annular calcification on echocardiography revealed a particular constellation of findings.

    Title Complete Av Block Following Mediastinal Radiation Therapy: Electrocardiographic and Pathologic Correlation and Review of the World Literature.
    Date January 1999
    Journal Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
    Excerpt

    The clinical, features, serial electrocardiograms, and autopsy findings of a patient with symptomatic complete AV block, who had received mediastinal radiation therapy 8 1/2 years previously, are presented. The cardiac histopathology disclosed immense fibrosis of the conduction system and of the atria and ventricles. The enormous amount of fibrosis was similar in location and intensity to that observed in our previously reported patient (Cohen et al., Arch Intern Med 1981; 141:676-679) who had undergone mediastinal radiation. We conclude that the severe fibrosis was primarily due to radiation, rather than secondary to atherosclerotic coronary artery disease, which also has been described as a consequence of mediastinal radiotherapy. This patient's serial electrocardiograms disclosed evidence of complete block both in the AV nodal area and infra His system, which correlated well with the histopathology. The characteristic clinical features of patients with symptomatic complete AV block post mediastinal radiation therapy are presented, along with a review of the world literature.

    Title Treatment of No-reflow in Degenerated Saphenous Vein Graft Interventions: Comparison of Intracoronary Verapamil and Nitroglycerin.
    Date February 1997
    Journal Catheterization and Cardiovascular Diagnosis
    Excerpt

    No-flow has been reported after 10-15% of percutaneous interventions on degenerated saphenous vein grafts. In this prospective study of 36 degenerated saphenous vein graft lesions (32 patients), no-flow (TIMI flow < 3 in the absence of a significant lesion or dissection) occurred in 15/36 (42%) lesions. A total of 32 episodes of no-flow occurred after angioscopy (n = 14), extraction atherectomy (n = 10), balloon angioplasty (n = 2) or stent implantation (n = 6). Intragraft nitroglycerin (100-300 micrograms) alone resulted in no improvement in TIMI flow in the setting of no-reflow (TIMI flow 1.2 +/- 0.6 to 1.4 +/- 0.8, P = NS). Intragraft verapamil (100-500 micrograms) resulted in improvement in flow in all 32 episodes (TIMI flow 1.4 +/- 0.8 before, to 2.8 +/- 0.5 after verapamil, P < 0.001). Although verapamil increased TIMI flow after all episodes of no-reflow, two (6.3%) had persistent no-reflow (TIMI 1) despite verapamil, associated with non-Q wave myocardial infarction. In conclusion, treatment of no-reflow with verapamil during degenerated vein graft interventions was associated with reestablishment of TIMI 3 flow in 88% of cases. In contrast, intragraft nitroglycerin alone was ineffective for reversing no-reflow.

    Title Optimal Burr and Adjunctive Balloon Sizing Reduces the Need for Target Artery Revascularization After Coronary Mechanical Rotational Atherectomy.
    Date January 1997
    Journal The American Journal of Cardiology
    Excerpt

    We analyzed the effect of differing burr and balloon sizes during mechanical rotational atherectomy on the need for target vessel revascularization at 6 months. The ideal burr/artery ratio and adjunctive balloon/artery ratio for optimizing acute luminal results and minimizing restenosis is unknown. Six-month clinical follow-up was obtained in 311 patients (339 lesions) treated with rotational atherectomy from August 1993 to September 1994, to determine whether procedural results or technique were related to the need for target vessel revascularization. Target vessel revascularization, defined as repeat percutaneous intervention or bypass surgery within 6 months after rotational atherectomy, occurred in 19% of patients. Larger burr/artery ratios, defined as the final burr size divided by the reference artery size, were correlated with decreased postatherectomy diameter stenosis (p <0.009) and decreased final diameter stenosis (p <0.03). However, there was no statistical association between postatherectomy or final diameter stenosis with need for revascularization (p = not significant [NS]). The need for revascularization was lowest for burr/artery ratio between 0.6 to 0.85 (15%) versus burr/artery <0.6 or >0.85 (25%) (p <0.04). Postatherectomy, smaller balloon/artery ratios, defined as the final balloon size divided by the reference artery size, were correlated with lower repeat revascularization rates. Balloon/artery ratios <0.95 (target vessel revascularization = 11% vs 25% in balloon/artery >0.95) were associated with the best luminal results and the least risk for clinical restenosis (p <0.006). For rotational atherectomy, despite improvement in acute luminal results with increased burr/artery ratio, the use of a moderate burr/artery ratio correlated with the lowest revascularization rates. There was no correlation between postatherectomy or final diameter stenosis and need for repeat interventions. However, the use of large balloon/artery ratios after rotablator was associated with higher target vessel revascularization rates.

    Title Successful Stent Implantation for Acute Myocardial Infarction After Failed Thrombolytic Therapy Associated with Massive Hemorrhage.
    Date December 1996
    Journal Catheterization and Cardiovascular Diagnosis
    Excerpt

    Stent implantation in the setting of failed rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction is considered a high-risk procedure, because of the possibility of stent thrombosis. Withholding anticoagulation in such a patient who also has a bleeding diathesis may further increase the risk of stent thrombosis. This case demonstrates the feasibility of stent implantation after failure of thrombolytic therapy and rescue angioplasty for acute myocardial infarction in the setting of massive intra-abdominal hemorrhage.

    Title Efficacy of Angioscopy in Determining the Effectiveness of Intracoronary Urokinase and Tec Atherectomy Thrombus Removal from an Occluded Saphenous Vein Graft Prior to Stent Implantation.
    Date December 1996
    Journal Catheterization and Cardiovascular Diagnosis
    Excerpt

    Percutaneous revascularization of thrombus containing saphenous vein grafts is associated with a high incidence of acute complications. This case report describes successful revascularization of an occluded vein graft employing angioscopically guided sequential urokinase infusion, TEC atherectomy and stent implantation.

    Title Repair of a Coronary Pseudoaneurysm with Percutaneous Placement of a Saphenous Vein Allograft Attached to a Biliary Stent.
    Date December 1996
    Journal Catheterization and Cardiovascular Diagnosis
    Excerpt

    Late coronary artery pseudoaneurysm formation is a rare complication of perforation following percutaneous intervention. While surgical intervention is the treatment of choice for large expanding pseudoaneurysms, the optimal treatment strategy for small-to-moderate pseudoaneurysms is unclear. We describe the percutaneous placement of a saphenous vein allograft for treatment of a coronary artery pseudoaneurysm presenting as a late complication of coronary perforation.

    Title Prospective Study of Extraction Atherectomy in Patients with Acute Myocardial Infarction.
    Date September 1996
    Journal The American Journal of Cardiology
    Excerpt

    Although percutaneous transluminal coronary angioplasty (PTCA) has been an effective treatment for primary reperfusion in acute myocardial infarction, patients with thrombolytic ineligibility, thrombolytic failure, cardiogenic shock, and vein graft occlusion remain at high risk for complications with PTCA treatment. The transluminal extraction catheter may be useful for treatment for such patients owing to its ability to aspirate thrombus. At 2 clinical centers, extraction atherectomy was prospectively evaluated in 100 patients (age 62 +/- 10 years). High-risk features included thrombolytic failure in 40%, postinfarct angina in 28%, presence of angiographic thrombus in 66%, presence of cardiogenic shock in 11%, and a saphenous vein graft occlusion in 29%. Procedural success, defined as a final residual stenosis <50% and Thrombolysis in Myocardial Infarction 2 or 3 grade flow, was seen in 94%. Events during the hospitalization included death in 5%, bypass surgery in 4%, and blood transfusion in 18%. In a substudy, patients enrolled at William Beaumont Hospital (n = 65) underwent elective predischarge angiography, which revealed a patent infarct-related vessel in 95%. These patients were also followed for 6 months with angiographic follow-up in 60%. Target vessel revascularization was necessary in 38%, and 6-month mortality was 10%. Although long-term vessel patency was 90%, angiographic restenosis occurred in 68%. Acute myocardial infarction patients can be treated with extraction atherectomy with a high technical success rate and a low incidence of complication. Infarct artery patency at 1 week and 6 months was excellent; however, angiographic restenosis remains a problem. Extraction of thrombus in this high-risk group of patients is associated with low in-hospital mortality and a high rate of vessel patency at 6 months.

    Title A Prolonged Intracoronary Infusion of Urokinase for Chronic Total Occlusions: Case Reviews.
    Date July 1996
    Journal The Journal of Invasive Cardiology
    Title Prospective, Randomized Trial of Prolonged Intracoronary Urokinase Infusion for Chronic Total Occlusions in Native Coronary Arteries.
    Date June 1996
    Journal Journal of the American College of Cardiology
    Excerpt

    OBJECTIVES: The purpose of this study was to determine the safety and efficacy of three dosing regimens of intracoronary urokinase for facilitated angioplasty of chronic total native coronary artery occlusions. BACKGROUND: Percutaneous transluminal coronary angioplasty of chronically occluded (>3 months) native coronary arteries is associated with low initial success secondary to an inability to pass the guide wire beyond the occlusion. METHODS: Patients were enrolled if a chronic total occlusion >3 months old could not be crossed with standard angioplasty equipment. Of the 101 patients enrolled, 41 had successful guide wire passage and were excluded from urokinase treatment. The remaining 60 patients were randomized to receive one of three intracoronary dosing regimens of urokinase over 8 h (group A = 0.8 million U; group B = 1.6 million U; group C = 3.2 million U), and angioplasty was again attempted after completion of the urokinase infusion in 58 patients. RESULTS: Coronary angioplasty was successful in 32 patients (53%) (group A 52%, group B 50%, group C 59%, p = 0.86). This study had a 90% power to detect at least a 50% difference between dosing groups at alpha 0.05. Bleeding complications requiring blood transfusion did not differ significantly among the dosing groups (A 0%, B 15%, C 6%, p = 0.14), although major bleeding episodes were less common in group A (p < 0.05). There were no major procedural or in-hospital complications. Angiographic follow-up in 69% of the patients with successful angioplasty revealed target vessel patency in 91% but an angiographic restenosis rate of 59%. CONCLUSIONS: A prolonged supraselective intracoronary infusion of urokinase can be safely administered and may facilitate angioplasty of chronic total occlusions. Lower doses of urokinase are equally effective and result in fewer bleeding complications than do higher dosage regimens. Vessel patency is frequently maintained, but restenosis remains a problem.

    Title Usefulness of Adjunctive Angioscopy and Extraction Atherectomy Before Stent Implantation in High-risk Aortocoronary Saphenous Vein Grafts.
    Date November 1995
    Journal The American Journal of Cardiology
    Title Vp-16, Vincristine and Procarbazine with Radiation Therapy for Treatment of Malignant Brain Tumors.
    Date July 1990
    Journal Journal of Neuro-oncology
    Excerpt

    Twelve patients aged 34 to 65 with malignant gliomas were treated with VP-16, Procarbazine, Vincristine and concurrent radiation therapy. There were 9 patients with glioblastoma multiforme and 3 with anaplastic astrocytoma. All patients had a subtotal resection or biopsy as the initial procedure. Six patients (1 anaplastic astrocytoma) have developed progressive disease. Mean time to tumor progression was 46 weeks. This combined modality treatment program was associated with reversible hematologic toxicity which was severe in 2 patients. These data compare favorably to data obtained from similar patients treated with radiation therapy and BCNU.

    Title A Phase Ii Study of Bisantrene in Advanced Refractory Breast Cancer. An Eastern Cooperative Oncology Group Pilot Study.
    Date December 1985
    Journal American Journal of Clinical Oncology
    Excerpt

    Thirty patients with advanced refractory breast cancer received bisantrene 260 mg/m2 intravenously every 3 weeks. Reversible myelosuppression was the most commonly observed side effect. Four patients (13.3%) achieved objective partial response (90% confidence intervals 3-24%), while two patients (6.6%) had disease improvement with a PR + IMP rate of 19.9%. Seven additional patients (23.3%) had stabilization of disease. This drug has antitumor activity against breast cancer and warrants further study, particularly if problems with drug delivery are overcome.

    Title Fetal Liver Ultrasound Measurements During Normal Pregnancy.
    Date October 1985
    Journal Obstetrics and Gynecology
    Excerpt

    The ultrasonically determined growth of the fetal liver during normal pregnancy is presented. The normal range of fetal liver sizes for each week of pregnancy from 20 weeks' gestation to term was determined. A linear relationship between fetal liver and abdominal circumference measurements also is described. Value and potential applications of this new fetal parameter are discussed.

    Title Ultrasound Fetal Thigh-calf Circumferences and Gestational Age--independent Fetal Ratios in Normal Pregnancy.
    Date July 1985
    Journal Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
    Excerpt

    The growth of the sonographically measured fetal thigh and fetal calf circumferences was studied during normal pregnancy. The normal range of fetal thigh and fetal calf circumferences for each week of pregnancy was determined from 20 to 41 weeks. The ratios of the ultrasonically measured fetal femur length to thigh circumference (expressed as femur length/thigh circumference X 100) and fetal tibia length to calf circumference (expressed as tibia length/calf circumference X 100) were also determined. These ratios were found to be relatively constant, with normal ranges after 20 weeks of 51.8 +/- 7.8 and 57.6 +/- 9.4 (mean +/- 2SD) respectively. The applications of these new fetal parameters in the evaluation of abnormal fetal growth patterns are discussed. It is suggested that these ratios should be used in evaluating fetal growth in high-risk patients who present late in pregnancy with unknown dates.

    Title Three Fetal Ponderal Indexes in Normal Pregnancy.
    Date July 1985
    Journal Obstetrics and Gynecology
    Excerpt

    The relationship of three different fetal ponderal indexes was studied in 116 normal pregnancies between 20 and 41 weeks. All three fetal ponderal indexes were found to be independent of gestational age. Throughout normal gestation, the femur length to abdominal circumference ratio X 100 was found to be 22.3 +/- 2.4 (mean +/- 2 SD), the tibia length to abdominal circumference ratio X 100 19.3 +/- 2.2 (mean +/- 2 SD), and the femur plus tibia length to abdominal circumference ratio X 100 41.6 +/- 4.2 (mean +/- 2 SD). The clinical applications of the different fetal ponderal indexes in evaluating fetal growth are discussed. Because they are independent of gestational age, the fetal ponderal indexes should prove most useful in evaluating fetal growth in high-risk patients with unknown dates.

    Title Zinc Transport in Pregnancy.
    Date August 1984
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    Although the importance of zinc nutrition during pregnancy has been well recognized, there have been few studies of zinc transport in maternal or fetal sera. We examined total serum zinc levels as well as zinc associated with its major transport proteins, albumin and alpha 2-macroglobulin, prospectively in 46 women during gestation and in 27 of their infants at term. In five women who developed preeclampsia during the third trimester, the mean total serum zinc level at 6 to 14 weeks was decreased by 14% compared to control values (p less than 0.05). Fetomaternal differences between the zinc transport proteins support the concept that each may have a specific role(s) in zinc homeostasis which is regulated to a greater extent by metabolic factors than by dietary zinc intake alone.

    Title Hereditary Angioedema and Pregnancy.
    Date July 1984
    Journal Obstetrics and Gynecology
    Excerpt

    Hereditary angioedema is a relatively uncommon disease that may affect women during their reproductive years. A case report of a pregnancy complicated by hereditary angioedema, followed by a review of the literature, is presented. Although the disease usually follows a benign course, maternal mortality has been noted. Features unique to pregnancy are discussed. Knowledge of the pathophysiology and possible complications is essential for the proper management of the pregnancy.

    Title Treatment of Meningeal Relapse in Childhood Acute Lymphoblastic Leukemia. I. Results of Craniospinal Irradiation.
    Date June 1984
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
    Excerpt

    Fourteen children were treated for isolated meningeal relapse occurring seven to 44 months (median, 14 months) after prophylactic cranial irradiation (2,400 rad/12 fractions) and intrathecal methotrexate (IT MTX, 12 mg/m2 for four doses during cranial irradiation). Eight had "high-risk" acute lymphocytic leukemia with age less than 2 years, white blood cell counts greater than 20,000, or T cell markers. Treatment for central nervous system leukemia included IT MTX (12 mg/m2 twice weekly until clearance of spinal fluid cytology) followed by craniospinal irradiation (CSI, 3,000 rad/20 fractions to the cranium and 1,800 rad/12 fractions to the spine). No maintenance IT MTX was given. Systemic chemotherapy was continued or reinstituted for a minimum of one year after CSI. No instance of second meningeal relapse has occurred. Five patients remain in secondary complete remission 66+, 54+, 36+, 26+, and 24+ months after meningeal relapse. Disease-free survival was limited by marrow relapse in eight patients (2-20 months after CSI) and testicular relapse in one. No acute toxicities were noted with CSI. Myelosuppression occurred in seven patients. Infections within two months of CSI were noted in five. No neurologic sequelae are apparent. Serial neuropsychometric studies in 10 patients revealed a significant decline in mean values on Global IQ scales. Long-term survival with acceptable toxicity is possible following aggressive, prompt treatment of meningeal relapse occurring after prophylactic cranial irradiation. Hematologic relapse remains the major obstacle to long-term disease-free survival.

    Title Treadmill Exercise Testing in Hypertensive Patients Treated with Hydrochlorothiazide and Beta-blocking Drugs.
    Date July 1983
    Journal Jama : the Journal of the American Medical Association
    Excerpt

    Twelve patients with hypertension who did not become normotensive after treatment with hydrochlorothiazide alone were studied. Treadmill exercise testing was done before and after additional treatment to standing resting normotension with beta-blocker drugs. The double product (peak mean BP times peak heart rate) at peak performance fell significantly because of decreases in systolic arterial BP and heart rate, but diastolic pressures still rose with exercise in ten of the 12 patients, in seven of them to 100 mm Hg or higher. Thus, the data show that patients with hypertension treated to resting normotension with hydrochlorothiazide and a beta-blocker still often demonstrate a significant diastolic BP rise with exercise. In such patients, a rise in diastolic BP with exercise cannot be used as evidence of coronary atherosclerosis. The measurement of the arterial BP response to exercise is probably important in the assessment of the effectiveness of individual antihypertensive regimens.

    Title Bilateral Renal Artery Thrombotic Occlusion: a Unique Complication Following Removal of a Transthoracic Intraaortic Balloon.
    Date August 1982
    Journal The Annals of Thoracic Surgery
    Excerpt

    An intraaortic balloon pump (IABP) was inserted through the ascending aorta during a coronary artery bypass operation. Five days later, after removal of the IABP and ligation of the end-to-side Dacron graft, the patient became acutely anuric. Abdominal aortography demonstrated a large "trapeze-shaped" thrombus which occluded both renal arteries. Following thrombectomy the patient recovered, with eventual return of renal function to the preoperative state.

    Title Prolactin Production by the Endometrium of Early Human Pregnancy.
    Date August 1980
    Journal The Journal of Clinical Endocrinology and Metabolism
    Title Sick Sinus Syndrome.
    Date February 1978
    Journal Archives of Internal Medicine
    Title Persistent Reversal of Severe Systemic Hypertension After Prolonged Toxic Reaction to Hydralazine.
    Date August 1976
    Journal Cardiology
    Excerpt

    A patient with severe progressive hypertension was treated with parenteral hexamethonium and large dosages of hydralazine. He developed a 'hydralazine syndrome', the etiology of which was not recognized for approximately 9 months. Upon discontinuance of hydralazine the patient was easily kept normotensive for over 20 years, using only small dosages of cryptenamine, reserpine and/or bendroflumethiazide. Similar observations are cited in the literature in seven other patients who were treated with hydralazine for significant periods of time after toxic symptoms occurred.

    Title The Tachycardia-bradycardia Syndrome.
    Date March 1976
    Journal The Medical Clinics of North America
    Excerpt

    The tachycardia-bradycardia syndrome (paroxysmal atrial fibrillation, flutter, or tachycardia followed by sinoatrial block or sinus arrest resulting in Stokes-Adams attacks) is an important clinical entity that requires familiarity by the clinician. Pathologic studies and physiologic mechanisms as revealed in the electrocardiogram indicate multiple disturbances in the conduction system of the heart (sinus node, atria, and atrioventricular junctional tissues). The electrocardiogram establishes the diagnosis. Pacemaker implantation with supplementary drugs has provided a satisfactory means of therapy. With proper treatment the prognosis of patients with the tachycardia-bradycardia syndrome has improved to the extent that the primary determinant of mortality is no longer the arrhythmia, but the underlying cardiac and/or systemic pathology.

    Title Tachycardia-bradycardia Syndrome (so-called "sick Sinus Syndrome"). Pathology, Mechanisms and Treatment.
    Date May 1973
    Journal The American Journal of Cardiology
    Title Response of Resistant Ventricular Tachycardia to Bretylium. Relation to Site of Ectopic Focus and Location of Myocardial Disease.
    Date March 1973
    Journal Circulation
    Title Clinical Pathologic Conference (coronary Disease).
    Date April 1967
    Journal American Heart Journal
    Title Effect on Serum Cholesterol of a Corn Oil and Skim Milk Mixture in Peptic Ulcer Patients.
    Date February 1966
    Journal The American Journal of the Medical Sciences

    Similar doctors nearby

    Dr. Mahmoud Rahim

    Internal Medicine
    33 years experience
    West Bloomfield, MI

    Dr. David Rosman

    General Practice
    27 years experience
    West Bloomfield, MI

    Dr. Tammi Cooper

    Internal Medicine
    17 years experience
    West Bloomfield, MI

    Dr. Steven Feldman

    Internal Medicine
    30 years experience
    West Bloomfield, MI

    Dr. Brian Kolender

    Internal Medicine
    18 years experience
    West Bloomfield, MI

    Dr. Gagandeep Randhawa

    Internal Medicine
    12 years experience
    West Bloomfield, MI
    Search All Similar Doctors