Search PubMed⌕ Search

Biomedical subjects

A Deutsch

Publications and source records attributed to A Deutsch.

At least 37 records · Page 2Linked to original sources
PubMed1996

An uncommon presentation of Salmonella.

Salmonella infection can cause appendicitis by direct invasion of the appendix, or can mimic appendicitis by causing mild inflammation of the appendix, ileum, or lymph nodes. Clinical presentation and radiologic and laboratory evaluation may not distinguish the extent of underlying pathology. This case of a child with an atypical presentation of Salmonella who underwent diagnostic laparotomy illustrates the overlap of enteric infections and acute appendicitis. A literature review confirms the variety of clinical scenarios of patients with suspected appendicitis and Salmonella-positive cultures. We conclude that enteric infection should be considered in children with atypical presentations of appendicitis, and that the knowledge that Salmonella can progress to appendicitis should guide management if signs and symptoms of appendicitis develop.

Adolescent↗
PubMed1995

Thoracic spinal nerve and root conduction: a magnetic stimulation study.

We describe a technique of magnetic coil (MC) stimulation of the thoracic spinal nerves and roots in 12 normal subjects and a patient with diabetes mellitus. We kept the MC flat against the vertebral column in the midline over T-7, T-8, and T-9 spinous processes and obtained compound muscle action potentials from the upper rectus abdominis, external oblique, and intercostal muscles. We obtained mean latencies to these muscles after stimulation in the posterior axillary line. We noted that the onset latencies remained fixed despite increasing the intensity of stimulation from 30% to 100% and on moving the coil up to 3 cm lateral to the spinous processes suggesting that the stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Prolonged latencies in the diabetic patient confirmed the diagnosis of radiculoneuropathy.

Adult↗
PubMed1995

Percutaneous magnetic coil stimulation of the phrenic nerve roots and trunk.

We describe a technique of percutaneous magnetic coil (MC) stimulation of the phrenic nerve trunk on one side of the neck and phrenic roots over the upper cervical vertebral column in 10 normal subjects and 2 patients. We were able to obtain compound muscle action potentials (CMAPs) from the diaphragm at two sites (xiphoid process and 7th intercostal space) after stimulation of the phrenic nerve trunk and roots. We noted that the onset latencies after phrenic root stimulation remained fixed despite increasing the stimulus intensity from 50% to 100% and on moving the MC vertically or laterally, suggesting that stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Absent responses unilaterally in one and prolonged latencies to diaphragmatic CMAPs in another patient confirmed phrenic neuropathy in these patients.

Action Potentials↗
PubMed1995

Personality traits in schizophrenia.

In recent years there has been a renewed interest in the integration of descriptive and interpersonal approaches to mental illness. Much of the impetus for this stems from the introduction in 1980 of the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) (American Psychiatric Association 1980), with subsequent research and clinical reports documenting important interactions between Axis I syndromes and Axis II personality trait factors. While many research efforts have described comorbidity in affective and anxiety disorders, less attention has been directed toward clarifying the relationships between stable and enduring character traits and Axis I symptoms in schizophrenia. In this paper we propose that schizophrenic patients display both adaptive and pathological personality traits throughout the illness, and that clinical and research efforts to address the interactions between syndromic and personality factors ("trait-state" interactions) will further our understanding of patterns of symptom presentation and treatment response in these patients.

Adult↗
PubMed1995

Elevated superoxide generation in mononuclear phagocytes by treatment with 1 alpha hydroxyvitamin D3: changes in kinetics and in oxidase cytosolic factor p47.

The effect of 1 alpha-hydroxyvitamin D3 (1 alpha OHD3) treatment on the superoxide production of phagocytic cells in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was studied. A 3-day treatment of CAPD patients with 3 micrograms per day of 1 alpha OHD3 (high-dose treatment) significantly increased NADPH oxidase and killing activities in peritoneal macrophages and peripheral blood monocytes (P < 0.001) as compared with low-dose (0.25 microgram/day of 1 alpha OHD3) treatment or nontreatment. The high oxidase activity observed in macrophages and monocytes after the treatment with 1 alpha OHD3, correlated significantly to the increase in the amount of the cytosolic factor p47 of the NADPH oxidase as detected by western blotting analysis. Superoxide production by the peripheral blood neutrophils of these patients only slightly increased with 1 alpha OHD3 treatment, and the amount of p47 was not affected by 1 alpha OHD3 administration. In order to evaluate the significance of the oxidase cytosolic factor in dictating oxidase activity, a reconstitution of NADPH oxidase was conducted by mixing macrophage cytosols and membranes in a cell-free system. The addition of macrophage cytosol from patients on high-dose treatment to macrophage membranes from patients in all of the categories of treatment resulted in significantly higher (P < 0.001) superoxide production as opposed to the macrophage cytosol from nontreated patients. These results suggest that 1,25(OH)2D3 causes an increase in NADPH oxidase activity in the peritoneal macrophages and monocytes of CAPD patients by inducing synthesis and elevating the amount of the cytosolic factor p47.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitriol↗
PubMed1994

Atrial natriuretic peptide and its potential role in pharmacotherapy.

Atrial natriuretic peptide (ANP) is a 28 amino-acid polypeptide secreted into the blood by atrial myocytes after atrial pressure and distension. Although its role in humans is not clear, it can produce a variety of physiologic effects including vasodilatation, natriuresis, and suppression of the renin-angiotensin-aldosterone axis. These actions are potentially useful in a variety of pathologic states such as hypertension and congestive heart failure, and diverse methods to augment the effects of ANP in these states have been devised. The results are exciting and, despite some problems, may lead to the pharmacologic use of enhancement of ANP actions in several clinical disorders.

Atrial Natriuretic Factor↗
PubMed1994

Symptomatic intraarticular ganglia of the cruciate ligaments of the knee.

This case report draws attention to the clinical presentation, differential diagnosis, and recommended diagnostic modality and treatment of symptomatic ganglia of the anterior and posterior cruciate ligaments. One patient presented with a recurrent inability to fully extend the left knee. Another patient presented with pain and soreness over the lateral aspect of the knee, including the lateral joint line. The diagnosis of ganglia of the cruciate ligaments was made after clinical, radiographic, and magnetic resonance examination. Both patients were treated successfully with resection of their ganglia using arthroscopic techniques.

Adult↗
PubMed1994

The superolateral portal for arthroscopy of the shoulder.

With the advent of arthroscopic procedures for the treatment of a variety of clinical conditions affecting the shoulder has come the need for better techniques for visualization of structural pathology, and better techniques for visualization of intracapsular structures during operative procedures. We present a new portal for shoulder arthroscopy that is safe to insert, providing a panoramic view of the glenohumeral joint (especially anteriorly), and allowing unobstructed observation of large instruments passed through more traditional anterior portals nearby. The superolateral portal is particularly suited for use in anterior stabilization procedures of the shoulder, where it can be used for direct visualization of the anterior glenoid neck, thus permitting the surgeon to perform such tasks as debridement or mobilization of tissues, and placement of tacks or sutures.

Arthroscopes↗
PubMed1994

Attention mechanisms mediate the syntactic priming effect in auditory word identification.

The syntactic priming effect and the involvement of attention in that process were investigated by testing identification of white noise-masked Hebrew words. Targets were either syntactically congruent or syntactically incongruent with the structure of the sentence. Relative to a neutral condition, similar facilitation and inhibition was found for congruent and incongruent targets, respectively. When syntactic congruency was blocked, the inhibition was attenuated, whereas the facilitation remained the same. A 350-ms silent interstimulus interval between context and target increased inhibition without affecting facilitation. We suggest that both the facilitation and the inhibition effects of syntactic priming are based on a veiled controlled process of generating expectations. The inhibition results from a controlled process of reevaluation that requires additional attention resources.

Acoustic Stimulation↗
PubMed1994

Direct antisperm antibodies using enzyme immunoassay or immunobeads. A prospective cohort comparison.

An enzyme immunoassay for detecting antisperm antibodies directly on sperm was compared to immunobeads in a prospective cohort design. In a series of 112 divided ejaculates evaluated for assisted reproductive technologies, there was moderate overall agreement (kappa = .64) between the methods. All ejaculates positive by immunobeads were also positive by enzyme immunoassay. The enzyme immunoassay could be performed even on oligospermic specimens. When both assays could be employed, the enzyme immunoassay was positive more often (P = .001). Positive specimens by enzyme immunoassay often bound IgA-class antibodies alone, without IgG. Enzyme immunoassay results may represent false-positive results or a new, lower threshold for antibody detection.

Antibodies↗
PubMed1993

Formation of morphological differentiation patterns in the ascomycete Neurospora crassa.

Morphological differentiation patterns--among them concentric rings and radial zonations--can be induced in the band-mutant of Neurospora crassa by appropriate experimental conditions, in particular by a mere shift of certain salt concentrations in the medium. The role of initial experimental conditions is examined and, furthermore, the influences of artificially induced phase differences are analyzed with respect to pattern formation. While the concentric ring pattern is due to some (endogenous) circadian rhythmicity within every hypha, nothing is known about the underlying mechanism of radial zonation development. Various hypotheses were tested with the help of a cellular automaton model which mimics growth, branching and differentiation of a fungal mycelium. In particular, sufficient conditions are provided which imply the formation of radial spore zonations. These conditions postulate a rather homogeneous microscopic hyphal branching pattern and induction of spore differentiation by means of an activator-inhibitor system. Furthermore, a working hypothesis for the formation of spore patterns in Neurospora crassa is suggested which is based on an extracellular control of fungal differentiation.

Cell Differentiation↗
PubMed1993

The role of personality in the treatment of schizophrenic and schizoaffective disorder inpatients: a pilot study.

As a prelude to a prospective study of personality functioning in chronically psychotic patients, the medical records of 736 hospitalized schizophrenic and schizoaffective disorder patients were retrospectively reviewed. The authors found much higher rates of Axis II personality disorder (PD) diagnoses among patients on extended-care inpatient units, which was consistent with their belief that clinicians on these units were using Axis II labels to document concurrent as well as premorbid personality factors. In addition, patients with PD diagnoses had significantly different courses of inpatient treatment, as documented by length-of-stay data. Level of function at discharge did not differ between those with and without PD diagnoses. The authors posit various hypotheses about these findings and discuss difficult conceptual and methodological issues regarding the influence of personality factors in schizophrenia.

Comorbidity↗
PubMed1992

Economic impact of HIV infection and coronary heart disease in immigrants to Canada.

OBJECTIVE: To compare the direct health care costs of illnesses associated with the human immunodeficiency virus (HIV) and of coronary heart disease (CHD) in immigrants to Canada. DESIGN: Comparative cost analysis. PARTICIPANTS: All people who immigrated to Canada in 1988. The numbers with HIV infection and CHD were estimated from country-specific HIV seroprevalence data and national CHD mortality statistics and data from the Framingham study. Health care costs, projected over the 10 years after immigration, were calculated on the basis of data from the Hospital Medical Records Institute and provincial fee schedules. RESULTS: Of the 161,929 immigrants in 1988, 484 were estimated to be HIV positive. The total cost of treatment of HIV-related illnesses from 1989 to 1998 (discounted at 3%) would be $18.5 million: $17.1 million would be spent on the outpatient and inpatient care of the HIV-positive immigrants, $1.0 million on care of the subsequently infected sexual partners and $0.4 million on care of the HIV-positive children born to seropositive immigrant women. In comparison, CHD would develop in 2558 immigrants during the same 10-year period. The total CHD costs would be $21.6 million: $8.4 million would be spent on treating myocardial infarction, $3.2 million on coronary artery bypass grafting, $1.6 million on pacemaker insertion and $8.4 million on treating other CHD events. CONCLUSIONS: The economic impact of HIV infection in immigrants to Canada is similar to that of CHD. This comparison identifies an important shortcoming in current immigration policy: economic considerations can be arbitrarily applied to certain diseases, thereby discriminating against specific groups of immigrants.

Adult↗
PubMed1992

Ultrastructural studies on the invasion of melanomas in initial lymphatics of human skin.

The way in which melanoma cells invade the initial lymphatics of the skin was investigated in this study. Samples of sixty melanomas were examined by transmission electron microscopy. Tumor cells invading lymph vessels were demonstrated in 20 specimens. In most cases the melanomas penetrated the subendothelial space as single cells. These fused with the endothelial cytoplasmic membrane and subsequently destroyed the endothelial wall.

Humans↗
PubMed1991

Kinematic magnetic resonance imaging of the joints: techniques and clinical applications.

Recently, kinematic magnetic resonance imaging (MRI) techniques have been developed to provide diagnostic information related to the functional aspects of the joints. The kinematic MRI evaluation of the joint is used to assess the various interactions of the soft tissues and bony anatomic structures that comprise the joint, and to evaluate the relative alignment of these structures through a specific range of motion. The use of kinematic MRI techniques for examination of the joints provides the radiologist and the clinician with augmented data of anatomic and movement-related information.

Humans↗