Recurrent subacute thyroiditis: a report of three cases.
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Adult↗
Biomedical subjects
A Friedman
Publications and source records attributed to A Friedman.
Hypertension screening in the follow-up of premature infants.
Results of hypertension screening using the Doppler technique in a group of premature infants following discharge from an intensive care nursery are reported. Systolic blood pressure (BP) was measured at follow-up in 79/99 premature infants who were cared for in the special care nursery over a 9-month period. The mean BP was 99.3 +/- 2.0 (SEM) mm Hg at a mean age of 14.7 +/- 1.3 weeks; mean age corrected for 40 weeks of gestation was 7.4 +/- 1.3 weeks. Seven infants (8.9%) with BP greater than 113 on three separate occasions were identified as hypertensive. Three of these hypertensive infants were found to have a specific etiology requiring treatment: neuroblastoma, coarctation of the aorta, and unilateral ureteropelvic junction obstruction. No difference was found between the hypertensive and normotensive infants for a variety of perinatal and neonatal factors, including the presence or duration of an umbilical arterial catheter. These data suggest that the premature infant may be at risk for the development of hypertension. In the future, neonatal follow-up programs may find hypertension screening a useful part of their evaluation.
Blood Pressure↗
Effect of frequent breast-feeding on early milk production and infant weight gain.
To investigate the effects of frequency and duration of breast-feeding on infants' milk intake and weight gain, two groups of mother-infant pairs were studied during the first month after delivery. Mothers in the control group (n = 24) nursed their infants on a 3- to 4-hour schedule. Those in the experimental group (n = 20) were encouraged to nurse frequently. During the first 14 postpartum days, all mothers recorded the length and time of each breast-feeding. On the 15th and on the 35th postpartum day, milk intake per feeding for 24 hours and infant weight gain from birth were measured. During the first 2 weeks after delivery, mothers in the experimental group nursed more frequently (9.9 v 7.3 feedings per 24 hours; P less than .0001). On day 15, their infants took more milk (725 v 502 mL/24 h; P less than .0002), and had gained more weight from birth (561 v 347 g; P less than .02). On day 35, although mothers in the experimental group were still nursing more frequently (9.8 v 6.8 feedings per 24 hours; P less than .01), milk intake and weight gain from birth were not significantly different.
Body Weight↗
Operative failure and secondary repair in Hirschsprung's disease.
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Abscess↗
Synthesis and immunoadjuvant activities of 2-acetamido-5-O-acetyl-6-O-acyl-2-deoxy-3-O-[(R)-2-propionyl-L-alanyl-D- isoglutamine]-D-glucofuranoses as potential prodrug forms of 6-O-Acyl Derivatives of N-acetylmuramyl dipeptide.
2-Acetamido-5-O-acetyl-6-O-acyl-2-deoxy-3-O-[(R)-2-propionyl-L-alanyl-D- isoglutamine]-D-glucofuranoses, designed as prodrug forms of the corresponding immunoadjuvant-active 6-O-acyl derivatives of N-acetylmuramyl dipeptide (MDP), were synthesized from benzyl 2-acetamido-2-deoxy-5, 6-O-isopropylidene-beta-D-glucofuranoside and found, when administered to mice in an aqueous medium, to elevate antibody production against bovine serum albumin. The 5,6-di-O-acetyl derivative 8 exhibited activity similar to that of MDP at 50 micrograms/dose. The antibody titer measured for the 5-O-acetyl-6-O-stearoyl compound 9 was comparable to that obtained with 6-O-stearoyl-MDP at 50 micrograms, and both compounds were more active than MDP at 5 micrograms. The more lipophilic 5-O-acetyl-6-O-[2-(behenoyloxy)isobutyryl] compound 10 was considerably more active than MDP at both 50 and 5 micrograms; moreover, its potent adjuvant activity was not diminished at the lower dose. The three 5-O-acetylated 6-O-acylated dipeptidyl furanose derivatives also significantly stimulated production of circulating antibodies against hepatitis B vaccine in mice; titers were comparable to those observed with the alum-adsorbed vaccine. The range of immunoadjuvant activities obtained with 8-10 and control compounds supports a prodrug mechanism for this class of furanoid MDP analogues.
Acetylmuramyl-Alanyl-Isoglutamine↗
Dividing attention within and between hemispheres: testing a multiple resources approach to limited-capacity information processing.
Two experiments tested the limiting case of a multiple resources approach to resource allocation in information processing. In this framework, the left and right hemispheres are assumed to have separate, limited-capacity pools of undifferentiated resources that are not mutually accessible, so that tasks can overlap in their demand for these resources either completely, partially, or not at all. We tested all three degrees of overlap in demand for left hemisphere supplies, using dual-task methodology in which subjects were induced to pay different amounts of attention to each task. Experiment 1 compared complete and partial overlap by combining a verbal memory load with a task in which subjects named nonsense syllables briefly presented to either the left or right visual field (LVF and RVF, respectively). Experiment 2 compared complete versus no overlap by using the same verbal memory load combined with a laterally presented same-different judgment task that did not require a spoken response. Decrements from single-task performance were always more severe when the visual field task stimulus was presented to the RVF. Further, subjects in Experiment 1 were able to trade performance between tasks on both LVF and RVF trials because there was always at least some overlap in left hemisphere demand. In Experiment 2, performance trade-offs were observed on RVF (complete overlap) trials, but not on LVF trials, where no overlap in demand existed. These results contradict a single-capacity model, but they support the idea that the hemispheres' resource supplies are independent and have implications for both cerebral specialization and divided attention issues.
Attention↗
Factors influencing changes in pH during storage of platelet concentrates at 20-24 degree C.
The magnitude of the pH change during platelet concentrate storage at 20-24 degree C in polyvinyl chloride containers is not determined solely by platelet count per cubic millimeter of plasma, since a wide variation in pH was observed with similar platelet concentrations. In modified platelet concentrates having lost through centrifugation 3-15% of total platelets and 61-92% of residual leukocytes, the pH was maintained at substantially higher levels than in the paired control platelet concentrates. Leukocyte levels do not appear to determine the magnitude of the pH fall. Continuous oxygen utilization is needed if the pH is to be maintained near 7.0. However, oxygen tension per se is not the factor which influences the extent of pH change. It has been concluded that a specific platelet subpopulation comprising a small proportion of the total platelets in concentrates and having an enhanced capacity to form lactate may be responsible for a major part of the pH reduction which occurs during storage of many platelet concentrates.
Antimycin A↗
Dietary adaptation of taurine transport by rat renal epithelium.
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Animals↗
Absorptive function of the aganglionic ileum.
In children with colonic and iliac aganglionosis, the aganglionic intestine is usually either removed or bypassed. Since fluid absorption occurs predominantly in the terminal ileum, malabsorption often occurs unless the intestinal transit time is reduced. The Martin-Duhamel operation, reducing transit and thereby increasing the time of exposure of intestinal content to the lowest part of the ganglionic intestine, has been used successfully in most children with colonic and short ileal aganglionosis. With longer segments the slowdown of intestinal transit may be inadequate and the aganglionic ileum can then be used. The aganglionic ileum maintains its absorptive capacity if the obstructive element is removed using an aganglionic-ganglionic iliac anastomosis similar to the Martin-Duhamel technique.
Female↗
Hemispheres as independent resource systems: limited-capacity processing and cerebral specialization.
In this article, we develop as framework for understanding how cerebral specialization of function contributes to the flexibility of human information processing. We propose that the left and right hemispheres together form a system of two mutually inaccessible and finite pools of resources. Further, we propose that these two types of resources cannot be made available in different amounts at any given time. This framework is essentially a special case of a multiple-resources model of limited-capacity information processing. It accounts for a broad range of data from experiments involving perceptual and cognitive information processing, control of motor performance, and changes in electrical activity of the brain. It also provides insights into why the cerebral specialization literature has been plagued with problems that have made theorizing so difficult. In addition, the theory provides insights into mechanisms that might be responsible for patterns of task interference that are not easily handled by an information-processing model in which processes compete for supplies from a single pool of undifferentiated resources. Thus, the framework we are proposing has important theoretical and methodological implications for researchers in both divided attention and cerebral specialization.
Attention↗
Adrenal scan in 17-alpha-hydroxylase deficiency: false indication of adrenal adenoma.
A patient who was thought to have testicular feminization syndrome and primary aldosteronism had an adrenal scan that suggested an adrenal adenoma. After later diagnosis of 17-alpha-hydroxylase deficiency, she was treated with glucocorticoids rather than surgery. Her clinical course and a repeat adrenal scan confirmed she did not have a tumor.
Adenoma↗
Effects of thiopentone on cardiac performance, coronary hemodynamics and myocardial oxygen consumption in chronic ischemic heart disease.
Thiopentone was administered as induction agent for general anesthesia to eight patients with stable ischemic heart disease; 6 mg/kg of the drug induced decrease in arterial blood pressure (-27%), systematic vascular resistance (-20%), stroke volume index (-14%), mean pulmonary arteriolar occlusion pressure (-15%) and left ventricular stroke work index (-38%), while heart rate increased by 10% and cardiac output remained unchanged. Total body oxygen consumption decreased by 30%. Myocardial oxygen consumption decreased by 39% with unchanged or decreased myocardial oxygen extraction and myocardial lactate uptake decreased by 40%. Arterial and coronary sinus hypoxanthine levels were unchanged and no ST-T-segment changes or dysrhythmias were recorded. In the present experimental setting, the results indicate that thiopentone substantially decreased myocardial oxygen requirements. In spite of the marked reduction in coronary perfusion, myocardial oxygen demand was matched by supply, myocardial dysoxia was not induced and cardiodepression was clinically negligible. Rate pressure product was a poor indicator of changes in myocardial oxygen consumption after thiopentone administration.
Aged↗
Hemodynamic and cardiometabolic effects of prenalterol in patients with acute myocardial infarction and shock.
Five patients with acute myocardial infarction and shock were treated with a new, highly selective beta-1-adrenoreceptor agonist, prenalterol. After 1 and 2 mg of the drug, all patients had markedly increased blood pressure and cardiac output, but no changes in heart rate or systemic vascular resistance. Left- and right-sided filling pressures decreased in three of the patients. In two of the patients, however, the increase in contractility and afterload was followed by a marked increase in left- and right-sided filling pressures, and myocardial lactate uptake changes to lactate production. After addition of sodium nitroprusside, blood pressure and filling pressures returned towards normal, and myocardial lactate uptake was restored. As anticipated from the hemodyanamic findings, myocardial oxygen consumption increased after prenalterol. It is suggested that the potent inotropic agent prenalterol may be used with great caution in cardiogenic shock.
Adrenergic beta-Agonists↗
Fanconi's syndrome in renal transplantation.
An association between Fanconi's syndrome and renal transplantation has been reported. We report a patient who developed Fanconi's syndrome coinciding with a rejection episode 4.5 years following living related donor transplantation. Recurrent disease and hyperparathyroidism were ruled out as etiologies of Fanconi's syndrome. The presence of Fanconi's syndrome--associated with rejection in the transplanted kidney--may signify immunologically mediated alterations in tubular function. Antitubular basement membrane antibodies have been reported in renal allograft recipients. Further study into the pathogenesis of Fanconi's syndrome in renal transplantation may shed light on the spectrum of immunologically mediated dysfunction following renal homotransplant.
Adolescent↗
Diabetic glomerulopathy may be preventable.
Variation in blood glucose levels throughout the day was assessed in six diabetic maintenance hemodialysis patients and six diabetic renal transplant recipients. None of the twelve studied patients had good control. Glucose levels greater than 300 mg/dl were noted in four of six dialysis patients and five of six transplant recipients. A regimen of self blood glucose measurement and multiple insulin doses was instituted for four transplant and three dialysis patients. Each patient achieved the desired glucose range of 60 to 120 mg/dl most of the time, with a resultant fall in mean hemoglobin A1c concentration from 10.3% to 7.9%. It is suggested that a long term trial of self glucose monitoring might prove beneficial to treated uremic diabetics.
Adult↗
The significance of splenomegaly in 101 adults with acute lymphoblastic leukemia (ALL) at presentation and during remission.
One-hundred-one adult patients with ALL were analyzed to determine the prognostic implications of splenomegaly occurring at any time during the course of their illness. The clinical status of the spleen at presentation was not found to be of major prognostic significance. Complete response rates, remission durations, and survivals did not differ between patients with and without splenomegaly at presentation. An enlarged spleen accompanied relapse in four patients. In six additional patients, splenomegaly was present during complete remission, and splenectomies performed in five of these patients revealed no evidence of leukemia to account for the splenomegaly. Splenectomy does not appear to be detrimental, as all five patients are currently in complete remission from 20 to 63 mo after splenectomy. Evidence implicating the spleen as a source of an antibody directed against autologous leukemia cells in one patient is reviewed.
Adolescent↗
Oxalosis-induced bone disease: a complication of transplantation and prolonged survival in primary hyperoxaluria.
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Amino Acid Metabolism, Inborn Errors↗
Foreign body in the airway. A review of 200 cases.
Two hundred children aged 6 months to 12 years were admitted to the hospital with a foreign body in the airway. Food materials constituted 93% of all foreign bodies. A positive history of foreign body aspiration was obtained in 88% of the cases. The most common symptoms of laryngotracheal foreign bodies were dyspnea, cough, and stridor, whereas those of bronchial foreign bodies were cough, decreased air entry, wheezing, and dyspnea. Chest fluoroscopy contributed to the diagnosis in 90% of the cases of bronchial foreign bodies, but only 32% of those in the laryngotracheal area. Of the foreign bodies removed, 98 1/2% were done by laryngoscopy, tracheoscopy, and/or bronchoscopy. Complications were involved in 6% of the cases, including one death. History of recurrent intractable pneumonia should make one consider a foreign body in the airway. Removal of one foreign body does not exclude the existence of another. The condition may be fatal; thus immediate removal of the foreign body is mandatory.
Airway Obstruction↗