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Biomedical subjects

A Kessler

Publications and source records attributed to A Kessler.

At least 73 records · Page 4Linked to original sources
PubMed1994

Lipoprotein(a) concentrations in cord and capillary blood from newborns and in serum from in-patient children, adolescents and adults.

Investigations have been made upon the distribution of lipoprotein(a) concentrations in cord and capillary blood from newborns and in serum from in-patient children and adults. Full-term neonates (n = 123), children aged 1 month to 16 years (n = 331) and adults aged between 17 and 88 years (n = 252) of age were included in the study. Lipoprotein(a) was determined using an immunoluminometric assay and a single lot of reagents. The assay had an effective measuring range of 1-800 mg/l. Lipoprotein(a) could be measured either in cord or capillary blood in the majority of cases. Problems arose in isolated cases, in each of which there was a large concentration difference in lipoprotein(a) between mother and child. The correlation data was: r = 0.897, n = 37, log (capillary blood) = 0.874 log (cord blood) + 0.165. The median lipoprotein(a) concentrations in cord and capillary blood were 13.9 and 10.2 mg/l respectively. Median lipoprotein(a) concentrations increased from birth up until the 6th decade (159 mg/l), decreasing to 95 mg/l during the 9th decade of life. In mature newborns, the median lipoprotein(a) concentrations correlated with gestational age. The distribution of lipoprotein(a) concentrations in serum is skewed throughout life, the ratio mean/median being 2.07 at birth, 2.71 in children and 2.72 in adults. The percentage of children with lipoprotein(a) concentrations above 250 mg/l was 23.0 (male) and 23.8 (female). The corresponding figures for adults was 38.2 for males and 28.2 for females respectively. In the group of newborns 27.7 percent had concentrations above 25 mg/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Infected renal cysts: sonographic diagnosis and management.

IRC are rare entities characterized by fever and unilateral flank pain resistant to antibiotic therapy. In our series of nine IRC in eight patients, the predominant sonographic finding was an abnormal echogenic texture of the cyst contents, in contrast to previous reports that stressed the frequency of wall thickening as a sign of infection. Sonographically guided cyst aspiration and drainage of eight cysts in seven patients provided diagnostic material and resulted in relief of symptoms. Although the cause of IRC is uncertain, these entities may be more common than previously suspected.

Adult↗
PubMed1994

Acute changes in concentrations of apolipoproteins A-I, B, C-II and lipoprotein(a) in serum covering the period from directly before to 48 hours after chronic haemodialysis.

This study reports the changes in total cholesterol, triacylglycerols, apolipoproteins A-I, B, C-II and (a) before, directly after and 48 hours after chronic renal dialysis on 46 non-selected patients (20 male, 26 female; time since first dialysis 1-203 months (median 22 months), median age 52 years, range 25-82 years). Thirty six of the 46 patients (17 men and 19 women) suffered from hypertension. There were no sex-linked differences in any analyte except cholesterol, which was significantly higher in women than in men at all times. The apolipoproteins were determined with immunoluminometric assays. Apolipoprotein C-II was determined as the apolipoprotein C-II: apolipoprotein B complex. Lipoprotein(a) was determined using two antibodies directed against apolipoprotein(a). Significant increases (p < 0.05) in serum concentrations before and after dialysis were seen for all analytes with the exception of cholesterol (no significant change) and apolipoprotein C-II (significant decrease). The median increases were: cholesterol 5%, triacylglycerols 28%, apolipoprotein A-I 19%, apolipoprotein B 11%, apolipoprotein C-II -39%, lipoprotein(a) [all patients 21%, <300 mg/l 8%, > 300 mg/l 163%]. The values 48 hours after dialysis were not significantly different from the value before dialysis for cholesterol (-5%), apolipoprotein B (0%) and lipoprotein(a) (-2% - all patients). Statistically significant lower concentrations of apolipoprotein C-II (-28%) (p < 0.01) and triacylglycerols (-19%) (p < 0.01) were observed, but not investigated further. The behaviour of lipoprotein(a) was not correlated with any of the other analytes except triacylglycerols, where a statistically significant negative correlation was seen in all groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Reproductive health: towards a brighter future.

In 1972 the World Health Organization initiated the Special Programme of Research, Development and Research Training in Human Reproduction. Now cosponsored by the United Nations Development Programme, the United Nations Population Fund, the World Bank and WHO, the Programme has become the main instrument of research in reproductive health in the United Nations system. The progress that has been made, and the prospects for the future, are reviewed below.

Contraception↗
PubMed1993

Myoma vs. contraction in pregnancy: differentiation with color Doppler imaging.

During pregnancy, leiomyomas may cause complications such as spontaneous abortion, premature labor, and obstruction of labor. The conventional real-time ultrasound examination usually detects myomas adequately, but, in some cases, a local thickening of the uterine wall persists throughout the examination, interfering with the differentiation between myoma and contraction. In such cases, repeat scanning approximately 30 minutes later differentiates contractions, which usually resolve, from myomas. We examined 10 patients with B mode and color Doppler ultrasonography. In the 5 patients with myoma, we observed splaying of the vessels around the mass, whereas in the 5 patients with contraction, there was no vessel displacement in the area of the local myometrial thickening. The use of color Doppler and observation of these findings may obviate a prolonged ultrasound examination in questionable cases.

Female↗
PubMed1993

Hepatic and splenic sarcoidosis: ultrasound and MR imaging.

Abdominal imaging studies may be performed for various indications in patients known to have sarcoidosis. To assess magnetic resonance imaging (MRI) and sonographic ability to detect abnormalities in sarcoidosis patients with abdominal involvement, a prospective study on 18 selected patients was performed. Besides organomegaly, when present, ultrasound demonstrated normal or increased hepatic parenchymal echogenicity, coarsening of the liver parenchyma with or without discrete nodules, focal calcifications, as well as contour irregularity. Splenic discrete nodules were seen on ultrasound in a single patient. Besides organomegaly, MRI abnormalities include abnormal hepatic signal intensity, discrete nodules, contour irregularity, speculation of small hepatic vascular branches, and a high periportal signal intensity. MRI splenic abnormalities include contour irregularity, nodularity, and abnormal signal intensity. The data presented in this study reveals the spectrum of ultrasound and MRI findings in sarcoidosis patients with abdominal organ involvement, potentially enabling the evaluation of the severity of the disease. MRI appears more sensitive than ultrasound for study of abdominal sarcoidosis.

Female↗
PubMed1993

Sonography of the knee in normal and abused infants.

Sonography of an infant's knee is relatively easy and can show the non-ossified cartilage and adjacent soft tissues with great clarity. The normal anatomic features are characteristic and easy to learn and recognize. In abused infants, sonograms can confirm subtle or questionable radiographic abnormalities. In infants with metabolic bone disease, detection of occult fractures of the epiphyses is clinically important. Metaphyseal abnormalities due to neonatal ricktes should not be mistaken as signs of child abuse.

Child Abuse↗
PubMed1993

Childhood epiglottitis in recent years.

Fifty-five cases of acute epiglottitis were diagnosed and treated at the Children's Hospital of Philadelphia between 1985 and 1991. To evaluate the changing patterns of the disease over recent years, we compared the current results with those obtained from an earlier study reported at our institution in 1979. The overall annual incidence was higher in recent years than in the earlier study, with a sharp decline in new cases over the last two years. Thirty-six percent of the Hemophilus influenzae type B (HIB) infections were ampicillin-resistant in recent years, while no resistance had been found in the past. Twenty-seven percent of the cases were vaccine failures, all before 1990. Endotracheal intubation was the sole method for upper airway maintenance, while in the past 31% of the children underwent a tracheotomy. No mortality or long-term complications were found in either study.

Acute Disease↗
PubMed1992

Renal pyelectasis in pregnancy: correlative evaluation of fetal and maternal collecting systems.

OBJECTIVE: The current study is aimed at assessing the possibility of a statistical relationship between fetal and maternal collecting system dilatation during pregnancy. STUDY DESIGN: Two hundred thirty consecutive pregnant women and their fetuses (20 to 40 weeks' gestation) were simultaneously examined by ultrasonography. The renal collecting systems were measured, and the frequency of dilatation was subjected to chi 2 analysis. The temporal incidence of fetal pyelectasis was compared with the maternal incidence. RESULTS: Dilatation of maternal collecting systems was detected in 91 of 230 patients (40%) and fetal pyelectasis occurred in 60 of 230 (26%). Fetal pyelectasis was 5.6 times more likely to occur in fetuses of mothers with dilated collecting systems. Furthermore, the temporal incidence of fetal pyelectasis throughout pregnancy appeared similar to that of maternal pyelectasis. CONCLUSION: This study points out the existence of a statistically significant association between maternal and fetal collecting system dilatation during pregnancy.

Chi-Square Distribution↗
PubMed1992

Urethral stones: US for identification in boys with hematuria and dysuria.

There are multiple causes for hematuria in infants and children. When hematuria is accompanied by dysuria, however, one should focus attention on the lower urinary tract. Although ultrasound (US) is a well-established method for assessing the kidneys and bladder, little attention has been focused on its use for evaluating urethral abnormalities, since voiding cystourethrography or retrograde urethrography usually is used. In the cases of two young boys, sonography aided in the identification of clinically unsuspected urethral stones. US evaluation of the urethra is now included as an integral part of urinary tract sonography in male patients with hematuria accompanied by dysuria.

Child↗
PubMed1991

Resistance to NK cell-mediated cytotoxicity (in K-562 cells) does not correlate with class I MHC antigen levels.

Natural Killer (NK) cells probably function as an early line of defense against virus-infected cells and tumor cells. In all cases, the killing by NK cell-mediated cytotoxicity (NK-CMC) is not MHC-restricted and the factors which determine the sensitivity to NK-CMC have not yet been identified. A positive correlation between resistance to NK-CMC and the level of class I MHC antigen (MHC I) expression on target cells has been reported in many studies, and in some cases a functional linkage between the two has been claimed. Several other studies have shown that there is no such correlation. By employing several experimental systems, we demonstrate here a lack of correlation between the level of MHC I and the sensitivity of K-562 cells to NK-CMC. Transfer of MHC I to MHC I-negative cells via vesicles had no effect on their resistance to NK-CMC. In addition, a decrease in resistance to NK-CMC and increase of MHC I levels was observed following target-cell membrane modulation by both application of cholesterol and hydrostatic pressure. Finally, no correlation between sensitivity to NK-CMC and MHC I expression was found in three sublines of K-562 cells. Since NK-CMC is a multistage process, it is concluded that components other than class I MHC antigens have a more prominent role in modulating the sensitivity of target cells to NK-CMC.

Cell Death↗
PubMed1991

Oblique facial cleft with anophthalmia in a mentally normal child.

An oro-ocular facial cleft with anophthalmia, classified as Tessier cleft no. 4, was satisfactorily corrected by a series of conservative procedures, including tube pedicle flap transfer, Z plasties, and bone grafting for orbital socket and zygomatic reconstruction. Beginning in 1975 when the patient was 4 months old, most of the reconstructions were performed before the routine tissue expansion and microsurgical tissue transfer techniques that are common today. The patient's development is normal and he is intellectually more advanced than most children his age. Correction of increasing asymmetry between growing and nongrowing regions of the skull in this young boy will probably be required.

Abnormalities, Multiple↗
PubMed1991

Platelet autoantibodies in dementia and schizophrenia. Possible implication for mental disorders.

Platelets isolated from blood of demented and schizophrenic patients were found to bear surface antibodies at a considerably higher titer than those found on platelets from normal age-matched groups or patients with affective disorders. The platelet count in demented and schizophrenic patients correlated inversely with the level of the platelet associated antibodies (PAA) which suggested an autoimmune route of opsonization. In most individual cases of dementia or schizophrenia PAA and platelet count were found to oscillate with time between high PAA-low platelet number and low PAA-high platelet number in approximately inverse correlation. PAA isolated from demented patients were found to cross-react with platelets from normals and with brain tissue from rats. Furthermore, molecular weights of specific brain antigens were identified by binding to PAA. These observations support the possibility that PAA might be implicated in the etiology of some mental dysfunctions associated with dementia and schizophrenia.

Adult↗
PubMed1991

Superior vena cava occlusion in a patient with antiphospholipid antibody syndrome.

A 55-year-old woman with a lupus like disease, associated with the lupus anticoagulant, was admitted because of facial edema. Her facial swelling was previously attributed to the steroids she had been taking and they were tapered without improvement. Laboratory tests revealed high titers of anticardiolipin antibodies. Computerized tomography of her chest and Doppler ultrasound examination of her neck veins demonstrated a thrombus in the superior vena cava. She was treated with heparin and was maintained with longterm warfarin therapy with uneventful followup. Superior vena cava obstruction should be added to the long list of thromboembolic complications of the antiphospholipid syndrome.

Antibodies↗
PubMed1990

[Rapid expansion of the scalp using a soft tissue expander].

Reconstruction of large scalp defects depends on the ability to cover them with hair-bearing tissue. Using expanded tissue provides sufficient skin with characteristics suitable for covering large scalp defects. We used this technique in a 2-year-old boy to reconstruct a scalp defect caused by birth trauma. Rapid expansion of the scalp, using an expander introduced under normal scalp and an external valve, is recommended whenever dealing with children.

Child, Preschool↗
PubMed1990

[One-stage flap reconstruction of mandibular defects].

Reconstruction of mandibular defects following severe trauma or resection for malignancy presents a challenge. The mandibular shape and the close relationship of the bone to intra- and extra-oral soft tissues, make surgical procedures difficult. Reconstruction has to correct the bony and soft tissue defects, preserve mandibular functions (mastication, speech and swallowing), and allow the patient to wear dentures and to present an esthetic appearance. Techniques used for mandibular reconstruction have included implants of synthetic materials or rebuilding with autogenous bone grafts, and require a well-vascularized recipient bed. We used the free osteocutaneous scapular and iliac flap techniques, which avoid the disadvantages of local flaps and grafts. They were used in 3 patients after mandibular resection for fibrous dysplasia, osteosarcoma, and squamous cell carcinoma of the oral mucosa invading the mandible, respectively.

Adult↗