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Biomedical subjects

A M Spiekerman

Publications and source records attributed to A M Spiekerman.

12 recordsLinked to original sources
PubMed1992

Testosterone deficiency as a risk factor for hip fractures in men: a case-control study.

The objective of this study was to determine whether decreased gonadal function is a risk factor for hip fracture in elderly men. The study was a matched case-control study performed at an in-hospital orthopedic service at a semi-rural and academic tertiary care center. The patients were seventeen men who presented with hip fractures after simple falls over a 10-month period, 11 men with a history of hip fractures in the preceding 25 months, and 28 randomly selected age-, race-, and living status-matched control subjects (mean age 73 years). Serum pooled total testosterone (9.2 +/- 5.5 nmol/L vs. 12.8 +/- 5.4 nmol/L; p less than 0.02) and free testosterone (37.9 +/- 18.8 pmol/L vs. 48.4 +/- 20.6 pmol/L; p less than 0.03) were significantly lower in hip fracture vs. control patients. Testosterone deficiency was found in 20 (71%) hip fracture men vs. 9 (32%) of the controls (p = 0.003; odds ratio 5.3). Analysis of testosterone values within the stratum of absence of any chronic disorder revealed similar results. Serum 25-hydroxyvitamin D levels were significantly lower in the hip fracture group than in control men (p less than 0.001). The conclusion is that gonadal deficiency appears to be an important and heretofore understudied risk factor for hip fractures in men. Prevention of hip fractures in men may involve early recognition and treatment of testosterone deficiency.

Aged↗
PubMed1991

Prostate-specific antigen levels from completely sectioned, clinically benign, whole prostates.

Clinically benign whole, untrimmed prostates and pelvic lymph nodes were obtained from 105 patients at autopsy. All 105 patients had premortem serum from which prostate-specific antigen (PSA) levels were obtained. Sixty-eight did not have carcinoma of the prostate (CAP), 28 had CAP less than 1 ml and 9 had CAP larger than 1 ml. Eleven untrimmed prostates weighed 80 g or more and eight had elevated PSA levels (more than 4.0 ng/ml): five of eight without CAP, two of two with CAP less than 1 ml, and one of one with CAP larger than 1 ml. Ninety-four whole untrimmed prostates weighed less than 80 g and 20 had elevated PSA levels: ten of 60 without CAP, two of 26 with CAP less than 1 ml, and eight of eight with CAP larger than 1 ml. This study suggests that PSA levels from patients with untrimmed prostates weighing 80 g or more (equivalent to a 60-g trimmed prostate) are usually elevated regardless whether CAP is present. However, CAP less than 1 ml, in untrimmed prostates less than 80 g, usually does not elevate PSA levels whereas CAP larger than 1 ml usually does (P less than 0.0001). The likelihood that elevated PSA levels, from patients with untrimmed prostates less than 80 g, are due to CAP larger than 1 ml increases as the PSA level increases.

Adult↗
PubMed1990

Long-term inhibition of cellular proliferation by immunotoxins.

The proliferation and fibrous metaplasia of retinal glial and pigment epithelial cells cause proliferative vitreoretinopathy. The immunotoxin 454A12 MAB-rRA is composed of a murine monoclonal antibody, specific for the human transferrin receptor, and is chemically linked to recombinant ricin A chain, a cellular toxin. The rapidly proliferating cells take up the immunotoxin, but non-proliferating cells do not. Using a collagen-gel medium to simulate the vitreous, we have studied the effect of the immunotoxin on fibroblast proliferation in vitro. Exposure of the fibroblasts to 1000 ng of immunotoxin per milliliter of the collagen gel medium for 10 minutes kills 96% or more of the cells for 20 days. These in vitro data indicate that the immunotoxin is effective in an environment similar to the vitreous; however, in vivo studies will be necessary to prove if it is a suitable agent for the long-term prevention of cell proliferation in the human eye.

Animals↗
PubMed1989

Prostatic complications of testosterone replacement therapy.

The prostatic complications of testosterone replacement therapy have received little clinical attention. We describe three hypogonadal men who had prostatic disease (adenocarcinoma in two) detected in relation to such therapy. Literature review suggests that surveillance for early prostate cancer is appropriate during replacement therapy in men over the age of 50 years. We discuss the selective use of digital rectal examination, transrectal sonography, directed prostate biopsy, and prostate-specific antigen determinations before therapy and in subsequent follow-up in this age group of men during androgen replacement.

Aged↗
PubMed1987

Euthyroid hyperthyroxinemia and inappropriate secretion of thyrotropin. Recognition and diagnosis.

Various disease states associated with euthyroid hyperthyroxinemia and inappropriate thyrotropin secretion are becoming increasingly recognized. These diagnoses were established in six (11%) of 57 patients referred for evaluation of elevated free thyroxine index over an 11-month period. Failure to separate these entities from primary thyrotoxicosis may result in unnecessary thyroid ablative therapy and subsequent clinical confusion. Several illustrative patient summaries are presented to outline an approach to this clinical challenge.

Adolescent↗
PubMed1987

Effects of eight weeks of physical conditioning on atherosclerotic plaque in swine.

Effects of individually prescribed exercise on the regression or interference with deposition of atherosclerotic plaque were studied. Twenty miniature swine allotted, by litter, to a control-diet group (groups CE and CS) and an atherogenic diet group (groups AE and AS). All pigs were subjected to injury (balloon catheter) of the aortic endothelium. They were fed for 8 weeks and after an initial graded exercise test was done, then each group was suballotted to an exercising group (groups CE and AE) or a sedentary group (groups CS and AS). Groups CE and AE (exercised) were given 8 weeks of training. Groups CS and AS (sedentary) were sham exercised during this period. A second graded exercise test was administered to the swine (all groups) before they were euthanatized. Aortas were analyzed for the percentage of area involved and for atherosclerotic plaque density. Samples of blood from the swine after they were fasted were obtained before the start of the project (base line) and once every 2 weeks thereafter. These were analyzed for triglycerides, high- and low-density lipoprotein, and total cholesterol concentration. Comparison of results of blood lipid analyses from weeks 1, 9, and 15 did not show significant differences within diet groups between exercise and sedentary. Significant differences at weeks 9 and 15 were observed between diet groups (ie, the pigs fed the atherosclerotic diet had higher blood lipids). Plaque formation was not found in the pigs fed the control diet (groups CE and CS). Plaque formation was evident in all pigs fed the atherosclerotic diet (groups AE and AS) with no significant differences between exercised and sedentary groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1979

Lactose and casein content of nonpuerperal breast secretion.

Twenty-seven patients with nonpuerperal breast secretion were evaluated for the presence of casein and lactose in the secretions. Only two of seven patients with brownish or greenish secretions were positive for both lactose and casein although an additional six patients were positive for casein alone. Two patients with clear breast secretions were positive for both casein and lactose. However, 16 of 17 patients with milky or white secretions were positive for both casein and lactose. Although casein and lactose are more likely to be present in white breast secretions, other types of breast secretions may also contain these constituents.

Adolescent↗
PubMed1975

Immunoglobulin characterization of human pancreatic fluid.

Human pancreatic fluid obtained from 2 subjects, each with a traumatic pancreatic fistula, contained detectable levels of IgG, IgA, IgM, IdD, and IgE. Although the mean IgG/IgA ratio for 10 random specimens was 1.63, the relative concentration was estimated to be less than unity when extreme values were eliminated. The molecular weight of IgA in pancreatic fluid was found to be comparable to that of the IgA molecule in serum. The absence of secretory component in pancreatic IgA provides further evidence that pancreatic IgA and serum IgA are similar. Serial determinations of the immunoglobulins stored at 4 degrees C showed a progressive decrease of all immunoglobulins, the order of stability being IgG approximately equal to IgA larger than IgM approximately equal to IgD. The demonstrated proteolytic activity in the specimens could account for the immunoglobulin decay and for the variable detection of IgM and IgD in pancreatic-fluid specimens.

Abdominal Injuries↗
PubMed1975

Complement component analysis in angiodema. Diagnostic value.

Complement component analysis is valuable for differentiating the various types of angioedema. Patients with hereditary angioedema have decreased levels of C1 esterase inhibitor and C4 in the presence of normal amounts of C3 and C1q. Acquired C1 esterase inhibitor deficiency secondary to malignant disease is also manifested by depressed C1 esterase inhibitor and C4, but decreased C1q levels distinguish it from hereditary angioedema. Normal values for these complement components are found in persons with allergic angioedema.

Angioedema↗
PubMed1975

Improved high-resolution high-voltage paper electrophoresis system for use in screening for aminoacidopathies.

High-voltage paper electrophoresis of small samples of serum and urine at pH 6.0 resolves basic and acidic amino acids and separates them from the neutral amino acids. For separation and identification of the neutral amino acids, the appropriate area of the electrophoretogram is cut out, sewn onto a second sheet of paper, and rerun at pH 1.9. By this method, amino acids are rapidly resolved. It is suited for use with special procedures such as oxidation of biological fluid with performic acid and specific staining for confirmation of amino acid identification.

Amino Acid Metabolism, Inborn Errors↗