Children's experience of surgery: creating a holistic environment.
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Ambulatory Surgical Procedures↗
Biomedical subjects
B Halpern
Publications and source records attributed to B Halpern.
Five ways to receive tax-free income.
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Humans↗
High school football injuries: evaluation.
An epidemiologic survey of the literature on high school football injuries revealed methodologic problems. These numerator-denominator inconsistencies and other confounding factors are discussed. The authors suggest a more reliable system of reporting these parameters to further reduce the risk of high school football injuries.
Adolescent↗
High school football injuries: identifying the risk factors.
This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are presented: 1) optimum maintenance of playing fields; 2) use of the soccer-style shoe; 3) noncontact and controlled activities in practice sessions; and 4) increased vigilance over technique during injury-prone preseason practices. The authors conclude that more research into factors such as exposure time and activity at injury will further reduce the risk to the high school football player.
Adolescent↗
Reduced prolactin binding to liver membranes during pheromonal emission in the rat.
Between 14 and 27 days of lactation, female rats excrete a pheromone in their feces that is cholic-acid dependent and that strongly attracts young. Previous research has shown that high circulating levels of prolactin are necessary before the pheromone can be emitted. However, during the time of pheromonal emission prolactin in serum conspicuously declines, while in hepatic cytosol the hormone reaches peak levels. We were interested in the question of how the liver can show peak cytosolic concentrations of prolactin at a time of falling blood levels of prolactin. Accordingly, we examined the prolactin binding capacity of liver membrane fractions during selected periods of lactation. We also studied the livers of virgin and pregnant females for comparison. Three membrane fractions were separated: the cell membrane, the nuclear membrane and a fraction consisting of the cell membrane and large non-nuclear organelles. In all three fractions, there was an increase in available and total prolactin binding in the liver when pregnant females were compared with nulliparous females. However, during the time of pheromonal emission, when prolactin in hepatic cytosol was elevated, there was a significant reduction in the prolactin binding capacity of the liver. How such a reduction increases the cytosolic concentration of the hormone and in turn heightens cholic acid output and pheromonal emission remains unsolved.
Animals↗
Gestational trophoblastic disease. The effect of duration of disease and hCG titer on response to therapy.
The height of the pretreatment hCG titer and the time interval from termination of the antecedent pregnancy to institution of treatment were determined in 352 patients with gestational trophoblastic disease in order to judge their effect, both individually and together, on response to therapy. When all patients in need of treatment for gestational trophoblastic disease, both metastatic and nonmetastatic, were considered as one group, examination of time alone, of hCG titer alone and of time and titer together each permitted the identification of patients at high risk with equal reliability (p less than 0.0005 for each). When patients with only metastatic gestational trophoblastic disease were evaluated, time and titer taken separately and together each identified those patients at high risk, but not in an equal manner (time alone, p = 0.02; titer alone, p less than 0.05; time and titer together, p less than 0.0005). Time and hCG titer, alone or in combination, did not have a statistically significant effect on outcome when patients with metastatic choriocarcinoma were considered separately. Other factors, such as metastatic site and antecedent pregnancy, seem to be more important in determining prognosis than duration of disease and hCG titer in this group of patients.
Choriocarcinoma↗
Gestational trophoblastic disease: treatment results at the Brewer Trophoblastic Disease Center.
Three hundred fifty-nine patients with gestational trophoblastic disease (choriocarcinoma and invasive mole) received complete treatment at the Brewer Trophoblastic Disease Center of Northwestern University Medical School from 1962 through 1978. Data were gathered as of December 31, 1978, to permit a minimum follow-up of 2 years. An overall remission rate of 92% was achieved: 100% (185/185) for nonmetastatic disease and 83% (144/174) for metastatic disease. All 200 patients with invasive mole and 129 of 159 patients (81%) with choriocarcinoma were cured. Chemotherapy was the main form of treatment, with adjuvant surgery and radiation therapy being used in selected patients. Five factors were determined to significantly influence response to treatment in patients with metastatic disease: 1) clinicopathologic diagnosis of choriocarcinoma versus invasive mole (71 versus 100%, P much less than .0005); 2) pretreatment human chorionic gonadotropin titer greater than 100,000 IU/liter and time greater than 4 months from pregnancy event to treatment (62 versus 93%, P much less than .0005); 3) metastases to sites other than lung and/or vagina (37 versus 92%, P much less than .0005); 4) antecedent term gestation compared with hydatidiform mole, abortion, and ectopic pregnancy (56 versus 79%, P less than .02); and 5) prior unsuccessful chemotherapy compared with no previous treatment (48 versus 83%, P much less than .0005). The value of secondary chemotherapy and adjuvant irradiation was evaluated. Relapse from remission was also studied.
Antineoplastic Agents↗
Mass spectographic analysis of stimulated release of endogenous amino acids from rat hippocampal slices.
Amino acids released from in vitro rat hippocampal slices following stimulation of the Schaffer's collateral pathway, were collected by micro-perfusion and analysed by chemical ionization mass spectrometry, with isotope ratiodetermination as the quantitative technique, through the use of stable, isotopically labeled internal standards. Stimulation at 10 pulses/sec resulted in a doubling of the release of aspartic acid over the resting level and about a 60% increase in glutamate release, which is in essential agreement with studies utilizing K+ depolarization-evoked release from slices.
Amino Acids↗
New metabolites in isovaleric acidemia.
Two metabolites, 4-hydroxyisovaleric acid and mesaconic acid, have been identified and quantified in the urine of a patient with isovaleric acidemia. These compounds do not appear to have been reported previously as being components of human metabolism. In addition, large quantities of 3-methylbutyrolactone, the lactone of 4-hydroxyisovaleric acid, were observed in the volatile profile obtained by headspace chromatography. The demonstration of 4-hydroxyisovaleric acid supports the contention that urinary methylsuccinic acid seen in patients with isovaleric acidemia has arisen by omega-oxidation of isovaleric acid. The identification of mesaconic acid may indicate that the methylsuccinic acid formed in these patients is subject to further metabolism.
4-Butyrolactone↗
In vitro effect of dopamine and pimozide on human chorionic gonadotropin secretion.
In human placental explants cultured in vitro, dopamine inhibited human chorionic gonadotropin (hCG) secretion into the culture media. In the control flasks, the level of hCG secretion was 751 +/- 215 mIU/gm of tissue. When 1 mM of dopamine was added, hCG levels decreased to 321 +/- 57.6 mIU/gm of tissue (n = 6, P less than 0.1)--5 and 10 mM of dopamine significantly inhibited hCG secretion. In contrast, 1 mM of pimozide enhanced hCG secretion by 1.8-fold compared to control levels (1,707 +/- 343 versus 3,117 +/- 0.005). This in vitro effect on hCG is similar to the effect of dopamine and pimozide on hCS secretion by placental explants.
Chorionic Gonadotropin↗
Hyperammonaemia and urinary organic acids.
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Amino Acid Metabolism, Inborn Errors↗
[Effect of Corynebacterium parvum on serum lysozyme (muramidase) levels (author's transl)].
An i.v. injection of 548 microgram of killed Corynebacterium parvum into C57B1 mice leads to significant changes in serum lysozyme (muramidase) levels. After an initial fall at 24 h, the activity of the enzyme increased progressively, reached a peak on the 9th day and returned to control range after the 15th day.
Animals↗
Studies on a child suspected of having a dficiency in 3-hydroxy-3-methylglutaryl-Co A lyase.
The urine of a child who presented with hyperammonemia was found to contain elevated levels of 3-hydroxy-3-methylglutaric acid, 3-methylglutaconic acid and 3-methylglutaric acid. An increased excretion of these organic acids has been reported previously in a child with 3-hydroxy-3-methylglutaryl-CoA lyase deficiency. Enzyme studies using cultured fibroblasts from this patient, however, indicated that the 3-hydroxy-3-methylglutaryl-CoA lyase activity was not markedly reduced.
Acyl Coenzyme A↗
Dicarboxylic aciduria: the response to fasting.
The urine of a child who presented with an episode of a disease resembling Reye's syndrome was found to contain large quantities of the dicarboxylic acids adipic and suberic acids, as well as the glycine conjugate of suberic acid, suberyl glycine. A variety of other dicarboxylic acids, both saturated and unsaturated, were also found in the urine at the time of the attack. It was found that the excretion of these unusual metabolites could be markedly increased by fasting for periods of greater than 10 h. These results indicate that the patient may have a defect in fatty acid oxidation which becomes clinically significant during periods of prolonged fasting.
Adipates↗
A defect in deoxyribose metabolism.
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Carbohydrate Metabolism, Inborn Errors↗
Effect of Corynebacterium parvum on hemopoietic stem-cell kinetics.
The intravenous administration of 548 microgram of killed Corynebacterium parvum (C. parvum) into C57BL mice leads to a significant decrease in the number of bone-marrow colony-forming-units in spleen (CFUs) as early as 12 h after the injection of the bacterium. This decrease persisted in varying degrees for 3 weeks. After an initial fall at 24 h, the splenic CFUs exhibited a rapid expansion and reached values 10 times higher than the control range on the ninth day. A significant rise in the number of circulating CFUs, reaching a first peak at 2 h and a second one on the fifth day, was also observed. The proliferative status of femoral CFUs was increased at 48 and 72 h, while that of splenic CFUs presented a significant increase only 48 h after the injection of C. parvum. The sequence of events which were observed in these experiments indicates that an accelerated migration of hemopoietic stem cells from bone marrow to spleen via the blood circulation has to take place.
Animals↗
The identification of 3-keto-2-methylvaleric acid and 3-hydroxy-2-methylvaleric acid in a patient with propionic acidemia.
Two abnormal metabolites, 3-keto-2-methylvaleric acid and 3-hydroxy-2-methylvaleric acid, have been identified and quantitated in the urine of a child with propionic acidemia. These metabolites may be produced as a result of the self-condensation of propionyl-CoA. Data are presented to show that the unusual ketone, 3-pentanone, which has been observed previously in the urine of patients with propionic acidemia, is produced as a result of the decarboxylation of 3-keto-2-methylvaleric acid.
Gas Chromatography-Mass Spectrometry↗
Abnormal deoxyribose metabolites in the urine of a child with a possible new inborn error of metabolism.
The urinary extract of a child investigated because of strabismus was found to contain large amounts of a compound which was identified using gas chromatography/mass spectrometry as 2-deoxyerythropentono-1,4-lactone. This lactone has not been observed previously in urinary extracts. When ion-exchange chromatography was used to isolate the organic acids from urine, the major peaks obtained by gas chromatography were shown to be 2-deoxyerythropentonic acid, 2-deoxyerythropentono-1,5-lactone and 2-deoxyerythropentono-1,4,lactone. Another abnormal metabolite, 2-deoxyribitol, was also excreted by the patient although this compound could not be detected in the urine of normal children. It is proposed that these unusual compounds accumulate in the urine of this child as a result of a defect in the catabolism of 2-deoxyribose.
Deoxyribose↗