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Biomedical subjects

C Kaplan

Publications and source records attributed to C Kaplan.

At least 145 records · Page 8Linked to original sources
PubMed1990

Sonographic differentiation of a large fetal cystic hygroma from the amniotic band syndrome.

An 18-year-old gravida 1, para 0 woman had an uncomplicated pregnancy until 22 weeks' gestation. Ultrasound examination revealed an abnormally shaped fetal head fixed against the placenta, minimal movement of the extremities, multiple bandlike projections traversing the uterine cavity, and bilateral pleural effusions. A diagnosis of amniotic band syndrome was suggested with subsequent termination of the pregnancy. Fetal examination revealed a large cystic hydroma, generalized edema with pericardial and pleural effusions, and Turner's syndrome. Illustrated is the difficulty in making the prenatal diagnosis of cystic hydroma and its confusion with amniotic band syndrome.

Adolescent↗
PubMed1990

HLA-associated susceptibility to acquired immune deficiency syndrome in HIV-1-seropositive subjects.

No difference in HLA-A, B or DR gene frequencies could be observed between 172 control subjects and 180 HIV-1-seropositive subjects of European ancestry diagnosed through the systematic screening of blood donations. In contrast, progression to acquired immune deficiency syndrome (AIDS; 21 patients) or CD4 lymphocyte loss equal or more than 20% over a 6-month period (37 subjects) was found to be associated with the B8DR3 haplotype (relative risk = 10.64, p less than 0.003, and 2.23, p less than 0.092, respectively). Other independently significant associations assessed through the multivariate Cox proportional-hazards model were B16, BW21 and B35 alleles as factors of bad prognosis. Conversely, A11 and DR4 alleles were factors favouring longer survival.

Acquired Immunodeficiency Syndrome↗
PubMed1990

In situ hybridization analysis for cytomegalovirus in chronic villitis.

Chronic villitis with villous lymphoplasmacytic, histiocytic infiltrate and stromal necrosis may have various etiologies. Infection with cytomegalovirus (CMV) is a frequent cause of such villitis, but the nuclear and cytoplasmic inclusions diagnostic of CMV are often not apparent. In this study placentas with chronic villitis were analyzed for CMV DNA by means of in situ hybridization. Of the eight cases of chronic villitis studied, three demonstrated inclusions diagnostic of CMV infection. On in situ hybridization, three additional cases had detectable CMV DNA. CMV was detected in endothelial, histiocytic, and fibroblastic cells and occasionally in the trophoblast. In cases with characteristic CMV inclusions, CMV DNA was often present in cells that lacked inclusions. CMV DNA was not detected in unremarkable placental tissue obtained from normal deliveries. It is concluded that CMV is commonly found in lymphoplasmacytic and histiocytic villitis and that in situ analysis for CMV is a rapid, easy, and sensitive way to detect the virus in placentas.

Adolescent↗
PubMed1990

The use of state-of-the-art mammography in the detection of nonpalpable breast carcinoma.

Between November 4, 1984, and September 1, 1988, a total of 16,439 patients were evaluated at the Comprehensive Breast Center at Mount Sinai Medical Center (MSMC) of Miami Beach with clinical examination, state-of-the-art mammography, and, when indicated, complimentary ultrasound mammography. As a result of this, 547 patients had open surgical biopsy, 207 carcinomas were detected in 207 patients, 183 carcinomas (80% of total malignancies) were clinically occult and detected only with breast imaging. Since 207 malignancies were found out of 547 areas examined, our rate was 1 carcinoma in every 2.6 biopsies. One hundred seventy-nine malignant lesions had preoperative needle localization and specimen radiography. Eighty-seven (47%) clinically occult carcinomas were identified because of microcalcifications by mammography alone. Two hundred twenty-six (98%) of the carcinomas were called malignant or suspicious for malignancy with only three (2.4%) false negatives. Twenty-two (10%) patients had axillary lymph-node metastasis. While recent large series report a 15 to 30 per cent rate of carcinoma for nonpalpable, mammographically detected breast biopsy specimens, it is our experience at MSMC with the use of physical exam and mammography, complemented by ultrasound when indicated, that rates of detection of carcinoma are more significantly improved than what the recent literature suggests; therefore, our approach to achieve this better detection will be discussed.

Adult↗
PubMed1990

A quantitative analysis of placental vasculature in the third-trimester fetus with autosomal trisomy.

Growth disturbance in the trisomic fetus is believed to be primarily fetal in origin. There has been only sparse description of placental pathology in the third trimester in these fetuses, and therefore the placental role in their growth and development remains unexplored. We performed quantitative morphometric analysis on the placentas of 18 fetuses with trisomy and ten normal control fetuses. Doppler umbilical artery analysis was performed on ten abnormal fetuses and all controls. The placentas of trisomic fetuses exhibited a significant reduction in small muscular artery count and small muscular artery/villus ratio. Abnormal Doppler waveforms correlated closely with reduced small muscular artery counts. Undervascularization and increased vascular resistance of the placenta of trisomic fetuses may contribute to diminished fetal growth. The placenta appears to be another fetal organ whose structure and function are affected adversely by abnormal karyotype.

Arterioles↗
PubMed1989

Calcium rise in human platelets elicited by anti-CD9 and -CD41 murine monoclonal antibodies.

Three murine monoclonal antibodies (anti-CD9: ALB6, anti-CD41: VI-PL3 and PL2-49/GPIIb - final concentration: 7.5 micrograms/mL) are shown to elicit after a lag time aggregation of washed platelets and a calcium signal (as detected by light emitted by loaded aequorin), which is only partially inhibited by aspirin. By comparison the rise induced by thrombin is greater and almost instantaneous. In the presence of EGTA a calcium mobilization from internal stores can be detected with thrombin and with ALB6, but neither with PL2-49 nor with VI-PL3, whereas platelets still change their shape and release ATP. It is tempting to speculate that although all the antibodies induce a calcium change, they activate platelets by different pathways: calcium may be not primarily involved in the activation induced by the anti-CD41 antibodies.

Adenosine Triphosphate↗
PubMed1989

Neutral protein-degrading enzymes in experimental fracture callus: a preliminary report.

The process of endochondral fracture healing is biochemically similar to growth plate calcification. Recent studies have identified potentially important roles for proteoglycan-degrading enzymes in the growth plate. The purpose of the study described herein was to identify, in healing fractures, neutral enzyme activities capable of degrading proteoglycans and other matrix proteins. Two sets of 60 male Sprague-Dawley rats underwent the production of closed femoral fractures. Calluses were retrieved at timed intervals, and cell and matrix vesicle fractions were prepared for electron microscopy, neutral peptidase, and alkaline phosphatase assays. In another group of 10 animals, fractions were prepared from 14-day calluses and examined for proteoglycanase activity. In the cell fractions, alkaline phosphatase, alanyl-beta-naphthylamidase, aminopeptidase, and endopeptidase activities showed somewhat parallel distributions peaking at approximately 14-17 days. In the matrix vesicle fractions, similar relative distributions were observed for alkaline phosphatase and endopeptidase. However, here the peak activities occurred up to 3 days later than they did in the cell fractions. Significant proteoglycanase activity was confirmed in both cell and matrix vesicle fractions. These findings are consistent with the hypotheses that (a) neutral peptidases, by virtue of their temporal expression in parallel with alkaline phosphatase, may be involved in preparing fracture callus matrix for calcification; and (b) matrix vesicles may convey certain of these enzymes to sites of both matrix degradation and calcification, since the same activities found in cells are found in matrix vesicles a few days later. The possibility that some of these enzymes are involved in growth factor activation remains to be investigated.

Alkaline Phosphatase↗
PubMed1989

Vaccinia virus: a suitable vehicle for recombinant vaccines?

The complications of vaccination against small pox are discussed in relation to the contemplated use as vaccines of recombinant vaccinia viruses carrying the genes for "protective" antigens derived from a range of pathogens. Recombinant vaccines are potentially extremely valuable instruments in the fight against infectious diseases, but caution is needed in their deployment. In addition to the dangers associated with the pathogenicity of various strains of vaccinia virus, there may be problems related to the ecology of the poxviruses--especially orthopoxviruses. Before recombinant vaccinia virus vaccines are widely used, ecological research is urgently needed. It should cover not only the ecology of orthopoxviruses, but also possible interactions between engineered vaccinia viruses released into the environment and wild viruses which may be resident in both target and non-target species in a wide selection of habitats.

Ecology↗
PubMed1989

Decreased stability and structural heterogeneity of the residual platelet glycoprotein IIb/IIIa complex in a variant of Glanzmann's thrombasthenia.

A patient is described with a disturbance of platelet function comparable to that in Glanzmann's thrombasthenia. Platelet aggregation and binding of fibrinogen to the patient's platelets were defective and thrombin-induced clot retraction was absent. The platelet fibrinogen content was only moderately reduced. As measured by monoclonal antibody binding in the presence of divalent cations, the platelets contained about 15% of the normal amount of GPIIb and GPIIIa and only 6% of the normal amount of intact GPIIb/IIIa complex. The residual GPIIb/IIIa complex exhibited a decreased stability as shown by the lack of binding of a complex-dependent anti-GPIIb/IIIa antibody to platelets incubated with ethylene diamine tetraacetic acid (EDTA) at 22 degrees C. Crossed immunoelectrophoresis (CIE) in the presence of divalent cations showed partial dissociation of GPIIb/IIIa as well as the presence of two forms of the residual intact GPIIb/IIIa complex. In addition, both CIE in the presence of the EDTA and two-dimensional sodium dodecyl sulphate (SDS) gel electrophoresis showed the presence of two forms of GPIIb. This form of thrombasthenia is characterized by a defective platelet function, a marked reduction of GPIIb and GPIIIa, decreased stability of the residual GPIIb/IIIa complex and structural heterogeneity of GPIIb.

Adult↗
PubMed1989

PL2-49, a monoclonal antibody against glycoprotein IIb which is a platelet activator.

PL2-49 is a murine monoclonal IgG1 antibody obtained after immunization of Balb/c mice with EDTA washed platelets. Binding could be detected on Zwa(+) as well as Zwa(-) platelets, but not on type I Glanzmann's thrombasthenia platelets using an ELISA screening test. Immunoprecipitation studies showed that PL2-49 bound to glycoprotein IIb when the glycoprotein IIb/IIIa complex dissociation was performed after the monoclonal antibody binding. Experiments with a human alloantibody against Zwa antigen were run in parallel to control the complex dissociation. Ascitic fluid, as well as the purified antibody, induced activation and aggregation of washed platelets and ATP release. PL2-49-induced aggregation did not require exogenous fibrinogen and was inhibited, partially, in the presence of aspirin, apyrase, isosorbide dinitrate. Raising intra-platelet cyclic AMP with a stable PGI2 analogue, iloprost, and/or a phosphodiesterase inhibitor, RA 233, suppressed the responses to PL2-49. F(ab')2 fragments did not induce aggregation of normal platelets but inhibited the response to the whole immunoglobulin. Finally PL2-49 was shown to induce aequorin-detected elevations in intraplatelet Ca++ levels. Thus PL2-49 seems to differ from monoclonal antibodies so far described, since it binds to glycoprotein IIb in a complex-dependent manner at least under our experimental conditions for immunoprecipitation studies, and it induces platelet Ca++ mobilization and platelet aggregation after a lag-time. These reactions depend both on Fab and Fc domains of the antibody and require neither complement nor exogenous fibrinogen.

Animals↗
PubMed1989

Pulmonary agenesis association with nonimmune hydrops.

Bilateral pulmonary agenesis is a rare malformation with 13 cases previously reported. To our knowledge, none of these cases have been associated with hydrops fetalis. We report a 36 weeks, hydropic female infant (46XX) with bilateral pulmonary agenesis, unilateral microophthalmia, and bilateral renal dysplasia. These eye and pulmonary findings have now been associated several times and may constitute a new syndrome. Ultrasound examination before delivery showed polyhydramnios and fetal hydrops. At autopsy the heart was structurally normal, aside from absent pulmonary connections. The ductus arteriosus was partially closed. This was felt to be etiologic in the hydrops. As the source of the amniotic fluid here could not be urine or pulmonary secretions, direct fluid transfer from fetal vasculature or skin was the likely origin.

Abnormalities, Multiple↗
PubMed1989

Granulocyte-associated immunoglobulins in asymptomatic HIV-infected subjects.

The purpose of this study was to determine the prevalence of granulocyte-associated immunoglobulins (GA-IgG) during the follow-up of asymptomatic human immunodeficiency virus (HIV)-infected subjects. An increase in GA-IgG was detected in 32 asymptomatic HIV seropositive subjects by a granulocyte immunofluorescence test (GIFT). At study onset, 7 (21.8%) had a positive GIFT. The prevalence of positive GIFT increased with time in the study subjects. No neutropenia was found. No significant difference was observed in subjects with positive or negative GIFT with respect to mean CD4 lymphocyte count and mean neutrophil count. The presence of GA-IgG was not associated to a positive direct antiglobulin test or of elevated platelet associated IgG.

Adult↗
PubMed1988

Prenatal diagnosis and management of bleeding disorders with fetal blood sampling.

The technique of fetal blood sampling for prenatal diagnosis has been shown to be both feasible and safe. The availability of fetal blood for direct evaluation has changed our attitude about the problems of both hereditary and acquired immune fetal bleeding disorders. We can continue with the classic approach and use fetal blood sampling for those conditions in which termination may be recommended, but we can also investigate less severe disorders in which the diagnosis allows us to plan the management of the pregnancy and minimize intrapartum and neonatal complications. We report our experience in prenatal diagnosis and management of 103 cases of hereditary and 18 cases of acquired immune bleeding disorders. We have developed specific management plans depending on the disorder under investigation, the severity of the condition in the fetus, and parental wishes. We have performed in utero transfusions of platelets and factor concentrate where appropriate. Efficacy of maternal therapy for fetal conditions can be directly assessed during gestation. Mode of delivery is determined by obstetric conditions and fetal status, directly assessed after appropriate therapy. Closer surveillance of the fetus by fetal blood sampling gives precise information on which to base clinical decisions to provide optimal maternal and fetal outcome.

Bleeding Time↗