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Biomedical subjects

D Bernstein

Publications and source records attributed to D Bernstein.

At least 91 records · Page 5Linked to original sources
PubMed1994

Ureteric stent in severe hydronephrosis of pregnancy.

Eleven women (12 pregnancies) were included in the study. A double-pigtail ureteric stent was passed under cytoscopic vision in 8 patients. The mean gestational age on insertion of the stents was 29 weeks (range, 25-35 weeks). Delivery took place at a mean of 39 weeks (range, 35-41 weeks). Stents remained in situ for a mean of 9 weeks (range, 6-14 weeks) before delivery and were removed 4-5 weeks postpartum. Double pigtail ureteric stents did not expose the women to infection. Renal function tests remained within the normal limits. Ureteric stent is an effective method for internal drainage of severe hydronephrosis during pregnancy.

Adult↗
PubMed1994

Carnitine palmitoyl transferase deficiency in pregnancy--a case report.

Carnitine palmitoyl transferase deficiency is one of the mitochondrial myopathies characterized by weakness, exercise intolerance, and myoglobinuria after prolonged exercise. This is the first case report concerning a pregnant woman with carnitine palmitoyl transferase deficiency that was also proved by the decrease of carnitine palmitoyl transferase activity in uterine myometrium biopsy.

Adult↗
PubMed1994

Pediatric cardiac transplantation. The Stanford experience.

BACKGROUND: Cardiac transplantation for children with endstage heart disease has become an accepted form of therapy and is being practiced with increasing frequency and improving short-term outcome. METHODS AND RESULTS: To assess the medium-term outcome of pediatric cardiac transplantation, we analyzed our experience with 72 patients under the age of 18 (range, 0.1 to 17.7 years; mean, 9 +/- 6.4 [SD]) who underwent orthotopic cardiac transplantation at Stanford University between 1977 and 1993. There were 38 male and 34 female patients. Preoperative diagnoses included congenital heart disease in 24 (33%), idiopathic cardiomyopathy in 27 (37%), viral cardiomyopathy in 12 (17%), and familial cardiomyopathy in 7 (10%) patients. Immunosuppressive management has evolved over time and has included a tapering schedule of steroids, azathioprine, rabbit antithymocyte globulin, cyclosporine in all patients after 1980, and induction with OKT3 since 1987. Operative mortality rate was 12.5 +/- 4.0% (mean +/- 70% confidence intervals). Actuarial survival estimates at 1, 5, and 10 years are 75 +/- 7.1%, 60 +/- 6.4%, and 50 +/- 8.1% (mean +/- 1 SEM), respectively. Causes of death included infection in 8 (28% of deaths), rejection in 7 (24%), graft coronary disease in 5 (17%), pulmonary hypertension in 4 (14%), and nonspecific graft failure in 2 (7%) patients. Survival rates were similar for patients over and those under age 10 years (including the infant cohort of 18 patients transplanted since 1986). Currently, there are 43 patients alive, all in New York Heart Association functional class I. Only 22 +/- 5.6% of patients were free of rejection at 1 year, but 86 +/- 5.4% were free of rejection-related death at 10 years. At 1 year, only 37 +/- 6% of patients were free from any infection, but 88 +/- 4.2% remained free of infection-related death at 5 years. Actuarial freedom from graft coronary artery disease (angiographic or autopsy proven) was 85 +/- 6.6% at 5 years and from coronary artery disease-related death was 91 +/- 4.7%. CONCLUSIONS: These data demonstrate satisfactory medium-term outcome of cardiac transplantation in selected pediatric patients with end-stage heart disease, but further progress is necessary to more effectively control rejection, infection, and graft coronary disease.

Actuarial Analysis↗
PubMed1994

Reliability of the KIDIES for diagnosing pervasive developmental disorder in children.

The Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES), a new instrument that uses affective and behavioral dimensions for categorization, was compared with DSM-III-R criteria to assess diagnostic reliability in childhood pervasive developmental disorder (PDD). Forty-two children with PDD and other developmental disorders were evaluated. Their diagnoses were based on DSM-III-R criteria. Subjects were videotaped during interviews with three different partners and rated using the KIDIES. Cluster analysis of KIDIES ratings revealed a significant correlation with DSM-III-R diagnostic categories, demonstrating the potential reliability of the KIDIES dimensional approach for diagnosing PDD in preschoolers.

Child Development Disorders, Pervasive↗
PubMed1993

Primary structure of the mouse beta 1-adrenergic receptor gene.

The mouse beta 1-adrenergic receptor was isolated from a genomic library and cloned into pBluescript SK-. Characterization of the clone revealed an open reading frame which encodes a predicted protein of 466 amino acids. The mouse beta 1 receptor is 92.7% identical to the human sequence, 98.5% identical to the rat sequence, and contains a consensus site for N-linked glycosylation at Asn-15 and a cAMP-dependent protein kinase phosphorylation site at Ser-301.

Amino Acid Sequence↗
PubMed1993

Tissue- and subunit-specific regulation of G-protein expression by hypo- and hyperthyroidism.

Thyroid hormone status has profound effects on signal transduction in various tissues throughout the body. Therefore, we quantified the signal transducing G-proteins in the rat heart, cerebral cortex, vas deferens and liver by immunoblotting and pertussis toxin labeling in response to chemically induced hypothyroidism (treatment with propylthiouracil) and hyperthyroidism (treatment with triiodothyronine). Levels of the pertussis toxin (PTX) substrates Gi alpha and Go alpha in the heart and vas deferens were inversely correlated with thyroid hormone levels, i.e. Gi alpha and Go alpha were decreased or unchanged in hyperthyroid rats and increased in hypothyroid rats compared to control animals. The cerebral cortex and liver expression of PTX substrates Gi alpha and Go alpha was not affected by changes in thyroid hormone. Regulation of Gs alpha protein was more complex in that Gs alpha was unaffected in the other tissues tested. Expression of G-protein beta-subunits was not affected by thyroid status in the heart, liver, or cerebral cortex. Our results suggest that tissue- and G-protein-specific factors are involved in the regulation of G-protein subunits by thyroid hormone. Moreover, cardiac expression of Gs alpha is upregulated by increases or decreases in the normal level of thyroid hormone.

Animals↗
PubMed1993

Alteration in Gs-mediated signal transduction in S49 lymphoma cells treated with inhibitors of microtubules.

We have assessed the possible interaction between the microtubular component of the cytoskeleton and signal transducing GTP-binding (G) proteins by examining the ability of colchicine and vinblastine (two microtubule disrupters) to alter Gs and Gi protein activity in S49 lymphoma cells. Treatment of wild type S49 cells with cholchicine and vinblastine increased beta-adrenergic agonist- and prostaglandin (PG) E1-stimulated formation of cAMP. The microtubular inhibitor nocodazole also enhanced isoproterenol-stimulated cAMP accumulation, whereas the inactive analog of colchicine, beta-lumicolchicine, did not have this action. Based on data obtained with wild type, cyc-, and UNC S49 cells, we determined that enhancement in cyclic AMP accumulation is proximal to the catalytic (C) unit of adenylylcyclase, distal to hormone receptors, and seems to be located on Gs. Treatment with colchicine increased guanosine 5'-(gamma-thio)triphosphate-stimulated accumulation of cAMP in permeabilized wild type cells. The increase in activity of Gs appeared not to result from a change in the intracellular concentration of GTP. Treatment of cells with colchicine or vinblastine also increased the amount of the alpha s-C complex, as assessed by the binding of [3H]forskolin to intact cells at 37 degrees C. In contrast to the observed effect on Gs, treatment of wild type S49 cells with colchicine failed to modify the degree of inhibition of cAMP formation produced by somatostatin, which acts via the activation of Gi. These data suggest that microtubules regulate the ability of Gs to interact with and activate the catalyst of adenylylcyclase.

Adenylyl Cyclases↗
PubMed1993

Assessing the relationship between affective responsivity and social interaction in children with pervasive developmental disorder.

An investigation of children with pervasive developmental disorder (PDD) was conducted using a new instrument, the Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES). The KIDIES rates several affective and behavioral dimensions based on facial, vocal, gestural, and postural cues. The study's goals were to determine whether the KIDIES could detect individual differences in responsivity among the PDD subjects; to ascertain the KIDIES' sensitivity in identifying group differences between PDD subjects and control children with other developmental disorders. Children were videotaped during episodes with three partners: the mother, a familiar female teacher, an unfamiliar male doctor. Episodes were scored using the KIDIES. PDD subjects were most severely impaired during the Mother episode in comparison to the controls. Equally as striking was the within-episode heterogeneity among PDD subjects. During the Teacher episode, PDD subjects were twice as variable in interpersonal response as the controls.

Affective Symptoms↗
PubMed1993

Assessment of risk factors for IgE-mediated sensitization to tetrachlorophthalic anhydride.

Two groups of workers with occupational asthma caused by tetrachlorophthalic anhydride (TCPA) have been reported on; in only one report was specific anti-TCPA antibody demonstrated. We received a request to investigate respiratory problems among workers at a plant where solenoid coils are manufactured with the use of epoxy resin and where a new TCPA hardener had been introduced in 1988. In response, we conducted a cross-sectional evaluation of 52 current workers and assayed serum samples from 49 workers for TCPA-human serum albumin-specific IgE and IgG by ELISA. Mean airborne TCPA concentrations ranged from 0.21 to 0.39 mg/m3 in 1989 and May 1990 but were considerably lower (less than 0.009 to 0.13 mg/m3) by July 1990 when ventilation was introduced. Workers were classified in four departments as molders (most directly working with TCPA), those intermittently exposed to TCPA, coil assemblers, and office workers. There was a high prevalence of reported work-related respiratory symptoms (from 27% to 39%). The mean decline in FEV1 over the shift in the molders (down 4.1%) was significantly different from the change in the office group (increased 2.5%). Intrashift change in FEV1 was inversely correlated with log personal TCPA concentration (r = -0.47). Of 49 current workers, 15 (31%) had elevated serum TCPA-human serum albumin-specific IgE antibody levels and 19 (39%) had elevated specific IgG levels. The prevalence of specific IgE was highest in the mold and intermittent groups (54%), in comparison with the coil assembly (25%) and office (0%) groups. Those workers who were IgE positive were significantly less likely to be current smokers and had worked significantly longer since 1988. Of those hired in 1988 or after, the proportion of workers who were IgE positive increased with duration of employment category (p value for trend 0.022). Since ventilation was installed and TCPA exposures reduced to less than 0.1 mg/m3, there has been a marked decrease in symptoms and no new cases of occupational asthma among newly hired workers at the plant.

Adult↗
PubMed1993

Neoplastic disorders after pediatric heart transplantation.

BACKGROUND: Because of their life-long requirement for immunosuppressive therapy, neoplastic disorders could represent a significant threat to long-term survival in infants and children after heart transplantation. This study determined the incidence and clinical spectrum of neoplastic disorders in 80 pediatric patients who underwent heart transplantation between 1974 and 1992. METHODS AND RESULTS: Follow-up ranged from 6 to 189 months (mean, 50.0 months). Tumors occurred in 10 patients (12.5%). Time to detection ranged from 3.3 to 139.2 months (mean, 52.7 months). Tumor incidence was greatest in 9 patients transplanted before the cyclosporine era (44%) compared with the subsequent 71 patients (8.5%, P < .05). There was no increase in risk related to sex, age, underlying disease, or blood type; however, patients with tumors received higher initial doses of cyclosporine and prednisone and had more rejection episodes in the first 3 months (P < .05). There was an increased risk associated with anti-thymocyte globulin (33%, P < .05) but not with OKT3 (6%, P = NS). There were eight lymphoproliferative disorders (four B-cell, one T-cell, three not determined) and one hepatocellular and one squamous cell carcinomas. Six cases of lymphoproliferative disorder had in situ evidence of Epstein-Barr virus. Patients were treated by reducing immunosuppression (7), radiotherapy (2), and chemotherapy (1). There were five deaths: two tumor related and the others due to rejection, renal failure, and infection. Of 5 survivors, 1 had tumor recurrence 4 years after diagnosis, and 4 are disease free. CONCLUSIONS: Tumors represent a small but serious long-term risk to pediatric heart transplant recipients. The incidence in children transplanted in the cyclosporine era is similar to that in adults, and the majority of tumors are lymphoproliferative disorders that often regress by reducing immunosuppression.

Actuarial Analysis↗
PubMed1992

Development and evaluation of a rapid, simple, sensitive, monoclonal antibody-based co-agglutination test for direct detection of Vibrio cholerae 01.

Cholera epidemics caused by Vibrio cholerae 01 continue to represent a major public health concern in many developing countries. A rapid and simple test kit for the detection of V. cholerae 01 has been developed. The kit, CholeraScreen is a monoclonal antibody-based, co-agglutination test and is used directly with stool specimens. It does not include culturing the specimen and is performed without the need for sophisticated laboratory equipment. Specificity of the test was demonstrated, using 118 reference cultures, to which cross-reactions were not observed. Preliminary results of field trials carried out in Guatemala and Bangladesh demonstrated that the test is equally sensitive as conventional culture methods in detecting V. cholerae and, in many cases, more sensitive. The CholeraScreen test is simple, specific, and does not require culturing procedures, making it suitable for direct detection of cells of V. cholerae in clinical specimens, even in the field. Also, the test requires less than five minutes to complete.

Agglutination Tests↗