Biomedical subjects
Publications and source records attributed to D Cohen.
Primary cholesteatomas (PCs) are embryologic residual nests in the middle ear cleft. Based on a study of 56 cases (48 of them from the literature), a new classification is suggested: tympanic cavity PC (71% of the cases), and temporal bone PC (29%). Among the tympanic cavity cases a significant number (63%) were found in the anterosuperior quadrant. The findings support the embryologic theory for the origin of PC.
Argon laser is widely used to coagulate the diabetic retina in order to inhibit the proliferative stage of diabetic retinopathy. Ten pigmented rabbits underwent retinal photocoagulation with argon laser. Retinal function was assessed electroretinographically before treatment and at different time intervals after treatment. The ERG responses measured 4-7 days after treatment were reduced in amplitude by a degree which was proportional to the number of laser applications. In five eyes that were treated with at least 1000 applications the ERG responses were very small when measured 4 days post-treatment. However, a gradual recovery was observed and within 2 months the ERG responses approached the normal pretreatment amplitudes. Histological findings from light and electron-microscopy suggested that the ERG recovery could not be solely explained by healing of the coagulated areas. Structural differences were seen in the pigment epithelial layer between a retina obtained immediately after treatment and one studied after ERG recovery. It is suggested that changes in the electrical resistance of the pigment epithelium may contribute to the ERG reduction seen immediately after laser treatment in the rabbit and to the increase in the ERG amplitude observed during the apparent functional recovery of the retina.
The cellular heterogeneity of large granular lymphocyte expansions has been illustrated by the phenotypic and genotypic findings in five patients. In one patient whose circulating cells were CD2+, CD3-, CD5-, CD7+, CD8-, CD11+, Leu7+, CD16+, and displayed strong natural killer activity, no rearrangement of the T cell receptor beta-chain gene and T cell rearranging gene gamma was detected. The four other patients presented with neutropenia without overt lymphocytosis. In these patients the circulating lymphocytes expressed a predominant T cell phenotype CD2+, CD3+, CD5+, CD7+, CD8+, Leu7+. In three of them the presence of a T cell clone was demonstrated on the basis of a unique pattern of rearrangement of the T cell receptor beta-chain genes.
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Recent development of new shigella vaccines has renewed interest in the current epidemiology of shigellosis in endemic regions. A prospective epidemiologic study of 5,774 soldiers was carried out in the Israel Defense Forces, between the months of May and September 1984. Shigellosis was found to be responsible for half the diarrhea epidemics and only rarely presented as sporadic cases of diarrhea. The epidemics occurred after exposure to field conditions, whereas under fixed military base conditions the finding of a case of shigellosis generally was not associated with an epidemic spread of the disease. It was concluded that, in this population, effective shigella vaccines may provide an important means of preventing epidemics of shigellosis in military units operating outside of permanent bases.
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The close genetic linkage between the gene for congenital adrenal hyperplasia due to 21-hydroxylase (21-OH) deficiency and HLA genes allowed us to use the polymorphism of this system as a marker of the disease. HLA genotyping can be performed by using restriction enzyme fragments hybridized with specific probes instead of serologic methods. In seven pregnancies at risk for 21-OH deficiency, a first trimester prenatal diagnosis has been performed by determining the fetal genotype by linkage analysis of DNA from chorionic villi using HLA class I and class II probes. In four of these pregnancies, determination of 17-OH progesterone in first trimester amniotic fluid afforded a complementary approach to the diagnosis.
DNAs from unrelated healthy individuals and unrelated individuals affected with 21-hydroxylase deficiency (congenital and late-onset adrenal hyperplasia) were digested with seven restriction enzymes and hybridized with a cDNA probe specific for human 21-hydroxylase genes. Associations were found between restriction fragments and the two forms of the disease: The late onset form is associated with a double dose of a 14 kb fragment generated by EcoRI and with a triple dose of a 3.2 kb fragment generated by Taq I in patients with HLA B14 haplotypes; The classical congenital form is negatively associated with the 14 kb fragment and with a 3.7 kb fragment generated by Taq I in patients with HLA Bw47 haplotypes. A 3.2 kb Taq I fragment is negatively associated with the HLA B8 haplotypes. The other five enzymes tested give no polymorphisms or polymorphisms without correlation with the two forms of the disease.
The metabolic error involved in idiopathic hemochromatosis, as well as the underlying genetic defect remain unknown. It has, however, been recently shown that this genetic lesion occurs at a locus linked to the major histocompatibility complex, probably close to the HLA-A locus, and that the disease is recessively transmitted. Therefore, in a family where one subject has idiopathic hemochromatosis his HLA-identical siblings should also be affected. We present here the restriction polymorphism with two MHC class I probes and one DR beta probe in an exceptional family with three HLA-identical siblings: one (the proband) has a major form of idiopathic hemochromatosis, while the other two are free of any clinical or biochemical signs of the disease. The restriction patterns observed after DNA digestion by enzymes EcoRI, EcoRV, BglII, BamHI, PvuII, TaqI, HincII, and HindIII led to the conclusion that one of the proband's chromosome 6 had undergone two alterations: one, a deletion in the DR region, was revealed by missing fragments all correlated with DR5; the other was an unbalanced cross-over or a genetic conversion in the MHC class I region. This latter alteration was revealed by modifications in the patterns of high molecular weight HindIII bands which hybridize with probe pHLA2 and also by the absence of a HindIII fragment of 7.4 kb hybridized by another class I probe. This latter alteration most likely involved the hemochromatosis gene and could be the first step toward a molecular approach to this gene.
In the present report, we used serological, cellular, and restriction fragment length polymorphism (RFLP) to investigate the DR1 haplotype in the Israeli population. We describe an Israeli homozygous typing cell (HTC), HLA-Dw"LVA", which defines a new lymphocyte-activating determinant associated with Bw65, DR1 and distinct from Dw1. The parents of this donor, non-Ashkenazi Algerian Jews, are first cousins and share HLA-Cw8,Bw65,BfS,DR1,DQw1,DPw4. No specificity could be assigned to HLA-Dw"LVA" using the 91 Ninth Workshop HTCs. Two families and forty unrelated DR1 individuals were studied with Dw"LVA" and a panel of DR1/Dw1 HTCs. HLA-Dw"LVA" showed segregation as a single determinant within families. This new specificity was present in 24 out of 40 (60%) unrelated DR1 individuals, indicating that in the Israeli population Dw"LVA" is the main lymphocyte-defined determinant associated with the serologically defined DR1 specificity, in contrast to non-Jewish Caucasoids where DR1 is significantly associated with Dw1. The vast majority of Dw"LVA"-positive carriers were also Bw65 carriers, indicating that Bw65,DR1, Dw"LVA" may represent a typical allele combination in the Israeli population. The RFLP analysis established the correlation of certain RFLPs with Dw1 and Dw"LVA". In addition, we describe a cluster of FRLPs that may correspond to a new Dw subtype associated with DR1, for which no serological and cellular reagents have been described so far.
Two variants of the serologically defined HLA-DR2 specificity have been reported: DR2 long and DR2 short. Distinct HLA-DR2-associated Dw subtypes have been described at the cellular level. In the Israeli population, DR2 individuals may be grouped into three clusters: DR2/Dw2, DR2/Dw12, and DR2/Dw"AZH". A new approach for the study of the polymorphism of HLA class II genes is to investigate restriction endonuclease fragments obtained from genomic DNA with specific class II cDNA probes. Previous analysis of DQ beta restriction endonuclease fragments subdivided the DR2 haplotypes into two subsets: a DQR1-positive subset and a DQR2.6-positive subset. These two subsets behave in the population as alleles that split HLA DQw1. In the present study, we have analyzed class II DQ alpha, DQ beta, and DR beta restriction fragment length polymorphism (RFLP) in HLA-DR2/Dw-typed healthy, unrelated Israeli individuals, as well as in 11 French HLA-DR2 insulin-dependent diabetes mellitus (IDDM) patients and 11 French DR-matched controls. Three DQ beta allelic clusters (DQR2.6, DQR1, and DQR12) were observed among the DR2 haplotypes and clearly correlated with Dw2, Dw"AZH", and Dw12, respectively. The vast majority of the DR2 IDDM patients (9 out of 11) fit into the DQR1 cluster which correlates with Dw"AZH", while only two patients (2 out of 11) belong to the DQR2.6 cluster (Dw2-like). In contrast, among 11 DR-matched healthy controls, 9 belonged to the DQR2.6 cluster and only 2 belonged to the DQR1 cluster. These studies establish the correlation between the DR2-associated Dw subtypes with specific RFLPs, and indicate that the frequency of the DQR1 subset which correlates with Dw"AZH" is increased in DR2 IDDM patients.
mRNAs for the two chains of the HLA-DQ molecule were analyzed, in particular the DQ alpha mRNA whose polymorphism had previously been suggested (Schenning et al. 1984). Northern blot transfers of the mRNA of 12 LCLs and of B lymphocytes from a healthy donor were carried out. We report that a length polymorphism of DQ alpha mRNA exists, and we show that it can be correlated with serologically defined specificities (DQw1, DRw53, DR3+5). This correlation could be explained by a linkage disequilibrium, as these specificities are considered to be different from those carried by the DQ molecule (except for the DQw1 specificity).
Recent importance in the signal-to-noise ratio of fetal phonocardiograms has been attributed to a 'compliance-matching' between the phono-sensor and the maternal abdominal wall. We have developed a device to measure objectively the compliance of the maternal abdominal wall in pregnancy. Using this we have shown that the compliance varies considerably from patient to patient and that it varies most significantly (and inversely) with gestational age. As a result of this study we are now in a better position to optimize the compliance-matching of phono-sensors and thereby to detect fetal heart sounds with much more fidelity than hitherto.
Renewed interest in fetal phonocardiography has brought about new phono-sensor designs. We have developed an experimental rig to simulate generation of fetal heart sounds and also their passage through to the maternal abdominal wall. Using this rig we have investigated the design techniques applied to the new phono-sensors and we have also analysed the sensors themselves. We can now approach an ideal sensor design for the faithful detection of fetal heart sounds.
Symptoms of approaching parturition and the stage of parturition were described for eight pluriparous camels. The average time for the complete process of parturition was 373.9 +/- 38.2 min. The body weights at birth of the newborn males and females were 31.3 +/- 1.69 and 24.5 +/- 2.5 kg, respectively. Standing and first suckling by the neonatal camels occurred at 68.6 +/- 6.2 and 98.6 +/- 11.3 min, respectively.
The experiment was performed using two young male camels which weighed 24 and 36 kg respectively at birth. Each young camel was weighed and abruptly separated from its mother after 30 days of nursing (or at 1 month of age). The weaned calves were fed milk substitutes prepared commercially for lambs by Mabarot Chemical and Veterinary Products (Israel). The weanling camels averaged daily weight gains of 0.400 and 1.0 kg per day respectively during the 30 day initial period when the milk substitutes were used. Following the period when milk substitutes were used, the camels achieved normal growth to arrive at 135 and 145 kg respectively at 6 months of age.
DNAs extracted from peripheral blood leukocytes of 24 individuals, selected for their HLA-DR types, -DR2, -DR5, and -DRw6, were analyzed with four restriction enzymes, BamHI, EcoRV, HindIII, and Taq I, using the Southern technique. This panel includes 16 individuals with homozygous typing cells and 8 heterozygous individuals who carry rare Dw subtypes or unusual DR-DQ associations. Eighty-five polymorphic fragments were detected and assigned to the DR or DQ gene families according to their hybridization signals. Thirty-eight fragments (DR or DQ) were found to correlate with single DR or Dw specificities or rare associations such as DRw14-DQw3. Forty-two fragments correlated with the association of immunologically defined specificities. In total, these 85 fragments constituted 44 different patterns, each comprising 1-9 fragments. For each homozygous typing cell a combination of patterns was observed. Fourteen different combinations of 10-20 patterns were found among the 16 individuals with homozygous typing cells, showing that Dw18, Dw19, Dw9, and Dw5 are heterogeneous at the genomic level whereas only the Dw2 individuals tested here are identical.