Biomedical subjects
E Flatau
Publications and source records attributed to E Flatau.
[Mechanical ventilation with high frequency positive pressure (HEPPV)].
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Knee-elbow position to detect the aortic diastolic murmur of regurgitation.
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[Gastric dilatation without mechanical obstruction].
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The use of conventional ventilators for high frequency positive pressure ventilation.
Ten randomly selected patients were ventilated for defined periods with 2 ventilatory modes: (a) high frequency positive pressure ventilation (HFPPV) (frequency 66-70 min; tidal volume 1-3 ml/kg body weight), (b) conventional IPPV (frequency 16/min; tidal volume (VT) 10-15 ml/kg). This was done successfully using conventional ventilators, and keeping other variables (FIO2, PEEP) constant. Various ventilatory and hemodynamic variables were measured and compared during both modes of ventilation. The most prominent finding was a considerable reduction of cardiac output (CO) and stroke volume (SV) during intermittent positive pressure ventilation (IPPV) compared with HFPPV. Peak tracheal pressure was significantly lower during HFPPV. An increase in mean systemic arterial pressure and in oxygen transport was observed during HFPPV, whereas transpulmonary shunt and pulmonary vascular resistance (PVR) decreased during HFPPV. These findings are in accordance with previously reported advantages of HFPPV, and might be of importance in the treatment of patients with bronchopleural fistula, adult respiratory distress syndrome (ARDS), left ventricular failure and other conditions in which conventional positive pressure ventilation (PPV) fails.
Variable 5-methylcytosine levels in human tumor cell lines and fresh pediatric tumor explants.
DNA methylation was measured in human tumor cell lines and freshly explanted pediatric tumors by [3H]uridine labeling followed by DNA hydrolysis and high-performance liquid chromatography. The percentage of cytosine residues modified to 5-methylcytosine in 4 cell lines derived from pediatric tumors was increased or similar to the levels of 3.45% found in two strains of diploid human fibroblasts. However, a fibrosarcoma line derived from an adult (HT1080) contained decreased levels of 5-methylcytosine. Four low-passage retinoblastomas had uniform 5-methylcytosine levels of approximately 3.9%, whereas the levels of the modified base in two freshly explanted rhabdomyosarcomas, one Wilms' tumor, and one medulloblastoma were 3.39, 3.56, and 3.45%, respectively. Two neuroblastomas had substantially lower levels (2.63 to 2.83%) of 5-methylcytosine in their DNAs compared to the retinoblastomas, which are also derived from neural tissue. The results show that while tumors of the same histological type had similar 5-methylcytosine values, discrepancies existed between values obtained for fresh tumors and their corresponding cell lines. Tumor cell lines may therefore be inadequate models for studies on the relationship between DNA methylation and cancer. The results also indicate that generalized statements on DNA methylation levels in pediatric tumors cannot be made, although substantial variations may occur between different tumors types.
Schönlein-Henoch syndrome in patients with familial Mediterranean fever.
Ten episodes of Schönlein-Henoch purpura (SHP) in 8 patients with familial Mediterranean fever (FMF) were observed. Five episodes developed 3-14 days after penicillin injections, suggesting an etiologic association. FMF and SHP have clear clinical similarities, and if the frequency of association of the 2 diseases is indeed high, perhaps a common etiologic factor should be sought. An immune complex mechanism might be the link between these 2 disease entities.
Treatment of lymphocytic infiltrative ulcers of the face by minimal dose irradiation of the spleen.
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60 years of medical activities in the Jezreel Valley. From the Archives of Central Emek Hospital in Afula.
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The history of malaria in the Jezreel Valley in the years 1922-1928 in En Harod.
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Linitis plastica infiltrating the entire gut.
A case of extensive spread of linitis plastica, involving the entire gastrointestinal tract, is reported. The tumor probably originated in the stomach. Because the mucosal and serosal layers remained intact, diagnosis was markedly delayed, as is commonly seen in scirrhous carcinoma. The method of spread of the tumor (mainly through the submucosal layer) is unusual, and is probably related to the histological type of carcinoma.
Treatment of cardiogenic shock with nitroglycerin infusion and high-frequency positive pressure ventilation.
A patient with chronic obstructive lung disease developed severe cardiopulmonary failure following acute myocardial infarction. High frequency positive pressure ventilation achieved good ventilation. The hemodynamic status was markedly improved when, in addition to dopamine, nitroglycerin was infused into the pulmonary artery. Within 24 h the cardiac index increased, and mean pulmonary artery pressure and pulmonary vascular resistance decreased. Pulmonary wedge pressure decreased more slowly than the pulmonary artery pressure and to a lesser extent. This critically ill patient responded very well to the treatment and was discharged in good health after 18 days in the General Intensive Care Unit. Intravenous nitroglycerin is a promising drug for the treatment of severe cardiopulmonary emergencies and should be tried in patients with chronic lung disease and acute cardiac or respiratory failure.
Mechanical ventilation in fiberoptic-bronchoscopy: comparison between high frequency positive pressure ventilation and normal frequency positive pressure ventilation.
High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over periods of at least 40 min, HFPPV gave normal PaCO2 and high levels of PAO2. Arterial blood pressures were higher and the airway pressures were lower than during NFPPV.
[Slow infusion of diazoxide for hypertensive crisis].
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West Nile fever encephalitis.
Three cases of meningoencephalitis caused by the West Nile virus in young people are described. All patients had high fever, severe headaches, and meningeal irritation. One patient had papillitis and a maculopapular rash. Lymphadenopathy, which is a common finding in West Nile fever, was not found in any of our patients. Duration of the disease was one to two weeks, and recovery was complete. Cerebrospinal fluid examination revealed an increase in protein and pleocytosis (predominantly polymorphonuclears). We believe that West Nile encephalitis is not rare in Israel.
Adult respiratory distress syndrome treated with high-frequency positive pressure ventilation.
Adult respiratory distress syndrome (ARDS) is a severe disease that carries a poor prognosis (50 to 60% mortality). Although modern ventilatory techniques, especially positive end-expiratory pressure ventilation, have reduced the mortality rate somewhat, they are still far from serving as the ideal solution to this grave condition. High-frequency positive pressure ventilation (HFPPV) is a relatively new technique that enables effective alveolar ventilation without creating high intrapulmonary pressures. HFPPV using a conventional ventilator, Bennett MA-1B (Suffex, England), was tried in a 22-yr-old man with ARDS due to pyocyanea sepsis, who had failed to respond to conventional ventilation. A dramatic improvement was achieved within 60 min of increasing the ventilatory rate from 12 to 80/min, with a concomitant decrease of tidal volume from 12 to between 2 and 23 ml/kg. HFPPV may be a useful alternative method in the treatment of patients with ARDS.
[Hypercalcemia in chronic myeloid leukemia].
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Thrombotic thrombocytopenic purpura with a subacute course: remission after steroids and high-dose plasma exchange.
A case of thrombotic thrombocytopenic purpura with an unusual subacute course is described. Treatment was initiated after the patient had been ill for four weeks. Low-dose plasma exchange (10 ml/kg body weight per day) was associated with a sharp drop in the reticulocyte count and a transient reduction of lactate dehydrogenase activity to within the normal range. The administration of corticosteroids was followed immediately by the disappearance of neurological symptoms, and after high-dose plasma exchange (25 ml/kg body weight per day) all the symptoms of disease remitted. The remission has lasted for 10 months; we suggest that each of the therapeutic measures employed played a role.