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Biomedical subjects

E Hirsch

Publications and source records attributed to E Hirsch.

247 records · Page 14Linked to original sources
PubMedDate not supplied

Multiple lymphoid polyposis and familial polyposis of the colon: a genetic relationship.

A case of multiple lymphoid polyposis of the colon and terminal ileum occurring in a family of familial polyposis is presented. Only one other such case has been reported. Other cases where an association between the conditions was mentioned are reviewed. There is a genetic factor in the etiology of the condition, and a definite link with familial polyposis of the colon is found to exist. Differentiation of the conditions on clinical grounds could be very difficult.

Child↗
PubMedDate not supplied

Inflammatory cytokines in a murine model of infection-induced preterm labor: cause or effect?

OBJECTIVE: To characterize the expression of inflammatory cytokines in a murine model of preterm delivery induced by heat-killed bacteria. METHODS: The right uterine horns of female CD-1 mice on day 14.5 of 19-20 days of gestation were inoculated with either sterile media or killed Escherichia coli bacteria (10(5)-10(10) organisms per mouse). The incidence of preterm delivery was recorded. The concentrations of cytokines (interleukin [IL-] 1 alpha, IL-1 beta, IL-1 receptor antagonist [IL-1ra], IL-6, and tumor necrosis factor alpha [TNF alpha]) within maternal and fetal tissue homogenates were determined by enzyme-linked immunosorbent assay at various times after inoculation. RESULTS: Killed E. coli induced preterm delivery in a dose-dependent fashion. Inoculation with 10(10) bacteria (sufficient to cause delivery in all mice) produced increases in IL-1 alpha, IL-1 beta, IL-6, and TNF alpha within uteri and fetal membranes, but not within placentas, fetal bodies, and maternal serum. Maximum mean uterine levels of IL-1 and IL-6 exceeded those of fetal tissues (membranes, placentas, and fetal bodies) by greater than 15-fold. Maximal uterine IL-1 and TNF alpha levels following inoculation with 10(10) bacteria exceeded those that followed inoculation with 10(7) bacteria (below the threshold for delivery) by 2.5- to 5-fold. The anti-inflammatory cytokine IL-1ra was expressed in higher concentrations in fetal than in maternal tissues and was unaltered by the bacterial inoculum. CONCLUSIONS: E. coli induce labor in mice even in the absence of bacterial viability. Although IL-1 and TNF alpha were upregulated by bacterial inocula causing delivery, peak levels were only 2.5- to 5-fold higher than those that occurred with inocula below the threshold for delivery (1000-fold fewer bacteria). Whether IL-1 and TNF alpha mediate labor during in vivo infection, or whether the upregulation of these cytokines merely represents an epiphenomenon accompanying infection, remains unknown.

Animals↗
PubMedDate not supplied

Pulse experiments as a prerequisite for the quantification of in vivo enzyme kinetics in aromatic amino acid pathway of Escherichia coli.

Glucose pulse experiments were performed to elucidate their effects on the carbon flux into the aromatic amino acid pathway in different Escherichia coli strains. Using a 3-deoxy-D-arabino-heptulosonate 7-phosphate (DAHP, aroB(-))-producing strain, a fed-batch fermentation strategy specialized for glucose pulse experiments was developed and further applied for 3-dehydroshikimate (DHS, aroE(-))- and shikimate 3-phosphate (S3P, aroA(-))-producing E. coli strains. The strains overexpress a feedback-resistant DAHP synthase and additional enzymes to prevent rate-limiting steps in the aromatic amino acid pathway. Changes of carbon flux into the aromatic amino acid pathway were determined via extracellular metabolite accumulations using (1)H NMR and HPLC measurements. As an important result, a close relationship between pulse intensity and aromatic metabolite formation rates was identified. The more downstream an aromatic pathway intermediate was located, the stronger the glucose pulse intensity had to be in order to detect significant changes in product formation. However, with the experimental conditions chosen, changes after pulse were detected even for shikimate 3-phosphate, the most downstream accumulating metabolite of this experimental series. Hence glucose pulse experiments are assumed to be a promising tool even for the analysis of final pathway products such as, for example, L-phenylalanine.

3-Deoxy-7-Phosphoheptulonate Synthase↗
PubMedDate not supplied

Assessing homeless population size through the use of emergency and transitional shelter services in 1998: results from the analysis of administrative data from nine US jurisdictions.

OBJECTIVES: This study reports findings from the first-ever systematic enumeration of homeless population size using data previously collected from administrative records of homeless services providers in nine US jurisdictions over a one year period. As such, it provides the basis for establishing an ongoing measure of the parameters of the homeless population and for tracking related trends on the use of homeless services over time. METHODS: Each participating jurisdiction collected data through its homeless services management information systems for persons and families who use emergency shelter and transitional housing. The jurisdictions organized the data by a standardized reporting format. These data form the basis for reporting homeless population size, both in raw numbers and as adjusted for each jurisdiction's overall population size, as well as the rate of turnover and average annual length of stay in emergency shelters and transitional housing. RESULTS: Individual jurisdictions had annual rates of sheltered homelessness ranging from 0.1% to 2.1% of their overall population, and 1.3% to 10.2% of their poverty population. Annual population size was 2.5 to 10.2 times greater than the point-prevalent population size. Results are broken down for adults and families. CONCLUSIONS: The prevalence of homelessness varies greatly among the jurisdictions included in this study, and possible factors for this diversity are discussed. Future reports of this nature will furnish similar series of homeless enumerations across a growing number of jurisdictions, thereby providing a basis for exploring the effects of different contextual factors on local prevalence rates of homelessness.

Adult↗
PubMedDate not supplied

Landau-Kleffner syndrome: a clinical and EEG study of five cases.

In five children with normal initial psychomotor development, a Landau-Kleffner syndrome appeared at age 3-7 years. No neuroanatomic lesions were noted. Aphasia and hyperkinesia were isolated in three patients and associated with global regression of higher cortical functions in one patient. Massive intellectual deterioration and psychotic behavior were associated with transient aphasia in one patient. The epilepsy (focal motor and generalized tonic-clonic seizures, subclinical EEG focal seizures during sleep, and atypical absences) always regressed spontaneously or with antiepileptic drug (AED) treatment. The EEG in waking patients showed focal and generalized spike-wave discharges on a normal background rhythm. Discharge topography and pattern changed frequently. During sleep, discharges always increased. At some time during syndrome development, all patients had bilateral spike-waves for greater than 85% of the sleep period, while at other times the discharges were discontinuous or continuous but focal or unilaterally hemispheric. Discharge topography and abundance changed from night to night. The abnormal EEG and the impaired higher functions developed and regressed together, but not with strict temporal correlation. Our own experience suggests that the Landau-Kleffner syndrome and epilepsy with continuous spike-wave activity in slow-wave sleep cannot be clearly differentiated. They may be different points on the spectrum of a single syndrome.

Aphasia↗
PubMedDate not supplied

Landau-Kleffner syndrome: a pharmacologic study of five cases.

Five children with Landau-Kleffner syndrome (epilepsy, acquired aphasia, and continuous spike-wave discharges during sleep), were treated with antiepileptic drugs (AEDs), sleep-modifying drugs, and corticosteroids. The pharmacologic profiles differed from those observed in focal epilepsies, resembling instead those of certain generalized epilepsies, such as West or Lennox-Gastaut syndromes. Phenobarbital (PB), carbamazepine (CBZ), and phenytoin (PHT) were ineffective or worsened the EEG and neuropsychological symptoms, whereas valproate (VPA), ethosuximide (ESM), and benzodiazepines were partially or transiently efficacious. Dextroamphetamine produced a dramatic but transient improvement in waking and sleep EEG in one of two children; aphasia did not change. Corticosteroid treatment resulted in improved speech, suppression of seizures, and normalization of the EEG in three of three children. Our own experience and data from the literature suggest that corticosteroids should be given in high doses as soon as the diagnosis is firmly established and should be continued in maintenance dose for several months or years to avoid escape. Early diagnosis, before mutism or global deterioration develops, appears to be essential for effective therapy with minimal neuropsychological sequelae.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Cerebral glucose utilization during sleep in Landau-Kleffner syndrome: a PET study.

Three right-handed male children (aged 5, 6, and 11 years) with signs, symptoms and/or history of the syndrome of acquired aphasia-epilepsy (Landau-Kleffner syndrome) were studied during drug-induced, electroencephalographically (EEG)-monitored sleep by positron-emission tomography (PET) and the [18F]fluorodeoxyglucose (FDG) method. Our data demonstrate that in Landau-Kleffner syndrome, cerebral glucose utilization is not normal during sleep. The metabolic pattern varied between the children but the metabolic disturbances always predominated over the temporal lobes. They were right-sided, left-sided, or bilateral. In the two first patients, EEG recordings showed continuous spike-and-wave discharges during sleep and a right-greater-than-left asymmetry was observed in temporal areas. In patient 1, the asymmetry was associated with a relative increase of glucose utilization of the right posterior temporal region. In patient 2, the glucose utilization was relatively decreased in the left anterotemporal and left perisylvian regions. In patient 3, the sleep EEG showed no discharge and no significant asymmetry was observed; however, glucose utilization of both temporal lobes was decreased. Lower metabolic rates in subcortical structures than in cortex were also noted in the three children. This metabolic pattern may be related to the maturation of the central nervous system (CNS).

Aphasia↗
PubMedDate not supplied

[Beta-blockers and migraine. Efficacy of time-release propranolol versus placebo].

The efficacy and safety of long-acting propranolol (LA.P) 160 mg once-daily in the prophylactic treatment of migraine were tested against placebo in a multicentric, double-blind, randomized study comparing the two groups in a parallel manner over a treatment period of 12 weeks, and following a 4 week-placebo run-in period. Fifty-five out of the 74 patients who entered the trial included at the end of the run-in period. Forty-one patients completed the study. Out of the 14 patients who withdrew from the study, none discontinued because of side-effects. The statistical analysis was done according to the "intention to treat" principle. LA.P was significantly more efficient than placebo in reducing the frequency of migraine attacks (p = 0.01 by variance analysis). LA.P reduced the average number of monthly crises by 48% on day 84. There was a slight but significant reduction of the systolic blood pressure and heart rate in the erect position. There was no significant difference between LA.P and placebo regarding either the number of complaints or the number of side-effects elicited out of an 17 item questionnaire. None of the observed side effects led to a withdrawal of treatment.

Adult↗
PubMedDate not supplied

Stenosis of the aqueduct of Sylvius. Etiology and treatment.

Etiology, mechanism and treatment remain controversial in aqueductal stenosis. The review of 114 cases operated on between 1975 and 1982 in the Service of Pediatric Neurosurgery of "Les Enfants-Malades" in Paris was undertaken with the hope of improving our understanding of these problems. Toxoplasmosis was in our series the most frequent etiology, accounting for 15% of the cases; 74% of the aqueductal stenoses in this series were of unknown origin. In two cases, a small arachnoid cyst, developed in contact with the ambient cistern, was the cause of the aqueductal stenosis. In about half of the 32 pneumoencephalograms performed, a rounded, dilated ambient cistern was found. No such dilatation was observed in 35 pneumoencephalograms performed in cases of communicating hydrocephalus. It is likely that some cases of aqueductal stenoses are the consequence of a compression of the brain stem by an overpressurized ambient cistern, whether communicating or not with the subarachnoid spaces. Although the ventricular volume is less reduced after percutaneous ventriculostomy than after shunting, the long term results of the two treatments are comparable. The risk of infection is lower with ventriculostomies, but the rate of failures is higher. Since ventriculocisternostomy is a safe procedure when patients are properly selected, it can be tested first, a shunt being inserted at a later time in case of failure.

Brain Diseases↗