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Biomedical subjects

E Rubenstein

Publications and source records attributed to E Rubenstein.

At least 19 recordsLinked to original sources

The cerebrospinal fluid production rate is reduced in dementia of the Alzheimer's type.

OBJECTIVE: To evaluate the production rate of CSF in patients with differing disease states. METHODS: The authors measured the production rate of CSF in three groups of patients: five patients with PD below age 60 (aged 51 +/- 4 years, mean +/- SD), nine with PD over age 60 (aged 69 +/- 6 years, mean +/- SD), and seven with dementia of the Alzheimer's type (AD) (aged 72 +/- 9 years, mean +/- SD). This method, based on the Masserman technique, employs ventricular rather than a lumbar access to the CSF space. Furthermore, the volume of CSF removed during the procedure is only 3 mL rather than 10 mL. RESULTS: These measurements indicate that the mean rate of CSF production in patients with PD under age 60 was 0.47 +/- 0.13 mL/minute, in patients with PD aged 60 or older the mean rate was 0.40 +/- 0.12 mL/minute, and in patients with AD the mean rate was 0.20 +/- 0.06 mL/minute. CONCLUSION: These results indicate that the rate of CSF production in patients with PD is normal, and that the rate of CSF production in patients with AD is markedly reduced.

Aged↗

Biologic effects of and clinical disorders caused by nonprotein amino acids.

Despite the fact that nonprotein amino acids are present in many commonly eaten foods, the biologic and clinical significance of this class of molecules has been largely overlooked. This is owing in part to their relatively low concentrations and their negligible nutritive value. Many of these compounds have the ability to interfere with a wide range of fundamental biochemical processes and cause disease. It is likely that the clinical effects of the ingestion of some nonprotein amino acids are yet to be described. Serious disorders in humans have followed the ingestion of these compounds as the result of food faddism, prodded by the commercial promotion of inadequately tested products. In view of the current popularity of herbal remedies and alternative medicine, these facts serve as another reminder to health care providers and the public at large about the need for critical analysis of the alleged benefits and the risks of exotic remedies and nutritional supplements. Beyond the public health issues they raise, non-protein amino acids take on significance because their misincorporation into proteins can trigger vigorous autoimmune attacks. To what extent this mechanism is responsible for highly prevalent diseases of autoimmunity remains to be determined.

Amino Acids↗

Extraterrestrial handedness: a reply.

Recent investigations of stable isotope ratios of amino acids from the Murchison meteorite have shown them to be of unambiguous extraterrestrial origin, and examinations of their enantiomeric compositions, where terrestrial contamination can be excluded, have found a consistent excess of L-enantiomers. One explanation for this observation has been the asymmetric photolysis of racemic extraterrestrial amino acids by circularly polarized light (CPL) in the synchrotron radiation from orbiting electrons around the pulsar remnants of supernovae. Mason (1997) has attempted to discredit this mechanism on the grounds that circular dichroism (CD) bands for optically active molecules alternate in sign and sum to zero over the entire spectrum, and hence enantioselective photochemical reactions cannot be induced by broad band CPL. We submit arguments disputing this conclusion and present reasons for expecting that broad band CPL synchrotron radiation would be quite capable of inducing asymmetric photolysis, particularly in aliphatic amino acids.

Amino Acids↗

The extraterrestrial origin of the homochirality of biomolecules--rebuttal to a critique.

Having concluded that abiotic terrestrial mechanisms would have been ineffectual for the origin of terrestrial homochirality, we have proposed an alternative extraterrestrial scenario involving stereoselective ultraviolet photolysis of the racemic constituents of interstellar grain mantles by circularly polarized synchrotron radiation from neutron stars, followed by terrestrial accretion of the resulting chiral molecules via cometary impact. Recently L. Keszthelyi (1995) has reviewed a number of our arguments and advanced several erroneous calculations and conclusions purporting to negate them. We offer here points of rebuttal to Keszthelyi's criticisms, and support our inferences with recent data regarding indigenous enantiomeric excesses of L-amino acids in the Murchison meteorite.

Amino Acids↗

Relationship of senescence of cerebrospinal fluid circulatory system to dementias of the aged.

In common with other organ systems, the cerebrospinal fluid circulatory system is subject to senescence. Cerebrospinal fluid production and turnover rates decline. The choroid plexus calcifies and its blood supply falters. Microvascular disease violates the integrity of the blood-brain barrier. The arachnoid membranes thicken. Arachnoid villi occlude and degenerate. The consequent functional losses are exacerbated by the deterioration of other interacting organ systems. Eventually, the cerebrospinal fluid circulatory system may fail, resulting in stagnation, contamination, compositional deficiencies, and impaired clearance of noxious substances. The hypothesis is that senescence of the cerebrospinal fluid circulatory system plays a part in some dementias of the aged.

Aged↗

Effect of otitis media on the vestibular system in children.

Forty-one children with otitis media (OM) were evaluated by moving platform posturography (Equitest, NeuroCom) before and after insertion of tympanostomy tubes, and were compared to children with no ear disease (N = 50). Velocity of sway increased with increasing difficulty of test conditions (I-VI) for both groups of children (p < .001), and children less than 7 years of age had a higher velocity than children 7 years old or older (p < .001). Children with OM had a higher velocity than normal children (p < .05). For children tested less than 30 days after insertion of tympanostomy tubes, the velocity for condition VI was significantly lower than before insertion (p < .05). Also, that the 6 children who had fallen on all trials on condition V or VI were able to stand on these trials after insertion of tympanostomy tubes indicates an improvement. These findings indicate that episodes of OM may affect balance, leaving children more clumsy and accident-prone, and possibly impairing motor development.

Adolescent↗

ESHAP--an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study.

PURPOSE: This study attempted to determine the efficacy of the combination of etoposide (VP-16), methyl-prednisolone, and cytarabine (Ara-C) with or without cisplatin in relapsing and refractory adult lymphoma patients. PATIENTS AND METHODS: The first 63 patients were randomized to receive VP-16 40 mg/m2/d for 4 days, methylprednisolone 500 mg intravenously daily for 5 days, and Ara-C 2 g/m2 intravenously over 2 to 3 hours on day 5 with or without cisplatin 25 mg/m2 IV administered by 24-hour infusion for 4 days (ESHA +/- P). Markedly different responses between ESHA (33%) and ESHAP (75%) led to deletion of the ESHA arm. A total of 122 patients on the ESHAP regimen were studied. RESULTS: Forty-five patients (37%) attained a complete remission (CR) and 33 (27%) attained a partial remission (PR), for a total response rate of 64%. The median duration of CR was 20 months, with 28% of remitters still in CR at 3 years. The overall median survival duration was 14 months; the survival rate at 3 years was 31%. Overall time to treatment failure (TTF) showed 10% of all patients to be alive and disease-free at 40 months. Response and survival rates were similar in patients with low-grade (n = 34), intermediate-grade (n = 67), transformed (n = 18), and high-grade (n = 3) lymphoma. The most significant factors for response and survival by multivariate analysis were the serum lactic dehydrogenase (LDH) level, tumor burden, and age (when analyzed as a continuous variable), while prior CR was highly significant by univariate analysis. A significant difference in survival was noted for patients with normal LDH levels and low- or intermediate-tumor burden or patients with low tumor burden and elevated LDH levels (55% 3-year survival rate) versus patients with elevated LDH levels and intermediate or high tumor burden (< 20%). Major toxicities included myelosuppression, with a median granulocyte count of 500/microL and platelet count of 70,000/microL. CONCLUSION: ESHAP was found to be an active, tolerable chemotherapy regimen for relapsing and refractory lymphoma. Applying a prognostic model based on tumor burden and serum LDH level shows significant differences in survival in this patient population.

Adolescent↗

An in-use evaluation of decontamination of polypropylene versus steel bedpans.

A prospective cross-over study in three different wards has demonstrated the lack of effect of two disinfectants compared with a detergent when added to the washing cycle of automatic bedpan washers that employ hot water centrally supplied at 60 degrees C. An unexpected and potentially important finding was that polypropylene pans were much more effectively cleaned and decontaminated than their stainless steel counterparts. The role, if any, of bedpans in the epidemiology of nosocomial infections remains a mystery. The continued absence of information clearly incriminating these ubiquitous devices in the transmission of potential pathogens, or of genes encoding antibacterial drug resistance, raises questions as to whether extensive efforts to achieve a high degree of decontamination of bedpans are necessary at all.

Cross Infection↗

Pathogenesis of trehalose dimycolate-induced interstitial pneumonitis. IV. Evidence against roles for immunoglobulins and the complement system.

We showed previously that trehalose dimycolate (TDM) in oil administered intraperitoneally into susceptible mice produced interstitial and hemorrhagic pneumonitis by the seventh day after injection and that mature T cells are necessary for the production of these lesions. TDM has been reported to activate complement and to be chemotactic for macrophages in vitro. Accordingly, we looked for involvement of humoral mechanisms in the pathogenesis of TDM-induced pneumonitis. Genetically C5-deficient B10D2/oSn mice developed pulmonary lesions just as well as C5-sufficient mice. No activation of C3 occurred in the plasma of TDM-treated mice as determined by crossed immunoelectrophoresis. Some splitting of C3 occurred in bronchoalveolar lavage fluids, but this was similar in control and experimental mice. By immunofluorescence microscopy, there was no deposition of C3 or immunoglobulins (Ig) along the alveolar membranes. These findings and our published data provide additional evidence that TDM-induced interstitial inflammation in mice is exclusively a T-lymphocyte-dependent process.

Animals↗

Cytokines.

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Biological Factors↗

Supernovae, neutron stars and biomolecular chirality.

Recent theoretical and experimental investigations of the origin of biomolecular chirality are reviewed briefly. Biotic and abiotic theories are evaluated critically with the conclusion that asymmetric photochemical processes with circulary polarized light (CPL), particularly asymmetric photolyses, constitute the most viable mechanisms. Solar CPL sources appear too weak and random to be effective. We suggest an alternative CPL source, namely, the synchrotron radiation from the neutron star remnants of supernova explosions. This could asymmetrically process racemic compounds in the organic mantles of the dust grains in interstellar clouds, and the resulting chiral molecules could be transferred to Earth by cold accretion as the solar system periodically traverses these interstellar clouds.

Biological Evolution↗

Synchrotron radiation for angiography.

The intensity, monochromaticity, and tunability of synchrotron radiation make it well suited for transvenous coronary angiography. An X-ray imaging system based on synchrotron radiation has provided images of the coronary circulation in dogs and in human subjects.

Angiocardiography↗

A relationship between sex hormone binding globulin and dehydroepiandrosterone sulfate in normally menstruating females.

Blood samples were collected from 120 normally menstruating women throughout the menstrual cycle. Serum was assayed for sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), estradiol (E2) and testosterone (T). There was an inverse relationship between SHBG and DHEAS, but no relationship between T or E2 and SHBG levels. There is at present no model which readily explains this inverse relationship between SHBG and DHEAS in normal subjects.

Adolescent↗

Transvenous coronary angiography in humans using synchrotron radiation.

The risks and costs of the present method of visualizing the coronary arteries have limited the use of coronary angiography in long-term serial studies needed to establish the natural history of coronary atherosclerosis and its response to interventions. A less invasive method, in which the contrast agent is administered intravenously, has been developed using synchrotron radiation as the illuminating source. The present report describes the initial results in human subjects. The findings indicate that transvenous coronary angiograms can be acquired in this manner. Further refinements in the x-ray imaging system are expected to result in increased x-ray fluence and improved image quality.

Angina Pectoris↗