Biomedical subjects
Publications and source records attributed to H Bank.
In identical experimental situations we tested 22 adults with our proposed Landolt C wall-chart and the so-called TNO Landolt-C chart. Contrary to theoretical expectations, it appeared that there was only a slight difference in the measured visual acuities. Further study will show whether this is an incidental or a structural occurrence.
Antithyroid drugs, considered the treatment of choice for hyperthyroidism during pregnancy, may have an adverse effect on intellectual development of the offspring. We examined the intellectual capacity of 31 subjects aged 4-23 years, born to women with Graves disease who received antithyroid drugs throughout pregnancy. Methimazole 40-140 mg/week (n = 15) or propylthiouracil 250-1400 mg/week (n = 16) was given. I.Q. was assessed using the Wechsler test appropriate for age. Twenty-five unexposed siblings served as controls. The exposed and unexposed groups did not differ with respect to the total I.Q. Both groups scored equally in verbal and performance skills and in each of six main subcategories of the tests. There was no difference between exposure to methimazole and propylthiouracil or between the higher (greater than 40 mg/week and greater than 600 mg/week, respectively) and lower dosages. All children were euthyroid at birth and none had goitre. We conclude that exposure to methimazole or propylthiouracil during pregnancy in doses sufficient to control maternal hyperthyroidism does not pose any threat to intellectual capacity of the offspring.
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Studies were conducted in a patient with idiopathic hypophosphatemic osteomalacia to delineate the roles of parathyroid hormone (PTH), vitamin D and renal tubular function. A 43-year-old woman presented with progressive skeletal pains resulting in severe incapacity. Workup revealed: hypophosphatemia with a low tubular maximal phosphate reabsorption per glomerular filtrate (TmP/GFR) of 1.05 mg/dl, normocalcemia, hypocalciuria, elevated alkaline phosphatase and glycinuria. PTH and urinary cyclic AMP (UcAMP) were normal, while calcitriol was low. Renal tubular acidosis or other transport defects were not present and no tumor was found. Biopsy was diagnostic for osteomalacia, and the patient responded to 1-alpha OHD3 and phosphate therapy. Hyperparathyroidism was ruled out by 1) normocalcemia persisting after 1-alpha OHD3 and calcium loading and 2) normal PTH and UcAMP challenged by phosphate supplements. Combined calcium and 1-alpha OHD3 administration resulted in hypercalciuria, decreased UcAMP and increased, but not corrected, TmP/GFR. These findings suggest that the osteomalacia was due to hypophosphatemia caused by a renal leak. PTH is only contributory to the phosphaturia. Low calcitriol level contributes to the osteomalacia directly and indirectly through impaired mineral absorption and, therefore, is also responsible for the hypocalciuria.
Potentiation of the anticoagulant-effect of warfarin by amiodarone was studied in 30 patients. Thirteen received both drugs concurrently, and 17 received warfarin alone and the combination sequentially. Warfarin doses were adjusted to maintain the prothrombin time between 25-30% of control and its kinetics were compared to those in 20 control patients who received warfarin alone. Potentiation occurred in 28/30 patients, presenting as a 35%-65% reduction in the required dose of warfarin, and was correlated with the dose of amiodarone (r = 0.77, p less than 0.01). The free warfarin fraction was not affected by amiodarone (1.8% vs 1.6% in the controls). Warfarin clearance was lower in amiodarone-treated patients than in the controls (1.4 vs 3.1 ml/min, p less than 0.01) with similar plasma concentrations (1.5 vs 1.2 micrograms/ml) despite administration of lower doses (23.3 vs 39 mg/week respectively). The amiodarone concentration was significantly correlated with the warfarin concentrations independent of the effect of amiodarone on the dose of warfarin. Amiodarone hat no effect on prothrombin other than through its actions on the dose and plasma concentration of warfarin. The mechanism of the amiodarone-warfarin interaction is pharmacokinetic through dose - and concentration - dependent inhibition of warfarin elimination.
Inbred C57BL/6 mice were inoculated intraperitoneally (i.p.) with mengo virus. The activity of cytotoxic T lymphocytes (CTL) and natural killer (NK) cells were measured during the first 22 days following infection. The CTL response began 7 days after virus inoculation, persisted for at least 22 days and was related to the dose of the virus inoculated. NK cell activity was elevated within 24 hr, reached its peak level on the fourth day and declined to normal levels on the eleventh day after exposure to the virus. These results suggest that NK cells represent the first cellular immune response to restrict mengo virus spread while specific CTL appear later and are probably responsible for further restriction, elimination and prevention of the viral disease.
We report an unusual case of unnoticed aspiration of an oat head by a healthy 19-year-old male. The foreign body migrated to the right pleural cavity and caused a severe persistent empyema, which resolved only after a thoracotomy . The lodging of a grass head in the pleura is a very rare event, almost never reported in an adult.
The in vitro effect of the anti-thyroid drugs (ATD), propylthiouracil (PTU) and methimazole (MMI) on blastogenesis of peripheral blood mononuclear cells (PBMC) from healthy subjects was studied in 72 hr PHA stimulated cultures. PTU in therapeutic concentrations (10 micrograms/ml) suppressed blastogenesis only when added at the last 18 hr of culture, while at 100 micrograms/ml significant suppression (25%) was recorded also for PTU present throughout culture. PTU had no cytotoxic effect on Raji cells as tested by 51Cr release assay and 3H-thymidine incorporation. Moreover, strong and irreversible suppression (33%) was induced in resting PBMC on 1 hr pre-incubation with PTU. These findings and the fact that suppression was recorded only in cultures exposed to suboptimal concentration of PHA (0.5 micrograms/ml) speak against a direct anti-metabolic effect. MMI in therapeutic concentration (1 microgram/ml) and tri-iodothyronine (T3) in pharmacological concentration (10(-7)M) were much less active. Suppression of blastogenesis by PTU appeared to be mediated through suppressor cell enhancement as indicated by: (a) the augmented blastogenesis following 24 hr pre-incubation, commonly ascribed to suppressor cell depletion, was blunted by pre-incubation with PTU; (b) mixing PTU pre-treated with untreated cells reduced the expected response to PHA and (c) PTU pre-incubated, mitomycin treated cells suppressed blastogenesis of autologous or allogeneic responder cells.
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Yersinia enterocolitica agglutinating antibodies were present in 42% of 36 patients with thyroid disease and in none of 77 control subjects. Since the frequency of Yersinia infections in Israel is low, the association of thyroid diseases with Yersinia antibodies is of particular interest. The significance of this finding is discussed in view of some recent observations.
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