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Biomedical subjects

H Gur

Publications and source records attributed to H Gur.

At least 55 records · Page 3Linked to original sources
PubMed1996

Acute dystonic reaction to methotrimeprazine in hypoparathyroidism.

OBJECTIVE: To report a case of acute dystonic reaction to methotrimeprazine in a patient with untreated hypoparathyroidism, emphasizing the potential increased sensitivity of hypocalcemic patients to the extrapyramidal adverse effects of antipsychotic drugs. CASE SUMMARY: An 80-year-old man who had untreated hypoparathyroidism and chronic hypocalcemia developed an acute dystonic reaction 20 minutes after ingestion of methotrimeprazine 25 mg. His medical history included an ill-defined psychiatric disorder for which he had been treated with methotrimeprazine several years earlier. The patient denied having any other diseases or taking any other medications. After 4 days, the disorientation, psychomotor restlessness, dystonic grimacing, protrusion of the tongue, and speech difficulties disappeared, despite a remaining low serum calcium concentration. DISCUSSION: A possible mechanism, by which striatal calmodulin-mediated adenylate cyclase activation is inhibited by the combined effects of phenothiazines and hypocalcemia, is discussed. CONCLUSIONS: In this patient, it is not possible to ascertain whether the dystonic reaction was due to hypocalcemia, phenothiazine administration, or both. However, it is suggested that patients with hypocalcemia may be sensitive to the extrapyramidal adverse effects of antipsychotics. In addition, acute unexpected dystonic reactions to a small dose of antipsychotics warrants measurement of the patient's serum calcium concentration.

Aged↗
PubMed1996

Clinical manifestations of temporal arteritis: a report from Israel.

OBJECTIVE: To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year period in the largest medical center in Israel. METHODS: The patients were included in the analysis if they fulfilled the new American College of Rheumatology Classification Criteria for the diagnosis of GCA. Patients were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared using Student's t test for comparison of continuous variables, and Fisher's exact test for comparison of proportions. RESULTS: The most common presenting symptoms of the patients with TA included headache (87% of the biopsy-proven patients), fever (64%), visual abnormalities (41%), and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonary involvement occurred in 5 patients. Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-proven and biopsy-negative groups revealed the feasibility of making the diagnosis of temporal arteritis on the basis of simple clinical variables, even without a positive biopsy, as the 2 groups of patients had comparable manifestations. However, the biopsy-proven group was older, included more males and presented significantly more with fever, compared to the biopsy-negative patients. Moreover, although not reaching statistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations. CONCLUSION: Compared to a previous report from Israel on patients with temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.

Age Distribution↗
PubMed1995

Autoantibody profile in the sera of women with hyperprolactinemia.

Prolactin (PRL) has been implicated as an important in vivo modulator of cellular and humoral immunity. In order to elucidate the impact of elevated serum PRL levels on the immune system, we measured circulating autoantibodies in the serum of 33 hyperprolactinemic (HPRL) women and in 19 healthy women with normal PRL levels. All sera were examined for the presence of autoantibodies against 15 different antigens, including: ssDNA, dsDNA, histones (H2AH2B), Sm, RNP, SS-A/Ro, SS-B/La, cardiolipin, Scl-70, Jo1, collagen, glomerular basement membrane (GBM), pyruvate dehydrogenase (PDH), proteinase-3 (PR3) and MPO. Twenty-five of 33 (75.7%) HPRL women were found to have at least one autoantibody, while none of the 19 women with normal PRL had any. Eight HPRL women had seven or more (up to nine) different autoantibodies. Some of the autoantibodies were more frequently expressed than others, namely: anti-ss-DNA, anti-dsDNA, anti-Sm, anti-PDH and anti-SS-A/Ro. Autoantibodies to the autoantigens tested are common in a variety of autoimmune and rheumatic disorders including systemic lupus erythematosus (SLE), Sjögren's syndrome, mixed connective tissue disease (MCTD), scleroderma, primary biliary cirrhosis (PBC), polymyositis/dermatomyositis and vasculitis. Yet none of the HPRL women whose serum was found to contain high titers of autoantibodies presented with symptoms related to the respective autoimmune disorders. Our results support the role of PRL in the regulation of immune responses in man.

Adult↗
PubMed1995

Autoimmune aspects of primary pulmonary hypertension.

Although primary pulmonary hypertension (PPH) is considered to be an idiopathic condition, it has been postulated that autoimmunity may play a role in the pathogenesis of the disease. This argument has been based on frequent coexisting clinical and serological rheumatic findings. Moreover, approximately in a third of the patients with PPH, and antinuclear factor can be detected. Pulmonary hypertension may appear as a secondary complication to various autoimmune conditions. In light of these findings we examined sera derived from 40 patients diagnosed as having PPH for the presence of 18 different autoantibodies by the ELISA and immunofluorescent techniques. Of the 40 patients, 62.4% had circulating autoantibodies and 47.5% presented with multiantibody responses. Autoantibodies most commonly observed were antinuclear (42.5%), anti-ssDNA (25%) and antithyroglobulin (30%) antibodies. These results may imply that in a subgroup of patients with PPH the disease may be ascribed to an immune dysregulation or alternatively that autoantibodies accompany the disease progression as an epiphenomenon.

Antibodies, Antinuclear↗
PubMed1995

Autoantibody profile of primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease of unknown etiology. It has been suggested that genetic and immunological factors are important in its pathogenesis. The present study examined the prevalence of 23 different autoantibodies in 25 PSC sera, by ELISA, in order to better define the autoimmune profile of PSC. The results indicate that 88% of PSC patients produced at least 1 autoantibody, and 36% had reactivity to multiple autoantibodies. Moreover, 35% of the PSC patients produced anti-endothelial-cell antibodies (AECA) and 75% of the sera contained perinuclear antineutrophil cytoplasmic antibodies (pANCA), detected by indirect immunofluorescence. The prominent ANCA autoantibody was anti-cathepsin-G, demonstrated in 35% of the patients. The multiplicity of the autoantibody profile, revealed in the present study, points to the autoimmune characteristics of PSC. In addition, the association of ANCA and of AECA in PSC may suggest a pathogenic role for these antibodies in PSC.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1994

The benign long-term effect of cholesterol crystal synovial cysts.

Synovial effusions containing cholesterol crystals are uncommon. Most of the few reported cases have been found in patients with seropositive rheumatoid arthritis. In vitro studies, as well as an animal model, have suggested that cholesterol crystals could have a role in inflammation of the joints. In this report we present a case of seronegative arthritis, complicated by large carpal synovial cysts which contained numerous cholesterol crystals. The long-term presence of the cysts, without evidence of joint destruction, suggests that cholesterol crystal formation is probably a rare epiphenomenon, rather than a harbinger of inflammation.

Aged↗
PubMed1992

Comparison of the capacity of murine and human class I MHC molecules to stimulate T cell activation.

The mechanism underlying the apparent differences in the capacity of murine and human class I MHC molecules to function as signal transducing structures in T cells was examined. Cross-linking murine class I MHC molecules on splenic T cells did not stimulate an increase in intracellular calcium ([Ca2+]i) and failed to induce proliferation in the presence of IL-2 or PMA. In contrast, modest proliferation was induced by cross-linking class I MHC molecules on murine peripheral blood T cells or human class I MHC molecules on murine transgenic spleen cells, but only when costimulated with PMA. Moreover, cross-linking murine class I MHC molecules or the human HLA-B27 molecule on T cell lines generated from transgenic murine splenic T cells stimulated only modest proliferation in the presence of PMA, but not IL-2. On the other hand, cross-linking murine class I MHC molecules expressed by the human T cell leukemic line, Jurkat, transfected with genes for these molecules, generated a prompt increase in [Ca2+]i, and stimulated IL-2 production in the presence of PMA. The results demonstrate that both murine and human class I MHC molecules have the capacity to function as signal transducing structures, but that murine T cells are much less responsive to this signal.

Amino Acid Sequence↗
PubMed1992

Modulatory effect of aggregating the CD3 molecular complex on T cell activation.

The role of cross-linking the TCR/CD3 complex in the induction of T cell activation was examined using human peripheral blood T cells and the Jurkat leukemic T cell line. IL-2 production was induced from these cells by pulsing them with mAb to CD3 and costimulating with phorbol myristate acetate (PMA). Cross-linking the anti-CD3 mAb with soluble goat anti-mouse immunoglobulin (GaMIg) markedly inhibited IL-2 production by these cells. Soluble GaMIg did not induce a generalized inhibition of IL-2 production as it was required for responses induced by mAb to class I MHC molecules. In addition, cross-linking anti-CD3 mAb with GaMIg did not inhibit IL-2 production induced by PMA and ionomycin. Inhibition of IL-2 production induced by soluble GaMIg reflected diminished accumulation of mRNA for IL-2. By contrast, immobilized GaMIg was a potent stimulus for IL-2 production by T cells pulsed with anti-CD3 mAb and costimulated with PMA. Cross-linking anti-CD3 with soluble GaMIg induced enhanced aggregation of the ligated molecules, but it did not alter the profile of the change in intracellular calcium induced. To determine whether cross-linking of mAb played a role in inducing IL-2 production as well as in limiting responsiveness, F(ab) fragments were employed. F(ab) fragments of anti-CD3 mAb failed to induce IL-2 production by PMA costimulated Jurkat cells. However, cross-linking of anti-CD3 F(ab)-pulsed Jurkat cells with low concentrations of soluble GaMIg induced IL-2 production in the presence of PMA, whereas higher concentrations suppressed responses. The data indicate that induction of IL-2 production requires aggregation of the TCR/CD3 complex, whereas excessive cross-linking diminishes the induction of IL-2 production. Moreover, the results indicate that various biologic activities of the CD3 molecular complex, including aggregation, signaling capability, and the ability to induce IL-2 gene transcription, are differentially affected by cross-linking.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1990

Analysis of T cell signaling by class I MHC molecules: the cytoplasmic domain is not required for signal transduction.

The structural requirements for signal transduction by class I major histocompatibility complex (MHC) molecules were examined. Native or mutant HLA-A2 or HLA-B27 constructs lacking most of their cytoplasmic domains were co-transfected with pSV2neo into Jurkat cells. Transfection of either native or mutant constructs resulted in a comparable expression of the gene products. Stimulation of transfectants expressing either native or truncated A2 or B27 molecules with specific mAb evoked an increase in [Ca2+]i upon crosslinking. Moreover, crosslinking native or truncated A2 or B27 induced IL-2 production upon co-stimulation with phorbol myristate acetate. These results confirm that crosslinking class I MHC molecules transduces an activation signal to human T cells. Effective signaling was observed when all but four of the intracytoplasmic residues were deleted, indicating that signal transduction does not require this portion of the molecule.

Animals↗
PubMed1988

Severe congestive lupus cardiomyopathy complicated by an intracavitary thrombus: a clinical and echocardiographic followup.

Severe congestive cardiomyopathy is an uncommon complication of systemic lupus erythematosus (SLE). We describe a patient with active SLE and a circulating anticoagulant. She presented with a rapidly progressive cardiomyopathy, complicated by an intracavitary thrombus and cerebral infarction. The course of the disease is described, with special emphasis on the usefulness of consecutive echocardiographic studies.

Adolescent↗
PubMed1988

Fulminant Wilsonian hepatitis: difficulties in diagnosis and treatment.

We present herein the case of a 16-yr-old girl with fulminant Wilsonian hepatitis. Complications included renal tubular damage, hemolysis, marked hypocomplementemia and hypergammaglobulinemia, spontaneous bacterial peritonitis, and Candida sepsis. The difficulties in diagnosis and treatment are discussed.

Adolescent↗
PubMed1987

Right ventricular thrombus and pulmonary emboli in a patient with emphysema: an echocardiographic and Doppler documentation.

Pulmonary hypertension is a known complication of chronic obstructive pulmonary disease (COPD). A worsening dyspnea in a patient with COPD is usually a sequela of the pulmonary disease. However, it may be due to pulmonary embolism, a complication which is difficult to diagnose in such patients. We present a patient with COPD in whom two-dimensional and Doppler echocardiography confirmed the diagnosis of pulmonary emboli by documenting right ventricular thrombus and pulmonary hypertension. This case report emphasizes the usefulness of these noninvasive cardiac imaging techniques in the detection and evaluation of pulmonary embolism in patients with COPD.

Aged↗
PubMed1987

Chronic predominant interstitial nephritis in a patient with systemic lupus erythematosus: a follow up of three years and review of the literature.

Predominant interstitial nephritis is a rare manifestation of systemic lupus erythematosus. Only seven cases have been reported in the literature. Owing to the rarity of this entity, the natural history of predominant interstitial nephritis in lupus has not been adequately recorded and an appropriate therapeutic approach has yet to be defined. In this report we present the case of a 25 year old woman with active systemic lupus erythematosus complicated by kidney failure and renal tubular acidosis due to predominant interstitial nephritis. We describe the course of her disease over a three year period. Seven additional patients with systemic lupus erythematosus and predominant interstitial nephritis are reviewed.

Adult↗