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Biomedical subjects

H Kaufman

Publications and source records attributed to H Kaufman.

At least 37 records · Page 2Linked to original sources

Immunosuppressive activity and polyamine levels of seminal plasma in azo-ospermic, oligospermic, and normospermic men.

Seventy specimens of human seminal plasma obtained from azo-ospermic, oligospermic, and normospermic men were tested for immunosuppressive activity on normal donor lymphocytes. Spermine and spermidine levels in acidic extracts were determined in 32 specimens of seminal plasma from the three groups. The original seminal plasma as well as the neutralized spermine extracts were examined for their effect on the functional activity of the lymphocytes. Seminal plasma obtained from the normospermic and oligospermic semen showed significant immunosuppressive activity, whereas no immunosuppressive activity was induced by seminal plasma from azo-ospermic semen. The latter finding was in accordance with the low spermine levels in azo-ospermic semen, which were about 50% of those found in normospermic and oligospermic seman. Acidic extraction of the seminal plasma of azo-ospermic origin resulted in an increase in spermine levels and also in immunosuppressive activity, demonstrating that in azo-ospermic men spermine is bound probably to a protein and is released after acidification, exerting its immunosuppressive activity only when unbound.

Graft vs Host Reaction↗

A circulatory model for combined nitroprusside-dopamine therapy in acute heart failure.

A computer model was developed to approximate the hemodynamic responses of dopamine and nitroprusside in acute left ventricular pump failure. The model is intended to aid the design of a multiple drug infusion system. A non-linear electrical analog model with baroreflex feedback was used to simulate the circulatory system. Heart failure was represented by a reduction in left ventricular inotropy. Pharmacodynamic relationships between the drugs studied and several elements of the system were incorporated into the model to simulate the overall drug responses which include secondary interactions between vascular components. Despite several shortcomings, the model showed good agreement with experimental and clinical data.

Acute Disease↗

Corneal subepithelial monoclonal kappa IgG deposits in essential cryoglobulinaemia.

A 60-year-old man suffering from photophobia and visual disturbances was found to have bilateral superficial corneal grey-white gelatinous deposits. An abnormal cold-precipitable serum component was found and characterised as homogeneous IgG-kappa immunoglobulin. Corneal immunohistochemical examination revealed subepithelial IgG-kappa deposits, focally replacing Bowman's layer. The patient underwent superficial keratectomy in both eyes with satisfactory visual results.

Cornea↗

Beta-endorphin and calcitonin in human semen.

The levels of beta-endorphin (beta-E) and calcitonin were estimated in 36 samples of seminal plasma from semen of normospermic, oligozoospermic, and azoospermic origins and in pools of isolated sperm. The mean levels in plasma calculated for all samples examined were 192 +/- 224 pg/ml for beta-E and 754 +/- 397 pg/ml for calcitonin. The amounts in sperm were as follows: for beta-E in pools with sperm counts of 0.1-10 x 10(6)/ml, 157.2 +/- 99.7 pg/10(8) and 27.9 +/- 23.6 pg/ml protein; in pools of greater than 10-30 x 10(6)/ml, 71.2 +/- 41.5 pg/10(8) and 6.5 +/- 1.2 pg/mg protein; in pools of greater than 30-200 x 10(6)/ml, 24.9 +/- 9.7 pg/10(8) and 61 +/- 1.9 pg/mg protein. For calcitonin the amounts were: 501.2 +/- 170.8 pg/10(8) and 27.4 +/- 21.5 pg/mg protein, correspondingly. It was suggested that beta-E and calcitonin present in seminal plasma are synthesized mostly in a compartment of the male reproductive system. The high cellular beta-E and calcitonin levels would be involved in the process of motility through their effect on calcium transport.

Calcitonin↗

Effects of estradiol and dexamethasone on choline acetyltransferase activity in various rat brain regions.

Estradiol, administered to ovariectomized rats, increased choline acetyltransferase (ChAT) activity in the caudate nucleus, cortex, hippocampus, and hypothalamus, suggesting possibly widespread central cholinergic involvement in estrus-related behavior. Dexamethasone also, except in hypothalamus, increased ChAT activity, notably (50%) in hippocampus. ChAT activity changes did not correlate with reported regional hormone receptor density. Estradiol's effect in the caudate suggests that hormone receptor and affected enzyme may not necessarily coexist intraneuronally.

Animals↗

When should hydrocortisone therapy be instituted in children with hypopituitarism?

The records of 72 pediatric and adolescent patients with multiple hypothalamic and/or pituitary hormone deficiencies of nontumoral origin who were followed up for years and receiving somatotropin, thyroxine, and sex hormones at the appropriate age have been reviewed. According to their corticotropin-releasing factor-corticotropin-cortisol (CAC) axis function as evaluated by basal plasma cortisol levels and the response of cortisol to insulin hypoglycemia and to corticotropin-releasing factor, the patients were divided into three groups: group 1 (n = 25), patients with multiple hypothalamic and/or pituitary hormone deficiencies with normal CAC axis; group 2 (n = 38), patients with partial CAC deficiency without cortisol replacement therapy (hydrocortisone); and group 3 (n = 9), patients with CAC deficiency receiving hydrocortisone therapy (5 to 10 mg/d). Repeated CAC axis evaluation in patients of group 2 over years revealed a progressive decrease in the basal and stimulated cortisol levels with age and pubertal advancement. Despite the low cortisol levels and the low cortisol response to insulin hypoglycemia, these patients did not have clinical symptoms until the end of puberty when nine of 24 patients complained of abdominal pain, weakness, or anorexia. Linear growth, which was followed up in all patients at regular intervals, showed a lower growth velocity and irregular growth in response to somatotropin treatment in the patients receiving low doses of hydrocortisone (group 3 patients when compared with group 2 patients not receiving hydrocortisone).

Adolescent↗

Ergonomic considerations in the design of neurosurgery instruments.

Surgical instruments should be designed to optimize control and interact with tissues or other objects while avoiding surgeon fatigue, muscle spasms, tissue ischemia, and injuries. Several well-established ergonomic criteria can be used in the design of instruments. Analysis of some commonly used bone biting instruments reveal how they violate these criteria. The thoughtful redesign of instruments using these principles is recommended.

Equipment Design↗

Simple methods for estimation of prednisone intake and metabolism.

For patients treated with high doses of prednisone (over 40 mg/day) laboratory follow-up is important, particularly when the therapeutic response does not correlate with the dose of prednisone prescribed. Taking advantage of the similarity in structure of prednisone to cortisone and of prednisolone to cortisol we evaluated simple, inexpensive methods for the assessment of prednisone and prednisolone intake and bio-availability. Free urinary prednisolone was estimated by radioimmunoassay for cortisol and found to be linearly correlated with the dose of prednisone administered (r = 0.9310). Levels of free prednisolone were 6.5-11% of the dose of prednisone per day. Free and metabolized prednisone and prednisolone were estimated as 17-OHCS in the 24-hr urine collection. Total, conjugated and free 17-OHCS were linearly correlated with the dose of prednisone, the best correlation being with total 17-OHCS (r = 0.9060). About 40% of the prednisone administered was secreted as total 17-OHCS.

Adult↗

Pregnancy and Cushing's syndrome: example of endocrine interaction.

Pregnancy rarely occurs in women with Cushing's syndrome, and when it does, fetal mortality and morbidity are very high. We describe a 30-year-old woman who was found to have severe Cushing's syndrome in the 22nd week of her first pregnancy, after a year of unsuccessful attempts to conceive. The patient had the majority of the symptoms and signs characteristic of the syndrome. Laboratory examinations revealed hypokalemia of 2.7 mEq/l, serum cortisol 39.5 micrograms/dl without diurnal variation, free urinary cortisol 1,850 to 3,500 micrograms/24 h, 17-hydroxycorticosteroids (OHCS) 52.5 mg/24 h, 17-ketosteroids (KS) 12 mg/24 h, and ACTH 29 pg/ml. No suppression was observed upon dexamethasone administration (2 and 8 mg). Ultrasound examination of the adrenal glands revealed a left adrenal tumor with a diameter of 4.2 cm. An adrenocortical adenoma was successfully excised in the 24th week of pregnancy. During the 37th week of pregnancy, she delivered a normal baby girl. Postoperatively, the patient was put on maintenance therapy. One year after delivery, mother and child are in perfect health.

Adenoma↗

Severe sexual impairment produced by morbid obesity. Report of a case.

A 45-year-old man, was admitted for investigation of severe sexual impairment. During 20 years of marriage, he had had no normal sexual intercourse and the couple was childless. Physical examination disclosed a severely obese man (weight 300 kg, height 1.75 m), with a relatively small and invaginated penis and small (5 ml) soft testes. Laboratory examinations disclosed the following: low serum testosterone (1 ng/ml), with a reduced response to HCG (3.8 ng/ml). Sex hormone binding globulin was at the lower limit of normal (0.38 microgram/dl), serum free testosterone was low (0.98% of total testosterone) as well as non-SHBG bound testosterone (22% of total testosterone). Daily total urinary estrogen excretion was increased (107 micrograms), the plasma estrone (78 pg/ml) and estradiol (74 pg/ml) were elevated. The gonadotropins were normal and responded adequately to LRH. Plasma growth hormone was decreased, prolactin, T4 and adrenal steroids were normal and responded normally to stimuli and inhibitors. Chromosomal constitution was 46XY. Thus, in this man the marked obesity produced a significant increase in estrogens which subsequently induced a severe decrease in testosterone and its free counterpart in excessive impairment of sexual function.

Hormones↗

Endocrine studies of the ovulatory disturbances in Wilson's disease (hepatolenticular degeneration).

Women with Wilson's disease may have severe oligomenorrhea or amenorrhea whose cause is unknown. The endocrine profile of four such cases was investigated by measuring basal values and the response to dynamic tests of hypothalamic, pituitary, thyroid, and adrenal function, which all proved normal. Ovarian function was disturbed, as witnessed by low estradiol, high total testosterone (T) levels with normal free T, and mildly elevated androstenedione. An interference of ovarian follicular aromatase activity possibly due to copper intoxication could explain these findings as the cause of the ovulatory disturbances of Wilson's disease.

Adolescent↗

Estimation of prednisone intake in pemphigus vulgaris patients with the use of simple laboratory methods.

Prednisone is a widely used medication in dermatology, particularly in pemphigus patients. Simple objective laboratory methods are suggested for the evaluation of prednisone intake, taking advantage of the similar chemical structure of cortisol and prednisolone. A linear correlation was found between the dose of prednisone, above 40 mg/day, free urinary prednisolone, measured with an radioimmunoassay kit for cortisol that cross-reacts with prednisolone, and 17-hydroxycorticosteroids, measured by Metcalf's method. Approximately 9% of the prednisone administered was recovered as free prednisolone and about 40% as 17-hydroxycorticosteroids. It is suggested that these simple laboratory methods constitute a useful substitute for the more costly, sophisticated methods available at present for determining levels of prednisone and prednisolone.

17-Hydroxycorticosteroids↗

The effect of long-term administration of digoxin on plasma androgens and sexual dysfunction.

The effect of long-term administration of digoxin on sexual dysfunction was investigated in correlation to plasma androgens level. The patients of the experimental (digoxin-treated) and control (without digoxin) groups were of similar cardiac functional capacity and age (25-40 years) and were randomly selected from the rheumatic heart disease patients. A subjective assessment of sexual behavior was carried out, using parameters such as sexual desire, sexual excitement, and frequency of sexual relations. Personal interviews and questionnaires were also used for the evaluation of sexual behavior. The findings support various reports concerning digoxin effect on plasma levels of testosterone (the difference in the mean was significant). The effect on plasma levels of androstenedione and dehydroepiandrosterone in the experimental group as compared to the control group were not significant. Tests used to evaluate the changes in sexual behavior, showed a significant decrease in sexual desire, sexual excitement phase (erection) and frequency of sexual relations in the digoxin-treated group.

Adult↗

Menopausal hot flushes and plasma beta-endorphins.

Plasma beta-endorphin levels were measured in five women in physiologic menopause suffering from frequent episodes of hot flushes, recorded objectively by the measurement of finger temperature. Significantly lower levels of plasma beta-endorphin levels were found at the onset of the hot flushes than five to 20 minutes before (P less than .001). After the flush there was a significant rise of plasma beta-endorphin levels at five, ten, and 15 minutes (P less than .002).

Body Temperature Regulation↗

The phenomenon of leukergy: induction and detection of leukocyte aggregation in whole human blood.

Leukocyte aggregation is involved in the generation of vascular damage during various inflammatory conditions. So far, in vitro leukocyte aggregation has been studied by mixing patients' plasma or serum with leukocytes of a normal donor in a platelet aggregometer. We evaluated the leukergy phenomenon, that is, the occurrence of aggregated leukocytes in peripheral blood of patients with inflammatory disorders, as an alternative tool to the former method. Leukocyte aggregation could be induced by zymosan-activated plasma, phorbol myristate acetate, and formyl-methionyl-leucyl-phenylalanine, as well as by the calcium ionophore A23187 in vitro in whole human blood. This aggregation was blocked by various lipoxygenase and cyclooxygenase pathway inhibitors. Leukergy was diagnosed in peripheral blood of patients with inflammatory disorders and was generally not associated with elevated concentrations of immune complexes, lactoferrin, C3a des Arg, or C5a des Arg. To the best of our knowledge, this is the first report on leukocyte aggregation studies performed in whole blood. Such study permits evaluation of the aggregation phenomena of leukocytes in their natural milieu. Furthermore, it is possible with this method to obtain direct visualization of leukocytic aggregates in the peripheral blood of patients. The significance of our results and their possible implications are discussed in light of the pertinent literature.

Adult↗