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Biomedical subjects

H S Kaufman

Publications and source records attributed to H S Kaufman.

At least 19 recordsLinked to original sources
PubMed1991

Bilirubin monoglucuronide promotes cholesterol gallstone formation.

Recent evidence suggests that cholesterol (Ch) solubility in bile is determined by a complex interaction of mixed micelles and lecithin-cholesterol vesicles. Bilirubin monoglucuronide (BMG), which binds to bile salts and incorporates into mixed micelles, may displace cholesterol from micelles into vesicles, thus favoring cholesterol monohydrate crystal precipitation. Therefore, we designed an experiment to test the hypothesis that BMG may enhance cholesterol gallstone formation without inducing cholesterol supersaturation. For 8 weeks, 28 adult male prairie dogs were fed either a control, nonlithogenic diet (0.03% Ch), a high carbohydrate diet (CHO) which has no cholesterol but increases hepatic bilirubin secretion, or the same CHO diet plus 0.03% Ch. Cholecystectomy was then performed, and bile was examined microscopically for stones or crystals and analyzed for BMG and biliary lipids. Cholesterol saturation index was calculated. Cholesterol gallstones were found in none of the control animals and in 13% of the CHO-fed animals. However, the addition of trace cholesterol to the CHO diet resulted in an 88% incidence of cholesterol gallstones (P less than 0.001 vs control, P less than 0.01 vs CHO, respectively). Gallbladder bile was unsaturated with cholesterol in all groups. (control = 0.65 +/- 0.05, CHO = 0.46 +/- 0.05, CHO + 0.03% Ch = 0.70 +/- 0.03). CHO feeding alone or with trace cholesterol significantly elevated gallbladder bilirubin monoglucuronide, phospholipid, and cholesterol concentrations when compared to controls. These data suggest that in the prairie dog a high carbohydrate diet with only trace amounts of cholesterol increases bilirubin monoglucuronide in gallbladder bile and causes cholesterol gallstone formation without inducing cholesterol supersaturation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Short-term fasting increases biliary calcium and bilirubin.

Fasting has been associated clinically with the development of gallbladder sludge and pigment gallstones, both of which are composed primarily of calcium bilirubinate. Although fasting has been demonstrated to increase the cholesterol saturation of bile, its effect on biliary calcium and bilirubin has not been investigated. We, therefore, tested the hypothesis that short-term fasting would increase gallbladder bile calcium and bilirubin levels. Fifteen prairie dogs were studied. Seven animals were not fasted, whereas eight were fasted for 16 hr prior to acute experiments. Gallbladder and hepatic bile samples were obtained and analyzed for calcium, bilirubin, pH, and biliary lipids. Gallbladder bile ionized calcium levels were significantly increased in fasted animals (1.7 +/- 0.2 mM) compared to those in nonfasted animals (1.1 +/- 0.1 mM). Similarly, total calcium (4.3 +/- 0.5 mM vs 2.3 +/- 0.3 mM), total bilirubin (63 +/- 12 microM vs 29 +/- 8 microM), and bilirubin monoglucuronide (58 +/- 10 microM vs 22 +/- 8 microM) were significantly increased in the fasted group. Fasted animals were also noted to have an increased biliary cholesterol saturation index (0.57 +/- 0.04 vs 0.36 +/- 0.03) and decreased biliary pH (6.9 +/- 0.1 vs 7.6 +/- 0.1). These data indicate that in the prairie dog short-term fasting results in significant alterations in gallbladder bile composition. The increased concentrations of gallbladder calcium and bilirubin observed in these experiments may account, in part, for the formation of pigment gallstones and gallbladder sludge seen clinically with prolonged fasting.

Animals↗
PubMed1990

Backscattered electron imaging and windowless energy dispersive x-ray microanalysis: a new technique for gallstone analysis.

Scanning electron microscopy with or without conventional energy dispersive x-ray microanalysis is currently used to identify gallstone microstructure and inorganic composition. Organic calcium salts are among many biliary constituents thought to have a role in gallstone nidation and growth. However, current analytical techniques which identify these salts are destructive and compromise gallstone microstructural data. We have developed a new technique for gallstone analysis which provides simultaneous structural and compositional identification of calcium salts within gallstones. Backscattered electron imaging is used to localize calcium within cholesterol at minimum concentrations of 0.01%. Windowless energy dispersive x-ray microanalysis produces elemental spectra of gallstone calcium salts which are qualitatively and quantitatively different. These combined techniques provide simultaneous structural and compositional information obtained from intact gallstone cross-sections and have been used to identify calcium salts in gallstones obtained at cholecystectomy from 106 patients.

Calcium↗
PubMed1990

Parietaria: an unrecognized cause of respiratory allergy in the United States.

Parietaria is considered the ragweed of the Old World. There are no prior reports of respiratory allergy due to Parietaria (P.) in North America. Following the identification of a lead case, 100 grass-sensitive patients who suffered from seasonal respiratory allergy were skin tested to P. judaica (P.j.) and P. officinalis (P.o.). Eight percent reacted. Five of 42 females (12%) and three of 58 males (5%) demonstrated skin test reactivity to extracts of P.j. and P.o. All reacted to P.j. There was a greater incidence (P less than .05) and reaction size (P less than .05) in females.

Adolescent↗
PubMed1989

The role of bacteria in gallbladder and common duct stone formation.

Debate continues as to the role that bacteria play in gallstone pathogenesis in Western countries. We therefore, examined gallbladder and common duct stones from 67 consecutive patients undergoing cholecystectomy and/or common bile duct exploration. Bile was cultured and stone cholesterol content was measured. Stones were examined by scanning electron microscopy (SEM) for bacteria. Individual calcium salts were classified by windowless energy-dispersive x-ray microanalysis. Gallbladder stones in 65 patients were identified as cholesterol in 46 (71%), black pigment in 17 (26%), and brown pigment in 2 patients (3%). Common bile duct stones from ten patients were cholesterol in 4, black pigment in 2, and brown pigment in 4 patients. The five patients with brown pigment stones were significantly (p less than 0.05) older, more likely to be men and to present with bile duct obstruction. Bile cultures were positive in 13% of patients with cholesterol stones, in 14% of those with black pigment stones, and in all of the patients with brown pigment stones (p less than 0.001). By SEM, bacteria were observed only within the calcium bilirubinate-protein matrix of brown pigment stones (p less than 0.001). In comparison to black pigment stones, brown stones were more likely to contain calcium palmitate (p less than 0.005) and cholesterol (p less than 0.001). We conclude that black and brown pigment stones have different pathogenic mechanisms and that bacterial infection is important only in the formation of brown pigment stones.

Adult↗
PubMed1989

Immunologic abnormalities associated with acute ischemic heart disease (a pilot study).

When in vivo and in vitro studies of patients with myocardial infarction (MI) were compared with healthy controls there was significantly diminished cutaneous cellular immunity and numbers of T lymphocytes in patients who suffered MI. This study contrasted patients with MI to controls and to patients with other types of cardiovascular disease. There was a significant difference when control patients were compared with those who failed to survive MI for 4 weeks (P less than .001). Patients who died in less than 1 month had 3.6 times less circulating percent T-cells than age-matched controls. A new method is described for categorization of in vitro T-cells in human subjects. If certain patients with low numbers of T-cells following MI die, perhaps this information may serve to alert the physician to intervene and correct the patient's course to recovery.

Acute Disease↗
PubMed1988

Antigen recognition in Filipinos, Japanese, Chinese, and Caucasians.

Allergic Chinese, Japanese, Filipinos, and Caucasian groups were compared and contrasted according to their skin test reactivity to pollens of grasses and trees. If a subject reacted to grasses, there was a significantly greater risk of reaction to trees (P less than .0005). The risk was profoundly greater in the three non-Caucasian groups (Filipino, Chinese, and Japanese) compared with the Caucasian group (P less than .0005). Reactivity to grass appeared to amplify the risk of reaction to trees. This effect was particularly striking in the non-Caucasian groups. In groups that did not react to grasses, there was no difference between races in reactivity to trees. The non-Caucasian races did not demonstrate significant differences in their reaction to grasses. All three non-Caucasian groups appear to be more sensitive than the matched Caucasians to cedar, cypress, and juniper.

Asthma↗
PubMed1988

Safe needles.

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Accidents, Occupational↗
PubMed1986

A rapid method of theophylline assay in the physician's office.

A competitive fluorescent enzyme immunoassay for theophylline is described which employs a theophylline monoclonal antibody. Fifty-two samples were assayed by this method and by high pressure liquid chromatography. The coefficient of correlation contrasting the methods equaled 0.979. The coefficient of determination was 0.959. The standard error of the correlation coefficient was 1.392. The bias of the immunoassay method versus high pressure liquid chromatography was 0.8 with 95% confidence limits of 0.4 to 1.2. In the same 52 patients, the precision of 1.6 with 95% confidence limits of 1.3 to 1.9 was obtained. There are numerous advantages of this new method compared with high pressure liquid chromatography. For the practicing physician, the rapid immunoassay for theophylline described here is proper for office application.

Asthma↗
PubMed1976

Immunological development in infants of allergic parents.

Serum immunoglobulins were determined every 4 months from cord blood to age 2 years in ninety-two infants of allergic parents. By 7 months of age, the concentration of IgA was significantly greater in infants who developed atopic dermatitis than those who did not. The IgA was also significantly greater than in matched non-allergic controls. The difference continued to the end of the 2-year study. No significant difference was found in the three groups for levels of IgG and IgM. These findings differ from the results of a previous report and possible explanations are presented.

Humans↗