Biomedical subjects
Publications and source records attributed to I Katz.
At age 50 two homozygote twin brothers developed bilateral paralysis of the diaphragm. No infectious, metabolic, degenerative or proliferative disorders of the neuromuscular system and no thoracic diseases which could explain this lesion were detected during four years of follow-up. It appears thus to be an isolated lesion of genetic origin. To the best of our knowledge, no similar cases have been reported in literature.
In order to study the dose-related effect of nifedipine on expiratory flow rates, 15 asthmatic patients were given sublingually 10 mg and 20 mg of the drug on two different days and the FVC and FEV1 were measured during 90 minutes. Then they received 2.5 mg albuterol (Salbutamol) by inhalation, and the two parameters were measured again after 30 minutes. It was found that the drug has a dose-related effect on expiratory flow rates. Indeed, 20 mg nifedipine produced a mild (less than 10 percent) but significant improvement in FVC (p less than 0.01) and FEV1 (p less than 0.05), while the response to 10 mg was mild, not significant and manifested rather by a decrease in both parameters. In three patients, the forced expiratory flow rates markedly worsened. No correlation could be established between the effect of nifedipine and the severity of the disease. In contrast, the improvement produced by albuterol was strongly related to the degree of airway obstruction (p less than 0.001). Nifedipine in both doses did not potentiate the bronchodilatation induced by albuterol.
Ciliary beat frequency (CBF), measured in vitro, and tracheal mean clearance rate (TMCR), measured in vivo, were studied in 20 nonatopic nonsmokers. CBF, measured by direct examination of nasal cells obtained by a fiberbronchoscopic brush, was 12.1 +/- 1.7 Hz (mean +/- SD). TMCR, assayed by a radioisotope technique, revealed values of 4.3 +/- 1.1 mm/min (mean +/- SD). Both of these values agree with results published by other workers. We attempted to correlate intersubject variation in TMCR with variation in CBF but found no direct relationship, findings similar to those reported in studies done on frog palate epithelium.
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A simple method for in vivo monitoring mucociliary tracheo-bronchial clearance is described. Eighteen healthy subjects and 13 patients with various chronic lung diseases were studied by this method. The principle of using an aerosol administration system similar to the system used for routine ventilation lung studies is stressed. Proximal large airway deposition of the radioaerosol was obtained by using relatively large particles (average diameter 2 microM) of [99mTc]MAA aerosol. Monitoring was performed by visual inspection of the tracheo-bronchial cinescintigraphic ascendence of the accumulated radioactive boli and by assessing their rate of clearance via automated computer analysis of the time-activity curves, following the movement of each bolus. The normal mean +/- s.d. clearance rate thus obtained was 4.7 +/- 1.3 mm/min. This rate appears to be more precise as compared with the range of results obtained by other radioisotopic methods. Significantly faster rates, mean 8.2 +/- 1.4 mm/min (p less than 0.001) were obtained in bronchiectatic patients while slower rates (2.8 mm/min) were seen in a patient with ciliary dyskinesia.
The medical need for human organs suitable for use as transplants far exceed the supply, and is growing. More favorable attitudes about organ donation would increase people's willingness to sign posthumous donation pledges. But effective educational programs require information about the public's present views. Verbal attitude scales were constructed and administered to 110 adults, resulting in reliable measurement of two independent dimensions, prodonation and antidonation (r = .003). Cluster analysis of the instrument revealed that the positive dimension involves belief in the humanitarian benefits of organ donation and feelings of pride experienced by the donor. The negative dimension reflects fears of body mutilation and of receiving inadequate medical treatment when one's life is at risk. Pro and anti scores in combination predicted willingness to sign a donor card. A 2 X 2 analysis of variance (High-Low Positive X High-Low Negative) revealed significant main effects for both positive and negative attitude. Also, a significant interaction effect was obtained. Those subjects who had both strong positive attitudes and weak negative attitudes were especially willing to sign donor cards. Suggestions for designing educational campaigns to promote organ donation are offered.
Recent memory correlated inversely with serum anticholinergic levels for verbal recall but not for recognition memory in 17 chronic schizophrenic inpatients taking neuroleptic medications. The results indicate that anticholinergic activity does not impair primary memory functioning in chronic schizophrenia.
To determine whether the appearance of interferon (IFN) and the modulation of humoral responses observed following injection of irradiated tumor cells were mediated by suppressor cells, the effects of in vivo injection of I-Js specific antibodies were studied. We found that anti-I-J-containing, as well as normal ascites fluids, obtained after repeated ip injection of complete Freund's adjuvant, contain a factor which (a) induces the appearance of serum IFN, (b) enhances the response to SRBC, and (c) suppresses the response to TNP-Ficoll, when injected 1 day before antigen. This effect is not immunologically specific, is probably not caused by intact Ig, and does not appear to be mediated by T cells. Although the nature of the factor(s) responsible for the observed results has not been fully clarified, we report these findings now as a cautionary note for the interpretation of studies where in vivo injection of unfractionated ascites fluids containing monoclonal antibodies are used.
Eighty-two cases of active tuberculosis (TB) were diagnosed only at autopsy in patients hospitalized in the Chaim Sheba Medical Center during a 21-year period (1960 to 1980). Some 75 percent of the patients were over 50 years old and a large number of them suffered from accompanying diseases or drug therapy which suppresses the immune system. Diagnostic measures for the confirmation of tuberculosis (skin tests; cultures of sputum, urine, gastric juice; liver biopsy) were not taken in 75 percent of the cases. In those taken, skin tests were negative in 75 percent of cases, most probably as a sign of anergy. The rest were borderline cases in whom the diagnosis of TB was not accepted affirmatively.
Thirty-four patients with the diagnosis of Hürthle cell tumor occurring from 1971 to 1984 were reviewed to help delineate an acceptable treatment policy. Twenty-nine of these occurred in the last 5 years of study so that extensive follow-up was not possible. Patients varied from age 17 years to 82 and consisted of five males and 29 females, most of whom had an asymptomatic solitary cold nodule. There was a 26% incidence of malignancy. One patient died of cancer caused by anaplastic change of underlying disease; this woman had refused surgery after an incisional biopsy specimen showed benign Hürthle cell tumor. Surgery consisting of lobectomy in 16 patients and near-total thyroidectomy in 18 was uncomplicated. No nodal surgery was necessary. Eighteen percent of patients had multicentric disease of which one half were malignant. Twelve percent of patients developed contralateral Hürthle cell tumor after lobectomy. Associated thyroid lesions occurred in 30% of patients, hyperparathyroidism in 10%. There are polar views in the literature on the management of these patients. While our own tumor experience has been reassuring, we feel that in view of the paucity of cases, those who view this tumor in a serious light deserve attention. Accordingly we advocate near-total thyroidectomy as a primary operation for those who are fit, lesser procedures for the disabled, and the difficult situation, and node sampling to detect early metastasis and improved survival in this group. It is apparent that further reporting of long-term follow-up experience is necessary for complete resolution of dilemmas in the treatment of this problem.
Radioreceptor assay, a promising new tool for studying serum levels of neuroleptics and their biologically active metabolites, was used to elucidate the role of neuroleptic plasma levels in 24 chronic schizophrenic patients with a poor clinical response to standard treatment. Most of these 24 patients attained serum levels reportedly associated with improvement in more acute patients, suggesting that their lack of response was not due to relative absence of drug in serum. Alternative reasons for lack of response despite adequate plasma levels are discussed.
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Despite increasing public and legal pressures to minimize the occurrence of tardive dyskinesia, the practicing clinician often feels there are no alternatives to the use of neuroleptic medication in the treatment of psychosis. However, there are many clinical situations in which the use of neuroleptics may be avoided; guidelines for such situations, including the treatment of affective disorders and of chronic schizophrenia, are presented. The authors also discuss the use of alternative treatment programs and psychosocial interventions that may allow significant reduction in neuroleptics, and they describe new areas of research aimed at preventing and treating tardive dyskinesia.
Three experiments tested a prediction derived from an ambivalence theory of behavior toward the stigmatized. The prediction was that unintentional harm-doers would be more likely to make restitution by doing a favor for a stigmatized victim than for a nonstigmatized one. In Experiment 1 it was upheld for black versus white victims. In Experiment 2, where the victim of harm-doing was either physically handicapped or normal, the prediction was upheld only among older subjects, following the post hoc introduction of an age variable. Experiment 3 also used a physical disability variable. The data were consistent with the prediction, although the adequacy of the harm-doing manipulation was not checked empirically. On the whole, these results are seen as complementing previous findings of amplified post-harm-doing denigration of black and disabled victims. An assumption that the relationship between harm-doing and altruism was mediated by guilt arousal received only fragmentary support. That is, self-reports of guilt were highest in the harm-doing black confederate condition in Experiment 1, and self-reports of negative affect were highest in the harm-doing/wheelchair confederate condition in Experiment 3, but there were no significant relationships between individual differences in guilt or negative affect on the one hand, and amount of helping, on the other.
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The initial hypothesis was that physically disabled help-seekers will receive more aid from normal people than will help-seekers when both types of actors display positive personal qualities, whereas the reverse outcome will occur when both display negative qualities. In the first experiment a wheelchair-bound or normal confederate was either friendly and achievement oriented (positive condition) or caustic and apathetic (negative condition) while administering verbal tasks to subjects who were later asked to help the confederate. Contrary to prediction, subjects offered more help to the normal than to the disabled tester in the positive condition, and showed the reverse pattern in the negative condition. It was conjectured that subjects in the positive condition were annoyed by the disabled person's display of "normal" characteristics, whereas in the negative condition they sympathetically accepted the disabled person's inadequacies as befitting a victim of severe misfortune. A new experiment was done, which replicated the independent variables of the first study, but substituted two new dependent variables: covert anger arousal and perception of the confederate as happy-unhappy. As expected, covert anger was greater in the wheelchair-positive condition than in the normal-positive condition, and greater in the normal-negative condition than in the wheelchair-negative condition. Regardless of the confederate's physical status, subjects perceived negative behavior as a sign of unhappiness.
65 chronic-schizophrenic outpatients were treated with fluphenazinedecanoate for 24 months. Hallucinations and delusions remitted between week 24 and 36, formal disturbances of thinking occurred in 50% of the patients up to the 24th week, mood disorders and disorders and schizophrenic changes in personality could only gradually be controlled. In the first 3 months of treatment the incidence and intensity of rigor grew up to the critical point after 24 weeks of treatment; by the 60th week of treatment it had completely vanished. Akathisia reached its peak after the first and the 36th week and two different populations could be distinguished. 8% of the patients showed dyskinetic reactions up to the 12th week; 20% of the patients showed hyper- and dyskinesia after 72 weeks of treatment. 30 to 40% of the patients required anticholinergics between the 12th and 48th weeks; after the 84th week this medication was no longer necessary.