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Biomedical subjects

J Adler

Publications and source records attributed to J Adler.

At least 199 records · Page 11Linked to original sources
PubMed1984

Diagnosis of dysuria in adolescent girls. A protocol encompassing common, often nonurinary, causes.

Vulvovaginitis, not urinary tract infection, is the most common cause of dysuria in adolescent girls, and the work-up for this condition involves more than just ordering urinalysis and urine culture. Factors essential to proper evaluation of dysuria include determination of the patient's age, stage of pubertal development, and sexual activity, as well as assessment of associated symptoms, concomitant conditions, and use of contraceptive or feminine hygiene products that may cause irritation. Thus, a thorough history and physical examination, including examination of the genital area, are mandatory.

Adolescent↗
PubMed1984

Perforated peptic ulcer--a seasonal disease?

All hospital admissions for perforated peptic ulcer in the State of Western Australia from 1971 to 1981 inclusive were used to study the seasonal fluctuation, prevalence and mortality. This represented 1187 admissions. A significant seasonal peak was found during November, December and January. There was a marked reduction in admissions in the last three years, i.e. 1979-81, representing a 35% drop from previous levels. The overall mortality was 6.6%, but was 1.8% in patients less than 65 years, and 17.3% in patients 65 years or older.

Aged↗
PubMed1984

Lysis of arterial clot by intravenous or intra-arterial administration of streptokinase.

Intra-arterial thrombolysis with streptokinase was studied in 38 patients. The indications were peripheral thromboembolism in nine patients (group 1), postreconstruction graft thrombosis in 26 patients (group 2) and renal artery thrombosis in three patients (group 3). The intra-arterial route was used for the first and third groups and in 16 of the second group. The intravenous route was used in the remaining ten patients. Lysis was achieved in all of the group 1 and 3 patients. The latter were also treated with percutaneous transluminal angioplasty after dissolution of thrombus of the renal artery. In group 2 patients, lysis was achieved in eight of 16 patients in whom lytic therapy was instituted within seven days of graft closure. There was no lysis in all ten patients in whom elapsed time was more than seven days. Postlytic angiographic visualization of etiologic mechanisms for thrombosis enabled subsequent successful correction in three of five patients in group 2. Attempts to correct graft failure by surgical treatment when lysis had failed were often unsuccessful (12 of 17). Lytic therapy is most effective for acute embolic occlusion and for thrombosis of less than seven days duration. Although there is no difference in drug efficacy by route of administration, a lesser number of complications (such as, fever and hematoma) occurred with intra-arterial infusion. The effectiveness of lysis is also directly related to the collateral circulation and runoff beyond the occlusion. Lysis is not indicated for severe acute ischemia if surgical treatment is an alternative or if it may cause distal embolism as with complete axillofemoral graft thrombosis. Lytic therapy is least effective for graft thrombosis with pre-existent poor runoff.

Aged↗
PubMed1983

Differential control of insulin secretion and somatostatin-receptor recruitment in isolated pancreatic islets.

Somatostatin receptors appear to be localized to secretory granules in pancreatic islet homogenates. Recruitment of these receptors to the islet-cell surfaces may mark the contact event between secretory granules and plasma membranes before release of insulin by fission. Isethionate, an impermeant anionic replacement for chloride, blocks the release step but does not affect receptor recruitment. By contrast, low concentrations of phenothiazine drugs, such as trifluoperazine and promethazine, inhibit both receptor recruitment and secretion. Scatchard analysis of phenothiazine effects on somatostatin receptors reveals that these drugs reduce the number of receptors but do not affect the affinity of the receptor for somatostatin. These data indicate that membrane contact and fission steps during exocytosis can be biochemically separated.

Animals↗
PubMed1983

Gastric rupture: an unusual complication of the esophageal obturator airway.

The esophageal obturator airway (EOA) has been used in the Jerusalem area by the ambulance services approximately 1,000 times in the past six years. We report an unusual complication of the EOA in the case of a 50-year-old man rescued from drowning who received both basic and advanced cardiopulmonary resuscitation. He was ventilated by an EOA attached to an Ambu bag; however, resuscitation attempts were unsuccessful. Autopsy revealed gastric rupture.

Esophagus↗
PubMed1983

Adenylate cyclase is required for chemotaxis to phosphotransferase system sugars by Escherichia coli.

We report that in Escherichia coli, chemotaxis to sugars transported by the phosphotransferase system is mediated by adenylate cyclase, the nucleotide cyclase linked to the phosphotransferase system. We conclude that adenylate cyclase is required in this chemotaxis pathway because mutations in the cyclase gene (cya) eliminate or impair the response to phosphotransferase system sugars, even though other components of the phosphotransferase system known to be required for the detection of these sugars are relatively unaffected by such mutations. Moreover, merely supplying the mutant bacteria with the products of this enzyme, cyclic AMP and cyclic GMP, does not restore the chemotactic response. Because a residual chemotactic response is observed in certain strains with residual cyclic GMP synthesis but no cyclic AMP synthesis, it appears that the guanylate cyclase activity rather than the adenylate cyclase activity of the enzyme may be required for chemotaxis to sugars transported by the phosphotransferase system. Mutations in the cyclic nucleotide phosphodiesterase gene, which increase the level of both cyclic AMP and cyclic GMP, also reduce chemotaxis to these sugars. Therefore, it appears that control of the level of a cyclic nucleotide is critical for the chemotactic response to phosphotransferase system sugars.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1983

Chemotactic response of Escherichia coli to chemically synthesized amino acids.

In Escherichia coli, seven of the commonly occurring amino acids are strong attractants: L-aspartate, L-serine, L-glutamate, L-alanine, L-asparagine, glycine, and L-cysteine, in order of decreasing effectiveness. The chemotactic response to each amino acid attractant is mediated by either methyl-accepting chemotaxis protein I or II, but not by both. Seven of the commonly occurring amino acids are repellents. This work was carried out with chemically synthesized amino acids.

Amino Acids↗
PubMed1983

The fate of patients with lung cancer: five-year review of 250 cases.

Two hundred fifty patients with bronchogenic carcinoma were followed for at least 5 yr after diagnosis. In 187 (75%), the tumor was diagnosed within 6 mo of the first clinical manifestation. Among 205 patients who were not operated on because of tumor spread or because of poor general condition, 139 (67.5%) died during the first year, 15 (7.5%) during the second year, and 51 (25%) were not available for follow-up and are presumed dead. Forty-five patients underwent curative resection, with one early death. Of the 44 survivors, 30 had lobectomy, 1 had sleeve lobectomy and 13 pneumonectomy. The cancer-free survival rate in this group was 32% at 5 yr and 30% at 7 yr. Except for small cell carcinoma, there was no correlation between tumor histology and prognosis. Due to the late appearance of symptoms, early diagnosis of lung cancer is impossible with present-day methods.

Adult↗
PubMed1983

Terrorist bombing experience during 1975-79. Casualties admitted to the Shaare Zedek Medical Center.

During a period of 4 1/2 yr, 24 terrorist explosions occurred in Jerusalem. Of the 511 casualties, 340 were evacuated to the Department of Emergency in our hospital. A total of 272 admissions were graded by the "Injury Severity Score" (1), with a breakdown into light injuries (87%), medium (3%) and severe (10%). The high proportion of light injuries may be explained by the evacuation of all casualties to the nearest hospital without on-site triage. Injuries to the head and neck comprised 19.3%, and to the extremities 39% of all injuries.

Abdominal Injuries↗
PubMed1982

Granule fusion and fission (discharge) are biochemically dissociable events of exocytotic hormone release.

Granule fusion and the subsequent fission leading to hormone discharge are distinct and separable events in exocytosis. As an index of fusion, we followed the recruitment of granule-bound somatostatin receptors to the islet surface, an event which accompanies secretion vesicle migration and insulin secretion. Granule fission was monitored by measuring insulin release. Substitution of the impermeant salt sodium isethionate for NaCl led to a 90% decrease in glucose-stimulated insulin release with no inhibition of somatostatin receptor recruitment. The phenothiazine drugs, trifluoperazine and promethazine, believed to inhibit calcium-sensitive proteins involved with stimulus-secretion coupling blocked insulin release and somatostatin receptor recruitment in parallel. This suggests that these agents suppress intracellular events promoting fusion of the secretion granule with the plasma membrane. IBMX appears to stimulate specifically granule fission since IBMX-induced insulin release occurs acutely without an increase in somatostatin receptor recruitment. Sodium isethionate, which inhibits granule lysis, blocked IBMX-stimulated insulin release.

1-Methyl-3-isobutylxanthine↗
PubMed1981

Bacterial cell envelopes with functional flagella.

Our aim was to isolate from bacteria a flagellated, subcellular system whose content could be changed at will. Because the control of bacterial chemotaxis resides in the direction of rotation of the flagella, such a system would be ideal for the study of this control mechanism. By incubating bacteria with penicillin and then lysing them osmotically, we were able to isolate cell envelopes from Escherichia coli and Salmonella typhimurium. These envelopes have the same sidedness and similar shape and dimensions as the original bacteria; they are practically free of cytoplasm; they are osmotically sensitive, having intact the cytoplasmic membrane and at least part of the cell wall; and they have flagella. This preparation was used to find out what is required to restore flagellar rotation, which had been lost during osmotic lysis. By visualizing the image of individual flagella with high intensity light microscopy or by tethering the cell envelopes, we found that adding artificial electron donors as an energy source is enough to restore rotation. This seems to indicate that no cytoplasmic components are required and that the proton electrochemical potential is indeed the driving force for flagellar rotation. However, the rotation was almost entirely counterclockwise, while in intact bacteria the flagella rotate in both directions. This may indicate that a cytoplasmic component is required to allow clockwise rotation. The significance of these results for the study of chemotaxis is discussed.

Cell Fractionation↗