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Biomedical subjects

J Hart

Publications and source records attributed to J Hart.

At least 19 recordsLinked to original sources

Neural subsystems for object knowledge.

Critical issues in the cognitive neuroscience of language are whether there are multiple systems for the representation of meaning, perhaps organized by processing system (such as vision or language), and whether further subsystems are distinguishable within these larger ones. We describe here a patient (K.R.) with cerebral damage whose pattern of acquired deficits offers direct evidence for a major division between visually based and language-based higher-level representations, and for processing subsystems within language. K.R. could not name animals regardless of the type of presentation (auditory or visual), but had no difficulty naming other living things and objects. When asked to describe verbally the physical attributes of animals (for example, 'what colour is an elephant?'), she was strikingly impaired. Nevertheless, she could distinguish the correct physical attributes of animals when they were presented visually (she could distinguish animals that were correctly coloured from those that were not). Her knowledge of input stimulus. To explain this selective deficit, these data mandate the existence of two distinct representations of such properties in normal individuals, one visually based and one language-based. Furthermore, these data establish that knowledge of physical attributes is strictly segregated from knowledge of other properties in the language system.

Aged

Chromosome assignments of the human TNF p55 and p75 receptor genes.

At least two different receptor molecules have been described that are capable of binding tumor necrosis factor alpha, a cytokine that plays an important role in inflammation and antitumor activity. Comparative analyses at the nucleotide sequence level suggest that these receptors are members of a newly defined protein family that also includes human and rat nerve growth factor receptors. In this study, we determine the chromosome assignments of the human TNF alpha receptor genes, one of which may have evolved as part of a conserved Hox locus-containing chromosome segment.

Base Sequence

Mumps-associated acute cerebellar ataxia.

During a mumps outbreak between 1987 and 1988, six children presented with symptoms of acute cerebellar involvement as the sole neurologic complication. The neurologic symptoms followed parotitis and lasted for up to 3 weeks. Serologic evidence was suggestive of recent mumps infection. Symptoms spontaneously resolved in all patients without any residual signs or symptoms during 2- to 2.5-year follow-up.

Acute Disease

Interleukin-3-like activity levels in pregnant women: possible modulation by progesterone.

Human interleukin-3-like activity (IL-3-LA), a factor possessing similar characteristics to interleukin-3 and having clony stimulating factor (CSF) activity, has recently been defined. In the present study, IL-3-LA levels in the sera of women before and after delivery were examined. The results indicate a significant increase in IL-3-LA levels in women before delivery as compared to IL-3-LA levels after delivery or to non-pregnant healthy women. The ability of mononuclear cells from women before and after delivery to produce IL-3-LA was similar to that of mononuclear cells from cord blood. In addition, the effect of progesterone on in vitro IL-3-LA production was examined and a stimulatory dose-dependent effect was observed. These observations point to the hypothesis that during pregnancy IL-3-LA levels are modulated by progesterone. With placental loss, the IL-3-LA in the sera decreases, although the mononuclear cells previously affected by the hormone continue to produce cytokines.

Female

Cultured human cord blood cells spontaneously produce a factor with basophil-promoting activity.

Cord blood is a source for pluripotential stem cells capable of differentiating into various hemopoietic cell lines in the presence of suitable specific growth factors. Without additional growth factors, cultured cord blood cells give rise to large numbers of basophils. We have recently defined a human basophil growth promoting factor, designated as interleukin-3-like activity (IL-3-LA), produced spontaneously by human monocytes and lymphocytes. In order to explain the phenomenon of spontaneous basophil development in cord blood cultures, we studied the relationship between basophil production and IL-3-LA release in these cultures. IL-3-LA produced by cord blood mononuclear cells increased from day 3 to day 14 and then decreased gradually by day 35. Basophil development was observed from day 14 on (33% +/- 6.4) and peaked on day 21 (51% +/- 7.4). Histamine release followed the same pattern i.e., 10 +/- 3.4 ng/ml on day 14, and 23 +/- 6.5 ng/ml on day 21. It is suggested that IL-3-LA spontaneously released by cord blood mononuclear cells induces basophil development in these cultures.

Basophils

Mutagenic activity of nine N,N-disubstituted hydrazines in the Salmonella/mammalian microsome assay.

The mutagenic activity of N,N-dimethyl-, N,N-diethyl-, N,N-dibutyl-, N,N-diisobutyl-, N,N-di(p-tolyl)-, N-ethyl-N-phenyl-, N,N-dibenzyl-, N,N-diphenyl- and N,N-diisopropylhydrazine was examined in the Salmonella/mammalian microsome assay using the strains TA1535, TA1537, TA97, TA98, TA100, TA102 and TA1530. All nine hydrazines were mutagenic in at least one tester strain, although of borderline significance for some of the compounds. The mutagenic potencies of the hydrazines varied 2-3 orders of magnitude, from very weak to moderate mutagenic activity. In general, the addition of S9 resulted in a lowering of the mutagenic activity and a lowering of the toxic properties of the hydrazines. The test results were relatively difficult to evaluate due to toxic effects of many of the test compounds on the test bacteria which may have resulted in an underestimation of the mutagenic potencies of some of the compounds. The pattern of mutagenic activity of the hydrazines in the different tester strains indicates that more than one mechanism of action may be involved in the mutagenicity.

Animals

Combined therapy for obese type 2 diabetes: suppertime mixed insulin with daytime sulfonylurea.

Combined insulin and sulfonylurea therapy for type 2 diabetes may improve the effectiveness of a single injection of insulin, thereby postponing the need for multiple injections. This concept was tested in 21 obese subjects imperfectly controlled by 20 mg of glyburide daily in a double masked, placebo-controlled, parallel design, 16-week protocol. Premixed 70% NPH/30% Regular insulin was taken before supper, and the dosage was adjusted weekly by an algorithm seeking nearly normal fasting glycemia. Eleven subjects using insulin plus 10 mg glyburide before breakfast had lower mean fasting glucose at 10-16 weeks than 10 subjects using insulin with placebo (mean +/- SEM; 5.9 +/- 0.3 versus 7.5 +/- 0.7 mmol/L; p less than 0.05), and had a greater decrement of glycosylated hemoglobin from baseline values (1.3 +/- 0.1 versus 0.8 +/- 0.2% A1, p less than 0.05). After 16 weeks the combined therapy group used half as much insulin as the insulin-only group (50 +/- 5 versus 101 +/- 13 units/d; p less than 0.01). Fasting serum free insulin values increased 58% from baseline after insulin therapy in the insulin-only group (p less than 0.05) but did not increase with combined therapy. Weight gain was similar in the two groups. These data support this form of combined therapy as one option for treating obese persons with type 2 diabetes no longer responsive to oral therapy alone.

Adult

The production of fatty acid modifying enzyme (FAME) and lipase by various staphylococcal species.

Eighty-six strains encompassing 11 species of coagulase-negative staphylococci were examined for the production of fatty acid modifying enzyme (FAME) and lipase. Staphylococcus schleiferi and S. saprophyticus most closely resembled S. aureus in that 80% of the strains produced both enzymes. In contrast, no strains of S. lugdunensis and S. haemolyticus tested produced these enzymes. S. simulans was unusual in that eight of 10 strains produced FAME, but only one produced lipase. Among the other species the proportion of strains producing both enzymes ranged from 10 to 60%. Generally there was a strong correlation between FAME and lipase production.

Acyltransferases

Comparison of the effects of moist and dry conditions on the process of angiogenesis during dermal repair.

The effect of moist and dry conditions on the process of angiogenesis during dermal repair was investigated. The moist conditions were achieved by covering excised wounds on porcine flank skin with the adhesive polyurethane dressing Opsite and dry conditions were achieved by exposure to air through dry gauze dressings. Angiogenesis was assessed during the period from 3 to 60 d after injury. Quantitative studies, using computerized image analysis, were carried out on microfocal x-ray images of skin sections whose blood system had been perfused in vivo with a radio-opaque medium. The analytical technique yielded information with regard to vessel number per wound and also the area occupied by blood vessels per unit wound area. Three regions were assessed in each wound bed: upper zone, just below the surface of the wound; the lower zone, just above the base of the wound bed; and the middle zone, midway between the other two zones. The results showed that the wounds maintained in a moist environment revascularized at a greater rate than those maintained in a dry environment. This was apparent in all of the zones of the wound bed examined. The development of new vessels occurred in a more orderly manner in the moist wounds. There was an early increase in vessel number rising to a peak around days 3-5, then a gradual decrease in number starting around day 7. In contrast, in the dry wounds the development of blood vessels was less rapid. Peak vessel number in the upper zone was significantly less than that achieved in the moist wounds, and was not reached until 7 d after injury. The decrease in vessel number from the peak was less rapid in the dry wounds, suggesting that there was a delayed entry into the remodeling phase in comparison with the moist wounds. The results also showed that the total percentage area of the wound bed occupied by blood vessels was greater in the moist wounds than the dry wounds from 3 d after injury until day 7. This level of vascularization was maintained beyond 7 d after injury even when the vessel number in the moist wounds was significantly less than in the dry wounds, suggesting that the vessels in the moist wounds were larger and, presumably, more mature. In general, moist wounds showed a more rapid decline towards uninjured skin levels of vascularization than dry wounds.

Animals

Sialic acid level in maternal and neonatal lymphocytes and sera correlated to birth order and sex of the neonate.

Sialic acid (N-acetylneuraminic acid) was determined 1 h after normal term deliveries on peripheral blood lymphocytes from 42 mother-neonate pairs and in 29 maternal and neonatal sera. Results were evaluated according to maternal parity and sex of the neonate. The cases were divided into two groups: primiparae, and secundi- and multiparae. In primiparae the sialic acid level on lymphocytes from male neonates and from their mothers was by 23-30% decreased as compared to female neonatal and maternal cells. In the higher parity group, a significantly increased sialic acid level was found on lymphocytes from male as compared to female neonates, and maternal serum sialic acid concentration, unrelated to the newborns' sex, was by 17-20% increased as compared to primiparae. The results suggest that with increasing parity higher levels of sialic acid on male neonatal cells may possibly contribute to mask fetal male-specific histocompatibility antigens. Increased sialic acid levels in maternal sera from secundi- and multiparae suggest its possible contribution to an increased serum blocking effect.

Birth Order

Simple partial seizures: clinicofunctional correlation--a case report.

A 12-year-old girl developed simple partial motor and sensory seizures due to a right perirolandic astrocytoma. Subdural EEG recording and functional stimulation disclosed close correlation between EEG-clinical manifestations of focal seizures and functional responses to cortical stimulation. This case supports the idea that responses in the perirolandic area to endogenous epileptogenic activity and to cortical stimulation reflect common underlying physiologic mechanisms.

Brain

Attitudes to primary-care gynaecology among family physicians and gynaecologists in Israel.

A postal questionnaire was sent to a random sample of Israeli gynaecologists and family physicians to study their attitudes to primary care gynaecology. The gynaecologists (n = 50) tended to think that family physicians should not be involved at all, except for adolescent sex education. The family physicians (n = 60) thought that they should be managing menstrual disorders, vaginal discharges, family planning counselling, prescription of oral contraceptives, insertion of intrauterine devices, routine antenatal and postnatal care, sexually transmitted diseases, breast examinations, and menopausal counselling. Both professions agreed that high risk pregnancies, hospital deliveries, infertility, and PAP smears were in the gynaecologists' domain. The younger family physicians and those in rural practice held these views more strongly than their older colleagues in urban practice. The results are discussed in the light of the patients' and the doctors' diverse interests.

Attitude of Health Personnel

Follow-up appointments at consultation clinics: consultants fail in knowing their own practice.

In National Health Care Systems excessive reappointments at consultative clinics can result in over utilization of those services and/or too much retention of patients which frustrates family physicians in their interest for continuity of care for chronic patients. In order better to understand many consultants' complaints about overwork, we examined the proportion of patients who were given follow-up appointments by type of specialty in 2840 consecutive services requested in a multispecialist centre of a prepaid system in Israel, analysing as well the suspected disparity between this proportion and the consultants' perceptions on this subject. The results of this study show that 44.7% of patients at consultant clinics were given follow-up appointments, and that there was a marked disparity between the real and the subjectively estimated rates of follow-up in surgical specialties (rate-ratio 2.4). This suggests that a problem exists in the knowledge that consultants have of the structure of their own practices.

Ambulatory Care Facilities

Dominant-side intracarotid amobarbital spares comprehension of word meaning.

Abolition of speech production after intracarotid amobarbital injection is generally considered evidence for language laterality. However, complex auditory comprehension may be preserved after injection of the dominant (left) side. The possibility that this sparing may be due to the intracarotid amobarbital injection not adequately deactivating some of the areas responsible for speech comprehension in the posterior part of the hemisphere was tested with a task known to be critically dependent on the left posterotemporal-inferoparietal region, one assessing visuo-verbal semantic relatedness. Even when the intracarotid injection of the left side produced marked deficits of speech production, comprehension of semantic relations was still intact in eight of 15 patients. Ten of these 15 patients also received right carotid injections, none of which affected comprehension of semantic relatedness. These data indicate that the intracarotid amobarbital injection cannot always specify the laterality of all language functions, an important concern when considering surgical procedures in the dominant posterotemporal-inferoparietal region.

Adolescent

Intraobserver and interobserver variation in the histopathological assessment of liver allograft rejection. The Liver Transplantation Database (LTD) Investigators.

A study to determine the reproducibility of histopathological findings and diagnoses of rejection was carried out on a series of 42 liver allograft needle biopsy specimens by five pathologists practicing at four liver transplant centers. Pathologists from each of the four centers read each slide independently on two different occasions and were asked to assess 12 histopathological features and render a diagnosis. For all histological variables, the intrarater agreement was higher than the interrater agreement. Moderate to excellent agreement occurred among the pathologists about all histological variables thought to be important in establishing the diagnosis of acute rejection (i.e., portal tract inflammation, subendothelial inflammation and bile duct damage). Other variables such as lobular disarray, bile duct proliferation and particularly arteritis, however, were only fairly or poorly reproducible. Surprisingly, the diagnosis of acute rejection was more reproducible than the individual histopathological findings that were thought to be the basis for the diagnosis. The agreement for the diagnosis of chronic rejection, however, varied according to observer. We noted that relatively inexperienced observers within this group had some difficulties agreeing with more experienced observers in establishing a diagnosis of chronic rejection. These findings demonstrate that the histopathological diagnosis of acute cellular liver allograft rejection is highly reproducible within a group of experienced pathologists and that this diagnosis can be pooled in a common data base with confidence.

Biopsy, Needle