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Biomedical subjects

J M Shapiro

Publications and source records attributed to J M Shapiro.

26 records · Page 2Linked to original sources

Mitochondrial abnormalities of liver in primary ornithine transcarbamylase deficiency.

Deficiency of hepatic ornithine transcarbamylase (EC 2.1.3.3) activity in a 17-month-old female patient is described. Enzyme activity was 11% of the mean control value. Electron microscopic examination of the liver specimen, taken by percutaneous needle biopsy, revealed striking abnormalities of the mitochondria: bud-like projections, sausage-link appearance, elongation with short cristae, or the presence of parallel arrays of tubules. The abnormalities do not resemble those seen in Reye's syndrome.

Female↗

Serum bilirubin: a prognostic factor in primary biliary cirrhosis.

We followed up 55 patients with proven primary biliary cirrhosis for several years or until death. A graph of the level of serum bilirubin versus time that was constructed for each patient shows an initial period of variable length in which the serum bilirubin level remained constant. This was followed by a period of rapid rise in serum bilirubin which culminated in the patient's death. Whenever two successive serum bilirubin values taken six months apart exceeded 34 mumol/l (2.0 mg/dl) the patient had entered a late phase of disease and lived an average of 49 months. Ninety-five per cent confidence limits on survival time were 32-74 months. If two successive six month bilirubin values exceeded 102 mumol/l (6.0 mg/dl), calculated survival time was 25 months, and if two successive six month bilirubin values exceeded 170 mumol/l (10.0 mg/dl), survival time was 17 months. Fifteen of the 41 living patients had two consecutive serum bilirubin levels greater than 34 mumol/l (2.0 mg/dl). However, the slope of the rising bilirubin in the living patients is only 35 mumol/l/yr (1.5 mg/dl/yr) compared with 42 mumol/l/yr (2.5 mg/dl/yr) in the dead patients. This means that patients with this disease not may be living considerably longer.

Adult↗

Antibodies to ribosomes in chronic active hepatitis.

A recently developed Farr-type radioimmunoassay for the detection of antibodies to tritium-labeled HeLa cell cytoplasmic ribosomes was evaluated as a serologic test in a variety of liver diseases. Ribosomal antibodies were detected in the sera of 31.4% of 70 patients with chronic active hepatitis (CAH) and primary biliary cirrhosis compared with only 4.2% of patients with chronic persistent hepatitis, acute viral hepatitis, alcoholic liver disease, and miscellaneous liver diseases (X2 = 17.89, P less than 0.001). The level of ribosomal binding activity was also significantly higher in sera of patients with CAH and primary biliary cirrhosis (15.4% vs 6.5%; t = 5.61, P less than 0.001). The antibodies were observed almost exclusively in HBsAg-negative CAH with autoimmune features and infrequently at lower titer in HBsAg-positive CAH or CAH without HBsAg or autoantibodies. Inhibition experiments with purified ribosomal RNA suggested that the ribosomal antibodies are in part reactive with ribosomal RNA. Ribosomal antibodies appear to represent another example of the exaggerated immune response associated with CAH and primary biliary cirrhosis.

Autoantibodies↗

Corneal thickness measured by interferometry.

An optical method for measuring the thickness of transparent structures has been developed, and has been used to measure, in vivo, the thickness of the human cornea. The thickness is measured by placing the anterior surface of the cornea at the focus of a beam of coherent laser light and then measuring the spacing between the interference fringes generated by the reflected light. The thickness is then calculated from the fringe spacing. The method has been used to measure corneal thickness in frog and human corneas. These measurements have been correlated with histologic and pachometer measurements of corneal thickness. A significant capability of this technique is to measure the thickness of optically opaque corneas.

Animals↗

Multivariate analysis of determinants of postoperative wound infection: a possible basis for intervention.

Multivariate analysis of variables hypothetically associated with the development of postoperative wound infection was attempted with use of large groups of patients undergoing certain surgical procedures over periods of 12-36 months. The data were obtained through prospective surveillance by specially trained nurse-epidemiologists. For patients who had colon surgery (n=261), the multivariate analysis showed that only four variables were independently associated with postoperative wound infection: more than one operation during a single episode of hospitalization (adjusted odds ratio, 7.3); Arab ethnicity (adjusted odds ratio, 6.1); prophylaxis according to the recommended protocol not given (adjusted odds ratio, 2.4); and opening of a colostomy as the specific operation (adjusted odds ratio, 2.3). Of all the variables analyzed, more than one operation during an admission was consistently associated with the highest risk of infection in patients who had cardiac and neurosurgery as well as colon surgery. On the other hand, a traditional risk factor, e.g., the presence of drains at the site of the operation, was not found to be independently associated with an increased risk of infection in any of the groups tested. This type of analysis is essential to facilitate the introduction of a more meaningful program for intervention based on proved rather than hypothetical risk factors

Analysis of Variance↗