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Biomedical subjects

J Michaeli

Publications and source records attributed to J Michaeli.

At least 55 records · Page 3Linked to original sources
PubMed1988

Expression of basic fibroblast growth factor mRNA in benign prostatic hyperplasia and prostatic carcinoma.

In our previous work we demonstrated that prostate-derived growth factor (PrGF) is homologous to basic fibroblast growth factor (bFGF), not acidic fibroblast growth factor (aFGF). Using Northern blot analysis we now show that the messenger RNA for bFGF but not aFGF is expressed in benign prostatic hyperplastic (BPH) tissue as well as in carcinoma of the prostate (CAP). This not only corroborates our previous results, but suggests that PrGF is produced locally and not merely stored in the prostate. The demonstration of local production of bFGF by prostate tissue may indicate that this growth factor plays a role, either alone or in conjunction with other factors, in the etiology of benign hyperplasia or prostatic cancer.

Animals↗
PubMed1988

Antinuclear antibody-negative systemic lupus erythematosus (SLE) and severe renal involvement: close correlation between disease activity and appearance of circulating anticoagulant.

A 16-year-old girl meeting the criteria for SLE is described. Salient features of the clinical course included active glomerulonephritis with dense subepithelial deposits on electron microscopy, pulmonary embolism, axillary vein thrombosis, arthritis, serositis and fever. Disease activity correlated with the presence of lupus anticoagulant as measured by VDRL and partial thromboplastin time (PTT). Her serum was consistently negative to ANA, anti-DS-DNA, anti-SS-DNA, ENA, anti-Ro, anti-La, and LE cells for the entire 4-year course. She responded remarkably to prednisone and azathioprine. Reappearance of VDRL and elevated PTT preceded exacerbation of disease activity and served as a serological guide for modifying medical treatment.

Adolescent↗
PubMed1988

Acute abdomen due to granulocytic sarcoma of the terminal ileum.

A 57-year-old patient with chronic granulocytic leukemia in blast crisis and severe neutropenia is presented. This patient developed right sided peritonitis due to an isolated transmural granulocytic sarcoma of the terminal ileum. The affected segment was resected and the patient survived 4 more months. Thus, despite neutropenia, an aggressive surgical approach should be considered in a leukemic patient presenting with unexplained acute abdomen, since, as demonstrated here, a localized lesion which could not have otherwise been detected, was ultimately found and promptly resected.

Abdomen, Acute↗
PubMed1987

Exacerbation of idiopathic pulmonary hemosiderosis in pregnancy.

Idiopathic pulmonary hemosiderosis (IPH) is a very rare disease in adults. Its occurrence in pregnancy has been described only once. A case of a 16-yr-old patient with an exacerbation of IPH during pregnancy resulting in intrauterine fetal death in the 28th week of gestation is described. The deterioration of the IPH is most probably related to the hemodynamic alterations which are at their maximum during the seventh month of pregnancy. Although rare, the case suggests that women with IPH should be followed carefully during pregnancy and, in the case of a deterioration in the patient's condition despite immunosuppressive therapy, termination of pregnancy should be considered.

Adolescent↗
PubMed1987

Failure of propranolol to improve exercise tolerance in patients with mitral stenosis in sinus rhythm.

Propranolol reduces left atrial pressure at rest and during exercise in patients with mitral stenosis by lowering cardiac output and heart rate. Ten patients (aged 19-56) with moderate to severe isolated mitral stenosis were studied to determine whether propranolol increased their exercise tolerance. All were in sinus rhythm and free of left or right ventricular failure. Patients were trained in an individually graded bicycle or treadmill exercise protocol that provoked a reproducible degree of near maximal dyspnoea during the second three minute stage of exercise. Propranolol (80 mg or 120 mg) or matching placebo in two or three divided daily doses was given for one week in random double blind fashion. Exercise testing and questioning about subjective clinical response were carried out at the end of each week by an investigator who was unaware of the patient's heart rate. During propranolol treatment the heart rate was 19 beats/minute slower at rest and 38 beats/minute slower at peak exercise, but there was no change in mean exercise time to dyspnoea (274 s during propranolol vs 283 s during placebo). Four patients felt worse during the propranolol week, one patient felt better during the propranolol week, and five patients felt no difference between the two weeks. Propranolol did not improve objective or subjective exercise tolerance in patients with isolated mitral stenosis in sinus rhythm.

Adult↗
PubMed1987

Idiopathic thrombocytopenic purpura presenting as iron-responsive thrombocytopenia.

We describe a patient with iron-deficiency anemia, thrombocytopenia and paucity of marrow megakaryocytes, in whom the anemia and the thrombocytopenia responded to the administration of iron. Thrombocytopenia recurred, despite maintenance of normal hemoglobin and iron levels and adequate marrow megakaryocytes. Corticosteroids and splenectomy were required for the control of the thrombocytopenia. In this patient, the initial manifestations of idiopathic thrombocytopenic purpura were modified by the presence of severe iron deficiency. This case strengthens the contention that iron is essential for megakaryopoiesis and thrombopoiesis.

Anemia↗
PubMed1986

Paravertebral extramedullary hematopoiesis associated with improvement of anemia in congenital dyserythropoietic anemia type II.

Thoracic masses resulting from extramedullary hematopoiesis developed in two sisters of Moroccan origin with congenital dyserythropoietic anemia type II (HEMPAS). In one patient, the diagnosis of extramedullary hematopoiesis was confirmed histologically. The appearance of extramedullary foci of hematopoiesis mimicking mediastinal tumors has not been previously described in HEMPAS. These masses result from persistent erythropoietic stimulation associated with chronic hemolytic anemia. In both patients, detection of the asymptomatic masses was preceded by normalization of hemoglobin levels. Thus unexpected correction of a chronic refractory anemia associated with the appearance of mediastinal masses might be the heralding manifestation of an effective extramedullary hemopoiesis.

Anemia, Dyserythropoietic, Congenital↗
PubMed1986

Second degree type II and complete atrioventricular block due to hyperkalemia.

An 83-year-old woman was hospitalized with complete atrioventricular block and a pulse of 20/min. Three days earlier an electrocardiogram had revealed right bundle branch block with classic type II second degree atrioventricular block. Admission potassium was 7.8 meq/L; within 24 hours the potassium was lowered to 4.9 meq/L and the atrioventricular block disappeared. The patient was followed for nineteen months and remained normokalemic without recurrence of atrioventricular block, although the right bundle branch block persisted. She was then readmitted with bradycardia due to complete atrioventricular block despite normokalemia. We conclude that hyperkalemia can produce the classic picture of progressive bilateral bundle branch disease leading to high degree atrioventricular block, although this seems to occur in patients with extensive intrinsic disease of the conduction system.

Aged↗
PubMed1986

Primary hyperparathyroidism presenting as cervical myelopathy.

Quadriplegia as a presenting syndrome in a case of primary hyperparathyroidism is reported. The clinical picture was misdiagnosed as a space-occupying lesion in the cervical spinal canal, for which an unnecessary laminectomy was performed. The neurologic deficits disappeared following the removal of a parathyroid adenoma. The neurologic presentations of hyperparathyroidism are reviewed and discussed.

Adenoma↗
PubMed1986

Laetrile intoxication and hepatic necrosis: a possible association.

A 65-year-old woman with cirrhosis and hepatoma lapsed into deep coma, hypotension, and acidosis after ingestion of 3 gm of Laetrile, a cyanogenetic glucoside. After initial treatment, the patient regained consciousness, but massive hepatic damage led to her death. We suggested a possible relationship between Laetrile poisoning and massive hepatic necrosis.

Aged↗
PubMed1986

Skin discoloration in chronic idiopathic thrombocytopenic purpura: detection of local iron deposition by X-ray spectrometry.

A forty-six-year-old woman with a 32 years' history of idiopathic thrombocytopenic purpura presented with black-brown discoloration of her lower limbs. Noninvasive diagnostic X-ray spectrometry (DXS) for determination of trace elements in external tissues revealed striking local iron deposition confined to the skin area with the pigmentary changes. Iron deposition in the skin was probably due to recurrent local purpura caused by longstanding bleeding disorder. Hence DXS proved useful in the detection of local iron load and eliminated the need for skin biopsy in this patient with bleeding tendency.

Female↗
PubMed1986

Stimulation of proliferation of human myeloid leukemia cells in culture: applications for cytogenetic analysis.

The use of chromosome banding techniques has provided a valuable diagnostic tool in various malignancies. The application of these methods, however, is often restricted by a low yield of mitotic cells and the patient's unwillingness to comply with repeated bone marrow aspiration. In an attempt to promote mitotic activity of leukemic cells from the bone marrow and peripheral blood, we employed a new method based on culturing the cells in the presence of a conditioned medium derived from a human bladder carcinoma cell line (5637). In addition to colony stimulating factor, this conditioned medium contains a factor that is capable of stimulating leukemic myeloblast proliferation. Bone marrow and peripheral blood mononuclear cells from 58 patients with a variety of myeloid leukemias were cultured for 24 to 120 hours in the presence or absence of conditioned medium. These bone marrow cells showed a pronounced increase in the mitotic index (5- to 50-fold) as compared to unstimulated cultures, and a greater than 100-fold increase as compared to fresh, uncultured bone marrow cells. Analyzable metaphases could be obtained even in marrow samples in which direct or 24-hour G-banding techniques had failed to reveal metaphases. The effect observed on peripheral blood cells was even more dramatic because prior to culture no mitotic cells were detected, whereas up to 2% mitotic cells were found in conditioned medium-stimulated peripheral leukemic cells. Karyotype analysis of 36 out of the 58 leukemic patients has shown that the chromosome changes discovered in conditioned medium stimulated cells were identical to those found in unstimulated cells. New chromosome aberrations, attributable to the stimulation of growth by conditioned medium, were not found. The quality of the metaphases analyzed following conditioned medium stimulation was considerably better than that of unstimulated samples. Frozen cells, when cultured with conditioned medium, were also suitable for cytogenetic analysis. Thus, the use of this conditioned medium permits adequate cytogenetic analysis even in cases where such analysis was previously impossible.

Cells, Cultured↗
PubMed1985

A disquisition on the energetics of immunoglobulin binding to receptors in vivo and in vitro.

The binding constant of Fc-moieties of IgG and their receptors (R), derived via the law of mass action, yields values that are of the order of 10(6) to 10(8) L/M. In circulating blood, phagocytic R must be bound rather strongly to IgG, which is normally present in high concentrations, so that it is unlikely that Fc-R mediated interactions between rather sparse sensitized particles and phagocytes take place to any significant degree in the blood stream. However, in the spleen, where Fc-R mediated interactions do play a more important role, the situation is different, due to: a) an increased cell concentration; b) a decreased relative IgG concentration; c) a locally very high macrophage concentration, with large numbers of R per cell. It can be shown that these changed conditions in the spleen cause a shift in the equilibrium of the Fc-R interaction in favor of sensitized particle Fc-R binding, with diminished involvement of freely circulating IgG. The law of mass action can also be used to predict the degree of washing of phagocytic cells needed to remove bound immunoglobulin. Conversely, measurement of the concentrations of free and bound immunoglobulin at different dilutions allows the determination of Ka as well as of the number of R per cell.

Adult↗
PubMed1985

Near drowning in the dead sea. Electrolyte imbalances and therapeutic implications.

Unusual serum electrolyte abnormalities developed in eight patients who nearly drowned (ND) in the Dead Sea. Elevations in serum calcium and magnesium levels in particular required specific therapeutic intervention. The Dead Sea has a uniquely high concentration of calcium, magnesium, sodium, potassium, and chloride. The unusual serum electrolyte elevation that was observed in the ND victims in the Dead Sea apparently reflected the large solute load to which they were exposed. Four patients died subsequent to ND. Near drowning in the Dead Sea therefore represents a clinical entity that is associated with a high fatality rate and in which unrecognized major electrolyte abnormalities, in addition to the known respiratory complications, may influence the outcome.

Aged↗