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Biomedical subjects

J Rapoport

Publications and source records attributed to J Rapoport.

85 records · Page 5Linked to original sources

Defective high-density lipoprotein composition in patients on chronic hemodialysis. A possible mechanism for accelerated atherosclerosis.

We determined serum high-density lipoprotein cholesterol content and analyzed the approtein structure of the various lipoprotein fractions in 21 patients on chronic hemodialysis. High-density lipoprotein cholesterol was significantly reduced in all patients as compared with 11 normal persons (mean +/-1 standard deviation: 26 +/- 13 vs. 52 +/- 9 mg per 100 ml; P less than 0.001) whether or not triglyceride levels were raised. In seven of those with Type IV hyperlipoproteinemia, protein content of high-density lipoprotein and its subfractions 1, 2 and 3 were also reduced (P less than 0.001) in parallel with reductions in cholesterol in these fractions. Apoprotein electrophoresis showed an increase in "arginine-rich" peptide in very-low-density lipoprotein and high-density lipoprotein fraction 1, and a reduction in apoprotein Cll in very-low-density and high-density lipoprotein. In addition to their reduced high-density lipoprotein cholesterol levels, a major factor in the atherosclerosis of these patients may be their abnormal high-density lipoprotein composition. Their raised triglyceride levels could be due to defective lipoprotein lipase activation by the reduced very-low-density lipoprotein apoprotein.

Adolescent↗

Newborn minor physical anomalies and prediction of infant behavior.

The relationship between a newborn score of minor physical anomalies (MPAs) and behavior at ages 1 and 2 was examined. From an initial screening population of 933, 63 high anomaly and 78 low anomaly infants were followed until age 2 by examiners blind for the newborn anomaly score. High anomaly infants were more likely to be temperamentally difficult as rated by parent interview and direct observation. A subgroup of six infants who were considered irritable at both ages 1 and 2 were all from the high anomaly group. However, there was little agreement between behavioral ratings across situations and over time, and there were no significant predictors of behavior problems at age 2 based on any newborn or 1-year measure. These results indicate that the newborn anomaly score by itself is unlikely to prove clinically useful in predicting preschool behavior problems for an unselected population. The usefulness of this measure for other, "high-risk," populations remains to be explored.

Child Behavior↗

The effect of acute extracellular volume expansion on sodium chloride reabsorption in the diluting segment in man.

1. The effect of extracellular volume expansion (ECVE) during water diuresis, and of water diuresis alone, on the formation of free water in man was compared. 2. ECVE reduced free water formation at any given rate of distal delivery compared with water diuresis. Thus, ECVE depresses distal sodium chloride reabsorption. 3. This attenuation of free water formation occurred both when urine flow (V/100 ml glomerular filtration rate) and distal chloride delivery [(Cwater + Ccl)/100 ml glomerular filtration rate] were used as the terms for distal delivery. 4. We suggest that the distal depression of sodium chloride reabsorption after ECVE is robably due to a direct inhibition of distal sodium chloride transport mechanisms, and not to the flooding of the diluting site by the poorly reabsorbable bicarbonate ion.

Absorption↗

Myxoedema ascites.

A case of myxoedema ascites complicating ischaemic heart disease is reported. Partial thyroid hormone replacement therapy, given slowly, eventually produced a diuresis and complete resolution of the ascites after a delay of 4 weeks.

Ascites↗

Aspergillus peritonitis in continuous ambulatory peritoneal dialysis patients.

Aspergillus peritonitis is a rare and serious cause of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. We report 3 cases of aspergillus peritonitis in CAPD which were successfully treated by catheter removal and amphotericin. Two of the 3 patients returned temporarily to CAPD, but were subsequently transferred to hemodialysis because of membrane failure. A novel finding in 2 of the 3 cases was a positive Limulus amebocyte lysate test, despite negative bacterial cultures. We discuss the possible relevance of this finding to the diagnosis of aspergillus infections and emphasize the importance of early catheter removal for successful treatment of this condition.

Aged↗

Laënnec and the discovery of auscultation.

René Théophile Hyacinthe Lënnec is famous chiefly for the invention of the stethoscope. In addition to this, he was also one of the pioneers of accurate clinical observation together with postmortem correlation of physical signs. One hundred and sixty years after his death, he is still considered to be one of the greatest clinicians of all time.

Auscultation↗