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Biomedical subjects

J Sack

Publications and source records attributed to J Sack.

At least 91 records · Page 5Linked to original sources
PubMed1983

Menarche and puberty in daughters of amenorrheic women.

Twenty-six daughters born to amenorrheic women after gonadotropin-induced ovulation were studied at 10 to 16 years of age. The aim of the study was to assess whether the mothers' condition, namely, amenorrhea and infertility followed by the pharmacologic induction of ovulation, had any effect on their female offspring in terms of endocrine disorders at puberty. The daughters were found to have normal onset of puberty as well as normal physical and mental development. The mean age at menarche, body weight, and height were similar to those of the general female population in Israel. A functioning hypothalamic-pituitary-ovarian axis was evidenced by the appearance of menarche followed by regular cycles. These data form a reassuring sample for the clinicians, the treated mothers, and their offspring.

17-Hydroxycorticosteroids↗
PubMed1983

Hypothalamic-pituitary function in patients with prolonged coma.

In eight patients (six males and two females) hospitalized for prolonged coma (164-1320 days; five patients were in traumatic coma, two after cardiac arrest during surgery, and one after a venomous scorpion sting), diurnal variation of cortisol secretion, human (L) GH, PRL, TSH secretion as well as the release of the pituitary hormones after TRH and L-dopa stimulation were assessed. Serum T4 cortisol, hGH, hPRL, and hTSH levels were normal. The cortisol diurnal variation was preserved in six patients. In seven of eight patients, the hPRL and hTSH responses to TRH test were normal and in five patients, there was a rise of more than 150% in serum hGH concentrations. After L-dopa administration, five patients responded with a rise in hGH. In three patients, there was no response of hGH to TRH or L-dopa. Five patients responded with significant reduction in the serum hPRL concentration after L-dopa, and in three patients, no change was observed. It was concluded that patients with prolonged coma have variable hypothalamic pituitary function. They preserve the cortisol diurnal variation and the hypothalamic-pituitary-thyroid axis as well as PRL secretion; however, hGH secretion may respond abnormally to various stimuli.

Adult↗
PubMed1983

Hemoglobin A1 and pancreatic beta cell function in cystic fibrosis.

Hemoglobin A1 (HbA1) blood levels were examined in 34 cystic fibrosis (CF) patients aged 1 1/2 to 20 1/2 yr. The mean (+/- SD) HbA1 concentration in the 34 patients was 7.97 +/- 1.16--significantly higher than that in 150 normal children (6.8 +/- 0.8). Oral glucose tolerance tests (OGTT) were performed in 11 patients and blood glucose and insulin concentrations were measured. There was no difference in the fasting blood glucose values between the two groups. Eight children had a normal OGTT, and three showed an impaired OGTT with a delayed peak response in insulin levels. There was a decreased insulin response in all the CF patients. No correlation was found between HbA1 concentration and the age of the patients, nor between HbA1 and the clinical status (Shwachman score). We conclude that insulinopenia in children with CF is not always accompanied by an increment in HbA1, although serial determinations of its level may reveal deterioration in glucose tolerance.

Adolescent↗
PubMed1983

Growth hormone and periarticular new bone formation--a causal relationship? A preliminary communication.

In an attempt to examine the relationship between growth hormone (GH) and periarticular new bone formation (PNBF), we studied eight patients with brain lesions of different origins who were in a prolonged comatose state for 164 to 1320 days. Five of them developed PNBF. The latter reacted to both the specific L-Dopa test and to the non-specific TRH test with an increase in GH serum concentration. Those patients who did not develop PNBF, failed to react significantly to either tests. The difference in GH values between the two groups is statistically significant at the 95% level of confidence. We hypothesize that there may be a causal relationship between high concentrations of GH in serum and PNBF.

Adolescent↗
PubMed1982

Serum T4, T3 and TBG concentrations during puberty in males.

Measurements of serum thyroxine (T4), thyroxine binding globulin (TBG), and triiodothyronine (T3), using RIA, were conducted in healthy Israeli boys, 149 children from the age 8 years were divided into five groups according to Tanner's puberty stages. The correlation with Tanner's staging showed a significant decrease in T4 and TBG concentrations during puberty. However, T3 decreased only toward the last stage of puberty (between P4 to P5). Our data indicate that during puberty in male subjects the decrease in TBG plays a significant role in the decrease of thyroid hormone concentrations.

Adolescent↗
PubMed1982

Aminopyrine accumulation by mammalian gastric glands: an analysis of the technique.

Isolated gastric glands from rabbits and parietal cells from dogs have recently become useful in studying the control and enzymatic mechanisms of gastric H+ secretion. The present studies were performed to determine the experimental variables that account for widely differing aminopyrine accumulation reported in various publications. We found that two principle factors were responsible for wide differences in aminopyrine accumulation. First, we found that commercially available aminopyrine contained an unidentified impurity that increased with storage. A procedure for purification is included. The contaminant is not accumulated in secreting gastric glands and thereby reduces the aminopyrine ratio that can be achieved. Mixing of glands appeared to be the second important variable. It was found that incubation in 1.5-ml capped conical polypropylene centrifuge tubes in the horizontal position with shaking in the long axis of the tubes gave aminopyrine ratios that were more than double the results obtained by other mixing techniques. In addition a gland density of 1--2 mg dry wt/ml glands and a mixing rate of 110 cycles/min gave the best results. Calculations indicate that, at high gland densities, even modest amounts of impurity in the aminopyrine will significantly reduce aminopyrine ratios. With optimal conditions our greatest aminopyrine ratio was 1,050, which suggests an H+ concentration of approximately 67 mM in the canaliculi and tubulovesicular membrane system of the parietal cell. Such a level of function approaches that of the intact in vivo organ.

Aminopyrine↗
PubMed1982

Clinical variability of congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency.

Studies in 18 Jewish families from Morocco, Tunis, Turkey and Iran revealed 26 patients with congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency. The clinical expression of androgen excess varied widely in affected females, and range from solely enlarged clitoris in the mildest forms to severely hypertrophied clitoris with penile urethra and fused labial-scrotal folds in the most extreme forms of masculinization. Intermediate degrees of severity were manifested by ambiguous genitalia. There was no correlation between the degree of virilization and the signs of mineralocorticoid excess. Severe volume-induced hypertension leading to vascular accidents and death were also observed in severe as well as in mildly virilized patients, while completely masculinized females were sometime normotensive. Overt hypokalemia was present in 6 patients but was not a constant feature of hypertensives. However, all affected individuals, except for 2 infants, had very low levels of plasma renin activity suggesting that a state of volume expansion was indeed present in the majority of cases, even though changes in blood pressure did not always occur. The clinical expression of this disorder is characterized by a wide range of variability in the signs of both androgen and mineralocorticoid excess, which do not necessarily correlate with the quantity of hormones secreted.

Adolescent↗
PubMed1982

Renal glomerular and tubular function following acute insulin deprivation in juvenile diabetes mellitus.

The effects of acute deprivation of insulin on renal glomerular and tubular functions were studied in 10 children with juvenile diabetes mellitus. Serum glucose concentrations were similar when insulin was administered (251 +/- 112 mg/dl) and when it was withheld (306 +/- 130 mg/dl; 0.5 greater than 0.2). Acute insulin deprivation was associated with a significant reduction in glomerular filtration rate, from 151 +/- 48 ml/min/1.73 m2 to 114 +/- 41 ml/min/1.73 m2 (p less than 0.01). The fractional excretion of sodium rose from 0.45 +/- 0.43 to 0.85 +/- 0.54% (p less than 0.05) and was associated with an enhanced natriuresis; the urinary excretion of sodium increased from 1.67 +/- 1.23 to 2.43 +/- 1.72 microEq/min/kg body weight (p less than 0.05), whereas the urinary excretion of phosphate was not significantly altered from control values. During insulin deprivation a drop occurred in the serum concentration of calcium from 10.37 +/- 0.52 to 9.73 +/- 0.61 mg/dl (p less than 0.01) as well as in its urinary excretion from 0.34 +/- 0.24 to 0.24 +/- 0.20 microgram/min/kg body weight (p less than 0.01). The serum concentration of potassium rose from 4.44 +/- 0.41 to 4.96 +/- 0.51 mEq/l, but its urinary excretion was not significantly different from control values. These data suggest that in juvenile diabetes mellitus the acute deprivation of insulin, dissociated from fluctuations in serum glucose concentration, is associated with a fall in glomerular filtration rate, an increased natriuresis, and a modified calcium and potassium homeostasis.

Adolescent↗
PubMed1982

Primary mesenteric venous thrombosis.

To elucidate further the characteristics, optimal management and ultimate outcome of patients with primary mesenteric venous thrombosis, the records of nine such patients were analyzed. There were seven male and two female patients, with a mean age of 47 years. Abdominal pain, vomiting, fever and hematochezia were the characteristics presenting complaints. Tenderness, distention and diminished intestinal sounds were the prominent abdominal physical findings and were often associated with tachycardia and hypotension. No one of the laboratory findings were specifically diagnostic for mesenteric venous thrombosis, but leukocytosis and hemoconcentration were commonly found. Roentgenographic findings were consistent with intestinal obstruction in six patients. Thrombosis of the mesenteric veins could not be attributed to any specific cause in these nine patients, thereby warranting the classification of primary. At operation, all nine patients were found to have a segment of infarcted small intestine--132 +/- 105 centimeters--with obvious thrombosis of the mesenteric veins but with patent mesenteric arteries. Five patients had bloody ascites. Two deaths occurred in the immediate postoperative period, both being due to sudden and unexpected cardiopulmonary arrest. Neither of these two patients received anticoagulant therapy. Two patients had undergone segmental resection at other hospitals and were referred to our institution because of a recurrence of acute abdominal signs and symptoms. Neither of these patients received anticoagulant therapy. At reoperation, both had recurrent segmental mesenteric venous thrombosis. Familiarity with this condition is essential in making the correct diagnosis, so that resection may be undertaken promptly. Heparin should immediately be administered intravenously after establishing the diagnosis of mesenteric venous thrombosis to prevent recurrent thrombosis and other possible thrombotic complications. If these steps are taken expeditiously, the prognosis of mesenteric venous thrombosis is often favorable.

Adult↗
PubMed1982

The Cohen syndrome: report of five new cases and a review of the literature.

The Cohen syndrome is a genetic disorder consisting of mental retardation, obesity, hypotonia, and a characteristic craniofacial appearance. Since its original description, 13 patients have been reported. This presentation gives an account of 5 additional cases in 4 families and provides further evidence that this disorder is most probably transmitted as an autosomal recessive trait. This study also demonstrates the range of clinical features observed in this syndrome and suggests that the basic defect may be one of connective tissue.

Adolescent↗