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Biomedical subjects

L Jacobson

Publications and source records attributed to L Jacobson.

At least 181 records · Page 10Linked to original sources

Plasma adrenocorticotropin is more sensitive than transcortin production or thymus weight to inhibition by corticosterone in rats.

After adrenalectomy, ACTH, corticosterone-binding globulin (CBG), and thymus wet weight increase in rats as a consequence of the removal of corticosterone (B) and decrease again in response to replacement with glucocorticoids. We have studied the effect of replacing adrenalectomized male rats with a variety of different concentrations of B. Plasma concentrations of ACTH and CBG and thymus wet weights were related to the measured concentration of free ultrafilterable B in plasma. In other experiments, the clearance of [125I]CBG was determined in adrenalectomized rats with and without B replacement, and the time required for the changes in plasma CBG concentrations after removal and/or replacement of B in adrenalectomized rats was determined. Five to 7 days after adrenalectomy and institution of a relatively constant B replacement signal, plasma CBG concentrations were highly correlated with circulating B concentrations (r2 = 0.745; P less than 0.001). The effect of B was on the CBG production rate, since clearance did not change. Because CBG concentrations decrease as total B concentrations increase, there is an amplification of free B concentrations with increasing total B. The relationships of plasma ACTH and CBG and thymus wet weight to circulating free B levels showed that 50% inhibition of ACTH was achieved at a free B concentration of 0.8 +/- 0.05 nM, whereas 50% inhibition of CBG and thymus wet weight were achieved at free B concentrations of 4.6 +/- 0.9 and 4.4 +/- 0.6 nM, respectively. These inhibition values correlate well with the known Kd values for the high affinity type I B receptor (0.5 nM) and for the lower affinity type II glucocorticoid receptor (2.5-5 nM), respectively, suggesting that ACTH secretion, CBG production, and thymus wet weight are regulated by the association of B with these receptor types.

Adrenalectomy↗

Cerebrospinal fluid insulin levels increase during intravenous insulin infusions in man.

We hypothesized that plasma insulin crosses the blood-cerebrospinal fluid (CSF) barrier and, as people gain weight, provides a physiological feedback signal to the central nervous system to inhibit food intake and further weight gain. However, it has not been demonstrated in man that insulin can enter the CSF from peripheral blood. To test whether increases in plasma insulin result in elevated CSF immunoreactive insulin (IRI) levels, we infused insulin iv in varying amounts approximating postprandial levels in eight normal subjects for 4.5 h. Euglycemia was maintained [88 +/- 3 (+/- SEM) mg/dl] by means of a variable glucose infusion. Samples were obtained every 30 min for measurements of insulin in peripheral plasma and insulin in lumbar CSF. Plasma IRI increased from a mean basal level of 12 +/- 1.2 microU/ml to a mean (during the 180- to 270-minute period) of 268 +/- 35 microU/ml. CSF IRI increased in all subjects during the infusion from a mean basal level of 0.9 +/- 0.1 microU/ml to a mean (during the 180- to 270-min period) of 2.8 +/- 0.4 microU/ml (P less than 0.006). By contrast, CSF IRI in two subjects who received an infusion of 0.9% saline did not increase. In summary, CSF insulin concentrations increased during peripheral infusions of insulin. This is the first demonstration in man that plasma insulin gains access to CSF and indicates a mechanism whereby peripheral insulin could provide a feedback signal to the central nervous system.

Adult↗

Potassium transport in suspension culture cells and protoplasts of carrot.

The properties of potassium transport in carrot (Daucus carota L.) suspension culture cells and their isolated protoplasts were examined. Cells cultured in Murashige and Skoog (MS) medium (Plant Physiol 15: 473-497) were potassium saturated and, consequently, they exhibited little net potassium accumulation. Cells that transport and accumulate potassium were derived from the MS-grown cells by culturing them in a potassium-free modified medium. The transport properties of the modified medium cells included: (a) smooth nonsaturating kinetics with 80% of the maximum rates occurring at 0.1 millimolar KCl, (b) linear transport for at least 75 min, (c) alkaline pH optimum, (d) little accompanying anion uptake with increased malate concentrations balancing net increases in positive charge, and (3) little effect on transport by plasmolysis. Potassium transport activity appeared to be 50% lower in protoplasts isolated from the modified medium cells. Nevertheless, the protoplasts exhibited essentially the same kinetics, time course, pH response, and malate adjustment as the intact cells. We concluded from these results that the low potassium cells and their isolated protoplasts are ideally suited to investigating potassium transport at the cell level without the complications associated with multilayered and highly differentiated tissues.

Journal Article↗

Enzyme-linked immunosorbent assay of antibodies to Epstein-Barr virus nuclear and early antigens in patients with infectious mononucleosis and nasopharyngeal carcinoma.

A sensitive enzyme-linked immunosorbent assay was used to measure titers of IgG antibodies against bacterially synthesized Epstein-Barr virus nuclear antigen and early antigen in sera from 100 healthy North Americans, 40 North American patients with infectious mononucleosis, and 48 Asian patients with nasopharyngeal carcinoma. All healthy persons previously infected with Epstein-Barr virus had antibodies to nuclear antigen, and 70% had very low but detectable antibody titers to early antigen. In contrast, patients with mononucleosis had nondetectable or very low levels of antibodies to nuclear antigen and high antibody levels to early antigen. High levels of antibody to early antigen also were seen in patients with nasopharyngeal carcinoma, and a decrease in this response during the first 12 months after diagnosis and treatment was a significant prognostic indicator of survival. The probability of survival was 75% for patients whose antibody concentration to early antigen remained constant or decreased, and near 0% for patients with increasing levels of antibody.

Antibodies, Viral↗

Wolff-Parkinson-White syndrome. Termination of paroxysmal supraventricular tachycardia with phenylephrine.

A patient with Wolff-Parkinson-White syndrome, susceptible to tachydysrhythmias , presented for eye surgery under general anaesthesia. He developed a supraventricular tachycardia refractory to a variety of treatments. Phenylephrine consistently abolished the dysrhythmia, probably by acting directly to stimulate the arterial baroreceptors and hence vagal output. Vasopressor therapy should be considered in Wolff-Parkinson-White syndrome tachyarrhythmias, when circumstances permit.

Adolescent↗

Long-term management of recurrent paroxysmal tachycardia by cardiac burst pacing.

Sixteen patients with either recurrent symptomatic supraventricular tachycardia (SVT) (ten) or ventricular tachycardia (VT) (six) unresponsive to drug treatment underwent insertion of chronic overdrive cardiac pacing devices for arrhythmia control. All patients with SVT followed for longer than 2.5 years required concomitant drug therapy for rhythm control. In addition, one of the ten patients required amiodarone and three required nonpharmacologic therapy (catheter ablation of the atrioventricular junction (one), surgical ablation of the Kent bundle and/or bundle of His (two). In the six patients with VT, only one patient used the device successfully. In the other five patients, either the arrhythmia failed to respond to burst overdrive pacing (three) or overdrive acceleration resulted (two). One death in the latter group was related to induction of rapid VT followed by ventricular fibrillation. Long-term follow-up of patients with paroxysmal SVT shows that virtually all require concomitant drug therapy and may require aggressive medical or surgical procedures for arrhythmia control. Use of ventricular overdrive pacing for those with VT appeared singularly disappointing in that pacing proved either ineffective (three) or resulted in overdrive acceleration (two) in 5/6 patients.

Adult↗

Calcium and periodontitis: clinical effect of calcium medication.

In contrast to the generally held concept that periodontal disease is caused by microorganisms, Henriksson (1968) suggested that a nutritional deficiency of calcium might be the cause. He elicited secondary hyperparathyroidism in beagles from a low calcium/high phosphorus diet and found that the osteolytic demineralization of bone that followed seemed to involve alveolar bone more than other bones. In a report on 10 persons with advanced periodontal disease, Krook et al. (1972) stated that the disease was reversed when they were given 1 g Ca/day for 180 days. These results have been disputed. The present study is an attempt to repeat the experiment performed by Krook et al. (1972) under more stringent conditions. The hypothesis that calcium supplementation reverses destructive periodontal disease is tested. 66 persons referred to our clinic for periodontal problems were prescribed at random calcium (1 g) or placebo tablets daily during a trial period of 180 days. Their periodontal status was examined at day 0 and at day 180. The parameters used for comparison were Plaque Index, Gingival Index, probing depth, mobility and furcation involvement. The radiographically registered level of alveolar bone was also recorded, but subsequently discarded since no change could be ascertained. The patients were interviewed as to their consumption of calcium via milk and cheese at days 90 and 180. This was in order to estimate roughly whether or not their dietary calcium consumption was adequate. The recommended allowance of 800 mg/day was used as a reference. During the trial period 7 persons withdrew -- 2 from the test group and 5 from the control group. This was due mainly to digestive disorders, reported by the patients. A comparison at day 0 between the 31 test and 28 control patients revealed no statistical differences concerning the periodontal parameters studied. At day 180 both groups showed a slight improvement in Plaque Index, Gingival Index and probing depth; however, there was still no statistical difference between them. The dietary analysis established a low calcium consumption among 1/3 of the patients. Even in these cases calcium supplementation had no effect. It is concluded that calcium supplementation for 180 days does not influence the periodontal status of patients with moderate to advanced periodontal disease. Secondly, patients on a low calcium diet do not differ from those receiving an adequate supply. Finally, the study cannot support the hypothesis that calcium deficiency is a main cause of destructive periodontal disease.

Adult↗

Randomized controlled trial of a nonpharmacologic cholesterol reduction program at the worksite.

Under experimental clinical conditions diet modification has been shown to reduce serum cholesterol levels. This paper reports such a positive response to a nonpharmacologic, behavioral education program at the worksite. Employees at the New York Telephone Company corporate headquarters were assigned randomly to treatment and control groups. Treatment consisted of an 8-week group cholesterol reduction program conducted during employee lunch hours. It comprised a multiple-treatment approach--food behavior change techniques combined with nutrition education, physical activity planning, and self-management skills. The treatment group showed substantial change compared with the control group at the program's completion. Those treated displayed a significant 6.4% reduction in total serum cholesterol (266 mg% average at baseline) as compared with control subjects with a corresponding decrease in high-density lipoprotein levels. A significant increase in nutrition knowledge and moderate weight loss were also documented for this group. The magnitudes of a participant's baseline serum cholesterol level and his/her reduction in percentage of ideal body weight were positively and independently correlated with percentage changes in serum cholesterol levels. Over the same period, decreases in high-density lipoprotein levels and no changes in serum cholesterol, weight, and nutrition knowledge were observed for the control group. Overall, participants in the treatment program successfully reduced the coronary heart disease risk factors of elevated cholesterol and weight. Directions for future study are suggested.

Behavior Therapy↗

Extradural versus intramuscular diamorphine. A controlled study of analgesic and adverse effects in the postoperative period.

The effects of diamorphine hydrochloride 0.1 mg/kg, given either extradurally or intramuscularly for postoperative analgesia were compared in two randomised double-blind studies involving 39 patients undergoing thoracotomy and major gynaecological surgery. Assessments were made at fixed intervals after the administration of diamorphine and consisted of the measurement of pain or analgesic effect. Segmental, sympathetic and any adverse effects were sought. There was no significant difference in the quality of analgesia between the two groups in either trial. Extradural diamorphine provided safe and effective analgesia of rapid onset, with no specific undesirable side-effects. In both studies, analgesia was more prolonged following extradural administration. The relative proportion of spinal binding may be increased after extradural administration and this may be reflected in the prolonged analgesia observed.

Adult↗

Epidural analgesia following thoracic surgery. A review of two years' experience.

The use of thoracic epidurals for postoperative pain relief in 58 patients following thoracic surgery is reviewed. Epidural catheters were inserted at the end of the operative procedure and it was planned that analgesia was to be maintained with a continuous infusion of bupivacaine. In those patients with evidence of successful neurological blockade there was a high incidence of adverse effects. Hypotension occurred in nearly 80% of patients and inadequate analgesia necessitating intramuscular opiates in 30%. The results suggest that the method adopted is unsuitable for some patients who have undergone major pulmonary surgery, although it has proved a useful adjuvant for pain relief in patients who have had other intrathoracic operations.

Adolescent↗

Plasma estriol in late pregnancy in relation to fetal outcome.

The study is a retrospective report on the capacity of plasma (P-) estriol (E3) determinations in late pregnancy to detect abnormal fetoplacental state at delivery. From the material of cases with P-E3-determinations, two extreme groups were chosen for comparison: those with absolutely normal fetoplacental status at parturition and those with severe disturbances of the fetoplacental status at delivery. The predictability of a single P-E3 value was generally low, especially at the end of pregnancy. Consecutive (at least 3) high or low values, respectively, in the individual case, proved to have a predictable value that might complement other clinical methods for assessing fetoplacental function.

Apgar Score↗

A clinical trial of alfentanil as an adjuvant for short anaesthetic procedures.

Alfentanil 700 micrograms and fentanyl 100 micrograms were compared as anaesthetic adjuvants in 90 patients undergoing short duration gynaecological procedures. The results show that, at the chosen dose ratio, alfentanil causes a higher frequency of post-induction apnoea, but thereafter the respiratory effects of the two drugs were comparable. No differences in incremental requirements or evoked movements were found. Among patients who had been given ergometrine, the alfentanil group suffered a greater frequency of nausea and vomiting in the period immediately after operation. It is concluded that in single i.v. doses, alfentanil 700 micrograms is more potent than fentanyl 100 micrograms. Moreover, the results suggest that, unlike fentanyl, this very short acting agent would be used to greater effect if given in divided doses during surgery.

Abortion, Induced↗

The molecular composition of the volutin granule of yeast.

The volutin granule was isolated from yeast by disruption of freeze-dried cells in an organic solvent and density-gradient-gradient centrifugation. The granule is composed of two types of macromolecule, a linear-chain polyphosphate and four basic proteins, of molecular weights ranging from 10 000 to 20 000. In the dissolved granule these macromolecules are in a complex that is uniform by hydrodynamic criteria (s20,w = 22.3 S). The polyphosphate separated from this complex gives a single 31P n.m.r. resonance and in the analytical ultracentrifuge behaves as a monodisperse solute of molecular weight 245 000 +/- 1000. In the 31P n.m.r. spectrum of yeast used for its isolation, this polyphosphate accounts for 14% of total cell polyphosphate.

Amino Acids↗

Teaching the very confused to make sense: an experimental approach to modular training with psychotics.

Close observation of the working-through process in psychotherapy has led to the development of operational instructions for teaching the inner behaviors that seem to maximize possibilities for insight. These "focusing" instructions, when employed in settings where "listening" is normative, have proved useful in clinical practice and controlled research with normal and neurotic populations. The project described here was a pilot study designed to explore the usefulness of this approach with psychotics. Through special procedures, listening and focusing instructions were introduced to 23 chronic schizophrenics in a weekly group that met for eight months in a psychiatric day treatment center. In written and oral evaluations of the project, program staff and patients were overwhelmingly favorable toward the general approach.

Adult↗

A variant of von Willebrand's disease with abnormal expression of factor VIII procoagulant activity.

Reports on variants of von Willebrand's disease are numerous, but many of these are based on tests that will show marked fluctuations with time and tests that might not be similar in affected family members. This report describes 8 patients with a new variant of von Willebrand';s disease in which there is a normal APTT, slightly reduced one-stage factor VIII:C assay (VIII:C-1), and a drastically reduced two-stage factor VIII:C assay (VIII:C-2). The VIII:C in this variant is more readily adsorbed to AI(OH)3. This variability in VIII:C assays and excessive adsorption to AI(OH)3 are corrected by the addition of either hemophilic plasma or hemophilic factor-VIII-related antigen. This variant is stable with restudy on multiple occasions and is inherited in a stable fashion in three generations of one family. The multimeric structure of the VIIIR:Ag appears normal, although the concentration is moderately reduced. The differences in functional activity, the adsorption to AI(OH)3, and the differences between functional and antigenic (VIII:C Ag) assays of VIII:C support that this is a functional abnormality of type I von Willebrand's disease.

Adult↗

Antithrombin III deficiency: decreased synthesis of a biochemically normal molecule.

A 29-yr-old white female has suffered from recurrent venous thromboses over the last 12 yr. Plasma antithrombin III (AT-III) levels were 48% of normal by immunoelectrophoresis and 56% by chromogenic assay. Three of four siblings and the father had similar AT-III levels without associated venous thromboses. Heparin-Sepharose chromatography demonstrated normal behavior of the patient's AT-III. Her purified AT-III could not be distinguished from AT-III purified from a normal control either by SDS polyacrylamide gel electrophoresis or by crossed immunoelectrophoresis, and the heparin cofactor activity and the progressive antithrombin activity of both AT-III samples were identical. Turnover studies were made in the patient using her own purified AT-III labeled with 131I, (*I). The results did not differ significantly from studies made with autologous *I-AT-III in two normal control women. Her fractional breakdown rate of 0.54 total plasma AT-III per day compared with 0.45 and 0.52 in the controls. These studies indicate that the patient synthesizes a normal AT-III molecule at half normal rates.

Adult↗