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Biomedical subjects

M H Klein

Publications and source records attributed to M H Klein.

At least 91 records · Page 5Linked to original sources
PubMed1985

Intimacy and depression in older women.

This study examines the effects of the qualities of intimate relationships on depression in older women. The data are from a study of women over 50, randomly selected from five census tracts in Madison, Wisconsin, who were given questionnaires about depression and the quality of their intimate relationships on two occasions (summer of 1978 and summer of 1979). The results showed that some dimensions of the relationships that the women described with their most significant others predicted depression. The more depressed the women were, the more they felt that (1) the relationship was less friendly, (2) their friendly feelings were not reciprocated by the significant other, (3) their relationship was less consistent and predictable, and (4) there was less time spent with the significant other in the best state. These findings are discussed as partially consistent with Seligman's arguments on the comparability of his "learned helplessness" model and depression and with the focus of cognitive theories of Beck and others on the role of perceptions and expectations in depression.

Aged↗
PubMed1985

The interaction of murine IgG subclass proteins with human monocyte Fc receptors.

The use of murine monoclonal antibodies in the immunotherapy of human disease has prompted interest in the interactions of murine IgG with Fc receptors (FcR) expressed on human effector cells. We examined the heterocytophilic interactions between monomeric murine IgG subclass proteins and the FcR expressed on human monocytic cells (peripheral blood monocytes and interferon (IFN)-gamma-induced U937 cells). All four murine IgG2a antibodies and both murine IgG3 antibodies that were tested bound to human monocyte FcR with high affinity (10(8) to 10(9) M-1). By contrast, the affinities of four murine IgG1 and four IgG2b monomers were 100-fold to 1000-fold lower than the affinity of the human IgG1-FcR interaction. A 68,000 to 72,000 dalton protein was isolated by affinity chromatography from blood monocytes and from IFN-gamma-induced U937 cells on murine IgG2a, IgG3, and human IgG immunoadsorbents. In binding assays with IFN-stimulated U937 cells, murine IgG2a and IgG3 antibodies showed complete cross-blocking with a human IgG1 myeloma protein, indicating that murine and human IgG interact with the same population of Fc-binding proteins. No evidence for heterogeneity of cross-reactive FcR was observed. The ability of murine IgG2a and IgG3 monomers to compete with human IgG1 monomers for binding to human monocyte FcR suggests the potential usefulness of antibodies of these isotypes in the immunotherapy of diseases in which monocyte- or macrophage-mediated, antibody-dependent cellular cytotoxicity may play a role in the modification or remission of disease.

Animals↗
PubMed1985

Intravenous streptokinase for thrombolysis of occluded arteriovenous access. Its use in patients undergoing hemodialysis.

Thrombosis of arteriovenous access is a major cause of morbidity in the patient population undergoing hemodialysis. This investigation utilized the technique of infusing streptokinase directly into the afferent limb of an occluded graft or fistula to restore patency. A total of seven patients was studied, one patient on two separate occasions nine months apart. Total clot lysis was observed in five of eight infusions. Partial clot lysis was seen in two of eight infusions, although one of these patients required thrombectomy to ensure persistent functioning of the fistula. One of the eight episodes was unsuccessful. A postinfusion fistulogram was performed on seven of eight occasions and demonstrated partial clot lysis in two patients or a stenotic lesion requiring surgical revision in two other cases. In conclusion, streptokinase infusion into the thrombosed vascular access appears to be a safe and efficacious technique for this patient population.

Adult↗
PubMed1985

Lung inflammation in scleroderma: clinical, radiographic, physiologic and cytopathological features.

Twenty-five patients with systemic sclerosis were studied by chest radiography, lung function, esophageal motility, gallium-67 (67Ga) lung scanning and bronchoalveolar lavage (BAL). Alveolar inflammation, as defined by an elevation of proportional BAL lymphocyte or neutrophil counts, or increased thoracic uptake of 67Ga was found in 16 patients. An NIH gallium index greater than 65 index units identified a subgroup of patients with a significantly higher proportional BAL lymphocyte count (13.7 +/- 8.5 vs 5.6 +/- 3.1, p less than 0.0005). The presence of an abnormal chest radiograph correlated with physiologic evidence of lung restriction (p less than 0.01), and an elevation of proportional BAL lymphocyte count (15.5 +/- 8.2 vs 6.6 +/- 5.1, p less than 0.01). Eight patients receiving oral penicillamine therapy had significantly lower BAL lymphocyte counts compared to untreated patients (4.7 +/- 3.6 vs 11.3 +/- 7.7, p less than 0.05). We suggest that alveolar inflammation in scleroderma is characterized by lymphocyte accumulation and increased thoracic uptake of gallium.

Adult↗
PubMed1984

Structural basis for the preferential association of autologous immunoglobulin subunits: role of the J region of the light chain.

We have used a series of sequenced V kappa 21 L-chains produced from murine myelomas to determine whether the V or J segment of the V region is responsible for dictating preferential recombination. In each competitive recombination, equimolar amounts of two different L-chains, selected on the basis of common V or J segments, were allowed to compete for a limiting amount of H-chain. It was found that the J segment of the L-chain was primarily responsible for dictating the ability of a chain to compete and that the nature of residue 96, the first residue of the J segment, was particularly important. Specifically, charged residues caused the L-chain to compete poorly against L-chains with hydrophobic side chains at this position. Furthermore, if Phe or, to a lesser extent, Tyr were present at position 96, the L-chain competed more successfully than chains with Trp-96 or Leu-96. This suggests that both the aromaticity and size of this residue were important factors in determining preferential recombination. It was also found that all other residues in VL were secondary to residue 96 in contributing to the ability of a chain to compete. Finally, unlike all previous studies, we observed a substantial number (64%) of preferred heterologous recombinations. These results are consistent with the hypothesis that the VL and VH gene rearrangements occur independently, thus resulting in random pairing of VH and VL domains.

Amino Acid Sequence↗
PubMed1984

Determination of circulating immune complexes, C3 and C4 complement components and anti-DNA antibody in different classes of lupus nephritis.

Circulating immune complexes (CIC) were measured in 237 sera from children who underwent a renal biopsy during the course of systemic lupus erythematosus. CIC-positive sera contained a lower mean level of C3 but not C4. Anti-DNA antibody was similar in CIC-positive and negative sera. The World Health Organization classification of lupus nephritis was used to categorize the biopsies. CIC, C3, C4 and anti-DNA antibody were determined to assess whether they correlated with the severity of renal lesions. Of 25 sera obtained at renal biopsy from patients with classes 2, 3 and 4, 16 were positive for CIC. C3 was significantly lower in classes 3 and 4 than in class 2. C4 was reduced and anti-DNA antibody was present in classes 2, 3 and 4. Determination of the level of C3 but not C4, CIC or anti-DNA antibody correlates with the severity of lupus nephritis seen on renal biopsies. Nevertheless, performance of a renal biopsy is preferred.

Antibodies, Anti-Idiotypic↗
PubMed1983

Clinical computer applications in mental health.

Direct patient-computer interviews were among the earliest applications of computing in medicine. Yet patient interviewing and other clinical applications have lagged behind fiscal, administrative, and research uses. Several reasons for delays in the development and implementation of clinical computing programs are discussed. Patient interviewing, clinician consultation, and other applications of clinical computing in mental health are reviewed, as well as changes that will facilitate their appropriate use.

Computers↗
PubMed1983

Estimation of polymeric IgA in human serum: an assay based on binding of radiolabeled human secretory component with applications in the study of IgA nephropathy, IgA monoclonal gammopathy, and liver disease.

Binding of 125I-human secretory component (SC) to human polymeric immunoglobulin A (pIgA) was employed to measure quantitatively the pIgA present in human sera. Interference by IgM in some sera was prevented by removal of IgM with glutaraldehyde polymerized anti-IgM antibodies. 125I-SC complexed to pIgA was measured by precipitation with anti-IgA antibodies and the quantity of pIgA in human serum was estimated by comparing the quantity of 125I-SC bound by several dilutions of human serum to that bound by standard quantities of human monoclonal pIgA proteins. The assay was specific for pIgA because heat-aggregated monomeric IgA or hypogammaglobulinemic serum did not bind 125I-SC greater than a precipitate formed with human monoclonal IgG and anti-IgG. Moreover, analysis of a series of IgA myeloma sera indicated no correlation between the IgA content of the serum and the quantity of pIgA measured. The quantity of pIgA found in 30 normal human sera was 0.13 +/- 0.08 mg/ml (1S.D.), which consisted of 11.3 +/- 5.3% (1 SD) of the total IgA. Patients with IgA monoclonal gammopathy were most often found to have predominantly monomeric IgA. Patients with IgA nephropathy also showed an elevation of pIgA, but this appeared to be a consequence of an overt IgA elevation. IgA nephropathy patients with elevated serum IgA in fact showed a significant elevation of monomeric IgA. Selective elevation of pIgA was observed in patients with primary biliary cirrhosis and alcoholic liver disease. A comparison of this assay with other assays to measure pIgA is discussed.

Aged↗
PubMed1982

Catecholamine metabolites in spinal cord injury.

Previous reports of catecholamine metabolism in spinal cord injury (SCI) have found elevated levels of urinary norepinephrine metabolites. These data have been cited as evidence of a sustained increase in peripheral norepinephrine activity in this population. A study was designed to test this hypothesis and to control for the effect of affective disorders on catecholamine metabolism. Determinations were made of the level of urinary 3-methoxy-4-hydroxyphenylethylglycol (MHPG) and vanillylmandelic acid (VMA) in 30 patients with SCI. Urinary MHPG and VMA were not significantly higher than normal in the total sample. However, in spastic quadriplegia, urinary MHPG was lower than normal, and a calculated VMA:MHPG ratio was higher than normal in complete quadriplegia and spastic quadriplegia. This high ratio was due primarily to decreased MHPG. The authors suggest that these changes are due to decreased norepinephrine turnover in the damaged SC and that a VMA:MHPG ratio is the most useful measure of norepinephrine activity in SCI.

Adolescent↗
PubMed1981

Psychiatric disorders in patients with spinal cord injuries.

Although previous studies have reported that all patients with spinal cord injuries experience depression, they have not distinguished between despondency and depressive disorder. Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria (RDC). 15 patients had RDC diagnoses before or after their injury. A depressive disorder developed in nine after injury. Eight depressive disorders developed within a month of the injury. Postinjury depressive disorders were more common in patients with complete spinal cord lesions but were divided equally between paraplegics and quadriplegics. Only one patient received antidepressants. The remainder recovered without treatment other than the rehabilitation program. The accident causing the injury seemed related to a psychiatric disorder before injury in six patients (four alcoholics and two hypomanics) and to drinking before the accident in 15 patients.

Accidents↗
PubMed1976

Routine on-line psychiatric diagnosis by computer.

With the advent of effective psychiatric treatments, greater accuracy in psychiatric diagnosis has become a vital concern for psychiatric training, research, and patient care. The authors have adapted current computer diagnostic procedures in order to obtain highly accurate diagnosis while simplifying and shortening the process of information input and diagnostic output. Their program requires a minimum of the clinician's time and provides feedback during the diagnostic process when the clinician requires it. The authors believe that routine use of this computer diagnostic program will improve psychiatric training, research, and patient care.

Diagnosis, Computer-Assisted↗