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Biomedical subjects

M Hirsch

Publications and source records attributed to M Hirsch.

At least 109 records · Page 6Linked to original sources
PubMed1987

Right atrial thrombus and recurrent pulmonary emboli secondary to permanent cardiac pacing--a case report and short review of literature.

A patient with a right atrial thrombus and recurrent pulmonary emboli secondary to permanent pacemaker insertion is described. Possible precipitating factors were damage to the subclavian vein, congestive heart failure, paroxysmal atrial fibrillation, and immobilization. Venography demonstrated a large atrial thrombus in the superior vena cava and right atrium. The patient was successfully treated with heparin and subsequently with warfarin and dipyridamole.

Aged↗
PubMed1987

Enkephalinase is involved in the degradation of endogenous substance P released from slices of rat substantia nigra.

The effects of various peptidase inhibitors were examined upon the K+-evoked overflow of substance-like immunoreactive material (SPLI) from slices of rat substantia nigra in order to assess the possible involvement of "enkephalinase," angiotensin-converting enzyme (ACE) and calpain in the enzymatic inactivation of endogenous substance P in brain tissues. The calpain inhibitor leupeptin and the enkephalinase inhibitors thiorphan and phosphoramidon increased markedly SPLI overflow, whereas the two ACE inhibitors, captopril and enalaprilat (up to 10 microM in the superfusing medium), were inactive. Surprisingly kelatorphan, which inhibits not only enkephalinase but also aminopeptidase and dipeptidylaminopeptidase activities, was less potent than thiorphan or phosphoramidon to enhance SPLI overflow. However, in the presence of ICI-154129 or naloxone to block opiate receptors, kelatorphan was as potent as thiorphan, therefore suggesting some negative influence of endogenous opioids on SPLI release with kelatorphan but not thiorphan. In agreement with this interpretation, the direct stimulation of delta opiate receptors by deltakephalin was found to significantly reduce SPLI overflow. Furthermore, an increased outflow of [Met]enkephalin-like material was observed from substantia nigra slices superfused with kelatorphan but not thiorphan. These results indicate that endogenous substance P released within the substantia nigra is very probably inactivated by enkephalinase and calpain, but not ACE. They also demonstrate that endogenous opioids can exert a negative control upon substance P release in this brain region.

Animals↗
PubMed1986

The association of rhinoviruses with lower respiratory tract disease in hospitalized patients.

An analysis of 32 hospitalized infants and children from whom rhinoviruses were isolated in our diagnostic laboratories in 1982-83 suggests that these agents are associated with lower respiratory tract disease with focal findings in susceptible patients. In 23 cases, an acute lower respiratory disease was the cause for admission, while nine patients were cultured after new respiratory symptoms developed during hospitalization. Presenting signs and symptoms included cough (23), fever (19), rhinorrhea (19), respiratory distress (14), and decreased feeding (15). Seventeen of 25 chest x-rays showed new focal abnormalities. Twenty-five patients had a significant underlying disease including seven with malignancies, six with respiratory tract abnormalities, and four with congenital heart lesions. Six of the remaining seven patients were less than 2 1/2 months of age. In no cases were significant bacterial or fungal pathogens isolated; two did have concomitant viral isolates. Rhinoviruses in the appropriate clinical setting are associated with significant pulmonary disease.

Adolescent↗
PubMed1986

Morphology of tight junctions in the ciliary epithelium of rabbits during arachidonic acid-induced breakdown of the blood-aqueous barrier.

A reversible breakdown of the blood-aqueous barrier in the iridial processes of rabbits has been induced by arachidonic acid as demonstrated by the passage of horseradish peroxidase at places through the tight junctions. Freeze-fracture images reveal very discontinuous P-face ridges. However, the analysis of complementary replicas demonstrates that discontinuities of P-face ridges are always complemented by particles or short bars found in the E-face furrows. Though the problem exists of correlating freeze-fracture images of the junctional structure to the focal passage of horseradish peroxidase, the data suggest that the discontinuities of P-face ridges cannot be the structural counterpart of the passage of horseradish peroxidase. Alternative pathways of horseradish peroxidase are discussed in context with the offset bifibrillary model of the junction.

Animals↗
PubMed1986

Pachymeningitis presenting feature of posterior sinus infection.

Pachymeningitis may be the presenting symptom of an adjacent paranasal sinus or ear infection. Inflammatory disease of the posterior sinuses (sphenoid and posterior ethmoid cells) may not clinically be apparent and might be overlooked. We report three patients presenting with symptoms and signs of pachymeningitis due to posterior sinus infection. Surgical and/or medical treatment of the local disease results in resolution of the pachymeningitis.

Adolescent↗
PubMed1986

Selective and reversible breakdown of the tight junctional barrier in the rabbit ciliary body induced by arachidonic acid. A tracer and freeze-fracture study.

Arachidonic acid induced a reversible breakdown of the blood-aqueous barrier in the iridial processes of the rabbit ciliary body, whereas the ciliary processes were not affected under the conditions of this study. The focal passage of horseradish peroxidase through the tight junctions was demonstrated. In freeze-fracture images, this breakdown of the barrier function was associated with focal changes: an alteration in the geometry of the tight junctional network; an increase in the number of discontinuities of the P-face ridges and particles and short bars in the E-face furrows; an increase in the density of intramembranous particles within the junctional area. The significance of the ultrastructural alterations of the tight junctions as a structural counterpart of the physiological changes is discussed.

Animals↗
PubMed1986

Quantitative analysis of tight junctions during ciliary epithelium development.

The tight junctions of the ciliary epithelium constitute the main morphological counterpart of the blood-aqueous barrier. Although well-known in the adult, they have only been poorly studied during the morphogenesis of the ciliary processes. We thus analysed them during this period in order to detect whether any changes appear in their general pattern. In the rat, results show that during ciliary body development, the junctional depth and the number of superimposed junctional fibrils decrease, the P-face intramembranous particle density within and outside the junctional domains increase, and particular structures, namely the 'complex strands', are numerous at the early stages and become rare in the adult. Thus, the tight junctions appear as non-stable structures during ciliary-body development and these modifications in their morphology may correspond to changes in barrier properties during the development of this tissue.

Animals↗
PubMed1986

Congenital depression of the neonatal skull.

Congenital depression of the neonatal skull has had an incidence of 0.1% (1/10 000) in our newborn population during the past 8 years. These skull depressions have two pathogenetic types: deformation without fracture and fracture accompanied by depression. The cause of skull depression being the pressure exerted by the digits and fist of the newborn on his skull has not been previously reported. The treatment of choice for selected cases is nonsurgical elevation with an obstetric vacuum extractor. A CT scan should be performed prior to this treatment to rule out intracranial complications such as hemorrhage.

Birth Injuries↗
PubMed1986

Adverse reactions to antihypertensive drugs in pregnancy.

In conclusion from a clinical pharmacological point of view it is stressed that side effects from antihypertensive therapy in part is related to dosage. Increased knowledge should make it possible to reduce the rate of side effects. In the individual case the physician always has to compare a number of factors: general condition of the patient, age, adherence to the prescribed therapy, side effects, and other factors in addition to blood pressure values. With all these limitations in mind there is agreement that the benefit of antihypertensive therapy far out-weigh the negative aspects of such treatment.

Antihypertensive Agents↗
PubMed1986

Cellular immune aspects of the human fetal-maternal relationship.

In the present study the number and the function of T lymphocytes obtained from peripheral blood of 35 mothers immediately after delivery and from the cord blood of the respective newborns were tested. Furthermore, the effect of the newborns' lymphocytes on the immunological competence of the mothers' lymphocytes was investigated by means of graft-versus-host-reaction xenograft test. The blood of 14 of the mothers and their newborns was also examined by monoclonal antibodies for determination of T helper and T suppressor lymphocytes. A marked reduction in the absolute number of T helper cells was found in the blood of mothers after delivery. In addition, mothers' lymphocytes manifested a high suppressor activity when added to normal human lymphocytes. It was also found that the cord blood contains lower number and percentage of T suppressor cells. Yet the T cells of the cord blood exert a high suppressor activity on the mother as well as on normal donor lymphocytes. The impaired function of cord blood lymphocytes could be impaired function of cord blood lymphocytes could be restored by in vitro addition of THF, a thymic hormone.

Female↗
PubMed1985

The assessment of affective disorders in children and adolescents by semistructured interview. Test-retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version.

The reliability of assessment of Research Diagnostic Criteria and DSM-III axis I affective disorders in children and adolescents was studied using a semistructured diagnostic interview. The Schedule for Affective Disorders and Schizophrenia (SADS) for School-Age Children (Kiddie SADS) Present Episode Version, an adaptation of the adult SADS for children was used. Fifty-two subjects, aged 6 through 17 years, were interviewed in a test-retest format by one of three pairs of interviewers. Assessment of symptoms and composite scales of the depressive syndrome were determined to have acceptable reliability, as were three depressive diagnoses. Conduct disorder was assessed with high reliability. Four anxiety disorders and their composite symptoms were assessed with unacceptable reliability; only separation anxiety was assessed with acceptable reliability. The results of this study showed generally lower reliability of symptoms, scales, and diagnoses than did two studies of adults using the SADS.

Adolescent↗
PubMed1985

Transluminal dilatation of the subclavian artery.

Transluminal dilatation of seven left subclavian arteries and one right subclavian artery was attempted in seven patients. Dilatation was successful in four left subclavian arteries and the single right subclavian artery treated. Five of the patients suffered from cerebral symptoms as well as ischemia of the upper limb, one had only cerebral symptoms and another had only arm claudication. All patients also had significantly reduced systolic blood pressures in the brachial artery. Standard techniques for percutaneous transluminal angioplasty (PTA) were employed, using the femoral route six times and the axillary route four times. No complications occurred. All patients were permanently given a maintenance dose of antiplatelet treatment with dipyridamole 75 mg tds after PTA. Follow-up of up to 36 months, indicates that angioplasty can be accomplished in the stenosed subclavian artery with relatively little hazard. Patients with hemodynamically significant stenoses should be considered for PTA if their symptoms and signs warrant such therapy.

Adult↗
PubMed1985

Nonimmune hydrops fetalis--a rational attitude of management.

A rational attitude of management of the nonimmune hydrops fetalis (NIHF) is stressed in order to achieve an optimal outcome of both the mother and the newborn. Of the two cases reported, both had an underlying cardiac condition. The first was due to rapid supraventricular tachyarrhythmia and responded favorably to intrauterine medication with digoxin and the subsequent delivery of a well baby. In the second case, cesarean section was performed unnecessarily for a fetal indication, since the hydropic infant died soon after birth from a severe cardiac malformation which was not unequivocally diagnosed prior to birth.

Adult↗