On the cause of preterm labor and birth.
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Female↗
Biomedical subjects
M Katz
Publications and source records attributed to M Katz.
Acute encephalopathy and chronic neurological damage after pertussis vaccine.
In August 1991, the Institute of Medicine released a report entitled Adverse Effects of Pertussis and Rubella Vaccines, which examined, among others, the relation between immunization with whole-cell diphtheria-tetanus-pertussis (DTP) vaccine and both acute encephalopathy and chronic neurological damage. The committee reviewed information from a wide range of both professional and lay sources and found that the evidence is consistent with a possible causal relation between DTP vaccine and acute encephalopathy, although it is insufficient to establish causality. The range of excess risk of acute encephalopathy following DTP immunization is consistent with that estimated from the National Childhood Encephalopathy Study: 0.0 to 10.5 cases per million immunizations. The committee concluded that the evidence is insufficient to indicate either the presence or absence of a causal relationship between DTP vaccine and permanent neurological damage. The evaluative methods used by the committee are briefly described and the evidence underlying its conclusions presented.
Acute Disease↗
Prospective study of the hypothalamic-pituitary axis in thalassaemic patients who developed secondary amenorrhoea.
OBJECTIVE: We aimed to prospectively evaluate during 10 years the GnRH-gonadotrophin secretory dynamics in a cohort of 15 menstruating girls with beta-thalassaemia major to determine whether they sustained progressive damage to this axis. DESIGN: Patients were characterized by 12-hour gonadotrophin profiles (by sampling blood at 15-minute intervals) and assessment of gonadotrophin responses to 100 micrograms GnRH bolus (by sampling blood at 20-minute intervals for 1 hour and at 2 hours) sequentially during the follicular and luteal phases of their menstrual cycles, 12-14 months and 5-6 years after the onset of secondary amenorrhoea. SUBJECTS: We studied 15 post-menarcheal thalassaemic girls and five age-matched control subjects who were the healthy siblings of the patients. MEASUREMENTS: FSH and LH assays were determined using commercial RIA systems and double antibody techniques. Pulse detection used the Pulsar technique of Merriam and Wachter. RESULTS: We demonstrated that during their amenorrhoeic period, all thalassaemic patients had gonadotrophin pulse abnormalities and low-normal GnRH-stimulated gonadotrophin levels indicating that they had GnRH-gonadotrophin secretory insufficiency. During the subsequent 10 years there was progressive deterioration of hypothalamic-pituitary function in all patients; 66% became apulsatile and all had marked reduction in their GnRH-stimulated gonadotrophin levels. CONCLUSIONS: Our investigation suggests that thalassaemic patients with secondary amenorrhoea had severe and progressive damage to their hypothalamic-pituitary axes despite intensive chelation therapy.
Adolescent↗
Pemphigus neonatorum.
The diagnosis of pemphigus neonatorum in an infant girl was based on clinical, histologic, and immunofluorescence evidence. The outcome was benign, and the skin lesions resolved within two weeks.
Female↗
Papillary cystadenoma of the lower lip mimicking hidradenoma papilliferum.
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Adenoma, Sweat Gland↗
Pharmacokinetics of sex steroids in patients with beta thalassaemia major.
AIMS: To assess the pharmacokinetics of oral, intramuscular, or transdermal hormone replacement in patients with beta thalassaemia major. METHODS: Oral (testosterone undecanoate 40 mg) and intramuscular (testosterone propionate 15 mg, phenylpropionate 30 mg, isocaproate 30 mg and decanoate 50 mg) testosterone and transdermal (17 beta oestradiol 25 micrograms and 50 micrograms) oestradiol were evaluated in 21 male (16-29 years) and 11 female (19-26 years) patients with beta thalassaemia major and various forms of hypogonadism. RESULTS: In male patients given oral testosterone, peak testosterone concentrations were observed either two to four hours or seven hours after administration; intramuscular testosterone produced peak values seven days after injection. Transdermal 17 beta oestradiol given to female patients produced a biphasic pattern with an initial peak concentration occurring at 36 hours and a secondary rise at 84 hours. CONCLUSIONS: The results indicate that oral androgens should be given twice daily in cases of hypogonadism, and where growth is incomplete, lower than recommended doses. If intramuscular testosterone is used, smaller doses of 10-25 mg should be given every one to two weeks. Transdermal administration of 25-50 micrograms 17 beta oestradiol generally produces a plasma E2 value in the early to mid-follicular phase range (100-300 pmol/l). This is appropriate in adults but excessive for prepubertal girls. Diffuse iron infiltration of tissues does not seem to interfere with the absorption of androgens and oestrogens from the gut, muscle, or skin.
Administration, Cutaneous↗
Gas enema for the reduction of intussusception: relationship between clinical signs and symptoms and outcome.
OBJECTIVE: The aim of this study was to establish the extent to which the clinical features of intussusception can be used to predict successful outcome of gas enema and to determine whether the nonsurgical management of intussusception in children can be improved by refining the criteria used to select patients for gas enema. SUBJECTS AND METHODS: Clinical data on 282 consecutive episodes of intussusception (255 patients) were collected prospectively from January 1987 to July 1991. Gas enema was performed in 273 episodes, in which the clinical signs and symptoms were studied by using logistic regression. Nine patients had primary surgery. RESULTS: Gas enema was successful in 216 (79%) of 273 enemas attempted. Fifty-seven patients had surgery after unsuccessful enema. Univariate analysis showed significant associations between successful enema and duration of signs and symptoms less than 12 hr, no rectal bleeding, absence of small-bowel obstruction, presence of a palpable mass, and normal hydration. Multivariate analysis showed that dehydration, small-bowel obstruction, and duration of signs and symptoms longer than 12 hr were significant predictors of unsuccessful enema; yet, in these groups the rate of success still justified attempted enema. Even in severe dehydration, the successful enema reduction rate was 31%. CONCLUSION: Our data suggest that although the factors identified had some predictive value in determining the outcome of attempted enema reduction, they could not be used to indicate patients in whom enema reduction should not be attempted. All patients with intussusception should have a gas enema if the absolute contraindications to enema (i.e., peritonitis or perforation) are absent.
Child↗
Induction of ovarian function by using short-term human menopausal gonadotrophin in patients with ovarian failure following cytotoxic chemotherapy for haematological malignancy.
Currently no treatment has proved successful in inducing ovarian steroidogenic and/or gametogenic recovery in patients with haematological malignancies treated by cytotoxic chemotherapy once biochemical failure becomes manifest i.e., when FSH levels exceed 40 IU/L. This paper reports two such cases with classical biochemical ovarian failure in which ovarian function was induced by brief stimulation with Human Menopausal Gonadotrophin (HMG).
Adult↗
Biology of aging in an Israeli population. 1. Review of literature and morphological variation analysis.
This article reports the results of a comparative morphological assessment carried out on five age segments of an Israeli population: 1. neonates, 2. early school age children (6.5-7.5 years old), 3. young adults (18-29), 4. mature adults (30-45) and 5. elderly people (75-94). The aim of the investigation was to analyze the relationship between developmental homeostasis phenomena and the aging process. Developmental homeostasis was assessed via group coefficient of variation (CV) for 21 morphological traits and fluctuating asymmetry (FA) for 8 bilateral traits. The majority of traits was found to show significantly increased CV and FA in the elderly group. This finding is consistent with the hypothesis that the aging process is accompanied by the total breakdown of the individual's developmental stability.
Adolescent↗
Chiropractic adjustment to the cervical spine and the Arnold-Chiari malformation.
OBJECTIVE: To present two cases in which patients with Type I Arnold-Chiari malformation (ACM) were treated with adjustments to the cervical spine for conditions unrelated to the anomaly. CLINICAL FEATURES: The ACM is an anomaly of central nervous system development in which structures from the posterior fossa descend below the level of the foramen magnum. INTERVENTION AND OUTCOME: The patients reported were adjusted multiple times to the cervical spine. No ill effects or complications were noted related to the ACM. CONCLUSIONS: Asymptomatic Type I ACM is not necessarily a contraindication to skilled adjustments to the cervical spine.
Adult↗
Patterns of leisure activities of young adults with mild mental retardation.
Leisure activities were examined for young adults with mild mental retardation. Some had disappeared from mental retardation services after leaving school; others were in adult day services. Peers without mental retardation (comparison subjects) were also included. Various leisure activities were combined using cluster analysis. Some adults with mental retardation and some comparison subjects were found in each of the 13 clusters obtained but proportions varied. Leisure patterns were strongly influenced by gender and marital status as well as mental retardation, except for one cluster, Socially Isolated, Impoverished, where there were more adults with mental retardation, irrespective of gender and marital status.
Adult↗
Terbutaline tocolysis and glucose intolerance.
OBJECTIVE: To determine whether there is an increased incidence of glucose intolerance in association with chronic terbutaline therapy, administered either orally or as a continuous subcutaneous infusion. METHODS: Sixty-nine women received terbutaline, orally (38 subjects) or as a continuous subcutaneous infusion (31 subjects). Their gestational diabetes screening results were compared to the results in 82 women not receiving beta-mimetic therapy. RESULTS: Subjects receiving terbutaline had significantly higher mean glucose concentrations after the 1-hour 50-g glucose tolerance test (GTT) than did controls (P < .05, one-way analysis of variance with multiple comparisons). Among subjects receiving a continuous subcutaneous infusion of terbutaline, the incidence of abnormal 3-hour 100-g GTT results was higher than among controls (20 versus 4%; P = .023 by chi 2). CONCLUSIONS: The incidence of GTT abnormalities is increased among women receiving terbutaline. We recommend surveillance of glucose tolerance among patients receiving terbutaline chronically, regardless of the route of administration.
Administration, Oral↗
Purification of basic fibroblast growth factor and alkaline phosphatase from human placenta.
Human placenta is an available hospital waste which is known to contain many valuable biochemicals that may be commercially exploited. Using placental tissue previously extracted for haemoderivatives, we purified basic fibroblast growth factor (bFGF), a soluble protein, and placental alkaline phosphatase (PALP), a membrane-linked protein, as a coupled process. bFGF purification comprises three steps: extraction and chromatographies on S-Sepharose and heparin-Sepharose. The final product includes a major 17 kDa and a minor 16 kDa component with a specific activity of 8.0 x 10(6) units/mg yielding 0.5-1.0 microgram/kg of placenta. PALP purification comprises four steps: acidic butan-1-ol extraction and chromatographies on Q-Sepharose, concanavalin A-Sepharose and Q-Sepharose. The purified PALP has a molecular mass of 70 kDa, a specific activity of 800 units/mg and yielded 50 micrograms/kg of placenta. The results show the possibility of purifying substances in placental haemolysed blood, soluble products from placental cellular mass and proteins from the cellular membrane in a one-stream process.
3T3 Cells↗
Frontostriatal disorder of cerebral metabolism in never-medicated schizophrenics.
We scanned 18 patients with schizophrenia who had never received neuroleptic medication and 20 age- and sex-matched controls by positron emission tomography with 18-F-fluorodeoxyglucose (fludeoxyglucose F 18) as a tracer of glucose metabolism. Subjects performed the Continuous Performance Test during 18-F-fluorodeoxyglucose uptake. Scan results were converted to metabolic rates, and computer algorithms were used to identify cortical regions. Previous reports of relative hypofrontality in schizophrenia were confirmed, indicating that this finding is not an artifact of previous treatment. Significantly reduced ratios of inferior and medial frontal regions to occipital cortex were found, together with diminished metabolism in the basal ganglia. This suggests the presence of a combined frontostriatal dysfunction in schizophrenia.
Adult↗
Striatal metabolic rate and clinical response to neuroleptics in schizophrenia.
A low metabolic rate in the caudate nucleus and putamen in schizophrenic patients while they were not receiving medication was found to predict a favorable clinical response to haloperidol. Twenty-five patients (21 men and four women) entered a double-blind crossover trial of haloperidol and placebo; to our knowledge, this is the first such trial with positron emission tomography to be reported. Patients received either placebo or medication for the first 5 weeks, and they received the other treatment for the second 5 weeks. Positron emission tomographic scans were obtained at weeks 5 and 10. Patients with low relative metabolic rates in the caudate nucleus and putamen while they were receiving placebo were more likely to show decreases in their Brief Psychiatric Rating Scale scores with haloperidol treatment than individuals with normal or high metabolic rates. Among responders, haloperidol treatment had a "normalizing" effect on metabolic activity in the striatum, with the metabolic rate while they were receiving haloperidol being higher than that while they were receiving placebo. Nonresponders were more likely to show a worsening of hypofrontality while they were receiving medication and an absence of change in the striatum.
Adult↗
1,25-Dihydroxy-vitamin-D3 enhances antiproliferative effect and transcription of TGF-beta1 on human keratinocytes in culture.
Both TGF-beta and 1,25-dihydroxy-vitamin-D3 (1,25(OH)2D3) have been reported to decrease the proliferation of normal human keratinocytes. The effect and expression of TGF-beta in keratinocytes treated with 1,25(OH)2D3 was investigated. Human keratinocytes were grown in the presence of various concentrations of TGF-beta and/or 1,25(OH)2D3 prior to enumeration. TGF-beta, alone, has a half maximal dose of inhibition (ED50) of approximately 750 pg/ml after seven days in culture in Keratinocyte Growth Medium (KGM; Clonetics) supplemented with 1.5 mM calcium. When 1,25(OH)2D3 (10(-7)M) was also added to cultures with various concentrations of TGF-beta, the ED50 shifted an average of 2-fold less. The presence of TGF-beta (10 pg/ml) augmented the potency of 1,25(OH)2D3 by at least 10-fold. In keratinocyte cultures, the antiproliferative effect of the two compounds together is synergistic. In keratinocytes grown for 1 week in the presence of 1,25(OH)2D3 at 10(-6)M, the TGF-beta 1 message increased approximately 5-fold. An increase is detected within 2 hours of exposure to 1,25(OH)2D3. There was only a 50% increase in the levels of TGF-beta 2 and no detection of TGF-beta 3. When keratinocyte cultures were treated with 1,25(OH)2D3 and neutralizing antibodies to TGF-beta, the induced-antiproliferative activity was blocked by more than 50%. The keratinocytes produced more active than latent TGF-beta after growth with high doses of 1,25(OH)2D3.
Antibodies↗
Flow velocity analysis of umbilical and uterine artery flow in pre-eclampsia treated with propranolol or pindolol.
In a double blind study, 20 gravidas with pre-eclampsia were randomly allocated to treatment with either propranolol 120 mg/day or pindolol 15 mg/day for 7 days. Flow velocimetry was performed before and after treatment to assess the influence of these two regimens of beta blocker on the feto-placental circulation. A continuous wave Doppler unit was used to measure umbilical and uterine artery flow velocity waveforms. The systolic/diastolic (A/B) ratio and the systolic minus diastolic divided by systolic (A-B)/A ratio (resistance index) were used as indexes of blood flow resistance in the umbilical and uterine arteries, respectively. A resistance to flow in the uteroplacental circulation was significantly less in patients treated with pindolol compared to those treated with propranolol (P less than 0.01). The same pattern was also found in umbilical velocimetry, although the statistical significance was borderline (P = 0.06). Although both drugs were equally effective in reducing blood pressure at rest, their effect on the peripheral resistance was different. Pindolol appears to act in part through a peripheral vascular mechanism. Our data support this assumption because the flow in the uteroplacental bed, as reflected by a decrease in resistance index, improved when patients were treated with the drug pindolol.
Adult↗
Lethal Pena-Shokeir 1 syndrome in three male siblings.
A consanguineous family with no living children and three male siblings with Pena-Shokeir 1 syndrome is described. Two children died antepartum and the third shortly after delivery. The importance of early prenatal diagnosis, appropriate counseling and thorough evaluation of the neuromuscular system is discussed.
Abnormalities, Multiple↗