Endocrine abnormalities in thalassemia.
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Adolescent↗
Biomedical subjects
M Katz
Publications and source records attributed to M Katz.
Duplex Doppler and spectral flow analysis of racial differences in cerebrovascular atherosclerosis.
We compared carotid artery disease in 99 black and 106 white patients using duplex ultrasonography (B-mode imaging and Doppler spectral analysis). Blacks had significantly less stenosis of the extracranial internal carotid artery than whites. Among the risk factors investigated, hypertension alone, ischemic heart disease, diabetes mellitus, and smoking failed to explain the racial difference. Although carotid stenosis of greater than or equal to 40% correlated significantly with age in both races (p = 0.001 in whites and p = 0.005 in blacks), blacks had significantly less carotid stenosis of any degree even when age was taken into account. Multivariate analysis showed that race is a significant and independent risk factor for carotid stenosis (p less than 0.0001). Hypertension interacting with race was also significant. Our results require verification in population-based studies. Carotid duplex ultrasonography offers a noninvasive method for carrying out such studies.
Age Factors↗
Distal accessory phalanx of the foot. A case presentation.
A rare case of an accessory phalanx is presented. It is hypothesized that this anomaly occurred because of an excessive cavitation in the embryonic mesenchyme of the second digit, resulting in an accessory bone and interphalangeal joint. The elongated digit caused jamming within the shoe, resulting in distal pain, a hammered digit, and associated atrophy of the distal aspect of the second toe.
Aged↗
Energy expenditure in normal labor.
The energy expenditure in 23 healthy parturient women during spontaneous labor was assessed by continuous measurement of their O2 consumption and CO2 production. Due to the intermittent character of uterine contractions, normal labor and delivery did not impose high energy demands on the parturient, whereas a prolonged labor and delivery in which energy input was high led to maternal metabolic disturbances.
Adult↗
Attempted murder with pancuronium.
A nurse was accused of attempting to murder her anesthesiologist husband on two occasions by administering to him a neuromuscular blocking agent. In both episodes, urine specimens were obtained from the victim shortly after the suspected assaults. The samples were initially tested fluorometrically using Rose Bengal dye as a pairing agent. Both were presumptively positive for pancuronium. Confirmation of these results was achieved by pairing the drug with potassium iodide, extracting the complex, and submitting the extract to thin-layer chromatography (TLC) cleanup, elution at the appropriate retardation factor (Rf), and, finally, gas chromatography/mass spectrometry (GC/MS) analysis in the selected-ion monitoring mode. The two quaternary amines of pancuronium appear to undergo pyrolytic N-demethylation in the injection port to yield an entity amenable to capillary column gas chromatography. The mass spectrum of the compound consists of a base peak of m/z 322, with additional fragments of 292, 323, 338, and 397 m/z, each of which was monitored. The confirmed positive findings were instrumental in adjudicating the case.
Gas Chromatography-Mass Spectrometry↗
Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf.
A 33-year-old woman developed subacute hepatic necrosis after several months of ingestion of Chaparral Leaf, an herbal product. Symptoms first appeared 3 months after she began taking the tablets. The patient unwittingly carried out a clinical challenge by reducing, then increasing, the dose of pills. The public and the medical profession must be wary of all "harmless" nonprescription medications, whether purchased in pharmacies or elsewhere.
Adult↗
Antepartum uterine activity characteristics differentiating true from threatened preterm labor.
Daily antepartum nursing contact and ambulatory uterine activity monitoring have been used for the early detection of preterm labor. However, it may be difficult to separate true labor from false labor. In this study, the uterine activity records of 110 women at risk for preterm birth with excessive contraction frequencies were evaluated by blinded reviewers. Maternal symptomatology and uterine activity characteristics such as low-amplitude high-frequency contractility, contraction amplitude, contraction duration, contraction interval, and contraction rhythmicity were assessed for their ability to differentiate true from threatened preterm labor. Neither maternal symptomatology nor any uterine activity characteristic other than contraction frequency could differentiate true from threatened preterm labor. Antepartum uterine activity monitoring should continue to rely on contraction frequency to identify the woman at risk for premature labor.
Adult↗
Ambulatory tocodynamometry data interpretation: evaluating variability and reliability.
The inter- and intra-observer variabilities of interpretation of uterine activity monitoring data were determined from the interpretations of 20 ambulatory tocodynamometry records by nine physicians and nurses. The presence of contractions lasting less than 40 seconds or presenting at a frequency of fewer than four per hour was associated with significantly reduced accuracy of interpretation. The reliability was 70% with one observer, 82% with two observers, and 88% with three observers. Higher variability and lower reliability values were obtained for interpretation of low-amplitude, high-frequency contractions. Understanding the limitation of uterine activity data interpretation should help in the clinical management of monitored patients.
Ambulatory Care↗
Mutagenicity of dihydrodiols and diol epoxides of dibenz[a, h]acridine in bacterial and mammalian cells.
Bay-region diol epoxides are ultimate carcinogenic metabolites of a number of polycyclic aromatic compounds. Dibenz[a, h]acridine can form two diastereomeric pairs of these diol epoxides which are not positionally equivalent as a result of the nitrogen atom at position 7. We have assessed the structure-activity relationships resulting from heterocyclic nitrogen substitution by examining the mutagenic activity of these four bay-region diol epoxides of dibenz[a,h]acridine in both bacterial and mammalian cells. In strains TA98 and TA100 of Salmonella typhimurium, the diastereomeric 10,11-diol-8,9-epoxides were 20 to 40 times more mutagenic than the corresponding 3,4-diol-1,2-epoxides. Furthermore, in strain TA100, dibenz[a,h]acridine 10,11-dihydrodiol, the expected metabolic precursor of the 10,11-diol-8,9-epoxide, was metabolically activated by rat hepatic microsomes up to a 12-fold greater extent than the 3,4-dihydrodiol. In Chinese hamster V79 cells, the 10,11-diol-8,9-epoxide diastereomers were 20 to 80 times more mutagenic than their 3,4-diol-1,2-epoxide counterparts. Quantum mechanical calculations of the predicted ease of benzylic carbocation formation at C-1 and C-8 from the diol epoxides indicate that the 3,4-diol-1,2-epoxides should be less reactive due to resonance destabilization of the C-1 carbocation as a result of the electronegative nitrogen atom. Decreased chemical reactivity of 3,4-diol-1,2-epoxides may explain their decreased mutagenic activity.
Acridines↗
Regional effects of 6-hydroxydopamine (6-OHDA) on free radical scavengers in rat brain.
Superoxide dismutase (SOD), catalase, glutathione (GSH), and glutathione peroxidase (GSH-Px) were measured in the caudate-putamen (CPu), the hippocampus (HIP), and the brainstem (BS) of the brains of control animals and of rats treated with one intracerebroventricular infusion of 6-hydroxydopamine (6-OHDA). Injection of 6-OHDA resulted in significant decreases in the activity of SOD in the CPu, the BS, and in the HIP. There were decreases in catalase in the CPu and in the BS, but not in the HIP. GSH was reduced in the CPu and the BS but not changed in the HIP. There were small decreases in the activity of GSH-Px only in the BS. These changes may be secondary to the production of free radicals after the infusion of 6-OHDA in rat brain.
Animals↗
[Angiographic management of angiomatous malformations in the central nervous system].
Angiomatous malformations of the central nervous system are relatively rare and have a serious prognosis. Clinical manifestations of such lesions of the spine include back pain associated with motor and sensory weakness, progressing to complete paraplegia. In angiomatous involvement of the brain, the symptoms may progress from headaches to coma and death. Computerized tomography and magnetic resonance imaging are new noninvasive modalities used in the diagnosis of such malformation, but they have not replaced myelography and angiography. Up to the past decade, the management of angiomatous lesions of the CNS was only surgical. Angiographic embolization is now widely accepted as an alternate method of management. Experience with embolic treatment of 3 cases is reported. In a 15-year-old boy with two adjacent thoracic vertebral hemangiomas (D7 and D8) compressing the spinal cord, embolization was used before surgery. A 23-year-old man with acute myelopathy due to extraretro-medullary arteriovenous malformations of the spinal cord (D9-D11) was successfully treated by selective embolization via catheter of the right 10th intercostal feeding vessel. An 82-year-old man had proptosis, bruit and pulsation in the right eyeball and loss of vision. Arteriovenous malformation of the dura of the anterior cranial fossa was demonstrated and was completely cured by bilateral selective embolization of the feeding branches of the internal maxillary arteries.
Adolescent↗
Vitamin E attenuates the toxic effects of intrastriatal injection of 6-hydroxydopamine (6-OHDA) in rats: behavioral and biochemical evidence.
Unilateral 6-hydroxydopamine (6-OHDA) injections into the striatum lead to the development of apomorphine-induced rotation in rats. The circling behavior was associated with significant decreases in dopamine, dihydroxyphenylacetic acid and homovanillic acid in the ipsilateral striatum. Pretreatments with either D-alpha-tocopherol or all-racemic-alpha-tocopherol caused significant attenuation of both the behavioral and biochemical abnormalities. These results are discussed in terms of their support for the free radical hypothesis of Parkinson's disease and for the role of antioxidants in the treatment of this neurodegenerative disorder.
3,4-Dihydroxyphenylacetic Acid↗
Patient care, resident stress, and government regulation.
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Humans↗
In utero prenatal diagnosis of Beckwith-Wiedemann syndrome; a case report.
The Beckwith-Wiedemann syndrome is an unusual complex of abnormalities that includes mainly omphalocele, macroglossia, natal and postnatal gigantism, visceromegaly and neonatal hypoglycemia. A case is presented where sonographic prenatal diagnosis of this rare condition was made. Prenatal findings and postnatal management are described.
Beckwith-Wiedemann Syndrome↗
The protein synthesis inhibitor, anisomycin, causes exacerbation of the iminodipropionitrile-induced spasmodic dyskinetic syndrome in rats.
The effects of anisomycin on dyskinetic head movements, circling, and locomotor activity were investigated in the IDPN-induced syndrome. Intracerebroventricular (ICV) injections of anisomycin in conjunction with IDPN caused exacerbation of all aspects of the syndrome, although circling and vertical head dyskinesias (retrocollis) were the most affected. Animals treated with only anisomycin showed persistent retrocollis but not laterocollis or circling. Biochemical studies confirmed the increases in the concentration of serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) previously observed in the striata of IDPN-treated rats two weeks after stopping administration of the drug. Rats treated with anisomycin alone also showed significant increases in striatal 5-HT and 5-HIAA concentrations which were somewhat higher on the side of the ICV infusions. Coadministration of IDPN and anisomycin did not cause any further increases in 5-HT or 5-HIAA. These results suggest that inhibition of protein synthesis by IDPN may be one of the processes involved in the development of the persistent dyskinetic syndrome.
Animals↗
Expanding practice horizons: learning from American Indian patients.
The integration of Western medicine with traditional folk medical systems remains a current challenge to individuals providing patient education in American Indian and Alaska Native communities. Cross-cultural patient education requires an understanding of contemporary Indian societies' cultural patterns, including theories of disease causality and therapy. Social organization and the relationship of the community to community-based health care delivery systems are important in making education relevant to prevailing values. This article reviews the history of patient education to Indian people, highlights some of the differences between traditional and allopathic approaches to patient care, and presents a case history of a recent community-based patient education program. The article includes suggestions for practice and identifies important questions to be addressed.
Cultural Characteristics↗
Quantitative computed tomography reflects vertebral fracture morbidity in osteopenic patients.
We studied the relationship between spontaneous vertebral compression fractures and lumbar vertebral trabecular bone density in 69 consecutive patients with suspected osteopenia. Seven had biopsy-confirmed osteomalacia. The remaining 62 were divided into three groups: group 1--asymptomatic patients suspected of having osteopenia on plain films, but with no vertebral compression fractures (N = 24); group II--those with one to five vertebral compression fractures (N = 16); and group III--those with six or more vertebral compression fractures (N = 22). A quantitative computed tomographic (QCT) scan of the lumbar spine was performed on all patients. Patients in group I had QCT values of 94 +/- 23 mg/cm3 (mean +/- SE); those in group II had QCT values of 66 +/- 28 mg/cm3; and those in group III had values of 34 +/- 28 mg/cm3. There were significant differences among all groups (P less than .001), although there was considerable overlap of individuals among the groups. There was no significant difference between the mean QCT value of patients with one compression fracture and the value of those with between two and five compression fractures. Patients with biopsy-proven osteomalacia had higher vertebral trabecular bone density than patients with osteoporosis and compression fractures. Our study provides evidence suggesting a strong inverse relationship between QCT-measured vertebral bone density and the presence of vertebral compression fractures in a group of osteopenic patients.
Absorptiometry, Photon↗
The influence of fetal number on antepartum uterine activity.
Home uterine activity monitoring was performed by 54 women with singleton, 30 with twin, and 34 with triplet gestations. Data were analyzed to determine the relationship between antepartum uterine activity, preterm labor, and fetal number. Preterm labor in singleton and twin gestations was preceded by significant increases in pre-labor contraction frequency (P less than .01). However, in triplets, preterm labor was not preceded by increased pre-labor contractions. Triplet and twin gestations with term labor were associated with higher baseline contraction frequencies than were high-risk singleton gestations with term labor (P less than .05). Fetal number had no impact on pre-labor contraction intensity, although triplet gestations had a significantly greater proportion of uterine activity occupied by low-amplitude, high-frequency contractility.
Female↗