Biomedical subjects
Publications and source records attributed to M Katz.
A patient developed an obstruction of an ileal loop conduit during pregnancy. A left percutaneous nephrostomy was done under local anesthesia, and a tube was placed under sonographic guidance. The pregnancy was successful.
The simultaneous occurrence of endometrial adenocarcinoma and intrauterine pregnancy is a rare phenomenon. Eight cases have been reported on, including the one discussed below. The presence of two apparently mutually exclusive conditions within a uterus is difficult to explain. The neoplasm may arise in foci of immature basal cells, which do not respond to hormonal stimulation. Although this event is rare, the clinician should be aware of the possibility.
A behavior disturbance classification was described and its distribution in childhood and the postschool period examined in a 5-year bith cohort of mentally retarded young adults. Approximately 60 percent had some behavior disturbance in each period. Hyperactive behavior was most frequent among children with lower IQs and antisocial behavior among children and young adults with higher IQs. Aggressive conduct disorder in childhood was most frequent among those with IQs below 50. Emotional disturbance was more frequent among females in the postschool period, and antisocial behavior was more frequent among males, both in childhood and the later period.
Four pregnancies in three patients with spinal cord injury are presented. The major complications encountered include anemia, pyelonephritis, decubiti, premature labor, precipitate labor, and autonomic hyperreflexia. Autonomic hyperreflexia, a severe mass autonomic reflex response to labor, is associated with tachycardia, hypertension, headache, diaphoresis, and severe anxiety. It is probably due to increased norepinephrine release, as very high urinary metanephrines were measured in the latter two cases presented. Maternal and fetal physiology in labor are altered. Despite severe maternal and fetal stress responses, no fetal depression was observed.
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A male fetus (one of twins) was noted to have ascites at 17 menstrual weeks and during the following 13 weeks developed a dilated and hypertrophied bladder, hydroureters, and hydronephrosis. Placement of an indwelling suprapubic catheter in utero allowed drainage of urine from the fetal bladder and further in utero development. The infant was born vaginally at 34 weeks and had "prune belly" syndrome but had normal pulmonary and renal function.
The changes in cardiac output, pulse rate, mean arterial pressure, and mammary blood flow were observed during pregnancy and nursing in a chronically instrumented rabbit preparation. Nursing and suckling were found to be associated with significant changes in cardiac output and mammary blood flow. These changes included a progressive increase in cardiac output during pregnancy. In addition, nursing animals had a significantly higher cardiac output than did nonnursing animals. Mammary blood flow was found to increase significantly prior to delivery and reached peak values at 2 weeks after delivery. The relationship between these changes and variables such as litter size, hormonal status, and puerperal stage is discussed in light of the possible physiologic mechanisms which control adaptation during nursing.
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The basal body temperature (BBT) charts in pregnancy cycles of 110 consecutive women who became pregnant by a single heterologous insemination were studied. The occurrence of ovulation was proved by the pregnancies in each case. All of these pregnancy charts showed a biphasic pattern, and most followed one of three stated types. The charts of 10 pregnancies that ended in miscarriage were no different from those 100 charts of pregnancies that proceeded to live births. No pregnancies occurred when artificial insemination by donor (AID) was performed before day 11 of the cycle or 2 or more days after the temperature elevation. Of 94 singleton pregnancies, 56 (60%) were male and 38 (40%) were female. This male predominance had not been noted previously. Knowledge of the appearance of a typical pregnancy chart is useful not only in the diagnosis of certain causes of infertility but also in the accurate timing of artificial insemination. Previous work on the association between the BBT chart and ovulation compared the chart with various tests of presumptive ovulation. In this series the charts were studied in ovulatory cycles proven by pregnancy.
Thirty normal computed tomography (CT) examinations of the thorax have been reviewed in order to analyze the anatomy of the pulmonary fissures. The major and minor fissures are constantly visible, and their orientation with respect to the scanning plane appears either as a narrow fibrous line or as a hypovascular band. On both sides, the major and minor fissures are constantly in close contact with the pars interlobaris of the pulmonary arteries.
End-stage deceleration (ESD) defined as deep and sustained fetal bradycardia during the second stage of labour was observed in 55 patients. Fetal well-being and neonatal outcome were assessed with fetal-scalp pH, umbilical-vein pH and 1-min Apgar score values. Only six infants with pathological fetal heart-rate patterns before ESD had a 1-min Apgar score of less than 7 and an acidotic umbilical-vein pH. The remaining 49 babies were born in excellent condition, although when ESD persisted for more than 15 min umbilical-vein pH decreased.
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Evidence is presented that the chemical mediator of insulin action is a peptide(s) and most likely glycopeptide(s). The mediator is formed proteolytically because 1) protease inhibitors inhibit insulin action and 2) trypsin mimicks insulin action via mediator formation. Trypsin mediator does not faithfully reproduce the action of insulin mediator, which indicates that the sites of proteolytic cleavage by insulin and trypsin differ. A coordinated multivalent proteolytic mechanism by which insulin acts to trigger an external membrane-bound protease to cleave mediator from a membrane glycoprotein precursor is presented.