The substitute for the intravenous route.
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Humans↗
Biomedical subjects
M Weiss
Publications and source records attributed to M Weiss.
Jacobson's nerve schwannoma: a rare middle ear mass.
The case of a 55-year-old woman with a middle ear mass is presented. The preoperative diagnostic workup, including an audiogram and imaging studies, and the histopathologic findings of the tumor are reviewed. The tumor, a schwannoma, arose from Jacobson's nerve in the middle ear. The surgical anatomy of Jacobson's nerve and the surgical approach to this tumor and to other tumors of the middle ear space are discussed. Tumors of the tympanic cavity are rare, with the exception of cholesteatoma; otherwise, the most common among them are paraganglioma and facial nerve neuroma. This report represents the first documented case of a schannoma arising from Jacobson's nerve in the tympanic cavity.
Cranial Nerve Neoplasms↗
The children of Yemen: bodies, medicalization, and nation-building.
Yemenite Jews were among the many immigrants from Arab countries who were flown to Israel after its establishment in 1948. Following many complaints regarding the disappearance of Yemenite children from hospitals and schools in the transit camps where the new immigrants were kept in the 1950s, a governmental investigation committee was established in 1995. This article provides a preliminary description, from an anthropological perspective, of what is called in Israel the "Yemenite children affair." My analysis focuses on interviews with Yemenite Jews, describing how the bodies of new immigrants were medicalized and commodified and how immigrants and their families have come to resist these processes. I then focus on the role of the Israeli medical profession in promoting national goals and maintaining collective identity.
Anthropology, Cultural↗
The outcome of local radiation injuries: 14 years of follow-up after the Chernobyl accident.
The Chernobyl nuclear power plant accident on April 26, 1986 was the largest in the history of the peaceful use of nuclear energy. Of the 237 individuals initially suspected to have been significantly exposed to radiation during or in the immediate aftermath of the accident, the diagnosis of acute radiation sickness (ARS) could be confirmed in 134 cases on the basis of clinical symptoms. Of these, 54 patients suffered from cutaneous radiation syndrome (CRS) to varying degrees. Among the 28 patients who died from the immediate consequences of accidental radiation exposure, acute hemopoietic syndrome due to bone marrow failure was the primary cause of death only in a minority. In 16 of these 28 deaths, the primary cause was attributed to CRS. This report describes the characteristic cutaneous sequelae as well as associated clinical symptoms and diseases of 15 survivors of the Chernobyl accident with severe localized exposure who were systematically followed up by our groups between 1991 and 2000. All patients presented with CRS of varying severity, showing xerosis, cutaneous telangiectasias and subungual splinter hemorrhages, hemangiomas and lymphangiomas, epidermal atrophy, disseminated keratoses, extensive dermal and subcutaneous fibrosis with partial ulcerations, and pigmentary changes including radiation lentigo. Surprisingly, no cutaneous malignancies have been detected so far in those areas that received large radiation exposures and that developed keratoses; however, two patients first presented in 1999 with basal cell carcinomas on the nape of the neck and the right lower eyelid, areas that received lower exposures. During the follow-up period, two patients were lost due to death from myelodysplastic syndrome in 1995 and acute myelogenous leukemia in 1998, respectively. Other radiation-induced diseases such as dry eye syndrome (3/15), radiation cataract (5/15), xerostomia (4/15) and increased FSH levels (7/15) indicating impaired fertility were also documented. This study, which analyzes 14 years in the clinical course of a cohort of patients with a unique exposure pattern, corroborates the requirement for long-term, if not life-long, follow-up not only in atomic bomb survivors, but also after predominantly local radiation exposure.
Cohort Studies↗
Genetic and pharmacological analyses of involvement of Src-family, Syk and Btk tyrosine kinases in platelet shape change. Src-kinases mediate integrin alphaIIb beta3 inside-out signalling during shape change.
Platelet shape change was found to be associated with an increase in protein tyrosine phosphorylation upon stimulation of thrombin-, ADP- and thromboxane A2-G-protein coupled receptors in human platelets and thromboxane A2 receptors in mouse platelets. By using PP1 and PD173956, two structurally unrelated specific inhibitors of Src-family tyrosine kinases, and mouse platelets deficient in the Src-kinase Fyn or Lyn, we show that Src-family kinases cause the increase in protein tyrosine phosphorylation. We further detected that the non-Src tyrosine kinase Syk was activated during shape change in a manner dependent on Src-family kinaseactivation. The pharmacological experiments and the studies on Fyn-, Lyn- and Syk-deficient mouse platelets showed that neither Src-family kinases nor Syk are functionally involved in shape change. Also human platelets deficient of the tyrosine kinase Btk showed a normal shape change. Binding of PAC-1 that recognizes activated integrin alphaIIb beta3 complexes on the platelet surface was enhanced during shape change and blocked by inhibition of Src-kinases. We conclude that the activation of Src-kinases and the subsequent Syk stimulation upon activation of G-protein coupled receptors are not involved in the cytoskeletal changes underlying shape change of human and mouse platelets, but that the stimulation of this evolutionary conserved pathway leads to integrin alphaIIb beta3 exposure during shape change.
Agammaglobulinaemia Tyrosine Kinase↗
Structure-hepatic disposition relationships for cationic drugs in isolated perfused rat livers: transmembrane exchange and cytoplasmic binding process.
This work studied the structure-hepatic disposition relationships for cationic drugs of varying lipophilicity using a single-pass, in situ rat liver preparation. The lipophilicity among the cationic drugs studied in this work is in the following order: diltiazem > propranolol > labetalol > prazosin > antipyrine > atenolol. Parameters characterizing the hepatic distribution and elimination kinetics of the drugs were estimated using the multiple indicator dilution method. The kinetic model used to describe drug transport (the "two-phase stochastic model") integrated cytoplasmic binding kinetics and belongs to the class of barrier-limited and space-distributed liver models. Hepatic extraction ratio (E) (0.30--0.92) increased with lipophilicity. The intracellular binding rate constant (k(on)) and the equilibrium amount ratios characterizing the slowly and rapidly equilibrating binding sites (K(S) and K(R)) increase with the lipophilicity of drug (k(on): 0.05--0.35 s(-1); K(S): 0.61--16.67; K(R): 0.36--0.95), whereas the intracellular unbinding rate constant (k(off)) decreases with the lipophilicity of drug (0.081--0.021 s(-1)). The partition ratio of influx (k(in)) and efflux rate constant (k(out)), k(in)/k(out), increases with increasing pK(a) value of the drug [from 1.72 for antipyrine (pK(a) = 1.45) to 9.76 for propranolol (pK(a) = 9.45)], the differences in k(in/kout) for the different drugs mainly arising from ion trapping in the mitochondria and lysosomes. The value of intrinsic elimination clearance (CL(int)), permeation clearance (CL(pT)), and permeability-surface area product (PS) all increase with the lipophilicity of drug [CL(int) (ml x min(-1) x g(-1) of liver): 10.08--67.41; CL(pT) (ml x min(-1) x g(-1) of liver): 10.80--5.35; PS (ml x min(-1) x g(-1) of liver): 14.59--90.54]. It is concluded that cationic drug kinetics in the liver can be modeled using models that integrate the presence of cytoplasmic binding, a hepatocyte barrier, and a vascular transit density function.
Algorithms↗
Androgen suppression and clinical improvement with dopamine agonists in hyperandrogenic-hyperprolactinemic women.
OBJECTIVE: To examine the effect of dopamine agonist (DA) treatment on clinical and biochemical features in hirsute, hyperprolactinemic (HPRL) women and the relationship between prolactin (PRL) and androgens. STUDY DESIGN: We evaluated 80 hirsute HPRL women (age, 27 +/- 1 years [mean +/- SE]) with neuroleptic treatment, prolactinoma and idiopathic HPRL (12, 13 and 55, respectively). DA, mainly bromocriptine, was administered for 11 +/- 1 months. Response indicators were Ferriman-Gallwey hirsutism (FGS) and Leeds acne (LAS) scores, circulating PRL, dehydroepiandrosterone sulfate (DHEAS), free and total testosterone, and androstenedione. RESULTS: Baseline PRL correlated positively with DHEAS (r = .23, P = .03) and free testosterone (r = .36, P < .001). In all women, FGS, LAS, PRL, free testosterone, DHEAS and androstenedione decreased by 40-85% during DA treatment (P < .001). The decline in free testosterone was higher when PRL was > or = 65 ng/mL than when PRL was < 65 (P = .03) and correlated positively with basal DHEAS (r = .40, P < .001). CONCLUSION: Our data suggest a modulation by PRL of adrenal androgen production. DA treatment reduces PRL and serum androgens. It results in a significant clinical improvement in acne and hirsutism. Therefore, DA is recommended as monotherapy for hyperandrogenic.
Adolescent↗
[Marine toxins. Natural substance with unexpected effects].
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Animals↗
The burden of hydrocele on men in Northern Ghana.
The social and economic impact of lymphatic filariasis was studied in Northern Ghana. Qualitative methods of gathering information revealed that even though the disease was a problem to both men and women, men with hydrocele suffered a greater psychosocial burden. Particular attention was paid to them, distinguishing men with small hydroceles and men with large ones. Out of frustration men with small hydroceles sought health care from a wider range of places than men with larger ones. The pain associated with adenolymphangitis (ADL) renders them inactive for up to 5 days. Complications of lymph scrotum and ridicule from community members were a problem. Unmarried men in particular found it difficult to find a spouse with their condition, and various degrees of sexual dysfunction were reported amongst married men. The clinical significance and the value of time and attention for counseling to mitigate the effects of the disease on damaged male identity and the need for gender studies to address male issues and the need for including psychosocial issues in the calculating of disability adjusted life years (DALY's) is also discussed.
Adolescent↗
Protein sorting in the Golgi apparatus: a consequence of maturation and triggered sorting.
To explain how resident proteins distribute in peak-like patterns at various positions in the secretory pathway, Glick and co-workers postulated that resident proteins comprise different populations (termed kin populations) and that these compete with each other for entering retrograde transport carriers [Glick et al. (1997) FEBS Lett. 414, 177-181]. Using modelling and computer simulation, they could demonstrate that differences in competitiveness sufficed to generate overlapping but distinct peak-like steady state distributions of the different kin populations across the Golgi stack. In this study, we have tested the robustness of the competition model and find that over-expression or changes in the number of kin populations affect their overall steady state distributions. To increase the robustness of the system, we have introduced a milieu-induced trigger for recycling. This allows for a decrease in the coupling between kin populations permitting both over-expression as well as changes in the number of kin populations. We have also extended the model to include a Golgi to endoplasmic reticulum (ER) recycling pathway and find that only a small amount of resident proteins may recycle at any time without upsetting their observed distributions in the Golgi stack. The biological relevance of a trigger-induced sorting mechanism and ER recycling is discussed.
Binding, Competitive↗
Basal plasma dehydroepiandrosterone sulfate level: a possible predictor for response to electroconvulsive therapy in depressed psychotic inpatients.
BACKGROUND: Dehydroepiandrosterone (DHEA) and its sulfate derivative DHEAS are neuroactive steroids. In the brain, they interact with gamma-aminobutyric acid (GABA(A)) receptors, which are involved in the regulation of anxiety and mood. The relevance of circulatory neurosteroids to psychiatric disorders and biological treatment is unknown. METHODS: Basal plasma levels of cortisol, DHEA, and DHEAS and the DHEAS-DHEA ratio were determined in 17 psychiatric inpatients before and after six electroconvulsive (ECT) therapy sessions, and all changes were statistically analyzed. For baseline values, 25 healthy individuals served as control subjects. Severity of depression and psychosis in the patients was measured with the Hamilton Depression Rating Scale (HDRS) and the Brief Psychiatric Rating Scale, respectively. RESULTS: Both basal and post-ECT levels of cortisol, DHEA, and DHEAS were significantly higher in the patients than in the control subjects. DHEAS levels in responding patients were higher at completion of treatment than at baseline. Patients defined as ECT nonresponders (change in HDRS < 30% from before treatments) exhibited elevated basal DHEAS levels compared with ECT responders. CONCLUSIONS: Markedly elevated basal DHEAS levels (mean + 2 SD of control value) are associated with resistance to ECT and may serve as a potential predictive marker of nonresponsiveness to ECT in depressed patients.
Adult↗
New class of eigenstates in generic hamiltonian systems
In mixed systems, besides regular and chaotic states, there are states supported by the chaotic region mainly living in the vicinity of the hierarchy of regular islands. We show that the fraction of these hierarchical states scales as Planck's over 2pi(alpha) and we relate the exponent alpha = 1-1/gamma to the decay of the classical staying probability P(t) approximately t(-gamma). This is numerically confirmed for the kicked rotor by studying the influence of hierarchical states on eigenfunction and level statistics.
Journal Article↗
Effect of estrogen replacement therapy on speed of sound at multiple skeletal sites.
OBJECTIVES: To evaluate the effect of estrogen replacement therapy (ERT) on postmenopausal bone loss by multi-site ultrasound measurement. METHODS: A cross-sectional comparison of postmenopausal women, ERT users and non-users. The two study groups were enrolled for the reference database collection for the Sunlight Omnisense (Omnisense) and were matched by years since menopause. Speed of sound (SOS) was measured at the distal radius (RAD), mid-shaft tibia (TIB), fifth metatarsus (MTR) and proximal phalanx (PLX). RESULTS: 143 ERT users for 5.2+/-3.6 years were compared with 139 ERT non-users (age: 57.0+/-5.3 and 57.5+/-5.5, respectively). Both groups were 7.1+/-5.0 years since menopause. SOS, expressed in T-score units, was higher at the RAD in ERT users as compared to ERT non-users (-0.55+/-1.30 and -1.36+/-1.60, respectively, P<0.0001), and at the TIB (-0.73+/-1.34 and -1.28+/-1.45, respectively, P=0. 003). Same trend was observed at the MTR and PLX, but not statistically significant because of fewer observations. In early post menopause period, the ERT-non users RAD data shows an annual SOS decrease of 0.17 versus annual increase of 0.12 T-score units (P=0.037). Similar effect is observed at the TIB, though not statistically significant (non-users decrease of 0.20 vs. users increase of 0.08 T-score units/year, P=0.086). CONCLUSIONS: SOS measurements by Omnisense at multiple skeletal sites support the ERT protective effect on bone.
Aged↗
Neuronal expression of Fos protein in the hypothalamus of rats with heart failure.
We sought to identify the areas that have altered neuronal activity within the hypothalamus of rats with heart failure (HF) by mapping neuronal staining of c-Fos protein (Fos) 6-8 weeks following coronary artery ligation (HF group; n=17) or sham surgery (sham-operated control group, n=15). Fos-like immunoreactivity was observed in the paraventricular nucleus (PVN), supraoptic nucleus (SON), median preoptic nucleus (MnPO), anterior hypothalamus (AH) and posterior hypothalamus (PH) using a standard ABC immunocytochemical protocol. The rats in the HF group displayed infarcts averaging 34+/-2% of the outer circumference and 41+/-1% of the inner circumference of the left ventricular wall. Sham-operated control rats had no observable damage to the myocardium. Rats with chronic heart failure (n=5) but no manipulation (no surgery) had a similar number of Fos-staining cells in PVN SON, MnPO, AH and PH compared to sham-operated rats. Acute surgery for isolation of vagus nerves and anesthesia for 90 min increased the number of Fos positive cells in PVN, SON and MnPO of both sham-operated rats and rats with HF. Furthermore, rats with heart failure (n=5) had significantly higher number of Fos-staining cells in PVN (four times), SON (4.5 times) and MnPO (1.5 times) compared to sham-operated rats after acute surgery for isolation of the vagus. The number of Fos-staining cells remained unaltered in AH and PH in both groups of rats. However, in a third series of experiments vagotomy reduced the number of Fos-staining cells in the PVN, SON or MnPO of rats with HF (n=5) to those observed in sham-operated vagotomized rats. This study shows that: (1) there is augmented neuronal activity as indicated by increased number of Fos staining neurons in the PVN, SON and MnPO due to acute surgical stress in rats with HF, and (2) vagal afferents are responsible for the increased neuronal activity in PVN, SON and MnPO of rats with HF during acute surgical stress. These data support the conclusion that vasopressin producing neurons and autonomic areas within the hypothalamus influenced by vagal afferents are activated during HF and are sensitive to 'acute surgical stress' and may contribute to the elevated levels of vasopressin and sympatho-excitation commonly observed in heart failure.
Animals↗
[Clinical value of scintigraphy for gastrointestinal bleeding. Experiences in a large community hospital].
BACKGROUND AND OBJECTIVE: In the majority of cases of gastrointestinal bleeding the site and cause can be determined by gastroscope. If this is unsuccessful, radiological and nuclear-medical tests are available. This study was undertaken to determine the value of scintigraphy in diagnosing of the site of gastrointestinal bleeding. PATIENTS AND METHODS: The data on 155 patients who, between 1984 and 1988, had undergone 161 scintigraphies (with 99mTc-labelled erythrocytes, 5 with 99mTc-Sn colloid) were retrospectively analysed. The results were compared with other diagnostic tests that had been performed, with the definitive diagnosis and, where applicable, the findings at surgery. RESULTS: 78 scintigrams (47%) provided positive results. The site of bleeding had been demonstrated ca. 20 hours after the diagnostic studies had begun. In 47 of the cases the diagnosis was confirmed by additional tests. The intestine was the most common site of bleeding. Localization of the source of bleeding by scintigraphy and other diagnostic tests succeeded in 34 cases, with a 82% concordance between the tests. No bleeding was demonstrated in 88 scintigrams (53%), including all those done with Sn-colloid. In 13 cases the final diagnosis suggested that there had been no previous bleeding and in 43 cases the source of bleeding could not be determined. In 32 scintigraphically negative cases the source of bleeding was demonstrated by other tests. But only 2 of the 13 angiograms and none of the 33 double-contrast studies of the small intestine gave positive results. Among the total number of cases in which bleeding was demonstrated, scintigraphy had a sensitivity of 71%. CONCLUSION: Because of the long duration of observation, scintigraphy with 99mTc-labelled erythrocytes proved superior to other diagnostic tests in the demonstration of the bleeding. By localizing the source of bleeding in a definite part of the gastrointestinal tract, scintigraphy points the way to choosing other diagnostic methods or treatment. If the initial endoscopy has failed, scintigraphy, a method of low invasiveness, should be included when further tests are planned.
Angiography↗
Commentary: using the convection-dispersion model and transit time density functions in the analysis of organ distribution kinetics.
The convection-dispersion model and its extended form have been used to describe solute disposition in organs and to predict hepatic availabilities. A range of empirical transit-time density functions has also been used for a similar purpose. The use of the dispersion model with mixed boundary conditions and transit-time density functions has been queried recently by Hisaka and Sugiyama in this journal. We suggest that, consistent with soil science and chemical engineering literature, the mixed boundary conditions are appropriate providing concentrations are defined in terms of flux to ensure continuity at the boundaries and mass balance. It is suggested that the use of the inverse Gaussian or other functions as empirical transit-time densities is independent of any boundary condition consideration. The mixed boundary condition solutions of the convection-dispersion model are the easiest to use when linear kinetics applies. In contrast, the closed conditions are easier to apply in a numerical analysis of nonlinear disposition of solutes in organs. We therefore argue that the use of hepatic elimination models should be based on pragmatic considerations, giving emphasis to using the simplest or easiest solution that will give a sufficiently accurate prediction of hepatic pharmacokinetics for a particular application.
Algorithms↗
[Neuroactive steroids: actions and risks] .
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Animals↗