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Biomedical subjects

N Kramer

Publications and source records attributed to N Kramer.

At least 37 records · Page 2Linked to original sources

Rapid analysis of fatty acids in plasma lipids.

A rapid and convenient procedure for the quantitative determination of the fatty acid composition of plasma lipids is described. Human plasma was applied directly to the preadsorbent zones of thin-layer silica gel plates with added antioxidant, internal standards and carriers. The thin-layer chromatography (TLC) plates were partially developed with methanol followed by chloroform/methanol (1:1, v/v), and then they were fully developed in hexane/diethyl ether/acetic acid (80:20:1, v/v/v) to separate the major classes of lipids. Silica gel from regions containing the separated lipids was scraped into screw-capped tubes and treated with boron trifluoride-methanol prior to gas chromatography. The method of direct application to TLC plates gave yields and compositions of fatty acids very similar to the method of applying extracted plasma lipids. This relatively simple method is suitable for analyzing the fatty acids in plasma lipids from a 50 microliter finger-tip blood samples from an individual, and it may be useful in wide-scale screening of different individuals to estimate the relative amounts of ingested polyunsaturated fatty acids.

Chromatography, Gas

Pyoderma gangrenosum complicating Felty's syndrome.

The case of a 54-year-old woman with Felty's syndrome whose course was complicated by mucocutaneous lesions clinically typical of pyoderma gangrenosum is described. Necrotizing sinusitis and saddle nose deformity were distinctive clinical features. Lymphocytic vasculitis and rheumatoid nodule formation observed within panniculus at the base of a cutaneous lesion and in a nasal mucosal lesion were unexpected histopathologic findings.

Felty Syndrome

Acute central nervous system symptoms caused by ibuprofen in connective tissue disease.

We describe 2 cases of acute encephalopathy in patients with connective tissue disease caused by small doses of ibuprofen. In addition to aseptic meningitis, both patients had altered mental status and focal neurologic signs, ophthalmoplegia in one and hemiparesis in the other. The spectrum of neurologic manifestations of ibuprofen hypersensitivity is reviewed.

Acute Disease

A study of facially expressed emotions as a function of age, exposure time, and sex in children.

Facial expressions and body language constitute a major component of communication in the human population. There are no studies in the dental literature that have examined children's ability to recognize facial expressions. The purpose of this study was to determine children's accuracy and latency to respond to facial expressions (photographs) as a function of age and sex. Sixty children were recruited randomly and placed into three groups according to their age (3, 6, and 9 years) with 20 children per group. They were shown photographs of three different emotions (happiness, anger, and sadness) expressed by actors at three different exposure times (0.2, 0.5, and 1.0 sec), tachistoscopically. The children's responses (accuracy and latency) were recorded. The results indicated that three year olds were significantly less accurate and took longer to respond than the older children. Factors that may have influenced the results and clinical implications are discussed.

Age Factors

Isolated, pupil-sparing third nerve palsy as initial manifestation of systemic lupus erythematosus.

A 29-year-old woman had an isolated, pupil-sparing third cranial nerve palsy. Serologic and CSF abnormalities and the subsequent course were consistent with systemic lupus erythematosus. Corticosteroid therapy resulted in improvement of ocular palsy within 4 weeks. The pathogenesis of cranial neuropathy in systemic lupus erythematosus and the unique presentation in this patient are discussed.

Adult

Colonic involvement in angioimmunoblastic lymphadenopathy resembling inflammatory bowel disease.

A woman 68 years of age had fever, malaise, diffuse lymphadenopathy, splenomegaly followed by abdominal pain, and diarrhea. A lymph node biopsy specimen showed nonspecific follicular hyperplasia. Symptoms were responsive initially to prednisone. Recurrent symptoms warranted colonic biopsy, which was consistent with Crohn's disease, and were responsive partially to prednisone and azulfidine. Because of progressive deterioration, a repeat lymph node biopsy was performed and showed the characteristic histologic feature of angioimmunoblastic lymphadenopathy (AILD). The evolution of the histopathologic features of the case is discussed, and gastrointestinal (GI) manifestations of AILD are reviewed. Although the GI tract is an unusual site for extra nodal AILD, colonic involvement can imitate the clinical and histologic features of inflammatory bowel disease.

Aged

Family process, chronic illness, and death. On the weakness of strong bonds.

Newer techniques for directly measuring social interaction in families permit more informative studies of the family's role in the course of chronic illness. We used laboratory techniques for measuring problem-solving strategies in family groups, supplemented by measures of the family's intelligence and accomplishments as well as its intactness, the latter indicated by measures of duration of marriage and the survival of grandparents. We studied 23 families, each containing an adult patient with end-stage renal disease who was being treated by center-based hemodialysis. In sharp contrast to expectations based on previous data, high scores on the problem-solving variables, as well as the measures of accomplishment and intactness, predicted early death rather than survival. Equally surprising was the finding that noncompliance accounted for most of the association between the family variables and survival.

Adult

Septal panniculitis as a manifestation of Lyme disease.

A 22-year-old woman presented with fever, chills, photophobia, and headaches, followed by a centrally clearing erythematous skin eruption, migratory polyarthralgias, conjunctivitis, and subsequently, tender, nodular skin lesions. Antibodies to Borrelia burgdorferi were consistent with acute Lyme disease. Skin biopsy revealed acute septal panniculitis. This dermatologic manifestation has not been previously described in Lyme disease.

Adipose Tissue

Deficient slowing of the heart among very heavy social drinkers.

Very heavy social drinkers demonstrated less slowing of their heart rate than controls while exhaling after a maximal inhalation. While this suggests defective autonomic control of the heart, clarification of the mechanism and significance of this reflex and its impairment must await sophisticated study.

Adult

Pulmonary hypertension in systemic lupus erythematosus: report of four cases and review of the literature.

Pulmonary hypertension has been reported rarely in patients with systemic lupus erythematosus (SLE). During the past 31/2 yr we have observed pulmonary hypertension as a major clinical manifestation of their disease in four of 43 patients with well-documented SLE followed at out institution. Pulmonary hypertension could be attributed to underlying lung disease in three and was considered to be primary in the remaining patient. Neither hydralazine nor prednisone administration had any effect on the course of the pulmonary hypertension in these patients. The presence of pulmonary hypertension in the course of active SLE may be more common than previously recognized.

Adult

An immunoglobulin (IgG) inhibitor of polymorphonuclear leukocyte motility in a patient with recurrent infection.

We isolated from the serum of a patient with recurrent skin infections an IgG immunoglobulin that irreversibly inhibits the random motility and chemotactic responsiveness of polymorphonuclear leukocytes. Although the patient's leukocytes behaved like normal cells with respect to adherence, phagocytosis, degranulation, and generation of the superoxide anion, they did not migrate normally toward standard chemotactic stimuli. Normal human polymorphonuclear leukocytes behaved similarly after incubation with the patient's serum. Inhibition of motility was not associated with cyutotoxicity. Inhibitory activity could be removed completely from the patient's serum by treatment with either agarose-bound anti-human IgG or Sepharose-bound staphylococcal protein A. Exposure of normal polymorphonuclear leukocytes to as little as 1.25 microgram per milliliter (0.00125 g per liter) of the patient's purified IgG caused significant inhibition of random motility and chemotactic responsiveness (P < 0.01). Thus, IgG immunoglobulins can inhibit leukocyte motility specifically and irreversibly, and thereby adversely affect host defenses against invading microorganisms.

Cell Movement

Echocardiographic practice in a large metropolitan area.

A survey performed concerning echocardiography in a metropolitan area. Of 110 hospitals in the area, 62 reported having echocardiographic facilities. Echocardiographic physicians and/or technicians from 41 of these hospitals responded to questionnaires designed to determine the following: (1) educational background and credentials of technicians, (2) average salaries of technicians, (3) role of the physician and technician in the performance and reporting of echocardiograms, (4) volume, cost, and method of storage of echocardiograms, and (5) number and type of echocardiographic units in use. Our data suggest various trends, including a lack of formal training among technicians, the prevalence of cardiologists-internists as directors of echocardiographic facilities, the performance of echocardiograms by cardiology fellows in only 46% of institutions with cardiology training programs, and the widespread projected availability of cross-sectional echocardiographic capability within the next two years.

Allied Health Personnel