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Biomedical subjects

R Schwartz

Publications and source records attributed to R Schwartz.

At least 289 records · Page 16Linked to original sources

Haemolytic-uraemic syndrome: an analysis of prognostic features.

Seventy-two children with the haemolytic-uraemic syndrome were seen between 1969 and 1980 at The Hospital for Sick Children and Guy's Hospital, London. They probably constitute the majority of such cases in south-east England during that period. Boys and girls were affected equally, the mean age at presentation was 3.5 years, and a peak incidence of the disorder in summer months was observed. In 52 (72%) there was a history of diarrhoea at onset. Fifty-seven (78%) were managed by dialysis. Fifty (70%) of the 72 children had a favourable outcome with complete recovery, 3 (4%) died in the acute phase of the illness, 8 (11%) had residual hypertension or chronic renal failure, and 11 (16%) never recovered renal function. The probability of complete recovery of renal function was analysed by logistic regression which indicated that younger age, presentation in the summer months, diarrhoea at onset and, in those patients who were dialysed, a short prodromal illness were associated with a good outcome. Further analysis of the interaction among these variables in the patient group as a whole indicated that diarrhoea favoured a good outcome among boys but not girls.

Acute Kidney Injury↗

Persistent glucose production during glucose infusion in the neonate.

In adults, glucose infusion results in a decreased glucose production rate (GPR) as a mechanism for maintaining euglycemia. To document the development of glucose homeostasis, we derived the GPR in 23 preterm appropriate for gestational age infants, 14 term appropriate for gestational age infants, and in 6 adults. After a 3-h fast, the average plasma glucose and insulin concentration was measured and the GPR was derived. During glucose infusion (5.6 +/- 0.3 mg X kg-1 min-1), compared with saline controls, the preterms had a rise in plasma glucose and plasma insulin, and the GPR was 1.4 mg X kg-1 min-1 (range, 0-4.4) vs. 3.0 mg X kg-1 min-1 (range, 1.8-4.1) (saline controls). In the term infants, only the plasma insulin concentration was elevated when the glucose infused (5.7 +/- 0.3 mg X kg-1 min-1) infants were compared with the saline controls and GPR was 0.4 X kg-1 min-1 (range, 0-2.6) vs. 3.4 mg X kg-1 min-1 (range, 2.8-5.7) (saline controls). In comparison to saline infused adults, glucose infusion (3.2 +/- 0.1 mg X kg-1 min-1) resulted in a significant rise in plasma glucose and in plasma insulin; and the GPR was reduced to 0.1 mg X kg-1 min-1 (range, 0-0.3) from 2.0 mg X kg-1 min-1 (range, 1.5-2.4). 5 of 13 preterms and 2 of 7 term infants had persistent GPR during glucose infusion; in contrast, the GPR in all adults was unmeasurable. There was no correlation between the plasma glucose concentration and the GPR in the newborn or in the adult. Both newborns and adults did have a correlation between plasma insulin concentration and the GPR; however, there was considerable variability in the neonate. We conclude that there are significant developmental differences in neonatal glucose homeostasis and that insulin is important in neonatal hormonal control of glucose production.

Adult↗

Fatal CNS toxoplasmosis in a homosexual man.

A compromised cellular immunity associated with an increased frequency of tumors and fatal opportunistic infections has recently been reported in homosexual men. We studied a homosexual man with fatal CNS toxoplasmosis to emphasize the value of CT in CNS toxoplasmosis and to alert neurologists to potentially curable opportunistic infections.

Central Nervous System Diseases↗

The one-film urogram in urinary tract infection in children.

The sensitivity and specificity of the 5 min postinjection radiograph during urography were studied in 131 children. The 5 min film was overall accurate in 83.2%, with a 56% sensitivity and 91.3% specificity in patients with urinary tract infection (n = 62). In cases in which the 5 min film was not diagnostic, it nevertheless raised enough suspicions to dictate additional films. It is suggested that in urinary tract infection, errors will not be made if the single 5 min postinjection film is reviewed and additional films are obtained only if parts of the urinary tract are incompletely visualized or appear questionable. Further study is necessary to explore the merits of a similar approach for pediatric urography unrelated to urinary tract infection.

Adolescent↗

Effects of dimethyl sulfoxide and thiourea upon intercalator-induced DNA single-strand breaks in mouse leukemia (L1210) cells.

The free radical scavengers, dimethyl sulfoxide (Me2SO) and thiourea, were used to assess the role of free radicals in the production of intercalator-induced DNA breaks and cytotoxicity in mouse leukemia L1210 cells. Both agents decreased X-ray break production, and this decrease was comparable in magnitude to the degree of inhibition of X-ray-induced cell killing. By contrast, Me2SO increased the DNA breaks produced by the intercalators, Adriamycin, 5-iminodaunorubicin, and 4'-(9-acridinylamino)methanesulfon-m-anisidide. This was not due to an enhancement of Adriamycin or 4'-(9-acridinylamino)methanesulfon-m-anisidide uptake by Me2SO. Strand break production by intercalators was decreased by thiourea. This was not due to an inactivation of the intercalators or to a decrease of Adriamycin or 4'-(9-acridinylamino)methanesulfon-m-anisidide uptake by thiourea. Experiments using nucleoid sedimentation to assess the DNA linking number and domain size from cells treated with Me2SO and thiourea indicated that these chemicals alter chromatin structure in a fashion which may account for effects on intercalator-induced DNA scission. The alterations in intercalator-induced DNA scission were not accompanied by corresponding alterations in cytotoxicity, thus dissociating intercalator-induced strand break production from lethality and the mechanism of X-ray break production.

Animals↗

An in vitro system for measuring intrinsic dietary mineral exchangeability: alternative to intrinsic isotopic labeling.

The primary purpose for the in vitro system described here was to provide an alternative method to intrinsic isotopic labeling for determining exchangeability of intrinsic food mineral with extrinsic inorganic mineral or one of its isotopes. In this system, foods or food mixtures extrinsically tagged with an isotope of the mineral of interest are incubated successively in media simulating peptic or pancreatic digestion. Radioactivity and mineral measurements are made on a)the mixture before digestion and after b)peptic and c)successive peptic pancreatic (P-Pa) digestion. Exchangeability is determined by comparing the specific activity in the peptic and P-Pa digest supernatants to that in the mixture before digestion. In addition, determination of the total soluble mineral after P-Pa digestion provides a measurement of potential bioavailability. The procedure was tested for calcium (Ca) exchangeability and bioavailability from a number of foods and food combinations with 45Ca as the tracer. It could be used for any mineral, however, including non-nutrient or toxic elements. It is likely to be most useful in association with human studies carried out with extrinsic stable (non-radioactive) or short-lived radioactive isotopes that are unsuitable for intrinsic labeling.

Biological Availability↗

Effect of L-phenylalanine mustard, adriamycin, actinomycin D, and 4'-(9-acridinylamino)methanesulfon-m-anisidide on naturally occurring human spontaneous monocyte-mediated cytotoxicity.

We have shown previously that cis-diamminedichloroplatinum(II) (cis-DDP), an active antineoplastic agent, and X-irradiation enhanced human spontaneous monocyte-mediated cytotoxicity in vitro. To ascertain whether this is a unique property of cis-DDP or common to other effective antineoplastic agents, we studied the effect of L-phenylalanine mustard (L-PAM), Adriamycin (ADR), actinomycin D, and 4'-(9-acridinylamino)methanesulfon-m-anisidide (m-AMSA) on spontaneous monocyte-mediated cytotoxicity, cis-DDP, ADR, L-PAM, and m-AMSA under appropriate in vitro conditions all increased spontaneous monocyte-mediated cytotoxicity. Activation involved (a) direct monocyte activation (cis-DDP and ADR); (b) inactivation of suppressor lymphocytes (X-irradiation); (c) a combination of the two (L-PAM); or (d) mechanisms not yet elucidated (m-AMSA). In contrast, incubating mononuclear leukocytes with 0.4 microgram actinomycin D per ml depressed monocyte-mediated killing. Thus, while stimulation of "nonspecific" killing is not a unique property of cis-DDP, it is not a universal effect of all chemotherapy agents. The stimulation and enhancement of already existing host defense mechanisms may be an important additional way in which many chemotherapeutic agents exert their antitumor effect.

Aminoacridines↗

26Mg as a probe in research on the role of magnesium in nutrition and metabolism.

The potential of the stable isotope 26Mg (natural abundance 11.01 atom %) as a biological tracer has been explored using neutron activation (NA) and mass spectrometry (MS) for detection. The high natural abundance of this isotope restricts its utility to purposes that can be met by means of an oral tracer. Net magnesium absorption can be measured by administration of 50-60 mg 26Mg and subsequent measurement of fecal isotope excretion. True absorption can be estimated by making isotope measurements in urine or plasma when a dose of oral 26Mg is supplemented by i.v. administration of 28Mg. Although NA analysis is feasible, it is time-consuming and relatively insensitive. MS analysis of the volatile chelate Mg (2,2',6,6'-tetramethyl-3,5-heptanedione)2 (Mg(THD)2) is more sensitive in measuring 26Mg enrichment and requires smaller absolute amounts per replicate analysis. This method is also time-consuming, however, and confounded by instrumental memory effects. Future uses of 26Mg will depend on the development of automated MS instruments utilizing thermal or other means of direct ionization of mineral elements, and/or innovative approaches to the use of biological tracers. Possibilities are in vitro methods that can substitute for in vivo absorption tests of intrinsically labeled foods, and cells and tissues cultured in close to 100% 24Mg to reduce the high abundance of 26Mg in natural magnesium sources.

Biological Availability↗