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Biomedical subjects

R Tepper

Publications and source records attributed to R Tepper.

At least 109 records · Page 6Linked to original sources
PubMed1992

[Cytokines in anorexia nervosa--nutritional or neuroimmunal changes?].

Natural cell-mediated cytotoxicity (CMC), spontaneous release of tumor necrosis factor (TNF-alpha) by mononuclear cells in vitro, and PHA-induced interferon (IFN-gamma) production were examined by standard methods in 14 females with anorexia nervosa (AN) and marked weight loss and in 16 normal matched controls. The results were confirmed by neutralization with monoclonal antibodies. In the anorectic patients there was a significant increase in TNF production (16 +/- 5 vs 4 +/- 3 mu/ml), and depressed CMC (4 +/- 2 vs 10 +/- 3 lytic units per 50/10(6) cells) and IFN-gamma production (172.5 +/- 25 vs 367 +/- 34 mu/ml). Following successful refeeding and nutritional rehabilitation, all values returned to normal. Thus there are changes in cytokines and defective natural cytotoxicity in AN, apparently related to undernutrition and not to neuroimmunomodulation. The increased TNF-release may further suppress food intake and enhance tissue catabolism, suggesting that nutritional rehabilitation should be the earliest therapeutic goal in anorexia nervosa.

Anorexia Nervosa↗
PubMed1991

Diagnostic relevance of clonal cytogenetic aberrations in malignant soft-tissue tumors.

BACKGROUND: Malignant soft-tissue tumors often present substantial diagnostic challenges. Chromosome aberrations that might be diagnostic have been identified in some types of soft-tissue tumors, but the overall frequency and diagnostic relevance of these aberrations have not been established. METHODS: We attempted to determine the karyotypes of a series of 62 consecutive, unselected malignant spindle-cell or small round-cell soft-tissue tumors (from 46 adults and 16 children) after direct harvesting of cells or short-term culture. All tumors were examined independently by immunohistochemical staining in addition to routine light-microscopical evaluation, and all but two tumors were examined by electron microscopy. RESULTS: Metaphases were obtained from 61 of the 62 tumors, and clonal chromosome aberrations were identified in 55 (89 percent). In the six tumors that yielded metaphases but lacked apparent clonal aberrations, the normal metaphases were found to originate from non-neoplastic stromal elements within the tumor specimens. Thus, all tumors in which karyotyping was successful contained clonal chromosome aberrations. Forty of 62 tumors (65 percent) contained clonal chromosome aberrations that either suggested or confirmed a specific diagnosis; in 15 of these tumors (24 percent of all tumors), the aberrations were important in establishing the final diagnosis. Cytogenetic analyses were particularly informative about small round-cell tumors from children: 8 of 14 round-cell tumors contained diagnostically important chromosome aberrations. Using the combined approaches of light and electron microscopy, immunohistochemistry, and cytogenetics, we established an unambiguous diagnosis for 60 of 62 tumors. CONCLUSIONS: Cytogenetic analyses reveal clonal chromosome aberrations in virtually all malignant soft-tissue tumors. These clonal chromosome aberrations, particularly in small round-cell tumors in children, often have diagnostic relevance.

Adult↗
PubMed1991

Effect of dexamethasone on pulmonary inflammation and pulmonary function of ventilator-dependent infants with bronchopulmonary dysplasia.

Seventeen ventilator-dependent premature infants with bronchopulmonary dysplasia (BPD) were enrolled in a double-blind, placebo-controlled study to determine the effects of 3 days of intravenously administered dexamethasone (0.5 mg/kg/day) on pulmonary function, pulmonary inflammation, and the requirement for respiratory support (FIO2, ventilator peak pressure [PP], and respiratory rate [RR]). Assessment of pulmonary function included measurement of FVC, flow at 25% vital capacity (V25), and static compliance of the respiratory system (Crs), whereas pulmonary inflammation was assessed by the neutrophil count, ratio of elastase/2 x alpha-1-antitrypsin, and the concentrations of albumin and fibronectin in the tracheobronchial lavage (TBL) fluid. After 3 days of placebo treatment there were no significant changes in any of the measured parameters. In contrast, the dexamethasone-treated group demonstrated a significant decrease in respiratory support (FIO2: 50 versus 36%; PP: 21 versus 16 cm H2O; RR: 22 versus 14 breaths/min) and improved pulmonary function (Crs: 0.63 versus 0.85 ml/cm H2O/kg; V25: 23 versus 68 ml/s/kg). In addition, pulmonary inflammation was suppressed in the dexamethasone-treated group (neutrophils: 23 versus 11 x 10(4)/mg albumin: elastase/2 x alpha-1-antitrypsin: 0.24 versus 0.10; albumin: 7.1 versus 3.5 mg/dl; fibronectin: 33 versus 17 micrograms/mg albumin). We conclude that short-term treatment with dexamethasone improves pulmonary function and suppresses pulmonary inflammation as well as decreasing the respiratory support required by ventilator-dependent premature infants with BPD.

Albumins↗
PubMed1990

Tumour necrosis factor production and cell-mediated immunity in anorexia nervosa.

Fourteen patients with anorexia nervosa (AN) were studied for the production of tumour necrosis factor (TNF), the activation of the interferon (IFN) system and cell-mediated cytotoxicity (CMC) and the results were compared with 16 age-matched healthy women. AN patients had significantly increased spontaneous TNF production by peripheral blood mononuclear cells (PBMC) in vitro (16 +/- 5 U/ml versus 4 +/- 3 U/ml in the control group; P less than 0.05), although no TNF was detectable in the plasma from either group. TNF production in vitro, following stimulation of PBMC by phytohaemagglutinin (PHA) or tumour cells, was similar in AN patients and controls; however, lipopolysaccharide (LPS) induced TNF production was found to be lower in AN (P less than 0.1). CMC was significantly lower in AN patients (4 +/- 2 versus 10 +/- 3 in controls, expressed as lytic units/10(6) cells; P less than 0.05), but no difference could be found between AN and controls in IFN activity as reflected by the level of the IFN-induced enzyme 2'-5' oligoadenylate synthetase (2-5A) in PBMC. Beta-endorphins in the plasma were higher in the AN group (P less than 0.05) but these levels could not be correlated to those of IFN, CMC or TNF. Defective CMC and increased TNF production by PBMC in patients with anorexia nervosa may possibly result from the nutritional deficiencies and neuroendocrine abnormalities associated with the disease, and may contribute to the pathophysiology of AN.

Adolescent↗
PubMed1990

Beta-endorphin levels in the follicular fluid of human oocytes fertilized in vitro.

This study was carried out in order to investigate the relationship between beta-endorphin (beta-ep) levels in plasma and follicular fluid and fertilization rates of oocytes from women undergoing treatment in our in vitro fertilization and embryo transfer program. Nine women suffering from severe tubal damage, with regular menstrual cycles, were studied. Follicular growth was induced with clomiphene citrate, combined with human menopausal gonadotropins. Analysis of follicular fluids and plasma showed no significant difference in beta-ep levels. The larger follicles (greater than 2 ml volume) had significantly higher beta-ep levels than smaller follicles (less than 2 ml volume; p less than 0.001); however, there was no significant difference in the fertilization rates of their oocytes.

Adult↗
PubMed1990

TNF, interferon-gamma and cell-mediated cytotoxicity in anorexia nervosa; effect of refeeding.

"Natural" cell-mediated cytotoxicity (CMC), spontaneous release of tumor necrosis factor-alpha (TNF-alpha) by mononuclear cells in vitro and PHA-induced interferon-gamma (IFN-gamma) production were examined by standard methods (confirmed by neutralization with monoclonal antibodies) in 14 female patients with marked weight loss due to anorexia nervosa (AN) and 16 matched healthy controls. We found a significant increase in TNF production in AN, as well as a depressed CMC and IFN-gamma production. Following successful refeeding and nutritional rehabilitation of the AN patients, all results normalized to levels similar to those of controls. Thus, undernutrition in AN is accompanied by changes in cytokines and defective "natural" cytotoxicity. The implications in vivo are unclear but our findings may reflect nutritional-related immunodeficiency in AN and moreover, the increased TNF-release may further suppress food intake and enhance tissue catabolism in anorexia nervosa.

Anorexia Nervosa↗
PubMed1989

Comparison of five clomiphene citrate dosage regimens: follicular recruitment and distribution in the human ovary.

One hundred fifty-six women with cycle disorders presenting as absence or infrequency of ovulation and with luteal phase deficiency (group II, according to the World Health Organization classification) received clomiphene citrate (CC) for ovulation induction. The administered dosage ranged from 50 to 250 mg/d. The follicular development in terms of numbers of small (less than 8 mm), intermediate (9 to 15 mm), and large (greater than 15 mm) follicles and their distribution in either one or both ovaries on the day of assumed ovulation was related to the dosage of CC. A statistically significant increase was found in the total number of follicles in relation to the dosage of CC (P less than 0.003). In view of the development of the mature follicles, the gradual increase in CC daily dosage was thought to be associated with additional mature follicles before ovulation. However, this increased follicular recruitment was not regarded as statistically significant. Treatment with low doses of CC resulted in follicular development in only one ovary, whereas increased follicular recruitment after high CC dosage was found in association with follicular development in both ovaries.

Clomiphene↗
PubMed1989

Serum growth hormone binding protein activity in healthy neonates, children and young adults: correlation with age, height and weight.

Serum growth hormone binding protein (GHBP) activity was estimated in healthy neonates (n = 6), children and adolescents (n = 97) and young adults (n = 19). GHBP activity was measured by incubating 125I-hGH (human growth hormone) (approximately 25,000 c.p.m.) with serum (100 microliters) in the presence and in the absence of excess unlabelled hGH, followed by separation of specifically bound 125I-hGHBP complexes from free 125I-hGH by gel filtration on Ultrogel AcA44 minicolumns. The results are expressed as the percentage specific binding relative to an adult reference serum (%RSB), after correction for endogenous hGH of the unknown serum. The between-assay coefficients of variation for two sera of %RSB activity of 51.2 and 115.4% were 6.0 and 7.0% respectively. In neonates, low values of serum GHBP were found (%RSB = 27.1 +/- 5.0 SEM) followed by a major rise during the first 6 years of life to a mean value (%RSB = 68.3 +/- 4.1 SEM) which more than doubled that of neonates. Thereafter, values rose progressively throughout childhood and puberty to reach maximum values in young adults (%RSB = 95.0 +/- 3.1 SEM). A novel observation was that serum GHBP activity correlated significantly with height standard deviation score (SDS) (males: r = 0.77, P less than 0.001; females: r = 0.56, P = 0.01) and weight SDS (P less than 0.001) for both sexes before puberty. During puberty GHBP correlated only with weight SDS in males (r = 0.60, P less than 0.01). In all age groups studied, no correlation could be found between serum GHBP and height velocity.

Adolescent↗
PubMed1988

Novel application of video image processing to biochemical and antimicrobial susceptibility testing.

ALADIN (Analytab Products, Plainview, N.Y.) is an automated instrument that uses video imaging (computer-assisted guided video camera) for the determination of biochemical and antimicrobial susceptibility test reactions. This collaborative investigation compared video-generated results obtained with ALADIN with visually determined findings. Both approaches were used to view identical reactions. Overall agreement for biochemical and antimicrobial susceptibility tests was greater than 95%. This study demonstrates that video imaging is an acceptable approach for determining microbial responses to biochemical and antimicrobial agents and may provide, with appropriate computer modifications, more accurate and reproducible results than are possible by visual scrutiny.

Bacteria, Anaerobic↗
PubMed1988

The effect of clomiphene citrate and tamoxifen on the cervical mucus.

The anti-estrogenic effect of clomiphene citrate (CC) and tamoxifen (TMX) on cervical mucus was evaluated in a prospective crossover study. Ten women underwent randomized alternate cyclical treatment with either 100 mg CC, 40 mg TMX daily, or with placebo. The effect of CC, TMX and placebo on serum estradiol (E2), cervical mucus secretion and on the development of ovarian follicles was evaluated. Compared with placebo, treatment with CC and TMX significantly increased the number of mature ovarian follicles on the day of assumed ovulation (p less than 0.05), elevated E2 secretion (p less than 0.05) and decreased cervical score (p less than 0.05). It can be concluded that anti-estrogenic agents reduced the secretion of cervical mucus. However, in most cases, the excessive E2 production due to multiple follicular growth overcomes the anti-estrogenic effect.

Adult↗
PubMed1987

Ultrasonic assessment of fetal colon by comparing ratios of colon circumference to abdominal circumference in normal pregnancy and two abnormal cases. A preliminary study.

Fetal gastrointestinal malformations occur with an incidence of approximately 6/1,000 births and can often be diagnosed in utero by ultrasound. Antenatal knowledge of these abnormalities can potentially decrease fetal and neonatal morbidity and mortality because the appropriate preparations can be made in advance of delivery. Changes in ultrasonic images of the fetal colon were measured by comparing ratios of colon circumference to abdominal circumference in 136 normal pregnancies. Normal values of these parameters are given for gestational age. Two abnormal case reports are included to exemplify the clinical applications.

Abdomen↗
PubMed1987

Evaluation of pulmonary parenchymal disease by magnetic resonance imaging.

Thirty-eight patients with a wide variety of different disorders of the lung have been imaged using magnetic resonance. The disorders studied include congenital abnormalities, acute and chronic inflammation, vascular disorders, primary and secondary tumours of the lung, haematomas and infarcts. Magnetic resonance imaging identified all lesions seen on chest radiographs, but it is not quite as sensitive as computed tomography is for detection of very small abnormalities. Magnetic resonance may provide information to aid in differentiation of a wide variety of disorders causing diffuse pulmonary abnormality and might also prove helpful in differentiating acute inflammation from pulmonary collapse or fibrosis. In some disorders, such as lobar emphysema, cystic adenomatoid malformation and sequestration, the findings on the magnetic resonance scan alone will permit a correct diagnosis to be made in many cases. It is believed that magnetic resonance imaging has more potential for pulmonary imaging than has previously been recognised.

Adolescent↗
PubMed1987

Menopausal hot flushes and plasma beta-endorphins.

Plasma beta-endorphin levels were measured in five women in physiologic menopause suffering from frequent episodes of hot flushes, recorded objectively by the measurement of finger temperature. Significantly lower levels of plasma beta-endorphin levels were found at the onset of the hot flushes than five to 20 minutes before (P less than .001). After the flush there was a significant rise of plasma beta-endorphin levels at five, ten, and 15 minutes (P less than .002).

Body Temperature Regulation↗