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Biomedical subjects

S Adler

Publications and source records attributed to S Adler.

At least 217 records · Page 12Linked to original sources
PubMed1980

Infectious complications with plasmapheresis in rapidly progressive glomerulonephritis.

We recently used plasmapheresis to treat eight patients with rapidly progressive glomerulonephritis. Life-threatening infections developed in five patients, three of which were caused by opportunistic pathogens. In contrast, only two infections occurred in 21 patients with similar renal disease treated with immunosuppressive drugs but not with plasmapheresis. Although infectious complications of plasmapheresis therapy have not been amphasized previously, our experience, coupled with that of previous reports, suggests that serious infections will develop in one third of patients undergoing plasmapheresis for renal disease. Plasmapheresis should be used with caution in patients with rapidly progressive glomerulonephritis.

Adolescent↗
PubMed1980

Occupational lead exposure, nephropathy, and renal cancer.

A 48-year-old lead worker was found to have a cystic renal carcinoma during an evaluation of his occupational lead poisoning. Clinical studies showed elevated blood lead levels, impaired urinary concentrating ability, and reduced creatinine clearance. Histologic and electron microscopic studies showed this cystic tumor to be similar to renal carcinomas observed in animals with prolonged lead exposure. Lead content of the tumor was elevated (2.49 micrograms/gm) in comparison with adjacent renal tissue and with normal adult levels. In light of previous animal studies, this case adds increased evidence to the concern over the carcinogenic potential of prolonged lead exposure.

Adenocarcinoma↗
PubMed1980

Propranolol-related bronchospasm in patients without history of asthma.

Three patients with no history of asthma or allergy developed bronchospasm while taking propranolol for hypertension. The bronchospasm was severe in all three and in one patient resulted in respiratory arrest. Since the bronchospasm was relieved with discontinuation of propranolol and supportive bronchodilator therapy, the bronchospasm was believed to be caused by propranolol. Furthermore, each patient was subsequently treated with other antihypertensive medications which, like propranolol, contain the stabilizer additive tartrazine. Bronchospasm did not recur, making it unlikely that tartrazine hypersensitivity caused this problem. Regardless of a negative history of asthma, therefore, life-threatening bronchospasm must be considered a possible complication of propranolol therapy.

Bronchial Spasm↗
PubMed1980

Hyponatremia and rhabdomyolysis: a possible relationship.

A 40-year-old schizophrenic presenting with an acute toxic psychosis was found to be severely hyponatremic with a serum osmolality of 217 mOsm/kg. The patient was combative and required physical restraints. Shortly after admission the patient's serum transaminase level was elevated, and the next day the CPK value was 175,000 IU. In addition, his serum and urinary myoglobin levels were markedly raised. Shortly after rhabdomyolysis was diagnosed, the patient developed reversible acute renal failure presumably secondary to the myoglobinuria. This report examines the possibility that the severe hyponatremia and hypoosmolality caused his skeletal muscles to become potassium depleted, leading to rhabdomyolysis during the stenuous exercise involved in his battling the restraints.

Adult↗
PubMed1980

Down syndrome and short-term memory impairment: a storage or retrieval deficit?

The majority of researchers investigating the memory skills of retarded individuals have utilized heterogeneous samples of subjects whose sole criteria for grouping was either IQ or MA. The present experiment was designed to evaluate the short-term memory performance of subjects representing a specific type of retardation. Three groups of subjects (Down syndrome, CA control, and MA control) received a battery of tests designed to assess recall and recognition memory utilizing either auditory or visual input with verbal and nonverbal responses. Results indicated that the Down syndrome group possessed deficits in both storage and retrieval abilities, with storage of visually presented stimuli being particularly impaired.

Adolescent↗
PubMed1979

T7-induced DNA polymerase. Characterization of associated exonuclease activities and resolution into biologically active subunits.

Bacteriophage T7-induced DNA polymerase has been isolated by a procedure suitable for large scale use and which yields near homogeneous enzyme. In addition to previously described DNA polymerase activity and 3' to 5' exonucleolytic activity on single stranded DNA (Grippo, P., and Richardson, C. C. (1971) J. Biol. Chem. 246, 6867-6873), the enzyme also possesses a highly active exonuclease which hydrolyzes duplex substrates with 3' to 5' directionality. The native polymerase has been dissociated using 6 M guanidine HCl and resolved into biologically active subunits: T7 gene 5 protein and Escherichia coli thioredoxin. The phage-specified subunit obtained by this procedure is deficient in DNA polymerase and double strand exonuclease activities, with deficiencies in these activities being apparent at the level of a single turnover. However, it possesses near normal levels of a single strand hydrolytic activity which is identical to that associated with the native polymerase with respect to substrate specificity and suppression of hydrolysis by low levels of deoxyribonucleoside 5'-triphosphates. Thioredoxin forms a molecular complex with the T7 gene 5 protein, and addition of the host protein restores restores DNA polymerase and double strand exonuclease activities to near normal levels.

DNA-Directed DNA Polymerase↗
PubMed1979

The paradoxial movement of the mediastinum. A diagnostic sign of foreign-body aspiration during childhood.

The paradoxical movement of the mediastinum, in relation to the respiratory cycle, is a valuable fluoroscopie sign in the evaluation of partial obstruction of air-flow through the trachea or larynx. Its recognition in the presence of the normal chest radiograms together with the clinical history of aspiration, is of importance in the diagnosis of a foreign body located above the tracheal bifurcation. The pathophysiology and the radiographic manifestations of this phenomenon are described. Various etiologies are discussed in which this sign is also seen. The experience with 18 pediatric patients is presented and 3 cases are outlined in details.

Airway Obstruction↗
PubMed1979

Life-threatening metabolic alkalosis in a comatose patient.

A 63-year-old man with obstructive pulmonary disease developed severe metablic alkalosis and coma while receiving steroid therapy and nasogastric suction. Treatment, which included the acute induction of hypercarbia and the simultaneous administration of acetazolamide and saline, restored acid-base balance within 24 hours. This combined approach eliminated the need to infuse hydrochloric acid.

Acetazolamide↗
PubMed1979

An extrarenal role for parathyroid hormone in the disposal of acute acid loads in rats and dogs.

Acid infusion studies were performed in nephrectomized rats and dogs with either intact parathyroid glands (intact) or after thyroparathyroidectomy (thyroparathyroidectomized [TPTX]) to determine the role of parathyroid hormone (PTH) in extrarenal disposal and buffering of acutely administered acid. 29 intact rats given 5 mM/kg HCl and 6 intact dogs given 7 mM/kg HCl developed severe metabolic acidosis but all survived. However, each of 12 TPTX rats and 4 TPTX dogs given the same acid loads died. Intact rats and dogs buffered 39 and 50% of administered acid extracellularly, respectively, whereas extracellular buffering of administered acid was 97 and 78% in TPTX rats and dogs, respectively. 17 TPTX rats and 6 TPTX dogs given synthetic PTH 2 h before acid infusion survived. The blood bicarbonate and extracellular buffering in these animals, measured 2 h after acid infusion, was similar to intact animals. Changes in liver, heart, and skeletal muscle pH determined from [(14)C]5,5-dimethyl-2,4 oxazolidinedione distribution seemed insufficient to account for the increased cell buffering of PTH-replaced animals. Indeed, muscle pH in TPTX dogs given PTH and acid was only 0.06 pH units lower than in control dogs given no acid, suggesting that another tissue, presumably bone, was the target for PTH-mediated increased cell buffering. This conclusion was supported by the observation that PTH did not alter the pH of intact rat diaphragms in vitro. These results indicate that PTH is necessary for the optimal buffering of large, acute acid loads presumably by increasing bone buffering.

Acidosis↗
PubMed1979

Effect of early plasmapheresis and immunosuppressive therapy on natural history of anti-glomerular basement membrane glomerulonephritis: report of a 22-month follow-up.

A patient with anti-glomerular basement membrane (GBM)-mediated necrotizing and proliferative glomerulonephritis with crescents was treated with plasmapheresis, cyclophosphamide, and steroids. Treatment resulted in decreased circulating anti-GBM antibody and prompt improvement of renal function that remained stable for 15 months after all treatment was discontinued. Renal biopsies were performed initially, at seven and 17 months. Immunofluorescent examination showed that anti-GBM antibody continued to be present on GBMs although light and electron microscopic findings demonstrated a transformation to a form of sclerosing glomerulonephritis. To our knowledge, this patient's course is the first demonstration that early treatment with plasmapheresis and immunosuppressions may transform the histologic findings in anti-GBM-induced rapidly progressive glomerulonephritis, thereby altering the natural history of this disease.

Adrenal Cortex Hormones↗
PubMed1978

Intervening polyadenylate sequences in RNA transcripts of vesicular stomatitis virus.

Purified and partially resolved vesicular stomatitis virus (VSV) messenger RNA has been annealed to the VSV genomic RNA and visualized in the electron microscope under conditions in which duplex regions have a wider image width than single-stranded RNA. The locations of the intercistronic boundaries between the messages have been mapped on the VSV genome. The contour of the double-stranded regions is occasionally interrupted by looped-out single-stranded RNA. The loops are comprised of post transcriptionally synthesized polyadenylate. Most of these structures are found at the intercistronic boundaries and covalently bridge adjacent message sequences. In this paper, we discuss the possible significance of these loops.

Chromosome Mapping↗
PubMed1978

Metabolic acidosis after hyperalimentation with casein hydrolysate. Occurrence in a starved patient.

A 29-year-old woman with short bowel syndrome and prolonged starvation developed hyperchloremic metabolic acidosis after initiation of hyoeralimentation with a casein hydrolysate solution. The acidosis was not due to bicarbonate loss but was associated with diminished ability of the kidney to increase urinary acid excretion, particularly titratable acidity. Supplemental parenteral bicarbonate administration was necessary for two weeks until urinary acid excretion rose to normal.

Acidosis↗