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Biomedical subjects

S Bernstein

Publications and source records attributed to S Bernstein.

At least 55 records · Page 3Linked to original sources
PubMed1985

The structural organization of skeletal proteins influences lipid translocation across erythrocyte membrane.

In order to define the influence of skeletal protein organization on transmembrane phospholipid movement in erythrocyte membranes, we measured the translocation rate of lysophosphatidylcholine in pathologic red cells. A simple method based on the differential extraction of lysophosphatidylcholine from the red cell membrane by saline and albumin solutions was used to quantitate the translocation rate. Two groups of pathologic red cells were chosen for these studies: red cells with quantitative deficiencies of the skeletal proteins, spectrin and protein 4.1, and sickle erythrocytes in which controlled reorganization of the membrane was induced by hemoglobin polymerization. Marked increase in lipid translocation rate was seen in red cells having quantitative deficiencies of spectrin and protein 4.1. The magnitude of the increase in translocation rate in spectrin-deficient red cells was related to the magnitude of protein deficiency. Translocation rate in sickle erythrocyte membranes increased by 50% upon deoxygenation as a result of sickle hemoglobin polymerization. No increase in translocation rate was seen in normal cells upon deoxygenation. By manipulating the extent of membrane reorganization that occurred following deoxygenation of sickle cells, we have been able to show that skeletal reorganization induced by hemoglobin polymerization and not hemoglobin polymerization per se is responsible for the increase in translocation rate. Together, these findings imply that the structural organization of membrane skeletal proteins plays an important role in regulating the rate of transbilayer movement of lipids across the erythrocyte membrane.

Anemia, Sickle Cell↗
PubMed1985

Vicryl mesh in pelvic floor reconstruction.

A new synthetic absorbable mesh made of polyglactin 910 (Vicryl) fiber was used to reconstruct the pelvic floor in seven women undergoing pelvic exenteration. The technique is described. The follow-up ranged from three to 31 months and no patient developed a bowel problem. The material seems to be appropriate for this use, is completely absorbed, and acts as a latticework for the deposition of granulation tissue. The technique can be applied in patients requiring pelvic irradiation following surgery for malignant neoplasms of the gastrointestinal or genitourinary tracts. The small bowel is effectively held out of the pelvis and the radiation field, and is spared the effects of the radiation beam.

Adult↗
PubMed1985

Transfer of human and murine globin-gene sequences into transgenic mice.

We have studied the transfer of human and murine globin gene sequences into fertilized mouse oocytes by microinjection. Germline transmission was demonstrated for the human delta- and beta-globin genes contained in the bacteriophage lambda H beta G1. Expression of these human globin-gene sequences was not detectable in either erythroid or nonerythroid tissues. A recombinant plasmid containing the murine beta maj promoter region coupled to the prokaryotic coding sequence for galactokinase was also successfully transferred to two mice, and stable germline transmission of integrated DNA was demonstrated for at least 3 generations. Despite the presence of a murine globin-promoter sequence, expression of the mouse beta maj galactokinase fusion gene was not observed in primary or secondary animals in erythroid or nonerythroid tissues. Analysis of primary and secondary animals from both series of injections revealed extensive de novo methylation in the integrated microinjected DNA. Administration of 5-azacytidine to mice containing the mouse beta maj-promoted galactokinase gene resulted in partial hypomethylation was associated with an apparent two- to threefold increase in galactokinase (gal K) gene expression.

Animals↗
PubMed1984

Pulmonary hemorrhage in lupus erythematosus without evidence of an immunologic cause.

Intra-alveolar hemorrhage is a known complication of lupus erythematosus (LE), but its cause is controversial. Some authors have shown immune complexes (ICs) deposited at various sites in the alveolar septae and postulated that these deposits result in pulmonary hemorrhage (PH). A patient with LE and PH had no detectable IC deposits at a time when IC disease was present in the kidney and vasculitis was active in the skin. Reviewing the literature, we show that IC deposits in the lung are nonspecific and are not correlated with PH. We propose that classification schemes that differentiate between IC-mediated PH and idiopathic PH are arbitrary, and that patients thought to have idiopathic PH should be followed up prospectively to monitor the development of possible immunologic disease.

Adult↗
PubMed1983

Adult non-Hodgkin's lymphoma. Correlation of cell surface marker phenotype with prognosis, the new working formulation, and the Rappaport and Lukes-Collins histomorphologic schemes.

The interrelationships between histomorphologic classification, cell surface marker phenotype and prognosis were prospectively studied in 130 adults with non-Hodgkin's lymphomas. Within each of the classification schemes used there were certain histologic variants that exhibited heterogeneity of cell lineage as well as those that were extremely uniform. Diffuse lymphomas with cell populations consisting of large cells, or mixtures of large and small cells were the most heterogeneous phenotypically and were most resistant to precise definition of immunologic cell lineage. The new Working Formulation for Clinical Usage likewise exhibited considerable heterogeneity of phenotype even within well defined histomorphologic categories. Two immunologic phenotypic variables that conferred a significant favorable prognosis were the expression of surface membrane immunoglobulin (B derivation) and the simultaneous expression of a membrane mu and delta immunoglobulin heavy chain. The results of this study suggest that cell surface marker phenotypic determinations have well defined and potentially useful correlations with histomorphologic classification schemes, and are useful in predicting biologic behavior and prognosis. It is suggested that a knowledge of both immunologic phenotype and histomorphologic characteristics is necessary in formulating therapeutic decisions.

Humans↗
PubMed1983

Problem orientated medical records.

Problem orientated medical records will accommodate and integrate information about minor and major problems, allow rapid updating of information and better communication between health agencies and primary care team members. They will allow colleagues to retrieve information and assess patient problems, enable better co-ordination to occur between patient investigation and treatment, and rationalise decision making. In Part Two a method of medical recording is described using various coloured forms. Problems encountered and suggested solutions have been made. It is felt that the introduction of this method will lead to improved medical care for patients.

Humans↗
PubMed1982

Post-neonatal mortality in rural India: implications of an economic model.

In this paper we develop and test a theory of childhood mortality after the first month of life. Parents are assumed to have well-defined family size and sex composition objectives and to face severe budget constraints. In this set of circumstances, it is understandable that they will make allocative decisions that will affect the survival probabilities of children. These decisions and the environmental influences on mortality are the basic forces which determine whether a child will survive through the post-neonatal period. The model is tested with survey data from rural Uttar Pradesh, India. The results are consistent with the hypothetical framework discussed above. The burden of this pattern of choice is felt particularly strongly by female births.

Attitude↗
PubMed1982

Surface marker identification of small cleaved follicular center cell lymphomas with a highly favorable prognosis.

Between 1976 and 1980, 143 cases of non-Hodgkin's lymphoma have been prospectively analyzed for correlations between surface marker phenotype, histomorphology, and prognosis. This study analyzed 44 adults with tumors classified by Lukes-Collins criteria as small cleaved follicular center cell lymphomas. Two surface marker phenotypic subsets were membrane immunoglobulin, immunoglobulin D (IgD), or a receptor for the third component of the complement system (C'3) (Group I = IgD+ and/or C'3+, group II = IgD-C'3-). Eleven of the 44 patients have died with a projected median survival of 58 months. Four patients in Group I have died with a median survival of 58 months while seven patients in Group II have died with a median survival of 30 months. The difference in the survival curves for the two subgroups is statistically significant (p = 0.01). An analysis of variables such as stage, age, sex, and sites of involvement revealed no differences between the two groups. When classified histologically, the two groups were morphologically indistinguishable and had similar distributions of nodular (follicular) and diffuse variants. Of interest, five patients in Group I were judged to require no initial therapy whereas none in Group II remained untreated initially. The expression of the second heavy chain delta and/or a receptor for C'3 appears to define a subgroup of small cleaved follicular center cell lymphomas with an indolent course and an excellent prognosis.

Adult↗
PubMed1982

Erythropoiesis in ha/ha and sph/sph mice, mutants which produce spectrin-deficient erythrocytes.

In order to characterize chronically accelerated erythropoiesis, we studied the ultrastructure of bone marrow and spleen of ha/ha and sph/sph mice, two mutants with profound hemolytic anemia secondary to deficiency of the erythrocyte membrane protein spectrin. The marrows and spleens of both varieties were extremely erythropoietic and were without histological abnormalities directly related to spectrin deficiency. Erythropoiesis was consistently associated with distinctive, dark branched cells which constituted large proportions of the stroma of the mutant spleens and marrow. These dark cells were not present in untreated and acutely bled controls. Plasma clot assays for erythroid progenitors revealed that CFU-E concentrations in the mutant marrows were significantly increased over those in untreated controls while BFU-E concentrations were approximately half. In addition, mutant CFU-E often gave rise to abnormal appearing colonies. Spectrin, though crucial to erythrocyte function is probably not important to the process of erythroid differentiation and maturation. The status of erythroid precursors in the marrows of the spectrin deficient mice is similar to that of mice subjected to an acute bleed. The divergent changes in CFU-E and BFU-E may indicate that these two cells play different roles in accelerated erythropoiesis. The dark cells that we describe are similar to stromal cells observed in models of the early stages of erythropoiesis.

Anemia, Hemolytic↗
PubMed1980

A method to estimate the number of house officers required in teaching hospitals.

A method of estimating the number of house officers needed for direct patient care in teaching hospitals is discussed. The method requires six input data elements: average daily census, annual admissions, annual outpatient visits, average house staff hours per inpatient per day, average house staff hours per outpatient visit, and average direct patient care hours per house officer per day. The first three are readily available annual statistics; the fourth and fifth data elements are easily estimable by service chiefs and immediate house staff supervisors. The sixth input item can either be a standard or an estimated value. An approach to estimating the sixth data element is included in the paper. An application of the proposed method is illustrated for 11 clinical services at the Los Angeles County-University of Southern California Medical Center.

California↗