[Diabetes in children: case report].
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Adolescent↗
Biomedical subjects
S Levy
Publications and source records attributed to S Levy.
The immunobiology of B cell lymphoma: clonal heterogeneity as revealed by anti-idiotype antibodies and immunoglobulin gene probes.
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Antibodies, Anti-Idiotypic↗
Interferon enhanced natural killer function in Hodgkin's disease.
Natural killer (NK) cell activity of peripheral blood mononuclear cells from 19 untreated patients with active Hodgkin's disease and 22 age- and sex-matched healthy individuals was evaluated using classical K 562 cells as targets in a 4-h assay. A significant decrease was demonstrated in the patients (P less than 0.01) in accordance with previous data from the literature. Preincubation of effector cells with alpha leucocyte recombinant interferon (500 units/10(6) cells/ml) led to a significant increase in NK function in the patients (P less than 0.001). However, 4 patients still remained below the normal range and some patients were poor responders to interferon indicating that the mechanisms of depressed NK cell activity associated with Hodgkin's disease could not be overcome by interferon at least in some patients.
Adult↗
Syngeneic antiidiotypic immune responses to a B cell lymphoma. Comparison between heavy chain hypervariable region peptides and intact Ig as immunogens.
The nucleic acid sequence of the heavy chain variable region (VH) expressed by 38C13, a B cell tumor of C3H origin, was determined by a combination of direct (messenger RNA) mRNA sequencing by primer extension and complementary DNA (cDNA) isolation and sequencing in M13. The VH amino acid sequence was deduced, and hypervariable regions were identified. From an analysis of predicted secondary structure, regions of predicted antigenicity were chosen, and a series of synthetic peptides corresponding to CDR2 and CDR3 (complementarity-determining region) were produced. These peptides were coupled to protein carriers and used to immunize syngeneic C3H mice. All peptides gave rise to a vigorous antibody response. However, only the CDR3 peptides induced antibodies that crossreacted with the isolated H chain protein. Only one CDR3 peptide induced antibody-producing clones, isolated as hybridomas, that reacted with the intact IgM protein. However, the appearance of these clones was a low-frequency event. All antibodies reacting with the H chain or the intact IgM protein were idiotypically specific for 38C13. These monoclonal antiidiotype (anti-Id) antibodies, raised against CDR3 peptides, gave strong reactions in enzyme-linked immunosorbent assays and immunoblots, but they were of low affinity compared to syngeneic anti-Id raised against the intact IgM protein. Moreover, while the intact IgM was capable of inducing tumor immunity, the CDR peptides were not able to do so.
Animals↗
Group comparisons of blood pressure and indices of obesity and salt intake in Pacific populations.
Group comparisons of blood pressure and indices of obesity and salt intake from epidemiological studies conducted in the Pacific early in the 1980s are presented. The comparisons were of a rural-urban type, and showed a trend for a lower prevalence of hypertension and for lower mean blood pressures in adults from rural areas, compared with urban populations. Rural residents were also slimmer and appeared to have a lower salt intake than did urban dwellers. These findings give possible support to the role of adiposity and salt intake in the genesis of essential hypertension.
Adult↗
An epidemic of influenza in the population of Niue.
An epidemic of influenza A occurred in the Niue population during May-June 1983. The infection was introduced by two index cases returning from New Zealand to the village of Makefu. The epidemic started in this village and then spread rapidly around the island. The incidence of infection was calculated to be 41 per 100 population based on 1981 census figures. There was no predilection for the infection to affect any particular age bracket, although the elderly were over-represented amongst the hospital admissions because of greater severity of illness in this age group. Two deaths occurred, and 3.4% of cases received treatment in hospital. Apart from generalised symptoms (fever, body pain, and headache), respiratory symptoms, particularly cough, were prominent. Gastrointestinal symptoms were reported in a minority. The average duration of illness was 6 days. Virology results indicated that the epidemic was due to influenza A/Bangkok/1/79(H3N3). Paired serological studies also revealed five cases of dengue fever. Previous records reveal that epidemics of influenza are a frequent occurrence in Niue, although not a major cause of mortality since the 1950s. It is suggested that early treatment of complications is the most important measure to decrease the impact of influenza and that measures such as isolation of cases, restriction of population movement and quarantine of incoming cases may be useful to prevent the propagation of epidemics in a small and isolated population.
Adolescent↗
Occurrence of high concentrations of postdexamethasone cortisol in elderly psychiatric inpatients.
The authors retrospectively studied 161 psychiatric inpatients who had received a dexamethasone suppression test (DST). The majority of the patients were over 60 years old, female, and had concurrent chronic medical illnesses. Age was significantly correlated with log-transformed postdexamethasone cortisol concentrations in the 118 nondemented patients with major depression. Four p.m. cortisol concentrations greater than 15 micrograms/dl occurred in 15 patients. All were over 60 years old; all but one had major depressive disorder (MDD); and five had dementia plus MDD. In the same population, a 5 micrograms/dl criterion did not distinguish MDD from non-MDD patients. The results support the existence of a clinically relevant age effect on the DST in patients with MDD. Elderly depressed patients with markedly elevated cortisol concentrations occur frequently, and warrant further clinical and pathophysiological study.
Adolescent↗
The use of transarterial microembolization in the management of hemangiomas of the perioral region.
The management of oral and perioral hemangiomas depends on several clinical factors. Surgery of these benign lesions can at times be disfiguring, especially when the lips, muscles, or the maxilla and mandible are involved. In addition, by the very nature of these lesions, surgical treatment may be associated with excessive intra- and perioperative blood loss. A series of five patients who had hemangiomas in the perioral region and who were initially treated with transarterial microembolization, preoperatively in two cases and as the only treatment in three cases, is presented. The technique of microembolization is described and recommendations for its use are given.
Adolescent↗
Diabetes in Wallis Polynesians: a comparison of residents of Wallis Island and first generation migrants to Noumea, New Caledonia.
A comparative study of diabetes, impaired glucose tolerance and obesity was undertaken in samples of rural Wallisians of Wallis Island and first generation Wallisian migrants in the urban centre of Noumea, New Caledonia. Approximately 20-25% of the adult population of the 2 communities was included in the study. Wallisians in Noumea tended to be more obese than those in Wallis (particularly females). The prevalence of diabetes was 7 and 4 times higher in Noumea compared to Wallis for males and females respectively. Differences in the extent of obesity appeared to account for some of the difference in prevalence of diabetes, but other environmental factors (such as constituents of the diet, and exercise) must be operative as well. The results of this study are consistent with previous findings concerning environmental determinants of diabetes in Pacific populations.
Adult↗
Relationship between light sensitivity and intracellular free Ca concentration in Limulus ventral photoreceptors. A quantitative study using Ca-selective microelectrodes.
The possible role of Ca ions in mediating the drop in sensitivity associated with light adaptation in Limulus ventral photoreceptors was assessed by simultaneously measuring the sensitivity to light and the intracellular free Ca concentration (Cai); the latter was measured by using Ca-selective microelectrodes. In dark-adapted photoreceptors, the mean resting Cai was 3.5 +/- 2.5 microM SD (n = 31). No correlation was found between resting Cai and absolute sensitivity from cell to cell. Typically, photoreceptors are not uniformly sensitive to light; the Cai rise evoked by uniform illumination was 20-40 times larger and faster in the most sensitive region of the cell (the rhabdomeral lobe) than it was away from it. In response to a brief flash, the Cai rise was barely detectable when 10(2) photons were absorbed, and it was saturated when approximately 10(5) photons were absorbed. During maintained illumination, starting near the threshold of light adaptation, steady Cai increases were associated with steady desensitizations over several log units of light intensity: a 100-fold desensitization was associated with a 2.5-fold increase in Cai. After a bright flash, sensitivity and Cai recovered with different time courses: the cell was still desensitized by approximately 0.5 log units when Cai had already recovered to the prestimulus level, which suggests that under those conditions Cai is not the rate-limiting step of dark adaptation. Ionophoretic injection of EGTA markedly decreased the light-induced Cai rise and increased the time to peak of the light response, but did not alter the resting Cai, which suggests that the time to peak is affected by a change in the capacity to bind Ca2+ and not by resting Cai. Lowering the extracellular Ca2+ concentration (Cao) first decreased Cai and increased sensitivity. Longer exposure to low Cao resulted in a further decrease of Cai but decreased rather than increased sensitivity, which suggests that under certain conditions it is possible to uncouple Cai and sensitivity.
Animals↗
Worry, fear, and concern differentiated.
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Adult↗
Aeromedical transportation via commercial airlines.
A report on 72 patients requiring medical escorts on long international flights by commercial airlines is presented. From experience gained, advice is given on facilitating medical attention during such journeys. Adequate preflight planning is the most important aspect.
Aircraft↗
Bepridil for recurrent sustained ventricular tachycardias: assessment using electrophysiologic testing.
Bepridil was found to possess electrophysiologic properties common to class I and IV antiarrhythmic agents. Intravenous and oral bepridil were evaluated using serial electrophysiologic studies in a selected group of 9 patients with recurrent sustained ventricular tachycardia (VT) unresponsive to usual therapy, including amiodarone therapy in 15 patients. Intravenous bepridil treatment terminated sustained, well tolerated, pacing-induced VT in 3 of 6 patients and prevented the initiation of VT in 2 of these and in a patient in whom the drug failed to restore sinus rhythm. Oral bepridil was administered at a loading dose of 800 mg on day 1, and 500 to 600 mg the following days, and programmed electrical stimulation was repeated 2 to 6 days after initial study. Oral bepridil therapy prevented VT initiation in 6 patients (66%). The tachycardia cycle length was prolonged (30 to 105 ms) in 2 patients in whom VT remained inducible. In 1 patient the tachycardia cycle length significantly shortened after bepridil and prompt cardioversion was required. Five of the 6 patients with successful results underwent long-term oral treatment with bepridil. VT recurred in 1 patient during the hospitalization period and an adverse effect (paralytic ileus) in another patient required drug discontinuation. Three patients remain symptom-free over a follow-up of 4 to 13 months. These data suggest that bepridil may be useful in patients with recurrent, sustained VT.
Administration, Oral↗
[Routine check-up in an asymptomatic population].
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Humans↗
Monitoring for neurotoxic effects from low level exposures to organophosphate pesticides.
Data from small scale studies on low level and delayed neurotoxic effects from exposure to organophosphate pesticides suggest the need for monitoring those at risk in agriculture and industry, as well as residents repeatedly exposed to aerosol drift from aerial spraying. A pilot program is put forth with the aim of determining whether such effects occur in exposed populations, and if they do, assessing their incidence, distribution and severity, as well as the efficacy of control programs.
Aryldialkylphosphatase↗
Selective coronary arteriography by percutaneous transaxillary approach.
Coronary angiography by the percutaneous femoral approach is widely used. This technique is potentially dangerous or impossible in patients with advanced arterial disease of the lower limbs, whether or not surgically treated. In these cases, percutaneous left or right axillary approach is an alternative to brachial approach. In this article, we report our multicenter experience involving 120 patients. The left axillary artery was used in 94 cases (78%) and the right in 26 cases (22%). We used performed coronary catheters usually associated with the femoral approach. The left axillary artery was used preferentially since this avoids catheterization of the innominated trunk and allows easier catheterization of the coronary ostia and aortic ends of aorto-coronary bypass grafts. The routine use of a sheath (arterial introducer) avoided arterial compression during catheterization, prevented hemorrhagic suffusion when the catheters were exchanged, and reduced the risk of thrombosis or laceration of the axillary artery. There were no failures in the catheterization of the axillary artery and no complication was observed during or after the procedure. Axillary percutaneous technique appears to have the following advantages over the brachial arteriotomy: 1) Investigation time is equivalent to the time needed for the femoral percutaneous approach. 2) There is the possibility of lateral and simultaneous bi-plane angiograms. 3) Arterial puncture is preferable to arteriotomy. The axillary approach could also be used for percutaneous transluminal coronary angioplasty.
Adult↗
Stage-related decrease in natural killer cell activity in untreated patients with mycosis fungoides.
Natural killer activity of peripheral blood mononuclear cells against the human cell line K 562 was evaluated in 11 patients with mycosis fungoides and simultaneously in 10 age- and sex-matched controls. In the patient group, nine had no previous treatment and in two topical therapy had been discontinued more than 3 months before. None had any associated disease or concurrent therapy that could interfere with the immune system. Patients with early disease showed a mean specific lysis and a range of individual data similar to the controls whereas patients with advanced disease had a significant defect of natural killer activity at effector: target ratios of 100 : 1, 50 : 1, and 25 : 1, as shown by the Mann-Whitney test. Preincubation of effector cells with alpha-interferon for 1 h in a single patient with low natural killing capacity led to a clear increase of the specific lysis, suggesting reduced functional activity rather than depletion of effector cells.
Adult↗
Induction in human skin fibroblasts of sister-chromatid exchanges (SCEs) by photoaddition of two new monofunctional pyridopsoralens in comparison to 3-carbethoxypsoralen and 8-methoxypsoralen.
The induction of SCEs in human fibroblasts by photoaddition of a pyrido[3,4-c]psoralen (PyPs) and its 7-methyl derivative (MePyPs), two newly synthesized monofunctional agents proposed for photochemotherapeutic use, was compared to that of another monofunctional agent, 3-carbethoxypsoralen (3-CPs) and to the bifunctional compound, 8-methoxypsoralen (8-MOP). The yield of SCEs/cell and of SCEs/chromosome was determined at equimolar concentrations (10(-6) M) of all the drugs with increasing doses of 365 nm radiation (UVA). In the dark, the drugs alone had either no effect (8-MOP, PyPs) or a very slight effect (3-CPs, MePyPs). Nor did UVA alone demonstrate at inducing action (14.4 kJ/m2). With all the agents the average frequencies of SCE increased with increasing UVA doses, reaching a plateau level for the monofunctional compounds. The order of effectiveness for the linear part of the induction curves was MePyPs greater than PyPs greater than 8-MOP much greater than 3-CPs, whereas at the maximal level the order was 8-MOP greater than PyPs greater than MePyPs greater than 3-CPs. Determination of the frequencies of 2nd generation mitosis indicates that MePyPs is the most cytotoxic. The results focus the attention on the importance of the structure of psoralen monoadducts which, for certain genetic endpoints, might be as efficient as cross-links.
Cells, Cultured↗