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Biomedical subjects

Y Katz

Publications and source records attributed to Y Katz.

At least 19 recordsLinked to original sources

Distinction between processing of normal and mutant complement C3 within human skin fibroblasts.

Inherited C3 deficiency may result from mutations in the C3 gene affecting transcription or translation (type I deficiency). We described a type II C3 deficiency caused by a mutation yielding an abnormal non-secreted C3. The post-translational processing of mutant and normal C3 was analyzed in fibroblasts grown from skin biopsies. Mutant C3 is located mainly in the endoplasmic reticulum (ER), whereas normal C3 is seen evenly distributed throughout the cytoplasm. Most of the mutant C3 is degraded within the cell, and only a small fraction (around 8%) is secreted after 20 h chase. Processing of C3 at 19 degrees C was reduced in normal fibroblasts but completely blocked in mutant fibroblasts. ATP depletion blocked processing of normal proC3 to C3. In contrast, the mutant proC3 was partly degraded in ATP-depleted cells, yet its complete degradation and secretion were blocked. Intracellular degradation of the mutant C3 was not inhibited by NH4Cl, thus excluding cleavage within lysosomes. These results demonstrate that the type II mutant C3 studied here is retained in the ER probably by a quality contol machinery that identifies abnormal protein folding. Consequently, it is destined to undergo a two-step intracellular degradation; an initial ATP-independent step followed by an ATP-dependent step.

Cells, Cultured

Indoor survey of moulds and prevalence of mould atopy in Israel.

BACKGROUND: Moulds are ubiquitous indoor as well as outdoor allergens and therefore potential candidates for indoor environmental control measures. However, very few studies have been performed to examine the significance of indoor moulds in allergic diseases and the effectiveness of measures to reduce the quantity of indoor moulds has not been established. OBJECTIVE: To determine the significance and the contribution of moulds to allergic manifestations. METHODS: Prevalence of allergic rhinitis and asthma in 395 members of a rural community were examined by questionnaire and examination of medical files. The atopic status in general and allergy to moulds was determined by skin-prick tests (SPTs) to a panel of aeroallergens including Aspergillus, Penicillium, Alternaria and Cladosporium. A study of indoor mould levels was performed by placing SDA plates in 59 houses. The type of fungi and the number of colonies from each species were recorded. RESULTS: Forty-two subjects, comprising 10.9% of the study group had positive SPT to moulds, 61.9% of those were classified as symptomatic. When taking into account individuals with a borderline positive SPT to moulds, an additional 23 had positive results. Of the 65 mould-positive subjects, 48% were symptomatic and of the 13 who were allergic to moulds alone, only two had allergic symptoms. Viable moulds were recovered from all 59 houses examined. The most common isolated genus was Aspergillus, followed by Penicillium, Alternaria and Cladosporium. Aspergillus was also the most abundant mould in houses. There was no significant correlation between the abundance of moulds, positive SPT to that mould and symptomatology. CONCLUSIONS: Viable moulds are common in houses in temperate climates. Allergy to moulds itself has a low predictive value to development of allergic symptoms, but allergy to moulds in otherwise atopic subjects increases the risk of symptomatic allergic disease.

Adolescent

Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval.

Assisted reproduction may be associated with repeated occasions of surgical intervention. Propofol, which is frequently used for induction of anaesthesia in such procedures, has been suspected of damaging oocytes. We compared in a randomized prospective design the use of general anaesthesia with fentanyl 0.017 mg/kg, propofol 2.5 mg/kg and isoflurane to that of sedation with midazolam 0.06 mg/kg and ketamine 0.75 mg/kg for transvaginal oocyte retrieval in 50 patients with no premedication. Overall, patient satisfaction was not different between the groups. Sedated patients were more arousable than anaesthetized patients during the procedure and experienced less postoperative abdominal pain at 30 min. Despite some movement in response to pain, oocyte retrieval was conveniently feasible in all sedated patients, of which none required a switch to general anaesthesia. A comparable number of oocytes was retrieved per cycle, 10.8 (+/-7.8) versus 9.6 (+/-10.9) with sedation and anaesthesia respectively. No patient recalled any pain sensation during the procedure. The rate of embryo transfers and pregnancies were not different between the two groups. We conclude that the sedative combination of midazolam and ketamine for oocyte retrieval may serve as an alternative for general anaesthesia.

Adult

Hypocomplementemic autosomal recessive hemolytic uremic syndrome with decreased factor H.

We describe the clinical course, complement components, and pathological findings of 10 infants with autosomal recessive hemolytic uremic syndrome (HUS). All patients were members of one extended highly inbred Bedouin kindred. The median age of presentation was 2 weeks (range 1-20 weeks). Eight patients died, 2 patients are alive, on dialysis. Renal biopsies revealed thrombotic microangiopathy with a predominant early arteriolar involvement and subsequent development of ischemic glomerular changes. Immunofluorescence was positive for C3 in glomeruli. All patients had low complement components levels during and between relapses, and in some this was evident soon after birth and prior to the onset of symptoms. This deficiency could not be normalized by repeated plasma transfusions. Biosynthetic labelling of patients' fibroblasts demonstrated normal rates of C3 protein synthesis. Serum factor H levels were greatly decreased or absent in 4 patients tested and moderately decreased in 15 of 23 healthy unaffected siblings and patients. This defect may cause complement activation and consumption, possibly at the endothelial cell level.

Arabs

'Respiratory epilepsy'--does it exist?

Past literature suggests a possible relationship between two recurrent illnesses: bronchial asthma and epilepsy. Only one preliminary study, performed 30 years ago, demonstrated epileptiform EEG activity in patients with bronchial asthma who were treated successfully for their asthma with antiepileptic drugs. We demonstrated epileptiform activity in six out of 24 (25%) children with bronchial asthma who had no history of neurological illnesses or epilepsy, compared to one out of 24 (4.2%) children in the control group. This relatively high percentage of EEG abnormalities raises the possibility that there is a subgroup of patients with bronchial asthma, in whom the asthma might be considered as an 'epileptic equivalent'. These patients possibly deserve a different, unique therapeutic approach.

Adolescent

[Analgesia in breast surgery with interpleural bupivacaine].

A control group of 15 patients undergoing breast surgery was given general anesthesia. In 15 other patients an interpleural block with 0.4 ml/kg bupivacaine, 0.5%, was performed 20 minutes before induction of general anesthesia for pre-emptive analgesia. This was extended further by continuous administration of bupivacaine 0.25%, 0.125 ml/kg/hr by automatic infusion pump, with supplements of opiates for postoperative pain management. The combined technique was associated with significantly reduced perioperative opiate requirement with better emergence from anesthesia, fewer side effects, a prolonged pain-free period, and overall better quality of postoperative recovery.

Analgesia

[Separation of conjoined twins: the anesthesiologist's perspective].

Managing anesthesia care for separation of conjoined twins poses a special challenge for the anesthesia team. Early preparation, thorough understanding of the anatomical and the physiological consequences of this complex anomaly, as well as careful coordination with the teams of surgeons, nurses and operating room personnel are mandatory to assure successful separation of the conjoined twins. It is recommended that the mother be transferred to and the babies be delivered at a tertiary care medical center, like the Children's Hospital. Special attention is devoted during the surgical procedure to cardiovascular stability, drug disposition, fluid balance and temperature control. The multidisciplinary team approach makes this complex surgery a success. When postoperative survival cannot be guaranteed for both twins, close contact and consultation is mandated with the parents, medical personnel and religious and legal advisors.

Anesthesia

Interleukin-1beta levels in serum and cerebrospinal fluid of children with febrile seizures.

We compared interleukin-1beta (IL-1beta) levels in peripheral blood and cerebrospinal fluid (CSF) of children with febrile seizures with those of children with febrile illnesses without seizures (control). Twenty patients were included in the study, 10 with febrile seizures and 10 with febrile illness not complicated by seizures (control). Blood and CSF were obtained after the patients' admission to the hospital. IL-1beta levels were measured by a specific radioimmunoassay method. No significant differences were observed between mean IL-1beta levels in CSF (4.15 +/- 1.5 pg/ml) and blood (2.92 +/- 2.6 pg/ml) of the patients with febrile seizures group as compared with those in CSF (3.2 +/- 3.2 pg/ml) and blood (3.44 +/- 3.16 pg/ml) in the control group. These results do not support the hypothesis that increased production of IL-1beta or increased diffusion of IL-1beta through the blood-brain barrier is involved in the pathogenesis of febrile seizures in children.

Blood-Brain Barrier

A comparison between arterial- and venous-sampled activated clotting time measurements.

In order to compare activated clotting time (ACT) sampled from an arterial (heparin-flushed) line with the control, a venous (heparin-free) line, arterial and venous ACT values were assessed before and after cardiopulmonary bypass in 150 patients while undergoing open-heart surgery. ACT was measured by Hemochron 801 automatic analyzer. Baseline arterial ACT was significantly higher than baseline venous ACT (14%; p < 0.001, using one-way analysis of variance and Bonferroni multiple comparisons test). The differences between the values of arterial and venous ACT after protamine reversal, between arterial ACT at baseline and after protamine reversal, and between venous ACT at baseline and after protamine reversal were not statistically significant. We conclude that arterial-sampled ACT measurement is suitable and reliable for monitoring heparin reversal by protamine after cardiopulmonary bypass.

Adult

[Correlation between exposure to allergenic pollens and allergic manifestations].

Due to increase in allergic morbidity, better understanding of the relationships between environmental parameters and clinical responses of patients is needed. Serious analysis of such correlations requires examination of an entire population. So far there has been no study in Israel that examined an entire population in order to establish the distribution of inhalant allergens, the prevalence of skin hypersensitivity and allergic clinical morbidity. To examine these parameters we studied the population of Kibbutz Netzer Sereni, a rural community exposed to large amounts of various pollen allergens. Of the 505 members aged 4-70 years, 395 (78.2%) responded. Air sampling, once a month throughout the year, identified the most prevalent inhaled allergens and measured amounts. Allergic profiles were evaluated using prick tests with allergenic extracts, clinical questionnaires and medical records. The most prevalent allergenic pollens in the air were pecan, olive, cypress and palm trees, grasses and weeds such as English plantain, sagebrush, pigweed and lamb's quarters. Over 45% of 395 participants were atopic to 1 or more of the 27 allergenic extracts. The most prevalent causes of atopy were the house dust mite (28.9%), sagebrush (16.5%), grasses (18.2%), pecan (13.2%) and cypress (11.1%). Over 50% of atopic residents were symptomatic, while 22.9% of those non-atopic reported symptoms that could be attributed to allergy. This investigation provides solid data for the prevalence of atopy and allergy in the region of this kibbutz.

Adolescent

Left, but not right, one-lung ventilation causes hypoxemia during endoscopic transthoracic sympathectomy.

OBJECTIVE: To describe the respiratory and cardiovascular effects of one-lung ventilation, using a double-lumen tube, during endoscopic transthoracic sympathectomy. DESIGN: A prospective clinical study. SETTING: A university-affiliated medical center. PARTICIPANTS: Nineteen adult patients (10 men, 1 woman) between 16 and 35 years of age, ASA (American Society of Anesthesiologists) physical status I and II, participated in the study. INTERVENTIONS: Endoscopic transthoracic sympathectomy was performed under general anesthesia, using a double-lumen endobronchial tube, after induction of artificial pneumothorax plus insufflation of CO2 into the operated chest. Via radial artery cannulae, one to three arterial blood gas samples were taken during two-lung ventilation before surgery, at each one-lung ventilation, in most cases during the period of two-lung ventilation when switching between the operated sides, and after surgery. MEASUREMENTS AND MAIN RESULTS: Comparisons were performed using the Wilcoxon matched-pairs single-ranks test. Left-lung ventilation and right-chest operation caused profound decrease of arterial oxygen partial pressure (PaO2), compared with two-lung ventilation before surgery (70.7%, P > 0.0003) and compared with PaO2 at two-lung ventilation during and after surgery (decrease of 80.1% and 75.3%, respectively; P > 0.001 and < 0.005, respectively). Right-lung ventilation and left-chest operation did not cause hypoxemia. Arterial CO2 partial pressure, pH, and bicarbonate, as well as hemodynamic parameters, did not change from baseline values throughout surgery. CONCLUSIONS: Pulse oximetry and repeated blood gas measurements are needed during endoscopic transthoracic sympathectomy in order to detect and treat hypoxemic events, which may jeopardize the patient's life.

Adolescent