Biomedical subjects
Publications and source records attributed to Y Shoenfeld.
A relatively small decrease in intraocular pressure secondary to submaximal work can be demonstrated when factors other than the work load itself are eliminated--diurnal variation, body position, and the effect of repeated examinations. A feedback mechanism that causes a return of IOP towards its normal value after work-induced decreases is postulated.
Sixty volunteers, 33 males and 27 females (18-63 yr), were divided according to age and sex. They were exposed for 10 min to extreme dry heat: 80-90 degrees C dry bulb temperature and 3-4% relative humidity. Their rectal temperature, skin temperature at eight different points, weight, and heart rate were recorded prior to and immediately following the exposure. A mean rise of only 0.5 degrees C in rectal temperature was recorded following exposure as compared to a mean rise of 5.2 degrees C in mean weighted skin temperature (MWST). Female subjects showed a significantly higher rise in MWST than the male subjects. Similarly, a significantly higher rise in MWST was observed in elderly male subjects as compared to the youngest male group (P less than 0.05). The differences in MWST possibly resulted from differences in mean skin blood flow causing differences in skin conductance. Large individual variation in heat response was recorded in rectal temperature, as well as in weighted skin temperatures. The increase in skin temperature during the first 10 min of exposure to extreme dry heat may serve as an indicator for heat tolerance time, and may help predicting heatstroke susceptible individuals.
A patient with multiple myeloma in whom recurrent right pleural effusion was the presenting sign of the disease is reported. An IgA (k) monoclonal component was found in both the pleural effusion and the serum. The bone marrow specimen was interpreted as typical for multiple myeloma and the pleural fluid contained numerous plasma cells. Treatment with cyclophosphamide was followed by clinical improvement and the disappearance of the pleural effusion.
A male patient, operated for squamous cell carcinoma of the lung, in whom sarcoidosis was discovered in the resected lung specimen, is reported. The increased association of sarcoidosis along with malignant diseases is discussed, as well as the various mechanisms probably responsible for this association.
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Twenty-two patients, 18 years old, with the predominant somatic type of NCA, and a control group of 22 healthy subjects participated in a short term training course lasting three weeks. Following the training the NCA subjects showed a significant change in the systolic and diastolic blood pressure after 5 minutes of recumbency as well as in the systolic blood pressure after 5 minutes of standing, diastolic pressures during 50 W load and submaximal effort (100-150 W) - all the values being significantly lower following the training, except the diastolic pressure during 50 W load which was higher following the course. The prominent training effect was on the heart rate during light work loads (50 W) in which a decrease from a mean of 151.2 +/- 13.9 to 118.3 +/- 16.3 beats/min was recorded. This decrease indicates the better adaptation of the NCA patients to physical effort. Similarly, a significant increase in the mean VO2max from 31.5 +/- 6.1 to 37.7 +/- 5.9 ml O2/kg B.W./min was observed. No changes were recorded in the ECG after the short training course. Following the training all the symptoms typical of the NCA syndrome vanished. A short physical training of 3 weeks can start the procedure of rehabilitation of a well selected group of NCA patients with predominant somatic complaints. The rehabilitation must be continued throughout life by continued physical training.
Orthostatic examinations were performed with a tilt table on 64 male volunteers, of whom 21 had sustained amputation of one or both lower limbs and 23 were paraplegic due to spinal cord injuries (SCI), with 20 healthy subjects as controls. Following tilting, signs and symptoms of fainting appeared in five of the SCI subjects, four of whom had spinal injuries above the level of D5. These phenomena appeared in only two of the controls and in none of the amputees. The mean systolic and diastolic blood pressures of the amputees at rest and standing were higher than those recorded in the other two groups. The mean pulse pressures were lower in the amputees than in the other two groups. The changes in the systolic, diastolic, and pulse pressures were more profound in those subjects with high spinal cord injuries than in subjects with lower cord injuries. ECG changes and fainting were more frequent among the SCI subjects than in the other two groups.
Twenty young men marched 6 and 12 km with a well-fitted back-pack load of 30 or 35 kg. Each subject served as his own control. No significant increase in mean heart rate, rectal temperature, or decrease in mean VO2 max and serum levels of glucose and muscle enzymes were recorded in the groups marching 6 km with 30 and 35 kg. Significant differences in the increases in mean heart rate, the decreases in VO2 max and the changes in blood glucose were noted between the two groups carrying 30 and 35 kg for 12 km. These significant differences were also supported by the subjective feelings of the volunteers. The present study shows the optimal back-pack load for healthy young men, marching at 6 km/hr on a paved level road to be 30 kg for 12 km and 35 kg for 6 km without considering the task too difficult and with no significant decrease in VO2 max. The results are relevant to hiking, rescue assignments, and military missions.
Benign familial leukopenia was found in 75 of 200 healthy Yemenite Jews examined. The leukopenia was not a constant finding and was not associated with a tendency toward infection. HLA typing showed no significant differences in the frequency of the various HLA antigens between the subjects with and without leukopenia. No similarity was found between the HLA of the Yemenite Jews with leukopenia and that reported in black Africans with benign familial leukopenia. The suggestion of a genetic contribution from African blacks to Yemenite Jews is not supported by these results. The question remains to be answered whether the familial leukopenia in Yemenite Jews and black Africans is the result of a mutation.
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A 12-year-old boy suffered from recurrent respiratory infections, an immune deficiency characterized by the complete absence of IgG, IgA, IgD, and the salivary "secretory component" associated with a plasma cell dyscrasia. Rectal and kidney biopsy specimens showed amyloid deposits. Amyloidosis has been extensively studied by several groups of investigators in patients with plasma cell dyscrasia in general, and in patients with lambda-Bence Jones proteinuria in particular, but the finding of a monocional serum IgM-lambda component in an agammaglobulinemic child with Bence Jones proteinuria and amyloidosis represents a puzzling clinical syndrome. Searching for monoclonal components in patients with amyloidosis, even if they are agammaglobulinemic, is important. We also discuss here the "mixed type" of amyloid deposition and its relation to the recurrent infections and the plasma cell dyscrasia in this patient.
Generalized pruritus appeared 2 years following resection of an adenocarcinoma of the stomach. The appearance of the pruritus was the presenting symptom of recurrence of the malignant process in the stomach as well as of its metastatic spread to the liver and to the lungs.
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Maximal oxygen uptake (Vo2max) was estimated in 1,200 sedentary men aged 18 to 50 years and in 400 active athletes aged 18 to 30 years participating in 10 different kinds of sport. The Vo2 in the 18- to 30-year-old sedentary group was 34.3 +/- 9.7 (SD) ml - kg-1 - min-1, and in the 31- to 40- and 41- to 50-year age groups a similar value of 28.1 +/- 9.9 ml - kg-1 - min-1 was recorded. The results in the sedentary group were lower than those recorded in active populations in other countries by 20 to 40%, possibly due to lack of physical activity. The mean Vo2max in 400 active athletes was 54.8 +/- 10.0 ml - kg-1 - min-1, which is very similar to Vo2max values recorded in active populations in other countries. The difference between the mean Vo2max of the 18- to 30-year-old sedentary group and that of the active one was found to be signifcant (P less than 0.005). The highest mean Vo2max values among the athletes were recorded in the group of long-distance runners (60.8 ml - kg-1 - min-1) and cyclists (61.9 ml - min-1), while unexpectedly low mean Vo2max values were recorded in the group of swimmers (50.1 +/- 8.1 ml - kg-1 - min-1) and football players (51.7 +/- 9.1 ml - kg-1 - min-1).