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Biomedical subjects

Y Weiss

Publications and source records attributed to Y Weiss.

90 records · Page 5Linked to original sources
PubMedDate not supplied

High levels of maternal serum human chorionic gonadotropin in Down syndrome pregnancies: the possible role of a transcription factor on chromosome 21.

Increased levels of human chorionic gonadotropin (hCG) are used as markers for Down syndrome (DS) screening of low-risk populations. The pathophysiology for increased hCG levels remains unknown. In general, hCG synthesis is limited by the rate of beta-chain formation. In the placenta, 2 of a total of 6 hCG beta-genes are expressed. We hypothesized that in DS, a transcriptional factor may upregulate beta-chain transcription by interacting with the beta5-promoter. Primary cell cultures of skin fibroblasts from both normal and DS midtrimester fetuses were established and transfected with the beta5-promoter linked to the chloramphenicol-acetyl-transferase reporter gene. The chloramphenicol-acetyl-transferase activity was measured. Three of six DS-derived cell cultures showed a three-fold increase in acetylation. The increase in hCG promoter activity in DS-derived fibroblasts suggests a possible role for a transcriptional factor located on the human chromosome 21 by either directly or indirectly interacting with the beta5-promoter.

Biomarkers↗
PubMedDate not supplied

Simplified management of operative wounds by early exposure.

Of a total of 3,674 surgical wounds, 2,525 were treated by the early exposure method, i.e. the wounds were left undressed from the first postoperative day. The incidence of wound infection was 1.7% in clean wounds and 7.9% in clean-contaminated wounds. The acceptance of the method by the patients was evaluated by questionnaire on a random sample of 100 patients. The response was overwhelmingly in favor of the method. It is submitted that the usually postulated indications for dressings (protection, prevention of contamination, absorption, compression and stabilization/immobilization) do not obtain after the first 24 postoperative hours. The hospitalized patient is not exposed to trauma, the risk of contamination is low, body hygiene can be resumed earlier and the need for pressure-dressings or splinting is negligible in general surgery. Dressings are expensive, time-consuming, often interfere with breathing and cause discomfort. They are unnecessary on a clean wound after 24 hours.

Bandages↗
PubMedDate not supplied

Delayed closure in the management of the contaminated wound.

Postoperative wound infection is still a major problem in contaminated wounds, with reported incidences as high as 30% and more. During a period of five years, 272 wounds were managed by open care and delayed closure. The overall wound infection rate was 4%, 5.1% in "contaminated" and 3.2% in "dirty" wounds. The incidence of wound dehiscence was 1.5%, but there were no other significant wound complications. Hospital stay was not prolonged, the patients accepted the method well and the work-load of the staff was not unduly increased. In view of the impressive reduction in infection rates the author recommends the open care/delayed closure method for potentially contaminated wounds.

Humans↗
PubMedDate not supplied

"Delayed rupture of the spleen" or delayed diagnosis of the splenic injury?

Splenic rupture is the most frequent intraabdominal injury following blunt abdominal trauma. Massive hemorrhage commonly occurs from injuries to this friable vascular organ. The mortality rate from simple splenic rupture is 1%. Delayed diagnosis of a ruptured spleen increases the rate to 10%. During 1964-79, 293 patients underwent splenectomy for blunt splenic injury, of whom 278 were operated on within 24 h. All had typical signs of splenic lacerations with intraperitoneal bleeding from the time of injury. Fifteen patients were operated on more than 48 h after sustaining the injury. A detailed analysis of these 15 patients revealed that in only three did the evidence support delayed hemorrhage following traumatic rupture of the spleen. In the other 12 patients, there was a delay in recognition of the intraabdominal injury, almost entirely the result of "diagnostic error." Careful clinical inquiry and peritoneal lavage are the mainstays of early diagnosis and therapy and should help to eliminate any delay in the diagnosis of a ruptured spleen.

Adolescent↗