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Biomedical subjects

B Frank

Publications and source records attributed to B Frank.

At least 19 recordsLinked to original sources
PubMed1992

[Phantom perception and phantom pain].

"Phantom limb" is a well-known phenomenon following loss or amputation of a limb. The limb still seems to be present, although it is no longer there, but the sensation is not associated with pain. Less well-known are the phenomena of autosomatognosis and pain after the loss of other parts of the body such as the genital parts or after partial or complete deafferentiations as in a traumatic transverse syndrome, lesion of the brachial plexus, or lesions of the CNS. Although many hypotheses have been advanced to explain the pathophysiological mechanisms resulting in these phenomena, the pathogenetic fundamentals have not been properly clarified to date. That is also why manifold approaches have evolved to treat phantom limb pain. The authors survey the literature published so far on this subject and report on their own studies. This gives an overall view of the many aspects of autosomatognosis, phantom limb pain, hypotheses on pathophysiology, and the currently employed treatment strategies.

Afferent Pathways↗
PubMed1992

Renal cortical endosomes participate in the degradation of insulin.

It has long been thought that metabolism of insulin by kidney proximal tubule cells takes place only in lysosomes. But previous studies with the perfused rat kidney and a proximal tubule-like cultured kidney cell line suggested that insulin degradation occurred in a nonlysosomal compartment. In this study we show that endosomes isolated from rat kidney cortex degrade insulin and that this process is ATP and pH dependent.

Adenosine Triphosphate↗
PubMed1991

[An epidural spinal abscess with caudal symptoms as a complication of Crohn's disease].

Progressive symptoms of caudal compression (flaccid paraparesis, sensory disorders), accompanied by severe pain and fever, developed over a few days in a 26-year-old man with Crohn's disease for 11 years. Spinal computed tomography, performed under the diagnosis of herniated disc, revealed intraspinal soft tissue, as well as gas in the spinal canal (L2-S3) and the paravertebral muscles. This led to the diagnosis of acute epidural abscess and a laminectomy was performed (at L4-S2). Intraspinally there was thickened, bluish fatty tissue; thick pus exuded between dura and the sacral roots. Suction-irrigation of the spinal canal was undertaken via an epidural drain. Postoperative contrast infusion into the colon demonstrated a fistula directed towards the sacrum. The postoperative course was complicated by severe respiratory impairment of which the patient died.--Epidural abscess is a rare complication of Crohn's disease. Because of its poor prognosis early diagnosis with magnetic resonance imaging or computed tomography should be undertaken in every patient with Crohn's disease who has back pain, fever or, particularly, symptoms of spinal compression.

Abscess↗
PubMed1991

Street studies that work and what they show in New York City.

The New York State Division of Substance Abuse Services (DSAS) maintains a street research unit that monitors drug activity on the streets of New York City. The Street Research Unit consists of a supervisor and several carefully selected researchers who have had a history of drug abuse. The team includes males and females, and whites, blacks and Hispanics. Their supervisor has trained them in social science methods and ethnographic techniques. The researchers' own knowledge of street language and drug behavior has enabled them to capture information that would escape most observers and even some participants. Despite the risks involved, the Street Research Unit has become a vital and indispensable part of the research capability of the agency. There is no better way to gather current information on drug activity on the streets of New York City. The paper traces the history of the Unit, discusses some methods that are used, describes the studies that have been conducted, and summarizes what works, what does not work in this type of ethnography, and the plans for the future.

Data Collection↗
PubMed1990

Giant aneurysm causing frontal lobe syndrome.

A 67-year-old patient with a completely thrombosed giant aneurysm of the anterior communicating artery is described. The only neurological findings were a disturbance of stance and gait and slight bilateral grasp reflexes. He had had the features of a frontal lobe psychotic syndrome for more than 12 years. Computed tomography demonstrated a primarily hyperdense calcified suprasellar space-occupying lesion. Magnetic resonance imaging proved valuable in establishing the correct diagnosis, which was confirmed post mortem.

Aged↗
PubMed1990

Why do they fall? Monitoring risk factors in nursing homes.

A pilot study identified 40 falls involving 29 patients from incident reports in a nursing home. About one fourth of the fallers fell more than once and accounted for about one fourth of the falls. The majority of research studies on falls were conducted in hospital settings on a one-time basis. Studies are needed in nursing homes to monitor risk factors on a continuous basis to design remedial nursing interventions. Age, male gender, mental impairment, and short stay were risk factors identified in this study. The association of dementia with falls is especially significant because of the increasing numbers of dementia patients in nursing homes. This pinpoints the need for special surveillance of these patients.

Accidental Falls↗
PubMed1989

Insulin degradation products from perfused rat kidney.

The kidney is a major site for insulin metabolism, but the enzymes involved and the products generated have not been established. To examine the products, we have perfused rat kidneys with insulin specifically iodinated on either the A14 or the B26 tyrosine. Labeled material from both the perfusate and kidney extract was examined by Sephadex G50 and high-performance liquid chromatography (HPLC). In perfusate from a filtering kidney, 22% of the insulin-sized material was not intact insulin on HPLC. With the nonfiltering kidney, 10.6% was not intact insulin. Labeled material from HPLC was sulfitolyzed and reinjected on HPLC. By use of 125I-iodo(A14)-insulin, almost all the degradation products contained an intact A-chain. By use of 125I-iodo(B26)-insulin, several different B-chain-cleaved products were obtained. The material extracted from the perfused kidney was different from perfusate products but similar to intracellular products from hepatocytes, suggesting that cellular metabolism by kidney and liver are similar. The major intracellular product had characteristics consistent with a cleavage between the B16 and B17 amino acids. This product and several of the perfusate products are also produced by insulin protease suggesting that this enzyme is involved in the degradation of insulin by kidney.

Animals↗
PubMed1989

Basolateral and apical binding, internalization, and degradation of insulin by cultured kidney epithelial cells.

In vivo, filtered insulin is absorbed and degraded in proximal tubules after binding to the apical membrane. Peritubular removal also occurs and involves basolateral receptor binding and degradation. Whether basolateral degradation proceeds within the cell or on the cell surface is unknown. Because of the difficulties in addressing this question in vivo, this study was carried out with a cultured opossum kidney epithelium cell line with proximal-like features and insulin receptors. Cells were grown in partitioned wells on polycarbonate filters and, when confluent, the monolayer effectively separated the culture well into apical and basolateral compartments. Apical and basolateral binding, internalization, and degradation were studied separately by incubating monolayers with 125I-insulin added to either the apical or basal compartment. At 37 degrees C insulin associated with either pole in a time-dependent manner. This interaction was specific, for it was competitively inhibited by cold insulin but not by unrelated peptides. Separation of surface-bound from internalized insulin was achieved by lowering extracellular pH. At 4 degrees C, 92% of the radioactivity added to either side of the monolayer was surface-bound, whereas at 37 degrees C and after 1 h, 57% was surface-bound and 43% internalized. Affinity of apical and basolateral receptors were similar (1-2 nM), but basolateral receptor number was greater, for at high insulin concentrations (5 x 10(-8) M) basolateral membrane binding exceeded apical by fivefold (250 +/- 81 vs. 56 +/- 11 fm/10(6) cells). Degradation followed exposure to either pole of the cell.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1989

Experiences of phantom limb sensations in dreams.

Phantom limb sensations in the waking state and in dreams were examined in 84 limb-amputated patients. These phenomena were divided into complete, reduced, intermittent and nonexisting phantom limb. Common features as well as differences between the phantom limb in the waking state and in dreams were characterized and illustrated by casuistics and dream reports. Thus it was shown that nearly half the patients had the same, whereas the others had a different phantom limb in the waking state and in dreams.

Aged↗
PubMed1989

[Treatment of the dry eye with vitamin A acid--an impression cytology controlled study].

To test the efficacy of topically applied tretinoin eyedrops (0.01%, twice daily, in a solution of peanut oil) in the treatment of squamous metaplasia of the conjunctival epithelium associated with dry-eye, the authors evaluated the impression cytology (IPC) of a total of 31 patients. The cytological findings were classified into four different stages with an overall range from 0 to 9 points. The average period of treatment was 12 weeks. The patients were classified into three groups: (1) Those with mucin deficiency (Mucin less than - greater than; n = 19), (2) those with Keratoconjunctivitis sicca (KSC; n = 6), and (3) a control group in whom pure peanut oil was used (n = 6). The IPC showed a considerable improvement of squamous metaplasia in the mucin less than - greater than group, by an average of 4.3 points (from 6.2 points before treatment to 1.9 points). No changes were seen in the IPC of the KCS patients or the control group. The results of this study show a good effect of tretinoin eyedrops in patients with a significant decrease in or loss of goblet cells seen in the IPC, a decreased break-up time and with no severe aqueous deficiency of tear film. These patients seem to have a "primary" mucin deficiency induced by the decrease in or loss of goblet cells. There is no indication for tretinoin treatment in patients with aqueous deficiency involving major or accessory lacrimal glands. The results of other previous and recent studies on tretinoin treatment are discussed.

Adult↗
PubMed1988

Regression of oral hairy leukoplakia after orally administered acyclovir therapy.

To define the role of Epstein-Barr virus (EBV) in the pathogenesis of oral hairy leukoplakia, 13 human immunodeficiency virus-seropositive men with clinical and histologic evidence of oral hairy leukoplakia were enrolled in an open-label trial of orally administered acyclovir therapy (3.2 g/d for 20 days). Of six patients who received therapy, five exhibited clinical regression. Once therapy was discontinued, recurrences occurred in all responders. Among seven patients who refused therapy, no spontaneous remissions occurred. Before therapy, EBV replication within the leukoplakia was demonstrated by immunofluorescence tissue staining or electron microscopy in five patients who were studied. Human papillomavirus was not detected by immunocytochemistry or electron microscopy from tissue specimens of six patients. After therapy, biopsy specimens from two patients with complete responses revealed a normalization of histologic abnormalities and an inability to detect EBV in previously involved mucosa by immunofluorescence or in situ DNA hybridization assays. It was concluded that EBV replication within the epithelial cells of the tongue is necessary for the development of oral hairy leukoplakia.

Acyclovir↗
PubMed1988

Complex repetitive discharges in the iliopsoas muscle.

A prospective electromyographic investigation of lower limb muscles in patients with different neurogenic disorders showed that complex repetitive discharges (CRD) were observed predominantly and often only in the iliopsoas muscle. Analysis of the EMG findings in acute and chronic lesions shows that CRD are a feature of a chronic proximal motor axon lesion. Furthermore, the frequently focal occurrence of CRD in the iliopsoas muscle in clinically distal diabetic polyneuropathies suggests that this muscle and its nerves represent a locus minoris resistentiae.

Acute Disease↗
PubMed1988

Transcranial Doppler ultrasonography of carotid-basilar collateral circulation in subclavian steal.

The combination of a carotid-basilar and a vertebro-vertebral collateral circulation was verified directly in a patient with a complete subclavian steal by means of transcranial Doppler ultrasonography. The patient showed permanently reversed blood flow in the basilar artery. The subclavian steal influenced the hemodynamics of the circle of Willis at rest and during functional tests of the collaterally supplied arm. Our investigation provides the first direct experimental evidence of increased blood flow velocity in the carotid artery after decompressing the collaterally supplied arm.

Arm↗