Biomedical subjects
Publications and source records attributed to D Berkowitz.
Actinomycosis is a rare infection which can attack most parts of the body, even in normal individuals. In the gastrointestinal tract it may imitate acute appendicitis, Crohn's disease or tumors. We present a young soldier with appendiceal involvement who was mistakenly operated on. Because of its very good response to antibiotics, this infection should be recognized early and treated, to prevent prolonged, unnecessary suffering.
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A study of the oxidation of prostacyclin and some of its analogs by three 15-hydroxyprostaglandin dehydrogenases was undertaken to determine the structural features of these compounds which might influence their rate of enzymatic inactivation. The effect of some structural changes seemed to be determined by the substrate specificity of individual enzymes. Other changes influenced the rate of oxidation by all three enzymes similarily. Among this latter group it was noted that a 15S hydroxyl group is necessary for oxidation to occur and that steric changes in the carboxy side chain and structural changes in the epoxy ring have a greater effect on the affinity of the substrate for the enzyme than on its maximum rate of oxidation. Certain analogs of prostacyclin are not substrates for one or more of the enzymes tested. Of these, (5S)-9-deoxy-5,9 alpha-epoxy-PGF1 and its methyl ester are potent inhibitors of only the placental enzyme---an interesting case of apparent selective metabolic regulation.
Studies on the substrate specificity, kcat/Km, and effect of inhibitors on the human placental NADP-linked 15-hydroxyprostaglandin dehydrogenase (9-ketoprostaglandin reductase) indicate that it is very similar to a human brain carbonyl reductase which also possesses 9-ketoprostaglandin reductase activity. These observations led to a comparison of three apparently homogeneous 15-hydroxyprostaglandin dehydrogenases with varying amounts of 9-ketoprostaglandin reductase activity: an NAD- and an NADP-linked enzyme from human placenta and an NADP-linked enzyme from rabbit kidney. All three enzymes are carbonyl reductases for certain non-prostaglandin compounds. The placental NAD-linked enzyme, which has no 9-ketoprostaglandin reductase activity, is the most specific of the three. Although it has carbonyl reductase activity, a comparison of the Km and kcat/Km for prostaglandin and non-prostaglandin substrates of this enzyme suggests that its most likely function is as a 15-hydroxyprostaglandin dehydrogenase. The results of similar comparisons imply that the other two enzymes may function as less specific carbonyl reductases.
Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of 99mTc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The 99mTc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.
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A prospective study of 12 patients with the diagnosis of polymyositis or dermatomyosiois was initiated to determine the characteristics of the esophageal manometric patterns in this group. All of the patients were women between the ages of 30 to 80 years and met three of four of Bohan's diagnostic criteria for these diseases. The patients' conditions were classified according to Rose and Walton's muscle weakness index. Almost two thirds of our patients exhibited distal esophageal dysfunction by manometry. Based on our roentgenographic and manometric data, we conclude that in addition to the well-described abnormalities in the striated portion of the esophagus, smooth-muscle dysfunction occurs with a high frequency in this patient population.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The total free fatty acids, blood glucose, and individual free fatty acids were studied in 8 patients with viral hepatitis and 13 with cirrhosis. The results were compared with those obtained in 9 normal control subjects. Free fatty acids were significantly elevated in liver patients as compared with normal controls. A fall in free fatty acids following ingestion of amino acids and dextrose was noted in normal subjects as well as liver patients. Glucose tolerance test, when done on patients with liver disease, was abnormal in most cases. Highly significant differences were found in the composition of individual free fatty acids in liver patients as compared with normal subjects. Arachidonic and linoleic acids were decreased, while monounsaturated and saturated fatty acids were increased in patients with viral hepatitis and cirrhosis. No significant changes were noted in the percent composition of individual free fatty acids following ingestion of amino acids and dextrose.
Radiation survival data of proteolytic (Walls 8G-F) and non-proteolytic (Eklund 83F) type F spores of Clostridium botulinum were compared with dose-response data of radiation-resistant type A (33A) and B (40B) spores. Strain Eklund 83F was as resistant as strain 33A, whereas strain Walls 8G-F was the most sensitive of the four strains tested. The methods suggested for computing both an initial shoulder and a D value for the dose-survival curves yielded results comparable to the graphic techniques used to obtain these two parameters.
A case of splenic invasion and rupture by a pancreatic pseudocyst is presented and previously documented cases are reviewed. The serious consequences of this complication are stressed. In the present case, splenic rupture occurred during clinical and radiological resolution of the pseudocyst.
Pseudomembraneous colitis has been increasingly observed after therapy with several antibiotics including ampicillin. This report describes the clinical and pathologic features of a patient who developed pseudomembraneous colitis while receiving ampicillin. The strikingly characteristic nature of these lesions is discussed and early diagnosis in the prevention of a potentially hazardous disorder is emphasized.