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Biomedical subjects

D Rubenstein

Publications and source records attributed to D Rubenstein.

At least 19 recordsLinked to original sources
PubMed1991

Antigen detection in pneumococcal pneumonia.

Streptococcus pneumoniae remains the commonest proven cause of community-acquired pneumonia in patients admitted to hospital, but no currently available diagnostic method can be regarded as a gold standard. Microscopy of sputum is usually considered insensitive and poorly specific, and more invasively-obtained specimens are not routinely collected. Cultures of blood and respiratory secretions, and countercurrent immunoelectrophoresis (CIE) and particle agglutination-based assays for capsular polysaccharides in serum and urine specimens, are specific but less than ideally sensitive. Some workers have reported specificity problems when immunoassays are applied to respiratory secretions. New diagnostic methods include detection of pneumococcal C polysaccharide in sputum and urine by ELISA and particle-agglutination assays, and these appear promisingly sensitive and specific in preliminary studies. Clinical assessments are now required to define the role of these techniques in guiding the treatment of individual patients.

Adult↗
PubMed1991

Aplasia cutis congenita associated with syndactyly and supernumerary nipples: report of a second family with similar clinical findings.

Aplasia cutis congenita (ACC) is a rare disorder characterized by localized absence of skin at birth. A subtype consisting of a solitary scalp defect in association with limb abnormalities has been described. We report a case of ACC in association with 3,4 syndactyly and supernumerary nipples with an apparent autosomal dominant inheritance pattern.

Abnormalities, Multiple↗
PubMed1991

Streptococci from primary isolation plates grouped by reverse passive haemagglutination.

Reverse passive haemagglutination, a novel microtitre based assay, was compared with the Streptex (Wellcome UK) latex slide agglutination kit for streptococcal grouping in a diagnostic microbiology laboratory. Three hundred and fifty two extracts from 349 consecutive primary isolation plates were assayed by both methods. Reverse passive haemagglutination gave identical grouping results for 98.0% of the 345 streptococci identified by Streptex, and the kappa coefficient of agreement between the methods for all 352 extracts tested was 0.973. Cross reactions with Listeria spp seen with Streptex were not found by reverse passive haemagglutination. In the reverse passive haemagglutination method 11 streptococci could be grouped on each 96-well plate and most reactions were stable for at least 30 minutes. Reverse passive haemagglutination is more rapid to perform than latex slide agglutination when many organisms are to be grouped, and the patterns of haemagglutination are easily recognised. If the method was taken into routine use in a diagnostic laboratory, the persistence of reverse passive haemagglutination reactions would enable grouping results to be checked for quality control purposes.

Genitalia↗
PubMed1991

Exfoliative dermatitis secondary to tobramycin sulfate.

We report a case of exfoliative dermatitis clearly linked to intravenous and intraperitoneal administration of tobramycin. Despite the complicated drug regimen with which the patient was treated, tobramycin was implicated by rechallenge with the drug once before its role was understood and again at an outside hospital.

Drug Eruptions↗
PubMed1988

Mother-daughter in vitro fertilization triplet surrogate pregnancy.

A successful triplet pregnancy has been established in a surrogate gestational mother following the transfer of five embryos fertilized in vitro. The oocytes were donated by her biological daughter, and the sperm obtained from the daughter's husband. The daughter's infertility followed a total abdominal hysterectomy performed for a postpartum hemorrhage as a result of a placenta accreta. Synchronization of both their menstrual cycles was obtained using oral contraceptive suppression for 2 months, followed by stimulation of both the surrogate gestational mother and her daughter such that embryo transfer would occur at least 48 hr after the surrogate gestational mother's own ovulation. This case raises a number of medical, social, psychological, and ethical issues.

Adult↗
PubMed1988

The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage.

The Segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia just distal to the plateau. It results from excessive internal rotation and varus stress. The plain film and arthrographic findings were studied in nine patients with the fracture. Although previous publications have relied primarily on the anteroposterior projection for diagnosis, the injury was apparent only on the tunnel view in two of our cases. The arthrogram was particularly important in identifying abnormalities of the anterior cruciate ligament (nine of nine cases) and/or meniscal tears (six of nine cases). The arthrographic findings related to the lateral ligamentous damage depended on the severity of the injury and on the interval between the injury and the arthrogram. In our series, the Segond fracture was uniformly associated with detachment of the capsular portion of the lateral collateral ligament and tears of the anterior cruciate ligament. In the majority of cases, there were associated injuries of the menisci and other supporting ligaments.

Adolescent↗
PubMed1987

Multiple cutaneous granular cell tumors in children.

Multiple cutaneous granular cell tumors are rare in childhood. We cared for two children with 15 and 6 tumors respectively. The tumors were asymptomatic nodules in the skin. Histologically, they consisted of large cells containing granules that were positive on periodic acid-Schiff stain and diastase resistant.

Child↗
PubMed1985

Effects of tumor promoters on sodium ion transport across frog skin.

Phorbol esters are tumor promoters and mitogens whose effects may be mediated by changes in ion transport across membranes. Clarification of the transport effects of these agents should be facilitated by using a well-characterized model epithelial system whose intracellular and transmural parameters are readily measurable. The current results constitute a preliminary study of the effects of 12-O-tetradecanoylphorbol-13-acetate (TPA), phorbol-12,13-dibutyrate (PDBU), and phorbol on the short-circuit current (Isc) across frog skin. TPA produced two effects: a stimulation of Isc of variable magnitude and a far more constant inhibition of the natriferic action of vasopressin. These effects appear related to the action of TPA as a tumor promoter insofar as PDBU (an active ester) also inhibited the natriferic response to vasopressin, whereas phorbol (inactive as a tumor promoter) had no significant effect. TPA is largely active from the mucosal medium, inhibits the natriferic response to adenosine 3',5'-cyclic monophosphate (cAMP) as well as that to vasopressin, and does not stimulate Isc in the presence of 10(-4) M mucosal amiloride. Inhibition of prostaglandin E1 production by indomethacin had no effect on the actions of TPA. The results indicate that frog skin is a promising model for studying the transport effects of the phorbol esters. The data further suggest that TPA acts on frog skin by activating the physiological amiloride- and cAMP-sensitive channels gating apical Na+ entry from the mucosal medium into the epithelial cells.

Amiloride↗
PubMed1979

Secretion of cholesterol-rich lipoproteins by perfused livers of hypercholesterolemic rats.

Rats maintained on a high-fat diet supplemented with propylthiouracil develop a hypercholesterolemia, an increased serum level of apolipoprotein (apo) E, abnormal very low density lipoproteins (VLDL) and low density lipoproteins (LDL), and a fatty liver which contains cholesterol ester as its major lipid. The fatty liver secretes apoE into a recirculating perfusate at a significantly higher rate and produces cholesterol ester-rich, apoC-deficient VLDL with slower electrophoretic mobility than the triacylglycerol-rich VLDL produced by perfused normal livers. LDL, secreted in significant quantities by the perfused fatty liver, but not by the normal liver, is also cholesterol rich and contains apoE as well as apoB. The incorporation of [(3)H]leucine into apoVLDL and apoLDL secreted by the livers of the hypercholesterolemic animals and the apoVLDL secreted by the normal liver corresponds to the pattern visualized when the apoproteins are separated by polyacrylamide gel electrophoresis. Similar patterns are noted when non-recirculating perfusates are studied. These results indicate that the cholesterol ester-rich, apoC-deficient VLDL and the apoE-containing LDL found in the serum of hypercholesterolemic rats are not solely catabolic remnants of VLDL and chylomicrons but are secreted by the liver. Separation of the perfusate lipoproteins by agarose gel filtration revealed that most of the apoE secreted by the livers of hypercholesterolemic rats is found in the VLDL and LDL, whereas apoE secreted by the normal livers is distributed equally between VLDL, high density lipoproteins, and a low molecular weight fraction which corresponds to the virtually delipidated apoprotein. Thus the distribution of apoE among the lipoprotein fractions may be related to the total amount of cholesterol being transported in the circulation.

Animals↗
PubMed1978

Initial splanchnic extraction of ingested glucose in normal man.

Estimates of initial splanchnic uptake of ingested glucose and the concomitant suppression of endogenous glucose production were obtained in man by validated tracer techniques for non--steady-state turnover measurement. Nine normal volunteers (18--44 yr old) fasted overnight received intravenous infusions of tracer (3-3H-glucose or 1-14C-glucose) and a low (45 +/- 1 g) or high (96 +/- 5 g) oral load of glucose labeled with an alternative tracer (1-14C-glucose or 2-2H-glucose). A two-compartment model was used to derive rates of peripheral appearance (Ra) of glucose from all sources (total) and the Ra of ingested glucose. Ra (total glucose) and Ra (ingested glucose) were integrated from the first appearance of ingested glucose until the basal Ra (total glucose) or 116 +/- 6 (SEM) mg/min was reattained. The total amount of glucose reaching the systemic pool in this time was 95 +/- 4 g and 46 +/- 3 g with high and low doses, respectively. Of these quantities 86 +/- 4 g and 40 +/- 3 g originated in the oral glucose, representing 90% +/- 4% of the administered glucose. The remainder (11% +/- 2% of the total) represented endogenous production, suppressed by 66% +/- 6% relative to basal. Sequestration of ingested glucose and subsequent release did not take place during the study since identical results were obtained with ingested 1-14C-glucose or 2-3H-glucose. The latter label would have been lost if the glucose had entered the hexose--phosphate pool. Thus, in normal man approximately 90% of an ingested glucose load is absorbed and passes through the liver to appear in the systemic pool.

Absorption↗
PubMed1978

The Gianotti-Crosti syndrome.

The Gianotti-Crosti syndrome is an infrequently recognized disorder with distinctive characteristics. The eruption, which lasts for two to eight weeks, consists of large, flat-topped, nonpruritic papules on the face, buttocks, and limbs. Its onset may be preceded by fever and upper respiratory tract symptoms. Associated findings include generalized lymphadenopathy, anicteric hepatitis, and HBs antigenemia. Two children with the syndrome are described to bring this entity to the attention of pediatricians.

Acrodermatitis↗
PubMed1978

Triad of lichen planus, myasthenia gravis, and thymoma.

Myasthenia gravis in a woman was followed by the development of severe erosive lichen planus and thymoma. Lichen planus is not ordinarily associated with other cutaneous or systemic disorders. The reported immunologic findings in some patients with lichen planus and especially the occasional association of lichen planus with certain disorders linked with immunologic disturbances suggest an autoimmune pathogenesis for this disorder.

Female↗