Rectovaginal fistula associated with fecal impaction.
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Aged↗
Biomedical subjects
H Rabinowitz
Publications and source records attributed to H Rabinowitz.
Leukocyte alkaline phosphatase score in patients with cerebrovascular disease and in patients with primary and metastatic brain tumors.
Leukocyte alkaline phosphatase (LAP) activity in peripheral blood was determined in 54 patients with cerebrovascular disease (CVD), 11 patients with primary brain tumor, and 23 patients with metastatic brain tumor. The LAP score of the primary brain tumor patients (155 +/- 40) was significantly higher (P less than 0.03) than the LAP score for cerebrovascular disease patients (96 +/- 87). The LAP score levels of the metastatic brain tumor patients (251 +/- 55) was significantly higher as compared with both the cerebrovascular disease (P less than 0.001) and primary brain tumor groups (P less than 0.001). The LAP score could serve as an additional, although non-specific, marker to assist in the differentiation between cerebrovascular disease and brain tumors.
Adult↗
A unified theory of aging.
In the 1988 issue of this Journal, in the article: "Aging: Causes and control," 17 aging theories were presented. Those theories are now amplified, and an additional 7 theories are considered. Utilizing concepts from these theories, a unified theory of aging is then presented.
Adult↗
[Anaphylactic shock after i.v. verapamil].
A 61-year-old woman who was being treated with verapamil because of atrial fibrillation with rapid ventricular rate, went into anaphylactic shock. Verapamil is safe and effective for treating supraventricular tachyarrhythmias and serious adverse effects are uncommon. However, hypotension, cardiogenic shock, bradycardia and precipitation or aggravation of heart failure have been described. The patient presented was successfully treated with corticosteroids and antihistaminics.
Adrenal Cortex Hormones↗
The dexamethasone suppression test (1 mg and 2 mg) in major depression: illness versus recovery.
This study reexamined the 1 mg and 2 mg DST in endogenous depression. Two groups of depressives were evaluated during illness and shortly after clinical recovery; one group with the 2 mg DST (N = 29) and another with the 1 mg DST (N = 16). The 2 mg DST was found to be a reliable state marker: all nonsuppressors during illness (N = 9) became suppressors after recovery. In contrast, the 1 mg DST was not a useful state marker: over 50% of the nonsuppressors during illness remained nonsuppressors after clinical recovery. A discussion of these discrepant findings dependent on the dose of dexamethasone is presented. This study suggests that although most psychiatric investigations are utilizing the 1 mg DST, the 2 mg DST should be reexamined.
Depressive Disorder↗
Aplasia cutis congenita and intestinal lymphangiectasia. An unusual association.
Aplasia cutis congenita (ACC) is a rare skin defect usually localized to the vertex. It has been reported in association with other disorders involving mainly ectodermal and mesodermal structures. We discovered the association of ACC and intestinal lymphangiectasia (IL) in a patient and probably in his brother. At birth, the propositus had ACC of the vertex and edema, which persisted for six months. At 3 years of age he presented with generalized edema and was found to have hypoproteinemia and lymphopenia. Radioisotope studies and a small-intestinal biopsy confirmed the diagnosis of IL. On a fat-free, medium-chain triglyceride-containing diet, clinical and laboratory findings returned to normal. A sibling born one year after his brother's presentation had nonpitting limb edema and extensive ACC of the vertex with an underlying bony defect. He died in shock at 2 months of age, after sudden profuse bleeding from the sagittal sinus. The association between ACC and IL is another example of combined anomalies with both ectodermal and mesodermal involvement that is most probably not coincidental.
Child, Preschool↗
Iron overload of the liver in the baboon. An ultrastructural study.
Liver biopsies from 4 baboons taken during 15 months of iron-polymaltose injections, were compared with specimens from 2 controls. A morphometric method was used to assess ferritin concentration in various cells. Initially, ferritin and siderosomes were conspicuous in reticuloendothelial cells but rare in hepatocytes. Unusual findings included intranuclear ferritin and coalesced ferritin within bile canaliculi. With advancing overload, ferritin and hemosiderin increased not only in sinusoidal cells, but also in hepatocytes, with concomitant elevation of transaminases. The hepatocytes now showed evidence of damage and excessive collagen was present mainly around portal spaces. A year after cessation of iron injections, hepatocyte ultrastructure was near normal while sinusoidal cells were still heavily overloaded. The baboon appeared to be a useful model for the study of iron overload. Although in this study most of the damage was reversible, it is suspected that more prolonged overload, a different route of administration or other, more toxic iron compounds, may lead to cirrhosis similar to that of the iron-loading anemias.
Animals↗
Asteroid bodies--an ultrastructural study.
An ultrastructural study of asteroid bodies in a vitreous aspirate from a patient suffering visual loss as a result of asteroid hyalosis is presented. Under appropriate conditions of fixation and high resolution transmission electron microscopy, a lamellar arrangement with a periodicity of 4.6 nm was observed. This lamellar arrangement is typical of liquid crystalline phases of lipids in water. X-ray micro-analysis confirmed the presence of calcium and phosphorus in the asteroid bodies. We propose that the asteroid bodies are not true crystals but rather liquid crystals of phospholipids in the vitreous humor.
Aged↗
Severe pulmonary hypertension with patent ductus arteriosus.
A 36-year-old man was found to have severe pulmonary hypertension and a right-to-left shunt secondary to a patent ductus arteriosus. Attempt at surgical closure was unsuccessful. The patient was followed up for 21 years, and his only significant medical problem is leg weakness to moderate exertion.
Ductus Arteriosus, Patent↗
Ribulose Diphosphate Carboxylase from Autotrophic Euglena gracilis.
Ribulose 1,5-diphosphate carboxylase (RUDPcase) from autotrophically grown Euglena gracilis was purified to homogeneity as measured by analytical ultracentrifugation, polyacrylamide gel electrophoresis, and immunoprecipitation reactions. The enzyme represented about 9% of total protein and 24% of soluble protein in the autotrophic cell. Light-grown, heterotrophic cells seemed to contain considerably less RUDPcase. Native carboxylase from autotrophic Euglena showed an s(20, w) at low protein concentrations of 17 to 17.5, suggesting a molecular weight of >500,000 daltons. Upon denaturation, the enzyme dissociated into two subunits having different amino acid compositions and molecular weights of 59,000 and 12,000 daltons. Based upon the amino acid mass ratios, a quaternary organization of 7 to 8 large and 8 to 10 small subunits per native enzyme molecule was indicated.The phylogenetic relationship of carboxylase from Euglena and from three higher plants was investigated. In general, the size, subunit formation, and quaternary structure of RUDPcase from the various sources seemed to be similar. A partial immunochemical reaction between anti-RUDPcase serum from Euglena and the enzymes from lettuce, cucumber, and New Zealand spinach suggested that the algal and higher plant carboxylases were related but not identical. This was borne out by amino acid analyses which showed a close correspondence between the large, but not the small, subunits of Euglena and lettuce.
Journal Article↗
Health care plan decisions regarding preventive services.
BACKGROUND: Medical decisions previously made by physicians and patients are increasingly influenced by health plans. It is important to understand how these decisions are made and who makes them. OBJECTIVES: To determine protocols used by health plans for recommending preventive services and to identify methods used to develop these protocols. METHODS: An interviewer conducted semistructured telephone interviews with medical directors from 6 major types of health plans regarding coverage of certain procedural preventive services. Each medical director was asked: (1) Is this procedure paid for by the health plan? (2) What is the frequency recommended for this procedure? (3) What age groups do you recommend for this procedure? (4) Do you encourage patients to receive this procedure, and if so, how? (5) Who developed these preventive services recommendations? (6) How were these recommendations developed? RESULTS: Ten interviews were completed representing 6 chosen types of health plans. While the different plans varied little regarding the preventive services recommended, there was variation in efforts to promote recommended services to members. There were also differences among the plans in the decision-making process for developing preventive services recommendations. CONCLUSIONS: Managed care organizations promote certain preventive services to members. All health plans had at least 1 preventive medicine task force charged with making coverage decisions about preventive services. However, more could be done to rationalize development of preventive services recommendations, primarily, implementation of evidence-based guidelines.
Adult↗
Recruitment and retention of rural physicians: how much progress have we made?
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Health Services Accessibility↗