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Biomedical subjects

H Rothstein

Publications and source records attributed to H Rothstein.

At least 19 recordsLinked to original sources

[Rupture of hepatic echinococcal cyst by minimal blunt abdominal trauma].

Hepatic echinococcosis is endemic in Israel, with about 90 new cases diagnosed each year. Although many are asymptomatic for years, 40% develop complications. We describe a man of 37 and women aged 22 and 35, respectively, in whom rupture of an echinococcal cyst followed minimal, blunt abdominal trauma. In each patient the rupture led to complications consisting of massive intra-abdominal bleeding in 1, diffuse peritonitis in another and cystocutaneous fistula with ureteral obstruction due to reactive retroperitoneal fibrosis in the third. All 3 underwent surgery to resolve the immediate complication, with no mortality. A striking feature was the disproportion between the stormy clinical presentation and the relatively innocent nature of the trauma. In only 1 of our cases was the correct preoperative diagnosis made, which in this condition depends primarily on a high index of suspicion.

Abdominal Injuries

Unilateral ureteral obstruction secondary to rupture of liver echinococcal cyst.

We report a case of ureteral obstruction by reactive retroperitoneal fibrosis secondary to rupture of a liver echinococcal cyst after minimal blunt flank trauma. The patient presented initially with a cyst-cutaneous fistula and was treated with mebendazole, since surgery was refused. Unilateral ureteral obstruction due to reactive dense retroperitoneal fibrosis developed 2 years later, which presumably was initiated by intense inflammatory reaction to the cyst content. Diagnosis was established by excretory urography, ultrasonography and computerized tomography, and was histologically confirmed. Hydronephrosis and hydroureter resolved following ureterolysis. This complication is anticipated to be encountered more frequently with the use of the new potent anthelmintic agents, which may successfully prevent daughter cyst formation but fail to abolish reactive retroperitonitis.

Aged

Acute symptomatic hernia.

Acute symptomatic hernia is a clinical entity characterized by the coexistence of acute incarceration of an abdominal wall hernia together with an acute abdominal disease. Thirteen such cases are described. Increased awareness of this entity, both pre- and intraoperatively, is probably the basis for the improved rate of correct diagnosis (60%) and the decreased mortality (7%).

Adolescent

Stationary radiation cataracts: an animal model.

The restitution of normal fibergenesis that occurs in stationary radiation cataracts provides a unique opportunity to study the cytopathomechanism of radiocataractogenesis. Previous attempts at investigating this phenomenon have been limited by the lack of an appropriate animal model. This report describes the induction of stationary radiation cataracts in postmetamorphic bullfrogs following ocular irradiation with a 10 Gy (1 Gy = 100 rads) dose of X-rays. The eyes of non-irradiated animals and animals irradiated with 25 Gy (an established dose known to induce progressive cataracts in frogs) served as controls. Animals were followed biomicroscopically and histopathologically over 79 weeks. As previously described, the cataracts developed in a dose-dependent manner. The 25 Gy irradiated lenses rapidly progressed to complete opacification (4+) by 26 weeks, while lenses exposed to 10 Gy advanced to the 2.5+ stage by 35 weeks and progressed no further. In the lower dose lenses, transparent cortex began to appear anteriorly and posteriorly between the capsule and opaque fibers at 45 weeks. As the clear fibers accumulated, the disrupted region came to occupy increasingly deeper cortex. Histologically, opacities in both groups were preceded by disorganization of the bow cytoarchitecture, meridional row disorganization, and the appearance in the lens epithelium of nuclear polymorphism, fragmented nuclei, micronuclei, clusters of nuclei, and abnormal mitotic figures. In the lenses exposed to the 25 Gy dose, this damage continued to worsen, so that the 4+ stage was characterized by extensive epithelial cell death, absence of the lens bow, degenerated fiber masses, and liquefied substrata. In contrast, prior to the appearance of transparent cortex in the 10 Gy group, the lens epithelial aberrations, are of the bow, and meridional row disorganization were all observed to improve. Further, by 69 weeks, the lens epithelium appeared as a largely homogeneous population, and the meridional rows and the are of the bow had become reestablished. The details of these observations and their possible relationship to the cytopathomechanism of radiation cataract formation are discussed.

Animals

A comparison of growth regulation of mammalian with amphibian lens epithelium.

In frogs hypophysectomy causes cell proliferation in lens epithelium to subside entirely, with better than 95% of the cells arresting in G1. The phenomenon has been traced to the action of insulin-like growth factors (IGFs) whose synthesis depends on anterior pituitary hormones, most notably GH. Both GH and purified somatomedin C can reinitiate mitosis in the lenses of hypophysectomized frogs. The present studies were done to determine if growth of rat lenses is controlled as is that of amphibia. It appears this may not be so because hypophysectomy has no effect on division in the rodent system. Protein calorie malnutrition (PCM) reduced the mitotic index and this effect is much enhanced by pituitary ablation. Of interest too, were the observations that the glucocorticoid, dexamethansone, is inhibitory in frog; the effect in rat is uncertain. Injection of bovine pituitary powder has no influence on rat while stimulating the amphibian material. It is therefore possible to modify growth of rat lens epithelium in vivo but the regulating mechanism(s) appears to be distinct from that operating in frogs. Whether the difference(s) is inherent in the cells themselves or is to be sought in the access routes through which they are reached by blood borne factors (e.g. permeability of blood-aqueous barriers) is, at present, unclear.

Animals

The use of laser in rectal surgery.

Ten patients with rectal tumors were treated by surgical excision of the tumor using a CO2 laser Sharplan 733 CO2 laser, Laser Industries Ltd., Israel. The laser permitted sharp excision, evaporization, or fulguration of tissue. Good hemostasis was achieved. Anesthesia was unnecessary in cooperative, calm patients. There was no mortality or morbidity related to the procedure. In five patients with villous adenoma the tumor was resected with one recurrence as yet (followup 4-16 months). Five patients with inoperable carcinoma were treated for palliation with good results. Our preliminary results indicate that the CO2 laser can be a useful asset in rectal tumor surgery, especially in elderly, moribund patients and in the definite treatment of benign tumors of the rectum.

Adenocarcinoma

Complete elimination of mitosis and DNA synthesis in the lens of the hypophysectomized frog: effects on cell migration and fiber growth.

Three weeks after hypophysectomy mitosis and DNA synthesis are absent in the lens of the leopard frog (Rana iiens). By labeling germinative zone cells in their last DNA synthetic period we were able to follow them in the absence of further proliferation. By this means it has been demonstrated that migration of epithelial cells to the equator of the lens is stopped. Based on indirect measurements it seems that lens fiber formation also ceases. A correlation coefficient of 0.86 was computed between average labeling index and average distance migrated. In hypophysectomized animals the correlation coefficient between time and migration was 0.02 while in intact animals it is 0.87.

Animals

Total disappearance of cell proliferation in the lens of a hypophysectomized animal: in vivo and in vitro maintenance of inhibition with reversal by pituitary factors.

Cell cycle kinetics of lens epithelium were studied in frogs following hypophysectomy, and subsequent replacement therapy with bovine growth hormone (bGH). Hypophysectomy led to a complete absence of cells in DNA synthesis and mitosis within 4 weeks. A small number of G2 nuclei was present in all preparations, but the number was much reduced with time after surgery. Occasional preparations with a significant G2 population were encountered. The major block to cycle traverse appeared to be in the G0-G1 segment. Mechanical injury to the lenses of hypophysectomized animals caused the cells to move closer to S without, however, reaching it. The in vivo block to cycle traverse persisted in organ-cultured lenses maintained in medium containing serum of hypophysectomized animals. The block to cycle traverse was reversed when the lenses were cultured in medium containing the serum of hypophysectomized animals that received replacement therapy with bGH. The serum became effective between 1 and 2 days after the star of replacement therapy. The lens epithelial cells from hypophysectomized frogs incur a deficit such that a protracted prereplicative phase is detected when favourable growth conditions are restored.

Animals

Mitotic variations in the lens epithelium of the frog IV. Studies with isolated anuran pituitary factors.

Proteins corresponding to growth hormone and prolactin have been electrophoretically separated from the pituitary gland of the frog (Rana pipiens berlandieri and Rana catesbeiana). These substances can independently stimulate mitosis in the lenses of animals where it had previously been inhibited by means of hypophysectomy. DNA synthesis is greatly augmented six days after the start of hormone administration to intact animals. Nine days are required before this occurs in hypophysectomized ones. No other anterior pituitary hormone has been found to achieve the effect described. Initial attempts at amino acid analysis, though incomplete, indicate that the two frog hormones are different from each other as well as from their bovine counterparts. Pituitary factors do not affect mitotic activity in either corneal epi or endothelium of the frog.

Amino Acid Sequence

Seasonal variations in mitosis in the frog: a field study.

Field studies have shown that there is a seasonal variation in mitosis of lens and corneal epithelium (high in May and June, low during the rest of the year). This phenomenon can be reproduced in the laboratory by temperature manipulation. The response in the lens depends on the presence of the pituitary gland while the corneal one seems to be independent of it.

Animals

Congenital cataracts associated with disorganized meridional rows in a new laboratory animal: the degu (Octodon degus).

A new laboratory animal, Octodon degus, a hystricomorph rodent, was found to display a naturally occurring congenital cataract. Histological examination of the lens epithelium revealed that a marked disorganization of the meridional rows is associated with the opacity. Studies of offspring of cataractous parents indicates that the disorganization precedes cataract appearance. These findings are discussed in reference to a general theory of meridional row involvement in a number of types of cataracts.

Animals