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Biomedical subjects

H Zuckerman

Publications and source records attributed to H Zuckerman.

At least 19 recordsLinked to original sources

The proliferation of prizes: Nobel complements and Nobel surrogates in the reward system of science.

In the last two decades, prizes in the sciences have proliferated and, in particular, rich prizes with large honoraria. These developments raise several questions: Why have rich prizes proliferated? Have they greatly changed the reward system of science? What effects will such prizes have on scientists and on science? The proliferation of such prizes derives from marked limitations on the numbers and types of scientists eligible for Nobel prizes and consequent increases in the number of uncrowned laureate-equivalents. These would-be surrogates for Nobel prizes extend the reward system of science in its upper reaches but this change is not fundamental. The spread of rich prizes to new fields provides added incentives to potential winners, which has its own disutilities; it reinforces competitiveness, concern for priority and attendant secrecy, all this amplifying ambivalence toward the reward system in science. There may also be modest positive effects of such new awards in the form of heightened popular esteem for science and interest in it.

Awards and Prizes

Breast stimulation in late pregnancy. Effect on prostaglandin secretion.

The effect of breast stimulation on the prostaglandin secretion was tested in 13 patients at 38-40 weeks of gestation. Uterine contractions following breast stimulation were documented in all cases. There was an increase in prostaglandin metabolite levels 10 min after breast stimulation.

Breast

Medically significant concentrations of prostate-specific antigen in serum assessed.

We used the method of Rudolph et al. (Clin Chem 1988; 34:2031-8) to find information in the data from correlated determinations of acid phosphatase (PAP, EC 3.1.3.2; DuPont aca) and prostate-specific antigen (PSA, Hybritech). We described there how we assign medical decision limits for two or more correlated variables and convert the database to a binary coded message, allowing separation of a selected disease class with minimum error. The decision point, analogous to a percentile upper limit on the ordered values of each variable in the reference group, satisfies the maximum entropy constraints of reference, producing a minimum entropy for the binary coded patient database. We found maximum entropy decision points at PAP = 0.75 U/L and PSA = 22.8 micrograms/L. Patients with PSA values exceeding 22.8 micrograms/L had no benign prostatic disease except for five patients with benign prostate hyperplasia (BPH) with adjacent colon carcinoma (95.3), BPH with infarction (27.6), BPH (23.4) 28.1), or acute prostatitis (34.6). We consider PSA exceeding 22.8 micrograms/L as indicative of carcinoma of the prostate, stage C or D, in the absence of disconfirming evidence. Another decision value for PSA is 11.3 micrograms/L. This bounds the region between 11.3 and 22.8 micrograms/L, where the frequency of BPH is 1.5 times that for adenocarcinoma. At PSA less than 11.3 micrograms/L there is a high frequency of BPH. PSA concentration is not correlated with prostatic size (mass) or with prostatitis. A metastatic carcinoma is as likely to be nonprostatic as prostatic when the PSA concentration is less than 11.3 micrograms/L.

Acid Phosphatase

Reliability of sonographic measurement of the fetal foot.

Reliability of sonographic measurement of the fetal foot was tested. Nineteen fetuses of 16 to 40 weeks gestational age were scanned by two physicians in two different planes of measurements. Repeatability of two measurements of each fetus by the same observer and agreement between the two planes was analyzed using the appropriate statistical method. Good agreement in repeated measurements for and between the two planes was found.

Embryonic and Fetal Development

Fetal habituation to repeated sound stimulation.

Habituation is the progressive decrement of response with repeated stimulation. Neonatologists use this phenomenon to assess newborns for various pathological conditions of the CNS. The present study examined the time required for habituation of the startle response in 103 fetuses at various gestational ages (32 to 40 weeks). The external stimulus was produced by a door buzzer (80 to 90 db). Habituation time decreased as gestational age increased. About 85% of the fetuses showed habituation after less than 20 stimuli, and about 95% after less than 30 stimuli. In all cases habituation time never exceeded 50 stimuli.

Acoustic Stimulation

Intracervical administration of prostaglandin E2-gel prior to therapeutic abortion: a prospective randomized double-blind study.

Forty primigravid women due to undergo first trimester termination of pregnancy were randomly selected for intracervical application of 1 mg prostaglandin E2 in gel or gel only as placebo. In the PGE2-gel group, a marked dilatation of the cervical canal was obtained, with post-gel treatment mean Hegar dilatation of 11.18 mm in that group, compared to 4.4 mm in the control group (P 0.001). Moreover, 16 (80%) patients in the PGE2-gel group had a complete abortion, one (5%) patient had an incomplete abortion and in the remaining three (15%) patients, fetal demise was observed. The mean induction-abortion interval in this group was 7.5 h. In the placebo group, none of the above effects were observed. The only side effect noted was vomiting, which occurred in five (25%) of the patients in the PGE2-gel group. Termination of pregnancy was found to be easier in the PGE2-gel group, compared to the placebo group.

Abortion, Therapeutic

Ultrasonically controlled retrieval of an intrauterine contraceptive device (IUCD) in early pregnancy.

Removal of an intrauterine contraceptive device (IUCD) in nonpregnant patients under ultrasonic guidance has previously been reported, but results of the method in pregnancy are controversial. In the present study removal of the IUCD was performed in 16 women who conceived with the device in place. Four women were scheduled for pregnancy termination and 12 women wished to continue their pregnancy. Removal was successful in all 16 patients with minimal complications. Fetal loss occurred in one case out of the 12 who wished to continue their pregnancy. The procedure was found to be feasible even in cases with the IUCD located behind the gestational sac. We suggest ultrasonic guided removal of the IUCD during pregnancy to be the method of choice.

Adult