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Biomedical subjects

I Blum

Publications and source records attributed to I Blum.

At least 37 records · Page 2Linked to original sources
PubMed1991

Hyperphosphataemia and hypocalcaemia induced by hypertonic phosphate enema--an experimental study and review of the literature.

1. The study objective was to determine the hyperphosphataemic and hypocalcaemic effect of hypertonic phosphate enema. The study was conducted in a department of Internal Medicine at a University Medical Center. 2. Fourteen patients were studied. Patients' mean age (+/- s.d.) was 78.5 +/- 9 years. The creatinine clearance was 48.2 +/- 17.4 ml min-1 (mean +/- s.d.). 3. 500 ml (approx. 7 ml kg-1) of Fleet enema (FE - Na2HPO4.7H2O 224 mmol l-1 and NaH2PO4.H2O 1160 mmol l-1) were administered to each patient. Blood was drawn before FE administration and 1/2, 1, 3, 5, 12 and 24 h thereafter. Serum was analysed for levels of inorganic phosphorus and for calcium. 4. The serum inorganic phosphorus level rose from 1.01 +/- 0.3 mmol l-1 to 1.4 +/- 0.5 mmol l-1 (P = 0.001) 1 h after FE was administered. Serum calcium decreased from 2.32 +/- 0.12 mmol l-1 to 2.12 +/- 0.1 mmol l-1 (P less than 0.001) 12 h after FE was administered. 5. We conclude that FE carries a potential risk for acutely ill elderly patients. To avoid untoward effects due to hyperphosphataemia and hypocalcaemia, the phosphate load must be adjusted to the patient's renal function, i.e. enema volume is to be lowered when phosphate concentration is high, so that if renal function is compromised the amount of phosphate absorbed does not exceed renal excretion capacity.

Adolescent↗
PubMed1989

Antisperm antibodies in young oral contraceptive users.

Thirty-five young oral contraceptive users (group A) and twenty-four non-users (group B) of comparable age and background were screened for the presence of serum antisperm antibodies, antibodies to Chlamydia trachomatis and vaginal infections. Twenty-three per cent (8/35) of the oral contraceptive users were found to have significant titers of antisperm antibodies as compared to none in the non-user group (p less than 0.05). In 17% of group A patients (6/35) the presence of antisperm antibodies coincided with the presence of serum antibodies to chlamydia and vaginal candidiasis. One of these patients had E. coli in her vaginal culture in addition to the serum antichlamydia antibodies. The other two patients harboring serum antisperm antibodies were free of any sign of vaginal infection. A significant correlation (r = 0.7038, p less than 0.0000005) was found between the presence of antisperm antibodies and antichlamydia antibodies. There appears to be an increased frequency of serum antisperm antibodies in oral contraceptive users. This finding coincides with infections or colonizations with potential pathogens of the lower genital tract.

Adult↗
PubMed1988

Influence of oral contraceptive treatment on blood pressure and 24-hour urinary catecholamine excretion in smoking as compared with non-smoking women.

Microgynon-30 was administered to 15 smoking (group B) and 14 non-smoking young women (group A) for a period of 4 months. Prior to the institution of treatment supine blood pressure and daily urinary catecholamine excretion (DUCE) were measured in both groups of patients. Both values were elevated in group B in comparison with group A. Treatment with Microgynon-30 for 4 months induced a significant increase in DUCE in both groups, the increase being most marked in group B (p less than 0.0004). The increased catecholamine excretion accompanied small non-significant elevations in blood pressure. It is concluded that treatment with low-dosage estrogen oral contraceptives produces a significant increase in daily catecholamine excretion, especially in patients who smoke.

Adolescent↗
PubMed1988

Pregnancy and Cushing's syndrome: example of endocrine interaction.

Pregnancy rarely occurs in women with Cushing's syndrome, and when it does, fetal mortality and morbidity are very high. We describe a 30-year-old woman who was found to have severe Cushing's syndrome in the 22nd week of her first pregnancy, after a year of unsuccessful attempts to conceive. The patient had the majority of the symptoms and signs characteristic of the syndrome. Laboratory examinations revealed hypokalemia of 2.7 mEq/l, serum cortisol 39.5 micrograms/dl without diurnal variation, free urinary cortisol 1,850 to 3,500 micrograms/24 h, 17-hydroxycorticosteroids (OHCS) 52.5 mg/24 h, 17-ketosteroids (KS) 12 mg/24 h, and ACTH 29 pg/ml. No suppression was observed upon dexamethasone administration (2 and 8 mg). Ultrasound examination of the adrenal glands revealed a left adrenal tumor with a diameter of 4.2 cm. An adrenocortical adenoma was successfully excised in the 24th week of pregnancy. During the 37th week of pregnancy, she delivered a normal baby girl. Postoperatively, the patient was put on maintenance therapy. One year after delivery, mother and child are in perfect health.

Adenoma↗
PubMed1988

Severe sexual impairment produced by morbid obesity. Report of a case.

A 45-year-old man, was admitted for investigation of severe sexual impairment. During 20 years of marriage, he had had no normal sexual intercourse and the couple was childless. Physical examination disclosed a severely obese man (weight 300 kg, height 1.75 m), with a relatively small and invaginated penis and small (5 ml) soft testes. Laboratory examinations disclosed the following: low serum testosterone (1 ng/ml), with a reduced response to HCG (3.8 ng/ml). Sex hormone binding globulin was at the lower limit of normal (0.38 microgram/dl), serum free testosterone was low (0.98% of total testosterone) as well as non-SHBG bound testosterone (22% of total testosterone). Daily total urinary estrogen excretion was increased (107 micrograms), the plasma estrone (78 pg/ml) and estradiol (74 pg/ml) were elevated. The gonadotropins were normal and responded adequately to LRH. Plasma growth hormone was decreased, prolactin, T4 and adrenal steroids were normal and responded normally to stimuli and inhibitors. Chromosomal constitution was 46XY. Thus, in this man the marked obesity produced a significant increase in estrogens which subsequently induced a severe decrease in testosterone and its free counterpart in excessive impairment of sexual function.

Hormones↗
PubMed1987

Adrenergic receptor hyperactivity--a cause for pseudopheochromocytoma?

Two patients with classical signs and symptoms of pheochromocytoma, are described. In these two patients the 24-hr urinary excretion of dopamine, norepinephrine, epinephrine and their metabolites were normal or low, both in basal states or after attacks (spontaneous or provoked). However, the 24-hr urinary excretion of cyclic AMP was exceedingly high in one patient (13000 nmol/gm creatinine), and elevated in the second (5920 nmol/gm creatinine). Both patients were benefited by treatment with a combination of alpha and beta adrenergic blocking drugs. The first patient, after stopping treatment, developed hypertensive crisis and died. Post-mortem examination did not detect a pheochromocytoma or any other abnormality which could explain the excessively elevated cyclic AMP. In the second patient, extensive X-ray and CT examinations were negative for pheochromocytoma. A hypothesis is developed linking the symptoms and biochemical findings of both patients to an abnormality of the adrenergic receptor.

Adrenal Gland Neoplasms↗
PubMed1987

A benign course of multicentric Castleman's disease with involvement of the spleen and bone marrow.

The multicentric variant of Castleman's disease (MCCD) is associated with a rapidly progressive and fatal course. The case described herein manifested unique clinical and histological features. Initial presentation as isolated splenomegaly was subsequently followed by widespread organ involvement, including lymph nodes and bone marrow. In spite of this, the patient had a very benign course of her disease. The case serves to expand even further the already wide clinical spectrum of Castleman's disease.

Aged↗
PubMed1987

Fenbufen induced pure red cell aplasia in rheumatoid arthritis.

Pure red cell aplasia occurred after fenbufen administration in a patient with severe rheumatoid arthritis. In vitro studies were performed to determine the pathogenesis of the selective red cell aplasia. No cellular or humoral inhibitory mechanisms were demonstrated on growth of erythroid and multipotent bone marrow progenitors. Also, no direct effect of fenbufen alone or in combination with IgG and/or patient serum was found. It is possible that a metabolite of the drug formed from its metabolism was responsible for the aplasia and that the target marrow cell precursor affected is later than both erythroid bone marrow progenitors (BFU-E and CFU-E) and therefore not apparent in our studies. Recovery upon cessation of fenbufen suggests its implication in the pure red cell aplasia.

Aged↗
PubMed1987

[Prospective study of the outcome of rheoplethysmographic parameters after deep venous thrombosis of the lower extremities. Role in the decision to discontinue anticoagulants].

Forty-eight patients (25 M, 23 F) age range 25 to 83 years were admitted for treatment of deep vein thrombosis (DVT) of lower limbs confirmed by phlebocavography. Lesions were sural in 6 cases (Gr. 1), subcrural in 28 (Gr. 2) and supracrural in 13 (Gr. 3). Rheoplethysmography with venous occlusion (ORP) was performed and repeated every four months until (possible) recovery of normal emptying parameters (EI). Mean observation period was 25 +/- 8 months. In group 1, ORP indices were always restored to normal values within 4 months. In groups 2 and 3, normal values of IDV were observed in 23/38 patients within a median period of 10 months. Actuarial analysis of changes in EI values showed normalization in 65% of patients within 12 to 16 months with lack of significant differences between values for groups 2 and 3. Beyond this period of time any recovery of normal emptying indices is more aleatory, the residual obstructive syndrome appearing to be established definitely. Antivitamin K therapy (AVK) was instituted in 44 patients, and discontinuation was a function of normalization of EI. Good long-term results (clinical and ORP) were noted in 26/28 cases: one patient had recurrence of DVT with regional extension of thrombus and another a thrombosis on a Mobin-Uddin filter. Restoration of normal EI values during the 16 months following onset of DVT of lower limbs constitutes a valuable index for cessation of AVK therapy. After this period, recovery from the obstructive syndrome is more aleatory and decision to continue therapy must be based on other criteria.

Adult↗
PubMed1986

The influence of short-term estrogen replacement therapy (ERT) on the blood pressure and daily urinary catecholamine excretion in a small group of post-menopausal women.

The blood pressure and daily urinary catecholamine excretion were examined in nineteen non-smoking post-menopausal women, receiving estrogen replacement therapy for a period of 4 months. The estrogens administered consisted of 17 beta-estradiol combined with estriol and norethisterone acetate administered sequentially (Trisequens, Novo, Denmark). Before the institution of treatment, the blood pressure and urinary catecholamine excretion were normal. After a period of 4 months, no change in blood pressure was observed. However, a marked and significant increase in daily urinary catecholamine excretion was noticed (72.3 +/- 18.96 micrograms/day to 102.0 +/- 26.0 micrograms: p less than 0.01). The pathogenetic implications of this increase are discussed.

Blood Pressure↗
PubMed1986

Recurrent hypothermia, hypersomnolence, central sleep apnea, hypodipsia, hypernatremia, hypothyroidism, hyperprolactinemia and growth hormone deficiency in a boy--treatment with clomipramine.

A boy referred at the age of 4 years because of obesity and under observation for 16 years, was found to be suffering from a hypothalamic syndrome of unknown origin characterized by progressive obesity, polyphagia, deficiency of growth and thyroid hormone, hyperprolactinemia, hypodipsia, hypernatremia and hyperosmolality without diabetes insipidus. At ages 11 and 16 there were 3 day episodes of spontaneous muscular weakness, hypersomnolence and hypothermia associated with central sleep apnea and severe bradycardia. Subsequently, decreased ventilatory responsiveness to carbon dioxide (CO2) was found as a consequence of blunted neural drive. Therapy with clomipramine HCl (Anafranil Ciba-Geigy) for 6 months led to a normalization of serum sodium levels, pulse rate, ventilatory response to dioxide with no recurrence of the central apnea within 4 following years.

Child, Preschool↗
PubMed1986

Propylthiouracil-induced cholestatic jaundice.

The typical propylthiouracil (PTU)-linked hepatotoxicity, is known to manifest itself by hepatocellular injury with greatly increased serum transaminase values and evidence of hepatic necrosis on liver biopsy. Herewith presented is a 33-year old, thyrotoxic woman who developed cholestatic jaundice two weeks after initiation of PTU therapy. The diagnosis was confirmed by liver biopsy. A causal link between PTU treatment and the cholestatic jaundice was suggested by: the time of onset, typical skin rash and a positive migration inhibition factor (MIF) test to PTU. Awareness of this rare complication of PTU treatment may prevent the performance of unnecessary, expensive and possibly harmful diagnostic procedures.

Adult↗
PubMed1986

Cellular immunity in patients with acquired immunodeficiency syndrome (AIDS) in Israel: effects of THF, a thymic hormone in vitro.

Markers and functions of T cell subsets were studied in 3 Israeli males suffering from AIDS, two of whom were homosexuals and one heterosexual developing AIDS after a coronary bypass operation followed by multiple blood transfusions. Two healthy homosexual partners of one of the AIDS patients were also studied. Sera from these individuals were also tested for suppressive activity on control normal donor lymphocytes. Monitoring of T-cell subsets during a period of 3-12 months demonstrated a reversed T helper: T suppressor ratio in the 3 AIDS patients and in one of the healthy homosexuals. Addition of AIDS sera to normal T helper cells abolished the helper activity whereas its addition to normal isolated T suppressor cells enhanced the suppressor activity. Incubation of the patients lymphocytes with THF, a calf thymus hormone, restored the impaired helper cell activity. A suppressor factor unrelated to acid labile interferon was demonstrated in the sera of the AIDS patients but was not found in the sera of the healthy homosexuals. THF neutralized the suppressor effect of this serum factor when tested on normal lymphocytes.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Histochemical and ultrastructural study on the innervation of human and porcine atrio-ventricular valves.

The presence of nerve fibers was investigated in porcine and human atrio-ventricular valves by AChE technique, formaldehyde-induced fluorescence, en bloc silver and gold chloride impregnation and electron microscopy. Elaborate nerve plexuses were observed in every leaflet and in some chordae tendineae of all the samples examined, without significant species differences in the pattern of innervation. The presence of a sensory innervation was inferred from the demonstration, in whole mount samples processed for acetylcholinesterase, of thick myelinated nerve fibers and of endings with dot-like or brush-like appearance. Moreover the results of the combined histochemical and ultrastructural methods showed the existence of both cholinergic and adrenergic efferent nerve fibers. Nerve varicosities with clear or dense-cored vesicles were frequently observed in proximity to blood vessels and to cardiac and smooth muscle bundles, which therefore can be considered as the targets of the efferent nerve supply. The complex pattern of the innervation herein demonstrated suggests the existence of a nervous control of valvular function through the regulation of contractile elements.

Adult↗
PubMed1984

Histochemical localization of monoamines and cholinesterases in Mytilus pedal ganglion.

The pedal ganglion is a peripheral ganglion which gives rise to the innervation for both the somatic and visceral organs of the Mytilus foot. In the present study, different histofluorescence methods for the demonstration of monamines (formaldehyde-glutaraldehyde followed by polyethylene glycol embedding; aluminium-formaldehyde; Falck) and acetylcholinesterase histochemistry were applied in order to characterize the neuronal population of the ganglion. The fluorescence methods employed showed that the cortical region of the pedal ganglion is composed of roundish cells; these mainly contained an orange autofluorescent pigment. Yellow-fluorescing cells were scattered in the anterior region of the cortex, but they were more numerous and arranged in clusters in the posterior region. Green-fluorescing cells were mainly located at the border between the cortex and neuropile and in the neuropile itself, where a rich plexus of beaded green-fluorescing fibres was also present. Of the three methods, that using formaldehyde-glutaraldehyde followed by embedding in polyethylene glycol gave the best preservation of morphological details. Acetylcholinesterase histochemistry showed the presence of positive cells and fibres mainly in the anterior region of the ganglion.

Acetylcholinesterase↗