PubMed Health⌕ Search

Biomedical subjects

I Penner

Publications and source records attributed to I Penner.

7 recordsLinked to original sources

[Voluminous ectopic polycystic ovaries in Mayer-Rokitansky-Küster-Hauser syndrome].

We report the case of a 20-year-old woman with primary amenorrhea, normally developed sexual characteristics, infantile external genitals and absence of vaginal orifice. Blood chemistry studies showed elevated serum levels of gonadotropin, estrogens, testosterone, 17OH-progesterone, prolactin and TSH and low concentrations of FT(3) and FT(4). Cytogenetic karyotyping and in situ fluorescence hybridization revealed a 46,XX karyotype and the presence of Barr chromatin body. Laparoscopy disclosed absence of a vagina, apparently normal, enlarged tubes, multifolicular ectopic gonads and symmetric bilateral uterine buds. Diagnostic work-up included skeletal radiography, renal ultrasonography, intravenous pyelography, pelvic echography, pelvic phlebography and magnetic resonance imaging studies to demonstrate possible associations between the genitourinary and skeletal anomalies. Based on the clinical and laboratory findings, a diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome was established, associated with the presence of enlarged ectopic polycystic ovaries in the abdominal cavity.

Abnormalities, Multiple↗

Joint Commission completes transition to functional standards.

The Joint Commission's new emphasis on performance-based standards led it to identify functions it believed were likely to have the most significant impact on patient outcomes. Carrying out these functions requires an interdisciplinary team approach to patient care. Thus, the old strategy of handing out one manual chapter to each department head and asking him or her to implement the standards in that chapter will not work in 1995. Rather, providers will have to allocate already stretched human and financial resources to redesign their methods of assessing and improving patient outcomes in order to comply with yet another major revision of the Accreditation Manual for Hospitals. To ensure an adequate understanding of and compliance with Joint Commission standards, organizations should make the entire CAMH "required reading" for its leadership and make it available in strategic areas of the hospital for review by all employees. While the Joint Commission recognizes that its new functional approach will take some time to implement, all providers that want to ensure that they remain accredited should begin now to orient their leadership, staff, and employees to the new functional standards in the CAMH and the ways in which those standards affect patient outcomes.

Accreditation↗

Special report on medical staff relationships. Ninth Circuit buttresses peer review immunities.

Following on the heels of Austin, the Fobbs and Smith decisions may result in a significant reduction in the number of federal antitrust claims filed by aggrieved physicians in the context of peer review actions. However, by permitting claims of discrimination and conspiracy to go forward in the Fobbs case, the Ninth Circuit may have encouraged the filing of more suits against peer reviewers based on these types of claims, rather than on antitrust theories. In order to benefit from HCQIA's immunities, medical staffs are once again admonished to review, and revise when necessary their medical staff bylaws and peer review policies to provide for adequate notice and hearing, and to assure that peer review participants are well informed about and carefully comply with all of HCQIA's requirements.

Antitrust Laws↗

Interaction of Klebsiella capsule type 7 with human polymorphonuclear leucocytes.

Klebsiella serotype K7 is found among the capsule types that are most prevalent in respiratory tract isolates. To evaluate the significance of the K7 antigen in bacteria-leucocyte interactions, K7-encapsulated Klebsiella pneumoniae strains and their non-capsulate mutants were investigated. The K7 isolates were compared to K2-capsulate strains and their respective K- derivatives. K7-capsulate bacteria were less hydrophilic, and more readily phagocytosed and killed by human polymorphonuclear leucocytes (PMNL) than K2 strains. Loss of the K7 antigen resulted in increased surface hydrophobicity but did not affect phagocytosis and killing, whereas loss of the K2 capsule caused greater susceptibility to the phagocytic and killing action of PMNL. Both the K7 and K2 antigen stimulated the extracellular release of lysozyme from neutrophils but not of myeloperoxidase, indicating degranulation of only secondary granules. All K- mutants induced the release of both lysozyme and myeloperoxidase. Our results suggest that, in contrast to the K2 antigen, the K7 capsular polysaccharide does not confer antiphagocytic properties on bacteria. However, the K7 antigen is able to impede the extracellular release of primary granule enzymes.

Antigens, Bacterial↗