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Biomedical subjects

J Reichman

Publications and source records attributed to J Reichman.

At least 19 recordsLinked to original sources
PubMed2000

An optimized probe set for the detection of small interchromosomal aberrations by use of 24-color FISH.

The rapid spread of the use of new 24-color karyotyping techniques has preceded their standardization. This is best documented by the fact that the exact resolution limits have not yet been defined. Indeed, it is shown here that a substantial proportion of interchromosomal aberrations will be missed by all multicolor karyotyping systems currently in use. We demonstrate that both the sensitivity and the specificity of 24-color karyotyping critically depend on the fluorochrome composition of chromosomes involved in an interchromosomal rearrangement. As a solution, we introduce a conceptual change in probe labeling. Seven-fluorochrome sets that overcome many of the current limitations are described, and examples of their applications are shown. The criteria presented here for an optimized probe-set design and for the estimation of resolution limits should have important consequences for pre- and postnatal diagnostics and for research applications.

Chromosome Aberrations↗
PubMed1999

Pathophysiology of radiocontrast nephropathy: a role for medullary hypoxia.

Recent experimental data underlies the role of hypoxic tubular injury in the pathophysiology of radiocontrast nephropathy. Although systemic transient hypoxemia, increased blood viscosity, and a leftward shift of the oxygen-hemoglobin dissociation curve may all contribute to intrarenal hypoxia, imbalance between oxygen demand and supply plays a major role in radiocontrast-induced outer medullary hypoxic damage. Low oxygen tension normally exists in this renal region, reflecting the precarious regional oxygen supply and a high local metabolic rate and oxygen requirement, resulting from active salt reabsorption by medullary thick ascending limbs of Henle's loop. Radiologic contrast agents markedly aggravate outer medullary physiologic hypoxia. This results from enhanced metabolic activity and oxygen consumption (as a result of osmotic diuresis and increased salt delivery to the distal nephron) because the regional blood flow and the oxygen supply actually increase. The latter effect may result in part from the activation of various regulatory mediators of outer medullary blood flow to ensure maximal regional oxygen supply. Low-osmolar radiocontrast agents may be less nephrotoxic because of the smaller osmotic load and vasomotor alterations. Experimental radiocontrast-induced renal failure requires preconditioning of animals with various insults (for example, congestive heart failure, reduced renal mass, salt depletion, or inhibition of nitric oxide and prostaglandin synthesis). In all these perturbations, which resemble clinical conditions that predispose to contrast nephropathy, outer medullary hypoxic injury results from insufficiency or inactivation of mechanisms designed to preserve regional oxygen balance. This underlines the importance of identifying and ameliorating predisposing factors in the prevention of this iatrogenic disease.

Acute Kidney Injury↗
PubMed1998

Likelihood ratios: getting diagnostic testing into perspective.

In modern medicine, sophisticated laboratory tests and imaging studies are often emphasized at the expense of history and physical examination, rather than complementing clinical assessment. Ancillary testing often fails to advance the diagnostic process, and increases patient risk and the expense of medical care. The relative value of clinical evaluation and technological methods is rarely considered, and the power of the clinical evaluation is therefore underestimated. The likelihood ratio (LR) is a semiquantitative measure of the performance of diagnostic tests which indicates how much a diagnostic procedure modifies the probability of disease, and is calculated from the sensitivity and specificity of the test (or directly from the change in probability associated with the test result). We review the performance of frequently-used tests by their LRs, and compare them to the power of clinical assessment, with clinical cases to illustrate the application of LRs in the diagnostic process. The discriminative power of clinical assessment and ancillary tests is often similar, and the combination of the two greatly increases accuracy in the diagnostic process. Clinical assessment is indeed frequently more informative than current technical modalities. LRs assist in putting the value of testing in proper perspective. Practice in evaluating pre-test probabilities of disease and in the application of LRs should be enhanced in medical training.

Diagnostic Techniques and Procedures↗
PubMed1997

Bradycardia in toluene poisoning.

BACKGROUND: Tachyarrhythmias are the classical manifestation of toluene cardiotoxicity. The presumed mechanism is sensitization of the myocardium to the potential arrhythmogenic effect of endogenous catecholamines, occasionally resulting in fatality. Bradyarrhythmias have been repeatedly shown in animal models, but have been reported only once in a human. CASE REPORTS: Two patients with toluene intoxication presented with severe sinus bradycardia. One patient had also atrial-ventricular dissociation. In both cases cardiac rhythm returned to normal within several hours. CONCLUSION: We suggest that the spectrum of cardiotoxic symptoms associated with toluene intoxication in humans includes bradyarrhythmias as well as tachyarryhthmias.

Adult↗
PubMed1993

New models for PA advancement. Forum discussion.

Many PAs are grappling with the problem of how to best advance their careers. In this roundtable, the participants discuss traditional methods of advancement and examine the need for new models.

Career Mobility↗
PubMed1982

Ovulatory function after tubal microsurgical procedures in the rabbit.

Ovulatory function as correlated with the production of corpora lutea was studied in 72 rabbits that were subjected to unilateral tubal microsurgical procedures. Isthmo-isthmic reanastomosis was performed in 11 rabbits, ampullo-isthmic reanastomosis in 10, and ampullo-ampullary reanastomosis in 11. In a second group of 40 animals, 20% to 100% of the isthmic portion (n=20) and 20% to 60% of the ampullary portion (n=20) were resected with reanastomosis. After natural copulation of the animals, without administration of gonadotropin, the numbers of corpora lutea on the operated and control side were counted. A slight but nonsignificant overall reduction in corpora lutea on the anastomosed side was observed. This showed no correlation to amount of tubal resection or proximity of the anastomosis to the ovary.

Animals↗
PubMed1981

Bacteriologic studies in second-trimester pregnancy termination: a comparison of intra- and extra-amniotic methods.

Vaginal and cervical cultures were obtained in 20 women undergoing intra-amniotic saline infusion and 20 women having extraamniotic saline infusion for second-trimester abortion. Following expulsion intrauterine cultures were taken and the patients were followed for signs of clinical infection. Sixty percent of the patients had pathogenic bacteria cultured intrauterine cultures after abortion and 7.5% had clinical infection. There was a positive correlation between infection-abortion time and pathogenic intrauterine cultures. No significant differences in the incidence of positive intrauterine cultures or clinical infection between the two groups were found. Of those patients with positive preabortion cultures 70% had identical pathogens cultured from the uterus after expulsion suggesting that most postabortal pathogens arise from endogenous vaginal and cervical sites rather than from exogenous sources.

Abortion, Induced↗
PubMed1981

Ovarian pregnancy: association with IUD, pelvic pathology and recurrent abortion.

Six cases of ovarian pregnancy were reviewed and their relationship with the IUD, fibromyoma of the uterus and previous spontaneous abortion was examined. In fact, 5 patients had an IUD in situ, in 2 women fibroids were found; 4 of the women had spontaneous abortions in their past history. The latter fact has been discussed, and it is suggested that this association may possibly contribute to an early diagnosis of ectopic pregnancy resulting in improved chances for conservative microsurgery. Attention is drawn to the fact that the diagnosis of ovarian pregnancy is often made only on microscopic examination. Thus, it is concluded that the true incidence of ovarian pregnancy may be higher than is apparent.

Abortion, Habitual↗
PubMed1980

Age-related glucose metabolism alterations in nondiabetic and potentially diabetic women.

The incidence of pathological glucose tolerance was investigated in women of three age groups: 20--39, 40--59 and over 60 yr, by means of oral glucose tolerance tests and the Danowski Index. The incidence was found to be significantly higher in older women: thus an age-related deterioration of glucose metabolism was confirmed. The women in each are group were further divided into "healthy" nondiabetic and "potentially diabetic" women. The parameter of "potential diabetes" was found to be associated to a greater extent with age-related glucose tolerance deterioration than advancing age alone. The existing theories for the etiology of carbohydrate metabolism alteration in older women are reviewed. it is suggested that in view of the age-related deterioration of glucose metabolism, a new normal range of glucose tolerance should be established in an ageing population.

Adult↗
PubMed1980

Contraception in the teenager. A comparison of four methods of contraception in adolescent girls.

The continuation rates, side effects and use-effectiveness of four types of contraceptive were studied during a two-year follow-up period in a group of 160 teenage girls of high socioeconomic standing who hd requested contraception advice. The method of contraception was selected by the girls after a discussion of the alternatives. Results showed good rates of continuation among girls selecting oral contraceptives, the intrauterine device (IUD) and condoms. Side effects and complications preclude the widespread use of oral contraceptives and the IUD in adoescents. There were no serious complications with the use of condoms or vaginal foam, but their use-effectiveness was lower than that of the pill or IUD. The condom is a reasonable alternative for motivated girls. The continuation rate was low in the group selecting the foam method and this form of contraception was quickly abandoned.

Adolescent↗
PubMed1979

Multiple carcinomas following therapy for Hodgkin disease.

A 52-year-old man developed synchronous squamous-cell carcinoma of the larynx and middle one-third of the esophagus following treatment of Hodgkin disease. This patient fell into the subgroup of patients treated by intensive radiation therapy followed by intensive chemotherapy. The link between the therapy and subsequent carcinoma is suggestive. Long-term follow-up care of patients with Hodgkin disease demands continuing evaluation of this possible complication.

Antineoplastic Agents↗