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Biomedical subjects

M D Kaplan

Publications and source records attributed to M D Kaplan.

At least 19 recordsLinked to original sources
PubMed2000

Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994.

OBJECTIVES: The purposes of this study were to report the neurodevelopmental, neurosensory, and functional outcomes of 1151 extremely low birth weight (401-1000 g) survivors cared for in the 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network, and to identify medical, social, and environmental factors associated with these outcomes. STUDY DESIGN: A multicenter cohort study in which surviving extremely low birth weight infants born in 1993 and 1994 underwent neurodevelopmental, neurosensory, and functional assessment at 18 to 22 months' corrected age. Data regarding pregnancy and neonatal outcome were collected prospectively. Socioeconomic status and a detailed interim medical history were obtained at the time of the assessment. Logistic regression models were used to identify maternal and neonatal risk factors for poor neurodevelopmental outcome. RESULTS: Of the 1480 infants alive at 18 months of age, 1151 (78%) were evaluated. Study characteristics included a mean birth weight of 796 +/- 135 g, mean gestation (best obstetric dates) 26 +/- 2 weeks, and 47% male. Birth weight distributions of infants included 15 infants at 401 to 500 g; 94 at 501 to 600 g; 208 at 601 to 700 g; 237 at 701 to 800 g; 290 at 801 to 900 g; and 307 at 901 to 1000 g. Twenty-five percent of the children had an abnormal neurologic examination, 37% had a Bayley II Mental Developmental Index <70, 29% had a Psychomotor Developmental Index <70, 9% had vision impairment, and 11% had hearing impairment. Neurologic, developmental, neurosensory, and functional morbidities increased with decreasing birth weight. Factors significantly associated with increased neurodevelopmental morbidity included chronic lung disease, grades 3 to 4 intraventricular hemorrhage/periventricular leukomalacia, steroids for chronic lung disease, necrotizing enterocolitis, and male gender. Factors significantly associated with decreased morbidity included increased birth weight, female gender, higher maternal education, and white race. CONCLUSION: ELBW infants are at significant risk of neurologic abnormalities, developmental delays, and functional delays at 18 to 22 months' corrected age.

Birth Weight↗
PubMed1999

Developmental and psychiatric evaluation in the preschool context.

This article documents the ways in which a school-based developmental evaluation can be an effective and powerful alternative to the traditional clinic-based evaluation. The child is not taken to a strange new place but observed and evaluated in his or her naturalistic environment. The families have increased access to care, and the foundation is laid for cohesive, trusting working relationships with families and teachers. Children are evaluated in one of two models or a combination of both naturalistic observation and individual direct assessment. Tensions between the clinical and educational system exist, but the early childhood evaluator who educates himself or herself about the cultures and forces at work can build from the strengths of each system to effect positive growth for young children at risk for developmental delays or psychiatric disorders.

Child, Preschool↗
PubMed1997

Cyclooxygenase-1 behaves as a delayed response gene in PC12 cells differentiated by nerve growth factor.

Treatment of PC12 cells with nerve growth factor (NGF) results in a differentiation program characterized by expression of immediate early and delayed response genes. In this program, morphological changes such as neurite extension are accompanied by phenotypic changes in enzyme expression, including an increased capacity for prostaglandin synthesis. Cyclooxygenase (COX), the enzyme responsible for prostanoid production, exists as two isoforms: constitutive COX-1 and inducible COX-2. We report that COX-1 behaves as a delayed response gene in PC12 cells exposed to NGF. Six hours following NGF treatment, COX-1 mRNA levels were elevated in PC12 cells, reaching nearly 5-fold above basal levels at 12 h. This increase was blocked by cycloheximide and was accompanied by concomitant increases in COX-1 protein and enzyme activity. COX-1 protein remained elevated for at least 10 days and localized to the cytoplasm and neurites of NGF-differentiated PC12 cells. Moreover, basic fibroblast growth factor, but not epidermal growth factor, caused similar increases in COX-1, which is consistent with expression characteristics of other delayed response genes in PC12 cells. This is the first example of neurotrophic factor regulation of cyclooxygenase and may have important implications for determination of the differentiated phenotype in PC12 cells.

Animals↗
PubMed1996

Interleukin-1 beta induces prostaglandin G/H synthase-2 (cyclooxygenase-2) in primary murine astrocyte cultures.

Activation of glial cells and the consequent release of cytokines, proteins, and other intercellular signaling molecules is a well-recognized phenomenon in brain injury and neurodegenerative disease. We and others have previously described an inducible prostaglandin G/H synthase, known as PGHS-2 or cyclooxygenase-2, that is up-regulated in many cell systems by cytokines and growth factors and down-regulated by glucocorticoid hormones. In cultured mouse astrocytes we observed increased production of prostaglandin E2 (PGE2) after stimulation with either interleukin-1 beta (IL-1 beta) or the protein kinase C activator phorbol 12-myristate 13-acetate (TPA). This increase in PGE2 content was blocked by pretreatment with dexamethasone and correlated with increases in cyclooxygenase activity measured at 4 h. Northern blots revealed concomitant increases in PGHS-2 mRNA levels that peaked at 2 h and were dependent on the dosage of IL-1 beta. Dexamethasone inhibited this induction of PGHS-2 mRNA by IL-1 beta. TPA, basic fibroblast growth factor, and the proinflammatory factors tumor necrosis factor alpha and lipopolysaccharide, but not interleukin-6, also stimulated PGHS-2 mRNA expression. Relative to IL-1 beta, the greater increases in PGE2 production and cyclooxygenase activity caused by TPA correlated with a greater induction of PGHS-2 mRNA. Furthermore NS-398, a specific inhibitor of cyclooxygenase-2, blocked > 80% of the cyclooxygenase activity in TPA-treated astrocytes. These findings indicate that increased expression of PGHS-2 contributes to prostaglandin production in cultured astrocytes exposed to cytokines and other factors.

Animals↗
PubMed1994

G-protein- and capacitatively regulated Ca2+ entry pathways are activated by muscarinic receptor stimulation in a human submandibular ductal cell line.

In the human submandibular ductal cell line (HSG) thapsigargin and carbachol stimulated Ca2+ release from the internal Ca2+ pool, resulting in the activation of capacitatively regulated Ca2+ entry (CRCE). This entry pathway was permeant to both Ca2+ and Mn2+, blocked by Ni2+ and insensitive to the muscarinic antagonist, atropine. Carbachol also stimulated an increase in cytosolic [Ca2+] in internal Ca(2+)-pool-depleted (i.e. thapsigargin-treated) cells which was dependent on the presence of external Ca2+ and blocked by Ni2+, demonstrating that it was due to Ca2+ entry. However, under the same experimental conditions, carbachol was unable to stimulate Mn2+ entry. Additionally, this latter carbachol-stimulated Ca2+ entry pathway was blocked by atropine. Pretreatment of HSG cells with AlF4-increased basal rates of Mn2+ entry due to CRCE activation, but attenuated carbachol-stimulated Ca2+ entry into thapsigargin-treated cells. The data suggest that two distinct divalent cation entry pathways are activated in muscarinic-receptor-stimulated HSG cells; a CRCE mechanism, permeable to both Mn2+ and Ca2+, and a second entry mechanism, permeable only to Ca2+. The latter does not depend on internal pool depletion, but appears to be regulated via G-protein activation.

Aluminum Compounds↗
PubMed1993

The functions of saliva.

Oral health is determined to a considerable extent by our ability to produce saliva. Not only must adequate amounts be produced, but a large number of specific proteins also must be secreted for the mouth to function properly. This brief review is directed at describing (1) how saliva is secreted, (2) the consequences of decreased salivary function, (3) the components necessary for oral homeostasis, and (4) the common causes of salivary hypofunction.

Homeostasis↗
PubMed1991

Disturbances of affect expression in failure-to-thrive.

Positive and negative affects were assessed in 28 6- to 36-month-old children with failure-to-thrive and 14 normally growing children in feeding and nonfeeding situations. The roles of malnutrition and severity of organic effects also were examined. Failure-to-thrive children expressed less positive affect in the feeding and nonfeeding situations and more negative affect in feeding than normally growing children. Among failure-to-thrive children, the presence of both acute and chronic malnutrition was associated with heightened negative affect during feeding, whereas the degree of organic contribution had no effect. These results, if replicated, may have implications for clinical assessment and are discussed in terms of current theories of failure-to-thrive.

Affective Symptoms↗
PubMed1985

Vascular recanalization with the argon laser: the role of blood in the transmission of laser energy.

Successful revascularization of stenosed arteries with the argon laser optical fiber catheter requires delivery of high-power-density energy to the lesion. Because of the high energy absorption by hemoglobin at the argon laser wavelengths, which would attenuate transmission of laser energy to the obstruction, we measured argon laser transmission through blood at different concentrations. We found that no transmission occurred through 1 mm of whole blood with hematocrit of 42 and that blood must be diluted to a hematocrit below 1 for laser energy to be delivered. Successful use of the intravascular argon laser is dependent on the creation of a transmission medium by displacement of blood by saline or other non-absorbing substance.

Arterial Occlusive Diseases↗
PubMed1979

Marketing: what it is, what it isn't.

If the marketing concept is to be successfully applied to the health care field, it must be viewed in its entirety. It must be seen as a business function that is tied to the goals of the hospital.

Community-Institutional Relations↗