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Biomedical subjects

M Lowy

Publications and source records attributed to M Lowy.

At least 19 recordsLinked to original sources

Human menopausal gonadotrophins in the treatment of unexplained infertility.

Ninety one patients with unexplained infertility were treated with human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG). The overall pregnancy rates were 29% per patient and 11% per cycle. In patients under the age of 37, the rates were 40% per patient and 15% per cycle. Many cycles (15%) were cancelled because of poor response to stimulation and by definition these women had normal cycles prior to stimulation. Within 1 year of ceasing HMG treatment, 9 patients had conceived spontaneously and another 4 conceived by GIFT.

Adult

Pituitary-adrenal-immune system in normal subjects and in patients with anorexia nervosa: the number of circulating helper T lymphocytes (CD4) expressing the homing receptor Leu8 is regulated in part by pituitary-adrenal products.

The association between plasma pituitary-adrenal (PA) hormones and the number of certain populations of peripheral blood lymphocytes (PBL) was examined in subjects with normal PA function and in patients with anorexia nervosa (AN). AN patients display several neuroendocrine dysfunctions, including hypercortisolemia. In the normal subjects there were positive correlations between adrenocorticotropic hormone (ACTH) and the number of PBL and helper T lymphocytes expressing the homing receptor Leu8 (CD4+Leu8+); there was a negative relationship between cortisol and these lymphocyte populations. These latter, inverse correlations did not occur in the AN patients, either while underweight or after weight recovery, with some persistence of hypercortisolemia. Administration of dexamethasone (DEX) suppressed cortisol levels and reduced, perhaps via a receptor-mediated mechanism, the number of circulating PBL and CD4+Leu8+ in the normal subjects but not in the AN patients. These results support the physiological relevance of PA-CMI interaction in subjects with normal PA function and indicate that the PA-CMI interrelationship is disrupted in AN patients with hypercortisolemia.

Adrenocorticotropic Hormone

Dynamic aspects of cytoskeletal and karyoskeletal intermediate filament systems during the cell cycle.

IF are major cytoskeletal and karyoskeletal components of eukaryotic cells (Steinert and Roop 1988). In numerous instances, their constituent protein subunits have been shown to be substrates for a variety of kinases such as A-kinase, C-kinase, and Ca++/calmodulin kinase (Geisler and Weber 1988; Inagaki et. 1988; Ando et al. 1991), as well as p34cdc2 (Chou et al. 1990; Peter et al. 1990; Ward and Kirschner 1990; Dessev et al. 1991). To date, all of the phosphorylation sites that have been mapped are in the non-alpha-helical amino- or carboxy-terminal domains (Steinert 1988; Ando et al. 1989, 1991; Geisler et al. 1989; Chou et al. 1991), and these secondary modifications can lead to IF reorganization and/or disassembly in vivo and in vitro (see, e.g., Iganaki et al. 1988; Lamb et al. 1989; Chou et al. 1990; Peter et al. 1990; Heald and McKeon 1990; Dessev et al. 1991). In addition, it is possible that the exchange seen between subunits and polymerized IF in interphase following the microinjection of unpolymerized protein (Vikstrom et al. 1989; Miller et al. 1991) may also be regulated in some fashion by phosphorylation/dephosphorylation reactions. In cultured fibroblasts such as BHK-21, the interphase equilibrium state that favors IF polymerization is shifted dramatically to a disassembled state in mitosis, apparently due to enhanced phosphorylation at specific sites mediated through the activity of p34cdc2. However, in other cells in mitosis, such as HeLa, the mechanisms involved in the regulation of cytoskeletal IF remain unclear. Therefore, no one common mechanism appears to be responsible for IF regulation during cell division. On the basis of the majority of data available, it appears that the regulation of IF phosphorylation plays an important role in the regulation of the supramolecular organization of IF cytoskeletal and karyoskeletal networks, especially in the remodeling events that take place as cells enter and exit mitosis. Although the functional significance of IF phosphorylation during interphase is not as obvious as it is in some mitotic cells, we are tempted to speculate that there may be a connection with mechanisms involved in signal transduction, since IF proteins appear to be targets for kinases known to be activated by second messengers such as Ca++ and cAMP.

Animals

The beneficial effects of joint orthopaedic-geriatric rehabilitation.

A London inner city Health District has had joint orthopaedic geriatric beds (RU) for rehabilitation of elderly orthopaedic patients since 1981. The effect of this on the orthopaedic department was studied by means of Hospital Activity Analysis data for 1980-85. The results showed that in patients greater than or equal to 60 years this approach leads to a significant reduction in length of stay for those with and without the diagnosis of fractured neck of femur and in the numbers staying 60+ days and 90+ days. The combined approach produced a saving of 46% in bed-days for fractured neck of femur alone. The relatively long duration of stay in the acute orthopaedic unit prior to admission to the RU suggests that intervention by the joint approach from the date of admission is required to maximize efficiency.

Aged

Clinical and immunologic response to Isoprinosine in alopecia areata and alopecia universalis: association with autoantibodies.

Twenty patients with alopecia universalis, alopecia semiuniversalis and alopecia areata were studied for their immune parameters. Fourteen of them received an oral treatment with Isoprinosine, a synthetic immunomodulator. Ten patients showed the presence of several autoantibodies. No significant abnormalities in various T cell rosette markers were found, but T4/T8 ratios tended to be elevated. Erythrocyte antibody complement (EAC) rosettes were usually decreased. Treatment with Isoprinosine produced a clinical response, as judged by total or partial hair growth, in nine of the fourteen patients treated. It was striking to observe that seven of the nine responders had autoantibodies prior to treatment. These autoantibodies disappeared or decreased with Isoprinosine therapy. In contrast, only one of five nonresponders had serum autoantibodies. After treatment, both groups showed an increase in blood-active T rosettes. These results suggest that alopecia is a heterogeneous disease subdivided by the presence or absence of autoantibodies since clinical response was mainly obtained in patients presenting autoantibodies.

Adolescent

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. I. Enhanced response in depression and mania.

The serum cortisol concentration following administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, a precursor of serotonin (5-HT), was significantly greater in unmedicated depressed and manic patients than in normal controls. Increases in serum cortisol levels greater than 5 micrograms/dL were significantly more frequent in both unmedicated depressed and manic patients than in the normal controls. There was significant test-retest reliability. Baseline serum cortisol concentration correlated negatively with the cortisol response to 5-HTP in normal controls. These results suggest increased 5-HT receptor sensitivity may be present, possibly in the hypothalamus or pituitary, in some patients with affective disorders. These results are consistent with the hypothesis that decreased serotonergic activity, which would be expected to produce increased 5-HT receptor sensitivity, may be present in both depression and mania.

5-Hydroxytryptophan

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II. Relation to suicide, psychosis, and depressive symptoms.

Serum cortisol levels were significantly higher after administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, in unmedicated patients with affective disorders than in controls. The magnitude of the serum cortisol increase correlated positively with the Schedule for Affective Disorders and Schizophrenia-Change (SADS-C) depression syndrome ratings and correlated negatively with psychotic symptoms in 26 patients with major depression. The serum cortisol response was greater in four depressed and three manic patients who made suicide attempts than in 33 patients who were not suicidal or only had suicidal thoughts. The cortisol response was also greater in patients with bipolar depression than in those with unipolar depression and those with a first-degree relative with an affective disorder. Absence of psychotic symptoms and commission of suicidal acts were associated with an increased cortisol response to 5-HTP in the depressed patients. The cortisol response to 5-HTP in the manic patients also tended to correlate with the SADS-C manic syndrome score.

5-Hydroxytryptophan

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. III. Effect of antidepressants and lithium carbonate.

Serum cortisol levels were significantly increased following administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, to patients with affective disorders. A three- to five-week period of treatment with lithium carbonate or monoamine oxidase (MAO) inhibitor augmented the mean 5-HTP-induced increase in serum cortisol concentration in manic or depressed patients, respectively: tricyclic antidepressant (TCA) and second-generation antidepressant treatment diminished the mean serum cortisol response in patients with major depression. These results are consistent with the hypothesis that lithium carbonate may enhance serotonin (5-HT) receptor sensitivity, whereas TCA and second-generation antidepressants diminish 5-HT receptor sensitivity. The enhancement of the cortisol response to 5-HTP by MAO inhibitors may be due to decreased metabolism of 5-HT. It is important to assess the effect of thymoleptic drug treatment on various responses to biogenic amine precursors or agonists in patients rather than laboratory animals.

5-Hydroxytryptophan

Enhanced serum cortisol response to 5-hydroxytryptophan in depression and mania.

The serum cortisol responses to D,L-5-hydroxytryptophan (5-HTP), 200 mg per oral, in unmedicated depressed and manic patients, were both significantly greater than that of normal controls. The cortisol response to 5-HTP in depressed patients was significantly correlated with ratings of specific symptoms of depression. It was also greater in non-psychotic than in psychotic depressed patients as well as in those manic or depressed patients who attempted suicide compared to those who had not. In view of evidence for decreased brain serotonergic activity in depression and perhaps mania, the results suggest at least some serotonin receptors may be supersensitive in some patients with affective disorders.

Adult

Pigmented villo-nodular synovitis: bone involvement of the fingers.

Pigmented villo-nodular synovitis may occur in either diffuse or nodular form. In the latter the fingers are the commonest site to be involved. The disease is rare, and in only 15% is there bone involvement. Two cases showing bone involvement of the fingers are presented. One of the cases (Case 2) adds radiological support to the theory of Scott (1968), based on pathological studies, that suggested that the bone changes are due to invasion by the villo-nodular tissue through and along the nutrient foramina. The site of these bone changes appears sufficiently typical to be a radiological diagnostic aid. The differential diagnosis of the radiological appearances of the disease in the digits is discussed.

Bone Diseases