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Biomedical subjects

M Ratner

Publications and source records attributed to M Ratner.

At least 19 recordsLinked to original sources

Inflammatory myofibroblastic tumor in children.

The authors presented the cases of two children with inflammatory myofibroblastic (IMF) tumor and reviewed the literature to facilitate the preoperative recognition, delineate the clinical features, and describe the natural history of this entity. The first child had IMF tumor arising from the mesentery of the small intestine. He presented with an abdominal mass associated with severe inflammatory response manifested by fever, impaired growth, thrombocytosis, and microcytic, hypochromic anemia. After surgical resection, his fever resolved and his growth rate and the laboratory abnormalities normalized. Five months after initial diagnosis, the fever, anemia, and thrombocytosis recurred along with two tumors arising from the omentum and the abdominal soft tissue. After the second surgery, he remains free of recurrent disease for 30 months. The second child presented with a lung mass that was radiologically indistinguishable from pulmonary sequestration. After surgical resection, she remains free of recurrent disease for 18 months. IMF tumor should be considered in any solid tumor that occurs in association with a chronic inflammatory response. IMF tumor should also be considered in the differential diagnosis of pulmonary sequestration.

Child

[Clinical and morphologic factors for assessment of risk of progression of chronic glomerulonephritis].

In 182 patients suffering from bioptical-proved and functional adapted chronic glomerulonephritis the relation between clinical course, morphological type and progression of disease has been evaluated. The presented results show a significant relation between the clinical course of chronic glomerulonephritis and the progression trend of this disease. The early finding of sclerotic changes may follow a benign course of the disease.

Adult

delta 9-Tetrahydrocannabinol: EEG changes, bradycardia and hypothermia in the rhesus monkey.

Administration of delta 9-tetrahydrocannabinol (THC; 0.75-4.0 mg/kg IP) to rhesus monkeys produced a biphasic pattern of high-voltage slow waves (HVSW) and fast waves (HVFW) EEG, along with behavioral depression and alertness, respectively. The HVSW phase appeared 20 to 30 min after drug injection and was uniquely characterized by spike-bursts in frontal and temporal lobes and hypothalamus, theta-waves in parietal and occipital lobes, and generalized HVSW in subcortical regions. During the HVSW phase, bradycardia and hypothermia occurred, and animals exhibited depression or sedation. After the HVSW phase lasting for 3-4 hr, HVFW predominated in overall EEGs with marked decrease in neocortical spike-bursts. Bradycardia and hypothermia occurred simultaneously 20 to 30 min after drug injection and reached maximal levels (30-40 percent decrease in heart rate, 1.5-2.0 degrees C decrease in body temperature) 2 to 3 hr after injection. The dose- and time-response relationships for bradycardia and hypothermia paralleled the HVSW phase with behavioral depression. Animals were alert and calm during recovery from bradycardia and hypothermia. THC levels and disposition in blood correlated with bradycardia, hypothermia and EEGs and behavioral changes following THC administration.

Animals

Congenital pyloric atresia and epidermolysis bullosa letalis in premature siblings.

Epidermolysis bullosa letalis has been associated with congenital pyloric atresia in an autosomal recessive syndrome. This report documents the second occurrence in premature siblings. Our review indicates that it is a lethal condition with death due to the septic complications of epidermolysis bullosa letalis. Surgical management of pyloric atresia should be withheld until the severity of the epidermolysis is known. Skin biopsy to document the type of epidermolysis bullosa is imperative as only the letalis form is documented to be lethal. The risk for subsequent siblings is 25% and parents should undergo genetic counseling. Prenatal diagnosis of epidermolysis bullosa letalis can be made by fetoscopic skin biopsy. We suggest nonoperative management of pyloric atresia unless the skin disease is responsive to treatment.

Epidermolysis Bullosa

[Recommendations for a clinical classification of chronic glomerulonephritis].

As a result of the long-term treatment of 360 patients with histologically ascertained glomerulonephritis including 41 dead patients who had suffered from uraemia a clinical classification of the chronic glomerulonephritis (Ratner, M.) is presented. In detail 5 types of clinical course are characterized: Nephritic types of course: maximally active nephritic type of course, active nephritic type of course, inactive nephritic type of course. Nephrotic types of course: nephrotic type of course without hypertension, nephrotic type of course with hypertension. The elaborated clinical classification allows conclusions to underlying renal histology, tendency of the progression of the disease and prognosis, including survival time.

Adolescent

Group treatment of patients with irritable bowel syndrome.

Irritable bowel syndrome, a chronic illness affecting a large segment of the population, has no known anatomic etiology. Symptoms are precipitated or aggravated by stress or emotional factors as well as diet, drugs and hormones. This article describes the illness and a group treatment approach which takes into account developmental antecedents, communication deficits and existential issues.

Adult

[New results concerning the effectiveness of therapy of chronic glomerulonephritis. Results of cytostatics-anticoagulants-aggregation inhibitors, cystostatics-anticoagulants-aggregation inhibitors-prednisone and cystostatics-prednisone therapy, derived from a retrospective study].

The indication and effectiveness of the immunosuppressive therapy of chronic glomerulonephritis is now as ever controversial. As a result of a retrospective therapy study in an at least one-year therapy with cytostatics, thrombocyte aggregation inhibitors and anticoagulants (CAA-therapy, n = 27), additional prednisone therapy (CAAP-therapy, n = 95) and cytostatic-prednisone therapy (CP-therapy, n = 33) we find favourable results for the CAA/CAAP-therapy in the nephrotic syndrome and glomerulonephritides with distinct clinical exacerbation also in sclerosations in histology. Clinically inactive nephritides with exclusive urinary findings and sclerosations cannot be influenced therapeutically.

Anticoagulants

Tubular function disturbances in chronic glomerulonephritis and their significance for identifying tubulointerstitial lesions.

The tubular and tubulointerstitial renal functions of 237 patients with chronic glomerulonephritis and functional compensation corresponding to their plasma creatinine levels were investigated and the results were compared with the light microscopic findings obtained by examination of kidney interstices obtained by biopsy. Pronounced structural interstitial lesions (TiC) were found in 30% of the cases. Investigation of the predictive values of tubular function data in respect of the presence or exclusion of TiC showed that, although individual parameters of the renal function permit the exclusion of TiC disturbances with a high degree of certainty, the diagnostic value can be enhanced by considering pairs of such parameters. Five parameter combinations were found to have the highest predictive value regarding the diagnosis of TiC. These were disturbed concentration capacity accompanied by reduced ammonia excretion or total acid excretion, reduced water diuresis accompanied by disturbed ammonia excretion or total acid elimination; and, finally, the total acid excretion and maximum dilution capacity. The highest predictive values for the exclusion of TiC are shown by inconspicuous concentration capacity accompanied by normal ammonia excretion, total acid excretion, water diuresis, free water clearance or urine dilution capacity.

Adolescent

Effects of phencyclidine (PCP) on cardiorespiratory functions in the rhesus monkey.

Effects of acute and chronic administration of phencyclidine (PCP) on heart rate (HR) and respiratory rate (RR) were studied in rhesus monkeys. Acute administration of PCP (2.0 and 4.0 mg/kg i.v.) produced decrements in both HR and RR within 15 to 30 min after drug administration. Simultaneously, with this cardiorespiratory slowing, EEG tracings evidenced High-Voltage Slow-Waves (HVSW) and delta-waves. As HR and RR began to recover, High-Voltage Fast-Waves (HVFW) along with theta-waves developed in EEG recordings and persisted for 2-6 h, while both HR and RR were gradually returning to their respective pre-drug control levels. The intensity and duration of these PCP-induced effects were directly related to dosage level. Following chronic administration of PCP (daily dose of 2.0 or 4.0 mg/kg i.v.), its ability to produce cardiorespiratory alterations was significantly diminished along with a decrease in PCP-induced depression of EEG and behavioral activities. These results suggest that chronic PCP administration produces a tolerance to its depressant effect on HR, RR, EEG and behavioral activities in rhesus monkeys.

Animals

[Correspondence of functional and structural findings in tubulo-interstitial disorders in chronic glomerulonephritis].

In 237 patients with chronic glomerulonephritis and according to the serum creatinine level of functional compensation tubular and tubulointerstitial renal functions, respectively, were investigated and compared with the light-microscopic findings of the renal interstice. A distinct structural tubulointerstitial lesion (tiK) was found in 30%. The diagnostic predictivity for the recognition and the exclusion of the tiK was tested for single or paired data of the renal function. As a result it is possible with a suitable combination of parameters in on an average more than 80% of the cases to establish or to exclude function-diagnostically a tubulointerstitial structural lesion even in still inconspicuous creatinine values. From the clinical point of view thus the information value of functional diagnostic investigations of the renal water treatment is confirmed (concentration power, dilution ability, water diuresis), in which case the differentiated test of the renal acidification may supplement the informations about the tiK-situation.

Adolescent

Morphologic and functional tubular changes in chronic glomerulonephritis.

In 135 patients with different glomerular diseases but normal glomerular filtration rates (CCr and In = 103 +/- 2ml/min) correlations between morphological tubular lesions (tic) and changes in tubular function were investigated. Between the extent of tubular lesions and the impairment of specific tubular functions (formula; see text) exists a highly significant correlation. The combined diminution in Uosmmax and UNH4 + V reflects in 72 per cent the appearance of a severe tubular lesion and should be used for its clinical recognition.

Biopsy

[Glomerulonephritis therapy. Immunosuppression or coagulation inhibitors - a comparison].

In 110 patients with mesangioproliferative glomerulonephritis the treatment (n = 48) with chlorambucil, warfarin, dipyridamol and prednisone (CAA) and the treatment with imuran and prednisone (CP, n = 23) are compared with the conditions of an untreated control group. The CAA-therapy is above all suited for active clinical pictures without sclerosis with short duration of the disease, even when the renal function is already restricted. The CP-therapy is suitable in non-active forms with sclerosis also in a longer duration of the disease.

Anticoagulants

[Therapy of primary glomerulonephritis. Comparative study on the effect of cytostatics-prednisone and cytostatics-anticoagulant-aggregation inhibitor combination].

The result of the treatment with chlorambucil, dipyridamol, heparin/warfarin and prednisone on 50 patients as well as with imuran and prednisone on 32 patients is compared. Basis for this is a detailed morphological and clinical subdivision. With the help of therapy results is tried to derive regions of indication: the therapy with cytostatics, anticoagulants and aggregation inhibitors is above all suitable for patients with a short duration of the disease and with sign of activity, also in renal insufficiency. On the other hand the therapy with cytostatics and prednisone is also successful in patients with longer duration of the disease and missing signs of activity.

Adolescent