Biomedical subjects
Publications and source records attributed to M S Cohen.
A case of papillary necrosis in a diabetic patient with Escherichia coli urinary tract infection is reported. Infectious contribution to the disease is presented, and the electron microscopic similarities of bladder response to infection are discussed.
The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.
Within 4 days, two oncology patients in the Clinical Research Unit had bacteremia causes by group Y Neisseria meningitidis. Three additional patients, identified by prevalence survey, were found to have nasopharyngeal colonization with that serogroup, compared with only one employee (not associated with patients) and no family contacts. Infected and colonized (case) patients were located in the same or adjacent rooms but did not have close contact. A comparison of host and risk factors showed no significant differences between case patients and the other (control) patients located in the same rooms. In retrospect, the index patient, who had marked sputum production but was not isolated, had unrecognized meningococcal pneumonia and probably was the hospital source of a heavy, airborne dispersal of organisms to other patients. Respiratory isolation is warranted for patients with suspected N. meningitidis infection.
Human polymorphonuclear leukocytes (PMNs) were labeled with indium-111 oxine in ethanol, and the effects of the labeling procedure, radioactivity, and concentrations of oxine and ethanol on PMN function and structure were studied in vitro. The standard labeling procedure did not alter the viability, random migration, chemotaxis, bactericidal capacity, or the ultrastructure of PMNs. Exposure to higher doses of radioactivity, or to higher concentrations of ethanol, had no appreciable effects on random migration and chemotaxis of PMNs. A dose-dependent reduction in their random migration and chemotaxis was observed when higher concentrations of oxine were used. These results indicate that In-111-labeled PMNs are structurally intact and have normal in vitro locomotion and bactericidal activity. Indium-111-labeled PMNs should be suitable for studying the kinetics and distribution of these cells in health and disease.
The response of the rat renal pelvis to Pseudomonas aeruginosa infection was examined using scanning electron microscopy. Bacterial attachment was noted in regions of microplical alteration with subsequent strand formation and epithelial cell exfoliation. These observations support the hypothesis that bacterial invasion initiates defense mechanisms in the renal pelvis similar to those noted in bladders, namely, membrane alteration with increased bacterial attachment, strand formation with further bacterial entrapment, and exfoliation of bacteria-laden epithelial cells which are eliminated via voiding.
Random migration, chemotaxis, phagocytosis, and bactericidal ability of neutrophils from 5 patients receiving lithium carbonate were compared with those of neutrophils from healthy donors. These cells functioned normally in all respects. Neither sera from patients receiving lithium carbonate nor the addition of lithium chloride to control cells in vitro significantly altered their functional capacity. These findings suggest that neutrophil function in patients receiving lithium therapy is preserved, and they support the potential utility of this drug as a leukopoietic agent in neutropenic states.
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A leiomyoma of the prostate presented as an encrusted intravesical mass on excretory urography. A prostatic leiomyoma usually is benign and is relatively rare with only 41 cases reported previously. Surgical and pathological findings and differential diagnosis are presented.
A patient is presented with multiple manifestations of an autoimmune diathesis: immune thrombocytopenia, red cell aplasia, hyperthyroidism, a lupus-like syndrome, and an anti-i autoantibody, with inability to be transfused. Some of these entities are known to be commonly associated, but some are not, and it is unusual to find five of these phenomena in a single patient.
A thorough investigation of the literature pertaining to therapy supervision reveals that supervision has never been examined from the viewpoint of the trainee. This paper examines live supervision of family therapy from that viewpoint. It suggests that live supervision is a powerful and effective tool--a tool that engenders strong emotional responses.
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Phycomycetes are ubiquitous saprophytic fungi sharing with other fungi a propensity for invasion and disease production in immunologically compromised hosts. Diabetes mellitus, in particular diabetic ketoacidosis, is a common clinical setting for phycomycosis. A pulmonary phycomycetoma was diagnosed in a diabetic patient from material obtained by bronchial brushing was treated successfully with a combination of surgery and amphotericin B.
Inflammatory exudates around intrauterine devices were found to produce large concentrations of prostaglandin F2alpha. To evaluate the effect of this substance, 100 semen specimens were incubated in concentrations 100 times greater than that found in normal semen. Motility indices were calculated, and significant inhibition of sperm motility was found. The effect of prostaglandin E on sperm motility is also reviewed. The physiology of prostaglandins and their mechanism of action via the cyclic nucleotide system are discussed.
It is clear that the group B streptococcus has become a major pathogen of young infants within the comparatively recent past. Further it is clear that, as with other endemic and epidemic pathogens, increasing clinical and laboratory experience brings to light variations not initially evident. In addition, therapy presumably effective in initial cases may not continue to be so. The following papers by coincidence were received over a relatively brief period of time. Hence, for emphasis of some of the problems related to this organism, they are presented as a group.