Biomedical subjects
Publications and source records attributed to S Pollak.
The diagnosis of typhoid fever (TF) is usually established by culturing S. typhi from the blood or by serology. In this report we describe three patients in whom the diagnosis of TF was made by the isolation of S. typhi from gastric contents, despite negative blood urine and stool cultures. Culture of gastric contents has not previously been recognized as a diagnostic tool in this disease.
Recent studies have shown 1,25(OH)2D3 receptor-mediated modulation of leukocyte proliferation, differentiation, and function. We examined the phagocytosis and killing of microorganisms by neutrophils and monocytes from five patients of three families with hereditary resistance to 1,25(OH)2D3. Phagocytosis of microorganisms by patients' neutrophils and monocytes was normal. However, defective neutrophil killing activity toward Candida albicans (30-40% of controls) was found in all patients. The killing of Staphylococcus aureus was normal. The neutrophil chemiluminescence, nitroblue tetrazolium (NBT) dye reduction, and the generation of superoxide ions and hydrogen peroxide by neutrophils and monocytes after induction by either soluble stimuli or zymozan particles, did not differ from those in controls. The neutrophil myeloperoxidase activity was also normal. Monocytes obtained from two patients of different families before long-term calcium infusion therapy and after they became normocalcemic, demonstrated a similar impaired fungicidal activity toward Saccharomyces cerevisiae, indicating that hypocalcemia itself was not the cause of the killing defect. However, the addition of the Ca+2 ionophore A23187 (1 microM) to the test medium restored the monocyte fungicidal activity to normal. As patients' neutrophil cytosolic free calcium concentration was similar to that in controls, it is suggested that 1,25-(OH)2D3 exerts its effect on leukocyte function by a putative receptor-mediated regulation of subcellular calcium localization which may be important for fungicidal activity.
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Improper rescue or transportation of a corpse by gripping the neck or using a sling can cause traumatization that might erroneously suggest strangulation in subsequent autopsy. On the basis of 3 observations, postmortal damages which, at first sight, had seemed suspicious are presented and discussed. In the first case a drowned person's neck showed a dried skin line simulating a strangulation by ligature. The 2nd case dealt with a male person who had died ventricumbent in consequence of an apoplectic cerebral haemorrhage, and who had been lifted by embracing the neck shortly after death; at the post-mortem examination, massive blood extravasations were found in the cervical musculature. In the 3rd case, a strap was slung around the neck of a male epileptic--subsequently found to have served for carrying a saxophone. Both great hornes of the thyroid cartilage were fractured. Inquiry revealed that the undertakers had used the sling to hoist the corpse in which changes due to decomposition had already developed.
In the absence of her parents, a girl of 4 months was killed by a 2-year old male Rottweiler dog belonging to the same family. The dog's front teeth left marks of individual, circular or scratch-like abrasions as well as slit-like severances of the skin, arranged in curved lines. The pattern of the skin-lesions largely correspond to the anatomy of the dog's set of teeth. No tissue defects (effects of devour) could be detected. Multiple traumatization of the trunk had led to serial rib fractures and ruptures of several organs.
Experiments were conducted on soft-tissue and bone preparations to determine the morphological characteristics of angle grinder injuries. The grinding effect of the rotating cutting-off wheel causes severances with local loss of tissue, resulting in tool-specific wound features. Superficial skin notches and (incomplete) severances of bony structures are of particular significance. Mutual trace transfer is a valuable means for determining the tool used and for interpreting the scene.
Report on two suicidal deaths by carbon monoxide, deriving from the exhaust fumes of gas water heaters. In the first case the exhaust system intentionally had been disconnected. In the second case a gas water heater with known defect (largely obstructed burner) acted as source of carbon monoxide; it had caused an accidental death some weeks before. Both suicides were aware that incomplete combustion of natural gas produces carbon monoxide. In one of the cases the CO poisoning remained undetected until autopsy.
Sharp-pointed full metal-jacketed bullets fired from assault rifles are expected to have a low tendency of deformation or destruction within biological tissues. In principle this also should apply to small calibre projectiles .223. If a bullet penetrates the oral region, contact with teeth can cause early break up and even total disintegration of the projectile. Under such circumstances the fragments are possibly retained within the body. A case of accidental gunshot injury to the head inflicted with an assault rifle AUG Steyr. 223 of the Austrian army serves to demonstrate and discuss the wound ballistic effects in relation to the altered behaviour of the projectile. Analogous findings were reproduced in experimental models.
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Two hundred and sixty-eight children with pediculosis capitis took part in a comparative study to test the efficacy of five different pediculocides commonly used in Israel. The preparations used were pyrethrin shampoo, pyrethroid spray, malathion solution, carbaryl shampoo and carbaryl lotion. Carbaryl lotion and malathion solution were much more efficient when compared to the shampoo and spray preparations.
A three-year old patient had ichthyosis and neutral lipid storage disease (Chanarin-Dorfman syndrome), characterized by congenital ichthyosiform erythroderma and leukocyte vacuoles. He did not show any of the internal system involvement that was found in previously described cases. Patients with this syndrome demonstrate a great variability of clinical involvement. The affliction may be very mild as in our case or it may lead to rapid death, as with the patient's brother born a Harlequin baby, who only survived 5 days. Because of this wide spectrum of clinical variability mild cases might escape diagnosis. It is, therefore, suggested that every case of ichthyosis should have a peripheral blood smear evaluation with special attention to the morphology of the leukocytes. Our case clearly demonstrates the value of such a screening examination. Although the patient had been under treatment for almost 3 years, only screening examination of blood smears of all the patients with ichthyosis finally led to the correct diagnosis.
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The characteristic appearance of gunshot injuries to the aorta is presented on the basis of 5 autopsy cases. (1) In sections showing no atherosclerotic changes, projectiles from hand weapons and from .22 calibre rimfire rifles leave remarkably small holes (comparable to the orifices of the intercostal arteries); in areas with sclerotic plaques the bullet holes are considerably larger. (2) Tears of several millimetres in length radiate from the entrance and exit perforations, so that the lesions may appear as stellate lacerations. The configuration of ante-mortem injuries was reproducible in test shots on aortas removed post mortem. The morphological findings can be explained by the ballistic wound response of elastic tissues.
Human choriogonadotropin (hCG) is a placental glycoprotein hormone composed of a 92-amino acid alpha subunit noncovalently linked to a 145-amino acid beta subunit. We report here the expression of biologically active hCG in mouse C127 cells transfected with expression vectors containing the DNA coding for both subunits. In addition, the same cell line was used to express the alpha subunit alone. The expression products were purified by affinity chromatography using specific monoclonal antibodies to hCG or its subunits. The system secreting biologically active hCG also produced a 10-fold or greater molar excess of free beta subunit. The dimeric hormone, as well as the excess beta subunit, resembles the standard urinary hCG and beta subunit by chemical and biological criteria. In contrast, when the vector encoding for the alpha subunit was expressed alone, the alpha subunit had a higher molecular weight than both standard alpha and the alpha found in the expressed dimeric hormone. The molecular weight difference between expressed alpha subunit and standard alpha was found to reside in the alpha peptide consisting of residues 52-91 which contained all of the carbohydrate of the alpha subunit. The N-asparagine-linked carbohydrate moieties in the recombinant alpha were found to be triantennary in contrast to biantennary in urinary alpha, and this hyperglycosylation was responsible for the higher molecular weight of the alpha subunit when it was expressed alone. We found no evidence of O-threonine glycosylation at position alpha 39 reported to be present in free forms of the alpha subunit; however, the companion paper (Corless, C.L., Bielinska, M., Ramabhadran, T. V., Daniels-McQueen, S. Otani, T., Reitz, B. A., Tiemeier, D. C., and Boime, I. (1987) J. Biol Chem. 262, 14197-14203) finds a small quantity of O-glycosylation. Since the excess beta subunit appears to be of normal size and contains the expected complement of sugars, only free alpha subunit seems to be a potential substrate for addition of extra sugar moieties. No large beta subunit forms have been found by others, while large alpha subunits have been described both clinically and in tissue culture systems. These observations imply that the conformation of the free alpha subunit, in the regions of the glycosylation recognition sites, allows easier access for glycosyltransferases than those same sites in the beta subunit. When alpha is combined with beta, the local structures around the alpha glycosylation sites are apparently altered so as to make the synthesis of triantennary chains less favorable.
The fire at the Vienna hotel "Am Augarten" (28.9 1979) caused 25 deaths. 24 victims died as a result of inhalation of fire gases; 10 of them also suffered 2nd and 3rd degree burns. In one case, death was due to internal injuries (sustained when jumping from a window). The fact that none of the bodies was charred facilitated identification. In all cases autopsy revealed the typical symptoms of inhalation of fire gases (soot deposition in the respiratory tract, presence of carboxyhaemoglobin in the blood). In public discussion the question was raised whether the inhalation of hydrogen cyanide (liberated from nitrogen-containing natural or synthetic polymers by pyrolysis) was a contributory factor to the fatal outcome. The cyanide concentrations in blood samples measured by gas chromatography were below the toxic range in all cases. Chemical investigation comprised the determination of the carboxyhaemoglobin concentrations and the demonstration of volatile hydrocarbons in the air of the lungs.
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In several cases of fatal blunt-trauma injuries or after exposure to severe burning, large-drop fatty substances, discernible to the naked eye, were found in the venous blood of the right ventricle. Thin-layer chromatographic separation of the extracted lipids demonstrated an increase in the triglyceride fraction. Analysis of the fatty acids by means of combined gas chromatography/mass spectrometry showed a shift towards oleic acid. The distribution pattern of the molecular weights was determined by means of DCI-mass spectrometry in order to characterize the triglycerides in detail. The total chemical findings indicated that the visible lipids present in the right ventricle had predominantly derived from the adipose tissues. In cases of post mortem burning (without vital traumata) no typical pulmonary fat embolism had developed despite massive lipemia in the venous blood.