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B D Shapiro

Publications and source records attributed to B D Shapiro.

6 recordsLinked to original sources
PubMed1998

The clinical significance of a biopsy-based diagnosis of focal active colitis: a clinicopathologic study of 31 cases.

Focal active colitis (FAC) is a common pattern of injury in colorectal biopsy specimens. Recently, FAC was found to be a marker of an infectious colitis-like diarrheal illness and ischemic colitis but not of Crohn's disease. We evaluated 31 cases of FAC at the Cleveland Clinic Foundation, Cleveland. Ohio, between 1982 and 1992, to assess the clinical significance of this histologic finding. We evaluated the degree of neutrophil-mediated crypt epithelial injury, the degree of neutrophil-mediated surface epithelial injury, and the lamina propria cellularity and cell type. In each biopsy specimen, all of the above features were scored as 1+ (involving < 10%), 2+ (10-25%), or 3+ (26-50%) of the specimen. Clinical follow-up for the 31 patients ranged from 1 to 51 months (mean, 26 mo). Clinical diagnoses included infectious-type colitis (15 cases, 48%); incidental FAC (9 cases, 29%), occurring in asymptomatic patients undergoing screening for colonic neoplasia; ischemic colitis (3 cases, 10%); and Crohn's disease (4 cases, 13%). Histologically, all of the cases had some degree of cryptitis, and 24 (77%) of the 31 had neutrophil-mediated surface epithelial injury. In 13 (42%) of the 31, there was an expansion of the lamina propria by neutrophils, in 12 (39%) by eosinophils, and in 11 (35%) by plasma cells. None of the histologic features correlated with specific clinical diagnostic categories (Fisher's exact test). In conclusion, FAC most commonly correlates clinically with an infectious-type of colitis. On occasion, FAC might be a harbinger of Crohn's disease. Histologic features are not useful in predicting specific clinical diagnoses as a correlate to FAC.

Bacterial Infections↗
PubMed1997

Idiopathic midesophageal stricture: a new cause of dysphagia in a patient with AIDS.

A number of disorders may result in the complaint of dysphagia in HIV-infected patients. These include fungal, viral, bacterial, parasitic, medication-induced, and idiopathic lesions in the esophagus. In the current case, a 32-year-old man with advanced HIV infection had recurrent bouts of esophageal stricture. No ulcer was associated with this stricture. No infectious causes of the stricture could be determined. The patient required multiple upper endoscopies and dilatations for treatment of this stricture and subsequently had a food impaction. This is the first case in the medical literature of an idiopathic stricture in the middle portion of the esophagus in an HIV-infected patient. We postulate that this lesion may have been caused by the patient's medications. Esophageal strictures should be considered in HIV-infected patients with severe dysphagia or food-bolus impactions of the esophagus.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Cancer biology in ulcerative colitis and potential use in endoscopic surveillance.

Because patients with longstanding ulcerative colitis are at an increased risk for developing colorectal cancer, surveillance colonoscopy and colectomy for dysplasia or asymptomatic cancer is advised as a method of reducing cancer-related mortality. Generally, the use of dysplasia as a criterion for a positive test in cancer surveillance has performed poorly. The emerging field of colon cancer genetics has identified several important tumor markers that have the potential to improve sensitivity for the detection of early neoplasia. Specifically, p53 tumor suppressor gene mutations, aneuploidy, and mucin-associated sialosyl-Tn expression appear most promising for future use in surveillance programs.

Aneuploidy↗
PubMed1991

Noise-induced changes in red blood cell velocity in lateral wall vessels of the rat cochlea.

The effects of loud sound on the microvasculature of the cochlea are not well characterized or understood. Morphological changes in the stria vascularis and changes in blood flow are known to occur during or following sound stimulation, however, the effects on cochlear blood flow appear to be complex. Studies have shown that noise exposure may produce increases in blood flow, decreases in blood flow, or no measureable change in blood flow. These inconsistent results probably reflect the various noise exposure parameters, the animal model used, and could be a function of the specific procedures utilized to assess blood flow changes. The purpose of the current study was to investigate the effects of one specific class of sound exposure (high intensity noise) on red blood cell velocity in the capillaries of the second turn of the rat cochlea using intravital microscopy. This class of sound exposure was selected in order to attempt a confirmation of previous findings of increased blood flow (Perlman and Kimura, 1962) using the quantitative technique of red blood cell velocity measurement. Following determination of pre-exposure red blood cell velocities in capillaries of the rat cochlea second turn, animals were exposed to 133 dB or 110 dB broad-band noise for ten minutes. The red blood cell velocity was recorded continuously during the exposure. Exposure to both sound intensities disrupted stable and orderly baseline flow patterns and resulted in overall intensity-dependent increases in red blood cell velocity.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗