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Biomedical subjects

C Greenberg

Publications and source records attributed to C Greenberg.

35 records · Page 2Linked to original sources

Preoperative assessment of fragment D-dimer as a predictor of postoperative venous thrombosis.

We used a latex agglutination assay to measure preoperative plasma fragment D-dimer levels in patients admitted to a gynecologic oncology service. Eight percent of 71 patients with gynecologic cancer had elevated fragment D-dimer levels; none of these patients developed postoperative deep venous thrombosis. Preoperative elevation of the fragment D-dimer level was not predictive of postoperative deep venous thrombosis.

Female↗

Superficial migratory thrombophlebitis and the lupus anticoagulant.

The lupus anticoagulant is an antiphospholipid antibody found in association with systemic lupus erythematosus and in a variety of other diseases, as well as in healthy individuals. In the laboratory, the antibody interferes with the conversion of prothrombin to thrombin and prolongs the partial thromboplastin time. In vivo, it exerts a procoagulant effect resulting in thrombosis, mainly of the larger veins and arteries. The case of a young woman who developed superficial migratory thrombophlebitis in association with a high titer lupus anticoagulant is presented. Her diagnosis was initially missed because the partial thromboplastin time was not elevated. This appears to have resulted from the use of a specific thromboplastin relatively insensitive to the presence of the antibody. Retesting with a more sensitive reagent showed a markedly prolonged partial thromboplastin time.

Adult↗

ENT abnormalities associated with Fraser syndrome: case report and literature review.

Fraser syndrome is an uncommon genetic disorder characterized by multiple congenital abnormalities. Newborns afflicted with this syndrome have abnormalities of the eyes, ears, nose, larynx, palate, extremities and urogenital system. A review of the literature shows a deficiency in the description of the ENT abnormalities. Most articles have appeared in the ophthalmologic literature with emphasis on the obvious ocular abnormalities. In this paper we will describe in detail, the ear, nose and throat abnormalities in a two-year-old child with Fraser syndrome.

Child, Preschool↗

Parathyroid hormone secretion: effect of estradiol and progesterone.

Previous studies have shown that estrogen therapy in postmenopausal women results in an increase in serum immunoreactive parathyroid hormone (iPTH) levels. It has been assumed that this effect of estrogen on PTH secretion is indirect, being mediated via mild hypocalcemia resulting from an inhibition of bone resorption. We evaluated the direct effect of 17 beta-estradiol (E2) and of progesterone (Prog) on secretion of PTH from bovine parathyroid tissue in vitro. Both E2 and Prog caused a significant stimulation of PTH secretion within one hour, which was progressive for the three-hour observation period. The responses were dose-related from 10(-7) to 5 X 10(-10) mol/L. There was no PTH response to 10(-7) mol/L alpha-E2, 3-methoxy estriol, estrone, testosterone, or 20-alpha-hydroxy progesterone, indicating specificity of the responses to E2 and Prog. There was a minimal PTH secretory response to 10(-6) mol/L cortisol and 10(-6) mol/L estrone. The E2 receptor antagonist tamoxifen did not inhibit the E2 effect on PTH secretion. This observation plus the rapid PTH response suggests that this hormonal effect may not be via the conventional intracellular E2 receptor. Therefore, E2 and Prog can stimulate PTH secretion by rapid, direct, and specific effects on parathyroid cells. These gonadal hormones may, therefore, be important in calcium homeostasis via their direct stimulatory effect on PTH secretion.

Animals↗

Effects of estradiol and progesterone on calcitonin secretion.

Estrogen therapy has been used to inhibit bone resorption and prevent osteoporosis in postmenopausal women. Previous studies have disagreed as to whether the mechanism of estrogen action involves stimulation of calcitonin (CT) secretion. We evaluated the direct effects of 17 beta-estradiol (E2) and progesterone (Prog) on CT secretion from the thyroid C cells of 8-day-old rats in vitro. Both E2 and Prog caused a significant stimulation of CT secretion within 1 h, which was progressive for the 3-h observation period. The responses were dose related from 10(-7) to 5 X 10(-10) M. There was no CT response to 10(-7) M alpha-estradiol, estriol, 3-methoxyestriol, estrone, testosterone, or 20 alpha-hydroxyprogesterone, indicating specificity of the responses to E2 and Prog. There was a minimal CT secretory response to 10(-6) M cortisol. The E2 receptor antagonist tamoxifen did not inhibit the E2 effect on CT secretion. This observation plus the rapid CT response suggest that this hormonal effect may not be via the conventional intracellular E2 receptor. Therefore, E2 and Prog can stimulate CT secretion by rapid, direct, and specific effects on the thyroid C cell. The gonadal hormones may, therefore, be important in inhibiting bone resorption via their direct stimulatory effect on CT secretion.

Animals↗

Precipitation of fibrinogen, fibrinogen degradation products and fibrin monomer by histone H3.

Incubation of histone H3 with normal citrated plasma resulted in the formation of insoluble aggregates, as determined by turbidity measurements. The precipitate was subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis, confirming that fibrinogen was a major component. Purified fibrinogen precipitated rapidly as determined with turbidity experiments and experiments with radioiodinated protein. The amount of fibrinogen precipitation was strongly dependent on H3 concentration. Variation of ionic strength (0.2-0.84) and pH (5.3-7.4), however, had little or no effect on the reaction. Fibrinogen subjected to gelatin-Sepharose chromatography or dialysis against 3.3M urea reacted equivalently with H3. Precipitation of 125I-fibrinogen by H3 was strongly favored by increasing temperature (4 degrees-45 degrees C). Precipitation of fibrinogen by protamine was maximized by decreasing the temperature. In addition, formation of insoluble fibrinogen-protamine aggregates was highly dependent on ionic strength and pH, suggesting that different types of protein-interaction are involved in the two studied precipitation reactions. Of the fibrinogen degradation products, only fragment X precipitated significantly when incubated with H3. Radioiodinated fibrin monomer also precipitated when incubated with H3 in solutions of sufficient ionic strength to prevent spontaneous polymerization. The extent of precipitation was equivalent for fibrin monomer and fibrinogen. Fragment D inhibited the precipitation of fibrinogen by H3 or protamine. These studies indicate that the proteins termed "paracoagulants" are not all equivalent and that the hydrophobic domain of H3 plays a critical role in fibrinogen precipitation.

Chemical Precipitation↗

Tracheal agenesis and associated malformations: a comparison with tracheoesophageal fistula and the VACTERL association.

Tracheal agenesis is a rare malformation of the lower respiratory tract. Investigation of a patient with multiple congenital anomalies and tracheal agenesis prompted a review of the literature which uncovered 42 previously published cases, most of whom had other defects. The presence in our patient of a tracheal abnormality in association with radial hypoplasia, single umbilical artery, tetralogy of Fallot, and left hydroureter initially suggested presence of the VACTERL association. However, numerical classification of malformation patterns in the reported patients with tracheal agenesis and in a series of patients with tracheoesophageal fistula and other components of the VACTERL association suggests that tracheal agenesis does not occur in the VACTERL association and may be part of another pattern of malformations which includes laryngeal atresia, complex congenital heart anomalies, radial ray defects, and duodenal atresia.

Abnormalities, Multiple↗

Chondro-osseous changes in Cerebro-Oculo-Facial-Skeletal (COFS) syndrome.

Radiological and pathological findings were described in three cases of COFS syndrome. Early diagnosis of this syndrome is possible by the recognition radiologically of the characteristic proximal displacement of second metatarsals and pathologically by the extensive cell necrosis in the iliac crest biopsy. Pathological findings, including the presence of nuclear bodies in chondrocytes and amianthoid fibres surrounding necrotic cartilage cells, are compatible with a primary degenerative/deformative disorder. The aetiology of this syndrome is unknown.

Abnormalities, Multiple↗

A cytogenetic survey of 14,069 newborn infants. IV. Further follow-up on the children with sex chromosome anomalies.

Between 1970 and 1973, 14,069 consecutive liveborn infants at the Women's Centre, Winnipeg, were subjected to karyotypic analysis. The details of the materials and methods and the preliminary findings of the study have been previously published [1,2]. A total of 15 nonmosaic and 4 mosaic infants with sex chromosome anomalies were detected: 12 males and 7 females. These children have been followed wherever possible by physical and developmental evaluations, and preliminary findings have been reported previously [3]. In order to obtain further baseline data on these children while they were still prepubertal, it was decided to recontact all families and encourage them to present their children for further physical evaluation and psychologic testing. Details of these investigations and their results are given in this paper.

Child↗

Acute respiratory failure following severe arsenic poisoning.

A 47-year-old man had an episode of severe respiratory failure after acute intoxication with arsenic. Features of the initial clinical presentation included nausea, vomiting, and diarrhea, acute psychosis, diffuse skin rash, and marked pancytopenia. A peripheral neuropathy then developed which resulted in severe weakness of all muscles of the limbs, the shoulder and pelvis girdles, and the trunk. The neuropathy continued to progress despite treatment with dimercaprol (BAL in oil). Five weeks after the initial exposure, the patient was no longer able to maintain adquate ventilation and required mechanical ventilatory support. Improvement in the patient's neuromuscular status permitted successful weaning from the ventilator after one month of mechanical ventilation. Long-term follow-up revealed no further respiratory difficulty and slow improvement in the strength of the peripheral muscles.

Arsenic Poisoning↗

Two levels of inferential behavior in young children.

5- and 6-year-old children made inferences about the spatial locations of animals and people in a series of 3 experiments. The tasks employed manipulable models to represent the spatial relations involved and were made as simple as possible. 2 levels of inferential behavior were found. The first constituted the ability to draw an inference consistent with information given, but with minimal understanding of the way in which inferences can assist in decisions between alternative outcomes. At the second level, children succeeded in discriminating inferences which were logically necessary from those which were merely consistent with the premises. Most 5-year-olds were at the first level, most 6-year-olds at the second level. 2 criteria for the identification of young children's behavior as inferential were established, and the results of the present study were discussed in terms of recent related work with both younger and older children.

Child↗

Psychological support to an autologous bone marrow transplant unit in a community hospital: a pilot experience.

Autologous Bone Marrow Transplantation (AuBMT) has emerged as an efficacious treatment for certain hematological and solid tumors. Some of the complications of allogeneic transplants are avoided with an autologous transplant. Due to the decreased toxicity of this procedure, AuBMT can be administered at a community hospital where the setting is less burdensome for patients and families. The latter can continue to provide support for the patient as relocation is not necessary and visiting is easier. This report is a case analysis of the first 30 patients to undergo an autologous transplant as a pilot study in such an environment. This pilot project--done in a community hospital in Connecticut--may provide cost effective, high quality care in a more personal environment in the patient's own community. The different neoplastic diagnoses are listed as well as the types of psychological interventions available for these patients. Two case studies are described for clinical illustration. A discussion presents how psycho-oncology can assist the multidisciplinary team.

Adult↗