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D Goldblatt

Publications and source records attributed to D Goldblatt.

At least 109 records · Page 6Linked to original sources
PubMed1990

Amo Amand/Amant.

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Electric Stimulation Therapy↗
PubMed1990

Branhamella catarrhalis: antigenic determinants and the development of the IgG subclass response in childhood.

A recently developed whole cell ELISA was used to investigate the development of IgG subclass antibodies to Branhamella catarrhalis in childhood. In addition, SDS-PAGE and immunoblotting were used to study the interaction between the outer membrane proteins (OMPs) of B. catarrhalis and IgG subclass antibodies. Specific IgG3 antibodies were undetectable or present only in low amounts in children less than 4 years old but were an important constituent of the response of older children. OMPs prepared from different isolates had similar molecular masses and bound IgG with identical immunoblotting patterns. Binding appeared subclass-specific, with IgG3 binding to the broadest range of OMPs. These findings should provide a better understanding of the pathogenic role of this organism and suggest possible strategies for the development of a vaccine.

Agammaglobulinemia↗
PubMed1989

A controlled clinical trial of baclofen as protective therapy in early Huntington's disease.

We carried out a controlled clinical trial to examine the potential of baclofen to slow the functional decline of patients with early Huntington's disease (HD). The basis of the trial was: (1) the hypothesis that excitatory amino acid neurotransmission mediates the neuronal degeneration of HD, (2) preclinical evidence that baclofen retards corticostriatal release of glutamate and aspartate, and (3) reports that baclofen produces short-term clinical benefits in some HD patients. Sixty patients with early HD were randomized to chronic baclofen, 60 mg/day, or placebo treatments and followed systematically for up to 42 months. Total functional capacity was not favorably influenced by baclofen treatment. Factors that contributed, although nonsignificantly, to a more rapid rate of total functional capacity decline included younger age (less than 35 years), earlier stage (stage I) of illness, paternal inheritance of the HD gene, and baclofen treatment. Our patients declined at a pace slower than that observed in other prospective studies, a finding likely due to selection criteria, avoidance of neuroleptic therapy, and strong psychosocial support.

Adolescent↗
PubMed1989

Dermatofibrosarcoma protuberans of the scalp: a series of cases.

Three cases of dermatofibrosarcoma protuberans on the scalp of young women are presented. The scalp is a rare but important anatomic site for this tumor because of the possibility of direct invasion into the skull and brain. The use of DNA analysis to predict biologic aggressiveness of a tumor is discussed.

Adult↗
PubMed1989

Like a cheap toy.

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Alzheimer Disease↗
PubMed1989

Starting and stopping the ventilator for patients with amyotrophic lateral sclerosis.

Only a minority of patients who have ALS require, request, and receive assisted or supported ventilation. Usually, when a mechanical ventilator is needed, nonsurgical methods can be used for prolonged periods of time. Appropriately timed discussions can reduce the need for emergency management of breathing failure. The doctrine of informed consent applies to decisions about life support. It involves both the physician (to exercise clinical judgment on behalf of the patient) and the patient (to make personal decisions). They must interact. The patient's firm decision must be clear but need not be in the form of a "living will," and it does not need to be sought repeatedly or reiterated endlessly. Just as a considered decision cannot be arbitrarily overthrown in a time of crisis, neither can a change of mind be willfully ignored. In practice, this may test the capability of even the most experienced and understanding physician, and may result in less-than-ideal outcomes, as our examples show. As in any other area of medical practice, personal experience teaches valuable lessons. Unfortunately, even extended publications discussing clinical management of ALS have failed to address the subject of discontinuing ventilatory support, and ethicists have not always been helpful. Bernat and Beresford have, however, successfully summarized the ethical issues involved. Failure to sustain breathing mechanically or withdrawing artificial support of breathing from a requesting patient who, in the terminal stage of ALS, has become unable to breathe without a mechanical ventilator cannot be called assisted suicide, mercy killing, or either passive or active euthanasia. It is allowing a competent person to die naturally of the incurable illness that afflicts him. The state has no legal interests to be served by intervening in the process just described, which bears no relationship to issues of malpractice, much less to criminal negligence or homicide. Neurologists have not uniformly understood these points, as demonstrated by previous publications addressing the issue and by the findings of our own survey of neurologists who have special experience in the area of neuromuscular diseases. In regard both to starting and to stopping the ventilator, we believe strongly that it is time to lay aside the moral, legal, and ethical conflicts that have needlessly delayed or prevented physicians from complying with the resolute decisions that competent patients have made about their own lives. We urge doctors to act in these cases, as in all others, with their best medical judgment.(ABSTRACT TRUNCATED AT 400 WORDS)

Amyotrophic Lateral Sclerosis↗
PubMed1988

The epidermal growth factor receptor as a substrate for a kinase-splitting membranal proteinase.

A brush-border membranal proteinase, which specifically clips the catalytic subunit of cAMP-dependent protein kinase, is shown to cleave the receptor for the epidermal growth factor (EGF) (Mr = 170,000) into two fragments of Mr = 140,000 and 30,000. The 140-kDa fragment retains its EGF-binding site and its EGF-dependent protein tyrosine kinase activity on exogenous substrates, but it loses its capacity to undergo self-phosphorylation. It is shown to be distinct from the 150-kDa fragment of the EGF receptor obtained by the Ca2+-activated neutral proteinase. The membranal proteinase strictly recognizes the native structure of the receptor and fails to cleave either the denatured receptor or its 150-kDa degradation product. Thus the membranal proteinase acts as a conformation-recognizing probe for both the protein-tyrosine kinase domain of the EGF receptor and the catalytic subunit of cAMP-dependent protein-Ser/Thr kinase, suggesting that the known sequence homology between these two kinases is also reflected in their conformation. The well defined 140-kDa fragment described here is useful for structure-function studies of the EGF receptor.

Adenosine Triphosphate↗
PubMed1988

Cerebrospinal fluid homovanillic acid and parkinsonism in Huntington's disease.

In Huntington's disease (HD), normal or decreased levels of homovanillic acid (HVA) in cerebrospinal fluid (CSF) have been reported but have not been analyzed with respect to severity of parkinsonism, which in certain cases may be a predominant feature of the illness. We obtained CSF by lumbar puncture from four groups of nonmedicated subjects: (1) those with HD in the earliest stages of illness (n = 51), (2) those with parkinsonism, including idiopathic (n = 10) and atypical forms (n = 4), (3) those with nonparkinsonian movement disorders (n = 19), and (4) normal volunteers (n = 4). HVA was determined by high-pressure liquid chromatography with electrochemical detection, and motor signs were assessed in standardized fashion. The parkinsonian group had reduced levels of CSF HVA, but the other groups showed no significant differences. For those with HD, no correlation was found between HVA level and severity of parkinsonism, and there were no differences in HVA level between those subjects with (n = 14) or without (n = 37) prominent parkinsonism or between subjects whose age at illness onset was 30 years or less (n = 16) and those whose age at onset was over 30 (n = 35). Our findings indicate that in early, untreated HD, CSF HVA is in the normal range and does not correlate with the severity of parkinsonism. This observation supports neuropathological findings suggesting that parkinsonian features in HD are largely related to the loss of postsynaptic striatal dopamine receptors rather than to presynaptic nigral degeneration.

Adult↗