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Biomedical subjects

E Friedman

Publications and source records attributed to E Friedman.

At least 415 records · Page 23Linked to original sources
PubMed1987

The association of biliary and pancreatic anomalies with periampullary duodenal diverticula. Correlation with clinical presentations.

Fifty-eight symptomatic patients with periampullary duodenal diverticula (PDD) were examined for pancreatic and biliary anomalies using endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography, and other imaging modalities. The pathologic findings in these patients were compared with those in a matched group of 58 patients without PDD, who were simultaneously undergoing a similar investigation for the same clinical presentations. Pathologic findings in the pancreas and/or biliary tree were detected in 70.7% of all patients with PDD, compared with 39.7% in the control group. In patients with PDD, pancreatobiliary anomalies were detected in all patients who presented with jaundice, 85% of patients with pancreatitis, and 27.8% of patients with abdominal pain, as compared with 60%, 40%, and 17%, respectively, in the control group. In 23 patients, ERCP findings demonstrated pancreatobiliary abnormalities that were not detected by other imaging modalities. Fifteen of the patients with PDD and pancreatobiliary anomalies had undergone cholecystectomy between six months and five years previously. We conclude that ERCP is essential in the investigation of all patients with PDD, especially those presenting with jaundice or pancreatitis. Biliary surgery in patients with PDD and a dilated bile duct should include a biliary drainage procedure to prevent recurrence of pancreatobiliary disease.

Aged↗
PubMed1987

Rickettsiosis-associated hyponatremia.

Two patients with hyponatremia (130 mEq/l and 122 mEq/l, respectively), and rickettsial disease are described. The causes of hyponatremia were attributed to rickettsial vasculitis and increased capillary permeability in the first patient and to the syndrome of inappropriate anti-diuretic hormone (ADH) secretion in the second patient. The differentiation between the mechanisms was established by measurement of urinary sodium excretion which was low in the first patient (7 mEq/l) and high in the second patient (60 mEq/l), and levels of ADH that were inappropriately high in the second patient (7-9 pg/ml) in the presence of low plasma osmolality. The differentiation between these causes of hyponatremia has important therapeutic implications.

Adolescent↗
PubMed1987

Defining conditions to promote the attachment of adult human colonic epithelial cells.

An improved method for the attachment and growth of normal human colonic epithelial cells from minute 1 to 3-mm3 biopsies has been developed. This yields four times as many cultured cells per biopsy than older methods, with a success rate of 97% in a series of 29 biopsies. Fetal bovine serum was eliminated from the medium, the medium pH was decreased to 6.7, the oxygen tension in the incubator was decreased to 3%, and the NCTC 168 medium was supplemented with ethanolamine, phosphoethanolamine, hydrocortisone, ascorbic acid, transferrin, glutamine, insulin, epidermal growth factor, pentagastrin, and deoxycholic acid. The best substrate for cell attachment was a mixture of ungelled collagen I and bovine serum albumin. This substrate was better than the identical mixture with fibronectin added, fibronectin alone, a thin gelatin film, collagen IV with or without fibronectin, and basement membrane preparations from four different cell lines.

Basement Membrane↗
PubMed1987

Prevention of fluphenazine-induced changes in dopaminergic and muscarinic receptors by lithium.

Co-administration of lithium carbonate to mice through their diet prevented the increase in dopamine receptor binding and the decrease in muscarinic receptor binding normally produced in striatum by chronic (12 week) administration of the neuroleptic, fluphenazine. The lithium treatment failed to prevent the muscarinic down-regulation induced by the muscarinic agonist pilocarpine in the hippocampus. These results (along with previous data) suggest that fluphenazine-induced striatal muscarinic receptor down-regulation and its reversal by lithium may be the consequence of changes in dopamine receptors in this brain region.

Animals↗
PubMed1987

Endoscopic retrograde cholangiography in the detection of small stones in the gallbladder.

Multiple small (2-5 mm in size) gallstones were demonstrated only by endoscopic retrograde cholangiopancreatography in eight patients who had recurrent upper abdominal pain and vomiting. Three patients had mild, rapidly resolving abnormalities of liver biochemistry and serum amylase. In the other five, both serum amylase and liver biochemistry were repeatedly normal. We conclude that endoscopic retrograde cholangiography may be useful in the detection of small gallstones in patients with symptoms suggestive of biliary tract disease, even in the presence of normal oral cholecystography, ultrasonography, serum amylase, and liver biochemistry.

Amylases↗
PubMed1987

Hepatic abscesses and fungemia from Torulopsis glabrata. Successful treatment with percutaneous drainage and amphotericin B.

A 39-year-old man with severe diabetes mellitus, chronic pancreatic insufficiency, intrapancreatic choledochal stricture, and secondary biliary cirrhosis developed postsurgical fungemia and large hepatic abscesses due to Torulopsis glabrata. These were treated successfully with a combination of amphotericin B and percutaneous drainage of the liver abscesses. We believe this is the first reported case of such infection due to this normally saprophytic agent.

Adult↗
PubMed1987

Radiologic and endoscopic appearance of intrabiliary rupture of hydatid liver disease.

Intrabiliary rupture of hydatid liver cyst was diagnosed in 6 patients presenting with obstructive jaundice. All patients underwent ultrasonography and endoscopic retrograde cholangiopancreatography prior to surgical drainage of the liver cyst. Hydatid debris were found in the common bile duct preoperatively in 3 patients, and postoperatively in an additional 3 patients. Accurate diagnosis was made in all patients based on combined duodenoscopic, cholangiographic and sonographic findings. It is concluded that the combination of ultrasonography and endoscopic retrograde cholangiopancreatography can accurately detect intrabiliary rupture of hydatid liver cyst and that both techniques should be performed early in the investigation of suspected ruptured hydatid liver cyst.

Adult↗
PubMed1987

Prediction of response to nortriptyline and phenelzine by platelet MAO activity.

Thirty-seven depressed patients over the age of 55 were treated for 5-7 weeks with either nortriptyline, a tricyclic antidepressant, or phenelzine, a monoamine oxidase (MAO) inhibitor. Patients' platelet MAO activity was measured following a drug washout period before treatment. Patients with higher MAO activity had a better response to treatment, regardless of which drug was used.

Aged↗
PubMed1987

Electrocardiographic effects of nortriptyline, phenelzine, and placebo under optimal treatment conditions.

The authors treated 44 outpatients 55 years old or older who were suffering from major depression with either nortriptyline, phenelzine, or placebo for 7 weeks. Plasma levels of nortriptyline were kept between 50 and 170 ng/ml, and platelet monoamine oxidase (MAO) inhibition in phenelzine-treated patients was kept between 70% and 80%. ECGs were compared before and after treatment. Nortriptyline produced statistically significant increases in both the heart rate and the PR interval, although none was outside the normal range. Phenelzine produced a significant decrease in the QT interval. None of the patients had pathological ECG changes under the closely monitored treatment conditions of this study.

Aged↗
PubMed1987

Response of depressive symptoms to nortriptyline, phenelzine and placebo.

The effects of nortriptyline, phenelzine, and placebo on 13 symptoms of depression were compared in 75 patients, aged 55 or over, who were suffering from major depression. Nortriptyline and phenelzine were more effective than placebo in treating depression mood, guilt feelings, suicidal ideation, agitation, anxiety, loss of energy, and a.m. diurnal variation of mood. Nortriptyline was better than phenelzine or placebo in improving middle/late insomnia. Most of the symptoms did not show significant improvement until the fourth week of treatment.

Aged↗
PubMed1987

A placebo-controlled comparison of the effect of nortriptyline and phenelzine on orthostatic hypotension in elderly depressed patients.

Seventy-five patients, 55 years or older, were treated for major depression with either nortriptyline, phenelzine, or placebo during a 7-week period. There was a significantly greater mean orthostatic fall in systolic pressure in patients treated with nortriptyline and phenelzine as compared to the placebo group, but no significant difference was evident between the nortriptyline and phenelzine groups. The orthostatic changes appeared during the first week of treatment and were not correlated with plasma level of nortriptyline, percent platelet monoamine oxidase inhibition, or pretreatment orthostatic changes.

Aged↗
PubMed1987

Measles epidemic in young adults. Clinical manifestations and laboratory analysis in 40 patients.

Between February and June 1985, 40 military personnel were hospitalized because of measles. Diagnosis in all patients was entirely clinical, and serologic investigations were noncontributory. A transient disturbance in liver function occurred in 70% of patients, and its extent correlated with duration of fever and disease complications. Spontaneously resolving, measles-specific hypocalcemia, which was not associated with hepatic dysfunction, was noted in about one third of the patients. All these patients were asymptomatic, except one patient who developed tetany. The pathophysiologic basis for the hypocalcemia is still unknown. The disease course in three previously immunized patients was benign and uncomplicated.

Adolescent↗