Biomedical subjects

E Goldin

Publications and source records attributed to E Goldin.

At least 91 records · Page 5Linked to original sources

PubMed1991

Efficacy of misoprostol and ranitidine in the prevention of duodenal ulcer relapse and its correlation with endogenous gastric prostanoid synthesis.

We determined endogenous gastric prostaglandin synthesis and its correlation with the prevention of duodenal ulcer relapse by misoprostol and ranitidine. Sixty-one patients with recent endoscopically healed duodenal ulcer were randomly allocated in a double-blind fashion for one year of treatment with misoprostol 400 micrograms nocte, ranitidine 150 mg nocte or placebo. Patients were followed every two months. Endoscopy was repeated at six and 12 months or beforehand, if relapse was suspected. Antral and fundic biopsies, 3-4 from each region, were obtained at each endoscopy for determination of prostaglandin synthesis. During the one year of treatment, 11 out of the 12 placebo treated patients flared up, as opposed to 10 out of 25 and four out of 24 misoprostol and ranitidine treated patients, respectively. The difference between all treatment groups was significant (P less than 0.0001). In all subjects who flared up, pretrial endogenous antral and fundic prostaglandin E2 synthesis were not different from their respective synthesis in those who did not relapse.

Adolescent↗

PubMed1991

Localized primary sclerosing cholangitis mimicking a cholecystectomy stricture relieved by an endoprosthesis.

Primary sclerosing cholangitis presenting as a localized stricture affecting a segment of the extrahepatic biliary tree is rarely found. We describe the case of a 39 year old woman with obstructive jaundice, in whom this diagnosis was proven by endoscopic retrograde cholangiography. An endoprosthesis was endoscopically introduced through the stenotic area which led to a dramatic improvement enabling a successful liver transplantation after 2 years.

Adult↗

PubMed1991

Type C Niemann-Pick disease: use of hydrophobic amines to study defective cholesterol transport.

Niemann-Pick Type C (NPC) disease is a cholesterol lipidosis resulting from defective postlysosomal cholesterol transport. In normal cells this segment of cholesterol trafficking is inhibited by treatment with either U18666A or imipramine. Other compounds are also capable of blocking postlysosomal cholesterol transport: stearylamine, RV-538, and sphinganine inhibit low-density lipoprotein-induced esterification of cholesterol and cause unesterified cholesterol to accumulate in perinuclear vesicles. These vesicles can be stained with filipin to give a staining pattern indistinguishable from that seen in NPC fibroblasts. Because all of these compounds are hydrophobic amines, we conclude that most, if not all, hydrophobic amines block the postlysosomal transport of cholesterol. These results also raise the possibility that an endogenous amine, e.g., sphinganine, may inhibit cholesterol transport in NPC.

Amines↗

PubMed1990

The danger of high compliance balloons for esophageal dilatation in achalasia.

High compliance balloons, commonly used for pneumatic dilatation of achalasia patients, theoretically subject the widened esophageal wall, proximal to the narrow zone, to increased pressure, and subsequently to a higher risk of perforation. The new type of inelastic cylindrically shaped balloons, such as the Gruntzig-type and Rigiflex Achalasia Dilator, seems to be safer, since it increases esophageal wall tension in the stenotic zone only. The purpose of this study was to present a pathophysiological consideration of this assumption, together with two cases which support it.

Adult↗

PubMed1990

Thromboxane and prostacyclin levels in fetal rabbit brain and placenta after intrauterine partial ischemic episodes.

The appearance of arachidonic acid (AA) oxidation products in fetal rabbit brain and placenta under normal or partial short-term ischemic episodes induced by placental blood vessel restriction was examined. Intracerebral administration of [3H]AA into close-to-term rabbit fetuses gave rise to radioactively labeled prostaglandin (PG) E2, thromboxane B2, and 6-keto-PGF1 alpha metabolites as detected by HPLC analysis. A significant increase of 20-30% of [3H]AA precursor into eicosanoids was detected in brain of fetuses after 2-h restriction. The thromboxane B2 and 6-keto-PGF1 alpha levels were determined by radioimmunoassay technique over a period of 48 h following ischemic episodes. Thromboxane B2 content in affected animals was higher by five- and twofold at 3 h over control fetal brain and placental tissue values, respectively, and remained significantly higher for 24 h. 6-Keto-PGF1 alpha levels reached a peak value that was greater by 2.5- and 1.5-fold at 6 h for the ischemic brain and placental tissue, respectively, compared with control fetuses. PGE2 levels were less affected, attaining a maximum of 1.9- and 1.1-fold in brain and placenta correspondingly. The thromboxane/prostacyclin ratio reached a maximum in the brain after approximately 3 h, while that in the placenta continued to rise even after 20 h. Persisting high levels of thromboxane are indicative of cerebral vasoconstriction and may suggest possible damaging effects.

Animals↗

PubMed1990

Diarrhea in hypothyroidism: bacterial overgrowth as a possible etiology.

Constipation is common but diarrhea is very rare in myxedematous patients. We report a young woman with myxedema in whom chronic diarrhea was the dominant symptom. A fasting breath hydrogen test was positive, indicating bacterial overgrowth as the cause of the diarrhea. Antibiotic treatment was successful. We conclude that bacterial overgrowth due to hypomotility may be the etiology of the diarrhea in such patients.

Adult↗

PubMed1990

Treatment of fistulas of the biliary tract by endoscopic insertion of endoprostheses.

Five patients with fistulas of the biliary tract are reported; three had fistulas caused by operative injury and two, by accidental blunt abdominal trauma. All patients were treated successfully by endoscopic transpapillary insertion of biliary endoprostheses. The endoprostheses were removed after four to 17 weeks in all patients, and no evidence of biliary leakage was revealed by repeat cholangiograms and other clinical follow-up study. This effective, simple and safe method allows the fistula to heal and is a good alternative to surgical treatment.

Adolescent↗

PubMed1990

Megaesophagus and recurrent apnea in an adult patient with familial dysautonomia.

A 42-yr-old woman with familial dysautonomia (FD) presented with severe episodes of apnea during the daytime, as well as during sleep. Investigations revealed a megaesophagus and a lower esophageal constriction. These caused accumulation of food in the esophagus, resulting in recurrent aspiration and apnea which disappeared after gastrostomy. Megaesophagus, a rare complication in FD patients, can occur in other diseases with autonomic dysfunctions, and one must be aware of its potential respiratory complications.

Adult↗

PubMed1990

Gastrointestinal manifestations in Castleman's disease.

Castleman's disease is a relatively rare disorder of lymphoid tissue. The disease is considered benign in its localized form, but severe in the multicentric type. Gastrointestinal manifestations were occasionally described. We herein report four patients with histologically proved Castleman's disease in whom various and different clinical and pathological manifestations were found in the gastrointestinal tract, correlated with the primary disease. We believe that the digestive tract may be secondarily involved in Castleman's disease and, in some cases, gives the first manifestation of the disease.

Adult↗

PubMed1989

Colonic substance P levels are increased in ulcerative colitis and decreased in chronic severe constipation.

Substance P content was determined by radioimmunoassay in colonic mucosa from 24 patients with chronic severe constipation, 16 with active ulcerative colitis, and 28 normal controls. In patients with chronic severe constipation, the mean concentration of substance P (19.9 +/- 8.2 pg/mg) was significantly lower than in normal subjects (71 +/- 18 pg/mg). In patients with ulcerative colitis, colonic substance P concentration in inflamed mucosa (170 +/- 46 pg/mg) was significantly higher than its levels in normal subjects. Substance P may therefore have a role in the pathogenesis of clinical conditions associated with diarrhea and constipation.

Biopsy↗

PubMed1989

Indomethacin-induced gastroduodenal damage is not affected by cotreatment with ranitidine.

A randomized, double-blind, placebo-controlled study was conducted to determine whether concomitant administration of ranitidine reduces gastroduodenal mucosal damage associated with 1 week of indomethacin treatment. One hundred ten subjects with acute musculoskeletal conditions and who received indomethacin 150 mg/day completed the trial: 55 were treated with ranitidine 150 mg b.i.d. and 51 subjects received placebo b.i.d. Endoscopic gastric and duodenal injury were assessed before and after one week of treatment. There was no statistically significant difference in the percentage of patients with gastroduodenal damage or in the severity of the lesions in both treatment groups. Ranitidine did not ameliorate indomethacin-induced gastrointestinal symptoms and there was no correlation between upper gastrointestinal symptoms and endoscopic findings.

Adolescent↗

PubMed1989

Ischemia stress and arachidonic acid metabolites in the fetal brain.

Hypoxic-ischemic insults caused by placental insufficiency in perinatal life are today considered a major cause for neuronal injury and impaired postnatal development. A major consequence of placental insufficiency and ischemia is the change in metabolism of arachidonic acid and its oxidation products. A burst of postischemic production of prostaglandins, unequivocally shown in many systems, is documented in the fetal rabbit brain as well as in placenta tissue soon after vascular restriction. PGE2, a most abundant prostaglandin of the fetal brain, is particularly elevated. Similarly, thromboxane B2 and 6-keto PGF1 alpha, the stable metabolites of thromboxane A2 and prostacyclin, are both increased over the control values. However, after 48 h of restriction, the levels of these eicosanoids are restored to near-normal values. The metabolic machinery responsible for the conversion of arachidonic acid into eicosanoids in brain and placenta tissues appears to be impaired following a period of placental insufficiency. This inhibition can be accounted for by excessive production of eicosanoids and also by formation of an endogenous inhibitor or free radicals. Studies are in progress to test these possibilities.

Animals↗

PubMed1988

Duodenal epithelial atypia. A specific complication of hepatic arterial infusion chemotherapy.

Severe duodenal lesions developed in five patients during hepatic arterial infusion (HAI) employing 5-floxuridine (FUDR) as the basic antineoplastic agent. These lesions comprised ulcerative as well as proliferative processes. Striking structural distortion with cellular pleomorphism of the affected duodenal mucosa were the histological hallmark in all cases. These lesions are a specific complication of HAI chemotherapy and should not be misinterpreted as malignancy.

Adult↗

PubMed1988

Effect of substance P on rat gastrointestinal transit.

The in vivo effect of substance P and related peptide analogs on gastrointestinal transit in unanesthetized rats was studied. Fasted male rats were given intragastrically 0.5 ml of a powdered charcoal (BaSo4.H2O) meal and were concomitantly injected intraperitoneally with 8 micrograms/kg of substance P or a related peptide. In control rats, the percentage of small intestine traversed by the meal 15 min after feeding was 44.9 +/- 1.4 (N = 12). Substance P, [pGlu6]SP, [pGlu6, gPhe8, mGly9]SP and [pGlu5, N-MePhe8, N-MeGly9]SP significantly accelerated intestinal transit: 59.5 +/- 3.1% (N = 7); 66.0 +/- 3.8% (N = 14), 66.8 +/- 2.4% (N = 25), and 58.4 +/- 4.4% (N = 4), respectively. Concomitant injection of [pGlu6]SP and BOC-Phe-Phe-Gly-NHOH, an inhibitor of enzyme degradation at a dose of 800 micrograms/kg lowered by 10-fold the dose of [pGlu6]SP needed to induce the same degree of intestinal transit acceleration. These results indicate that in rats, substance P and related peptides accelerate gastrointestinal transit.

Animals↗

PubMed1988

Seasonal variations in the frequency of endoscopically diagnosed duodenal ulcer in Israel.

The seasonal pattern of endoscopically diagnosed duodenal ulcer disease in a representative Israeli medical center was evaluated retrospectively for the period 1980-1986. We reviewed all 9861 endoscopy records and found 1692 duodenal ulcers. We calculated the percentage of duodenal ulcers of the total examinations performed each month. In Israel, the frequency of duodenal ulcers was significantly increased during January and February and was significantly lower during the months May-June and July-August when compared to the rest of the year.

Duodenal Ulcer↗

PubMed1988

No correlation between indomethacin-induced gastroduodenal damage and inhibition of gastric prostanoid synthesis.

The effect of 1 week of treatment with indomethacin 150 mg/day on human gastric prostanoid synthesis was correlated with its effect on gastric and duodenal mucosa. Before and following 1 week of treatment, endoscopic appearance of the mucosa was evaluated and scored. Following 1 week of treatment with indomethacin, antral PGE2 and 6-keto-PGF1 alpha were significantly lower than in normal subjects, but similar in patients with significant or with no mucosal damage. Co-treatment with ranitidine 150 mg b.d. or with cimetidine 400 mg b.d. reduced the mean mucosal damage score but did not affect gastric prostanoid synthesis, which was similar irrespective of the presence or absence of mucosal damage. It is therefore suggested that there is no correlation between indomethacin-induced inhibition of gastric prostanoid synthesis and its induction of mucosal damage.

Adolescent↗

PubMed1988

Acute uteroplacental ischemic embryo: lactic acid accumulation and prostaglandin production in the fetal rat brain.

A new experimental model for studying the effects of acute ischemia on brain development in the near-term fetal rat has been devised. Ischemic conditions are achieved by complete clamping of blood vessels branching from the uterine vasculature into each individual fetus for designated times followed by removal of the clamps to permit reperfusion. Accumulation of lactic acid in the fetal brain depends on the length of the restriction period, reaching a plateau level of 29 mumol/g tissue at about 30 min. It also depends on the reperfusion time. Thus after a period of 15 min of restriction lactate levels show an increase over the next 30-min reperfusion to a value of 25.5 mumol/g followed by a rapid decrease to normal values by 3 h of reperfusion. Restriction of 15 min followed by reperfusion of 45 min causes an elevation of prostaglandin E2 (PGE2) level from 12.4 +/- 0.86 ng/g to 21.1 +/- 0.6 ng/g (p less than 0.001). This elevation in PGE2 level is less apparent after 20 min of restriction. No effects are seen on the level of PGF2 alpha. Both PGE2 and PGF2 alpha accumulate in vitro in a time-dependent manner by brain particulate fraction. In vitro synthesis of both PGE2 and PGF2 alpha is inhibited by indomethacin (100% and 68%, respectively) and AA861 (94% and 76%, respectively). BW755c and nordihydroguaiaretic acid do not affect PGE2 formation but enhance PGF2 alpha production by 112% and 152%, respectively. Particulate fractions from restricted brain produce less PGF2 alpha than control brains (6.38 +/- 1.62 versus 11.43 +/- 2.2, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

4,5-Dihydro-1-(3-(trifluoromethyl)phenyl)-1H-pyraz↗

PubMed1988

Cimetidine decreases indomethacin induced duodenal mucosal damage in patients with acute musculoskeletal disorders.

The effect of two doses of cimetidine, 400 mg at night and 400 mg bd, on the protection of indomethacin (50 mg tid) induced mucosal damage was evaluated in a double blind study in patients with acute musculoskeletal disorders. Endoscopic mucosal lesions were scored before and after five to seven days of treatment. One hundred and ninety one patients were endoscoped before the trial, 34 (17.8%) had greater than one erosion and were not recruited. Forty patients were excluded for non-compliance, or lost to follow up. At the second endoscopy, oesophageal, and fundic damage was negligible. Gastric and duodenal lesion score in patients treated with cimetidine 400 mg bd: 2.7 (0.5) (SE); n = 42) was significantly lower (p less than 0.0122) than in placebo treated patients: 6.1 (0.9) (n = 50) or in patients treated with cimetidine 400 mg at night 7.1 (0.8) (n = 21). Cimetidine 400 mg bd provided significant protection for the duodenum, but its protection of antral mucosa did not reach statistical significance. There was no correlation between upper gastrointestinal symptoms and endoscopic findings.

Adolescent↗