Biomedical subjects
Publications and source records attributed to G Goldman.
We describe a case of a malignant fibrous histiocytoma (MFH) arising in a scar. Previous reports have described this tumor associated with radiation, bone infarcts, foreign body reaction and in previous surgery sites. The present case emphasizes the correlation between chronic reparative reactions with external irritation and the appearance of this tumor.
In a retrospective study, 153 male patients who underwent surgical treatment of the colon and rectum presented with complaints indicating obstruction of the prostate gland and clear indications for preoperative administration of alpha-blockers. Between the years 1982 and 1984, the alpha-blocker phenoxybenzamine hydrochloride (PB-HCl) was prohibited from use by the Ministry of Health because of suspicions of its carcinogenic properties. This enabled a comparative study between two groups of patients. Seventy-five patients (group 2a1) were prohibited from receiving PB-HCl. Urinary retention occurred in 54.7 per cent and urinary tract infection in 65.3 per cent. Seventy-eight patients (group 2a2) were administered PB-HCl. In this group of patients, urinary retention occurred in 19.2 per cent and urinary tract infection in 15.4 per cent. Forty-one patients with urinary retention of group 2a1 who were not administered PB-HCl were compared with 50 patients with urinary retention (group 3) who received PB-HCl. Spontaneous relief was observed in 21.9 and 76.0 per cent, respectively. PB-HCl was shown to be extremely effective, both as a preventative and therapeutic agent, when complaints indicating the prostate gland are present in patients undergoing surgical treatment of the colon and rectum.
One hundred patients underwent anal dilatation for acute or chronic anal fissure during the period 1983-1984; white blood count, serum, muscle enzymes, and blood cultures were done. Positive blood cultures were found following the procedure in eight patients. A correlation based on serum enzymes, bacteremia, and trauma can be made. Prophylactic broad-spectrum antibiotics are recommended for patients at risk.
A 58-year-old man with recurrent spontaneous perforations of the colon is reported. The first two events were of the sigmoid colon, and a sigmoidectomy was performed after the second perforation. The third spontaneous perforation had occurred in the transverse colon, however, although a patent sigmoid colostomy was present. Neither primary colonic pathology nor elevated intraluminal pressure were found, which means that the cause and pathogenesis of these perforations are unknown. Six months later, a subtotal colectomy with ileo-sigmoid anastomosis was performed with an apparent satisfactory result.
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A case of a 96 year old woman with an incarcerated gallbladder in an epigastric hernia causing acute acalculous cholecystitis is described. At operation the gallbladder was replaced in its anatomical site and the hernia was repaired. This unique case of acute acalculous cholecystitis demonstrates cystic duct obstruction and cystic vessel compression as possible aetiologies for this pathology.
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Counts of neurons in locus coeruleus of Fisher 344 rats of ages from 12 to 32 months showed no loss with advancing age. Species comparisons of age changes in locus coeruleus neuron counts and measures of catecholamine systems suggested that the human and nonhuman primate locus coeruleus shows age changes and seen in rodent locus coeruleus. It is suggested that although rodent models of human aging have value under some circumstances, rodent and primate brain should not be considered equivalent with regard to phenomena related to noradrenergic mechanisms.
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Thirty-six patients having granuloma inguinale were treated at the 483 USAF Hospital, Cam Ranh Bay, Republic of South Vietnam between October 1970 and September 1971. In 24 cases biopsy of the genital ulcerations revealed Donovan bodies pathognomonic for the disorder. The lesions generally did not heal during tetracycline therapy. All but 2 of the 31 cases treated primarily with ampicillin responded with complete healing of the local lesions which occurred primarily on the penis or in the groin. Of the remaining 2 patients, one responded to a second course of ampicillin and the other patient responded to a two week course of lincomycin after dorsal slit had been performed for partial phimosis and balanoposthitis. The 5 patients who were allergic to penicillin were treated primarily with lincomycin and all responded with complete healing. No previous reference could be found in the literature for the successful use of lincomycin in patients with granuloma inguinale. Further clinical trials with this medication are indicated.
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Frontal and off-lateral complex motion tomography was performed in 72 consecutive patients selected for endolymphatic sac surgery for episodic vertigo or sensorineural hearing loss. They were selected for this operation because of a fluctuating hearing loss. The morphology and visualization of the vestibular aqueduct and the degree of periaqueductal pneumatization were correlated with surgical results and the presence of bilateral disease. The surgical results were evaluated with use of the classification of the American Academy of Ophthalmology and Otolaryngology. Computer analysis was performed on the data for vestibular aqueduct radiographic anatomy and surgical results or bilateral disease. There was no correlation between visualization or morphology of the vestibular aqueduct and surgical results or presence of bilateral disease.
This study was performed to determine whether biliary cholesterol nucleates primarily from vesicles or micelles. Twenty gallbladder biles and 12 hepatic biles from patients with gallstones as well as 16 model biles were examined. The nucleation times (days) of the biles as well as their isolated vesicular and micellar fractions were determined and their lipid composition was analyzed. In 41 of 46 comparisons, cholesterol nucleated faster from vesicles than micelles; in only one case was the opposite found. The mean (+/- S.D.) nucleation times of vesicles and micelles in gallbladder biles were 8.9 +/- 5.4 vs. 15.4 +/- 8.6, in hepatic biles 14.6 +/- 9.4 vs. 20.6 +/- 9.1, and in model biles 9.0 +/- 3.7 vs. 18.9 +/- 9.1 days, respectively. All these differences were significant (p less than 0.005). Gallbladder biles (n = 7) devoid of vesicles nucleated more slowly (9.0 +/- 9.5 days), as compared to gallbladder biles (n = 13) containing vesicles (3.8 +/- 2.2 days). The nucleation time of gallbladder and hepatic biles was significantly correlated with the nucleation time of the vesicles from these biles (r = 0.847, p less than 0.05). There was no correlation with the nucleation time of micelles from the same biles. The percentage of cholesterol carried by vesicles in bile was positively correlated to the molar percentage of biliary cholesterol and the cholesterol saturation index and negatively correlated to the molar percentage of bile salts. Our data suggest that phospholipid vesicles are the major vehicle for cholesterol precipitation in bile as well as an important determinant of the nucleation time of bile.