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Biomedical subjects

H Goldman

Publications and source records attributed to H Goldman.

At least 127 records · Page 7Linked to original sources
PubMed1984

Intraepithelial eosinophils in endoscopic biopsies of adults with reflux esophagitis.

A consecutive series of 50 adult patients was reviewed to evaluate the utility of endoscopic grasp biopsies of the esophagus in the diagnosis of reflux esophagitis. Endoscopic and histologic features were independently recorded and correlated. Measurements of basal zone thickness, papillary height, and vascular dilatation were possible in only 14% of the cases because of limited specimen orientation. However, 62% of the patients had other histologic features of esophagitis, including intraepithelial eosinophils, intraepithelial neutrophils, and epithelial necrosis. Intraepithelial eosinophils were the most frequent abnormality; they were noted in 52% of the cases and correlated best with the gross endoscopic features. Eosinophils were easily identified even in the poorly oriented grasp biopsies and were the only histologic finding in seven patients (23% of the abnormal cases). Thus, we conclude that esophageal grasp biopsies taken at the time of endoscopy are of value in the assessment of patients with suspected reflux esophagitis, and intraepithelial eosinophils are the most common and useful histologic criterion. This feature was previously observed in children and occurs as well in adults with reflux esophagitis.

Adolescent↗
PubMed1983

Acquired immunodeficiency in an infant: possible transmission by means of blood products.

An infant who received multiple transfusions during the first few days of life for rhesus disease became ill with recurrent infections when 6 months old. Hepatitis, thrush, Candida dermatitis, otitis media, and disseminated Mycobacterium avium intracellulare infection occurred by 14 months of age. Immunological studies showed raised immunoglobulin levels, decreased mononuclear-cell responses to allogeneic cells and mitogen, and a decreased helper/suppressor cell ratio. It was determined that one of the blood donors, who was well at the time of blood donation, had died 17 months after with multiple opportunistic infections and acquired immunodeficiency. The clinical and laboratory findings in our patient suggest that he acquired a transmissible infectious agent from a blood transfusion, resulting in acquired immunodeficiency, and that this agent was not cytomegalovirus, Epstein-Barr virus, or hepatitis B virus.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Spontaneous diabetes mellitus syndrome in the rat. III. Pancreatic alterations in aglycosuric and untreated diabetic BB Wistar-derived rats.

The pancreatic alterations in aglycosuric and untreated diabetic BB Wistar-derived rats are described. A common finding, often seen in young aglycosuric rats, is that of discrete foci of periductular and/or acinar aggregates of lymphocytes and macrophages. Sites of periductular mononuclear cell infiltrates usually lack endocrine cells. In contrast, foci of acinar infiltrates, although distinct from the predominant endocrine cell mass in the islets of Langerhans, often contain small numbers of alpha and/or beta cells. It is suggested that these clusters of endocrine cells may in some way be antigenically different from those resident in the principal islets and thus serve as an additional target for the immune system in rats bearing the BB genome. The development of overt diabetes requires a massive destruction of beta cells within the islets of Langerhans. Two forms of diabetes mellitus emerge in untreated animals. The more common, designated unstable diabetes, is severe and lethal unless treated with insulin. Less commonly, a stable type of diabetes mellitus ensues for which insulin therapy is not mandatory. In each, the concentration of pancreatic immunoreactive insulin is profoundly decreased, although relatively greater amounts are present in the stable form. Unstable diabetic rats demonstrate a reduction in the concentration of pancreatic immunoreactive glucagon and somatostatin, suggesting that alpha and delta cells also sustain injury in this model of insulin-dependent diabetes mellitus.

Age Factors↗
PubMed1983

Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications.

Assessment of epithelial dysplasia in ulcerative colitis has been hindered by inconsistencies in and disagreements about nomenclature and interpretation. To resolve these issues, pathologists from ten institutions participated in three exchanges of multiple slides and, following each exchange, in discussions of the results. A classification system for the epithelial changes that occur in ulcerative colitis was developed, which should be applicable to other forms of inflammatory bowel disease as well. The classification makes use of standardized terminology, addresses specific problem areas, and offers practical solutions. The reproducibility of the system was studied by means of examinations of both inter- and intra-observer variations. The clinical implications of the findings were incorporated into suggestions for patient management. The basis of the classification is that the term "dysplasia" is reserved for epithelial changes that are unequivocally neoplastic and may therefore give rise directly to invasive carcinoma. Specimens are categorized as negative, indefinite, or positive for dysplasia. The negative category includes all inflammatory and regenerative lesions and indicates that only continued regular surveillance is required. The indefinite category is applied to epithelial changes that appear to exceed the limits of ordinary regeneration but are insufficient for an unequivocal diagnosis of dysplasia or are associated with other features that prevent such unequivocal diagnosis. Clinically, it indicates that early repeat biopsy is often required to assess the changes more accurately. The positive category is divided into two subcategories: 1) high-grade dysplasia, for which colectomy should be strongly considered after confirmation of the diagnosis, and 2) low-grade dysplasia, which also requires confirmation and early repeat biopsy or colectomy, depending on other findings.

Biopsy↗
PubMed1983

Serotonin-induced disruption of implantation in the rat: II. Suppression of decidualization.

Subcutaneous injection of serotonin (20 mg/kg) on Day 5 of pregnancy disrupts implantation in the rat as indicated by the reduction in number of live fetuses/cornu present on Day 19 (0.9 vs. 6.1, treated vs. control). Such disruption of implantation possibly results from impaired decidualization. To test for suppression of decidualization, serotonin was administered to pseudopregnant rats on the day before, on (Day 4) or after artificial induction of the decidual cell reaction. Relative to saline-treated controls (C), serotonin (S) reduced decidualization when injected either before [C: 1987 +/- 130 vs. S: 1085 +/- 155 mg (Day 3); P less than 0.005] or after [C: 1987 +/- 130 vs. S: 173 +/- 8 mg (Day 5); P less than 0.001] administration of the deciduogenic stimulus. In addition, serotonin markedly decreased uterine blood flow (C: 0.47 +/- 0.05 vs. S: 0.25 +/- 0.06 ml/min per g; P less than 0.01) during pseudopregnancy. However, serotonin altered neither the duration of luteal function in pseudopregnant rats (C: 15.3 vs. S: 14.3 days) nor serum progesterone levels (C: 74-91 vs. S: 53-82 ng/ml) in pregnant animals. It is concluded that serotonin may disrupt implantation, in part, by suppression of decidualization. The loss of endometrial competence to undergo decidualization appears to be a consequence of serotonin-induced uterine ischemia rather than impaired corpus luteum activity.

Animals↗
PubMed1983

Massive mural edema in severe pseudomembranous colitis.

Three patients had severe acute pseudomembranous colitis due to Clostridium difficile toxin and required surgical resection. In addition to the characteristic mucosal lesions, the colonic specimens showed a marked degree of diffuse mural edema that extended into the muscularis propia and involved areas of the colon with and without pseudomembranes. To our knowledge, such extreme edema has not been previously noted in pathologic descriptions of this disorder; it may possibly result from a toxic effect on the vessels combined with a large parenteral fluid replacement. Lesser degrees may be seen in other forms of acute colitis, but it would appear that the presence of massive and diffuse mural edema is most typical of Clostridia-associated colitis. The detection of such edema in a case of acute colitis should prompt an investigation for antibiotic usage and C difficile toxins.

Adult↗
PubMed1982

Changes in the location and type of gastric adenocarcinoma.

To document our impression of major changes in aspects of gastric adenocarcinoma, we reviewed and compared 62 consecutive cases from 1975 through 1978 and 31 cases from 1938 through 1942. The average age at diagnosis increased from 58 to 68 years, the male to female ratio decreased to approximately 1:1, and carcinomas composed predominantly (50% or more) of signet-ring cells (SRC) increased from 9 to 39% of the total cases. In the recent series, carcinomas with SRC (compared with those without SRC) occurred nine years earlier, were more frequent in women, were located distally, and had an infiltrative growth pattern. Carcinomas originating in the proximal stomach (cardia) were not noted in the old series but formed 27% of the recent cases. These tumors showed a male predominance, contained SRC less often, and were less commonly associated with chronic gastritis. The implications of these observations are discussed.

Adenocarcinoma↗
PubMed1982

Development and use of a nonrestraining waveguide chamber for rapid microwave radiation killing of the mouse and neonate rat.

The use of microwave energy for rapid killing of small rodents such as the mouse or rat has become a standard pharmacologic technique since approximately 1975. This method allows investigation of rapidly modulated neurochemical indices, neuromodulatory substances, and some neurotransmitters to be determined at basal concentrations in brain regions and microregions. Previously described devices for use with microwave generators have relied on total body restraining holders in order to properly position rodents and neonates within a closed waveguide during microwave energy exposures. The present information describes two alternate chamber designs which do not require restraint of the rodent. A positioning device is described which must be used with the waveguide chambers. The animal chambers are designed to be used with 2450 MHz energy.

Adenosine Triphosphate↗
PubMed1982

Mucosal biopsy of the esophagus, stomach, and proximal duodenum.

The past decade has occasioned the development and extensive use of flexible endoscopes for visualization of large areas of the alimentary tract. Numerous small grasp biopsies are now performed to determine the diagnosis and course of a large variety of inflammatory and neoplastic disorders. In this review, the authors have concentrated on the uses and interpretation of endoscopy and biopsy of the upper alimentary tract including the esophagus, stomach, and proximal duodenum. They have also commented on the limitations of endoscopic biopsy with respect to its size, superficial nature, and imperfect orientation in the evaluation of some disorders.

Biopsy↗
PubMed1982

The long-term outcome of restorative operation in Crohn's disease: influence of location, prognostic factors and surgical guidelines.

The course of all 113 patients with Crohn's disease whose initial procedure involved an anastomosis operated upon from 1942 to 1972 was followed through 1980. The calculated cumulative 30-year total mortality was 23.4%, 16.7% disease-related. The cumulative recurrence rate was 29% at five years, 52% at ten years, 64% at 15 years and 84% at 25 years, with no important differences between disease locations and types of operation. Sex, age, duration, granulomas, enteral or perirectal fistulas and length of the resection, the disease, and the proximal resection margin had no significant influence on the rates of development of recurrent disease or on functional outcome. By far the most common site of recurrence was the neo-terminal ileum, but in ileocolitis compared with ileitis, recurrence was 5.2 times more likely (p = 0.0001) to involve the adjacent or remote colon as well. Moreover, only 1/63 ileitis patients eventually required ileostomy, whereas 15/47 patients with ileocolitis or colitis ultimately required this procedure (p less than 0.001). The current status of the patients was excellent or good in 64% and unwell or dead related in 24%. Urolithiasis developed in 19%.

Colectomy↗
PubMed1982

The psychological parenting and permanency principles in child welfare: a reappraisal and critique.

The psychological parenting and permanency of care principles address important problems in child welfare. The focus of the theories, however, draws attention away from the underlying cause of family stress, and may serve to validate child welfare departments' failures to respond to that stress in the context of the family. It is suggested that aspects of the theories are overly mechanistic, and that there exists a substantial subset of child welfare clients for whom they are not relevant.

Child↗
PubMed1982

Pressures on the dental care system in the United States.

A number of significant pressures are creating tensions in the dental profession and the dental care delivery system. These pressures may be categorized in five major areas: 1) regulation and deregulation pressures involve changes in the state dental practice acts, court decisions concerning antitrust and advertising, and the inclusion of consumers on State professional regulatory boards; 2) cost of services includes factors involving the out-of-pocket cost of dental care and the growth of dental insurance; 3) dentist-related factors include the increased number of dentists and the indebtedness of dental graduates; 4) the pressures of changes in the American populations include the decline in population growth and the increase in proportion of elderly people; 5) changes in the distribution of dental care are based on new epidemiologic data concerning dental caries and progress in the prevention of periodontal disease. Many of these pressures are inducing competition in the dental care system. It is clear that the dental care system is in the process of change as it responds to these complex pressures.

Dental Caries↗