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Biomedical subjects

H Greenberg

Publications and source records attributed to H Greenberg.

At least 91 records · Page 5Linked to original sources
PubMed1986

Association between transient pulmonary congestion during acute myocardial infarction and high incidence of death in six months.

In a prospective multicenter study of 866 patients after acute myocardial infarction (AMI), an increased or excessive mortality rate (13%) was confined to the first 6 months after AMI. In the subsequent 18 months of follow-up, the mortality rate (4%) was similar to that in coronary patients in chronic stable condition. Analysis of patients who died in the first 6 months revealed that 55% had had pulmonary congestion at the time of the index AMI. Neither these patients nor the others who died in the early period were found to have more severe ventricular dysfunction, more malignant arrhythmias or more severe ischemia than patients who died after 6 months. The reason for the high and early mortality in patients with pulmonary congestion is not clear, particularly because 30% had reasonable ventricular function, with an ejection fraction of more than 40%. However, given the poor prognosis of these patients, early and aggressive diagnostic efforts should be undertaken to exclude jeopardized regions remote from the initial AMI.

Arrhythmias, Cardiac↗
PubMed1986

Condylomas of the uterine cervix initially interpreted as squamous carcinoma: a report of four cases including a lesion resembling the Buschke-Loewenstein giant condyloma.

The recognition of human papilloma virus (HPV)-induced cervicovaginal condylomatous lesions is in a period of dynamic development. It is estimated that condylomatous involvement of the uterine cervix is epidemic and that is particularly true in the younger, more sexually active woman. While cervical condylomas are often associated with cervical dysplasia, carcinoma in situ, or even invasive carcinoma, they are sometimes misdiagnosed as these entities. Four cases of cervical condylomas are presented that were clinically suspicious for malignancy and initially interpreted as squamous carcinomas on the basis of the histopathological findings.

Adult↗
PubMed1986

Effects of intraventricular methotrexate on cerebrospinal fluid monoamine metabolites in rhesus monkeys.

Previous work suggested that methotrexate (MTX) may cause encephalopathy by inhibiting biosynthetic pathways for dopamine and serotonin in the brain. We examined this issue by measuring the neurotransmitter metabolites homovanillic acid and 5-hydroxyindoleacetic acid in the lumbar CSF of rhesus monkeys receiving continuous intracerebroventricular infusions of MTX or dichloromethotrexate. Infusion of the lowest dose (0.05 mg/day) produced a large (300%) rise in homovanillic acid levels and a modest elevation in 5-hydroxy-indoleacetic acid. During higher dose infusion, which was associated with clinical encephalopathy, the biogenic amine metabolites fell from their previous elevated levels. In one encephalopathic monkey, an injection of 1 mg of leucovorin produced a marked elevation in CSF monoamine metabolites within 1 hour and rapid clinical recovery. In contrast, leucovorin produced no change in monoamine metabolites in control animals. The data suggest that MTX may block egress of monoamine metabolites from CSF at the lower doses and suppress neurotransmitter turnover at toxic doses which cause encephalopathy. Serial measurements of CSF monoamine metabolites deserve further investigation as biochemical markers for toxic effects of MTX on neuronal metabolism in the CNS.

Animals↗
PubMed1985

Prolonged outbreak of Norwalk gastroenteritis in an isolated guest house.

During November and December 1982, a persistent outbreak of gastroenteritis took place in an isolated guest house. An estimated 26% of the changing population of guests and staff developed symptoms. Laboratory studies implicated Norwalk agent as the cause of illness, although the original source of the outbreak could not be established. Information on clinical features of the illness, its mode of spread, and eventual control is presented.

Adolescent↗
PubMed1985

Pelvic tamponade in puerperal hemorrhage. A case report.

A case of puerperal hemorrhage was associated with disseminated intravascular coagulation following hysterectomy. Following unsuccessful surgical intervention, pelvic tamponade was accomplished via use of the Logothetopulos pack.

Adult↗
PubMed1984

Dysgerminoma with syncytiotrophoblastic giant cells presenting as a hydatidiform mole.

There have been a total of 11 cases of pure dysgerminoma with syncytiotrophoblastic giant cells (SGC) previously reported in the literature as of June 1981. All were Stage IA, all were treated with unilateral salpingo-oophorectomy, and the preoperative serum human chorionic beta-gonadotropin (beta-hCG) titers ranged from 2000 to 3160 mlU/ml. A recent case at William Beaumont Army Medical Center involved a 20-year-old Hispanic female who presented with a 20 weeks' size pelvic-abdominal mass which was sonographically consistent with a hydatidiform mole. An initial preoperative serum beta subunit hCG was 193,000 mlU/ml. At the time of surgery a Stage IC dysgerminoma of the right ovary was discovered and right salpingo-oophorectomy performed. In reviewing all 11 previously reported cases, not only is this case the first Stage IC reported, but it also is the first to present as a hydatidiform mole, has the highest ever reported preoperative beta-hCG, and provides the first ultrastructural study of this tumor type. The unusual clinical presentation and management of this case are discussed and a brief review of the clinical and pathological features of this unusual tumor is given.

Adult↗
PubMed1984

Transvaginal absorption of estrogens through irradiated mucosa.

Serum concentrations of unconjugated estrone (E1) and 17 beta-estradiol (E2) have been measured in eight patients before and after 1.25 mg of conjugated estrogens administered intravaginally. The measurements were repeated using 2 mg of micronized estradiol administered intravaginally 1 week later to six of the women and 7 months later in one. All the patients had completed a full course of irradiation for pelvic malignancy at least 8 months prior to the study. Baseline, 1/2, 1-, 2-, 4-, 8-, and 24-hr samples were analyzed. After conjugated estrogens mean serum E2 increased 4.5-fold to peak at 163 pg/ml at 2 hr while serum E1 increased 3.2-fold to peak at 222 pg/ml at 2 hr. After micronized E2 mean serum E2 increased 89.3-fold to peak at 1250 pg/ml at 1 hr while E1 increased 3.1-fold to peak at 416 pg/ml at 2 hr. These data indicate that rapid absorption of E1 and E2 occurs through irradiated vaginal mucosa.

Absorption↗
PubMed1984

Left ventricular dysfunction after acute myocardial infarction: results of a prospective multicenter study.

In a multicenter prospective study of 866 patients who survived the coronary care unit phase of an acute myocardial infarction, variables reflecting left ventricular function were examined to assess their impact on 2 year survival. Single variables that reflected left ventricular dysfunction before infarction and in the acute and recovery phases were, respectively, history of prior myocardial infarction, rales in the coronary care unit dichotomized at greater than bibasilar and predischarge radionuclide ejection fraction dichotomized at less than 0.40. When combined in a stepwise fashion, patients lacking these three risk characteristics had a 2 year 4.2% mortality rate, whereas patients possessing all three characteristics had a 45% mortality rate. Rales in the coronary care unit and predischarge ejection fraction act independently, and each contributes to mortality. Fifty-two patients with advanced rales but an ejection fraction of 0.40 or greater had a 21% mortality rate. Similarly, 208 patients with few rales but an ejection fraction of less than 0.40 had a 15% mortality rate. These data suggest that the mortality risk imposed by those factors that assess permanent left ventricular damage is independent of and additive to the mortality risk contributed by dynamic, acute phase dysfunction. These data fit the hypothesis that acute phase dysfunction is, in part, due to transient ischemia that, on reversal, can restore function toward normal. The results suggest 1) that assessment of left ventricular function during the acute and recovery phases of myocardial infarction is necessary to define prognostic characteristics of an individual patient, and 2) that of particular importance is the identification of patients whose postinfarction course is consistent with reversible ischemia.

Cardiac Output↗
PubMed1984

Nonfatal cardiac events and recurrent infarction in the year after acute myocardial infarction.

The occurrence and importance of nonfatal cardiac events in the year after an acute myocardial infarction were studied in 866 patients who were enrolled by nine hospitals with a broad geographic distribution. The extensive clinical data acquired on each patient included special tests, such as radionuclide-determined ejection fraction, 24 hour ambulatory electrocardiogram and a low level exercise tolerance test. Recurrent events were frequent in the first 5 months, and certain events were significant indicators of a poor prognosis. An ejection fraction less than 40% and angina after discharge from the coronary care unit predicted patients at high risk of rehospitalization. Recurrent infarction was similarly predicted by angina, but not by any features of an exercise test. This study demonstrates the considerable morbidity that occurs after an acute myocardial infarction and its relation to and role in subsequent mortality.

Coronary Artery Bypass↗
PubMed1984

Relative frequency of rotavirus subgroups 1 and 2 in Venezuelan children with gastroenteritis as assayed with monoclonal antibodies.

Monoclonal antibodies recently developed against the 42,000-dalton protein of two rotavirus strains were used in an enzyme-linked immunosorbent assay to determine the subgroup specificity of 252 specimens collected during a 45-month period from Venezuelan children with rotavirus gastroenteritis. Subgroup 2 rotavirus was shed by 85% of the children, whereas only 14% shed subgroup 1 rotavirus (one-half of them in a 3-month period). No differences were found in the occurrence of fever and vomiting between children shedding either rotavirus subgroup, but it appeared that the syndrome tended to last longer in children shedding subgroup 2 rotavirus. The monoclonal subgrouping enzyme-linked immunosorbent assay seemed to be more sensitive than an immune adherence hemagglutination assay, an enzyme-linked immunosorbent assay with polyclonal antibodies, or the electrophoretic analysis of RNA extracted from the virus. Overall, 99% of the specimens could be subgrouped by this assay.

Antibodies, Monoclonal↗
PubMed1983

Sudden death during ambulatory monitoring. Analysis of six cases.

The ambulatory electrocardiographic recordings of six patients with coronary artery disease who died during monitoring were analyzed. In four patients, sinus rhythm was interrupted by sinoatrial, atrioventricular, nodal, or infra-His conduction abnormalities leading to bradyarrhythmic sudden death. Two patients died of sustained ventricular tachycardia or ventricular fibrillation. These data emphasize that the arrhythmias involved in the sudden death syndrome may be more heterogenous than currently appreciated.

Aged↗
PubMed1983

Diarrhea among infants and young children in Canada: a longitudinal study in three northern communities.

Diarrhea among neonates and their siblings was studied in 98 families living in Winnipeg, Manitoba, and in 31 native Indian families and in 15 Inuit (Eskimo) families living in isolated settlements in northern Canada. The rate of infection due to rotavirus in neonates was significantly higher and infection occurred more often in the first six months of life in the northern communities (range, 0.36 in Winnipeg to 1.07 in Eskimo Point). No protective effect of breast-feeding was discerned, since infection due to rotavirus occurred more frequently and earliest in neonatal life in Eskimo Point, the community with the highest rate of breast-feeding. In contrast, infection due to Norwalk virus was most common among the neonates of Berens River (0.15 infections per child per year), the only community with relatively unsafe water supplies. Infection due to rotavirus appears to be more frequent in the far North, whereas infection due to Norwalk virus appears to be related more to inadequate sanitation.

Child↗
PubMed1983

Serological analysis of the subgroup protein of rotavirus, using monoclonal antibodies.

Ten monoclones directed to the 42,000-dalton inner structural protein of rotavirus were analyzed. Eight monoclones reacted broadly with antigenic domains common to virtually all mammalian rotaviruses. Two monoclones had specificities similar or identical to previously characterized subgroup specificities. These subgroup monoclones were more efficient in detecting subgroup antigen than either hyperimmune or postinfection antisera. Using the subgroup monoclones, we determined that some animal as well as human rotavirus strains carry subgroup 2 specificity and that epizootic diarrhea of infant mice virus and turkey rotavirus are antigenically distinct from other mammalian rotavirus strains.

Animals↗
PubMed1983

The origin of the pseudoglandular spaces in metastatic smooth muscle neoplasm of uterine origin. Report of a case with ultrastructure and review of previous cases studied by electron microscopy.

The entity known as "leiomyomatous hamartoma," a term that has been used in reference to metastatic smooth muscle neoplasms of uterine origin (MSMNUO), is uncommon. Several articles have dealt with clinical and light microscopic aspects of this lesion. Four reports on the ultrastructure of this type of neoplasm have been published, but they have been primarily concerned with its smooth muscle component. Much controversy exists as to whether the glandular elements are part of the neoplastic process or preexisting pulmonary elements. This ultrastructural study confirms that the gland-like spaces represent entrapped alveoli and terminal respiratory bronchioles.

Female↗
PubMed1982

Foodborne Norwalk virus.

On December 6, 1979, three luncheon banquets were served in a New Jersey restaurant. Thirty-eight of 41 members (92.7%) of the first group became ill as did 25 of 31 members (80.6%) of the second group. None of 12 members of the third group were ill. Illness consisted primarily of diarrhea (76%), nausea, (73%), vomiting (67%), cramps (46%) and fever (18%); the median incubation period was 31 hours and median duration 24 hours. The same foods were served to all three groups, except that cole slaw was substituted for a green salad and mixed vegetables for lima beans for the third group. Consumption of green salad was associated with illness (p less than 0.0001). A total of 118 other persons who ate at the restaurant on the same day were interviewed, 60% of whom reported being ill. Green salad was significantly associated with illness for this group at lunch (p = 0.005) and dinner (p = 0.00007). Serologic studies on seven of 12 patients and on one of four exposed controls showed a fourfold or greater rise in antibody titer to Norwalk virus.

Epidemiologic Methods↗