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Biomedical subjects

H Greenberg

Publications and source records attributed to H Greenberg.

At least 127 records · Page 7Linked to original sources
PubMed1975

Inferior myocardial infarction and right coronary artery occlusive disease. A correlative study.

The present study represents an attempt to correlate the electrocardiogram and coronary arteriogram in patients with an inferior transmural infarct - or total occlusion of the right coronary artery. The influence of the collateral circulation on these findings was also evaluated. Fifty patients with a total occlusion of the right coronary artery had characteristic electrocardiographic changes of an inferior infarct in 44 per cent, very suspicious changes in 32 per cent, and no changes suggesting an inferior infarct in 24 per cent. However, in this latter group who had no evidence of an inferior infarct, we were able to recognize a small number who showed an anterior wall infarct. Collateral circulation was more frequently present and more extensive in those patients whose electrocardiograms did not show changes typical of inferior transmural infarction. This suggested that collateral circulation might minimize some of the electrocardiographic abnormalities which would normally result from occlusive disease of the right coronary artery. Another 50 patients, selected because of definite electrocardiographic evidence of typical inferior transmural infarction, were evaluated by coronary arteriography. Severe obstructive disease of the right coronary artery was present in 86 per cent of the group. In the remaining 7 patients (14 per cent) minimal or no disease was found. Infarction of the inferior wall may have resulted from occlusive disease of the anterior descending artery or have been the result of a right coronary artery occlusion with subsequent recanalization. We conclude from our study that a careful analysis of electrocardiographic abnormalities in theinferior leads will, with certain limitations, permit us to estimate the likelihood of a severe lesion in the right coronary artery, and, in the face of definite electrocardiographic evidence of an inferior infarct, to predict the diseased artery.

Angiography↗
PubMed1974

Asymptomatic infection of adult volunteers with a temperature sensitive mutant of Mycoplasma pneumoniae.

Temperature sensitive mutants of Mycoplasma pneumoniae were developed with the expectation that their temperature sensitive defects would restrict replication in vivo at the temperature of the lower respiratory tract, whereas such defects would not seriously impair replication in the cooler environment of the upper respiratory passages. One such ts mutant, ts-H43, which does not replicate at a temperature of 37 degrees or above, although noninfectious for hamsters, infected each of 16 seronegative adult volunteers when given by the intranasal route. The mutant remained genetically stable throughout the course of infection and stimulated a moderate systemic and local antibody response. The mutant was entirely avirulent for the volunteers but appeared to stimulate resistance to subsequent challenge with partially attenuated wild-type (ts(+)) Mycoplasma pneumoniae.

Adult↗
PubMedDate not supplied

Prognostic factors in patients with subdiaphragmatic Hodgkin's disease.

Between April 1969 and December 1980, 329 patients with pathologically staged IA-IIB Hodgkin's disease were treated at the Joint Center for Radiation Therapy. Twenty-five (7.6 per cent) of these patients presented with inguinal-femoral or superficial iliac adenopathy and had disease limited to below the diaphragm. In addition 11 patients presented with intra-abdominal masses and Hodgkin's disease was diagnosed on laparotomy. The median age, histologic subtypes, and actuarial relapse free and overall survival of patients with peripheral adenopathy limited to below the diaphragm were similar to patients with supradiaphragmatic Hodgkin's disease. Patients with disease limited to the pelvic or inguinal-femoral nodes were treated with pelvic and para-aortic irradiation alone. Staging laparotomy identified those patients with para-aortic or splenic involvement and these patients were treated with total nodal irradiation or combined modality treatment. The small group of patients who presented with intra-abdominal disease without peripheral adenopathy was older, had a predominance of lymphocyte depleted histology, and had a worse prognosis than the other patients described.

Actuarial Analysis↗
PubMedDate not supplied

Ciliated hepatic foregut cysts: US, CT, and contrast-enhanced MR imaging.

Hepatic foregut cysts are uncommon lesions of the liver. In this report we prospectively examined two patients by means of computed tomography (CT), ultrasound, and contrast-enhanced magnetic resonance imaging. Ciliated hepatic foregut cysts were subsequently demonstrated in both patients following CT-guided biopsy. Magnetic resonance imaging was found to be useful in differentiating these cysts from other lesions.

Aged↗
PubMedDate not supplied

MR findings in patients with acute tibial plateau fractures.

OBJECTIVE: The purpose of this study was to demonstrate the MRI findings associated with acute tibial plateau fractures. MATERIALS AND METHODS: MR scans of 29 patients with acute tibial plateau fractures were analyzed retrospectively. The images were evaluated for the presence of injuries involving the menisci, cruciate and collateral ligaments. The presence of a lipohemarthrosis or a simple joint effusion was also noted. The tibial plateau fractures were classified according to the scheme devised by Schatzker. RESULTS: Evidence of internal derangement of the knee was found in 28 (97%) patients. Tibial collateral ligament (55%) injuries and lateral meniscus (45%) tears were noted most frequently. Medial meniscus tears were seen in 21% and fibular collateral ligament injuries were diagnosed in 34%. Forty-one percent had anterior cruciate ligament injuries while the posterior cruciate ligament was injured in 28%. Twelve (41%) patients demonstrated the characteristic MRI features of a lipohemarthrosis. Simple joint effusions were found in the remaining 17 (59%) patients. CONCLUSION: MR imaging in patients with acute tibial plateau fractures commonly demonstrates associated ligamentous and meniscal injuries. By imaging in multiple planes, MRI can aid in the accurate characterization of tibial plateau fracture patterns and severity.

Adult↗
PubMedDate not supplied

Implications regarding atypical squamous cells of undetermined significance among women residing in a US-Mexico border city.

We conducted a study of Mexican American women living in a US-Mexico border city who attended a gynecology clinic for Papanicolaou (Pap) smear. The objective of this study was to describe the cytologic outcomes of women who had atypical squamous cells of undetermined significance (ASCUS) diagnosis after a Pap smear and to observe any changes during follow-up colposcopy. A total of 852 abnormal Pap smear were identified through a computer search for a 6-month period. Histology data were available for 317 cases. Benign findings were observed in 45.4% of cervical biopsies. A clinically significant diagnosis was reported in the remaining tissue sample. The diagnosis report was either single or combined and recorded as follows: human papilloma virus 46.3%, cervical intraepithelial neoplasia (CIN) 1, 23.6%; CIN 2, 5.6%; and CIN 3, 1.5%. There was one case of invasive cervical cancer. Overall, the incidence rate of ASCUS was 5%. However, we found that a significant proportion of this population had CIN 1 through CIN 3. Furthermore, this population has traditionally been noncompliant and routinely failed to attend follow-up appointments. Based on these results, the clinician should not ignore an initial abnormal Pap smear. Therefore, it is not unreasonable to perform colposcopy in Mexican American patients with a first time diagnosis of ASCUS on routine Pap smear.

Adolescent↗
PubMedDate not supplied

Multifocal gastric neoplasia after recurrent laser therapy for the watermelon stomach.

Repeated laser therapy has become an accepted therapeutic approach in the treatment of watermelon stomach, and to date no important negative sequelae have been reported. The case of a patient who underwent repeated sessions of neodymium: yttrium aluminum garnet (Nd:YAG) laser therapy over a five-year period for the treatment of the watermelon stomach is presented. Postlaser therapy the patient developed deep ulcerations that would heal; however, he ultimately developed a nodular antrum. Random biopsies of antral nodules revealed carcinoma-in-situ. A Billroth I gastrectomy revealed two foci of carcinoma-in-situ/high grade dysplasia and multiple foci of lower grades of dysplasia. This case suggests a possible association between use of laser therapy and development of gastric neoplasia.

Aged↗