Search PubMed⌕ Search

Biomedical subjects

H Gutman

Publications and source records attributed to H Gutman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Locomotion through three-dimensional type I rat tail collagen. A modified mini-assay.

There is an increased application of three-dimensional type I rat tail collagen as an in vitro model for the peritumoral matrix in analysis of lymphocyte migration. The increased demand prompted us to modify the previous methods. We here describe our 'mini'-setup of the collagen model assay, which uses only 1/20 the amount of collagen medium and the number of cells used in the conventional assay. The modified assay was tested for optimal collagen concentration in gel for upward and downward migration, for locomotion from a collagen-gel bead into a collagen overlayer for demonstration of the effect of inhibitors and for differentiation between locomotory properties of lymphocyte subpopulations. The results verify that the mini-assay is an applicable in vitro model, easily read and amenable to limited blood samples such as those obtained from cancer patients, and reflects well known in vivo events.

Animals↗
PubMed1991

[Evaluation of non-occurrence by TI-59 programmable calculator].

A TI-59 programmable calculator program is presented for calculating either risk probability, sample size or confidence level (given 2 of the 3 variables) in cases in which an event of concern did not occur, or as expressed mathematically, had zero numerators. Its main usefulness is as a tool for interpreting previously published data containing no adverse event of concern while contemplating medical alternatives. These conditions are not infrequent in rare medical events--either diseases or complications. However, applicability of the program extends beyond these confines, exemplified in experimental planning for considering expected sample size or in calculating certainty in terms of confidence level.

Mathematical Computing↗
PubMed1991

Choledochoduodenostomy an important surgical tool in the management of common bile duct stones. A review of 126 cases.

Of 2,000 patients who underwent cholecystectomy between 1965-1984, 457 had their common bile ducts explored and of these 126 had choledochoduodenostomies. There were 70 women and 56 men and a third were over 70 years old. Forty-three also had acute cholecystitis or pancreatitis, and 73 had an increased serum concentration of bilirubin. Of the 126, 103 had stones in the common duct, and 16 had benign strictures of the sphincter of Oddi. Morbidity included wound infections in 18 (14%) and bile discharge from the drain for over 14 days in four (3%). Five patients died (4%), and they were all over 70 years old. Ninety-seven of 103 patients followed-up over 1-19 years were symptom free (94%). Two patients required re-operation for a narrow anastomosis. Three patients developed a "sump" syndrome; two were treated with antibiotics, and the third responded to endoscopic sphincterotomy. Choledochoduodenostomies should be considered during operation for benign biliary disease, when stones or a stricture in the common bile duct are anticipated.

Adult↗
PubMed1991

Spontaneous remission in Cushing's disease.

Four patients with proved Cushing's disease underwent spontaneous clinical and biochemical remission. They were part of an 11-patient group treated with methods that allowed spontaneous remission to be observed. Each patient was treated differently, one each with metyrapone tartrate, ketoconazole, bilateral adrenalectomy and adrenal autotransplantation, and no treatment. Spontaneous remission occurred 9 months to 5 years after diagnosis as evidenced by restoration of normal adrenal function occurring symptomatically in two patients and advent to hypoadrenalism with addisonian crisis in the two others. We conclude that spontaneous remission in Cushing's disease may not be a rare entity, although its actual incidence has yet to be established.

Adolescent↗
PubMed1991

Hemosuccus pancreaticus and intraperitoneal bleeding secondary to spontaneous rupture of the splenic artery.

Hemosuccus pancreaticus is a rare condition where bleeding occurs through the pancreatic duct, usually due to a pseudoaneurysm of the splenic artery. We describe a patient with spontaneous rupture of the splenic artery that caused hemosuccus pancreaticus and later massive hemoperitoneum. The pathological process had lasted at least 10 days before the diagnosis was established. The patient underwent an emergency operation during which splenectomy and distal pancreatectomy were successfully performed.

Hemoperitoneum↗
PubMed1990

Achievements of physical therapy in patients after modified radical mastectomy compared with quadrantectomy, axillary dissection, and radiation for carcinoma of the breast.

Flexion of the shoulder, abduction, and external rotation in 90 degrees abduction are impaired after operations for breast cancer. We compared postoperative range of motion in 27 patients who underwent modified radical mastectomy and 21 patients who underwent quadrantectomy with axillary dissection and radiation therapy. The patients in the quadrantectomy group demonstrated a significantly higher range of flexion on postoperative day 1 and the day of suture removal. After 3 months, all patients had regained their preoperative range of flexion, with no difference between the groups. The better compliance of the quadrantectomy group to physical therapy may indicate that they suffer less pain and require a briefer or less intensive course of physical therapy.

Adult↗
PubMed1990

Unusual presentations of aortoiliac aneurysms.

Unusual presentations of aortoiliac aneurysms may be the reason for a delay in diagnosis of potentially life-threatening conditions. Five such unusual clinical pictures are presented and discussed. The aneurysms were falsely diagnosed as malignant disease, renal colic, sciatic syndrome, intra-abdominal bleeding of unknown origin, and psoas muscle abscess. The medical staff was misled by the atypical complaints, signs and symptoms, which resulted in a dangerous delay in diagnosis. The use of currently available ultrasonography and CAT scans, which enables early diagnosis, depends on the alertness of clinicians when they confront an atypical clinical picture that may be the first clue of a noninnocent aneurysm of the aortoiliac complex. Early surgical intervention before dissection, rupture or fistulization occur ensures a positive outcome and avoids emergency procedures with their attendant high operative mortality and postoperative morbidity.

Aged↗
PubMed1989

Barrett's mucosa of distal esophagus with concomitant isolated Crohn's disease and intramucosal adenocarcinoma. Report of a case and analysis of the literature.

The presence in the esophagus of three distinct entities--Barrett's mucosa, Crohn's disease, and adenocarcinoma--is a very rare finding. In a 60-year-old man with a long history of heartburn and recently developed dysphagia, narrowing of the distal esophagus was found to be related to the presence of Barrett's mucosa. A short time later repeated endoscopy revealed adenocarcinoma in this area. The patient underwent esophagogastrectomy and died a few days after surgery. Findings in the surgical specimen and upon autopsy were consistent with isolated Crohn's disease of the distal esophagus as well as with intramucosal adenocarcinoma. Analysis of the data available in the literature reveals that Crohn's disease of the esophagus, although rare, clearly possesses some definite characteristics of its own. It is suggested that the presence of these three features in a single patient constitutes no more than a chance coexistence.

Adenocarcinoma↗
PubMed1989

Growth inhibition and induction of phenotypic alterations by L-histidinol in B16 mouse melanoma cells.

L-Histidinol, a histidine analog was recently shown to be an inducer of differentiation in the promyelocytic cell line HL-60. In the present study we show that L-histidinol inhibits the growth of B16 melanoma cells in vitro. Growth inhibition is accompanied by phenotypic alterations that include a marked increase in the activities of NADPH cytochrome c reductase and gamma glutamyl transpeptidase, lipid accumulation and cell enlargement. These phenotypic alterations are similar to those induced by other chemical inducers of differentiation in melanoma cells.

Animals↗
PubMed1989

Computed tomography diagnosis of primary aorto-enteric fistula.

Primary aorto-enteric fistulae are rare. Preoperative diagnosis is important but is difficult and cannot usually be confirmed by upper gastrointestinal series, aortography and endoscopy. Computed tomography demonstrating an abdominal aortic aneurysm with air bubbles in its wall and "soft tissue" mass posteriorly should raise the possibility of penetration of the aneurysm into the lumen of the bowel and related consequences (hematoma, sepsis, infected operating field).

Aged↗
PubMed1989

Small bowel obstruction: a review of 264 cases and suggestions for management.

Two hundred and sixty-four cases of acute small bowel obstruction were retrospectively reviewed for the purpose of defining factors which could point to the presence of strangulated bowel. History, physical signs and investigations, including body temperature, X-rays, white blood count, and serum amylase, were not significantly different in the simple and strangulated groups. Although an elevated urinary white blood count and a palpable mass were more common in the strangulated group, they were not sufficiently reliable for early diagnosis of strangulation. In reviewing the literature, it is clear that all hernias with obstruction must undergo emergency surgery. Cases with intra-abdominal complete intestinal obstruction should also undergo emergency surgery. A more conservative attitude can only be taken when there is incomplete obstruction.

Adolescent↗
PubMed1989

Clinical experience treating varicose veins in the aged.

Patients over 70 years of age suffering from varicose veins or complications of venous insufficiency formed 6.7 per cent of the population treated in our phlebologic clinic in 10 years. This group of patients is unable to perform intensive walking exercises and fails to use high-pressure elastic stockings; thus, most of the so-called "conservative armamentarium" is nonapplicable. This challenged us to find alternative or modified ways of treatment for this high-risk-for-surgery group. An isolated Trendelenburg procedure under local anesthesia, with sclerotherapy and/or transfixion sutures as an outpatient procedure, was used. In the case of stasis ulceration, patients were treated with sequential intermittent pneumatic compression including local hyperbaric oxygen and teaching the use of elastic support as an inhospital procedure. Both methods proved successful, thereby offering a more acceptable solution to one of the chronic problems of the older age group.

Aged↗
PubMed1988

Exogastric neurilemmoma presenting as acute abdomen: role of computed tomography in diagnosis.

A case of subserosal gastric neurilemmoma is hereby presented. This reported case is unique in its clinical presentation including the appearance of acute abdomen and fever subsequent to unremarkable and uneventful upper gastrointestinal endoscopy. The tendency of neurilemmoma to cause mucosal ulceration with fistula formation probably led to this clinical presentation. The role of computed tomography in establishing diagnosis of exogastric tumor is emphasized.

Abdomen, Acute↗
PubMed1988

The use of respiratory stimulants in organophosphates' intoxication.

1. Depression of the respiratory center causing acute respiratory insufficiency is the main cause of death in acute poisoning with organophosphates (OP) 2. Various authors recommend the use of respiratory stimulants as an adjuvant to the usual therapeutic arsenal. 3. This survey of the literature was undertaken in order to explore the theoretical basis for this therapeutic attitude and to critically assess its usefulness. 4. The conclusion of this review is that respiratory stimulants should not be used in the treatment of acute organophosphates' intoxication in human beings.

Central Nervous System Stimulants↗