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Biomedical subjects

I Goldstein

Publications and source records attributed to I Goldstein.

At least 235 records · Page 13Linked to original sources
PubMed1987

Growth of the fetal stomach in normal pregnancies.

Fetal stomach dimensions were measured sonographically in 152 fetuses with gestational ages ranging from nine to 40 weeks. Nomograms of the mean +/- 2 standard deviations (SD) for the longitudinal, anteroposterior, and transverse diameters of the fetal stomach were generated throughout pregnancy. A linear growth function was observed across gestational age, and a high degree of correlation existed between gestational age and the transverse (r = 0.809, P less than .0001), anteroposterior (r = 0.798, P less than .0001), and longitudinal (r = 0.749, P less than .0001) diameters. These data provide a method by which variations from the norm can be assessed, and offer potential prenatal diagnosis of a variety of gastrointestinal lesions.

Embryonic and Fetal Development↗
PubMed1987

Ultrasound assessment of fetal intestinal development in the evaluation of gestational age.

A prospective ultrasound study was conducted in 289 uncomplicated pregnancies with gestational ages ranging from 16-40 weeks. Biometric measurements obtained included biparietal diameter (BPD), head and abdominal circumferences, measurements of long bones, and maximal transverse colon diameter. The pattern of small intestinal peristalsis, presence of colonic haustra, and progressive changes in the colon's intraluminal echogenicity were also evaluated. A high degree of correlation was found between gestational age and transverse colon diameter (in millimeters) (R2 = 0.859; P less than .0001), increasing colonic intraluminal echogenicity (R2 = 0.741; P less than .0001), and the appearance and progressive increase in small intestinal peristalsis (R2 = 0.726; P less than .0001). Colonic haustra were visualized in 87.5% after 30 weeks (specificity 100%, sensitivity 77.4%). A high degree of correlation with gestational age was also found if echogenicity and peristalsis were combined (R2 = 0.873; P less than .0001), and proved superior to that found with measurement of BPD (R2 = 0.655; P less than .0001) or femur length (R2 = 0.805; P less than .0001) after 28 weeks. Observations of progressive changes in small intestinal peristalsis and colonic intraluminal echogenicity, together with the development of colonic haustra and progressive increase in transverse colon diameter, allow one to estimate gestational age independent of standard biometry. This approach has particular utility in the third trimester, when sonographic estimation of gestational age is least accurate.

Colon↗
PubMed1987

Penile revascularization.

Penile revascularization surgery has dramatically improved the lives of many young patients who otherwise had to consider prosthetic options for treatment of their erectile dysfunction. Nonetheless, it appears that only few patients with erectile impotence are truly excellent candidates. Dynamic infusion cavernosometry and cavernosography studies reveal that corporal leakage syndrome exists in more than 80 per cent with organic erectile dysfunction. As the pathophysiology of corporal leakage syndrome is better appreciated, the role for penile reconstructive surgery will become more obvious. It may be realized that most patients with corporal leakage syndrome will be treated medically with intracavernosal pharmacotherapy. In these cases, reconstructive surgery may be utilized primarily to augment the pharmacologic erectile response.

Adult↗
PubMed1986

Antithyroid antibodies in Hispanic patients with type I diabetes mellitus. Prevalence and significance.

Antithyroglobulin antibodies (ATA) and antithyroid microsomal antibodies (AMA) were sought and thyroid function was determined in 90 Hispanic patients with type I diabetes mellitus followed up for up to seven years. We detected ATA in 7.5% of our patients and AMA in 34.8%. All serum samples positive for ATA also contained AMA. There was no sex difference in the prevalence of thyroid autoimmunity. A small, firm goiter was present in eight patients, one of whom developed Graves' disease. Our results suggest that a relatively high prevalence of AMA and no sex difference in thyroid autoimmunity may be unique features of Hispanic children and adolescents with type I diabetes mellitus. Such patients should be clinically evaluated for thyroid dysfunction and should be screened annually for the presence of AMA. When antibodies are present, laboratory evaluation of thyroid function should be performed frequently.

Adolescent↗
PubMed1986

Maternal and newborn levels of glucose, sodium and osmolality after preloading with three intravenous solutions during elective cesarean sections.

The influence of maternal i.v. loading with 1500 ml fluid prior to epidural anesthesia and elective cesarean section was studied in 60 healthy parturients near term. Three different solutions were used. Normal saline 0.9%, Hartmann's solution and dextrose 5%. A significant rise in glucose level accompanied by a significant decrease in sodium level was found in mothers and newborns of the group hydrated with the dextrose solution.

Blood Glucose↗
PubMed1986

[Presence of immunoglobulins and complement in the walls of the coronary arteries in atherosclerosis].

A histopathological and histoimmunological comparison was performed on 143 fragments on coronary arteries taken from 43 patients who died of ischemic heart disease and from 20 patients who died of other diseases. The immunological study research of Ig (A, G, M) and C3 fraction of complement in the 3 coronary layers was done by the immuno-peroxidase technique. The fixation was essentially observed in fibromyocytes. A good correlation existed between atherosclerosis lesions and fixation of Ig and C3 fraction of complement in both the media and the intima. On the other hand, this correlation was not observed in the adventitia. Accumulation of immunoglobulins and of the C3 fraction of complement in atherosclerosis seemed specific and proportional to the degree of arterial well lesion. The significance and the role of this accumulation remains to be studied. It may be hypothesized that Ig and complement fixation on fibromyocyte cell receptors or on the fibrous tissue fundamental substance is followed by the formation of antigen-antibody complexes, which act as foreign bodies which are either responsible for (or a reflection) of the onset of lesions or, at least, of their increasing severity or their persistence.

Complement C3↗
PubMed1985

Intrauterine fetal activity in at term and prolonged pregnancies.

Fetal body movements and breathing movements were recorded with a real time ultrasound scanner in 26 fetuses. There were two recording periods of 25 min each, before and half and hour after maternal IV administration of 50 gr glucose. Six fetuses were at 280 days of gestation (Group A), twelve fetuses were at 294 days of gestation (group B), eight fetuses at 294 days gestation were classified as stage I postmature (group C). The incidence of fetal body movements was not significantly different in the three groups. Maternal glucose administration had no significant influence on fetal body movements in any group. On the other hand fetal breathing activity was significantly increased in all three groups after maternal glucose administration. Breathing activity was significantly greater in group A when compared to group C in both recording periods, and when compared to group B in the period which followed maternal glucose administration. It is concluded that fetal breathing activity is reduced in prolonged pregnancies.

Female↗
PubMed1984

Radiation-associated impotence. A clinical study of its mechanism.

External beam pelvic irradiation in men is frequently complicated by erectile dysfunction. We tested the erectile function in 23 patients (mean age, 65 years) who received radiation therapy for prostate cancer. Fifteen patients experienced changes in erectile potency following radiotherapy. Neurological, endocrine, and vascular testing revealed abnormalities in 0, 5, and 15 of these patients, respectively. In two, arteriography revealed bilateral occlusive disease in the distal internal pudendal and penile arteries overlying the pelvic radiation field. A significant difference with cigarette smoking was found among the 15 patients whose erectile capacity decreased and the four patients whose capacity remained unchanged. Vasculogenic impotence is the most consistent organic erectile abnormality in RAI.

Aged↗
PubMed1983

Neurourologic findings in conus medullaris and cauda equina injury.

Fifty-seven patients with documented conus medullaris and cauda equina injury underwent neurourologic evaluation consisting of cystometrography (CMG), perineal floor electromyography (EMG), and bethanechol chloride supersensitivity testing (BST). The bulbocavernosus reflex was normal in only 16% of the patients, and perineal sensation and muscle stretch reflexes were absent or significantly diminished in 77%. The predominant CMG finding was detrusor areflexia (93%). Neuropathic EMG changes were noted in 67% and a positive BST response in 95% of the cases. Statistical analysis showed significant correlations between (1) a compromised bulbocavernosus reflex and perineal floor neuropathy (.01 less than P less than .05) and (2) sex of the patient and incidence of urinary incontinence among subjects with perineal floor neuropathy (P less than .01). The major neurourologic features in these patients (1) An absent or substantially diminished bulbocavernosus reflex, (2) detrusor areflexia on CMG, (3) neuropathic perineal EMG changes, and (4) a positive BST response.

Adolescent↗
PubMed1983

Nonstress Test in standing and lying women.

The effect of the maternal postural position on the Nonstress Test (NST) was evaluated in 14 normal pregnancies at 38-40 weeks of gestation. Each women was studied for two periods of 30 min, each in the standing and left lateral recumbent positions. Comparing both positions no significant difference was found in the number of fetal movements and heart rate accelerations. The total surface area of accelerations (TSAA) was significantly larger in the standing position.

Female↗
PubMed1983

The changing neurourologic pattern of multiple sclerosis.

The changing clinical course of multiple sclerosis is a hallmark of the disease. The neurourologic findings in this disorder have been well documented in the literature but the occurrence of urodynamic changes with time has been mentioned only briefly. Ten men and 8 women had 2 or more urodynamic evaluations, consisting of cystometrography and perineal floor needle electromyography during 2 months to 6 years (mean 25 months). The initial urodynamic patterns included a normal study in 1 patient, detrusor areflexia in 7 and detrusor hyperreflexia in 10 (5 with vesicosphincter dyssynergia). Re-examinations were done for persistent or new symptoms. The urodynamic pattern changed in 10 patients (55 per cent), including cystometrographic changes in 7, newly developed neuropathic changes on electromyography in 5 and changes in detrusor-sphincter interaction in 9 (with 5 new cases of vesicosphincter dyssynergia). Of the 8 patients who did not demonstrate a urodynamic change 5 had vesicosphincter dyssynergia that persisted on followup. Vesicosphincter dyssynergia was the predominant pattern noted on re-evaluation, acting as a urodynamic indicator of progressive multiple sclerosis. Careful neurourologic assessment should be performed routinely in the followup of multiple sclerosis patients who are unresponsive to treatment or who manifest new symptoms.

Adult↗
PubMed1983

Neurourologic findings in Parkinson's disease.

A total of 30 patients with an established diagnosis of Parkinson's disease and symptomatic voiding dysfunction underwent neurourologic evaluation. Detrusor hyperreflexia associated with appropriate sphincter relaxation was found to be the most common urodynamic pattern, occurring in 75 per cent of the cases. Two types of increased electromyogram activity at the time of detrusor contraction were identified: 1) pseudo-dyssynergia (7 per cent)--a voluntary contraction of the perineal floor in an attempt to prevent leakage and 2) sphincter bradykinesia (11 per cent)--a manifestation of skeletal muscle hypertonicity characteristic of parkinsonism. On the basis of these observations it is assumed that the effect of the basal ganglia on micturition is inhibitory in nature. The diagnostic and therapeutic approach to the parkinsonian patient with voiding dysfunction is discussed.

Aged↗
PubMed1983

Rheumatic-like carditis induced in rabbits by cross-reacting antigens: Streptococcus A polysaccharide and rabbit aortic glycoproteins.

A rheumatic-like carditis was induced in rabbits by 8 mo of immunization with small doses of Streptococcus A polysaccharides or peptoglycane and rabbit aortic glycoprotein. Cardiac lesions were detected 5 to 6 mo after the beginning of immunization and were preceded by the appearance of circulating antibodies. The immunopathological study with peroxidase-labeled antibodies indicated the binding of IgG and C3 complement to the damaged cardiac areas. Enzyme-labeled antibodies to streptococcal polysaccharides were bound to the connective tissue of the cardiac valves and the coronary vessels. An immunological cross-reactivity was detected between Streptococcus A polysaccharide and aortic glycoprotein; this suggests that the immunopathological process initiated by the streptococcal infection may subsequently involve the cardiac tissue itself.

Animals↗
PubMed1982

Vasculogenic impotence: role of the pelvic steal test.

A new dynamic pelvic flow test is described that measures differential right and left corporeal artery blood pressure changes with exercise. Previous penile blood flow measurements have been made at rest. It is well known that exercise may unmask vascular pathological conditions not apparent at rest. Furthermore, cases have been reported that document potency at rest and impotence following exercise. As a result exercise was used to stress the pelvic vasculature in 97 patients chosen from vascular and urology clinics. A decrease of 0.15 or more in penile-brachial index with exercise was found to be statistically abnormal. A total of 23 patients (27 per cent) fulfilled the criteria for positive pelvic steal testing. In this group there were high incidences of smoking (52 per cent), hypertension (52 per cent) and diabetes (30 per cent). Although 70 per cent of these patients had at least occasional morning erections 78 per cent complained of loss of erection with exercise. The pelvic steal test detected vascular pathological conditions in 17 patients (20 per cent) previously missed by resting penile-brachial index measurements. Nocturnal penile tumescence studies in these patients demonstrated poor quality erections and correlated with the intermediate penile-brachial index values. Angiographic data performed in 5 of 23 patients corroborated the pathophysiology of a pelvic steal condition in each case. The pelvic steal test is simple to perform and markedly improves the sensitivity and yield of penile blood pressure measurements. The test appears to have better results in patients with suspected vasculogenic impotence and intermediate resting penile-brachial index values.

Adult↗