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Biomedical subjects

I Goldstein

Publications and source records attributed to I Goldstein.

At least 253 records · Page 14Linked to original sources
PubMed1982

Neurourologic abnormalities in multiple sclerosis.

Multiple sclerosis is a demyelinating disease of the central nervous system, often producing abnormalities in sexual function and urinary control. Eighty-six patients with this disorder were referred to our neurourologic facilities for evaluation (45 women and 41 men). Symptomatic voiding dysfunction was present in 84 patients (97 per cent). Sexual dysfunction was present in 29 of the 41 men (71 per cent). Neurourologic evaluation was performed by rapid-fill carbon dioxide cystometry and perineal floor needle electromyography. Several neurourologic patterns were identified in multiple sclerosis patients: the most common cystometry pattern was detrusor hyperreflexia (76 per cent) and the most common electromyography finding was vesico-sphincter dyssynergia (50 per cent). Voiding symptoms alone were not found to correlate with neurourologic findings. The presence of bilateral extensor plantar reflexes was found to indicate the possibility of vesico-sphincter dyssynergia. The addition of sacral-evoked responses to the neurourologic evaluation was useful in the identification and localization of occult sacral cord pathology and was of special significance to men with sexual dysfunction undergoing evaluation for neurogenic impotence. The combination of abnormal perineal electromyography, abnormal sacral latency and detrusor hyperreflexia was suggestive of multilevel spinal cord dysfunction and, possibly, has diagnostic as well as therapeutic significance. Neurourologic patterns were found to change in 4 of 9 patients re-evaluated because of symptom changes or poor treatment responses. Neurourologic testing in multiple sclerosis patients may be used to identify pathologic lesions, characterize sexual and voiding dysfunctions, corroborate neurologic diagnosis in doubtful cases and form a basis for rational treatment planning.

Adult↗
PubMed1981

Nephrostomy drainage for renal transplant complications.

The use of temporary diverting nephrostomy drainage in the management of immunosuppressed renal transplant patients with supravesical urinary extravasation, fistulas or ureteral obstruction is reviewed. In a literature survey covering an 11-year interval and 4,307 transplants there were 204 cases (4.7 per cent) of ureteral extravasation or fistula and 113 cases (2.6 per cent) of ureteral obstruction. Attempts at urologic repair in these 317 cases resulted in 30.9 per cent failure rate (98 cases), of which 86.7 per cent (85 cases) occurred in patients without nephrostomy compared to 13.3 per cent (13 cases) in patients with nephrostomy. In our 255 consecutive renal transplant patients there were 7 (2.7 per cent) with ureteral extravasation or fistula and 14 (5.5 per cent) with ureteral obstruction. Temporary nephrostomy was done in all 21 patients to protect the urologic repair and, when necessary, to control sepsis and allow for patient stabilization before delayed urinary tract reconstruction. In our series there was no mortality and only 1 renal unit (4.7 per cent) was lost as a consequence of urologic complications. The use of nephrostomy in transplant patients with ureteral extravasation, fistulas or ureteral obstruction is encouraged strongly to optimize patient and renal unit survival.

Drainage↗
PubMed1981

Functional voiding disorders in men.

A total of 47 men who complained of recurrent voiding symptoms and/or peri-genital pain syndrome of obscure etiology underwent neuro-urologic evaluation. Results of urodynamic assessment were divided into 3 groups: bladder areflexia with nonrelaxing perineal floor (50 per cent), bladder hyperreflexia (36 per cent) and normal studies (14 per cent). Pain symptoms were reproduced during bladder filling or contraction in 45 per cent of the patients. Treatment was according to the type of urodynamic abnormality demonstrated, resulting in a 77 per cent improvement rate. The concept of functional voiding disturbance and its relation to chronic prostatitis are discussed.

Adolescent↗
PubMed1980

Is routine use of the nasogastric tube justified in upper abdominal surgery?

Three hundred patients who underwent upper abdominal operations were studied. One hundred fifty patients were treated by insertion of a nasogastric tube, and 150 patients were treated without it. The incidence of postoperative pneumonia was 10 times higher in the patients treated with a nasogastric tube. Pneumonia was directly related to the patient's age and the duration of the tube's use. In view of the disadvantages and complications of the nasogastric tube, its routine use appears unjustified. It should be reserved as a tool for treating postoperative complications such as paralytic ileus and acute gastric dilatation.

Abdomen↗
PubMed1980

Mechanism of implant inflammation.

Polymethylmethacrylate lenses with nylon-6 loops can activate the complement system. Such activation occurs primarily at the loops. This activation may be one pathway of implant-caused inflammation.

Complement Activation↗
PubMed1980

Experimental nephropathy induced in rabbits by immunization with Escherichia coli 055 lipopolysaccharide. 2. Immunologic findings.

Thirty-seven rabbits were immunized against lipopolysaccharide from Escherichia coli or Salmonella enteritidis over a period of up to 16 months. The animals developed antibodies against rabbit renal glycoproteins and against bacterial polysaccharide; they also showed signs of kidney lesions. The immunoperoxidase test showed antibody and complement (C3) fixation on the periphery of glomeruli and tubules. Antibodies extracted from the kidneys of the immunized animals reacted with isologous and autologous renal glycoproteins, suggesting that the renal lesions were due to an immunologic response. The cross-reactivity between the bacterial lipopolysaccharide and the renal glycoproteins appears to be responsible for these lesions.

Animals↗
PubMed1980

Suppression of immune response in mice by navy bean lectin.

A cluster of cases of Hodgkin's disease was observed in a small town which contained a large navy bean elevator. In previous investigations a lectin was isolated from the navy beans and lymphocytes from town residents were shown to be sensitized to this lectin. Mice were exposed to 15 weekly injections of navy bean lectin. Splenic lymphocytes from injected mice incorporated greater amounts of thymidine than did controls when incubated with the lectin. Cell-mediated immunity as measured by a Concanavalin A dose-response curve was significantly suppressed (p < 0.01) in the injected mice. Long term studies are needed to see if the decreased Concanavalin A response in the mice chronically stimulated with navy bean lectin will predispose to lymphoreticular malignancies.

Animals↗
PubMed1978

Experimental nephropathy induced in the rabbit by immunization with a lipopolysaccharide from Escherichia coli.

Twenty rabbits were each injected with 100 microgram of lipopolysaccharide from Escherichia coli 055 at weekly intervals for up to 15 months. The antisera showed an immunologic cross-reactivity with rabbit kidney glycoprotein. A macroscopic nephropathy was present in 14 of the 17 rabbits in which the kidneys were examined. All the rabbits showed extensive histologic lesions involving all the structures of the kidney: organized thrombosis of the arteries, extensive areas of infarction, glomerular atrophy, tubular necrosis and proliferation of young connective tissue. A marked infiltration with lymphoid cells and some plasmacytes was present. The immunologic character of this nephropathy and the immunopathogenic mechanism involved in its pathogenesis are discussed.

Animals↗
PubMed1978

Hyperimmunoglobulin E syndrome.

A 24-year old woman had the major features of the hyperimmunoglobulin E syndrome: recurrent staphylococcal skin infections (from the age of 6 months), an extremely elevated serum immunoglobulin E level (25,000 units/ml), and defective neutrophil chemotaxis. This patient also had peripheral blood eosinophilia and cutaneous candidiasis. There was a family history of asthma, but the patient herself did not have a history of asthma or hay fever, and, on examination, had no evidence of atopic dermatitis. The patient has not had any systemic infections. Results of the skin biopsy showed dermal edema and a perivascular infiltrate with eosinophils and an increased number of mast cells. The clinical spectrum of the hyperimmunoglobulin E syndrome may include atopic dermatitis, mucocutaneous candidiasis, systemic infections, and/or the features of Job's syndrome.

Adolescent↗
PubMed1977

A double-blind parallel study of acetylcysteine-isoproterenol and saline-isoproterenol in patients with chronic obstructive lung disease.

A double-blind parallel study in patients with asthma compared the safety and efficacy of saline-isoproterenol (SI) and acetylcysteine-isoproterenol (AI), when administered at home as an aerosol, over a one-week period, using a conventional nebulizer compressor. Measurements of pulmonary function revealed statistically significant differences between the two therapies for FEV1 and FVC in favour of AI. In the group treated with AI, the average sputum viscosity after six days of treatment was significantly less than pre-treatment values, or when compared to the results with SI treatment. No serious side-effects were reported during treatment with either therapy. These results indicate that acetylcysteine combined with a bronchodilator, such as isoproterenol, may be safe and of significant value in the treatment of patients with asthma who are also sputum producers.

Acetylcysteine↗
PubMed1976

Concanavalin A induces microtubule assembly and specific granule discharge in human polymorphonuclear leukocytes.

Human neutrophils stimulated by concanavalin A (Con A, 100 microng/ml) contained markedly enhanced numbers of microtubules and discharged peroxidase-negative (specific) but not peroxidase-position (azurophile) granules. Release of lysozyme from specific granules was dose and time dependent, could be inhibitied by alpha-methyl-D-mannoside, and enhanced by cytochalasin B. Many microtubules were associated with internalized plasma membrane bearing Con A binding sites.

Cell Survival↗