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Biomedical subjects

J Gold

Publications and source records attributed to J Gold.

At least 181 records · Page 10Linked to original sources
PubMed1983

Surgery for abdominal aortic aneurysms. With special reference to high-risk patients.

Between 1973 and 1980, 150 patients with an abdominal aneurysm underwent aneurysmectomy at St Vincent's Hospital, Sydney. Of these, 52 were high-risk patients with significant medical disease, including myocardial ischaemia, angina pectoris, obstructive airways disease, portal hypertension, and end-stage renal disease. The operative mortality for the 150 patients was 4.6%; it was 9.6% in the high-risk group. The predicted overall survival rate at seven years, with a minimum of two years' follow-up, was 55%, which compares favourably with that reported in other series, particularly in view of the advanced age of most of the patients--43% were in the eighth decade of their lives. The predicted survival rate of 26% for the high-risk group is nearly four times the survival rate predicted by Szilagyi for patients with untreated aneurysms. This increased life expectancy justifies the adoption of the widest possible selection criteria for elective aneurysmectomy.

Adult↗
PubMed1983

Defective T-cell response to PHA and mitogenic monoclonal antibodies in male homosexuals with acquired immunodeficiency syndrome and its in vitro correction by interleukin 2.

We studied the ability of phytohemagglutinin (PHA) and two anti-T-cell monoclonal antibodies OKT3 and Pan T2, to induce proliferation and interleukin 2 (IL2) production in peripheral blood lymphocytes (PBL) from 21 homosexual patients: 12 with Kaposi's sarcoma (KS), 4 with reactive lymphadenopathy, and 5 with opportunistic infections. All patients with KS and opportunistic infections had significantly lower mitogen-stimulated DNA synthesis, as compared to the controls, irrespective of the mitogen used (P less than 0.01). The patients with lymphadenopathy exhibited significantly lower responses only in the OKT3 assay as compared to normals (P = 0.009). The production of endogenous IL2 was significantly lower in PBL cultures from patients with KS and with opportunistic infections, irrespective of the mitogen used, as compared to healthy male controls, and also significantly lower in the Pan T2-stimulated cultures from patients with lymphadenopathy. The addition of highly purified IL2 was able to restore partially lymphocyte proliferation in vitro in the presence of these mitogens in all patients. Our studies demonstrate (1) that male homosexuals even without clinical manifestations of immunodeficiency frequently exhibit a proliferative T-cell defect when anti-T-cell monoclonal antibodies rather than PHA are used as mitogens, (2) that this proliferative defect is associated with defective IL2 production, and (3) that this defect is at least in part correctable in vitro by highly purified IL2.

Acquired Immunodeficiency Syndrome↗
PubMed1983

A prospective study of complications of pulmonary artery catheterizations in 500 consecutive patients.

Five hundred twenty-eight pulmonary artery catheters were inserted in 500 patients at the New York University Medical Center between May and November, 1981. Complications occurred in 126 of 528 catheterizations. Serious complications occurred in only 23 of these 528 catheterizations (4.4 percent). These complications, while serious, did not contribute directly to any of 31 deaths seen in these patients. Pulmonary artery catheters were reported by clinicians to have been of benefit in the management of 80 percent of these patients. We conclude, in view of this experience, that the wide use of these catheters is justified, but only if there is a probability that the catheters will significantly contribute to the management of the individual patient.

Adult↗
PubMed1982

Aspergillus Peritonitis complicating perforated appendicitis in adult acute leukemia.

A 38-year-old male with terminal transferase positive acute lymphoblastic leukemia experienced fever, polymicrobial bacteremia, gastrointestinal bleeding, abdominal pain during induction therapy, and remission. Cecal perforation, Aspergillus peritonitis, and subsequent disseminated aspergillosis were successfully managed with colon resection, drainage, and antibiotic and antifungal therapy. Serologic tests for antibody to Aspergillus were repeatedly negative.

Adult↗
PubMed1982

Microenvironmental immunoregulation: possible role of contrasuppressor cells in maintaining immune responses in gut-associated lymphoid tissues.

The addition of Peyer's patch T cells from most strains of mice to spleen cells in primary Mishell-Dutton cultures either has no effect or augments the spleen cells' response to sheep erythrocytes. However, if the Peyer's patch T cells are treated with an anti-I-J antiserum and complement to remove contrasuppressor-inducer cells, the remaining Ly-2 cells (T cells that express Ly-2 but not Ly-1) are highly suppressive. This "latent" suppressor cell activity also can be revealed by removing contrasuppressor-acceptor (transducer) cells from the splenic assay population with either an anti-I-J or anti-Ly-2 antiserum. These findings, taken together with previous work showing that orally administered antigen leads to systemic tolerance, give experimental support to the notion that contrasuppression may be important in allowing microenvironmental immune responses (in this case the gut-associated lymphoid tissue) to take place while systemic immunity is suppressed.

Animals↗
PubMed1982

Hypoxemia reflexly increases secretion from tracheal submucosal glands in dogs.

We anesthetized dogs, ventilated their lungs via the lower trachea, and exposed the epithelial surface of the upper trachea and coated it with powdered tantalum. Secretions from submucosal gland ducts formed elevations (hillocks) in the tantalum layer; we counted the number of hillocks that appeared in a 1.2-cm2 field. In 12 dogs, during normoxemia, 12 +/- 2 hillocks/cm2 formed in 90 s; during severe hypoxemia [fractional inspired O2 concentration (FIO2) = 0.05], 40 +/- 4 hillocks/cm2 formed in 90 s. Injections of sodium cyanide (25-75 micrograms) into the arterial supply to the carotid body also stimulated tracheal submucosal gland secretion. Secretory response to hypoxemia was suppressed by 1) section of both carotid sinus body nerves in six dogs and 2) section of both superior laryngeal nerves and vagus nerves in six other dogs. During mild hypoxemia (FIO2 = 0.10 or 0.15) tracheal submucosal gland secretion still increased. We conclude that hypoxemia increases secretion from submucosal glands in canine trachea by a carotid body chemoreflex.

Animals↗
PubMed1982

Opportunistic infection in previously healthy women. Initial manifestations of a community-acquired cellular immunodeficiency.

Opportunistic infections and unusual tumors have been reported in an unprecedented outbreak of community-acquired cellular immune deficiency among homosexual and drug-abusing men. We report five women with the same syndrome. The women were residents of metropolitan New York City closely associated with drug abuse either by personal use (our patients) or close sexual contact with an abuser (one patient). One patient was bisexual. All five patients developed Pneumocystis carinii pneumonia as well as combinations of other opportunistic infections including oral candida, disseminated mycobacteria, and ulcerative herpes simplex infections. All patients had marked depression of cellular immune function. Three patients died. The appearance of this syndrome in women has important implications with regard to the epidemiology and etiology of this emerging syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions.

Four homosexual men presented with gradually enlarging perianal ulcers, from which herpes simplex virus was cultured. Each patient had a prolonged course characterized by eight loss, fever, and evidence of infection by other opportunistic microorganisms including cytomegalovirus, Pneumocystis carinii, and Candida albicans. Three patients died; Kaposi's sarcoma developed in the fourth. All were found to have depressed cell-mediated immunity, as evidenced by skin anergy, lymphopenia, and poor or absent responses to plant lectins and antigens in vitro. Natural-killer-cell activity directed against target cells infected with herpes simplex virus was depressed in all patients. The absence of a history of recurrent infections or of histologic evidence of lymphoproliferative or other neoplastic diseases suggests that the immune defects were acquired.

Adult↗
PubMed1981

Anabolic profiles in late-stage cancer patients responsive to hydrazine sulfate.

The anabolic profiles of 59 late-stage cancer patients responsive to hydrazine sulfate were examined; the drug had been given either as a sole agent or added to preexisting therapy to which the patients had become refractory. Most of the patients (79.7%) responded which Indicated Appetite Improvement (IAI), expressed by protocol-code, clinical evaluation and/or direct quantitation. In those patients receiving hydrazine sulfate alone the IAI was 86.1%; in those in whom hydrazine sulfate was added to pre-existing therapy the IAI was 69.6%. Of those cases expressed in direct quantitation the average weight gain for patients receiving hydrazine sulfate alone was 8.2 lbs, whereas the average weight gain for those with pre-existing therapy was 0.6 lbs (p = 0.01). The results suggest the use of hydrazine sulfate as a specific chemotherapy for cancer cachexia, and implicate ineffective concurrent or prior therapy as an apparent negative factor in the generation of anabolic response.

Appetite↗
PubMed1980

Fatal ectopic pregnancy after attempted legally induced abortion.

From 1973 through 1978, the Center for Disease Control identified ten deaths caused by ruptured ectopic pregnancy after attempted legal abortions for those pregnancies. The women ranged in age from 18 to 31 years, seven were black, three were white, and five were nulliparous. The estimated gestational age was 16 menstrual weeks or earlier. In seven cases tissue obtained at abortion was sent for outside microscopic pathological examination; attempts to contact four of the patients when no products of conception were found were unsuccessful. An important factor in preventing fatal ectopic pregnancy for women who have legal abortions is the identification of products of conception at the time of the abortion procedure while the patient is still available for reexamination and recurretage.

Abortion, Legal↗
PubMed1980

Ultrasound demonstration of anicteric dilatation of the biliary tree.

This report presents eight patients with dilatation of the biliary tree, six of whom had no clinical or laboratory evidence of biliary tract disease except for elevated levels of serum alkaline phosphatase. In two patients, dilatation was caused by obstruction of only one hepatic duct; in three, it was caused by a pancreatic tumor; and in three, it was associated with gallstones which exercised a ball-valve effect, producing intermittent obstruction. The elevation of the alkaline phosphatase level in six of these patients suggests that it is a more sensitive indicator of biliary tract obstruction than the serum bilirubin level is. The recognition of biliary dilatation in one or both lobes of the liver should lead to a careful examination, with ultrasound or another modality, of the porta hepatis, common bile duct, and pancreas.

Aged↗
PubMed1980

Seasonal variation in spontaneous abortions.

Using a national sample of hospital discharges, we found identical seasonal patterns for spontaneous abortions and conceptions but no significant seasonal variation in the rate of spontaneous abortions per 1,000 conceptions. The differences between our findings and those of previous investigators of spontaneous abortion may reflect our more comprehensive definition of spontaneous abortion, our more complete estimate of the monthly number of conceptions, and our more rigorous statistical analysis. The periodic regression analysis (PRA) reported in our study may be useful in other studies that monitor short-term trends.

Abortion, Spontaneous↗