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Biomedical subjects

J Goldberg

Publications and source records attributed to J Goldberg.

At least 289 records · Page 16Linked to original sources
PubMed1986

Randomized trial of high-dose cytarabine versus amsacrine in acute myelogenous leukemia in relapse: a Leukemia Intergroup Study.

Patients with acute myelogenous leukemia in relapse who were ineligible for further anthracycline therapy either because they were judged to be anthracycline resistant or had received the maximum doses were randomized to receive high-dose cytarabine (3 g/m2 every 12 hours for 6 days) or amsacrine (75 mg/m2 daily for 7 days). The response rates in both groups were similar: three of 25 patients given high-dose cytarabine and three of 23 given amsacrine obtained complete remissions.

Adolescent↗
PubMed1986

The inheritance of Felty's syndrome in a family with several affected members.

A family in which 3 siblings had Felty's syndrome is described. All affected family members shared the common haplotype HLA-A2, B15, Cw3 and DR4. In addition, all affected siblings possessed the A2 and ABO phenotype. Four unaffected siblings possessed either the HLA-A2, B15, Cw3 and DR4 haplotype or the A2 ABO phenotype or neither but not both. We believe our data support the hypothesis that multiple genetic factors are involved in the predisposition of family members to Felty's syndrome.

Adult↗
PubMed1986

Age at death and risk factors in sudden infant death syndrome.

The age at death curve of the Sudden Infant Death Syndrome (SIDS) is considered to be its most unique characteristic. Investigation of SIDS in Cook County, Illinois, for the years 1975-80 indicate that: it is similar to that observed for SIDS in numerous other geographical areas, with low neonatal rates, high rates during the first 2-3 months of life and declining rates thereafter; the age at death for SIDS significantly differs from that of 21 other causes of infant mortality; and the age at death is independent of risk factors such as race, birthweight, urbanization, the month in which prenatal care was initiated, maternal age, legitimacy, gender and seasonality, all of which factors are quantitatively associated with SIDS mortality rates. These observations indicate that the aetiology of SIDS may be multifactorial with the underlying mechanism, which may be associated with normal growth and development, operating primarily in the period of high susceptibility i.e. at 2-4 months of age. Secondary factors, possibly present since birth, operate during this period of high susceptibility. Any suggested underlying aetiology for SIDS must account for the unique age at death pattern.

Adult↗
PubMed1985

Treatment of patients with acute nonlymphocytic leukemia in relapse: a Leukemia Intergroup study.

Forty patients with acute nonlymphocytic leukemia (ANLL) in first relapse were treated at eight member institutions of the Leukemia Intergroup with a 10-day continuous intravenous infusion of cytosine arabinoside and an anthracycline antibiotic administered on days 1, 2, and 3. Twenty of the 40 patients achieved a complete response. Seven of the patients who did not enter remission were drug-resistant failures, while 13 patients failed to enter remission for reasons other than persistent leukemia. Pretreatment parameters such as age, presence of infection, platelet count, and liver function tests were important predictors of survival. The percent bone marrow cellularity, the percent circulating abnormal (leukemic) cells, and the height of the white blood cell count prior to treatment were helpful in distinguishing patients who would enter remission from those who would not enter remission because of persistent leukemia.

Adolescent↗
PubMed1985

Mitoxantrone: an overview of safety and toxicity.

Mitoxantrone (Novantrone), is an anthracenedione which in preclinical studies demonstrated a spectrum of antitumor activity similar to the anthracyclines, but with less cardiotoxicity. Novantrone is a cytotoxic agent that produces dose-dependent myelosuppression. When administered to patients intravenously every three weeks, white blood cell (WBC) and platelet nadirs occurred between days 8 and 15 with hematologic recovery by day 22. In multiple clinical trials in over 4450 patients, including 372 patients in randomized trials against Adriamycin, Novantrone was consistently associated with a reduced incidence of moderate and severe acute side-effects. In four randomized trials the adverse experience profile associated with Novantrone was superior to that of Adriamycin with statistically significant lower incidences of mucositis/stomatitis, nausea, vomiting and alopecia. Novantrone was less cardiotoxic than Adriamycin and cardiac events were rare in patients without predisposing risk factors. The high level of activity combined with improved patient tolerance and decreased toxicity make Novantrone a promising agent for patients requiring cytotoxic chemotherapy.

Anthraquinones↗
PubMed1985

Changes in the characteristics of the bone marrow during therapy for acute non-lymphocytic leukemia: relationship to response to remission induction therapy.

The bone marrows of patients with acute non-lymphocytic leukemia being treated with 'high dose' cytosine arabinoside remission induction therapy were sampled prior to the initiation of chemotherapy, after 6 days of therapy and again 7 days after the conclusion of therapy. These studies demonstrated that the marrows of patients who would enter remission (CR patients) contained less leukemic cells prior to therapy than patients who would fail to enter remission because of persistent leukemia (resistant disease, or RD patients). A comparison of the day 6 and 7-day post-therapy marrows with the pretherapy marrow demonstrated that while the % reduction in leukemic cells was greater for CR patients than for RD patients, the absolute reduction in leukemic cell mass was the same for both groups. While there was no relationship between the percentage of cells in S phase and the pretherapy leukemic cell mass, the greater the pretherapy leukemic cell mass the greater the likelihood that the leukemic cells would be resistant to the metabolic effects of cytosine arabinoside in vitro.

Aged↗
PubMed1985

Acute granulocytic leukemia following systemic lupus erythematosus.

Corticosteroids, alkylating agents, and other immunosuppressive drugs are currently being used to treat a variety of systemic diseases. An increased incidence of acute granulocytic leukemia (AGL) has been noted in patients receiving such therapy. It is unclear whether AGL is the direct consequence of drug treatment or whether it represents a new expression of the natural history of the primary disorder. This report describes two cases of systemic lupus erythematosus (SLE) treated with immunosuppressive agents. Acute granulocytic leukemia developed and was the underlying cause of death in both patients.

Adrenal Cortex Hormones↗
PubMed1985

Behavioural evaluation of workers exposed to mixtures of organic solvents.

Reports from Scandinavia have suggested behavioural impairment among long term workers exposed to solvents below regulatory standards. A cross sectional study of behavioural performance was conducted among printers and spray painters exposed to mixtures of organic solvents to replicate the Scandinavian studies and to examine dose-response relationships. Eligible subjects consisted of 640 hourly workers from four midwestern United States companies. Of these, 269 responded to requests to participate and 240 were selected for study based on restrictions for age, sex, education, and other potentially confounding variables. The subjects tested had been employed on average for six years. Each subject completed an occupational history, underwent a medical examination, and completed a battery of behavioural tests. These included the Fitts law psychomotor task, the Stroop colour-word test, the Sternberg short term memory scanning test, the short term memory span test, and the continuous recognition memory test. Solvent exposure for each subject was defined as an exposed or non-exposed category based on a plant industrial hygiene walk-through and the concentration of solvents based on an analysis of full shift personal air samples by gas chromatography. The first definition was used to maintain consistency with Scandinavian studies, but the second was considered to be more accurate. The average full shift solvent concentration was 302 ppm for the printing plant workers and 6-13 ppm for the workers at other plants. Isopropanol and hexane were the major components, compared with toluene in Scandinavian studies. Performance on behavioural tests was analysed using multiple linear regression with solvent concentration as an independent variable. Other relevant demographic variables were also considered for inclusion. No significant (p greater than 0.05) relation between solvent concentration and impairment on any of the 10 behavioural variables was observed after controlling for confounding variables. Exposed/non-exposed comparisons showed a significantly poorer digit span among those exposed, but this has not been generally reported in the Scandinavian studies. The medical examination showed no abnormalities of clinical significance. The inability to replicate the findings of the Scandinavian studies could have been due to the shortness of the duration of workers' exposure, the type of solvents in the mixtures, use of different behavioural tests, or to selection factors.

Adult↗
PubMed1985

Cervicocollic reflex: its dynamic properties and interaction with vestibular reflexes.

Electromyographic activity of dorsal neck muscles elicited by sinusoidal rotations of the body and head was studied in decerebrate cats over a wide range of rotational frequencies and amplitudes. Rotation of the body with the head held fixed in space elicited a cervicocollic reflex (CCR) in the biventer cervicis, complexus, obliquus capitis inferior, rectus capitis major, and splenius muscles. As stimulus amplitude increased, CCR amplitude increased first rapidly and then more slowly, displaying two linear incremental sensitivity ranges. In contrast, the vestibulocollic reflex (VCR) elicited by whole body rotation had a minimum stimulus threshold below which no response was observed, whereas the vestibuloocular reflex (VOR) saturated at intermediate stimulus intensities. When stimulus frequency was varied, the CCR exhibited second-order dynamic behavior. At frequencies below 0.5 Hz, muscle EMG activation was in phase with peak platform angular deviation in the direction that stretched the muscle, and the gain measured as the percent modulation of EMG activity per degree of rotation remained constant. As frequency increased to 3-4 Hz, response phase advanced by 120 deg or more and gain increased with a slope approaching 40 dB/decade. The data were well-fitted by second-order transfer functions containing two zeros. Both the dynamic behavior of the CCR and its high sensitivity to small stimuli resemble the properties of muscle spindle primary afferents, suggesting that the latter may provide the major input responsible for the CCR. Dynamic properties and gains of the CCR and VCR were quite similar at frequencies between 0.2 and 3-4 Hz. Transfer functions of both reflexes contained two zeros whose time constants were correlated in a population of 11 cats, suggesting that reflex dynamics may be matched to the mechanical properties of each animal's head-neck system. Interaction of the CCR and VCR was studied under two conditions. When the head was driven by a servomotor while the body remained stationary, EMG activation by the two reflexes added linearly to produce a large response. When the body was rotated with the head allowed to counterrotate about the C1-C2 joint, the two reflexes combined linearly in an antagonistic fashion: the CCR acted to oppose head rotations produced by the VCR, thus preventing the ratio of head counterrotation to body rotation from exceeding 0.5. The data indicate that the CCR and VCR behave approximately linearly, both individually and in combination. Acting together, the two reflexes assist each other in preventing oscillation of the head on a stationary body.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1985

Spatial and temporal response properties of the vestibulocollic reflex in decerebrate cats.

Vestibulocollic reflex responses of several neck muscles in decerebrate cats were studied during angular rotations of the whole body in a large number of vertical and horizontal rotation planes, at frequencies from 0.07 to 1.6 Hz. Vestibulocollic responses were compared to eye muscle and forelimb muscle vestibular responses. Electromyographic activity was recorded by fine wires inserted in biventer cervicis, complexus, longus capitis, obliquus capitis inferior, occipitoscapularis, rectus capitis major, splenius, lateral rectus, and triceps brachii. At frequencies of approximately 0.5 Hz and above, neck muscle electromyographic response gains were sinusoidal functions of stimulus orientation within a set of vertical or horizontal planes, and a muscle's response phase remained constant across rotation planes, or reversed by 180 degrees. Response patterns at high frequencies were consistent with vestibulocollic reflex activation by semicircular canals through brain circuitry that modifies canal dynamics. At frequencies of approximately 0.5 Hz and above, the stimulus orientation in which a given neck muscle's response was maximal remained nearly constant across frequencies. Thus, we used responses to rotations at high frequencies to calculate axes of maximal response of each muscle in three-dimensional space. Lateral rectus, obliquus, and to a lesser extent, splenius and longus capitus were activated predominantly by horizontal rotations. Biventer was activated predominantly by pitch, triceps predominantly by roll, and complexus, occipitoscapularis, and rectus major significantly excited by rotations in all three coordinate planes. In some cases, at frequencies less than 0.5 Hz, neck muscle response phase varied depending on the vertical plane in which the cat was rotated, and the optimal response plane was poorly defined and varied with frequency. These responses indicated that, at some frequencies, neck muscle activity can result from summation of inputs with differing spatial orientation and dynamics (spatial-temporal convergence). Differences between responses to vertical and horizontal rotations suggested that low-frequency spatial-temporal convergence behavior of the vestibulocollic reflex during vertical rotations was due to convergent semicircular canal and otolith receptor inputs.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1985

A pilot study of the multidisciplinary management of childhood asthma in a family practice.

A small, controlled trial of joint treatment of childhood asthma by a doctor, a physiotherapist, a psychologist, and a social worker, working together in the family setting, demonstrated an improvement in ventilatory capacity. The limited scope of this trial does not permit more general conclusions as to the effect of such treatment on the severity and frequency of attacks, but the observation that some measurable physiological improvement occurred suggests that the place of multidisciplinary nonpharmaceutical management of childhood asthma should be investigated in more detail.

Adolescent↗
PubMed1984

Optimal response planes and canal convergence in secondary neurons in vestibular nuclei of alert cats.

Responses to natural stimulation were studied in electrically identified secondary vestibular neurons of awake cats. A class of neurons was identified whose response dynamics and responses to rotations in several vertical and horizontal planes indicated that they received semicircular canal input. Each canal neuron had clearly defined planes of maximal and null sensitivity to rotation. The orientation of these planes indicated that 44% of the neurons received input from one pair of canals, 40% from two, and 16% from all 3 canal pairs. Many cells also had oculomotor-related discharges and/or responded weakly to neck rotation.

Animals↗
PubMed1984

Spatial and temporal response properties of secondary neurons that receive convergent input in vestibular nuclei of alert cats.

Responses to rotation in many vertical and horizontal planes were studied in electrically identified secondary vestibular neurons of alert cats. This report concerns secondary neurons that gave responses which could not be explained as due to a summation of semicircular canal inputs. These cells responded to sinusoidal rotation of the cat in any vertical plane, and response phase depended on the plane of rotation. The responses were modeled as the result of summation of two inputs that differed in their spatial orientations and dynamics. Response dynamics and a comparison of responses to vertical and horizontal rotations showed that some cells were sensitive to rotation with respect to gravity. Their responses both to gravity and horizontal rotations argue that these secondary neurons received convergent otolith and canal inputs. Some cells also had oculomotor related discharges and/or responded weakly to neck rotation.

Animals↗
PubMed1984

The value of nuclear angiography in the preoperative assessment of patients undergoing elective aortic surgery.

Eighteen patients undergoing elective aortic surgery, either for peripheral vascular insufficiency or abdominal aneurysm, were studied preoperatively by nuclear angiography. By this technique the resting ventricular function of each patient was measured. Nuclear angiography is a safe non-invasive technique which has been shown to have excellent correlation with conventional contrast angiography in the assessment of ejection fraction. Throughout the intraoperative period, measurements of the central venous pressure and pulmonary capillary wedge pressure were taken simultaneously at approximately five-minute intervals. An average of 18 data points was established in each case. The correlation between central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) was examined. Ten of our patients had preoperative resting ejection fractions less than 55 per cent. In only four of these patients (40 per cent) was correlation between CVP and PCWP judged to be good intraoperatively. Eight of our patients had preoperative ejection fractions greater than 55 per cent. Six of these (75 per cent) showed good correlation between CVP and PCWP intraoperatively. We also assessed our ability to predict by purely clinical means which patients would show poor correlation between CVP and PCWP. Evaluation on purely clinical grounds was as good as the scans at predicting in which patients CVP would not correlate with PCWP and we feel that the routine use of this test would not modify our use of Swan Ganz catheters for intraoperative monitoring in patients undergoing aortic surgery, in the future.

Aorta, Abdominal↗