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Biomedical subjects

J Goldsmith

Publications and source records attributed to J Goldsmith.

At least 91 records · Page 5Linked to original sources
PubMed1987

Clinical and experimental aspects of single-lung transplantation.

Recent progress in immunosuppressive therapy for lung transplantation, improvements in surgical technique, advances in lung preservation methods, and appropriate management of cadaver organ donors have all improved the prospects for lung transplantation as a feasible therapeutic procedure for selected patients with end-stage pulmonary disease. The major limiting factor in the application of this operation will be the scarcity of good lung donors.

Animals↗
PubMed1985

Obtaining consent for organ donation.

The medical, emotional, and legal environments in which consent for organ donation is pursued greatly influence the outcome of this request. Knowledge of the circumstances and facts regarding brain death are important first steps in resolving misconceptions a potential donor's family may have that might preclude a favorable decision. The attitudes of hospital staff members toward these issues, and the grief and shock experienced at these times by next-of-kin, further complicate the circumstances in which consent for organ donation is requested. Clarification of traditional religious beliefs and reconciliation of these with the concept of organ donation may also have to be addressed at this time. Significant benefit to the bereaved family as well as to the transplantation process can accrue only in an atmosphere in which all involved understand the facts of brain death, and in which organ donation is viewed positively.

Attitude of Health Personnel↗
PubMed1985

Revascularization of ischemic bronchial anastomoses by an intercostal pedicle flap.

Ischemia of the donor bronchus, perfused solely by retrograde collaterals from the pulmonary circulation, is an important factor in the impaired healing of the bronchial anastomosis of transplanted lungs. The healing of two experimental models of bronchial anastomotic ischemia, the bronchial segmental autograft and the postpneumonectomy bronchial autograft, was assessed in dogs. The application of a polytetrafluoroethylene wrap to the bronchial segmental autograft and the application of an intercostal pedicle flap to the postpneumonectomy bronchial autograft, with and without concomitant administration of corticosteroids, were also studied to elucidate factors that affect bronchial anastomotic healing. The bronchial segmental autograft healed normally without stricture, but isolation of this autograft from the mediastinum and lung by the polytetrafluoroethylene wrap resulted in necrosis of the autograft. All dogs that had a postpneumonectomy bronchial autograft died of bronchopleural fistulas due to autograft necrosis. Application of an intercostal pedicle flap to the autograft resulted in healing in all animals. Arteriography and Microfil injection demonstrated revascularization of the postpneumonectomy bronchial autograft by the pedicled intercostal artery. Several conclusions can be drawn: With the lung in situ the bronchial segmental autograft survives, probably as a free composite graft. In contrast, the postpneumonectomy bronchial autograft is an excellent model of bronchial anastomotic ischemia. The intercostal pedicle flap is a reliable method for providing neovascularity and mechanical reinforcement to an ischemic bronchial anastomosis. Its effect on bronchial anastomotic healing was not diminished by administration of corticosteroids. The intercostal pedicle flap may be useful in preventing bronchial anastomotic complications in clinical lung transplantation.

Bronchi↗
PubMed1985

Multiple organ procurement from one donor.

To maximize organ utilization, we assessed the feasibility of retrieving the heart and two single lungs or the heart and a separate bilateral lung block for transplantation into multiple recipients. In eight dogs the excision of the heart-lung block or of the left lung was followed by six hours of lung preservation. Four of these lungs and all eight hearts were transplanted successfully. In addition, satisfactory retrieval of the three separate organs or of the heart and a separate bilateral lung block was done in six human cadavers. An appropriate division of the left atrial wall provided suitable cuffs for individual transplantation of the three organs or for the heart and bilateral lung block. This study demonstrates the feasibility of multiple organ donation from a single donor followed by separate organ transplantation.

Animals↗
PubMed1984

Ophthalmologic findings in acquired immune deficiency syndrome (AIDS).

Forty-one homosexually active men had ophthalmologic and immunologic evaluations. Four of eight with acquired immune deficiency syndrome (AIDS) had abnormal ocular findings that included cotton-wool spots, retinal hemorrhages, cytomegalovirus, retinitis and conjunctivitis due to cytomegalovirus, and keratoconjunctivitis sicca. The other four patients with AIDS and 33 homosexual male controls had normal ocular examinations. Patients with AIDS and abnormal eye findings had a notably lower total leukocyte count, absolute lymphocyte count, percentage T-helper lymphocytes, helper-suppressor lymphocyte ratio, hematocrit level, and platelet count than patients with AIDS and normal results on eye examination or controls. All patients with AIDS and abnormal eye examination results died; the four other patients with AIDS and normal eye findings remain alive. These observations suggest that ophthalmologic abnormalities are common in patients with AIDS, are associated with severe immunoregulatory abnormalities, and carry a poor prognosis.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The spectrum of immunologic abnormalities and clinical findings in homosexually active men.

Clinical and laboratory evaluations of 181 men were performed; the population studied included 131 homosexual or bisexual men (who were stratified into one of three groups on the basis of symptomatology and abnormal findings on physical examination), 39 heterosexual men (who served as controls), and 11 men with acquired immunodeficiency syndrome (AIDS). The presence of specific symptoms and/or lymphadenopathy in homosexual men was associated with perturbation of immunoregulation. A large percentage of asymptomatic, homosexually active men had abnormalities in lymphocyte numbers, subpopulations, and subclasses. Symptomatic individuals had clinical findings, immunologic alterations, and abnormalities of hematopoiesis similar to those found in patients with AIDS. These data suggest that clinical evaluation in conjunction with laboratory studies may serve to identify individuals at increased risk of developing AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Maintenance protocol for potential organ donors in multiple organ procurement.

Donor organs that are suitable for transplantation remain scarce, especially in view of the number of types of organ transplants now possible and the ever-increasing number of waiting recipients. This scarcity of donor organs can, to some extent, be ameliorated by the adoption of potential organ donor maintenance protocols that protect the organs from irreversible damage. Of key importance to the success of any such protocol is the establishment of hemodynamic adequacy and stability. Appropriate and vigorous antibiotic prophylaxis is also a major consideration, especially with regard to the pulmonary and genitourinary systems. The use of ophthalmologic preparations for protection of the corneas, attention to skin cleanliness, and the practice of rigorous sterile technique in the care of all indwelling catheters are measures that are strongly encouraged in order to provide the best possible chance of successful donation of organs that otherwise may be compromised.

Humans↗
PubMed1983

Acquired immunodeficiency syndrome in a patient with multiple risk factors.

To our knowledge, we report the first case of a homosexually active man with severe hemophilia A in whom acquired immunodeficiency syndrome (AIDS) developed. Alterations in cell-mediated immunoregulation and development of AIDS have been described in both healthy homosexually active men and heterosexual men with hemophilia A. Patients with multiple risks may be more likely to have AIDS develop. Physicians should be aware of the risk factors associated with AIDS; persons with multiple predisposing factors require intensive examination and close follow-up.

Acquired Immunodeficiency Syndrome↗
PubMed1983

The response of young Peking ducklings to sibling distress calls.

Peking ducklings were tested at 1-2 or 7-8 days of age for their tendency to inhibit their own distress calling in response to the distress calls of siblings. At both ages the ducklings displayed a significant inhibitory response to the sibling calls, although the response of the older birds was greater. When the younger ducklings were subsequently tested with a variety of acoustic stimuli that were similar to the conspecific calls, however, they showed the same degree of response specificity displayed by older ducklings in previous research: in both cases the ducklings more strongly inhibited their vocalizing in response to the sibling calls than to most of these other stimuli. Finally, it was demonstrated that this differential responsiveness to sibling calls was not due merely to differences in pretest exposure to the sibling calls vs these other stimuli. This sensitivity of 1-2-day-old ducklings to sibling distress calls is of interest because (1) this age period is of great importance for the formation of social attachments, including sibling bonds, (2) distress calls are known to play an important role in maintaining family cohesion, and (3) it stands in contrast to the common view that young precocial birds do not respond to sibling distress calls.

Aging↗
PubMed1982

Interactions of insulin with bovine endothelium.

Bovine endothelial cells have been isolated from pulmonary and systemic vessels and grown in culture as primary, passaged and passaged cloned-strains. The cultures were shown to be endothelial in nature on the basis of several endothelial-specific and endothelial-associated traits. Endothelial cells from all sources had specific receptors for insulin in primary culture and after serial passage. Endothelial cells derived from pulmonary arteries and aortas bound 2.5 times more insulin than cells derived from the pulmonary vein. Each endothelial cell type maintained a specific complement of receptors through at least 25 passages in vitro. Coupled with previous findings of insulin receptors on endothelial cells from human umbilical vessels, these data suggest that insulin receptors may be an intrinsic component of all vascular endothelium.

Animals↗