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Biomedical subjects

J Goldstein

Publications and source records attributed to J Goldstein.

At least 289 records · Page 16Linked to original sources
PubMed1984

Clinical, hemodynamic, and operative descriptors affecting outcome of aortic valve replacement in elderly versus young patients.

One hundred and fifty-two patients age 70 years or more underwent aortic valve replacement (AVR) at Emory University Hospital between July 1, 1974 and July 1, 1982. Of these, 98 had isolated AVR (elderly AVR group) and 54 had concomitant coronary artery bypass grafts (elderly AVR/CABG group). Results of surgery in these patients were compared to results in patients aged 20 to 69 years operated on in the same period (young AVR/CABG groups). Comparative descriptors with statistically significant differences included a higher incidence of both stable and unstable angina in patients undergoing concomitant CABGs ; less cardiomegaly in the young AVR/CABG group; less hypertension, a higher incidence of pure aortic regurgitation, and less frequent use of inotropes in the young AVR group; a higher perioperative stroke rate in elderly AVR/CABG patients; a higher perioperative psychosis rate in patients having CABGs regardless of age; and a longer postoperative hospital stay for the elderly patients. There were no significant differences between the four groups for the following descriptors: sex ratio; history of congestive heart failure; the presence of atrial fibrillation; left ventricular end diastolic pressure, ejection fraction and contractility; number of diseased coronary arteries; number of vessels bypassed; use of the intra-aortic balloon pump; re-exploration for hemorrhage; perioperative myocardial infarction rate; and major wound infection rate. Operative mortality was 5.1% for the elderly AVR group, 5.6% for the elderly AVR/CABG group, 1.9% for the young AVR group, and 5.1% for the young AVR/CABG group (p = NS). Overall, hospital mortality was 3.3%. Actuarial survival curves for all elderly versus all young patients showed no significant difference. The curve for elderly patients compares favorably with the actuarial survival of the same age group in the general population. Actuarial survival curves for the four subgroups did not differ significantly when compared at a follow-up of 36 months after surgery. We conclude that AVR with or without concomitant CABGs can be performed in elderly patients with an acceptably low mortality and morbidity, and the postoperative survival compared favorably both with younger patients and with the general population of the same age.

Actuarial Analysis↗
PubMed1984

Growth of coagulase-negative staphylococci on colistin-nalidixic acid agar and susceptibility to polymyxins.

Colistin-nalidixic acid agar, although recently recommended as a replacement for blood agar for primary plating of urine specimens ( Fung et al., J. Clin. Microbiol. 16:632-636, 1982), has also been reported to suppress the growth of some strains of staphylococci that are susceptible to colistin (polymyxin E). The susceptibility of 11 species of staphylococci to polymyxins was determined, and the ability of these species to grow on colistin-nalidixic acid agar was examined. Although the MICs for most of the strains tested were 8 micrograms/ml or less, only a few coagulase-negative staphylococci grew on or were inhibited by colistin-nalidixic acid agar. This descrepancy was explained by the antagonistic effects that medium components, such as physiological concentrations of magnesium and calcium and 5% sheep blood, had on the activity of polymyxin. Colistin-nalidixic acid agar is still recommended for routine urine processing; however, the poor growth of 13% of the Staphylococcus saprophyticus strains tested suggests that blood agar should be included in the primary plating battery of urine specimens obtained from female outpatients.

Agar↗
PubMed1984

Administration of sulmazol in low-output states following cardiac surgery.

Sulmazol (AR-L 115BS), a phenylimidazopyridine derivative, which combines positive inotropic and vasodilating properties, was administered to nine patients who had a low cardiac output state (cardiac index below 2.0 L/min/m2) within 24 hours after cardiac surgery for valvular replacement (eight patients) or septal repair after myocardial infarction (one patient). Sulmazol, administered as a 60-minute infusion of 1.8 mg/min, resulted in significant increases in cardiac output and cardiac work, associated with significant decreases in cardiac filling pressures. Arterial pressure did not change notably, and systemic vascular resistance decreased significantly. A small but significant increase in heart rate was also observed. By its combined inotropic and vasodilating properties, sulmazol can be helpful in the management of low-output states after cardiac surgery.

Aged↗
PubMed1984

Brain sarcoma of meningeal origin after cranial irradiation in childhood acute lymphocytic leukemia. Case report.

The authors report their experience with an unusual case of intracerebral sarcoma of meningeal cell origin in an 8 1/2-year-old girl. This tumor occurred 6 1/2 years after cranial irradiation at relatively low dosage (2200 rads) had been delivered to the head in the course of a multimodality treatment for acute lymphocytic leukemia. The tumor recurred approximately 10 months after the first surgical intervention. Macroscopic total excision of the recurrent growth followed by whole-brain irradiation (4500 rads) failed to eradicate it completely and local recurrence prompted reoperation 18 months later. This complication of treatment in long-term childhood leukemia survivors is briefly discussed, as well as the pathology of meningeal sarcomas.

Brain Neoplasms↗
PubMed1983

Variation of (2'-5')oligo(adenylate) synthetase activity during rat-liver regeneration.

The interferon-induced double-stranded RNA-activated (2'-5')oligo(adenylate) synthetase converts ATP into (2'-5')oligo(adenylate) [(2'-5')oligo(A)] and pyrophosphate. In turn, (2'-5')oligo(A) activates a latent endoribonuclease which cleaves single-stranded RNA. (2'-5')Oligo(A) synthetase activity has been characterized in liver cells of normal and germ-free rats. This enzyme is predominantly nuclear. After partial hepatectomy, (2'-5')oligo(A) synthetase activity decreased rapidly (after 10 h) and markedly to a minimum of 25% of the control after 20 h. This decrease was followed by a slow restoration of the activity. No such change was observed in sham-operated animals. This important decrease of enzymatic activity occurred during the first few hours of liver regeneration (6-24 h). This period corresponds also to the prereplicative and replicative (18-24 h after hepatectomy) phases of DNA. Detailed kinetics indicated that the loss of (2'-5')oligo(A) synthetase activity preceded the onset of the incorporation of tritiated thymidine in DNA and was minimal when the rate of DNA synthesis was maximal. These results and those obtained in culture of cells in vitro are compatible with the hypothesis that the (2'-5')oligo(A) system participates in the negative control of cell proliferation.

2',5'-Oligoadenylate Synthetase↗
PubMed1983

The Sdx antigen and antibody: biochemical studies on the inhibitory property of human urine.

Anti-Sdx is an IgM complement-binding autoantibody that defines a red cell antigen which is independent of I, i, Sp1 (Pr) and Gd. Hemagglutination by the antibody is unusually sensitive to variation in pH, salt, or other charged molecular species. The antibody is inhibited by urine from Sd(a+) persons, but inhibition is a nonspecific effect caused by charged molecules. No specific Sdx substance could be demonstrated, and Sdx antigen does not appear to be directly associated with the Sid blood group. In view of these findings we propose that this antibody should be renamed anti-Rx.

Animals↗
PubMed1983

Monocusp aortic valve replacement in dogs: an experimental model.

Aortic valve replacement using human allograft valves is a well established procedure, following which histological evidence of a host-graft interaction is seen. This varies in intensity, depending on the types of sterilizing and storage agents to which the allograft is exposed prior to insertion. A canine experimental model which enables study of these tissue ingrowth patterns in variously treated allografts has been devised. The technique is described in detail.

Animals↗
PubMed1983

Effect of different media on determination of novobiocin resistance for differentiation of coagulase-negative staphylococci.

Species identification of coagulase-negative staphylococci often requires the determination of novobiocin susceptibility. Although previous investigators have recommended the use of P agar for this purpose, most clinical laboratories do not routinely utilize this medium. For this reason, studies were performed to compare novobiocin susceptibility results obtained with 11 different species of staphylococci (10 isolates of each species), using P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar. Tests performed on 70 susceptible isolates (minimal inhibitory concentration less than 1.6 micrograms/ml) resulted in zones of inhibition around 5-micrograms novobiocin disks ranging from 19.6 to 33.9, 16.2 to 26.6, and 21.3 to 36.4 mm on P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar, respectively. Forty resistant isolates (minimal inhibitory concentration greater than or equal to 1.6 micrograms/ml) exhibited zones of inhibition ranging from 6.0 to 11.3 mm on P agar, 6.0 to 11.6 mm on Trypticase soy agar with 5% sheep blood, and 6.0 to 13.5 mm on Mueller-Hinton agar. Using the established cut off of 16 mm to define novobiocin resistance for the identification of coagulase-negative staphylococci, we correctly identified 100% of the strains tested, regardless of the media utilized.

Coagulase↗
PubMed1983

Immediate and delayed alterations of adrenocorticotropin and cortisol nyctohemeral profiles after corticotropin-releasing factor in normal man.

Intravenous injections of 50 micrograms corticotropin-releasing factor (CRF) to four normal men at 0900 and 2300 h were followed by significant plasma ACTH and cortisol elevations, without changes in GH and PRL concentrations. The responses were more easily assessed late in the evening than in the morning, when they were superimposed upon the spontaneous hormonal variations. The initial hormonal response was always followed by a period of decreased hormonal values compared to control patterns. The normal pituitary-adrenal response to CRF was blunted or abolished by prior administration of dexamethasone. These data suggest that exogenous administration or CRF-induced endogenous production of glucocorticoids modulates the sensitivity of corticotropic cells to the action of CRF. Since normal ACTH and cortisol secretory episodes are likely to obscure the effects of CRF, stimulation tests for clinical purposes should be performed during the quiescent period, i.e. late in the evening.

Adrenocorticotropic Hormone↗
PubMed1983

Multiple NMR T2 relaxation values in human liver tissue.

Twenty-one human hepatic liver biopsy samples were evaluated by nuclear magnetic resonance spectroscopy. This spectroscopy was performed by obtaining multiple and not single T2 values (T2-long and T2-short). Neoplastic tissue had greater T2-long and T2-short values than diffuse liver disease. The T2-short correlated, r = 0.947 (p less than 0.01), with the percentage of cancer cellularity within the tissue specimens. There was no correlation between the multiple T2 values and the degree of fibrosis and inflammation. Minimal correlation was noted between the T2-long and percentage of fat within the diffuse disease (cirrhotic) specimens, r = 0.636 (p less than 0.05). The possible reasons for the above findings are discussed.

Biopsy↗