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Biomedical subjects

J Lieberman

Publications and source records attributed to J Lieberman.

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

Serial changes in markers of disease activity with corticosteroid treatment in sarcoidosis.

Serial changes in various markers of disease activity with corticosteroid therapy were assessed in 12 patients with active sarcoidosis. After six weeks of treatment with 40 mg daily of prednisone, all but one patient demonstrated symptomatic and radiographic improvement. For the entire patient group, there were corresponding improvements in forced vital capacity, from 59.2 +/- 5.5 to 70.5 +/- 5.3 percent of the predicted value (p less than 0.001, Student paired t test), serum angiotensin-converting enzyme levels, from 66.0 +/- 12.1 to 28.2 +/- 4.0 U/ml (p = 0.003), 67gallium lung scanning scores, from 3.6 +/- 0.2 to 0.8 +/- 0.3 (p less than 0.001), serum gamma globulin levels, from 2.40 +/- 0.2 to 1.5 +/- 0.1 g/dl (p less than 0.001), and erythrocyte sedimentation rate, from 26.8 +/- 2.7 to 14.8 +/- 3.0 mm per hour (p less than 0.001). Changes in percent of bronchoalveolar lavage fluid lymphocytes were less impressive (from 28.7 +/- 4.9 to 21.2 +/- 5.1, p = 0.034), but the geometric mean number of bronchoalveolar lavage fluid-IgG-secreting cells decreased from 23,861 to 3,830 (p = 0.013). Serial evaluations in five patients treated with decreasing doses of alternate-day prednisone for an additional 10 1/2 months indicated that changes in 67gallium lung scanning scores corresponded most closely to the clinical course in five of five patients. Determination of serum angiotensin-converting enzyme levels also closely paralleled the clinical course in four of five patients, whereas the other parameters measured were more variable markers of clinical response. However, abnormalities of bronchoalveolar lavage fluid-IgG-secreting cells often persisted in the absence of clinically evident disease, and the percentages of bronchoalveolar lavage fluid lymphocytes were frequently normal in patients who responded subsequently to corticosteroids. Larger prospective studies are warranted to more extensively evaluate various measurements of disease activity, especially bronchoalveolar lavage fluid analysis, in sarcoidosis.

Adult↗
PubMed1983

Clinical correlations of serum angiotensin-converting enzyme (ACE) in sarcoidosis. A longitudinal study of serum ACE, 67gallium scans, chest roentgenograms, and pulmonary function.

Thirty-one patients with biopsy-confirmed sarcoidosis were studied for two to four years to compare serum angiotensin-converting enzyme (ACE) levels to clinical status, 67gallium scans, chest x-ray films, and pulmonary function tests (PFTs). Serum ACE levels and changes in ACE level correlated best with the clinical status of patients and their gallium scans (p less than 0.0005), and less with their chest x-ray films (p = 0.012) or PFTs (p = 0.007). The gallium scan was especially useful for localizing areas of disease involvement. Serial measurements of serum ACE were found to be a sensitive means for following the clinical course of patients with sarcoidosis and at times for predicting clinical relapse or improvement.

Adolescent↗
PubMed1983

Nuclear magnetic resonance imaging of the mediastinum and hili: early impressions of its efficacy.

Nuclear magnetic resonance (NMR) scans of the mediastinum and/or hili were obtained in 22 of 25 patients selected on the basis of an abnormal CT scan. All patients had proven disease; 19 malignant and four benign processes were studied successfully. The high contrast resolution of NMR in the mediastinum allowed clear definition of disease in all cases. In six, NMR showed a greater extent of disease than CT. The ability of NMR to perform sagittal and coronal images also aided in disease analysis. In this preliminary study, NMR proved to be as useful as CT, or more so, in the evaluation of malignant disease of the hili and mediastinum.

Humans↗
PubMed1983

Angiotensin-converting enzyme activity in postmortem human tissues.

Angiotensin-converting enzyme (ACE) was assayed spectrophotometrically with hippuryl-histidyl-leucine as substrate. Postmortem tissues from 11 patients with various causes of death and pancreatic juice obtained during endoscopic cannulation of the pancreatic duct were assayed. Activity of most human tissues other than those of the gastrointestinal tract were found to be predominantly associated with the particulate fraction of the homogenates. Tissues with more than twice the ACE activity of lung included kidney, ileum, duodenum, and uterus; seven tissues with ACE activity approximately equal to that of lung included prostate, jejunum, lymph node, thyroid, colon, testis, and adrenal. Twelve other tissues had lower levels of activity with the heart consistently showing the least ACE activity. In the small intestine, the level of ACE activity increased with increasing distance from the pylorus. Inhibitors of ACE were detected in most tissues by assaying serial dilutions of the tissue homogenate; the presence of partial inhibitors did not significantly affect the relative activities of the various tissues. Lysis of hippuryl-histidyl-leucine by the pancreas and pancreatic juice resulted from an enzyme believed to be carboxypeptidase A which is present as a zymogen and activated by trypsin; this activity differed from ACE in that it had a smaller molecular weight (25,000) compared with ACE of serum (240,000), and it was not strongly inhibited by ethylenediaminetetraacetic acid or SQ 20881 (a specific ACE inhibitor). These studies show that human tissues vary in their content of ACE and suggest that ACE may serve a digestive or detoxifying role in the human small intestine and kidney, as well as functioning to activate angiotensin I.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1983

Circulating immune complexes in patients with diabetes mellitus.

Circulating immune complexes (CIC) were detected by the solid phase C1q binding assay in 16% of 103 diabetic patients and by the fluid phase C1q binding assay in 31% of patients as compared to 5% of 58 control subjects for each assay. Plasma glucose determinations revealed that most patients were moderately hyperglycaemic (mean glucose = 264 mg/dl), and thus were not selected for tight metabolic control. All but six patients had elevated levels of plasma insulin, including both the insulin treated and diet treated subgroups. There was no correlation between the presence of CIC detected by either assay and plasma glucose, insulin, or the presence of microangiopathy. Multiple factors must contribute to the increase in CIC in both insulin deficient and insulin resistant diabetics. The role of these various factors remains to be defined.

Adult↗
PubMed1983

Pseudoclubbing in a patient with sarcoidosis of the phalangeal bones.

We treated a patient who had sarcoidosis with pseudoclubbing. The involvement was asymmetric and involved some fingertips more than others. It did not involve the toes. The pseudoclubbing totally disappeared with effective prednisone therapy. Roentgenograms of the hands showed bone cysts of the distal and middle phalanges, and a gallium citrate Ga 67 scan showed uptake in two of the phalanges. We believe the pseudoclubbing in this patient is a manifestation of phalangeal bone involvement by sarcoidosis with associated dactylitis. A literature review indicates that true clubbing can exist in patients with sarcoidosis, but this case indicates that it must be distinguished from dactylitis.

Adult↗
PubMed1982

Elevation of serum angiotensin-converting enzyme level. Occurrence in alcoholic liver disease.

Serum angiotensin-converting enzyme (ACE) levels were measured in 151 patients with chronic alcoholism and alcoholic liver disease. The mean serum ACE level was elevated to 30.8 +/- 13 units/mL compared with 22.8 +/- 6 units/mL in control subjects. Approximately 30.0% of the patients had elevated ACE levels. Abstinence from alcohol for six to 27 months by 11 patients was associated with persistently normal serum ACE levels. Angiotensin-converting enzyme level elevations did not correlate with abnormalities of other liver function test results or with any acute clinical condition associated with alcoholic cirrhosis. Hypoxemia was not present in the patients with elevated serum ACE levels. Elevations of serum ACE levels in patients with alcoholic liver disease may relate to an effect of alcohol on the hepatic-sinusoidal lining cells. This elevation could interfere with the use of this test for supporting the diagnosis of sarcoidosis.

Alcohol Drinking↗