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Biomedical subjects

L Goldstein

Publications and source records attributed to L Goldstein.

At least 109 records · Page 6Linked to original sources

Improved methods in long term venous access using the P.A.S. Port.

An over-all lower cost implantable chronic venous access is readily accomplished using the Cath-finder and implantable P.A.S. Port. This system has few complications and is less expensive, time saving and easy to maintain. The Cath-finder system allows the surgeon to access accurately the central venous circulation without the use of a fluoroscope. The implantable P.A.S. Port has wide acceptance with many types of patients, including those with tumors, cystic fibrosis and AIDS.

Catheterization, Central Venous↗

OSHA bloodborne pathogens standard. Implications for the occupational health nurse.

The Occupational Safety and Health Administration (OSHA) has promulgated a standard, expected to become mandatory in mid 1991, designed to protect employees from all exposure to blood and other potentially infectious materials. Employers should begin now to institute an infection control plan. Methods of compliance of the standard include: universal precautions, engineering and work practice controls, personal protective equipment, and housekeeping. The occupational health nurse should coordinate development, maintenance, and revision of a program to comply with the OSHA regulations. The occupational health nurse should also educate management about the hazards of bloodborne pathogens and assist them in complying with the final standard so that a safe and healthy work environment can be achieved.

Blood↗

Application of a thermally-reversible polymer-antibody conjugate in a novel membrane-based immunoassay.

We have developed a novel method to immobilize antibodies onto a cellulose acetate membrane using a conjugate of an N-isopropylacrylamide polymer covalently bound to the antibody. When compared with the unconjugated antibody, over 30-fold increase in retention of the antibody on the membrane was observed when it was conjugated to poly (N-isopropylacrylamide). Studies of the polymer-membrane interaction suggest a combination of hydrophobic and ionic forces, especially the former, is responsible for the high retention. We applied this novel immobilization technology in the development of a membrane-based immunoassay.

Antibodies↗

Hypotonicity stimulates phosphatidylcholine hydrolysis and generates diacylglycerol in erythrocytes.

Exposure of skate erythrocytes to hypotonic medium stimulates a rapid increase in levels of 1,2-diacylglycerol. Other treatments which produce cell swelling such as replacement of a portion of medium NaCl with the permeant solutes ethylene glycol or ammonium chloride also stimulate increases in diacylglycerol. Whereas the reduction of medium osmolarity to 460 mosm (from 940) stimulated a persistent diacylglycerol increase, the increase after reduction to 660 mosm was transient, peaking at 2.5 min and then slowly declining. This decline could be prevented by preincubation with the diacylglycerol kinase inhibitor R59022. To investigate the source of the increased diacylglycerol, the rate of incorporation of [32P]PO4 into each major phospholipid was measured. Reduction of osmolarity to 660 mosm stimulated the incorporation of phosphate into phosphatidylcholine markedly, with a smaller increase observed into phosphatidylinositol. To demonstrate phosphatidylcholine hydrolysis, erythrocytes were prelabeled with [32P]PO4. Subsequent exposure to hypotonic (660 mosm) medium stimulated a decrease in radioactivity in phosphatidylcholine and a large increase in radioactivity in phosphatidic acid. When stimulated in the presence of ethanol, 32PO4-labeled phosphatidylethanol was formed, suggesting activation of phospholipase D. In addition, the initial formation of 32PO4-labeled phosphatidic acid was not sensitive to inhibition of diacylglycerol kinase, supporting the role of direct activation of phospholipase D. These results indicate that hypotonicity and the accompanying cell swelling induce cell membrane phospholipid turnover, predominantly phosphatidylcholine, and production of the protein kinase C activator, diacylglycerol, which appears to occur via activation of phospholipase D.

Animals↗

Mechanisms of mercurial and arsenical inhibition of tyrosine absorption in intestine of the winter flounder Pseudopleuronectus americanus.

Effects of HgCl2 (100 microM) para-chloromercuribenzene sulfonate (PCMBS) (1 mM), and oxophenylarsine (OPA) (250 microM) were determined on (a) the rate of Na pump activity in intact winter flounder intestine; (b) activity of Na-K-ATPase in tissue homogenates; and (c) Na-dependent and Na-independent uptake of tyrosine in brush border membrane vesicles. Initial rate of uptake (influx) of 86Rb from the serosal solution of tissues mounted in Ussing chambers, a measure of Na-K-ATPase activity in the intact cell, was inhibited by all three agents with differing time courses. Rapidly permeating HgCl2 inhibited influx to the same degree as ouabain at 30 min, whereas the effects of PCMBS and OPA required 90 min. Cell potassium was also measured as an indirect indicator of ATPase activity and cell membrane permeability. All three agents decreased cell K, although effects on cell K lagged behind those for inhibition of the ATPase. At the concentrations used in the Ussing chamber (or at one-tenth concentration), all agents completely inhibited Na-K-ATPase activity in enzyme assays performed with tissue homogenates. In contrast, only HgCl2 decreased Na-dependent uptake of tyrosine by brush border membrane vesicles. These results suggest that mercurial and arsenical effects on tyrosine absorption are due to inhibition of the Na-K-ATPase thus decreasing the driving force for the cellular uptake by the Na-tyrosine cotransport system. Direct effects on Na-tyrosine cotransport may play a role in the inhibition observed with HgCl2, but not for PCMBS or OPA.

4-Chloromercuribenzenesulfonate↗

Dental pathology and alcohol-related indicators in an outpatient clinic sample.

A relationship between alcoholism and dental pathology (particularly missing teeth), has been reported in studies of male, inpatient alcoholics. The present exploratory study was undertaken to assess how readily these findings can be generalized to an unselected sample of male and female dental patients. Data on drinking behavior, alcohol-related problems, and risk factors for alcoholism were obtained through an interview and questionnaire. A dental chart review provided measures of dental pathology. The results showed that measures of dental pathology (including tooth loss, carious teeth, and periodontal disease) correlated significantly with alcohol-related indicators. The associations were more evident for males than for females, which is consistent with some studies of alcohol-related medical consequences. The results suggest that further analytic studies of alcohol consumption and dental pathology are warranted. Because the relationship between tooth loss and harmful drinking was clearest among males with a history of conduct problems, subsequent research would benefit from a focus on this high-risk group.

Adult↗

Cell volume regulation by skate erythrocytes: role of potassium.

The role of K transport during cell volume regulation in response to extracellular osmolality, protein kinase C activation, and cellular Ca was examined in skate (Raja erinacea) red blood cells (RBC). Reduction of medium osmolality from 960 to 660 mosmol/kgH2O had no effect on K uptake or efflux despite a 25% increase in cell volume. Further reduction to 460 mosmol/kgH2O caused K uptake to double and K efflux to triple resulting in net K loss. Net K efflux in 460 mosmol/kgH2O medium was correlated with the presence of a regulatory volume decrease, which was sensitive to the anion transport inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) and insensitive to chloride replacement. K-K exchange was absent in both isotonic and hypotonic media. Treatment with the Ca ionophore A23187 in the presence of Ca had no effect on either cell volume or K efflux in isotonic medium, indicating the absence of Ca-activated K transport. In contrast, phorbol ester treatment caused cell volume, Na content, and proton and K efflux to increase. Consistent with activation of Na-H exchange, phorbol ester effects were inhibited by dimethylamiloride. This study constitutes the first demonstration of volume-sensitive K transport in RBC from the most primitive vertebrate studied to date.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

Late auditory magnetic sources may differ in the left hemisphere of schizophrenic patients. A preliminary report.

We recorded magnetoencephalographic auditory evoked fields from the left and right hemispheres of six medicated, paranoid schizophrenic subjects and six normal controls. The magnetic field data were used in estimating the location, orientation, and depth of the source generating the 100-millisecond latency evoked field component (M100). The M100 latencies were slightly shorter than simultaneously recorded vertex electroencephalographic evoked potential N100 latencies, suggesting that magnetoencephalographic and electroencephalographic recordings were examining slightly different aspects of the source(s). The M100 sources demonstrated substantial interhemispheric asymmetry in normal controls, and were located more posteriorly, with more nearly vertical orientations, over the left hemisphere. The M100 sources in schizophrenics did not exhibit the same interhemispheric asymmetry. Left hemisphere source orientation differed significantly between normal controls and schizophrenics. Discriminant function analysis correctly classified normal controls and schizophrenics at 100% using the conservative jackknife procedure on the basis of left hemisphere orientation alone. Our findings, while preliminary, support altered left hemisphere function, or possibly structure, in this group of schizophrenic subjects, and suggest that magnetoencephalographic recordings may be a useful research method in this major mental illness.

Adult↗

Amanita poisoning: treatment and the role of liver transplantation.

Fatal mushroom poisoning has long been recognized as a major health problem in western Europe and more recently in the United States. The majority of deaths are attributable to the genus Amanita. Amanita phalloides (death cap) has been found with increasing frequency across the United States and presents a significant health hazard in this country to those who pick and consume wild mushrooms. This article discusses the pharmacologic basis and clinical manifestations of Amanita intoxication. It outlines the rationale of various treatment modalities and, from these, summarizes a protocol that the authors believe will be useful to the clinician. In addition, two patients are presented who underwent successful orthotopic liver transplantation for fulminant hepatic failure secondary to Amanita poisoning. The role of liver transplantation both acutely and as treatment for chronic active hepatitis secondary to severe intoxication is discussed.

Adult↗

Bulimia nervosa and dietary restraint.

Patients with bulimia nervosa were compared with non-bulimic restrained and unrestrained eaters on several questionnaire and interview measures related to eating patterns, preoccupation with dieting and food, and general psychopathology. Bulimic subjects did not differ significantly from non-bulimic restrained eaters on measures of fear of weight gain, dietary restraint, and the Eating Disorders Inventory (EDI) subscales of Drive for Thinness and Body Dissatisfaction, although both groups scored significantly higher on these measures than unrestrained eaters. Subjects with bulimia nervosa differed significantly from both restrained and unrestrained eaters on the Eating Habits Checklist, the Beck Depression Inventory, the EDI total score and Interoceptive Awareness, Introversion and Bulimia subscales, the Three Factor Eating Questionnaire (TFEQ), Disinhibition subscale and the Symptom Checklist 90-revised version. These findings show that bulimic patients may be quite similar to their restrained, non-bulimic counterparts on dietary concern and ideals of slenderness and suggest the importance of including a restrained control group in attempts to isolate the variables that differentiate individuals with the clinical eating disorder from their peers who demonstrate normative discontent about body weight and shape.

Adult↗

Organic solute profiles and transport in the rat renal medulla.

Renal inner medullary cells accumulate high concentrations of organic solutes. Sorbitol and glycerophosphorylcholine accumulation (concentration) increase progressively from the outer medulla to the papillary tip. Inositol accumulation is the reverse; its concentration decreases from the outer medulla to the papillary tip. Diabetes mellitus (1 week) increases sorbitol at all levels of the inner medulla, decreases glycerophosphorylcholine and has little effect on inositol. Thin slices of the inner medulla incubated in vitro concentrate inositol and choline from the medium. Although the inner medullary cells are permeable to sorbitol, membrane transport appears to play no role in its accumulation.

Animals↗

Modeling splanchnic hemodynamics after distal splenorenal shunt: a computer simulation and sensitivity analysis.

The distal splenorenal shunt operation was specifically designed to preserve portal flow and maintain elevated portal pressure. However, although this goal is met in the immediate postoperative period, flow decreases over time, and in as many as 75% of alcoholic patients, portal flow is lost in the first year. Various explanations have been offered for this observation, and modifications of the original operation have been proposed (splenopancreatic disconnection). Although other portacaval shunts have been successfully modeled as electrical circuits, this approach has never been described for the distal splenorenal shunt. In this study we developed a computer program that modeled the distal splenorenal shunt as an electrical circuit. We performed an analysis to determine the sensitivity of portal flow to changes in each resistance element and then performed a series of simulation experiments to critically examine the various explanations offered for the gradual changes in hepatic hemodynamics. We found that portal flow was most sensitive to resistance in the renal vein followed by resistance in the anastomosis. The simulation experiments suggested a new alternative to splenopancreatic disconnection--restricting the ability of the splenic vein, anastomosis, or renal vein to dilate. Additional clinical studies will be needed to test these predictions.

Collateral Circulation↗

Perfect fit.

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Equipment Design↗