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Biomedical subjects

L Hoffman

Publications and source records attributed to L Hoffman.

At least 91 records · Page 5Linked to original sources
PubMed1989

Low plasma beta-endorphin in post-traumatic stress disorder.

We compared serum cortisol, ACTH and plasma beta-endorphin in 21 Post-Traumatic Stress Disorder patients and 20 controls. Although we found no important disturbance in diurnal rhythms, the PTSD patients had significantly higher A.M. serum cortisols compared with controls. Both A.M. and P.M. plasma beta-endorphins in PTSD patients were significantly lower compared with controls. These data suggest that plasma beta-endorphin may be a marker for PTSD and that chronic endogenous opioid depletion may play a role in the pathogenesis and perpetuation of this disorder.

Adrenocorticotropic Hormone↗
PubMed1989

Chronic high velocity projectile injury to the foot.

Acute projectile injuries to the foot can present a challenge for the podiatric physician, especially in terms of their chronic effects. The case of a shrapnel wound to the right foot and ankle that resulted in recurrent episodes of soft tissue infection and disability is presented. Treatment consisted of excision of the shrapnel fragment, debridement, and primary closure of the sinus tract created by the projectile. The authors discuss the acute and chronic effects of projectile injuries, factors responsible for determining the severity of these wounds, and various methods of treatment.

Acute Disease↗
PubMed1989

The psychoanalytic process and the development of insight in child analysis: a case study.

This paper describes a segment of the analysis of an aggressive latency-age child. The data demonstrate the relationship between the establishment of a psychoanalytic process (the analysis of transference, defense, and resistance), the development and nature of insight in the child, and the resulting therapeutic change. Examination of the process shows that the therapeutic gains were a result of insights acquired by the child, particularly his awareness of painful affects that had been warded off. This case is compared with Bornstein's treatment of a phobic child who manifested severely "out-of-control" behavior.

Acting Out↗
PubMed1988

The neuropsychiatry of post-traumatic stress disorder.

The publication of DSM-III introduced the diagnosis Post-Traumatic Stress Disorder (PTSD), thus providing, for the first time, a framework for studying the consequences of extremely stressful events. Previously, traumatic neuroses had attracted a wide variety of labels - as wide as the experiences that produced them. Competing explanations in psychological and biological terms have characterised the approach to these disorders, and social and legal issues have added to the confusion. In recent years, psychosocial issues have tended to dominate the literature in relation to PTSD. While acknowledging the importance of such phenomenological and psychosocial approaches, this paper seeks to redress the balance by focusing on a biological perspective.

Dominance, Cerebral↗
PubMed1986

Elevated serum creatinine levels in three patients treated with phenacemide.

Three adolescent patients with severe seizure disorders were treated with phenacemide. All three patients showed elevated serum creatinine and normal blood urea nitrogen values while on phenacemide. Simultaneous urea and creatinine clearance studies performed on each patient demonstrated normal urea clearances and decreased creatinine clearances. Inulin clearance performed in one patient was normal. The medication was discontinued in two of the patients because of co-existing neutropenia. Serum creatinine values returned to normal after phenacemide treatment was terminated. The elevation in serum creatinine values with phenacemide appears to be dose related, reversible, and unrelated to impairment of glomerular filtration.

Adolescent↗
PubMed1984

Boilermakers' bronchitis. Respiratory tract irritation associated with vanadium pentoxide exposure during oil-to-coal conversion of a power plant.

Severe respiratory tract irritation occurred in at least 74 of 100 boilermakers who were exposed to high levels of vanadium pentoxide fume during oil-to-coal conversion of a utility company power plant in a rural area of western Massachusetts. Many were welders working in confined areas with inadequate ventilation. Most frequent symptoms were productive cough, sore throat, dyspnea on exertion, and chest pain or discomfort. The illness was severe enough to cause 70 workers to consult physicians and most of them to lose time from work (median, five days). Wheezing (in 39%) was the most frequent finding on physical examination. Mild hypoxemia was noted in several workers; most (72%) had normal chest x-ray films. Expiratory flow rate over the middle 50% of the forced vital capacity was the pulmonary function test most remarkably affected (median, 57% of predicted for 24 workers tested). The Occupational Safety and Health Administration documented levels of vanadium pentoxide fume at or above the permissible exposure limit in all eight air samples taken from inside the boiler; it cited the company for inadequate mechanical ventilation and an inadequate respiratory protection program for workers. The report of this outbreak may help prevent future problems by drawing attention of physicians, workers, and managers to the potential pulmonary hazards in power plant conversion.

Adult↗
PubMed1983

A comparison between islet transplantation and parenteral insulin in the control of diabetes and prevention of renal complications in mice.

The control of diabetes and the prevention of renal complications were studied in mice that received different treatment regimes for six months. Transplantation of syngeneic cultured fetal pancreas completely reversed streptozotocin-induced diabetes (mean FBG 5.1 +/- 0.4 mmole/liter six months after transplantation, versus 5.8 +/- 0.2 mmole/liter in normal mice). The mean fasting blood glucose (FBG) level of insulin-treated mice was lower than the mean FBG level of untreated diabetic mice (9.0 +/- 1.2 mmole/liter versus 11.5 +/- 1.3 mmole/liter, P less than 0.05) but exceeded the FBG level of transplanted mice (P less than 0.001) or normal controls (P less than 0.001). There were no significant differences between the mean level of glycosylated hemoglobin (HbA1c) of normal (4.8 +/- 0.3%), transplanted (4.5 +/- 0.3%), or insulin-treated mice (5.3 +/- 0.4%), but the HbA1c level in the untreated diabetic group was increased (7.0 +/- 0.5%; P less than 0.001). Six months after transplantation, the thickness of the glomerular capillary basement membrane (GCBM) was not different in the transplanted group and normal controls (156.4 +/- 5.7 nm versus 157.3 +/- 12.6 nm); the GCBM was thicker in the insulin-treated mice than in the transplanted mice (179.8 +/- 4.2 nm versus 156.4 +/- 5.7 nm; P less than 0.02), but thinner than in untreated diabetic mice (179.8 +/- 4.2 nm versus 202.2 +/- 4.4 nm; P less than 0.001). It is concluded that islet transplantation, in contrast to good control as judged by normalization of HbA1c levels achieved with parenteral insulin, prevents GCBM thickening in experimental diabetes.

Animals↗
PubMed1983

A randomized trial of cadexomer iodine in decubitus ulcers.

Thirty-four patients with decubitus ulcers were studied in a randomized trial to compare topical cadexomer iodine with the standard decubitus ulcer treatments used in the participating hospitals. There was a significant reduction of ulcer area with both treatments within three weeks; however, eight of 16 patients treated with cadexomer iodine had a reduction of ulcer area of more than 50 per cent, compared with one of 18 patients treated with the standard treatment (P less than 0.01). Twenty-seven patients continued the same treatment for five more weeks, during which time six in the cadexomer iodine group healed, compared with one in the standard treatment group (P less than 0.05). Cadexomer iodine was superior to the standard treatment in removing pus and debris from the ulcer surface and in reducing pain at the ulcer site. It was found to be easy both to apply and to remove from the ulcers and did not stain skin or clothing. Transient smarting during the first hour after application was reported by three patients, and one patient complained of skin irritation. The results show that cadexomer iodine applied daily has a debriding effect on decubitus ulcers and accelerates healing.

Administration, Topical↗
PubMed1982

Insulin secretion by fetal human pancreas in organ culture.

Whole fetal human pancreases of 12-22 weeks gestation, showed histological growth and differentiation in vitro over 3 weeks. At glucose concentrations of 1-4 g/l, there was no difference in insulin secretion into culture medium over 1 h. There was no stimulation of insulin release by D-glyceraldehyde, thus defective glucose-stimulated insulin release was probably not due to impairment of an early step in glycolysis. In the presence of 0.5 mmol/l dibutyryl cyclic AMP, insulin secretion was enhanced (0.188 +/- 0.030 versus 0.100 +/- 0.012 mU x mg tissue-1 x h-1, p less than 0.001) independently of glucose concentrations. It thus appears that impairment of glucose-stimulated insulin release was unlikely to be due to insufficient intracellular cyclic AMP. Insulin release increased in response to tolbutamide and theophylline. Insulin secretion was stimulated in the presence of a fivefold increase in amino acid concentration (0.118 +/- 0.018 versus 0.031 +/- 0.008 mU x mg tissue-1 x h-1, p less than 0.001). There was a fourfold increase in basal insulin secretion from islets previously grown in high concentration of amino acids compared with standard culture medium, (0.284 +/- 0.052 versus 0.067 +/- 0.011 mU x mg tissue-1 x h-1, p less than 0.001), emphasizing the important role of amino acids as substrates for B cell metabolism and development.

Amino Acids↗
PubMed1982

Spontaneous cholecystocutaneous fistula: a complication of neglected biliary tract disease.

Spontaneous cholecystocutaneous fistula is rarely seen today because of the relative safety of early treatment of biliary tract disease. Two cases are presented, one complicated by carcinoma of the gallbladder. The literature is reviewed with reference to clinical presentations, diagnosis, and treatment. The long-standing inflammatory process that precedes such an unusual occurrence makes the problem more common among patients of the geriatric age group.

Aged↗
PubMed1982

Treatment of mixed-dust pneumoconiosis with whole lung lavage.

A patient with silicosis and progressive dyspnea on exertion is described in whom open lung biopsy revealed active chronic inflammation with many macrophages filling alveolar spaces. Because of the extensive involvement by the disease of small air spaces, bilateral whole lung lavage was performed. The lung lavage effluent was striking in its blackish brown color. It was composed predominantly of macrophages containing silica, silicates, and graphite. Particles in the tissue and lavage were analyzed using scanning electron microscopy and energy dispersive X-ray analysis. The dry weight of the material removed was approximately 25 g, of which an estimated 135 mg was silica. The procedure resulted in immediate symptomatic improvement in the patient. Although his pulmonary function did not change significantly, it is hoped that removal of this material will improve his long-term prognosis.

Biopsy↗
PubMed1982

Organ culture of fetal mouse and fetal human pancreatic islets for allografting.

In organ culture of fetal human and fetal murine pancreas under "conventional" conditions (10% CO2 in air), the islet cells of both species survive, proliferate and function but the acinar tissue rapidly degenerates. Fetal mouse islet cells also survive in 90% O2 and 10% CO2 but nonendocrine cells, including fibroblasts and macrophages, degenerate. Fetal mouse islets grown in 90% O2 show diminished immunogenicity when transplanted into recipients differing across the entire MHC, but a reduced allograft response by the host is frequently still present in the absence of immunosuppression. Fetal human islets, grown in 10% CO2 in air, produce insulin in vitro for prolonged periods, and as xenografts, differentiate under the kidney capsule of athymic mice, suggesting that under appropriate conditions both in vitro and in vivo, the fetal human islets can survive. However, fetal human pancreatic cells of all types are highly susceptible to high oxygen concentrations and are rapidly killed. Because of the susceptibility of fetal human pancreas to oxygen, conditions for the culture of fetal human islets for allotransplantation may need to be modified from those tolerated by fetal mouse islets. Fetal human islets may be a useful source of transplant material in human insulin-dependent diabetes, but it is likely that tissue matching and immunosuppression may be required in addition to modification of islet immunogenicity by prior organ culture.

Animals↗