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Biomedical subjects

M F Goldberg

Publications and source records attributed to M F Goldberg.

At least 145 records · Page 8Linked to original sources
PubMed1981

[Morbus Coasts, Histopathological findings in an adult patient (author's transl)].

Light and electron-microscopic analysis of the enucleated eye of a 55-year-old man confirmed the diagnosis of Coats' syndrome. The histopathologic findings in this adult patient are identical to those seen in typical cases of Coats' syndrome of childhood. The characteristic thickening of vessel walls and the apparent deficiency of healthy, viable retinal vascular endothelial cells support the hypothesis that the ocular changes in this syndrome are directly related to a primary retinal vascular defect leading to abnormal permeability.

Chorioretinitis↗
PubMed1981

Uveal melanoma in association with multiple malignancies. A case report and review.

A 66-year-old man had a pigmented choroidal lesion in his right eye. Over a subsequent period of 8 1/2 years, the lesion showed slight growth. At autopsy, the diagnosis was spindle B melanoma of the choroid without evidence of systemic metastasis. A very unusual feature of this case was the presence in this patient of seven primary malignant tumors and five benign neoplasms. In addition to the choroidal melanoma, these included three distinct pulmonary carcinomas, leiomyosarcoma of the stomach, adenocarcinoma of the sigmoid colon, and basal cell carcinoma. The literature on multiple malignancies in association with uveal melanoma is reviewed.

Adenocarcinoma↗
PubMed1981

Large capillary aneurysms secondary to retinal venous obstruction.

Three patients had unusually large capillary aneurysms. Two of the patients had had previous branch vein occlusions, while a third had had a central retinal vein occlusion. The large capillary aneurysms were located in areas of ischaemic retina that were drained by the previously obstructed veins. Retinal ischaemia and, possibly, increased hydrostatic pressure following vein occlusion were postulated to result in the development of these atypical capillary aneurysms. They are similar in size to arterial macroaneurysms, but originate from the venous side of the capillary bed. Like typical capillary microaneurysms and arterial macroaneurysms, these large capillary aneurysms may result in visual loss from macular oedema, serous elevation of the macula, and circinate lipid exudation. Argon laser obliteration of the aneurysms appears to be effective therapy.

Aged↗
PubMed1981

Secondary pupillary membranes treated by the pars plana/pars plicata approach: long-term results of 108 cases.

One hundred and eight pupillary membranes treated with the vitrophage through a pars plicata or pars plana approach were evaluated for long-term results. The average follow-up was 3.86 years, with a range of 1 to 7 years. No major operative complications were encountered. Anatomical success was achieved in all cases. Vision improved in 67.5% of eyes. In 4 cases (3.7%) postoperative visual acuity was worse, because of glaucoma secondary to previous blunt ocular trauma. Six cases showed delay rhegmatogenous retinal detachment postoperatively. These could not be attributed to the surgical procedure per se.

Adult↗
PubMed1981

Fundus photocoagulation with the argon and krypton lasers: a comparative study.

Photocoagulation of the monkey fundus with an argon-krypton laser photocoagulator was performed. Lesions produced by argon and krypton wavelengths were compared at various power settings, spot sizes, and exposure durations. At low energy levels argon laser lesions appeared clinically stronger than those produced by the krypton mode. Lesions in the foveal area produced with the argon laser demonstrated more extensive microscopic damage to the inner retinal layers than did those produced with the krypton laser. Histologically, both modalities affected the outer layers of the retina. However, the krypton wavelength affected more of the choriocapillaries and the larger choroidal vessels than the argon wavelengths. Conversely, argon laser coagulation of the retinal vessels damaged the perivascular tissue in the nerve fiber layer more than the krypton laser did. Rupture of Bruch's membrane and choroidal hemorrhage occurred frequently with the krypton laser at low energy levels when a small spot size and a short coagulation time were used. Both complications were less likely to occur with argon burns at similar dosage parameters. By choosing larger spot sizes and longer coagulation times for the krypton laser, these complications were prevented.

Animals↗
PubMed1980

First-trimester fetal chromosomal diagnosis using endocervical lavage: a negative evaluation.

A report in the literature indicated that fetal cells could be obtained by endocervical lavage during the first trimester of pregnancy and successfully cultured. This would allow prenatal diagnosis earlier in pregnancy than is currently possible with second-trimester amniocentesis. Therefore, we attempted to confirm these findings. Our results indicated that the cultural cells were maternal in origin. We disagree with interpretations of the data given in the initial report and conclude that first-trimester prenatal diagnosis is not feasible at this time.

Adolescent↗
PubMed1980

Prenatal chromosomal diagnosis. Racial and geographic variation for older women in Georgia.

In a study of Georgia women aged 40 years and older, 15% made use of prenatal chromosomal diagnosis. There was, however, substantial racial and geographic variation, ranging from a use ratio of 60% among whites in two large urban counties to 0.5% among blacks outside Augusta and Atlanta health districts. This simple population-based epidemiologic analysis suggests that future program planning for genetic services in Georgia should address ways to increase access by rural women, especially blacks. Similar analyses in other states could be used for planning genetic services.

Abortion, Therapeutic↗
PubMed1980

Spontaneous separation of epiretinal membranes.

Three patients had spontaneous separation of an epiretinal membrane from the macular region. Two of the patients had had argon laser photocoagulation of peripheral retinal lesions three to four months earlier. Vitreous contraction, which had led to the fundus conditions that required photocoagulation, may have created alterations in the vitreous or in the membrane itself, which enhanced the peeling of the membranes. Although photocoagulation may sometimes worsen macular puckers, the presence of an epiretinal membrane near the macula should not be considered an absolute contraindication to peripheral fundus photocoagulation when the pathologic process that is to be coagulated has a substantially worse prognosis if left untreated.

Adult↗
PubMed1980

Retinal breaks after photocoagulation of proliferative sickle cell retinopathy.

Retinal breaks developed in four eyes of four patients with hemoglobin SC disease and advanced proliferative sickle cell retinopathy (PSR) after argon laser photocoagulation of feeder vessels. These cases represented 8.7% of the 46 eyes with PSR treated with the argon laser at our institution in 1977 and 1978. In three patients, the retinal breaks were immediately adjacent to the site of photocoagulation. A scleral buckling procedure was necessary in only one of the four eyes; the breaks were successfully managed in the other three cases by encirclement with further laser treatment. None of the four eyes lost vision. In patients with vitreous traction in association with seafan neovascularization, argon laser photocoagulation may result in retinal breaks and retinal detachment.

Adult↗
PubMed1980

Vitrectomy in the management of intraocular foreign bodies and their complications.

Twenty-six eyes with intraocular foreign bodies (IOFB) and/or their sequelae were treated by pars plana vitrectomy and associated surgery. One-step removal of the IOFB in combination with pars plana vitrectomy resulted in early visual rehabilitation and minimal complications. Of 11 eyes with IOFB treated by primary vitrectomy at the time of IOFB removal 20/50 or better visual acuity was obtained in 10 (91%). Four of these eyes had retinal injury, 3 of which were successfully repaired without subsequent complication and with retention of good visual function. In 3 eyes IOFBs were not removed owing to chronic retinal encapsulation. These eyes continue to retain good visual acuity, and ERG studies show no evidence of retinal toxicity. Of 12 eyes in which vitrectomy was performed for sequelae of IOFB only 5 (41%) showed visual improvement better than 20/50. Only in 2 of 7 eyes with tractional retinal detachment could the retina be reattached. In cases of retinal injury primary vitrectomy, cryocoagulation, and scleral buckling are suggested for prevention of late traction retinal detachment.

Adolescent↗
PubMed1980

Chorioretinal vascular anastomoses resulting from photocoagulation in cynomolgus monkeys.

We studied the effects of intense argon laser photocoagulation in cynomolgus monkeys to determine whether or not anastomosis between the choroidal circulation and the major retinal arterioles could be produced. Chorioretinal vascular anastomosis occurred in nine of 19 sites in which photocoagulation was intense enough to occlude a major retinal arteriole and create disruption between the choroidal and retinal vasculatures. Anastomosis was seen by fluorescein angiography during the healing phase after treatment--none occurred earlier than seven weeks after photocoagulation. As a result of the anastomosis, previously nonperfused retinal blood vessels became reperfused (with choroidal blood). This model suggests future applicability in reperfusing segments of retinal arterioles or venules that have been obstructed by naturally occurring pathologic processes. The remaining ten treated sites showed no anastomosis, even through histologic studies showed that photocoagulation produced chorioretinal disruption and hemorrhage. None of the eyes developed neovascularization.

Animals↗
PubMed1979

Reducing birth defect risk in advanced maternal age.

The incidence of birth defects increases with maternal age. Recent advances in fetal diagnosis, coupled with elective abortion, offer the older pregnant woman an opportunity to reduce this risk. To determine the magnitude of potential risk reduction, we reviewed the maternal age-specific incidence of infants born with one or more severe birth defects in metropolitan Atlanta from 1968 to 1975, removing from analysis certain anomalies that were preventable by currently available methods. For women aged 35 to 44 years, the risk of bearing an infant with a severe birth defect was reduced to a level comparable with that for younger women. Despite prenatal diagnosis and elective abortion, the risk for women aged 45 years or older, although reduced considerably, was two times greater than that for women aged 34 years or younger.

Adult↗
PubMed1979

Rh hemolytic disease. Epidemiologic surveillance in the United States, 1968 to 1975.

Nationwide surveillance of Rh hemolytic disease of the newborn showed that associated infant mortality decreased from 941 deaths in 1968 to 269 deaths in 1975, or from 2.7 to 0.9 per 10,000 live births. The incidence of Rh hemolytic disease declined from 45 per 10,000 total births in 1970 to 21 per 10,000 in 1975. In 1970, an estimated 16,000 infants were affected, whereas in 1975, the number was 6,000. Several state-based Rh disease surveillance programs reported declining mortality and incidence and increasing use of Rh immune globulin. Rh immune globulin was administered to an estimated 80% of eligible Rh-negative women in 1974, eighty-one percent in 1975, and 82% in 1976. More concerted efforts are needed to determine the frequency of maternal sensitization and to identify and correct gaps in postpartum and postabortion use of Rh immune globulin.

Erythroblastosis, Fetal↗
PubMed1979

Interpreting elevated amniotic fluid alpha-fetoprotein levels in clinical practice: use of the predictive value positive concept.

The amniotic fluid alpha-fetoprotein assay (AF-AFP) is the single most valuable method of detecting anencephaly--spina bifida (ASB) in utero. A raised AF-AFP, however, is a more reliable indicator of a fetus with ASB in the pregnancy at high risk for ASB. Most women undergoing fetal chromosomal analysis are at low risk for ASB. Consequently, gravid patients who have an AF-AFP incidental to chromosomal studies, and elect abortion because of a raised AF-AFP, will more frequently abort a normal fetus than the gravida who has previously had an infant with ASB. For the obstetrician utilizing this assay, the predictive value positive (PVP) concept, a guide for the interpretation of a positive result, is introduced and then applied to examples of patients at varying risk for ASB in their offspring.

Amniocentesis↗
PubMed1979

The angiographic pattern of the peripheral retinal vasculature.

Various diseases of the peripheral retinal vasculature, such as sickle cell retinopathy and Eales' disease, demonstrate vascular abnormalities. For comparative purposes, we documented angiographically the peripheral retinal vasculature in young, healthy subjects. Our findings showed the density of the capillary bed to be highest in the posterior pole and least concentrated toward the periphery. Peripheral capillaries are considerably larger than those found posteriorly and have fewer bifurcations. Our technique also detected the periarterial capillary-free zone and the zone without capillaries adjacent to the ora serrata. These aspects were consistent with findings of other investigators using in vitro techniques. By creating a standard of normalcy in vivo, the angiographic technique allows vascular abnormalities evident in diseases of the peripheral retinal vasculature to be more precisely defined and compared.

Adolescent↗