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Biomedical subjects

M Goldberg

Publications and source records attributed to M Goldberg.

At least 397 records · Page 22Linked to original sources
PubMed1989

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1989

Multimedia radiological reports: creation and playback.

Multimedia radiological reports tie together radiographic images and operations on these images with textual, vocal, or graphic annotation. The result is an animated presentation of the radiological examination report. A temporal representation for a multimedia radiological report that describes the temporal behavior of the animated report is introduced. The temporal behavior specifies the synchronization requirements for the coordinated presentation of the multimedia report components. The temporal behavior is encoded in a temporal semantic network that is a network of temporally ordered nodes, where each node represents some primitive behavior. Automatic creation of the multimedia radiological report consists of the capture, interpretation, and storage of the temporal semantics of the radiologist's reporting session in terms of a set of primitive behaviors. Automatic playback of the multimedia radiological report is the orderly traversal of the temporal semantic network, invoking the behavior associated with each of the nodes in the temporal order described by the interconnecting arcs.

Artificial Intelligence↗
PubMed1989

Context-dependent enhancements for radiological images.

Many techniques have been proposed to enhance radiographic images and each of them may be optimal depending upon the circumstances. However, the problem confronting the radiologist or the physician is which enhancement to use and how to select the parameters when a specific feature is to be emphasized. At the University of Ottawa, our research work is oriented towards automatic context-dependent enhancements. Our approach attempts to match the three phases involved in viewing a radiograph: getting a global impression, analyzing the objects and the local features, and focusing on the image perturbations. In this article, we report on enhancements to support the first two phases in the case of chest radiographs and on the applicability of gray level reversal transformations.

Emergency Service, Hospital↗
PubMed1989

Image organization and navigation strategies for a radiological work station.

One can distinguish two distinct preliminary phases in the "analog" radiographs reading process. The first phase deals with the film selection and placement on viewboxes (image organization), and the second with the actual film reading (involving image navigation, ie, the means for accessing the individual images). Our multimedia radiological work station will replace the view boxes with a low-resolution control monitor and a single high-resolution image monitor for viewing the radiographic images of the patient. These are organized by body area and examination view, and are associated with a sketch of a human body on the control monitor. This "anthropomorphic" organization of the images helps the radiologist create a mental picture of the entire patient radiographic file. We expect that together with the requisition information, a proper representation of the file will improve the search for relevant radiographic images. The work station supports image navigation by means of a "soft" representation of the physical viewboxes. In the same manner that radiographic films can be placed onto physical viewboxes, image labels can be dragged with the mouse onto soft viewboxes embedded on the image monitor. Evaluation of results from tests conducted with 15 physicians are presented.

Data Display↗
PubMed1989

Closure of chronic postpneumonectomy bronchopleural fistula using the transsternal transpericardial approach.

Thirteen patients with postpneumonectomy bronchopleural fistula occurring 4 months to 10 years after the initial operation have been treated with a transsternal transpericardial approach after the associated empyema had been treated by either tube thoracostomy or open-window thoracostomy. In 10 patients, there were contraindications to using an ipsilateral transthoracic approach. In 10 of the 13 patients, the procedure was successful. Three fistulas recurred; two were quite small, one of them closing spontaneously within 6 months. There were no deaths or clinically significant morbidity related to the transsternal approach. We have found this technique to be most applicable in those patients in whom other procedures have failed to resolve the problem. The technique is relatively simple and safe.

Adult↗
PubMed1989

Use of silicone stents in the management of airway problems.

We report the use of a silicone rubber T tube for the management of complex airway problems in 47 patients during the past 15 years. The tube has been used for palliation in 11 patients with malignant obstruction of the airway, and as the sole treatment or as an adjunct to operation in 36 other patients. Based on the satisfactory results with the use of these tubes, we have utilized silicone stents in the bronchus and bifurcation prostheses at the carina. In the past, we have inserted the T tubes through a tracheostomy stoma. More recently, we have used a technique for endoscopic placement of the T tubes in which the horizontal limb is pulled out through the tracheostomy stoma. This technique facilitates introduction of the tube and maintains the airway during insertion. The use of silicone stents provides an important tool in the management of complicated airway problems, and we anticipate their increased use in the future.

Bronchi↗
PubMed1989

DSM-III diagnoses of patients with myofascial pain syndrome (fibrositis).

Rheumatology centers report that chronic pain patients with myofascial pain (fibrositis) are prone to psychiatric pathology. However, the distribution of DSM-III diagnoses in this population is unknown. This distribution is reported for 238 chronic pain patients with fibrositis. Statistical comparisons of men and women were also made with regard to the prevalence of each diagnosis, and the results were compared to published DSM-III diagnoses prevalence data for mixed chronic pain patients and rheumatology fibrositis patients. In our sample, women with fibrositis were equally as likely as men with fibrositis to have current depression. Within the general chronic pain population, women are more likely to have current depression. The incidence of current major depression and current and past major depression was much lower in our fibrositis sample than that reported by rheumatology programs. These results indicate that there may be psychiatric differences between chronic pain patients with and without fibrositis. Fibrositis patients in rheumatology programs may also be psychiatrically different from chronic pain program patients with fibrositis.

Adult↗
PubMed1989

Regulation of macrophage growth and antiviral activity by interferon-gamma.

Interferons, in addition to their antiviral activity, induce a multiplicity of effects on different cell types. Interferon (IFN)-gamma exerts a unique regulatory effect on cells of the mononuclear phagocyte lineage. To investigate whether the antiviral and antiproliferative effects of IFN-gamma in macrophages can be genetically dissociated, and whether IFN-alpha and IFN-gamma use the same cellular signals and/or effector mechanisms to achieve their biologic effects, we have derived a series of somatic cell genetic variants resistant to the antiproliferative and/or antiviral activities of IFN-gamma. Two different classes of variants were found: those resistant to the antiproliferative and antiviral effects of IFN-gamma against vesicular stomatitis virus (VSV) and those resistant to the antiproliferative effect, but protected against VSV and encephalomyocarditis virus (EMCV) lysis by IFN-gamma. In addition, a third class of mutants was obtained that was susceptible to the growth inhibitory activity, but resistant to the antiviral activity of IFN-gamma. Analysis of these mutants has provided several insights regarding the regulatory mechanisms of IFN-gamma and IFN-alpha on the murine macrophage cell lines. The antiproliferative activity of IFN-gamma on these cells, in contrast to that of IFN-alpha, is mediated by a cAMP-independent pathway. The antiproliferative and antiviral activities of IFN-gamma were genetically dissociated. Variants were obtained that are growth resistant but antivirally protected, or are growth inhibited but not antivirally protected against VSV or EMCV. The genetic analysis indicated that IFN-alpha and IFN-gamma regulate the induction of the dsRNA-dependent P1/eIF-2 alpha protein kinase and 2',5'-oligoadenylate synthetase enzymatic activities via different pathways. Finally, a unique macrophage mutant was obtained that was protected by IFN-gamma against infection by VSV, but not EMCV, suggesting that antiviral mechanisms involved in protection against these different types of RNA viruses must be distinct at some level.

2',5'-Oligoadenylate Synthetase↗
PubMed1989

Homicide-suicide and chronic pain.

Homicide-Suicide (H-S) is a form of dual death where the murder is closely followed by the suicide of the perpetrator. H-S is extremely rare and has not previously been described within the chronic pain patient population. Such a case is presented. Psychiatric examination data from the victims of H-S revealed a number of complex, psychiatric, social, vocational, and litigation problems. Demographically the case displays some characteristics associated with suicide pacts.

Chronic Disease↗
PubMed1989

"Koro" (genital retraction syndrome): psychotherapeutic interventions.

"Koro" is a belief or delusion of retraction of the penis into the abdomen. Originally thought to be a Chinese and Indonesian culture-bound syndrome, it has recently been noted to occur in "Western" patients. Two Western patients with this syndrome are described and their psychotherapeutic treatment and outcome outlined. A stepwise approach to the treatment of the Koro symptom is suggested.

Adult↗
PubMed1989

Autometallography for histochemical visualization of rat incisor polyanions with cuprolinic blue.

Autometallography was applied to semi-thin sections of rat incisors fixed a solution of cuprolinic blue-aldehyde. The resulting reduction of silver ions to metallic silver amplifies the copper sulfide signal of the cationic dye. Silver grains were seen over the cell bodies of ameloblasts and odontoblasts but not over their processes. This was owing to the interaction of cuprolinic blue with the DNA and RNA of these cells. In the extracellular matrix, silver grains were unevenly distributed over the predentin, dentin, and forming enamel. The distal predentin near the mineralization front and a thin band of dentin located near the dentino-enamel junction displayed unexpectedly intense accumulation of silver grains, whereas all other portions of the extracellular matrix exhibited the distribution of glycosaminoglycans expected from previous studies. The present investigation constitutes a new application of autometallography to glycosaminoglycan histochemistry.

Animals↗
PubMed1989

Brain white-matter lesions and psychosis.

In a prospective study of late-life onset psychosis, five of the first 27 patients studied had extensive white-matter lesions demonstrated by MRI and/or CT. None of 60 age-matched psychiatrically healthy controls demonstrated such lesions. All five patients had a mild dementia and a frontal behavioural syndrome. In addition, every patient performed poorly on neuropsychological tests of frontal function. Dysfunction of the frontal cortex associated with white-matter lesions appears to contribute to the clinical picture of some cases of late-life psychosis.

Aged↗
PubMed1989

Gallbladder distention in premature neonates receiving parenteral nutrition.

Contraction of the gallbladder is mediated through the release of cholecystokinin from duodenal cells secondary to enteral feedings. Premature infants are often nourished by parenteral hyperalimentation leading to prolonged inactivation of the gallbladder. Such inactivation probably accounts for the increased incidence of gallbladder distention observed in premature neonates. Two cases of premature infants are described in whom distention of the gallbladder occurred during parenteral hyperalimentation. The distention resolved spontaneously secondary to the introduction of enteral feedings. A trial period of oral or tube feeding is recommended in such cases prior to any attempt to release the distention by a surgical intervention.

Gallbladder↗
PubMed1989

Differential localization of calmodulin, the 67kDa calcimedin and calpactin II in secretory ameloblasts.

By using specific antibodies, we have shown by Western blots that dental tissues contain calmodulin, the 67 kDa calcimedin and calpactin II. Moreover, by immunogold electron microscopy, we were able to compare the intracellular distribution of these three calcium-binding proteins in secretory ameloblasts. They were all found in the cytosol of these cells but only calcimedin was detected in the mitochondria. Calpactin II was the only one present in secretory vesicles. Twice as much calmodulin and calpactin II were detected in cell bodies as in Tomes' processes, but calcimedin was more abundant in the latter. The presence of these calcium mediators in well defined areas of ameloblasts may indicate differential ways for these cells to regulate different calcium-dependent processes during enamel formation.

Ameloblasts↗