Search PubMed⌕ Search

Biomedical subjects

M Goldberg

Publications and source records attributed to M Goldberg.

At least 433 records · Page 24Linked to original sources
PubMed1988

Endoscopic laser treatment for bronchogenic carcinoma.

The use of laser therapy for endobronchial lesions has met with general enthusiasm. From published series it is difficult to determine specific indications for its use, based upon patients' complaints, locations of tumor, and any concomitant therapies. Most reports do not provide sufficient information to permit adequate comparisons regarding improvement in symptoms and long-term efficacy. Exophytic lesions of the trachea and mainstem bronchi are most amenable to therapy by laser, and improvement in symptoms correlates best with improved patency of large airways. In most patients the major portion of the endobronchial debulking procedure can be performed quickly and safely by physically coring out the exophytic tumor mass with the rigid end of the bronchoscope. A large biopsy forceps can help accomplish this with very little bleeding. The laser can then remove any remaining tumor and produce hemostasis by coagulation of the tumor bed. The major purpose of laser therapy is to lessen or completely relieve symptoms of airway obstruction. Laser therapy to obstructed lobar or segmental bronchi rarely reduces symptoms unless they are associated with post-obstructive pneumonia. When the obstruction is longstanding, laser ablation may fail to establish airway patency. Hemoptysis from exophytic lesions can usually be well controlled. Treatment of lesions that produce extrinsic compression of the trachea or bronchi is of little value. At present, laser therapy is one of several treatments available for neoplastic endotracheal or endobronchial obstruction. Other local therapies include external-beam irradiation, cryotherapy, electrocoagulative therapy, and intraluminal brachytherapy with insertion of afterloading catheters. Most of these modalities are available in large oncologic centers, and it will take the better part of the next decade to identify specific indications for each of these therapies individually and in combination. Currently, Nd:YAG therapy has an established role in the palliative treatment of obstructive endobronchial disease. Response rates to therapy with relief of obstruction are in the range of 80 to 85 per cent. Nd:YAG therapy is easy, quick, and, with proper caution, safe. In the majority of cases it must be repeated on one or several occasions. Photodynamic therapy is now being critically evaluated for the treatment of similar lesions.

Aluminum↗
PubMed1988

Interferon-gamma-induced transcriptional activation is mediated by protein kinase C.

Interferon-gamma (IFN-gamma) regulates a variety of biological functions and is the principal lymphokine known to activate macrophages. In studies of the molecular mechanisms by which these cells are regulated by IFN-gamma, the transcriptional activation of an IFN-gamma-inducible gene, gamma.1, in human macrophage-like cell lines was examined. Transcription of this gene is rapidly induced by 0.1-1 unit of IFN-gamma. In addition, gamma.1 transcription is efficiently induced by phorbol 12-myristate 13-acetate, which is known to activate protein kinase C (PKC). Both stimulators of gamma.1 transcription induce the translocation of PKC from the cytosol of a membrane fraction. Two selective inhibitors of PKC, H7 and sphingosine, suppressed not only the induction of gamma.1 mRNA but transcription of HLA-DR by IFN-gamma as well. These findings establish that PKC plays a significant role in the signal transduction pathway leading to transcriptional activation of some IFN-gamma-regulated genes of cells of the mononuclear phagocyte lineage.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMed1988

The utility of electromyographic biofeedback in the treatment of conversion paralysis.

Conversion paralysis has a poor prognosis when there is evidence of nonresponse to previous treatment, long duration, and secondary atrophy of the "paralyzed" muscles. The authors present four such cases in which conversion paralysis was treated successfully by means of electromyographic (EMG) biofeedback. Each of the four patients also suffered from a chronic pain condition. Results from statistical analyses indicated that the four patients demonstrated significant improvement in the functional capacity of the "paralyzed" muscles as measured by isometric maximum voluntary contraction and EMG activity. The improvements occurred without explicit psychotherapy and suggest that behavioral modification techniques alone may be helpful in such cases.

Adult↗
PubMed1988

Quantification of free water in human dental enamel.

The amount of free water in 50 samples of air-dried enamel from permanent and deciduous teeth was measured by the Karl Fischer method. Samples included both contemporary and burial specimens. The mean values obtained showed that free water constituted about 1% of enamel mass. However, the range of individual values varied considerably, from 0.56 to 1.48%. The proportion of free water did not seem to depend on the patient's age, the type of tooth, or the relationship between the tooth and its oral environment. On the other hand, the deciduous enamel tested displayed a mean free water content that was three times the mean for the permanent teeth (3.01 vs. 1.00%) and the five burial teeth, a mean content of 1.68%.

Adult↗
PubMed1988

Induction of resistance to Schistosoma mansoni by immunization with subfractions of worms.

Induction of resistance to a Schistosoma mansoni infection was analyzed following injections of glutaraldehyde-fixed parasites or of subfractions prepared from nonfixed parasites killed by repeated freeze-thaw cycles. The parasites were isolated from mice infected 4 weeks previously and the subfractions were prepared by extraction in buffered saline or in detergent. A variety of immunization protocols were conducted in rats and mice. These included different sites of injection, dose size, and number of booster injections; different adjuvants; and the effects of boosting with live infections. Induction of a partial resistance is observed in rats, but has not been achieved in mice immunized by the same procedures. The alum-precipitated detergent-solubilized fraction was superior at lower doses. Exposure of rats to a low dose cercarial infection 3 weeks prior to challenge did not boost the resistance if the rats were already partially resistant through vaccination with worm subfractions in adjuvant. Serum from vaccinated rats transfers partial protection to a challenge infection of naive rats.

Animals↗
PubMed1988

[Relationship between the development of the health status and the activity of the health care system in developed countries].

The question of the relationship between the evolution of health status and the activity of health care system in developed countries is treated frequently through epidemiological studies. However, there are numerous methodological difficulties linked to this type of investigation and it is not possible to give a certain answer to this question. Particular difficulties concern the choice of indicators (indicators of health status and indicators of health care system). This choice may influence largely the outcome of the results. If general mortality has tended to decline over the last thirty years, some causes of death have progressed and many studies show an increase of the level of morbidity and disabilities declared in the population and an increase of social disparities in health status. The analysis concerning the role of health care systems, in order to explain this evolution, does not lead to a single conclusion. Some works show the positive effect of the activity of health care systems (especially for infant mortality). According to other authors, the growth of chronic diseases must be considered as the negative aspect of the success obtained in the struggle against mortality. But above all, interpretation of results needs a continuous reference to methodologies used and it is only on this condition that such data may be useful for public health decisions.

Aged↗
PubMed1988

Esophagectomy for complex benign esophageal disease.

We evaluated the use of total thoracic esophagectomy and replacement with stomach in a group of 21 patients between 1976 and 1986 who had undergone multiple unsuccessful esophageal operations. All patients had between one and four unsuccessful operations for benign esophageal disorders. Sixteen patients had primary motor disorders: achalasia in nine and esophageal spasm in seven. Of these patients, 11 also had recurrent gastroesophageal reflux and peptic esophagitis. Complicated reflux disease characterized by severe esophagitis, stricture, and impaired peristalsis without primary motor disorder occurred in five patients. In one patient a functionally impaired long-segment colon interposition was removed and replaced with stomach. Total thoracic esophagectomy and cervical esophagogastric reconstruction was done in all patients. The transhiatal approach was chosen for resection in 16 patients and thoracotomy was used in the other five. There was one perioperative death (5%), from massive aspiration 4 days after transhiatal esophagectomy. Other complications included transient anastomotic leak (three patients), tracheoesophageal fistula (one), recurrent nerve palsy (one), and transient hoarseness (two). Follow-up is complete between 1 and 10 years and reveals the following functional results: 12 patients good to excellent, seven fair, one poor. In this patient group in which multiple prior procedures have failed to improve severe incapacitating symptoms, we believe further attempts at hiatal reconstruction are unlikely to succeed. For this circumstance, we recommend total thoracic esophagectomy with the use of stomach as the replacement organ of choice.

Adult↗
PubMed1987

Epidemiology of respiratory cancers related to nickel mining and refining in New Caledonia (1978-1984).

The incidence rate of respiratory (lung and upper respiratory tract) cancer related to the nickel industry was studied in the male population of New Caledonia over a 7-year period (1978-1984). The findings show no excess incidence of lung or upper respiratory tract (larynx, pharynx, nasal cavities) cancer cases in the population of nickel workers compared with the rest of the male population in New Caledonia. This result was corroborated by a case-control study which does not indicate any particular role of hazards specific to the nickel mining and refining industry. Our findings, which may be specific for the type of ore processed in New Caledonia, must nevertheless be confirmed by extending the study to a total of 10 years (1978-1987). The incidence rate of male respiratory cancer in New Caledonia was also compared to that of cancers of this type reported in certain regions of industrialized countries (Australia, France, U.K., USA). Such findings are very similar to those observed in New Caledonia, thereby confirming a predominant role of tobacco and alcohol consumption in a territory which, despite certain characteristics of a developing country, has life-style habits similar to those of industrialized countries.

Adult↗