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Biomedical subjects

M Goldstein

Publications and source records attributed to M Goldstein.

At least 937 records · Page 52Linked to original sources
PubMedDate not supplied

[Surgical considerations on the duration of heparin therapy in deep venous thrombosis].

The authors report their experience of the medical treatment of deep venous thrombosis. Certain surgeons have attempted venous thrombectomy at the acute stage, but many have abandoned this technique which appears perfectly sound. The authors have continued to rely on heparin treatment by intravenous injection ; the introduction 5 years ago of phlebographic methods for following the evoluton of thelesions has led the authors progressively to prolong the duration of heparin treatment. The results of this approach to therapy are illustrated in several cases by phlebograms.

Adult↗
PubMedDate not supplied

[A case of fibromuscular dysplasia in an unusual location].

Unusual localization of fibromuscular dysplasia on the common carotid artery. In this paper, the authors are describing an unusual localization of the fibro-muscular dysplasia on the common carotid artery, a lesion that has undergone surgical treatment without any complication.

Adult↗
PubMedDate not supplied

[Vascular injuries: vascular syndromes and their clinical diagnosis].

The authors present a short review of vascular trauma and their clinical signs. The diagnosis of traumatic vascular lesions is rather obvious in most cases, but it may also be uneasy in a lot of other cases. The frequency and the localization of vascular trauma is mentioned relating to publications about series; no part of the body seems to be safe for arterial and/or venous complications. Not infrequently does it concern polytraumatic patients, which show bone, nerve, lung and abdominal lesions, etc. Haemorrhage and shock are frequent clinical signs. Tissular ischemia is found in 70 to 90% of the vascular lesions of the limbs, which on their own represent 75 to 90% of all vascular trauma. It is often necessary to use angiography to determine the extent of the lesions before surgical intervention.

Angiography↗
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[Vascular complications in a case of hemolytic anemia due to pyruvate kinase deficiency].

A rare case of congenital non-spherocytic hemolytic anemia due to pyruvate kinase deficiency is reported. Of particular interest is the never before in the literature mentioned complication of migratory phlebitis and acute thrombosis of the left lower limb associated with trophic changes of the foot. Arteriography disclosed thrombosis of all three calf arteries. The patient was treated by lumbar sympathectomy combined with streptokinase fibrinolysis and resulted in healing of the trophic changes. The distal location of the vascular lesions made direct vascular reconstruction illusory. Fogarty thrombectomy is not indicated either due to the thrombotic nature of the lesions in association with thrombocytosis.

Adult↗
PubMedDate not supplied

[Does intermittent claudication justify surgical intervention].

The authors have re-examined their therapeutic attitude toward the intermittent claudication upon arteriopathy. They feel that it is useful to divide patients having an arteriopathy (Stage II) into two groups: the first having isolated (or dominant) high aorto-iliac lesions and the second with isolated or dominant lesions at the mid-femoral level. In the first group, we remained faithful to reconstructive surgery and our preference goes to thrombo-endarteriectomy with accompanying low lumbar sympathectomy. In femoral lesions, we do not recommend reconstructive surgery of the arteries but rather low lumbar sympathectomy. For the past year, we have undertaken a program of physical re-education and the results seem very encouraging, especially in patients having isolated femoral lesions. It is not impossible that this physical therapy may be used instead of lumbar sympathectomy, to which one can always resort in case of insufficient results.

Aged↗
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Phototherapeutic keratectomy in the treatment of corneal scarring from trachoma.

Trachoma is still one of the world's major blinding diseases. Characteristically, trachoma causes deep scarring of the conjunctiva and tarsus that can result in tear deficiency, trichiasis, and entropion. Another common finding is a diffused corneal opacity that is the end stage of peripheral and central corneal infiltrates. The conventional treatment of the corneal opacities is keratoplasty, which has a guarded prognosis because of severe dryness and trichiasis. We report on our experience in treating patients with corneal trachoma with phototherapeutic keratectomy (PTK) with the excimer laser.

Aged↗
PubMedDate not supplied

Testis factors that may regulate gene expression: evidence from a patient with Kartagener's syndrome.

Patients with Kartagener's syndrome characteristically have immotile cilia and flagella. Ultrastructural analysis of the efferent ducts of the patient described in this report revealed that the cilia totally lacked dynein arms. Based on clinical findings his respiratory cilia also were not functional. In contrast, this patient's spermatozoa were motile and displayed normal ultrastructure, including dynein arms. This suggests that two genes exist that code for slightly different proteins with analogous functions; one of these genes functions in somatic tissue and the other in the male germ tissue. Differential gene expression in somatic and male germ tissue may be related to the syncytial nature of male germ cells, low scrotal temperature, or haploid gene expression.

Adult↗
PubMedDate not supplied

Implications of directly observed therapy in tuberculosis control measures among IDUs.

Tuberculosis (TB) is a rapidly growing problem among injecting drug users (IDU), especially those infected with human immunodeficiency virus. The authors review IDUs' responses to current TB control strategies and discuss the implications of their findings for the proposed implementation of directly observed therapy (DOT), a method for ensuring that patients take prescribed medication. Field workers carried out 210 ethnographic interviews with 68 IDUs in a Brooklyn, NY, community during 1990-93. Case studies suggested that many IDUs are uninformed about TB and often misinformed about their personal TB status. Ethnographic interviews and observations indicated that the threat of TB-related involuntary detainment may lead IDUs to avoid TB diagnostic procedures, treatment for TB, or drug abuse treatment, and to avoid AIDS outreach workers and other health-related services. IDUs who tested positive for the purified protein derivative (PPD) of TB sometimes have left hospitals before definitive diagnoses were made, because of a perceived lack of respectful treatment, fear of detention, or lack of adequate methadone therapy to relieve the symptoms of withdrawal from drugs. Current TB diagnosis and treatment systems are, at best, inadequate. The threat of TB-related detention discourages some IDUs from seeking any type of health care. There is an urgent need to educate IDUs about TB and to educate and sensitize health care providers about the lifestyles of IDUs. DOT may help in servicing this difficult-to-serve population, particularly if techniques are incorporated that have been developed for other successful public health interventions for IDUs.

Adult↗
PubMedDate not supplied

Erythropoietin with oral iron in peritoneal and hemodialysis patients. A comparison in an inner city population.

Studies on the comparative efficacy of erythropoietin (rHuEPO) in chronic hemodialysis (HD) and peritoneal dialysis (PD) patients are scarce. The authors compared the use of rHuEPO in 74 stable patients on hemodialysis with 24 on chronic peritoneal dialysis. All patients were on oral iron supplements. In PD patients, hematocrits were 23.1 and 30.1%, rHuEPO dose 80.9 and 89.0 U/kg/wk, whereas in HD patients, hematocrits were 21.2 and 27.5 and rHuEPO dose was 140.2 and 165.0 U/kg/wk at initiation and 6 months, respectively. Serum iron and transferrin saturations were unchanged in peritoneal, but decreased in hemodialysis patients on rHuEPO therapy. These findings suggest that rHuEPO is more effective in peritoneal dialysis patients than in hemodialysis patients receiving oral iron. The improved efficacy of rHuEPO in peritoneal dialysis may be due to decreased blood loss, subcutaneous administration, or better removal of inhibitors of erythropoiesis. Peritoneal dialysis may be more cost effective and desirable than hemodialysis for rHuEPO dependent or resistant patients.

Administration, Oral↗
PubMedDate not supplied

Identification and localization of copper-zinc superoxide dismutase gene expression in rat testicular development.

Reactive oxygen species are highly toxic agents that appear to have an important role in male infertility. In order to understand the potential for the testis to be protected from reactive oxygen, the mRNA levels of the natural reactive oxygen scavenger, copper-zinc superoxide dismutase (SOD), were determined in testes and other organs in rats using northern analysis and in situ hybridization. Northern analysis of total RNA from organs of 60-day-old rats demonstrated an SOD mRNA with a transcript length of 0.77 kb; its concentration was highest in the kidney, liver, testis, and epididymis. In testis, northern analysis of total RNA demonstrated two mRNA transcripts of 0.77 kb and 0.94 kb. The concentrations of the 0.77-kb transcript varied only slightly between 10 and 100 days of age. In contrast, the 0.94-kb transcript became detectable by northern analysis between 30 and 40 days of age, then its concentration rose progressively to peak at 60 days. In situ hybridization studies demonstrated a uniform distribution of SOD mRNA within seminiferous tubules of prepubertal rats at 10 days of age and a heterogeneous, stage-specific pattern in older animals. In mature rats, the highest level of SOD mRNA was detected in tubules just prior to spermiation (stages VI-VIII). In conclusion, two SOD mRNA transcripts were identified in the rat testes that followed significantly different patterns of expression during development. In situ hybridization studies revealed that accumulation of the SOD mRNA in the seminiferous tubule was stage specific. These data suggest that SOD may play an important role during testicular development and spermatogenesis in rats.

Aging↗
PubMedDate not supplied

Motile sperm in human testis biopsy specimens.

We prospectively studied 62 consecutive infertile men who underwent 100 intraoperative wet prep cytological examinations of testis biopsy material obtained simultaneously with permanently fixed specimens. Wet preps were performed by placing a small sample of fresh testicular tissue on a slide, adding a drop of Ringer's lactate, and compressing the specimen under a glass coverslip. Among these 100 wet preps, complete sperm with tails were identified in 62 specimens, of which 44 contained nonmotile sperm and 18 contained motile sperm. Reproductive tract obstruction was documented in 65 testes (65%) on subsequent reconstructive surgery and/or inferred from histological evaluation, including mean mature spermatid counts on the permanent sections fixed in Bouin's solution. Obstruction was absent in the remaining testes (35%). All 18 testes with motile sperm found on wet prep were obstructed. These testes were also found to have complete spermatogenesis, a category selected to include normal spermatogenesis and slight hypospermatogenesis, determined by examination of the permanently fixed sections. The finding of motile vs. nonmotile sperm on a wet prep has positive predictive values of 100% vs. 81% for the presence of reproductive tract obstruction and 94% vs. 86% for complete spermatogenesis, respectively. The presence of motile sperm in human testis biopsy specimens is a novel finding. When any complete sperm with tail is found in a testis biopsy wet prep, obstruction is likely. When motile sperm are present, obstruction is almost certain, and immediate exploration and reconstructive surgery can be justified.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗