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Biomedical subjects

M L Goldman

Publications and source records attributed to M L Goldman.

At least 19 recordsLinked to original sources
PubMed1995

Quantitative DNA analysis: a comparison of conventional DNA ploidy analysis and teleploidy.

JPEG compression can be used on images for DNA ploidy analysis if careful consideration is given to the level of compression used for file storage. The amount of JPEG compression possible may vary depending on the type of tissue analyzed, however, a compromise may be reached for all types of tissue. JPEG compression should not go over a level of 70 for DNA analysis as this would result in possibly erroneous IOD calculation and erroneous DNA ploidy analysis. Also, the resulting file quality is so poor that even visual analysis is not possible. With careful training of personnel in cell selection, remote DNA ploidy analysis would be an effective tool for standardization and quality control in the pathology laboratory. By using remote DNA ploidy analysis, it is possible for hospitals to consolidate their workload, and make DNA ploidy analysis by image cytometry a cost effective test in the laboratory. Proficiency testing would also become possible as all laboratories performing DNA ploidy analysis would receive the same fields of view for testing. DNA ploidy analysis by image cytometry using stored images could be a versatile tool for the telepathology community.

Animals↗
PubMed1991

Role of duplex scanning for the detection of atherosclerotic renal artery disease.

To assess the accuracy of renal artery duplex scanning for the purpose of diagnosing atherosclerotic renal artery stenosis, we compared the findings of renal arteriograms to the results of duplex scanning in 41 patients. Using an increase of renal artery peak systolic flow velocity of greater than 180 cm/sec, duplex scanning was able to discriminate normal from diseased renal arteries with a sensitivity of 95% and a specificity of 90%. Using the principle that blood flow velocity across a stenosis is roughly proportional to the degree of stenosis, it appeared that a ratio of the peak velocity in the renal artery to the aorta (RAR) of greater 3.5 predicted a greater than 60% diameter reduction of that renal artery, which is felt to be a significant stenosis. Forty-eight vessels were classified as having a greater than 60% diameter reduction by arteriography. Using the RAR of greater than 3.5, duplex scanning agreed in 44 renal arteries (sensitivity 92%). In the 26 renal arteries where arteriography showed a less than 60% diameter reduction, duplex scanning agreed in 16 vessels and correctly detected a focal narrowing in nine of the remaining ten vessels. Ten of 11 occluded renal arteries were correctly identified by duplex scanning. Duplex scanning determined the location of the renal artery lesion with an accuracy of 95% (kappa 0.74). Since duplex scanning can accurately demonstrate and locate focal renal artery stenosis, we believe it may become an accurate screening test for renovascular hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

The role of duplex scanning in the selection of patients for transluminal angioplasty.

As part of our initial evaluation to determine whether patients with lower extremity ischemia are candidates for intervention, arterial duplex examinations are performed in the noninvasive vascular laboratory. Patients with isolated short stenoses on the duplex examination are referred for transluminal angioplasty. One hundred thirty-four arteriograms were performed for ischemic peripheral vascular disease in 122 patients between July 1987 and March 1990. One hundred ten (82%) of the arteriograms were preceded by a lower extremity arterial duplex evaluation. Fifty cases (45%) were scheduled for transluminal angioplasty based on the findings of the duplex examination. Transluminal angioplasty was performed in 47 of 50 cases (94%). No significant differences in age, sex, or diabetes were found between the patients who were referred for transluminal angioplasty and those who were not. These data demonstrate that duplex scanning of the lower extremities allows the detection of lesions that will be amenable to transluminal angioplasty. We think that duplex scanning should become the standard screening tool for detection of treatable lower extremity lesions.

Angiography↗
PubMed1991

Gallstone susceptibility to in vitro fragmentation by a 480-nm pulsed dye laser. Correlation with computed tomography characteristics.

The object of this investigation was to determine gallstone susceptibility to laser lithotripsy and to discover whether this susceptibility is related to the computed tomography (CT) appearance of gallstones. Gallstones collected from surgery were scanned by CT and classified as homogeneously dense (greater than 90 Hounsfield units [HU]), homogeneously faint (30-60 HU), or rimmed. Sixty stones were subjected to laser energy at 20, 40, 60, 80, or 100 mJ. Fracture and fragmentation (all particles less than 2 mm) were assessed in relation to the energy level setting and number of laser pulses delivered. The authors found that a 480-nm, flashlamp-pumped pulsed dye laser can fragment completely all the types of human gallstones that were tested, although there is significant variability in gallstone susceptibility to laser lithotripsy. This susceptibility varies with CT appearance: dense stones require fewer pulses and lower energies for fracture and fragmentation, compared to faint or rimmed stones. The authors anticipate that CT characterization of gallstones may be a clinically useful screening tool before laser lithotripsy.

Cholelithiasis↗
PubMed1991

Renal vascular hypertension during pregnancy.

We report two women with renal artery stenosis in pregnancy. The first patient presented with severe hypertension in the first and second trimesters characterized by an extremely high vascular resistance (maximum 2455 dyne.second.cm-5). Transluminal angioplasty was performed at 20 weeks' gestation, resulting in resolution of the patient's hypertension. After angioplasty, her vascular resistance fell to 1600 dyne.second.cm-5, but did not reach normal pregnant levels. The pregnancy was carried to term without complication. The second patient's hypertension improved during pregnancy, and she delivered at term without complication. Twelve weeks postpartum, the patient again became severely hypertensive, and transluminal angioplasty was performed.

Adult↗
PubMed1989

Treatment of acute renal artery occlusion after percutaneous transluminal angioplasty.

Four patients with occlusive complications after percutaneous transluminal renal artery angioplasty (PTA) have been treated from July 1, 1984, to March 14, 1988. During this interval such renal artery angioplasties were performed in 44 patients. Two resulted in complete main renal artery occlusion, one angioplasty resulted in occlusion of a stenotic renal artery bypass graft, and one renal PTA resulted in segmental branch renal artery narrowing, which was thought to represent a dissection. The latter segmental renal artery narrowing was treated expectantly with good long-term results. One of the main renal artery occlusions was treated by radiologic means by reentry and repeat transluminal dilation. The other two acute complete occlusions, one of an autogenous artery and the other of an aortorenal bypass graft, were treated by aortorenal or ileorenal bypass grafting, respectively. The overall incidence of main renal artery occlusion (including the bypass graft occlusion) after PTA requiring operative intervention was 4.5% (2/44). Revascularization was accomplished after 6 and 8 hours of renal ischemia time for the two surgical procedures. Despite this, the bypass grafts done emergently remain patent, and the involved kidneys appear to be functional. The incidence of main renal artery occlusion after PTA is not as low as would be apparent from a review of the literature. It is proposed that main renal artery occlusion after PTA can be treated successfully by surgical and interventional radiologic techniques because of the presence of protective renal collateral circulation whose formation was stimulated by the renal artery lesion that prompted PTA.

Aged↗
PubMed1983

Hepatic perfusion and splanchnic oxygen consumption in patients postinjury.

Hepatic dysfunction following injury is felt to be due to hepatic ischemia. To test this hypothesis we measured hepatic blood flow (HBF) and splanchnic oxygen delivery and consumption in nine multiply injured patients. HBF, measured by indocyanine green clearance, was 0.4 +/- 0.1 L/min/m2 12 hours after injury. It steadily increased to 1.3 +/- 0.1 L/min/m2 by 1 week after injury. Changes in cardiac output were similar and were due largely to changes in HBF. Hepatic hypoperfusion was correlated with subsequent increases in serum bilirubin. High oxygen consumption was associated with high HBF and oxygen delivery, and splanchnic oxygen consumption became a large fraction (range, 21-67%) of total body oxygen consumption. Although splanchnic oxygen delivery was diminished with low HBF, splanchnic oxygen consumption remained normal (37 +/- 2 ml/min/m2) due to increased oxygen extraction. We conclude that hepatic blood flow is markedly reduced after injury. Reduced HBF is correlated with liver dysfunction although normal splanchnic oxygen consumption is maintained.

Accidents, Traffic↗
PubMed1981

Correction of hypersplenism without splenectomy.

Permanent interruption of splenic artery blood flow to the spleen was accomplished in a 4.5-yr-old girl with significant hypersplenism secondary to biliary cirrhosis. The splenic artery was successfully occluded by transfemoral catheterization and selective instillation of bucrylate tissue adhesive.

Child, Preschool↗
PubMed1981

Intra-arterial tissue adhesive for medical splenectomy in humans.

Bucrylate (isobutyl 2-cyanoacrylate) was used for the transcatheter embolization of the splenic artery in 4 patients with bleeding gastric varices secondary to splenic vein thrombosis, 3 patients with symptoms of hypersplenism, and 8 patients with bleeding esophageal varices secondary to portal hypertension. The splenic artery was completely occluded in 13 patients and partially occluded in 2. In all but one of the patients, functioning splenic tissue was preserved and no abscess developed. Medical splenectomy with Bucrylate appears to be a safe and effective method for treating bleeding gastric varices secondary to splenic vein thrombosis, and it can alleviate symptoms of hypersplenism. Its role in controlling bleeding from esophageal varices in patients with generalized portal hypertension is worth further study.

Adhesives↗
PubMed1980

Bucrylate embolization of abdominal aortic aneurysms: an adjunct to nonresective therapy.

Abdominal aneurysmectomy in a patient with an abdominal aortic aneurysm who has cardiac, renal, or pulmonary disease is associated with a high surgical mortality. Fifteen such patients underwent nonresective therapy of an abdominal aortic aneurysm consisting of an axillobifemoral bypass graft which maintains blood flow to the lower extremities. At the time of the graft the iliac vessels were ligated, occluding the outflow tract from the aneurysm, and resulting in retrograde thrombosis. In three of the 15 patients, however, the aneurysm remained patent because of patency of the hypogastric arteries. The outflow tract in these three patients was occluded by a transcatheter injection of Bucrylate, a tissue adhesive, into the distal abdominal aorta and iliac vessels. Bucrylate embolization is a potentially useful adjunct to nonresective treatment of abdominal aortic aneurysms.

Aged↗
PubMed1979

Epidural venography in the diagnosis of lumbar spinal stenosis.

Epidural venography is valuable in diagnosing lumbar spinal stenosis. It shows anterior displacement of the posterior medial longitudinal intervertebral veins at the level of the lamina and the superior and inferior articular facets. This results in decreased distance between and sometimes overlapping of the posterior and anterior medial longitudinal intervertebral veins. Three cases of spinal stenosis diagnosed by epidural venography are presented.

Adult↗