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Biomedical subjects

P Goodman

Publications and source records attributed to P Goodman.

At least 73 records · Page 4Linked to original sources
PubMed1989

Mycobacterial esophagitis in AIDS.

A patient with acquired immune deficiency syndrome (AIDS) who presented with dysphagia is described. Barium swallow demonstrated diffuse esophagitis with longitudinal ulceration and sinus tracts to the mediastinum. Mycobacteria were seen on esophageal biopsies and Mycobacterium tuberculosis was cultured from a pleural effusion. Mycobacterial esophagitis should be considered in the differential diagnosis of esophagitis in AIDS, particularly when sinus tracts are demonstrated.

Acquired Immunodeficiency Syndrome↗
PubMed1989

CT diagnosis of perforated duodenal diverticulum.

We present a case of perforated duodenal diverticulum diagnosed preoperatively on computed tomography. This rare but potentially fatal condition has been difficult to detect with more conventional radiographic techniques.

Diverticulum↗
PubMed1989

Omental cakes in American Burkitt lymphoma. Computed tomography demonstration.

Diffuse tumor infiltration of the omentum or so-called omental "cakes" is well recognized on computed tomography (CT) and is usually associated with pelvic or gastrointestinal carcinoma. However, this has not been described in American Burkitt lymphoma despite frequent intraabdominal involvement in this disease. We report two cases of American Burkitt lymphoma in which omental cakes were demonstrated by CT.

Abdominal Neoplasms↗
PubMed1989

Perioperative pulmonary function in acute respiratory failure: effect of ventilator type and gas mixture.

Whether maintaining pulmonary nitrogenation and/or a stable ventilatory pattern during surgery would minimize changes in perioperative pulmonary function in two groups of patients with acute respiratory failure (ARF) whose lungs were being mechanically ventilated was examined. Group 1 (n = 39 cases) (inspired oxygen fraction [FIO2] less than or equal to 0.5, minute ventilation less than or equal to 15 l/min, peak inspiratory pressure less than or equal to 50 cmH2O, positive end-expiratory pressure [PEEP] less than or equal to 10 cmH2O) were assigned randomly to one of four intraoperative ventilator-gas mixture (FIO2 approximately 0.5) combinations: 1) Siemens 900C ventilator, N2/O2; 2) Siemens 900C ventilator, N2O/O2; 3) Ohio anesthesia ventilator, N2/O2; or 4) Ohio anesthesia ventilator, N2O/O2. Group 2 (n = 15 cases) (ventilatory requirements exceeding any of those in Group 1) had their lungs ventilated intraoperatively with the Siemens 900C ventilator and a gas mixture determined by their anesthesiologist (FIO2 approximately 0.6-1.0). In patients whose lungs were ventilated with the Ohio N2O/O2 combination, PaO2/FIO2 decreased significantly (P less than 0.05) from 358 +/- 93 mmHg (mean +/- SD) preoperatively to 282 +/- 77 mmHg intraoperatively. The level of PEEP increased significantly from 5 +/- 3 cmH2O preoperatively to 9 +/- 4 cmH2O intraoperatively (P less than 0.05). In patients whose lungs were ventilated with the Ohio N2/O2 combination, PaO2/FIO2 decreased significantly from 270 +/- 86 mmHg preoperatively to 174 +/- 74 mmHg intraoperatively. These variables did not change significantly in patients ventilated with the Siemens ventilator (groups 1 and 2). Pulmonary oxygen gas exchange returned to preoperative values by the first hour postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1988

Combined surgical management of myasthenia gravis and Graves' disease.

It is rare that a patient with Graves' disease has concomitant myasthenia gravis, despite the impression that both diseases have an autoimmune basis. Even less common is the opportunity to simultaneously approach both diseases surgically. We have described a patient meeting these qualifications, and have reviewed the pertinent principles of diagnostic and perioperative management of these two disease entities.

Adult↗
PubMed1987

Alleles at the PRH1 locus coding for the human salivary-acidic proline-rich proteins Pa, Db, and PIF.

We cloned and sequenced the entire exon and intron structures of Db and Pa genetic determinants at the PRH1 locus. Their derived amino acid sequences and that previously determined for the PIF protein completely explain the electrophoretic phenotypes of the acidic proline-rich proteins (PRPs) Pa, Db, and PIF. Thus, the Cys substitution near Arg 106 in the Pa protein sterically interferes with proteolytic cutting at Arg 106 and accounts for the single-banded phenotype. In contrast, the Db and PIF proteins are proteolytically cut at Arg 106 and show a double-banded phenotype. The Db protein has an extra 21-amino acid repeat that accounts for its larger size compared with the equal sized Pa monomer and PIF proteins. Several amino acid substitutions account for the charge and mobility differences of the Pa, Db, and PIF proteins in isoelectric-focusing gels. These DNA/protein correlations, as well as the extremely similar genomic-DNA sequences that differ by less than 1%, establish that Pa, Db, and PIF are alleles at the PRH1 locus. On the basis of the DNA sequences, we conclude that Db and Pa alleles diverged more recently from a common precursor than did the PIF allele from its precursor.

Alleles↗
PubMed1983

Nuclear magnetic resonance imaging of the thorax.

Nuclear magnetic resonance (NMR) images of the thorax were obtained in ten normal volunteers, nine patients with advanced bronchogenic carcinoma, and three patients with benign thoracic abnormalities. In normal volunteers, mediastinal and hilar structures were seen with equal frequency on NMR images and computed tomographic scans. The hila were especially well displayed on spin-echo images. Spin-echo images showed mediastinal invasion by tumor, vascular and bronchial compression and invasion, and hilar and mediastinal adenopathy. Tumor and benign abnormalities could be separated from mediastinal and hilar fat because of their longer T1 times. Lung masses and nodules as small as 1.5 cm could be seen on the spin-echo images. NMR imaging shows promise for assessment of benign and malignant mediastinal, hilar, and lung abnormalities.

Adult↗
PubMed1980

Five-year follow-up of maximal treadmill stress test in asymptomatic men and women.

A five-year follow-up of 888 asymptomatic men and women without known coronary heart disease (CHD) who had a maximal treadmill stress test (MTST) revealed a CHD incidence of 1.1% per year. In women, exercise duration of 3 minutes or less by the Ellestad protocol correlated with subsequent development of CHD (p less than 0.001), although abnormal ST-segment and R-wave responses did not. In men 40 years of age or younger, the MTST did not correlate with subsequent CHD. In men older than 40 years, ischemic ST response (p less than 0.01), an increase or no change in R wave (p less than 0.01), and an exercise duration of 5 minutes of less (p less than 0.001) all correlated with subsequent development of CHD. Five of five men (100%) who had all three criteria developed CHD within 5 years. When men older than 40 years who had all three criteria either present or absent were considered, specificity was 100%. The sensitivity, specificity, predictive value of an abnormal test, and risk ratio for developing CHD within 5 years for the various MTST criteria alone and in combination are tabulated.

Adult↗
PubMed1978

Uptake and release of norepinephrine by slices of rat cerebral cortex: effect of agents that increase cyclic AMP levels.

Cerebral cortical slices from rats were incubated in physiologic saline, and the uptake, release, and K+-stimulated release of norepinephrine were measured. Dibutyryl cyclic AMP, the phosphodiesterase inhibitors aminophylline and papaverine, and adenosine (which stimulates adenyl cyclase) all caused a variable increase in uptake of norepinephrine at concentrations ranging from 10(-7) to 10(-4) M. Prostaglandins E1 and E2 appeared to have no effect on uptake, but this may be because the alcohol required to dissolve them had an inhibitory effect on uptake. None of these compounds appeared to affect basal or K+-stimulated release of norepinephrine. These agents therefore seem to have an effect opposite to that of the tricyclic antidepressants (which inhibit uptake of norepinephrine). Since norepinephrine's postsynaptic effects are usually inhibitory in the cortex, the stimulatory effect of the drugs tested on the presynaptic uptake of norepinephrine may explain the stimulant and epileptogenic effects of these drugs.

Adenosine↗
PubMed1977

The problem-oriented medical record as a training tool for staff.

After numerous deficiencies were found in a psychiatric center's medical records, a task force devised a system that incorporated the four components of the problem-oriented medical record plus other elements required by the center's structure. They divided the record into ten sections and also developed a four-page form for recording the patient's assessment and treatment plan. Two-hour mandatory training sessions were held to teach all levels of mental health staff how to use the new system; various kinds of follow-up instruction were also given. That training, the authors say, was a valuable way to teach staff not only proper record-keeping but also clinical thinking and logical treatment planning.

Hospitals, Psychiatric↗
PubMed1977

Administrative receivership and troika management.

The authors describe the use of troika management and administrative receivership to upgrade a unit in a state mental hospital. The experiment included a three person unit chief, transitional leadership, and collective decision making.

Administrative Personnel↗