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R Goldberg

Publications and source records attributed to R Goldberg.

At least 127 records · Page 7Linked to original sources
PubMed1991

Structural features of the cell-wall polysaccharides of Asparagus officinalis seeds.

The fine structure of a beta-)1----4)-linked glucomannan from Asparagus officinalis has been determined by n.m.r. analysis of the oligosaccharides obtained by acidic and enzymic hydrolyses. Cleavage of the glucomannan with beta-D-mannase from Aspergillus niger and purification by h.p.l.c. gave oligosaccharide fractions that contained Man (mannose), GlcMan (beta-glucopyranosylmannose), Man2, Glc2Man, and Glc3Man as the major components. Simulated digestion of a polymer composed of randomly distributed monomers with the same Glc:Man ratio as glucomannan from A. officinalis led to the same polysaccharides. The random distribution of the monomers of glucomannan from A. officinalis was corroborated by the diffraction diagram of the raw flour, which indicated that the "in situ" glucomannan was amorphous, whereas both cellulose and mannans are crystalline.

Acids↗
PubMed1991

Affectedness and direct objects: the role of lexical semantics in the acquisition of verb argument structure.

How do speakers predict the syntax of a verb from its meaning? Traditional theories posit that syntactically relevant information about semantic arguments consists of a list of thematic roles like "agent", "theme", and "goal", which are linked onto a hierarchy of grammatical positions like subject, object and oblique object. For verbs involving motion, the entity caused to move is defined as the "theme" or "patient" and linked to the object. However, this fails for many common verbs, as in fill water into the glass and cover a sheet onto the bed. In more recent theories verbs' meanings are multidimensional structures in which the motions, changes, and other events can be represented in separate but connected substructures; linking rules are sensitive to the position of an argument in a particular configuration. The verb's object would be linked not to the moving entity but to the argument specified as "affected" or caused to change as the main event in the verb's meaning. The change can either be one of location, resulting from motion in a particular manner, or of state, resulting from accommodating or reacting to a substance. For example, pour specifies how a substance moves (downward in a stream), so its substance argument is the object (pour the water/glass); fill specifies how a container changes (from not full to full), so its stationary container argument is the object (fill the glass/water). The newer theory was tested in three experiments. Children aged 3;4-9;4 and adults were taught made-up verbs, presented in a neutral syntactic context (this is mooping), referring to a transfer of items to a surface or container. Subjects were tested on their willingness to encode the moving items or the surface as the verb's object. For verbs where the items moved in a particular manner (e.g., zig-zagging), people were more likely to express the moving items as the object; for verbs where the surface changed state (e.g., shape, color, or fullness), people were more likely to express the surface as the object. This confirms that speakers are not confined to labeling moving entities as "themes" or "patients" and linking them to the grammatical object; when a stationary entity undergoes a state change as the result of a motion, it can be represented as the main affected argument and thereby linked to the grammatical object instead.

Attention↗
PubMed1991

Multiple adnexal tumors and a parotid basal cell adenoma.

A 72-year-old woman had a preauricular mass and several scalp nodules. Her medical history included excisions of multiple cutaneous tumors, including cylindromas, trichoepitheliomas, basal cell epitheliomas, and a trichilemmoma. The parotid mass and a scalp nodule were excised. On light microscopy, the parotid mass and scalp nodule appeared similar. Ultrastructural features revealed by electron microscopic analysis of the tumors allowed diagnosis of a cylindroma of the scalp and a parotid basal cell adenoma. The association of trichilemmoma and membranous basal cell adenoma of the parotid has not been previously described. The pathogenesis of these multiple cutaneous tumors from a common cell of origin is considered.

Adenoma↗
PubMed1991

Chromosomal deletion 4p15.32----p14 in a Treacher Collins syndrome patient: exclusion of the disease locus from and mapping of anonymous DNA sequences to this region.

Treacher Collins syndrome is an autosomal dominant condition of bilateral craniofacial abnormalities of structures derived from the first and second branchial arches. A patient with severe manifestations of Treacher Collins syndrome and a de novo chromosomal deletion in region 4p15.32----p14 was identified. Anonymous DNA sequences of loci D4S18, D4S19, D4S20, D4S22, and D4S23 were mapped to the deleted region. DNA probes previously mapped to loci on chromosome 4p (D4S10, D4S15, D4S16, D4S26, D4S35, D4S95, D4S144, RAF1P1, QDPR, and HOX7) were not deleted in this patient. Linkage analysis between the D4S18, D4S23, and QDPR loci and Treacher Collins syndrome in eight families excluded the Treacher Collins syndrome locus from the region of the deletion.

Chromosome Deletion↗
PubMed1991

Syntax and semantics in the acquisition of locative verbs.

Children between the ages of three and seven occasionally make errors with locative verbs like pour and fill, such as *I filled water into the glass and *I poured the glass with water (Bowerman, 1982). To account for this pattern of errors, and for how they are eventually unlearned, we propose that children use a universal linking rule called object affectedness: the direct object corresponds to the argument that is specified as 'affected' in some particular way in the semantic representation of a verb. However, children must learn which verbs specify which of their arguments as being affected; specifically, whether it is the argument whose referent is undergoing a change of location, such as the content argument of pour, or the argument whose referent is undergoing a change of state, such as the container argument of fill. This predicts that syntactic errors should be associated with specific kinds of misinterpretations of verb meaning. Two experiments were performed on the ability of children and adults to understand and produce locative verbs. The results confirm that children tend to make syntactic errors with sentences containing fill and empty, encoding the content argument as direct object (e.g. fill the water). As predicted, children also misinterpreted the meanings of fill and empty as requiring not only that the container be brought into a full or empty state, but also that the content move in some specific manner (by pouring, or by dumping). Furthermore, children who misinterpreted the verbs' meanings were more likely to make syntactic errors with them. These findings support the hypothesis that verb meaning and syntax are linked in precise ways in the lexicons of language learners.

Child↗
PubMed1991

Verification of a new clinicopathologic staging system for colorectal adenocarcinoma.

Rectal adenocarcinoma is said to have a poorer outcome than colon adenocarcinoma when compared on the basis of Dukes' staging. However a new staging system, determined by a multivariate analysis of 147 patients with rectal adenocarcinoma, has revealed three other variables significantly related to outcome. Therefore this study analyzed the authors' experience with colonic carcinoma during the same time period as they had studied for rectal carcinoma to determine whether the new staging system is valid for colon carcinoma as well, and, if so, to compare the outcome of patients with colon and rectal carcinoma on the basis of this new staging. A total of 603 patients with 611 colonic adenocarcinoma were operated on at the University of Chicago Medical Center between 1965 and 1981. Two hundred seventy-nine adenocarcinomas (45.7%) were located proximal to the splenic flexure and 332 (54.3%) were located between the splenic flexure and the rectosigmoid. Four hundred sixty-two patients underwent segmental colectomy, 46 subtotal colectomy, 26 total colectomy, 18 proctocolectomy, 5 abdominal-perineal resection, 1 appendectomy, while 20 had local excision of the tumor through colotomy and 25 had permanent diverting stoma as the only procedure. The operative mortality rate was 6.1% in the whole group, but was only 2.7% in the group of potentially curable patients. Complete follow-up was obtained in all patients. To validate a previous staging system for Dukes' B and C rectal adenocarcinoma, the authors investigated the correlation between 5-year survival for colonic carcinoma patients and all relevant variables that they had considered potentially meaningful in the previous study with rectal adenocarcinoma. The resulting multivariate analysis using Cox regression showed that the four variables found previously to be significantly related to outcome for rectal adenocarcinoma patients (stage, race, tumor morphology, and vascular and/or lymphatic microinvasion) were the only four variables significantly (p less than 0.05) associated with outcome for colonic adenocarcinoma patients. In addition, by using the results of their previous staging system for rectal adenocarcinoma patients, they 'predicted' the 5-year survival rates of the colon adenocarcinoma patients, divided in 16 staging subgroups. In subgroups of at least 15 patients, the rectal staging system predicted the outcome to within 1 to 6 percentage points of the observed outcome of the colonic adenocarcinoma patients. Thus this study validates this staging system, incorporating stage, race, tumor morphology, and microinvasion to predict 5-year survival rate more accurately than Dukes' staging alone for both colon and rectal adenocarcinoma.(ABSTRACT TRUNCATED AT 400 WORDS)

Academic Medical Centers↗
PubMed1991

Heart disease in native Americans.

Cardiovascular disease is one of the major causes of death among native Americans. Ischemic heart disease has been relatively uncommon in the past, but this entity is rapidly becoming more frequent among Indians as a result of Western acculturation (Western high-fat diet, smoking, sedentary lifestyle). Hypertension remains a major problem in native American populations. Hypertension is often inadequately detected and treated in Indians. Rheumatic fever and rheumatic heart disease are moderately common and apparently in decline among native Americans. Finally, the fetal alcohol syndrome with its accompanying cardiac malformations is all too common among North American Indians. The amount of information available concerning cardiovascular disease in native Americans is rather small. Considerably more attention should be paid to this area in the future.

Coronary Disease↗
PubMed1991

Protracted infusion of 5-FU with weekly low-dose cisplatin as second-line therapy in patients with metastatic colorectal cancer who have failed 5-FU monotherapy.

Forty four patients who had documented progression of metastatic colorectal cancer while receiving 5-fluorouracil (5-FU) monotherapy were treated with continuous infusion 5-FU, 300 mg/mg2/day, plus weekly low-dose cisplatin, 20 mg/m2. Treatment was given in 12-week cycles, consisting of 8 weeks of chemotherapy followed by a 4-week rest period, and was well tolerated. Three of 23 patients (13%) who had failed bolus 5-FU but not been exposed previously to infusional 5-FU responded. Of 21 patients who had failed infusional 55-FU monotherapy, only one (5%) responded. Time to progression (5.7 vs. 1.8 months) and survival (12 vs. 5.5 months) were significantly longer for patients who had not previously received infusional 5-FU but who had failed bolus schedules, compared with patients who had previously failed infusional 5-FU (p less than .001).

Adult↗
PubMed1991

Training family practice and internal medicine residents to counsel patients who smoke: improvement and retention of counseling skills.

This investigation builds on an earlier study by describing the final results of a training program that teaches internal medicine and family practice residents to counsel patients to stop smoking. In this study, 198 residents participated in a three-hour training program which included small group discussion and role-playing exercises. Videotaped observations of role-playing performances were used to assess behavioral outcomes related to counseling skills for 104 residents who completed pre-, immediate post-, and long-term follow-up testing. The present findings support previous results that show the training program has a significant positive effect on physician smoking cessation counseling skills. A subsample of residents continued to exhibit improved counseling skills one year after the initial educational interventions, suggesting that these skills can be retained over time.

Counseling↗
PubMed1990

Comparison of the effects of lovastatin and gemfibrozil on lipids and glucose control in non-insulin-dependent diabetes mellitus.

Patients with non-insulin dependent diabetes mellitus have an increased incidence of coronary artery disease which may, in part, be associated with abnormalities in plasma lipids. In a double-blind, parallel, randomized study, lovastatin and gemfibrozil were compared in 102 diabetic patients with primary hypercholesterolemia; two-thirds of the patients were treated with oral hypoglycemic agents and one-third received diet therapy alone for their diabetes. Mean pretreatment total and low-density lipoprotein (LDL) cholesterol values were 273 and 193 mg/dl, respectively. Lovastatin significantly reduced total, LDL and very low density lipoprotein cholesterol (20, 26 and 28%, respectively) and raised high-density lipoprotein (HDL) cholesterol (14%). Gemfibrozil significantly reduced triglycerides and very low density lipoprotein cholesterol (36 and 41%, respectively) and, to a lesser extent, total cholesterol (9%); it also increased HDL cholesterol (21%). Lovastatin therapy was not associated with a significant change in triglycerides, and gemfibrozil did not significantly lower LDL cholesterol. The decrease in the ratio of total to HDL cholesterol tended to be greater with lovastatin than with gemfibrozil (26.5 and 20.4%, respectively; p = 0.053). Changes in lipid profiles with both agents were of a degree similar to those reported in nondiabetic patients. Neither agent had a clinically important effect on fasting glucose or hemoglobin A1c. Both drugs were well tolerated with the exception of 2 patients treated with gemfibrozil who developed symptoms of cholecystitis.

Adult↗
PubMed1990

Pre-diagnostic symptom recognition and help seeking among cancer patients.

Failure to recognize symptoms which signal cancer may delay contact with the medical care system, thus decreasing the chances of diagnosis at an early stage of disease. We investigated the determinants of cancer symptom recognition and delay in seeking medical care in a population-based sample of 625 newly diagnosed lung, breast and colorectal cancer patients. Although the majority (79.5%) of patients reported noticing symptoms prior to diagnosis, one quarter of these patients (24.7%) delayed longer than three months in seeking medical care. Contrary to the findings of research based on clinic samples, logistic regression analysis revealed that no demographic or social support factors were predictive of symptom recognition or delay, with the exception that older colorectal cancer patients were less likely to notice symptoms, but also less likely to delay. Lung and colorectal patients diagnosed with advanced disease were more likely to notice symptoms than patients with local disease. Results of a content analysis of patients' remarks indicate that breast cancer patients were significantly more likely than lung or colorectal cancer patients to attribute their symptoms to cancer (p less than .001). Symptoms common to lung and colorectal cancer appear to be attributed to other, less serious causes. Given the lack of demographic predictors of symptom recognition and delay in seeking care, we suggest that education programs address risk groups for specific cancers, rather than the general public as a whole, grouping together all cancers and cancer symptomatology.

Aged↗
PubMed1990

Panic disorder in cardiac outpatients.

The prevalence of and nature of panic disorder were investigated in an ambulatory cardiology practice. Questionnaires about panic symptoms were mailed to 414 patients, and possible or definite panic disorder was found in 104 of the 310 respondents. Interviews with 52 of the 104 patients substantiated diagnoses of panic disorder, for a prevalence of 9.2% of the total sample population of 414. Comparison of patients grouped by duration of panic disorder revealed that long-duration panic disorder had its onset before age 30 and followed a chronic course. Short-duration panic disorder developed at an older age following the appearance of cardiac disease.

Anxiety Disorders↗
PubMed1990

The validity and reliability of the navicular fat stripe as a screening test for detection of navicular fractures.

STUDY OBJECTIVE: The purpose of this study was to determine if the navicular fat stripe (NFS) is a valid and reliable screening tool in assessing potential navicular fractures. DESIGN: Retrospective analysis. SETTING: Minor trauma section of the Los Angeles County-University of Southern California Medical Center emergency department. TYPE OF PARTICIPANTS: Study population included patients seen for wrist injury between January 1987 and December 1988. The individuals who interpreted the radiographs included eight observers with varying degrees of radiographic experience. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: The positive predictive value averaged 12% or 15% depending on how we counted a straight NFS, and the negative predictive value averaged 93% or 95%, again depending on how we counted a straight NFS. A straight NFS was ten times as likely to occur among normal wrists than among those with navicular fractures. Interobserver reliability was found to be high with a Hoyt reliability coefficient of .79. CONCLUSIONS: An abnormal NFS is a poor predictor of a navicular fracture while both a straight and a normal NFS are good predictors of no navicular fracture. A normal NFS may allow less stringent treatment by the emergency physician. Extremes of radiographic experience were found to have no significant effect on NFS interpretation.

Adipose Tissue↗
PubMed1990

Cancer patients' concerns: congruence between patients and primary care physicians.

To investigate whether physicians perceive concerns of cancer patients in the same way as patients, we asked primary care physicians and cancer patients to complete an instrument that allowed each to indicate their views of the relative importance of a variety of treatment and disease-related concerns. The instrument was completed by 195 physicians (56% response) and 119 newly diagnosed breast, lung, and colorectal cancer patients (50% response). Psychometric analysis of responses to the instrument revealed two components: general concerns and physician-treatment concerns. For both the physician and the patient groups, internal consistency (coefficient alpha) of these two components was high (greater than .83). Within the patient group, scale scores did not differ as a function of performance status, cancer type, extent of disease, or age. For physicians, scale scores were not related to years in practice, board certification, or number of new cancer patients seen per year. A comparison of scale scores between groups indicated that there was good physician-patient congruence on only one of the two concern components. Physicians do not adequately appreciate the extent of concern patients have with regard to treatment and physician interaction issues.

Activities of Daily Living↗
PubMed1990

Local recurrence after curative resection of colorectal adenocarcinoma.

A total of 853 patients with 861 colorectal adenocarcinomas were operated on at our institution between 1965 and 1981. Complete follow-up information was obtained in all but six patients (99.4%), and all available histologic slides were reviewed to determine pathologic stage and characteristics. Six hundred fifty-one patients (76.3%) underwent a potentially curative procedure, and their operative mortality rate was 2.8%. Of the 627 patients available for analysis, 50 (8%) had a local recurrence. The median time to local recurrence was 18 months, and only 16% of local recurrences were diagnosed 5 years after the original resection. Median survival of patients with a local recurrence was 3 1/2 years from the original resection, and 16 patients (32%) survived 5 years or longer. A multivariate logistic regression analysis was conducted to examine the influence of several clinical and pathologic characteristics on local recurrence among Dukes' stages B and C adenocarcinomas (n = 539) after exclusion of patients with synchronous tumors (n = 8), postoperative deaths (n = 18), loss to follow-up (n = 6), or incomplete data (n = 11). This analysis revealed that the local recurrence rate was significantly related to depth of invasion (B1 + C1 = 0%; B2 + C1 = 10%; p less than 0.01), site of origin (right plus transverse colon = 6%; left plus rectosigmoid colon = 10%; rectum = 12%; p less than 0.05), and lymphatic or capillary microinvasion (absent, 6%; present, 14%; p less than 0.05). This analysis attempts to identify patients at high risk for development of local recurrent disease to select candidates for postoperative adjuvant therapy.

Adenocarcinoma↗
PubMed1990

Increasing frequency of staphylococcal infective endocarditis. Experience at a university hospital, 1981 through 1988.

To determine the characteristics of infective endocarditis in our hospital, we reviewed all patients with that diagnosis at the University of Massachusetts Medical Center, Worcester, between 1981 and 1988. Of 113 patients with infective endocarditis, 56 (50%) had staphylococcal endocarditis. Despite aggressive medical and surgical therapy, in-hospital mortality was 25%. Forty-five (80%) of the 56 cases of staphylococcal endocarditis involved Staphylococcus aureus with a mortality of 28% vs 9% in the non-S aureus group. Mortality was higher in patients with congestive heart failure (35%), atrioventricular block (45%), atrial fibrillation (42%), and prosthetic valve endocarditis (50%). Seventy-six percent of the patients with congestive heart failure required surgery. Patients with congestive heart failure and S aureus infection had a mortality of 45%. Thirty-six patients (64%) were alive at late follow-up (mean, 28.6 months). Mortality was highest (23%) during the first 3 months following diagnosis of staphylococcal endocarditis. Staphylococcal endocarditis represents an increasingly large proportion of patients with infectious endocarditis. Mortality rates remain high despite aggressive management of the patient's condition.

Adolescent↗
PubMed1989

Frequency of Mycobacterium tuberculosis bacteremia in patients with tuberculosis in an area endemic for AIDS.

Mycobacterium tuberculosis bacteremia has recently been reported in patients infected with the human immunodeficiency virus (HIV). At our institution, tuberculosis occurs commonly among patients with and without HIV infection. We sought to determine the frequency of M. tuberculosis bacteremia among patients with newly diagnosed tuberculosis. During a 4-month period, mycobacterial blood cultures were obtained on all identifiable patients with newly diagnosed tuberculosis. Fifteen percent (9/59) of consecutive patients with tuberculosis had positive blood cultures for M. tuberculosis. Twenty-six percent (7/27) of patients known to be infected with HIV had positive mycobacterial blood cultures; two intravenous drug users who refused HIV-serologic testing also had positive mycobacterial blood cultures. M. tuberculosis bacteremia occurred at a higher rate among HIV-infected patients with an AIDS-defining opportunistic infection in addition to tuberculosis (3/3) than among HIV-infected patients without such an opportunistic infection (4/24; p less than 0.02). M. tuberculosis bacteremia occurred in 83% (5/6) of patients with disseminated tuberculosis and in 8% (4/53) of patients without disseminated tuberculosis (p less than 0.001). In all cases, tuberculosis was diagnosed in patients with M. tuberculosis bacteremia or else they died prior to the blood cultures demonstrating mycobacterial growth (mean time to detection of mycobacterial growth: 43 days). However, the frequent occurrence of M. tuberculosis bacteremia in HIV-infected patients with disseminated tuberculosis suggests that mycobacterial blood cultures may help confirm the diagnosis of tuberculosis in this group of patients.

Acquired Immunodeficiency Syndrome↗