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S J Rosenberg

Publications and source records attributed to S J Rosenberg.

At least 19 recordsLinked to original sources
PubMed2001

Prospective evaluation of multilayered epithelium in Barrett's esophagus.

OBJECTIVE: We recently identified a distinctive type of multilayered epithelium in two patients with Barrett's esophagus, which shows morphological characteristics of both squamous and columnar epithelium. This study was performed to prospectively evaluate the prevalence of multilayered epithelium in patients with Barrett's esophagus. METHODS: Mucosal biopsies were obtained from the squamocolumnar junction (Z-line) of 58 patients with endoscopic evidence of esophageal columnar epithelium and from the gastroesophageal junction in 21 patients without endoscopic evidence of esophageal columnar epithelium. Specimens were evaluated for the presence of multilayered epithelium and goblet cells. RESULTS: Twenty-four of 58 (41%) of the patients with endoscopic evidence of esophageal columnar epithelium had multilayered epithelium compared with only one of 21 patients (5%) in the control group (p = 0.005). Of the 58 patients in the study group, 43 had goblet cell metaplasia and 15 did not (p < 0.001). Only patients with goblet cell metaplasia had multilayered epithelium. Shorter lengths of columnar epithelium were noted in the 24 patients with goblet cells and multilayered epithelium compared with the 19 patients with goblet cells and no multilayered epithelium (p < 0.05). CONCLUSIONS: Multilayered epithelium is strongly associated with goblet cell metaplasia in patients with endoscopic evidence of esophageal columnar epithelium. These data support the hypothesis that multilayered epithelium may represent a transitional stage in the development of Barrett's esophagus.

Aged↗
PubMed1999

Chronic clozapine, but not haloperidol, alters the response of mesoprefrontal dopamine neurons to stress and clozapine challenges in rats.

Previously, we demonstrated that serotonin-lesioned rats had an enhanced mesoprefrontal dopaminergic response to restraint stress. This study attempted to extend our knowledge regarding this serotonin/dopamine interaction by seeing if suppression of serotonin metabolism by chronic administration of the atypical antipsychotic, clozapine, would have similar effects. Both typical and atypical neuroleptics require chronic administration in humans before antipsychotic activity is seen. Rats treated for 21 days with clozapine or haloperidol, a typical antipsychotic without significant binding affinity for serotonergic receptors, showed lowered basal dopamine metabolism in the medial prefrontal cortex, the nucleus accumbens, and the striatum, as expected. Basal serotonin metabolism in the prefrontal cortex was also lowered by clozapine treatment, but not haloperidol. One of two challenges were given to chronically treated rats: 30 min of restraint stress or an acute challenge of clozapine. When corrected for baseline differences, both challenges significantly elevated dopamine metabolism in the prefrontal cortex of the clozapine group more than the saline or haloperidol groups. No hyperresponsiveness was seen with serotonin metabolism in the prefrontal cortex or either dopamine or serotonin metabolism in the nucleus accumbens in clozapine-treated, challenged rats. Additionally, this augmentation of the dopaminergic stress response was not seen with a single, acute administration of clozapine. The significance of the clozapine-induced hyperresponsiveness of the mesoprefrontal dopamine system is discussed with regard to clinical efficacy of clozapine.

Animals↗
PubMed1998

Effect of gamma subunit carboxyl methylation on the interaction of G protein alpha subunits with beta gamma subunits of defined composition.

A baculovirus expression system was used to determine the contribution of carboxyl methylation of specific G protein gamma subunits to the interaction between alpha and beta gamma subunits. beta gamma subunits were carboxyl methylated by a membrane bound methyltransferase in Sf9 cells, and periodate-oxidized adenosine inhibited this methylation by 90%. Carboxyl methylation of beta(1) gamma(2), beta(2) gamma(3), and beta(2) gamma(7) enhanced pertussis toxin-catalyzed ADP-ribosylation of alpha(i2) and alpha(i3) by about 2-fold. On the other hand, methylation did not enhance membrane attachment of beta gamma subunits. These results suggest that methylation of isoprenylated gamma subunits is required for optimal G protein-mediated signal transduction, but not membrane attachment.

Adenosine Diphosphate Ribose↗
PubMed1995

Heartburn in patients with achalasia.

Heartburn, the main symptom of gastrooesophageal reflux disease (GORD), might be expected to occur infrequently in achalasia, a disorder characterised by a hypertensive lower oesophageal sphincter (LOS) that fails to relax. Nevertheless, it is often described by patients with achalasia. The medical records of 32 patients with untreated achalasia who complained of heartburn, and of 35 similar patients who denied the symptom, were reviewed to explore the implications of heartburn in this condition. Data on endoscopic and manometric findings, and on the onset and duration of oesophageal symptoms were collected. Three patterns of heartburn were observed: (1) in 8 patients (25%) the onset of heartburn followed the onset of dysphagia, (2) in 15 patients (47%) heartburn preceded the onset of dysphagia and persisted as dysphagia progressed, and (3) in 9 patients (28%), heartburn preceded the onset of dysphagia and stopped as dysphagia progressed. The mean (SD) basal LOS pressure in the patients with heartburn (38 (16) mm Hg) was significantly lower than that in patients without the symptom (52 (26) mm Hg); the lowest LOS pressure (29 (11) mm Hg) was observed in the subset of patients whose heartburn preceded the onset of dysphagia and then stopped. It is concluded that patients who have achalasia with heartburn have lower basal LOS pressures than patients who have achalasia without this symptom. In some patients with achalasia, the appearance of dysphagia is heralded by the disappearance of longstanding heartburn. For these patients, it is speculated that achalasia develops in the setting of underlying GORD.

Deglutition Disorders↗
PubMed1993

Factors favoring continence, the avoidance of a diverting ileostomy and small intestinal conservation in the ileoanal pouch operation.

Ileoanal pouch operation was performed upon 38 consecutive patients with ulcerative colitis (36 patients) or familial polyposis (two patients). Mucosectomy was avoided by rectal mobilization to the dentate line and eversion and stapling of the exteriorized anorectal junction with the dentate line in view. An 8 centimeter J pouch was stapled to the anorectal junction. A diverting ileostomy was not used in 34 of the 38 patients. Physicians independent of the operation evaluated patients postoperatively. Eighty-four percent of the patients did not experience any problems with incontinence or nocturnal spotting at one month postoperatively. No incontinence or nocturnal spotting was seen in any patient by one year postoperatively, with the exception of one patient with chronic pouchitis who had occasional nocturnal spotting that continues to improve. The average number of bowel movements per 24 hours was five at 12 months postoperatively, despite the small pouch. The mean distance from the dentate line to the ileoanal anastomosis was 0.9 +/- 0.5 centimeter (range of zero to 2 centimeters).

Adenomatous Polyposis Coli↗
PubMed1992

Small cell carcinoma of the esophagus in a patient with longstanding primary achalasia.

Achalasia is believed to be a predisposing factor for the development of esophageal cancer. Small cell carcinoma of the esophagus is a rare neoplasm, with fewer than 150 cases having been reported in the world literature, and it has been described only once previously in a patient with longstanding achalasia. We describe a case of an 85-yr-old woman with long-term primary achalasia who developed primary small cell carcinoma of the esophagus. We hypothesize that this patient's recurrent, worsening dysphagia is related to a paraneoplastic phenomenon. We discuss this association and review the literature.

Aged↗
PubMed1991

Transference.

Explore the source record for details and available documents.

Humans↗
PubMed1991

Childhood sexual abuse in patients with paradoxical vocal cord dysfunction.

We present three prototypical cases of paradoxical vocal cord dysfunction. The symptoms of this functional disorder mimic those of bronchial asthma attacks. These patients typically have experienced extensive medical intervention including intubation and corticosteroid use. We identify a history of childhood sexual abuse as an important factor contributing to the development of this psychosomatic disorder. We discuss the severity of psychopathology in patients with paradoxical vocal cord dysfunction and how this physical symptom may have developed to express psychological difficulties.

Adult↗
PubMed1990

Psychoanalytic psychotherapy with brain-injured adult psychiatric patients.

Scant attention has been paid to psychotherapy with patients who have acquired neurological conditions. In this paper the authors describe the common psychological problems and repetitive themes that emerge in the therapeutic process with these patients, as well as the salient attitudes toward therapy and the therapist that these patients manifest. Case vignettes illustrate the theoretical and technical considerations.

Affect↗
PubMed1990

Personality styles of patients asserting environmental illness.

Case reports and chart reviews of patients asserting environmental illness suggest that they suffer from psychiatric difficulties, typically somatization disorder. We assert that viewing these patients solely as somatizers or hysterical characters searching for a nurturant relationship will undermine the doctor-patient relationship. Rather, many of these patients are obsessive/paranoid characters searching for a medical explanation to their physical symptoms. This distinction is highlighted by contrasting the clinical presentations of hysteric/somatizing patients with those environmental illness patients demonstrating an obsessive/paranoid style. Further illustration is provided by a case report with psychological test data. Finally, treatment recommendations based upon this distinction are delineated.

Adult↗
PubMed1988

Depression in medical in-patients.

Between one-fifth and one-third of patients hospitalized on general medicine wards experience significant depressive symptoms during their hospitalization. This study employed 71 general medical in-patients and examined the relative association of illness/hospitalization characteristics, patient characteristics and environmental characteristics with in-patient medical depression. Multiple regression results indicated that in-patient medical depression was related to pre-hospitalization depression and social functioning, patient perception of physician supportiveness and patient perception of illness-related life-disruption. None of the objective illness/hospitalization variables related to depression while in the hospital. These results are interpreted with regard to several current theories in medical psychology including a life-stress model emphasizing the ability of prior disorder to predict subsequent disorder, a social interaction model focusing on the effects of physicians' supportive behaviour on patients' emotional adjustment in the hospital, and models of illness that stress cognitive appraisal in determining illness-related mood and behaviour.

Adolescent↗
PubMed1987

Coping behaviors among depressed and nondepressed medical inpatients.

Sixty medical inpatients completed a variety of psychological measures related to factors associated with depression. An analysis of self-reported depression and coping response indices revealed significant differences in coping strategies between depressed and nondepressed medical inpatients. Depressed patients more often reported avoidance strategies to cope with the stressors associated with hospitalization, while nondepressed patients were more likely to utilize active coping techniques. Since the coping and depression measures were assessed concurrently, the direction of influence cannot be determined. Still, these findings are consistent with the learned helplessness model of depression for medical inpatients and suggest specific psychological interventions for treating this population. Such treatment would attenuate the adverse effects of inpatient medical depression and thereby enhance the desired benefits of medical hospitalization. It is suggested that future research examine the effectiveness of coping in a prospective design to clarify the direction of the coping and depression relationship.

Adaptation, Psychological↗
PubMed1987

Revising the Seriousness of Illness Rating Scale: modernization and re-standardization.

The burgeoning research in psychosomatic medicine requires quantitative measures reflecting important biological, psychological, and social variables. The Seriousness of Illness Rating Scale (SIRS), although twenty years old, is currently utilized in psychosomatic research as an index of illness seriousness. In light of medical advances during the past two decades, an expansion and re-standardization of the SIRS appeared warranted. Forty-six medical students, residents, and faculty rated the seriousness of 137 disease items. High inter-rater reliability was demonstrated by a concordance coefficient of 0.716 and overwhelming agreement on relative disease item rankings between the three medical groups. Thus, the Seriousness of Illness Rating Scale-Revised (SIRS-R) is an ordinal level scale which reliably measures current views on illness seriousness and can be easily employed in multivariate psychosomatic research.

Adult↗