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Biomedical subjects

S Meyers

Publications and source records attributed to S Meyers.

At least 109 records · Page 6Linked to original sources
PubMed1981

Occurrence of Clostridium difficile toxin during the course of inflammatory bowel disease.

Clostridium difficile toxin, the presumed mechanism of antibiotic-associated pseudomembranous colitis, has been suggested as a contributory factor to mucosal injury in inflammatory bowel disease. We evaluated its incidence and apparent role in 65 consecutive patients with diarrheal and inflammatory bowel diseases. Toxin was demonstrated in 3 of 18 patients with ulcerative colitis (17%), 1 of 26 with Crohn's colitis (4%), and 5 of 21 with a variety of diarrheal illnesses (24%). Toxin appeared only in those who had been exposed to antimicrobials within 2 mo. In inflammatory bowel disease, presence of toxin was not correlated with disease severity. We conclude that Clostridium difficile toxin appears only in patients exposed to antimicrobials and is unlikely to be a significant contributory factor in inflammatory bowel disease.

Anti-Bacterial Agents↗
PubMed1980

Connective tissue activation. XVII. Radioimmunoassay of a human platelet derived connective tissue activating peptide (CTAP-III) and specificities of anti-CTAP-III sera.

The platelet-derived connective tissue activating peptide (CTAP-III) has been shown to be an important factor stimulating the metabolism and proliferation of human connective tissue cell strains, including synovial tissue cells. The quantities of CTAP-III affecting the cellular changes and the amounts of various biologic fluids and tissues are small. The objectives of this study were to develop a radioimmunoassay (RIA) for CTAP-III and to ascertain the specificities of the anti-CTAP-III sera reagents. The antisera were shown not to cross-react with a number of polypeptide hormones. However, two other platelet proteins, beta-thromboglobulin and low affinity platelet factor-4, competed equally as well as CTAP-III for anti-CTAP-III antibodies in the RIA system. Thus, the three platelet proteins are similar or identical with respect to those portions of the molecules constituting the reactive antigenic determinants. The levels of material in normal human platelet-free plasma that inhibited anti-CTAP-III--125I-CTAP-III complex formation were determined to be 34 +/- 13 (S.D.) ng/ml.

Animals↗
PubMed1980

Echocardiographic practice in a large metropolitan area.

A survey performed concerning echocardiography in a metropolitan area. Of 110 hospitals in the area, 62 reported having echocardiographic facilities. Echocardiographic physicians and/or technicians from 41 of these hospitals responded to questionnaires designed to determine the following: (1) educational background and credentials of technicians, (2) average salaries of technicians, (3) role of the physician and technician in the performance and reporting of echocardiograms, (4) volume, cost, and method of storage of echocardiograms, and (5) number and type of echocardiographic units in use. Our data suggest various trends, including a lack of formal training among technicians, the prevalence of cardiologists-internists as directors of echocardiographic facilities, the performance of echocardiograms by cardiology fellows in only 46% of institutions with cardiology training programs, and the widespread projected availability of cross-sectional echocardiographic capability within the next two years.

Allied Health Personnel↗
PubMed1979

Acquired cyanotic heart disease secondary to traumatic tricuspid regurgitation. Case report with a review of the literature.

A case of traumatic tricuspid insufficiency leading to right atrial enlargement and to a patent foramen ovale with right to left shunting is presented. Six similar cases previously reported are reviewed. The time course of clinical deterioration was related to the type of tricuspid valve damage incurred. Papillary muscle rupture led to surgery within a year, whereas less severe chordal damage allowed a more benign course that lasted from 10 to 25 years from the time of injury to the time of surgery. Surgical repair of the incompetent tricuspid valve and closure of the atrial septal defect led to significant improvement. The diagnostic usefulness of radionuclide imaging and echocardiography is demonstrated in this case. A mechanism of right to left interatrial shunting in the presence of normal pulmonary arterial pressures is proposed; this invokes phasic increases in right atrial pressure from tricuspid insufficiency and streaming of blood from the inferior vena cava into the left atrium across a patent foramen ovale in a manner that resembles conditions in the fetal circulation.

Adult↗
PubMed1979

Sex-linked retinitis pigmentosa: ultrastructure of photoreceptors and pigment epithelium.

An ultrastructural study of a postmortem donor eye from a 24-year-old male patient with sex-linked retinitis pigmentosa showed abnormalities in all remaining cones and rods. Central foveal cones were reduced in number by about 50% and had shortened and severely distorted outer segments. Cones from the parafovea through the midperiphery gradually decreased in density and had no organized outer segments. In the far periphery, cones and rods had only slightly shortened outer segments. Photoreceptors equidistant from the fovea in all quadrants showed similar changes. The virtual absence of organized cone outer segments from the parafovea through the midperiphery was conspicuous in that this patient had full visual fields with large test lights 3 weeks prior to death. The pigment epithelium contained abnormally large numbers of melanolysosomes and few free melanin granules from the fovea through the midperiphery and few melanolysosomes and many free melanin granules in the far periphery. Whether or not these observations in the pigment epithelial cells represent a primary defect in this disease or reflect changes secondary to a defect in the photoreceptor cells remains to be defined.

Adolescent↗
PubMed1978

Sterile corneal ulcers after cataract surgery in keratoconjunctivitis sicca.

Mild keratoconjunctivitis sicca can become dramatically worse after cataract extraction and result in corneal thinning and perforation. Anticipation of this problem can prevent it, but lack of recognition may result in permanent central scarring from ulceration, which responds slowly to treatment.

Bandages↗
PubMed1978

Significance of anergy to dinitrochlorobenzene (DNCB) in inflammatory bowel disease: family and postoperative studies.

To evaluate the pathogenetic significance of impaired cellular immunity in inflammatory bowel disease (IBD), we have measured the cutaneous responsiveness to dinitrochlorobenzene (DNCB) among 58 patients with IBD, 33 with Crohn's disease and 25 with ulcerative colitis, 63 of their clinically normal relatives, 24 additional ileitis and colitis patients who had undergone resection of all visibly diseased bowel, and 23 control subjects. Cutaneous anergy to DNCB was demonstrated among 70% of the patients with CD and 48% of those with UC, as against only 9% of the controls (p less than 0.001). There was no increased incidence of anergy among either 44 first-degree relatives (7%) or 19 spouses (3%), nor was there any special proclivity toward anergy among six pairs of patients with familial inflammatory bowel disease. In Crohn's disease, anergy was still present after bowel resection in six of 10 patients (60%), while in ulcerative colitis anergy was found after colectomy in only two of 14 patients (14%). Our data suggest that the immune defect in patients with inflammatory bowel disease may be a secondary phenomenon. In ulcerative colitis, the defect appears to reverse after colectomy, but in Crohn's disease it persists despite resection. This finding is consistent with the observed tendency of Crohn's disease, but not ulcerative colitis, to inexorable postoperative recurrence.

Colitis, Ulcerative↗
PubMed1978

Cardiovascular responses to upper gastrointestinal endoscopy.

Continuous Holter monitoring and serial blood pressure recordings were obtained during upper gastrointestinal endoscopy on 51 unselected patients, 18 with cardiovascular disease. Sedation with intravenous diazepam produced a small but significant fall (P is less than .001) in blood pressure, heart rate and rate-pressure product. During endoscopy, the blood pressure rose only to base line levels but the heart rate and rate-pressure product went significantly higher (P is less than .001). Nine subjects (fice with pre-existing cardiovascular disease, four normal) exhibited electrocardiographic changes, including supraventricular arrhythmias, ventricular ectopy and significant ST segment depression. None of the patients had bradycardia or significant vagal symptomatology. The difference in incidence of abnormalities between the normal patients (4/33) and those with cardiovascular disease (5/18) was not statistically significant (P = 0.3). Endoscopy can be safely performed even in patients with cardiovascular diseasebut attention to the reduction of cardiac stress would further increase its safety.

Adolescent↗
PubMed1977

Lenegre's disease in youth.

The case of a 22-year-old white male without known heart disease who presented with activity related lightheadedness at age 19 and dizziness and fatigue at age 21 is described. Standard electrocardiograms (ECG's) revealed intermittent complete trifascicular block. Rapid progression of symptoms over the succeeding eight months resulted in increasing incapacity. Holter monitoring demonstrated that symptoms were related to development of second and higher degrees of A-V block. Normal A-H interval and markedly prolonged H-Q interval on His bundle electrograms indicated that block was infranodal and localized to bundle branch system. Conduction problems aside, clinical and laboratory evaluation, including echocardiograms and cardiac catheterization, were unremarkable. Progression of bilateral bundle branch disease in a young patient without other demonstrable heart lesions and a negative family background conforms with criteria for Lenegre's disease. To our knowledge, this represents the youngest reported patient with this entity. Possible electrophysiologic basis of block and of exercise induced improvement in A-V conduction also are considered.

Adult↗
PubMed1977

Myocardial uptake of thallium-201 augmented with bicarbonate: concise communication.

Sodium bicarbonate was used to enhance the myocardial concentration of Tl-201 in rabbits and dogs. Organ distribution studies in rabbits and in vivo imaging in dogs showed a 1.5-2 fold increase in myocardial Tl-201 concentration in bicarbonate-treated animals as compared with matched controls. Image improvement was noted, with threefold enhancement of myocardium-to-liver ratios. The results suggest that a similar improvement may be possible for clinical myocardial imaging.

Animals↗
PubMed1977

Anemia and intestinal dysfunction in former residents of the Caribbean.

A group of subjects had common features of megaloblastic anemia due to vitamin B12 deficiency, normal or high serum folate, and evidence of intestinal malabsorption. They were all former residents of the Caribbean area now living in New York City. Despite similar symptoms and diagnostic studies, two subjects were found to have pernicious anemia and three to have tropical sprue. Achlorhydria, serum anti-intrinsic factor antibody, the severity of small intestinal abnormalities, and posttherapy Schilling tests were helpful differential factors. These subjects illustrate the problems that may be encountered in differentiating tropical sprue and pernicious anemia.

Adult↗
PubMed1977

The roentgenographic demonstration of a gastric mucosal laceration (Mallory-Weiss Lesion).

The Mallory-Weiss lesion is responsible for many cases of upper gastrointestinal hemorrhage. Rapid diagnosis should be obtainable by endoscopic procedures. During active bleeding, angiography is the radiologic procedure of choice. The upper gastrointestinal series has been considered of little diagnostic use. Our case emphasizes that it may add valuable information when particular attention and careful technic are paid to the esophagogastric area.

Endoscopy↗
PubMed1976

Anergy to dinitrochlorobenzene and depression of T-lymphocytes in Crohn's disease and ulcerative colitis.

Skin reactivity to dinitrochlorobenzene (DNCB) and levels of circulating T-lymphocytes were measured in 15 patients with ulcerative colitis, 15 patients with Crohn's disease, and 12 normal control subjects. Diminished reactivity to DNCB was demonstrated in 87% of patients with Crohn's disease (P less than 0-001) and in 53% with ulcerative colitis (P less than 0-02), as compared with only 8-5% of controls; anergy was more frequent in Crohn's disease than in ulcerative colitis (P less than 0-05). Levels of circulating T-lymphoctes were also depressed in both Crohn's disease and ulcerative colitis (P less than 0-001) as compared with controls, with the values lower in Crohn's disease than in ulcerative colitis (P less than 0-02). There were no correlations of DNCB response with extent, duration, or severity of disease nor with T-cell levels within any patient group. These data provide further support for the concept that there is impairment of cell-mediated immunity among many patients with chronic inflammatory bowel disease, including both Crohn's disease and ulcerative colitis.

Colitis, Ulcerative↗
PubMed1976

Reduction of gastric ammonia by ampicillin in normal and azotemic subjects.

Ampicillin was tested with regards to its capacity to reduce gastric ammonia production in basal and betazole-stimulated gastric secretion. A 7-day course of oral ampicillin (4 g per day) reduced basal gastric ammonia concentration from 5.5 +/- 1.4 to 1.8 +/- 0.3 mM and postbetazole ammonia from 4.7 +/- 0.9 to 1.3 +/- 0.3 mM (P less than 0.01) in 7 control subjects. Similar results were obtained after oral neomycin (4 g per day) or intramuscular ampicillin (4 g per day), each given to a separate group of 7 control subjects. In 5 azotemic patients, oral ampicillin treatment resulted in a reduction of ammonia concentration from 16.3 +/- 4.7 to 3.1 +/- 0.7 mM in basal secretion and from 18.3 +/- 8.1 to 2.3 +/- 0.6 mM in betazole-stimulated gastric juice (P less than 0.01). Antibiotic therapy did not alter volume of gastric secretion. Gastric acidity appeared lower in azotemic patients and increased significantly after treatment, indicating that the higher ammonia content could account for at least part of the hypoacidity. Because ampicillin is active orally as well as parenterally and can be readily used in renal failure, it may be of value for the treatment of hepatic encephalopathy, especially in the azotemic patient in whom neomycin is toxic.

Ammonia↗