Biomedical subjects
Publications and source records attributed to S Silberman.
A case of signet ring cell lymphoma, a rare variant of follicular center cell lymphoma, is presented with a review of 20 other such lymphomas previously reported in the English literature. The histologic, immunocytologic, and electron microscopic features are described with speculation as to the possible relationship of this lymphoma to other B-lymphocyte-derived neoplasms.
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A case of sinus histiocytosis with massive lymphadenopathy (SHML) is reported, in which the patient had severe life-threatening complications resulting from SHML. The disease process was extensive involving the respiratory tract, skeleton, integument, orbit and eyelid, uveal tract, and the lymphatic system. Treatment with cytotoxic agents (chlorambucil, prednisone) resulted in resolution of the airway obstruction and was effective in managing these severe complications with minimal observed toxicity.
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Delayed hypersensitivity was induced in rats by means of sheep erythrocytes and bovine serum albumin-lipid conjugate. Administration of heparin to rats sensitized to either antigen resulted in diminution of the delayed hypersensitivity reaction. Administration of ancrod, however, failed to inhibit the delayed cellular reaction to either antigen. Granuloma formation remained unaffected when rats were injected with either heparin or ancrod. The lack of ancrod effect, in contrast to heparin effect, on delayed hypersensitivity is discussed.
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The effect of butyric acid (BA) and all trans-retinoic acid (RA) on murine melanoma cells was investigated in vitro and in vivo. The in vitro assays included 3H-IdUR incorporation, adhesion, migration and invasion experiments. Butyric acid decreased 3H-IdUR cellular incorporation within 24 h and increased adhesion as measured by trypsin release of 3H-IdUR labelled cells from either polycarbonate (p.c.) or Matrigel-coated p.c. membranes. Migration and invasion rates after 72 h were quantified by scanning electron microscopy (SEM). The invasion barrier consisted of Matrigel-coated p.c. membranes. Butyric acid significantly enhanced migration and invasion of B16a cells, while RA significantly decreased migration and invasion of B16a and K-1735 cells. Subcutaneous administration of either BA or RA pellets significantly decreased the number of lung nodules in the experimental metastatic assay. The experimental metastatic assay is defined as a tail vein inoculation protocol followed by subsequent lung evaluation.
In order to determine if inspiratory time in preterm infants was influenced by lung volume, two studies were carried out. In the first investigation, carbon dioxide was used to stimulate tidal volume to a level three to six times normal. The anticipated decrease in inspiratory time at increased tidal volumes was not found. These preterm infants behaved in a similar fashion to vagotomized animals studied in the same way by Clark and von Euler. In the second investigation, Hering-Breuer activity was measured in relation to lung volume changes occurring with growth, measured in a body plethysmograph. Although thoracic gas volume correlated well with age and weight, inspiratory slowing with airway occlusion was found to be independent of both age and lung volume. These investigations suggest that neurologic factors have a significant influence on the inspiratory time in newborn human infants.
BACKGROUND: While aortic valve prostheses are known to perform well at rest, few studies have examined them under stress. We compared stress hemodynamics of mechanical valves and nonstented porcine valves in the aortic position to that of normal native aortic valves. METHODS: Dobutamine echocardiography was used to assess mean and peak gradients and effective orifice area index (EOAI) at rest and exercise in patients with the Toronto Stentless Porcine Valve (SPV) (n = 13, mean implant size 25.7 mm), Sorin Bicarbon mechanical valve (SOR) (n = 11, mean implant size 24.5 mm), and patients with normal native aortic valves (NOR) (n = 10). Dobutamine infusion was started at 5 micron/kg per minute, and increased by increments of 5 micron/kg per minute until the target heart rate was achieved or until a maximal dose of 40 micron/kg per minute. RESULTS: At rest and exercise, respectively, cardiac output (L/min) was 5.2 and 10.4 for Toronto SPV; 7.4 and 13.5 for SOR; and 4.6 and 11.2 for NOR. Measured EOAI (cm2) was 1.1+/-0.2 and 1.15+/-0.2 for TORONTO SPV; 1.60+/-0.3 and 1.58+/-0.3 for SOR; and 1.45+/-0.2 and 1.46+/-0.2 for NOR. Mean gradients (mmHg) were 5.48+/-1.1 and 5.83+/-0.9 for TORONTO SPV; 5.26+/-0.8 and 11.3+/-1.8 for SOR; and 1.54+/-0.4 and 2.18+/-0.7 for NOR. Peak gradients (mmHg) were 11.9+/-2.0 and 21.0+/-3.7 for TORONTO SPV; 10.79+/-1.7 and 25.9+/-3.4 for SOR; and 2.38+/-0.9 and 6.1+/-2.3 for NOR. CONCLUSIONS: Although the mechanical group (SOR) had larger measured EOAI, the greater increase in gradients with exercise in this group suggests that the TORONTO SPV is less obstructive to flow.
BACKGROUND: Patients with ischemic mitral valve insufficiency (MR) and poor left ventricular (LV) function present a high operative risk. Whether to repair or replace these valves is controversial, while some suggest that heart transplant offers a better solution. We investigated our early and late results in this difficult subset of patients. METHODS: Between 1993-1999,115 patients underwent mitral valve repair (MVR) in our department. Twenty-one patients had severe LV dysfunction with ejection fraction < 25%. Mean age was 60 years (range 45-81). Nineteen (90%) were in New York Heart Association (NYHA) Class IV, 7 (33%) underwent emergency surgery, 3 (14%) were in cardiogenic shock, and 2 (10%) were taken to the operating room under cardiopulmonary resuscitation. All underwent coronary artery bypass grafting (CABG) in addition to MVR, with a mean number of grafts 2.9 per patient. RESULTS: There were no early operative deaths. The average stay in intensive care was 5.9 days (range 1-52). There were three late deaths (14%). Follow-up evaluation up to 3 years showed marked improvement in clinical status. Twelve (67%) patients are in NYHA Class I-II, and three (17%) in Class III. Echocardiography revealed good function of the mitral valve in all, although overall LV function did not change significantly. CONCLUSION: (1) MVR in patients with severe ischemic cardiomyopathy can be accomplished with excellent results. (2) There is marked symptomatic improvement in these patients, even though LV function did not seem to be improved. (3) Long-term survival still needs to be defined.