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Biomedical subjects

A Goldsmith

Publications and source records attributed to A Goldsmith.

At least 19 recordsLinked to original sources
PubMed1998

Pediatric temporal bone fractures.

OBJECTIVE: To examine the etiology, presentation, and management of temporal bone fractures in children. STUDY DESIGN: Case control. METHOD: Retrospective review of a level I pediatric trauma center from July 1, 1990 to November 1, 1996 identified 680 patients. Inclusion criteria of age less than 14 years and only blunt temporal bone trauma identified 122 patients, with 97 charts available for review. The criteria for temporal bone fracture consisted of both clinical and radiologic information. Only patients with temporal bone fractures confirmed by computed tomography, a complete otolaryngology examination, and audiometric evaluations were included in the study. The data were analyzed with the Kruskal-Wallis analysis of variance (ANOVA) for examining the three separate age groups of fractures. Chi-squared analysis was used to compare these data with previously published adult and pediatric temporal bone fracture series and to examine the three separate age groups of fractures. RESULTS: The review identified 72 children with 79 temporal bone fractures: 47 boys and 25 girls. The patients ranged from 6 months to 14 years of age, with a bimodal distribution of patients with peaks at 3 years and 12 years of age. The most common causes of fractures were motor vehicle accidents (47%), falls (40%), biking accidents (8%), and blows to the head (7%). Common presenting signs and symptoms included hearing loss (82%), hemotympanum (81%), loss of consciousness (63%), intracranial injuries (58%), bloody otorrhea (58%), extremity fractures (8%), and facial nerve weakness (3%). The most common causes of temporal bone fractures were falls and motor vehicle accidents. Forty-two patients were noted to have bloody otorrhea and possible cerebrospinal fluid leak. Twenty-four received intravenous antibiotics. No patient developed prolonged otorrhea or meningitis during hospitalization and the follow-up period. The classification of fracture patterns was longitudinal, 54%; transverse, 6%; oblique, 10%; squamous, 27%; and other, 3%. Hearing loss was found in 59 patients, with conductive hearing loss being the most common finding in 56% of the patients, followed by sensorineural hearing loss in 17% and mixed hearing loss in 10%. CONCLUSIONS: Pediatric temporal bone fractures are associated with falls and motor vehicle accidents. There is a high incidence of associated intracranial injuries and hearing loss, but facial nerve injuries are uncommon. Timely management minimizes complications.

Accidental Falls↗
PubMed1997

Natural and photoperiodically induced changes in plasma prolactin levels in male great tits.

Plasma levels of prolactin showed a pronounced annual cycle in free-living male great tits (Parus major). During the period from August to April, levels were very low. Prolactin levels started to increase in mid-April, and maximal levels were reached in June. By mid-July prolactin levels had decreased to near basal levels. The exact breeding stage was known for all males captured during the breeding period, and prolactin levels increased continuously from the period of territorial defense to the nestling period. Males were exposed to different light regimes at three different times of the year (late August, late November, and early March). Males exposed to 14L:10D (14 h light:10 h darkness) and 20L:4D showed pronounced prolactin cycles at all times of the year, but the patterns differed markedly with the season. In November the 20L:4D and the 14L:10D prolactin patterns differed markedly from each other. In the 20L:4D group prolactin levels started to increase before testes had reached maximal size, whereas in the 14L:10D group prolactin levels did not start to increase until testes were almost completely regressed. In early March the prolactin pattern of change over time was the same for great tits kept on 20L:4D and 14L:10D. In both cases prolactin levels increased during the testicular growth period, and prolactin levels were maximal during the period of spermatogenesis. Prolactin levels did not change over time in males kept on 8L:16D in August and November. Males exposed to short days in early March showed a significant increase in prolactin levels about 3 weeks after the onset of the experiment. Plasma levels of prolactin in males castrated in late November and exposed to a 20L:4D light regime did not differ from those in intact males. In castrated males given a testosterone implant prolactin levels immediately increased to significantly higher levels than those observed in intact or castrated males. Prolactin levels remained significantly higher in the testosterone implanted males for about a month. In one group of castrated birds the testosterone implant was removed 13 days after the onset of the experiment. This removal resulted in a significant decrease in circulating levels of prolactin.

Animals↗
PubMed1996

Cell-cell interactions influence oligosaccharide modifications on mucins and other large glycoproteins.

Intratumoral phenotypic diversity is well documented with regard to tumor associated carbohydrate antigens (TACA). The factors which control the expression of these cell-surface oligosaccharides on different cells of the same tumor are not understood. We investigated the expression of a panel of mucin associated oligosaccharides in cell lines growing at different surface densities (number of cells per cm2 of growth flask). Results show that the apparent expression of extended Lea-Lex, Lea and Lex, sialyl Lea, Tn and sialyl Tn varies with density of growth by an invasive human squamous cell lung carcinoma cell line (NU6-1), a benign variant (NE-18) and the human lung epithelial cell line BEAS-2B. The results indicate that one of the factors influencing the apparent expression of mucin-associated oligosaccharides is cell-cell interactions.

Antibodies, Monoclonal↗
PubMed1995

Scratch and sniff. The dynamic duo.

Are odors diagnostic? In this age of polymerase chain reactions, in situ hybridization, and immunohistochemical staining, is there any room left for the nose in diagnosing disease? Long ago, and perhaps far away, smell was crucial to describing an illness. Infectious diseases were known by their characteristics odors--scrofula as smelling like stale beer; typhoid, like freshly baked brown bread; rubella, like plucked feathers; and diphtheria, as "sweetish." Anosmics might be banned from medical school. Perhaps we have left the descriptions behind along with these illnesses we rarely encounter today. After all, how many young physicians, residents, or medical students have ever seen a case of diphtheria or even rubella, and how many fewer have ever plucked a chicken? We have learned that pellagra (that "must appear" diagnosis in our differential by rote, but not by example, for photosensitive dermatoses) should smell like sour bread and that the exotic favus should smell "mousy" (Table 1). What does Candida smell like--a "heavy sweetness"? Darier's disease in poor control--"organic"? Pseudomonal infections--"foul and biting"? And are not our patients with noninfected eczematous dermatitis distinct for lacking any peculiar odor, do they not actually smell "dry"? We cannot blame the abandonment of our olfactory skills on the younger generation, for how many of us could describe those odors we smell every day? Would we be able to detect a subtle change in the odor of our patient with psoriasis, a change perhaps signifying superinfection?

Animals↗
PubMed1990

Regulation of chloride transport in parotid secretory granules by membrane fluidity.

Zymogen granule membranes contain Cl- conductance and Cl/anion exchange activities that become important for primary fluid production after fusion with the apical plasma membrane of the acinar cell. We have used steady-state fluorescence anisotropy of diphenylhexatriene derivatives and measurements of Cl- transport in isolated secretory granules to determine the contribution of membrane fluidity to the regulation of transport across the granule membrane. Secretory granules from several unstimulated glands (rat pancreas and parotid, rabbit gastric glands) were shown to have low membrane fluidity compared to plasma membranes. In addition, Cl- transport activity in different granule preparations showed a strong correlation to the membrane fluidity when measured with 1-[4-(trimethylammonio)phenyl]-6-phenyl-1,3,5-hexatriene p-toluenesulfonate (TMA-DPH), but not with 3-[p-(6-phenyl)-1,3,5-hexatrienyl)-phenyl]propionic acid (PA-DPH). These data suggest that TMA-DPH preferentially partitions into a specific lipid environment associated with, or which exerts an influence on, the Cl- transport proteins and that increases in the fluidity of this environment are associated with higher transport rates. Data from other types of plasma membranes indicate that TMA-DPH partitions much more than PA-DPH into the cytoplasmic leaflet, suggesting that this part of the granule membrane is involved in the observed fluidity changes. Furthermore, increasing the bulk membrane fluidity with the local anesthetics benzyl alcohol and n-alkanols increased the Cl- transport rates up to 10-fold. This increase was apparently through specific transporters as anion selectivity was maintained in spite of the higher absolute rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohols↗
PubMed1989

A comparative evaluation of the safety and contraceptive effectiveness of 65 mg and 100 mg of 90-day norethindrone (NET) injectable microspheres: a multicenter study.

The first of a second generation of slow-release injectable contraceptives is the norethindrone (NET) microspheres with a 90-day duration of action. It was evaluated at 65-mg and 100-mg doses for safety and contraceptive effectiveness in two randomized, single-blind trials among 131 women: 94 women for 12 months and 37 women for 6 months. The 6-month trial included additional evaluations of ovarian function and serum NET values. In the 6-month trial, no indication of ovulation was detected in the 100-mg dose group, while 3 of the 19 women in the 65-mg group showed signs of ovulation (progesterone greater than 3 ng/ml). No pregnancies were reported in the 100-mg group and one pregnancy in the 65-mg group resulted in a life-table pregnancy rate for that dose of 2.6 per 100 woman-years (95% confidence interval, 0 to 7.5). Days of vaginal bleeding were analyzed for 30 days before treatment and in 90-day reference periods after treatment. The mean number of vaginal bleeding and spotting days increased initially after the first injection in both dose groups, but decreased to below baseline in both dose groups after 6 months. The two doses appear comparable in clinical safety, side effects, vaginal bleeding patterns, and laboratory measures. With the preliminary estimate of efficacy, the 65-mg dose would be the minimally effective dose for the NET 90-day injectable contraceptive.

Adult↗
PubMed1987

Intrauterine administration of methyl cyanoacrylate as an outpatient method of permanent female sterilization.

Results are presented of multicenter studies on the intrauterine delivery of 0.6 ml methyl cyanoacrylate with the FEMCEPT device (BioNexus Inc., Raleigh, North Carolina) for the purpose of causing permanent obstruction of the fallopian tubes. The studies included 1279 women and were conducted under several different protocols that required either one or two methyl cyanoacrylate application procedures. Based on hysterosalpingograms obtained about 16 weeks after the last methyl cyanoacrylate application, one procedure resulted in a tubal closure rate of 71.4% and two procedures resulted in a tubal closure rate of 89.4%. Complications of the procedure were infrequent and none required surgical treatment. Cumulative pregnancy rates among women with hysterosalpingogram-demonstrated bilateral tubal closure were similar for the one- and two-application procedures that used nonradiopaque methyl cyanoacrylate and were significantly lower (p less than 0.05) compared with a single application of radiopaque methyl cyanoacrylate. The 3-year pregnancy rate for two applications of nonradiopaque methyl cyanoacrylate was 1.7 +/- 1.2 per 100 women.

Ambulatory Care↗
PubMed1986

Seasonal changes in prolactin and luteinizing hormone in the polyandrous spotted sandpiper, Actitis macularia.

The polyandrous spotted sandpiper (Actitis macularia) is a species characterized by female dominance over males and predominant male parental care. Prolactin (Prl) and luteinizing hormone (LH) were analyzed in plasma samples obtained serially from individuals across different stages of the breeding season. The reproductive status of each sampled individual was known in detail. Similar Prl values were obtained independently by two different assays. Males tended to have higher plasma Prl levels than females throughout the breeding season. Prl was significantly elevated in both sexes by the first few days of incubation. This rapid rise in Prl may indicate its role in brood patch development and the onset of incubation behavior. In males Prl continued to rise during incubation, whereas it remained constant in females. Higher levels of Prl in males than females, especially late in incubation, reflects the greater contribution of males to incubation. LH declined markedly in males and females from prelaying to early incubation. There was a significant negative correlation between Prl and LH among males, especially from the prelaying to early incubation phases of the season. There was no such correlation among females.

Animals↗
PubMed1986

The endocrine control of reproduction and molt in male and female emperor (Aptenodytes forsteri) and adelie (Pygoscelis adeliae) penguins. I. Annual changes in plasma levels of gonadal steroids and LH.

Changes in plasma LH, testosterone, and estrogens were investigated throughout reproduction and molt in free-living male and female emperor (Aptenodytes forsteri) and adelie (Pygoscelis adeliae) penguins. In both sexes and species, plasma LH and gonadal steroids were severalfold above basal level at the time of arrival on the breeding grounds, suggesting that environmental cues (especially decreasing daylength in emperors) rather than mating and courting primarily stimulate gonadal development and reproduction. In both species a marked increase in plasma LH (both sexes), testosterone (males), and estrogens (females) corresponded with the time of maximum gonadal size, and peak values were obtained at the time of copulation, i.e., in emperors about 10-15 days prior to egg laying. In females, plasma LH and estrogens dropped to low levels between copulation and egg laying. Similarly, following copulation in males plasma testosterone fell to lower levels that in emperors were maintained during incubation and brooding of the non-thermally emancipated chick. Plasma LH levels followed the same trend as testosterone, falling after copulation and falling further prior to molt. Though lower than at copulation, plasma LH was higher in incubating (males) and brooding (males and females) emperors than during rearing of the thermally emancipated chicks, suggesting that plasma LH might be related to incubating, brooding, and territorial behavior. In male and female emperors and in male adelies, plasma gonadal steroids and LH were at basal levels throughout molt.

Animals↗
PubMed1985

Transcutaneous procedures for male sterilization.

Outside the People's Republic of China transcutaneous methods of male sterilization are not widely used, even though there are advantages of these methods over surgical vasectomy procedures. Methods of transcutaneous sterilization (intratesticular, intraepididymal, and intravasal) that have been evaluated in men are reviewed.

Animals↗
PubMed1984

Lack of tubal occlusion by intrauterine quinacrine and tetracycline in the primate.

The effects of slow- and fast-releasing quinacrine pellets and tetracycline tablets on the genital tracts of 20 cynomolgus monkeys was evaluated. After surgical implantation of the pellets, the primates were observed for three months. No signs of toxic effects to the drugs were observed during the three-month period and on autopsy. Histopathological evaluation of the fallopian tubes, cervix, ovaries and uterus (except the endometrium) indicated they were all within normal limits. In no case were the uterotubal junctions obstructed. Endometrial changes were more frequent for quinacrine-treated monkeys. The results of the study point to the need for additional research regarding the optimal dose and duration of quinacrine administration.

Animals↗
PubMed1984

The effects of modifying incubation on prolactin secretion in free-living pied flycatchers.

Plasma prolactin concentrations in female pied flycatchers are high during incubation, but fall from 156 +/- 27 to 67 +/- 6 ng/ml (P less than 0.01) between 2 and 4 days after the young hatch. The timing of the fall in prolactin could be determined by factors associated with the hatching of the eggs and growth of the offspring; alternatively, prolactin may remain high for a fixed period (16 days) after the onset of incubation. To distinguish between these possibilities, eggs were exchanged between nest boxes to ensure incubation periods of either 10, 14, or 19 days by different females. The results showed that the period of high prolactin secretion was shortened by 2-4 days where the eggs hatched early, but, conversely, was not lengthened in those females with extended incubation periods, the levels actually falling in these birds before the eggs hatched. There was, however, a secondary rise in prolactin 3 days after hatching, when the level of 114 +/- 11 ng/ml 22 days after the onset of incubation was much higher than that (30 +/- 4 ng/ml) at a comparable stage in the control females. Thus, high prolactin secretion cannot be maintained for longer than 16-17 days in incubating birds, but newly hatched, naked young can stimulate prolactin release in female flycatchers over a flexible period.

Animals↗
PubMed1981

Postpartum contraception.

Recently-delivered women who wish to avoid pregnancy should initiate contraception before ovulation. Since the return of ovulation is not predictable, regardless of the woman's lactation status and duration of postpartum amenorrhea, contraception should be initiated as soon as is reasonable after delivery. The choice of contraceptive method will depend on several factors, including: the woman's lactation status, the preference of the woman and her partner, and the health status of the newborns. For women who do not wish to have additional children, tubal sterilization through a minilaparotomy incision is the procedure of choice. For other women who are not lactating, all methods, with the exception of the use of cervical caps and diaphragms, may be initiated immediately after delivery. However, preference should be given to IUD use by lactating and non-lactating woman, especially for women who may not return for any additional postpartum care.

Contraception↗