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Biomedical subjects

A J Rosenberg

Publications and source records attributed to A J Rosenberg.

At least 19 recordsLinked to original sources
PubMed1999

Treatment of central giant cell granuloma of the jaw with calcitonin.

Giant cell granuloma of the jaw is a benign lesion that may cause local destruction of bone and displacement of teeth. The common therapy is curettage or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. An alternative treatment has recently been introduced, in which patients receive a daily dose of calcitonin. Four patients who have been treated with calcitonin in various concentrations for at least 1 year are reported. In all patients, complete remission of the giant cell granuloma was observed, without signs of recurrence. The working mechanism of calcitonin is discussed, as are length of treatment and optimal dose.

Adolescent↗
PubMed1998

Prospective comparison of rapid urease tests (PyloriTek, CLO test) for the diagnosis of Helicobacter pylori infection in symptomatic children: a pediatric multicenter study.

OBJECTIVE: Rapid urease tests are reliable methods to diagnose Helicobacter pylori (HP) infection in the endoscopy suite. The PyloriTek test kit is a new rapid urease test that has the advantage of a 1-h final reading. The aim of this study was to compare the accuracy of PyloriTek and the test in the diagnosis of H. pylori infection in children. METHODS: Children from four different pediatric gastroenterology centers were recruited prospectively into the study. These children were >5 yr old and had an upper endoscopy procedure. Antral biopsies were examined for both rapid urease tests in the endoscopy suite, and others were sent for routine histological examination. RESULTS: A total of 242 children were recruited into the study over approximately 1 yr. The concordance between PyloriTek and CLO test was 98% (238 of 242). Twenty-five children were positive for HP organisms by PyloriTek and CLO test, whereas four children were positive by PyloriTek but negative by CLO test. PyloriTek was comparable to CLO test for the diagnosis of HP organisms and HP-associated gastritis. Moreover, in 48% of the positive results, PyloriTek gave significantly faster results than CLO test. CONCLUSIONS: We conclude that PyloriTek is an appropriate rapid urease test to use in children and may have an advantage over the CLO test because of its shorter reading time.

Biopsy↗
PubMed1997

[Calcitonin therapy in large or recurrent central giant cell granulomas of the lower jaw].

In three patients, boys aged 4 and 3 years and a woman aged 18 years, central giant cell granuloma of the mandible was diagnosed. As an alternative to mutilating surgery all three patients were treated with calcitonin, the second one when he was 16 years old and after the tumour had recurred 5 times following extirpation. After an average therapy of 14 months, no recurrences were encountered. Mean follow-up was 8 months. In local biopsies mature bone tissue was seen during the first 3 months of therapy, slight changes of the levels of procollagen peptide type 1, parathormone and hydroxyproline in 24-hour urine were noticed, all within the normal limits. During and after termination of therapy serum calcium, phosphate and parathormone stayed within the normal range. Side effects consisted of flushes, nausea and vomiting. Calcitonin is still an experimental therapy for central giant cell granuloma, but may be a good alternative to mutilating surgery in case of large or multiple recurring tumours.

Adolescent↗
PubMed1985

Cobalamin malabsorption in three siblings due to an abnormal intrinsic factor that is markedly susceptible to acid and proteolysis.

Three siblings presented in their second year of life with megaloblastic anemia that responded to parenteral cobalamin (Cbl). Schilling tests were less than 1%, correcting to 5 to 15% after addition of hog intrinsic factor (IF). Gastric acid analysis and gastric biopsies were normal by light and electron microscopy. Gastric juice contained less than 3 pmol/ml of Cbl-binding ability due to IF (normal, 10-34 pmol/ml) and less than 2 pmol/ml of IF when measured with a radioimmunoassay (RIA) using normal human IF-[57Co]Cbl and rabbit anti-human IF serum (normal, 17-66 pmol/ml). However, RIA employing rabbit anti-hog IF serum gave values of 4-13 pmol/ml of IF (normal, 11-33 pmol/ml). This material had an apparent molecular weight of 40,000 (normal IF = 70,000). The IF from gastric biopsies appeared normal in terms of Cbl-binding ability, ileal binding, molecular weight, and both RIAs. This IF differed from normal mucosal IF, in that it lost its Cbl-binding ability when incubated at 37 degrees C at acid pH or in the presence of pepsin or trypsin. This loss was retarded when [57Co]Cbl was bound to the IF before these incubations. The stabilizing effects of neutralization and Cbl were also demonstrated in vivo. Schilling tests for the siblings of 0.4, 0.5, and 1.0% increased to 2.7, 5.7, and 4.3% (P less than 0.05), respectively, when the Schilling tests were repeated with the addition of NaHCO3 and cobinamide (which allows Cbl to bind immediately to IF). We conclude that Cbl malabsorption in these children is due to an abnormal IF that is markedly susceptible to acid and proteolytic enzymes which cause a decrease in its molecular weight and Cbl-binding ability and a loss of antigenic determinants that are recognized by the anti-human IF serum.

Anemia, Megaloblastic↗
PubMed1983

A new simplified technique for pediatric anorectal manometry.

Using a new simple technique that is well tolerated and rapid for assessing anal sphincter functions in pediatric patients with fecal incontinence and constipation, 86 patients with varying degrees of anorectal dysfunction were tested. A microtip pressure transducer was used for recording anal sphincter responses to rectal balloon distension. Results were obtained within 15 to 30 minutes. In 17 patients, the internal anal sphincter showed no response or positive spike to balloon distension, consistent with the manometric diagnosis of aganglionic megacolon. These findings were confirmed by absence of ganglion cells on rectal biopsy. Sixty-nine children had normal internal sphincter relaxation to rectal distension. Ganglion cells were present in nine biopsy specimens. In the remaining 60 patients, no further workup of aganglionosis was necessary. There were no false-positive or false-negative results. This technique has proved to be effective for initial evaluation of infants and children with constipation and encopresis.

Adolescent↗
PubMed1982

Anorectal manometry: a new simplified technique.

Several noninvasive techniques using anal balloons or catheter systems to measure anal sphincter function associated with rectal balloon distention have been used in differentiating functional constipation from aganglionic megacolon. We have developed a simplified method for anorectal manometry that uses a microtip pressure transducer to record anal sphincter responses. Seventy-three patients (51 children and 22 adults) with constipation have been studied with this technique. Normal responses of internal anal sphincter relaxation to rectal distentions were obtained in 60 patients (40 children and 20 adults), consistent with the diagnosis of functional constipation. Abnormal responses-no internal anal sphincter relaxation-were recorded in 13 patients (11 children and two adults), consistent with the diagnosis of Hirschsprung's disease. The manometric diagnosis was confirmed in all 21 patients biopsied. There were no false-positive or false-negative results. The technique is a simple, well tolerated, and rapid method for assessing anal sphincter function.

Adolescent↗