PubMed Health⌕ Search

Biomedical subjects

A S Goldenberg

Publications and source records attributed to A S Goldenberg.

At least 19 recordsLinked to original sources
PubMed2002

Transplantation for hepatocellular carcinoma and cirrhosis: sensitivity of magnetic resonance imaging.

The sensitivity of magnetic resonance imaging (MRI) in patients who undergo transplantation for hepatocellular carcinoma (HCC) and cirrhosis is not known. We prospectively evaluated 24 patients with known HCC who underwent MRI and subsequent transplantation within 60 days (mean, 20 days). Using a phased-array coil at 1.5T, breath-hold turbo STIR and T2-weighted MR images were performed. Dynamic gadolinium-enhanced MRI was performed using a two- or three-dimensional gradient echo pulse sequence with images obtained in the hepatic arterial, portal venous, and equilibrium phases. The prospective interpretation of the MR study was directly compared with thin-section pathology evaluation of the explanted livers. All 24 patients had at least one HCC, and MR diagnosed tumor in 21 (88%) of these patients. On a lesion-by-lesion basis, MRI depicted 39 of 118 HCC for an overall sensitivity of 33%. MRI detected five (100%) of five lesions >5 cm, 20 (100%) of 20 lesions >2 cm but not exceeding 5 cm, 11 (52%) of 21 lesions between 1 and 2 cm, and three (4%) of 72 lesions <1 cm. Of the nine patients with carcinomatosis (innumerable lesions less than 1 cm), MR detected three lesions in one patient. Of the 15 dysplastic nodules found at pathology, MRI depicted a single 1.8-cm high-grade lesion, for a sensitivity of 7%. In conclusion, MRI is sensitive for the detection of HCC measuring at least 2 cm in diameter but is insensitive for the diagnosis of small HCC (<2 cm) and carcinomatosis.

Adult↗
PubMed2001

Clinical experience with a new specimen capturing bone marrow biopsy needle.

The SNARECOIL needle is a specimen capturing bone marrow biopsy needle that incorporates a tiny internal capturing coil. It was developed to minimize postinsertion needle manipulation and to facilitate specimen recovery. Forty-four patients underwent 50 bone marrow biopsy procedures with the SNARECOIL needle for a variety of hematologic indications. Second and third procedures were done for follow-up or staging. Each procedure retrieved a specimen with an average length of 2.1 cm. Fifty-two percent of the specimens were > or =2.0 cm in length. The majority of specimens demonstrated intact marrow architecture enabling a pathologic diagnosis in every case. Delicate cores of nontrabeculated marrow were recovered in three cases. The SNARECOIL bone marrow biopsy needle reliably retrieves intact bone marrow core specimens for pathologic interpretation.

Biopsy, Needle↗
PubMed2000

MEIS1 and HOXA7 genes in human acute myeloid leukemia.

Co-activation of Meisl with Hoxa7 or Hoxa9 homeobox genes by retroviral gene insertion has recently been reported to be leukemogenic in murine myeloid leukemia. In this study we determined their expression in human leukemia. Most human myeloid leukemia cell lines co-expressed MEIS1 with HOXA7 and HOXA9. Among patients with acute leukemia, 50% of AML patients expressed MEIS1, while the majority of ALL patients were negative. A total of 89.5% of patients expressing MEIS1 co-expressed HOXA7. In unadjusted models, poorer response to chemotherapy was associated with expression of HOXA7 regardless of MEIS1 status and older patients were more likely to express either gene.

Cell Line↗
PubMed1997

The dental referral process. New insights.

Doctor-patient, doctor-doctor dental relationships are discussed. The dental referral process is a triad of patient, general practitioner and specialist and, in many ways, is dependent upon Freud's concept of transference-countertransference. The unconscious distortions of this process may affect the patient's treatment, as well as interpersonal and intraprofessional relationships.

Attitude↗
PubMed1996

Central venous catheter placement in patients with disorders of hemostasis.

OBJECTIVE: To define the incidence of bleeding complications from central venous access procedures performed by a critical care service in patients with disorders of hemostasis. DESIGN: Prospective, consecutive sample, collection of clinical data. SETTING: University teaching hospital. PATIENTS: Seventy-six consecutive patients with disorders of hemostasis who required central venous access for clinical management between October 1992 and October 1993. MEASUREMENTS: Age, sex, clinical diagnosis, most recent platelet count, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were recorded from the medical record of patients with known coagulation or platelet abnormalities. The site of central venous catheter placement, the number of needle passes necessary to complete the procedure, and the occurrence of complications were reported by the critical care attending physician performing or supervising the procedure. RESULTS: One hundred four central venous access procedures were performed on 76 patients with disorders of hemostasis. Seventy-three percent of catheters were placed in patients with platelet counts less than 100,000/mL and 40% of catheters were placed in patients with abnormalities of PT, aPTT, or both. Thirteen percent of patients had abnormalities of both platelets and coagulation profile. There were no serious complications. Bleeding complicated 7 (6.5% of the procedures; 5 patients had bleeding from the skin (from the suture sites in four), and 2 patients developed small periosteal hematomas. All patients with bleeding complications had thrombocytopenia with mean platelet counts of 22,000/mL and a range of 6,000 to 37,000/mL. Most patients with platelet counts in this range did not have clinically evident bleeding. CONCLUSIONS: Central venous access procedures can be done safely in patients with disorders of hemostasis by skilled physicians who frequently perform these procedures. Patients most likely to experience bleeding from these procedures are patients with severe thrombocytopenia. In this series, only a single patient, with a platelet count of 6,000/mL, required therapeutic blood product administration.

Blood Coagulation Disorders↗
PubMed1993

Referral patterns of dentists: transference-countertransference.

The doctor-patient, doctor-doctor dental relationships are discussed from the viewpoint of transference-countertransference psychodynamics. The dental referral process is a triad of patient, general practitioner and specialist and, in many ways, is dependent upon Freud's concept of transference-countertransference. The unconscious distortions of this process may affect the patient's treatment as well as the interpersonal and intraprofessional relationships.

Countertransference↗
PubMed1992

B-cell lymphoma presenting as infiltrative renal disease.

Acute renal failure is rarely the presenting manifestation of non-Hodgkin's lymphoma. Of the reported cases of renal insufficiency secondary to diffuse renal infiltration with lymphoma, few have presented with acute renal failure. We present a patient with acute renal failure secondary to diffuse bilateral renal infiltration by a B-cell non-Hodgkin's lymphoma. The findings of an elevated serum lactate dehydrogenase (LDH), lymphopenia, and homogenous bilateral renal enlargement on computed tomographic (CT) imaging were important in suggesting the diagnosis of primary renal lymphoma. Renal biopsy with immunohistochemical and ultrastructural analysis was instrumental in confirming this diagnosis.

Acute Kidney Injury↗
PubMed1992

Referral patterns of dentists: analysis and implications of a questionnaire.

The interpersonal and psychodynamic aspects of the referral process, that is, the reciprocal relationship between the specialist and his referral source are investigated. A questionnaire designed by the author, with anonymity guaranteed, was given to the members of 2 dental societies. There were more similarities than differences in the answers of the respondents in both groups. Several conscious patterns of referral emerged or were evident. A number of unconscious, psychodynamic motivations were explored.

Attitude of Health Personnel↗
PubMed1990

Phase II study of CHIP chemotherapy in advanced adenocarcinomas of the upper gastrointestinal tract.

Iproplatin (CHIP) is a second generation cisplatin analogue which has completed its Phase I trials. We studied the efficacy and toxicity of CHIP in 36 previously untreated patients with advanced upper gastrointestinal tract adenocarcinomas (GE junction, cardia, antrum and body of the stomach). The starting dose was 275 mg/m2; course were repeated on an every four week schedule. Thirty-five patients were evaluable for response. Three partial remissions (8.5%) [95% confidence limits 2.5-15%] were seen. Toxicity was tolerable and included mild myelosuppression and mild nausea and vomiting. Although well tolerated, in patients with gastric and GE junction adenocarcinomas, CHIP chemotherapy was not more and probably slightly less, effective than the parent analogue cisplatin.

Adenocarcinoma↗
PubMed1990

Transient diplopia from a posterior alveolar injection.

Several anatomical vascular pathways have been proposed to explain oculomotor disturbances observed after injection of local dental anesthetics. The author suggests another possible pathway to account for the unusual clinical observations described in this report.

Adult↗
PubMed1990

Extrapulmonary Pneumocystis carinii infection in AIDS: CT findings.

Clinical and computed tomographic (CT) findings in three cases of extrapulmonary Pneumocystis carinii infection in patients with acquired immunodeficiency syndrome (AIDS) were reviewed. Proved sites of involvement included the spleen (n = 2), bone marrow (n = 1), liver (n = 1), and peritoneal and pleural fluid (n = 1). CT findings included focal low-attenuation splenic lesions that became progressively calcified in rimlike or punctate fashion; punctate calcifications in the liver, renal cortices, and adrenal glands; calcification of lymph nodes; and pleural and peritoneal effusions with subsequent calcifications of the pleural and peritoneal surfaces. Although rare both before and since the onset of the AIDS epidemic, extrapulmonary P carinii infection in AIDS patients has been reported with increasing frequency in recent years, and more cases with radiologic manifestations should be expected.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Expression of transforming growth factor alpha and epidermal growth factor receptor messenger RNA in neoplastic and nonneoplastic human kidney tissue.

Using Northern blot analysis, we have demonstrated that mRNA for transforming growth factor alpha (TGF-alpha) was expressed in five malignant kidney tissue specimens but was not detected in their autologous nonneoplastic homologues. In addition, the expression of epidermal growth factor (EGF) receptor mRNA in these malignant tissues was 2- to 3-fold greater than in nontransformed tissues. In two cases examined using immunohistochemistry, we were able to correlate the increased expression of the mRNA with an increase in protein expression. Since TGF-alpha is known to bind to the EGF receptor, the finding of an increased expression of both TGF-alpha and EGF receptor mRNA in kidney tumor tissue suggests that interaction between TGF-alpha and the EGF receptor may play a role in promoting transformation and/or proliferation of kidney neoplasms, perhaps by an autocrine mechanism.

Blotting, Northern↗