PubMed Health⌕ Search

Biomedical subjects

H I Friedman

Publications and source records attributed to H I Friedman.

At least 37 records · Page 2Linked to original sources
PubMed1983

Use of technetium-labeled autologous red blood cells in detection of gastrointestinal bleeding.

Twenty patients with occult gastrointestinal bleeding underwent diagnostic evaluation with autologous TcRBC imaging, which identified a locus of bleeding in 19. Bleeding was demonstrated in the esophagogastroduodenal area in four patients, the cecum in four patients, the ascending colon or hepatic flexure in nine patients and the descending colon in two patients. In the six patients who underwent surgical intervention, the source of bleeding had been correctly located by imaging. The advantages of imaging over those of conventional arteriography included its minimally invasive nature and its ability to detect areas of intermittent minimal bleeding for a period of 30 hours. The major disadvantages of the technique were that localization of the site of bleeding was not as precise as that obtained with arteriography, imaging could not be used as a treatment modality and the nature of the lesion could not be defined. However, we believe that, as an adjunct to conventional angiography and other techniques, autologous TcRBC imaging will improve the localization of obscure foci of gastrointestinal bleeding. Studies are underway to determine the proper place of TcRBC imaging in the gastroenterologic armamentarium. Its noninvasive nature and sensitivity to intermittent hemorrhage suggest that it may become the initial investigative modality of choice in many instances.

Adult↗
PubMed1983

Morphologic effects on the retina of massive exchange transfusion with stroma-free hemoglobin solution.

Retinal morphology serves as an extremely sensitive end point to hypoxic and ischemic conditions manifested by circulatory perturbations. Therefore, the effect of massive transfusion of stroma-free hemoglobin solution (SFHS) on retinal morphology of rats was evaluated. Seventy-three rats were divided into three groups. Two groups were transfused to 75% blood volume replacement--one (n = 30) with 7% SFHS one (n = 26) with 7% albumin solution and the third group (n = 17) was cannulated, not transfused (controls). Animals in each group were killed at 1, 5, 12, and 24 hours and 2 months after the procedure. In the transfused rats, focal and perivascular regions of edema, axonal swelling, and vacuoles were observed by light and transmission electron microscopy in the nerve fiber layer of the central retina. These conditions progressively decreased from 1 to 12 hours in the albumin-treated group. The retinas of SFHS-treated rats killed at 12 and 24 hours had similar but more severe morphologic changes than any of the albumin-treated animals; swelling was more severe in those obtained at 24 than at 12 hours, whereas vacuoles were larger in animals obtained at 12 hours. Abnormalities were observed in the prelaminar portion of the optic disc of the SFHS-treated groups killed at 12 and 24 hours. Subretinal hemorrhaging occurred in about 50% of the SFHS-treated animals killed at both 12 and 24 hours and was associated with swelling, vacuolization, and disruption of the photoreceptor outer segments and retinal pigment epithelium. Below normal levels of glycogen were present in the Müller cells of the retinas of albumin-treated rats killed at 5, 12, and 24 hours. At 12 hours after transfusion the Müller cells in lesions of the retinas obtained from the SFHS-treated rats were devoid of glycogen. High glycogen levels, however, appeared in a zone peripheral to the lesions. The latter effect was not apparent in the specimens obtained at 24 hours. The damage observed was probably due to hypoxic and ischemic effects secondary to urinary hemoglobin excretion and concomitant blood volume loss. No abnormalities were seen in the controls. The retinas of SFHS-treated rats killed at 1 and 5 hours showed normal retinal morphology and glycogen levels. Presumably, SFHS exerted a protective effect during this time period. If the current formulation of SFHS is to be used clinically, it will have to be administered continuously until blood is available for transfusion, and the patient's intravascular volume should be monitored carefully to prevent hypovolemia.

Animals↗
PubMed1982

Morphological effects of transfusions with hemoglobin solutions.

The current investigation describes the morphological and pathophysiological effects of stroma-free hemoglobin solution (SFH) on the liver and kidney. One h after a 75% blood volume exchange in animals receiving 7% SFH, hepatic morphology was normal. Animals whose blood was similarly exchanged with 7% albumin demonstrated evidence of cellular hypoxia. These findings suggested that SFH initially transported and offloaded sufficient oxygen to prevent hypoxic alterations. Twelve and 24 h after exchange with albumin, the livers were normal, whereas those of SFH-transfused rats exhibited centrolobular necrosis. Studies of intravascular volume, free circulating hemoglobin distribution, and urinary volumes revealed that the hemoglobin tetramer was degraded rapidly into monomers which traversed the glomerular basement membrane, causing a diuresis. The latter resulted in a 40% loss of intravascular volume, 6 h after SFH administration. When intravascular volume and hemoglobin concentration were maintained by bolus infusions of SFH, hepatic necrosis did not occur. Free hemoglobin was incorporated into the cytoplasm of proximal renal tubular cells and also appeared in the lumens of the distal tubules. However, 24 h after exchange transfusion, almost all of the hemoglobin had left the kidneys and there was no morphological evidence of renal dysfunction. Serum creatinines were normal after SFH administration. The slight rise in BUN was attributed to the dehydration caused by hemoglobin diuresis.

Albumins↗
PubMed1981

The mucosal response in the excluded limb after jejunoileal bypass for morbid obesity.

Twelve patients underwent a takedown of the jejunoileal bypass with restoration of normal continuity of the intestine. Specimens were obtained for biopsy from the excluded proximal jejunum and distal ileum as well as the distal in continuity jejunum. Hypertrophy of the mucosa was observed in the in continuity segment, as previously described. Villi of the bypassed jejunum displayed no evidence of hypertrophy or of atrophy and were identical in size to villous measurements prior to creation of the jejunoileal bypass. At the ultrastructural level, absorptive cells of bypassed jejunal segments exhibited normal morphologic characteristics. There was no indication of cellular immaturity above the level of the intestinal crypts. In contrast, villi of bypassed ileum, near the colonic anastomosis, demonstrated hypertrophy, presumably reflecting reflux of luminal material into this segment of bypassed intestine. The results of this investigation support the concept that significant morphologic alterations of the mucosa do not occur in totally bypassed segments of intestine after the jejunoileal bypass procedures with attainment of weight stabilization.

Atrophy↗
PubMed1980

Massive exchange transfusions with crystalline hemoglobin solution and subsequent replacement of hemoglobin and blood volume.

Crystalline hemoglobin solution was used to exchange transfuse rats to 75 per cent blood replacement. At three hour intervals after transfusion, the rats received bolus injections of hemoglobin solution to replace plasma hemoglobin and intravascular volume lost during each time interval. At 12 and 24 hours after termination of exchange transfusion, the livers of five of six rats exhibited normal hepatic structure. One rat had centrilobular hepatic neurosis similar to that reported for rats given a single transfusion. Plasma hemoglobin, packed cell volume, plasma oncotic pressure and oxygen-carrying capacity of the intravascular fluid were monitored; the data demonstrate that changes observed in these parameters are rectified by the bolus injection which brought their values to the levels observed after transfusion. No hepatic lesions or other abnormalities were observed in the rats in the control group exchange transfused isovolemically with pooled rat blood or subjected to surgical procedures only. Serial bolus injections of hemoglobin solution, by rapidly restoring blood volume and hemoglobin concentration, appear to prevent the hepatic necrosis observed in rats a few hours after a single transfusion, as reported in previous studies.

Animals↗
PubMed1979

The ultrastructural changes of prostate adenocarcinoma following external beam radiation therapy.

Ultrastructural studies were done to determine the effects of radiation therapy on prostatic adenocarcinoma. Twenty patients were included in the study: 6 with benign hyperplasia, 4 with untreated adenocarcinoma and 10 with adenocarcinoma who had received radiation therapy. Benign and malignant ultrastructural characteristics were established. On the basis of these characteristics 6 of the 10 radiated prostates were believed to have tumor cells present after therapy. Of the remaining 4 patients 3 had ultrastructural changes suggesting radiation effects and a possibly altered malignant potential.

Adenocarcinoma↗
PubMed1979

Primary herpetic gingivostomatitis accompanying lesions on fingers: report of case.

A case is presented of primary herpetic gingivostomatitis with herpes simplex virus infection involving the right thumb and little finger of an 18-year-old white man. The lesions all started at the same time. The disease was allowed to run its course except for symptomatic treatment. The diagnosis was made both from clinical signs and laboratory isolation of the virus.

Adolescent↗
PubMed1978

Alterations in intestinal structure, fat absorption and body weight after intestinal bypass for morbid obesity.

Eleven patients underwent jejunoileal bypass for morbid obesity. Serial intestinal biopsies were obtained prior to, and at timed intervals following, operation in both fasted and fat-fed states. Villus height increased asymptotically, reaching a plateau one year after operation, with an increase of 80 per cent in mean villus length. The postbypass body weight reached a plateau at 63.9 per cent of initial body weight and correlated linearly with villus height following an asymptotic curvilinear course. The time required to attain 90 per cent of total body weight loss was 15.9 months. A study of intestinal fat absorption at both the light microscopic and ultrastructural levels showed that the enlarged villi are lined along the entire villus by functionally mature epithelium capable of transporting lipid. Villus hypertrophy is an important mechanism in the plateauing of weight loss after jejunoileal bypass for morbid obesity.

Body Weight↗
PubMed1978

Morphologic effects following massive exchange transfusions with a stroma-free hemoglobin solution. I. Liver.

Hepatic morphology was studied in rats that were exchange transfused with either a stroma-free hemoglobin solution (SFHS) or with various asanguineous resuscitative fluids. The animals under-went 75 per cent blood volume replacement and tissues were collected and fixed at timed intervals after the exchange transfusion. In addition, blood volumes were determined, using chromium labeled red blood cells, in both albumin and SFHS-treated rats at varying time periods after exchange transfusion. One hour following exchange transfusion, livers of animals infused with asanguineous fluids demonstrated marked centrolobular hepatocellular vacuolization and mitochondrial shape alterations consistent with the effects of hypoxia. SFHS appeared to protect the liver from these early abnormalities. However, at later time intervals livers of albumin-treated animals appeared normal, whereas those of SFHS-transfused rats exhibited centrolobular necrosis. Blood volume was reduced approximately 10 per cent during the first 18 hours after exchange transfusion with albumin, while SFHS-treated rats experienced a 42 per cent blood volume decrement in only 6 hours. Blood volumes were near normal in all animals by 48 hours. These findings suggest that SFHS protects the liver from hypoxia immediately after exchange transfusion, presumably by its ability to transport and release oxygen. However, the eventual disappearance of hemoglobin from the intravascular space is associated with a marked reduction in blood volume which is accompanied by hepatic ischemia and centrolobular necrosis.

Animals↗
PubMed1977

Alterations in the endoplasmic reticulum and Golgi complex of intestinal epithelial cells during fat absorption and after termination of this process: a morphological and morphometric study.

Earlier investigations of intestinal fat-absorption have stressed the importance of continued protein synthesis to provide membranes which are utilized for the intracellular transport of resynthesized lipid. The resulting membranes, when incorporated into the endoplasmic reticulum (ER) and Golgi complex, serve as vehicles for the movement of fat within the cell and for its release to the extracellular space. In the current study, attention was focused on the morphological changes in the ER and Golgi complex both during fat absorption and at successive time intervals after fat-absorption termination. Morphological interpretations were confirmed by morphometric analysis. This investigation supports the interpretation that during fat absorption, membrane synthesis by the rough endoplasmic reticulum (RER) is insufficient to accomodate membrane utilization and intraconversion, resulting in a decrease of both ER and Golgi complex components. However, following fat-absorption termination, and cell is able to replace previously depleted components of the ER and Golgi complex and regain the full membrane complement of the fasted state. Replenishment of cellular membranes is postulated as resulting from a continued synthesis of new membranes by the RER which eventually exceeds membrane utilized during lipid transport.

Animals↗
PubMed1977

Hepatic intramitochondrial filaments in morbidly obese patients undergoing intestinal bypass.

The characteristics of hepatocyte intramitochondrial filaments (IMF's) were studied in 16 patients undergoing jejunal ileal bypass for morbid obesity. At the time of bypass, all of the liver biopsies showed varying degrees of steatosis and IMF's were present in 13 of the 16 operative specimens. The IMF's were most prominent in the periportal cells, whereas the intracellular lipid was concentrated in centrilobular cells. Midzonal hepatocytes were intermediate in both respects. The IMF'S were more abundant in biopsies showing moderate steatosis than in those with marked lipid accumulation in which the IMF's were limited to hepatocytes in juxtaposition to portal triads. The IMF's appeared to originate from mitochondrial cristae. When steatosis resolved 12 to 18 months after intestinal bypass the prevalence of IMF's diminished also. It is hypothesized that the presence of IMF's is ultrastructural evidence of an adaption to an altered metabolic environment which resolves when the inciting influence is removed.

Biopsy↗