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Biomedical subjects

J Geiger

Publications and source records attributed to J Geiger.

53 records · Page 3Linked to original sources

Glucose metabolism and colorectal carcinoma.

We evaluated nine patients with colorectal cancer and six control patients in a postabsorptive state in an attempt to define the effect of cancer on glucose turnover, oxidation, recycling, and resting metabolic expenditures (RME). The glucose kinetics were determined using a double-labeled [U-14C] glucose and [6-3H] glucose, and energy expenditures were measured by indirect calorimetry. In addition, we also measured the same parameters in the cancer patient group on a total parenteral nutrition (TPN)-glucose system on the fourth day before and on the fifth day after removal of tumor. In the postabsorptive state, glucose turnover and oxidation rates were similar in the cancer and control group; however, the mean glucose pool size of the cancer group was 47% larger than the control group and was statistically significant (P = .05). Glucose recycling was also two times the control group and was statistically significant (P = .05). The recycling of glucose, both preoperatively and postoperatively, continued in the face of infused glucose; however, the rate was suppressed compared with the fasting cancer group. Postabsorptive RME of the cancer group did not differ from those predicted by the Harris-Benedict equation. Following a 4-day infusion of TPN-glucose that supplied a mean of two times the patients' energy needs, the preoperative cancer group showed a mean increase in RME of 25.6% and a 31.58% increase on the fifth postoperative day of TPN-glucose, presumably due to increased lipogenesis and to a much lesser extent from the increased protein synthesis (4 g positive N balance).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Iatrogenic left main coronary artery stenosis following PTCA or valve replacement.

We report three patients who developed iatrogenic severe left main coronary artery stenosis. In two, it was secondary to coronary cannulation during aortic valve replacement and in one it followed distention of the artery during balloon dilatation of a proximal lesion in the left anterior descending artery. In all three, the stenosis was clinically manifest a few months after the intervention. All were successfully treated by aortosaphenous coronary bypass. A common mechanism for the three cases may be mechanical distention of the left main coronary artery resulting in intimal damage with secondary fibrosis and stenosis. The percutaneous transluminal coronary angioplasty-related stenosis is, to our knowledge, the first reported case of this nature, and represents a previously unrecognized complication of this procedure.

Adult↗

Personal networks of ex-mental patients in a Manhattan SRO hotel.

This paper describes the results of the first systematic investigation of ex-mental patients residing in a large Manhattan Single Room Occupancy hotel. Utilizing a "Network Profile" questionnaire, personal interviews, and participant observation, the study focuses on the relationship of social networks to the degree of personality disturbance and the chances of remaining in a nonhospitalized environment. The findings indicate that: (1) schizophrenics have significantly fewer numbers of personal contacts than nonpsychotics; however, even the most impaired schizophrenics are not totally isolated; (2) within the schizophrenic spectrum, there are differences regarding network size, multiplexity, directionality of relationships, and degree of connectedness; these findings are correlated with the ability of schizophrenics with minimal residual deficits to become important members of the hotel community; (3) small, nonmultiplex networks with a low degree of connectedness are correlated with more frequent rehospitalizations.

Group Structure↗

Cerebrospinal fluid levels of immunoreactive substance P and somatostatin in patients with multiple sclerosis and inflammatory CNS disease.

Cerebrospinal fluid (CSF) levels of substance-P like immunoreactivity (SPLI) and somatostatin-like immunoreactivity (SLI) were measured in 43 patients with multiple sclerosis (MS), differentiated according to course and activity of the disease, in 23 patients with inflammatory disease of known bacterial or viral etiology and in 16 control patients using specific radioimmunoassay. SPLI and SLI levels were not significantly different from controls in MS patients whereas SLI was significantly increased in patients with infectious disease of central nervous system and/or subarachnoidal space. It is assumed that CSF SPLI and SLI cannot serve as a diagnostic or prognostic indicator of disease state in multiple sclerosis. Analysis of immunoreactivity by reverse phase HPLC-RIA revealed marked molecular heterogeneity of both neuropeptides.

Adult↗

Citrobacter diversus at Grace Hospital, Detroit, Michigan.

Over a six-month period from December 1973 to June 1974, isolations of Citrobacter diversus were obtained from nine patients at Grace Hospital. Our initial experience was with a patient who developed pneumonitis and a massive fatal empyema due to this organism. Seven of the nine patients were 50 years of age. Three patients had an underlying malignancy. Four patients experienced significant clinical infections. Isolations in three patients were considered to be commensal, and two isolations were of indeterminate significance. Our Citrobacter diversus isolates, which can be confused with Escherichia coli, were uniformly resistant to ampicillin and carbenicillin and sensitive to the cephalosporins, tetracyclines, and gentamicin. These results agree with previous reports. Citrobacter diversus appears to be capable of causing serious clinical disease. Patients most at risk are elderly compromised hosts and infections are usually hospital acquired.

Adult↗